Omicron is considered a milder coronavirus, but scientists aren’t so sure

Authors: Melissa Healy August 13, 2022 la times

For more than two years, Cathy Baron and Sara Alicia Costa managed to duck the coronavirus. But despite their being fully vaccinated and boosted, the Omicron variant finally caught them.

Baron is an actress and dance instructor who lives in Santa Monica. Costa is an architect in Austin, Texas. Both are 40 and healthy. But the two friends saw two very different sides of the variant they expected to be gentler on its victims than earlier strains.

For Costa, the Omicron variant lived up to its reputation for mildness, causing headaches and “something like a crummy cold” for a couple of days. She was visiting Baron and surfing in Santa Monica a week after testing positive.

Baron’s illness was deeply chastening. She was flattened for several days with a high fever and debilitating muscle aches and was too exhausted to teach her pole dancing class for three weeks. Two months later, she’s still coping with fatigue, brain fog and episodic coughing fits. She hopes never to repeat the experience.

Baron and Costa are what scientists would dismiss as an “n of 2.” If their experience were a study, the sample size would be far too small to draw any conclusions, especially one as important as whether the Omicron variant really is less virulent than the SARS-CoV-2 variants that came before it.

And yet, their contrasting experiences are as telling as many of the research studies conducted to date that have tried to determine how dangerous Omicron really is.

“It’s an excellent question,” said Dr. Stanley Perlman, a University of Iowa virologist and a leading expert on coronaviruses. Many researchers think they know the answer, and “I think it’s true” that the Omicron variant is causing milder illnesses, he said. But the true picture is “not clear,” he cautioned.

Omicron arrived in the United States at a time when 60% of Americans had the protection of COVID-19 vaccines and roughly a third of Americans (including some who’d been vaccinated) had a past infection. Not only was there a high level of population immunity, those who did become ill had access to treatments that weren’t available to people sickened by the initial strain from Wuhan, China, or the Alpha and Delta variants that followed.

Perhaps these are the reasons why those infected with Omicron have tended to experience milder illnesses.

“It’s widely said that Omicron is inherently less pathogenic, but there is no real evidence for that,” said Dr. Christopher Chiu, a COVID-19 researcher at Imperial College London.

“Comparisons with Delta are like apples and oranges,” he said. “Delta was circulating at a time when many were still not vaccinated or previously infected. In contrast, Omicron is largely causing breakthrough infections in people who already have partial protection from immunity conferred by vaccines or infection.”

Since its earliest appearance in November, researchers have seen that compared with previous variants, Omicron was less likely to send infected people to the hospital or to their graves.

First in South Africa and later in communities across America, the new variant bucked expectations spawned by earlier surges. In the two to three weeks after Omicron cases spiked, hospitalizations and deaths rose as well — but more slowly, and they’d topped out at lower levels.

Still, as Americans have learned from hard experience, the Omicron variant is a highly capable killer. Just over 200,000 of the country’s COVID-19 deaths are likely attributable to some version of the Omicron variant, which arrived here around Thanksgiving and became dominant in January.

And don’t forget, Perlman added: It’s still killing some 400 people a day in the United States.

How much of Omicron’s supposed mildness should be credited to the protective effect of vaccines is not really known.

During June, the Centers for Disease Control and Prevention concluded that COVID-associated hospitalizations among unvaccinated adults were 4.6 times higher than they were among vaccinated people. But the picture is muddier than such data would suggest.

Americans’ immune profiles run the gamut, making it hard to slot people into neat categories and compare how they fared when infected by different variants. Those who’ve been vaccinated are experiencing various degrees of waning immunity, even if they’ve been boosted. The same goes for people who’ve recovered from infections. The readiness of their immune systems depends on how long ago they had the infection, what variant infected them, their vaccination status, and factors like age and the medications they take.

With so many variables to consider, it’s hard for researchers to draw a clean comparison between Omicron and its predecessors. But they’ve tried.

In one study published in Nature, scientists showed that Omicron was drawn to a wide range of human tissues. When observed in petri dishes, the variant established itself in cells that mimicked the upper airways of the respiratory system, though with less gusto than the Delta variant. In addition, Omicron was far less adept at infecting lower airway cells, including lung tissue, than either Delta or the original SARS-CoV-2 strain that left Wuhan.

And in studies that infected animals such as hamsters and genetically engineered mice, the Omicron variant caused less weight loss (a proxy of severe disease) and touched off less inflammation in the lungs than either Delta or the original strain.

Adding to the uncertainty is the fact that coronavirus testing was undergoing sweeping changes just as the Omicron variant took hold. As at-home testing ramped up and fewer new infections were reported to public health agencies, the relationship between cases on the one hand and hospitalizations and deaths on the other — a previously dependable measure of a variant’s ability to sicken — became less reliable.

The Omicron variant’s astonishing infectiousness and propensity to spin off new subvariants complicate the picture even more. In a recent meeting convened by the Food and Drug Administration, even experts from the agency shrugged when asked to compare the subvariants.

Collectively, those Omicron subvariants muscled Delta aside so quickly that doctors and researchers didn’t have time to collect groups of similar patients, genetically sequence the viruses that infected them, and compare how their illnesses proceeded.

That’s the kind of study that might shed light on the divergent experiences of Cathy Baron and Sara Alicia Costa. They’re a seemingly well-matched pair of healthy 40-year-old women, yet Omicron attacked one of them like a lion and treated the other like a lamb. With the experiences of hundreds or thousands of people thrown in, such research might reveal factors that nudge an Omicron infection in one direction or the other.

There is a more direct way to learn how Omicron compares to earlier variants in its ability to sicken and kill. Researchers could deliberately infect volunteers with different versions of the coronavirus and track their physiological responses to infection over the course of an illness.

Chiu and his colleagues at Imperial College London have just such an undertaking in mind. They are planning “human challenge” studies involving the Delta and Omicron variants to mirror one already conducted with the original version of the virus.

The resulting data could yield a clearer picture of exactly how Omicron behaves in healthy humans, and how a prior infection or different levels of vaccination affect an individual’s illness.

Chiu said a new study would seek to enroll people who gained immunity through vaccination, a past infection, or a combination of both. That would give them more insight into whether so-called hybrid immunity is an important bulwark against becoming sick in the Omicron era.

If research confirms that the Omicron variant is indeed milder than its predecessors, and that getting it confers some protection from future illness, some may conclude it’s time to let the virus spread.

Baron would take some convincing of that.

“When people say, ‘let’s just let it rip’ and allow ourselves to get infected over and over again — that’s scary to me,” she said. “I don’t want to just let it rip. I don’t want to get it again.”

Delta reinfection risk low among unvaccinated children

But scientists warn that the findings do not mean that children should not be vaccinated against COVID-19.

Authors: Heidi Ledford July 4, 2022 NATURE

Children and adolescents who had not been vaccinated against COVID-19 mounted a long-lasting immune response to infection with the Delta variant of the coronavirus SARS-CoV-2, according to a large study of Israeli health records1. The study, which has been published as a preprint on medRxiv, has not yet been peer reviewed.

A year and a half after an infection, the resulting immune response was still about 80% effective at preventing reinfection, the study found. But it isn’t clear how the results will translate to infections by coronavirus variants of the Omicron lineage, which is now dominant in many countries. “There is a much less-robust immune response to Omicron among previously infected and/or vaccinated individuals,” says Yvonne Maldonado, chief of paediatric infectious diseases at Stanford School of Medicine in California. “Such immune responses are also significantly less durable.”

Even so, the study — which includes data from about 300,000 children and adolescents — is a welcome addition to the relatively small pool of knowledge about immune responses to SARS-CoV-2 in children, says paediatrician Nigel Crawford at the Murdoch Children’s Research Institute in Melbourne, Australia, who studies vaccinology. “They’re a group for which we haven’t seen a huge amount of data to date,” he says.

When Delta dominated

The study’s authors collected data on coronavirus infections from Maccabi Healthcare Services, an Israeli health-insurance plan. They focused on the risk of infection from 1 July to 13 December 2021, when the Delta variant was dominant in Israel.

The team found that unvaccinated children and adolescents were 89% less likely to be infected with SARS-CoV-2 3–6 months after their first infection than were children who had not previously been infected. For the 12–18 age group, this protection against reinfection dropped to 82.5% from 9 months to a year after infection and remained at around that level until up to 18 months post-infection.

Children aged 5–11, however, maintained the same level of protection. That, says Crawford, could fit with observations that young children often experience milder COVID-19 than do adolescents and adults.

The study authors are now working to collect data on Omicron infections, but that analysis will be more difficult because many people in Israel switched from PCR tests to at-home rapid antigen testing in December 2021. This means that fewer positive test results have since been reported in electronic health records.

Overall, the study design is robust, says clinical data scientist Hossein Estiri at Harvard Medical School in Boston, Massachusetts. He notes that some Twitter users have picked up on the preprint and are touting it as evidence that children who have had SARS-CoV-2 infections do not need to be vaccinated. But Estiri says it’s not clear from the study how well protection from natural infection stacks up to that from vaccines, because the researchers did not include a head-to-head comparison. “This study doesn’t say that those children don’t need to be vaccinated.”

Don’t discount vaccines

And because severe COVID-19 is rare in children, the study could not make strong conclusions about protection from serious illness and hospitalization. “We know that a lot of vaccine efficacy is against severe disease,” he says.

In addition, Crawford notes that people who have both been vaccinated and had a SARS-CoV-2 infection often experience a super-charged immune response compared with those who have had only a vaccine or infection. “You wouldn’t want to rely purely on infection alone for immunity,” he says. “We have no idea what the next wave will bring.”

COVID-19: Omicron variant did not wipe out Delta, it could return

While the Delta virus wiped out the variants that preceded it, Omicron has not eliminated Delta, according to a new study from Israel’s Ben-Gurion University of the Negev.

Authors:  JUDY SIEGEL-ITZKOVICH Published: MAY 2, 2022 

Don’t throw away your unused face masks yet. COVID-19’s Omicron variants may burn themselves out in the next couple of months, and the Delta variant might re-emerge, researchers at Beersheba’s Ben-Gurion University of the Negev (BGU) suggest in a new scientific paper.

Their findings were just published in the peer-reviewed journal Science of the Total Environment under the title “Managing an evolving pandemic: Cryptic circulation of the Delta variant during the Omicron rise.”

The first new coronavirus to appear at the end of 2019 was Alpha, followed by Beta (first detected in South Africa); Gamma (first detected in Brazil); Delta (that revealed itself in India); and the more-infectious but milder Omicron, which has developed a variety of sub-variants and spread all over the world.

While the Delta variant wiped out the variants that preceded it, Omicron has not eliminated Delta, according to Prof. Ariel Kushmaro and Dr. Karin Yaniv, who just received her doctorate in the field.

The lab team has developed sensitive arrays that can differentiate variants from each other in wastewater, which continues to give indications of where the coronavirus is active, even when PCR and rapid testing of people declines.

Kushmaro, who earned his advance degrees in molecular microbiology and biotechnology at Tel Aviv University, trained as postdoctoral fellow at the Hebrew University and at Harvard. He arrived at BGU 21 years ago and established a lab at the School of Sustainability and Climate Change and the Goldstein-Goren Department of Biotechnology Engineering.

The lab specializes in wastewater microbiology, marine microbial ecology and antimicrobial activity of varies microorganisms as well as biological treatment of industrial wastewater.

His team monitored Beersheba’s sewage from December 2021 to January 2022 and noticed this disturbing interaction between the Omicron and Delta variants.

They also built a model with Granek that predicts that Omicron is burning itself out while Delta is just waiting to pounce on the population again.

“SARS-CoV-2 continued circulation results in mutations and the emergence of various variants. Until now, whenever a new, dominant, variant appeared, it overpowered its predecessor after a short parallel period,” they wrote.

“Despite vaccination efforts in Israel, with a large portion of the population being vaccinated between the first to fourth dose of vaccine and despite high infection rates by previous variants, the Omicron variant had now rooted itself in Israel.”

The latest variant of concern, Omicron, is spreading swiftly around the world with record morbidity reports, wrote the authors. “Unlike the Delta variant, previously considered to be the main variant of concern in most countries, including Israel, the dynamics of the Omicron variant showed different characteristics.”

If their prediction comes to pass, its circulation may result in the reemergence of a Delta morbidity wave or in the possible generation of a new threatening variant, they wrote.

With the expected significant decline in morbidity from all the recovered Omicron cases, the Israeli government and the Health Ministry have eliminated most restrictions. “In the meantime, the Delta, which is still circulating in a population with waning immunity and under fewer restrictions, may re-emerge in larger numbers or even produce a new, different variant to generate infections in Israel.”

In any case, the team recommended wastewater-based epidemiology as a “convenient and representative tool for pandemic containment.

“Of course, there are a lot of factors involved, but our model indicates there could be another outbreak of Delta or another coronavirus variant this summer,” warned Kushmaro, who was assisted by Dr. Eden Ozer and Marilou Shagan at BGU and Dr. Yossi Paitan from Ilex Labs. 

Two COVID Variants Just Combined Into a ‘Frankenstein’ Virus

Authors: David Axe Published  Apr. 07, 2022 4:49AM ET 

The first subvariant of Omicron, the latest major variant of the novel coronavirus, was bad. BA.1 drove record cases and hospitalizations in many countries starting last fall.

The second subvariant, BA.2, was worse in some countries—setting new records for daily cases across China and parts of Europe.

Now BA.1 and BA.2 have combined to create a third subvariant. XE, as it’s known, is a “recombinant”—the product of two viruses interacting “Frankenstein”-style in a single host.

With its long list of mutations, XE could be the most contagious form of the coronavirus yet. “From the WHO reports, it does appear to have a bit more of an edge in terms of transmissibility,” Stephanie James, the head of a COVID testing lab at Regis University in Colorado, told The Daily Beast.

But don’t panic just yet. The same mix of subvariants that producedXE might also protectus from it. Coming so quickly after the surge of BA.1 and BA.2 cases, XE is on track to hit a wall of natural immunity—the antibodies left over from past infection in hundreds of millions of people.

Those natural antibodies, plus the additional protection afforded by the various COVID vaccines, could blunt XE’s impact. For that reason, many experts worry less about XE and more about whatever variant or subvariant might come after XE.

And rest assured, that future subvariant is coming. “COVID-19 continues,” Eric Bortz, a University of Alaska-Anchorage virologist and public health expert, told The Daily Beast.

Testers first detected XE in the United Kingdom back in mid-January. Six weeks later U.K. authorities had identified 600 XE infections. Those cases are a proverbial drop in the bucket in light of the millions of BA.1 and BA.2 cases the U.K. has tallied in the past three months. But XE stood out.

According to the World Health Organization, XE is 10 percent more contagious than BA.2, which itself is up to 80 percent more contagious than BA.1, a subvariant epidemiologists described as the most transmissible respiratory virus they’d ever seen when it first appeared in South Africa back in November.

There’s a lot of uncertainty about XE. The WHO stressed that its own finding about the subvariant “requires further confirmation.” But given what we think we know, it seems XE evolved in someone with overlapping BA.1 and BA.2 infections, when two separate but related viruses swapped genetic material.

“We don’t have a roadmap.”

XE isn’t the first COVID recombinant—there have been at least two others, including the so-called “Deltacron” subvariant that sprang from simultaneous Delta and BA.1 infections. But with two highly contagious parent viruses, XE stands a chance of being the fastest-spreading recombinant. Health officials have also detected XE in Thailand.

The subvariant hasn’t shown up in U.S. tests yet. But that doesn’t mean it hasn’t reached U.S. shores. “It might not be detected by the standard analysis pipeline,” Rob Knight, the head of a genetic-computation lab at the University of California, San Diego, told The Daily Beast. Major new forms of SARS-CoV-2 can require tweaks to testing methods.

XE is a nasty bug, owing to potentially dozens of mutations to its spike protein, the part of the virus that helps it grab onto and infect our cells. And it’s a strong reminder that the pandemic isn’t over. Even with widespread natural immunity and highly effective and safe vaccines, SARS-CoV-2 keeps finding pockets of unprotected people—and opportunities to evolve.

But it’s not 2020 anymore. The novel coronavirus has changed, but so have we. Each successive wave of infections—Alpha then Delta then both major forms of Omicron—has seeded the population with natural antibodies that offer strong, albeit temporary, protection against the worst effects of future infection by a related form of the virus.

The leading vaccines, meanwhile, have stood up to each new variant and subvariant, especially when you add one or two booster doses.

Even as more and more countries fully reopen schools, businesses and borders, the peak death rate from a COVID wave keeps dropping in a lot of countries. Cases might go up as some new subvariant outcompetes an earlier subvariant and becomes dominant. But deaths don’t necessarily increase in the same proportion—a phenomenon epidemiologists call “decoupling.”

Decoupling is partially a function of the time between waves. Natural antibodies from past infection can begin fading after three months. But if two variants or subvariants strike within a few months of each other, the second strain collides with the immunity left over from the firs strain—especially if the strains are related. Meanwhile, the second strain produces antibodies that could mitigate the worst outcomes of the next strain, assuming it arrives fast enough.

That’s why Omicron has infected more people than the previous variant, Delta, but has killed fewer. And why many experts consider XE less frightening than BA.2 or BA.1. “Immune responses to XE should be similar to that of Omicron,” Bortz said. “Those with prior Omicron infection and vaccination are going to be mostly immune.”

By the same token, a big gap between separate variants—that is, a long reprieve from COVID—might actually be more dangerous to a population than back-to-back-to-back waves of related strains.

There’s another risk. We were lucky with the major variants and subvariants before XE, in that the leading vaccines worked really well against all of them. Experts are cautiously optimistic that the jabs hold up against XE, too. “XE is, as you say, supposed to be more contagious than BA.2 [or] BA.1,” Edwin Michael, an epidemiologist at the Center for Global Health Infectious Disease Research at the University of South Florida, told The Daily Beast, “but it seems not to be more severe or immune-evasive.”

But if some new variant, perhaps even a recombinant of XE and some other strain, eventually mutates in a way that helps it evade the vaccines and arrives three months or longer after the previous surge in cases, we could be in trouble.

“While thus far mutants that are more transmissible have emerged and spread, there is also the possibility of one that is both more transmissible and immune-evasive to emerge,” Michael said. In that case, neither of our approaches to building population-level immunity–vaccines and natural antibodies—would be able to prevent a devastating spike in deaths.

COVID cases rise again in half the states

Change in reported COVID-19 cases per 100k people in the last two weeks

March 23 to April 5, 2022

Half of the states are seeing COVID case numbers rise again while nationwide totals continue to fall.

The big picture: The Omicron subvariant known as BA.2 is the dominant strain circulating around the U.S., accounting for almost three out of every four cases.

By the numbers: Overall, cases dropped 5% across the U.S. to an average of about 28,700 cases from an average of more than 30,000 cases two weeks ago.

  • Three states — Alaska, Vermont and Rhode Island — had more than 20 new cases per 100,000 people.
  • Nine states — Utah, Montana, South Dakota, Kansas, Louisiana, Iowa, Arkansas, Indiana and Tennessee — had three or fewer new cases per 100,000 people.

Between the lines: Deaths fell to an average of 600 a day, down 34% from just over 900 a day two weeks ago.

What we’re watching: While U.S. officials have said they aren’t expecting a significant rise in hospitalizations or deaths, there have been signs of hospitalizations rising among older individuals in the U.K., the Guardian reported.

  • Since those numbers lag behind new cases, we won’t have a clear view of that impact in the U.S. for a few weeks.
  • The highly contagious subvariant surged through parts of Europe but probably will spare many Americans, thanks in part to this winter’s Omicron surge.

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They’re called mild cases. But people with breakthrough covid can still feel pretty sick.

Authors: Fenit Nirappil The Washington Post Aug. 31, 2021

Andrew Kinsey knew that even after being vaccinated against the coronavirus, there was a chance he could still fall ill with covid-19.

He just never expected to feel this lousy from a case doctors call mild.

For nearly a week, Kinsey felt like he had been “run over by a truck.” He struggled to walk a few steps and to stay awake through episodes of the TV show “Doomsday Preppers.” He returned to work last Monday as a corporate litigator but needs midday naps.

“The vaccine appears to have worked to protect my lungs, so that kept me from having life-threatening symptoms, but at the same time, a so-called mild course can be . . . sort of the sickest I’ve ever been in my life,” said Kinsey, who is 38 and lives with his wife and three children in Pennsylvania. “It’s important for people to know that what they picture in their head of a bad cold isn’t necessarily what will actually happen even if they get a mild course.”

Kinsey and other vaccinated people who develop breakthrough cases of covid-19, the illness caused by the virus, are learning a mild case may not seem so mild to the person enduring the infection. Those cases can be as modest as a few days of sniffles, but, in other circumstances, can spawn debilitating headaches and fatigue. Symptoms can persist longer than the usual cold.

But public health authorities and scientists stress that research overwhelmingly shows that coronavirus vaccines are keeping people out of the hospital and that most breakthrough cases are mild or moderate.

Seven vaccinated people who ended up sicker than they expected shared their stories and said they did not want to cast doubt on vaccines – because they believe their outcome would have been much worse had they not been inoculated. Instead, they said they want to help fellow vaccinated people weigh their risks as they decide when to wear a mask and whether to attend a wedding or travel for vacation. They also do not want people to assume a mild case is trivial.

Kinsey is re-examining how he weighs risk this upcoming school year after his family’s battle with the virus. He’s not sure how he and his wife, Lisa, who is also vaccinated, were exposed. They are generally cautious and wear masks to protect their daughter Sarah, who is too young for vaccines at age 8 and has significant medical issues.

Sarah also contracted the virus and was hospitalized for nearly two weeks, later mostly recovering while her vaccinated siblings stayed healthy. For at least several months, the family expects to have protection from natural and vaccine-induced antibodies. But Kinsey says his experience was a reminder of the urgency of paying close attention to the changing understanding of the virus.

Matt Longman, who is 41 and lives in Tucson, Ariz., said he had a 103-degree fever, experienced aches in his elbows and toes like he had never encountered before and could not stop shaking even after wrapping himself in three blankets. Longman fears he would have ended up in the hospital had he not been vaccinated, especially because his immune system is weakened from migraine treatments.

Model predicts 100,000 more COVID deaths unless U.S. changes its ways

AUGUST 27, 2021 / 7:50 AM / AP

The U.S. is projected to see nearly 100,000 more COVID-19 deaths between now and December 1, according to the nation’s most closely watched forecasting model. But health experts say that toll could be cut in half if nearly everyone wore a mask in public spaces.

In other words, what the coronavirus has in store this fall depends on human behavior.

“Behavior is really going to determine if, when and how sustainably the current wave subsides,” said Lauren Ancel Meyers, director of the University of Texas COVID-19 Modeling Consortium. “We cannot stop Delta in its tracks, but we can change our behavior overnight.”

That means doubling down again on masks, limiting social gatherings, staying home when sick and getting vaccinated. “Those things are within our control,” Meyers said.

The U.S. is in the grip of a fourth wave of infection this summer, powered by the highly contagious Delta variant, which has sent cases, hospitalizations and deaths soaring again, swamped medical centers, burned-out nurses and erased months of progress against the virus.

Deaths are running at over 1,100 a day on average, turning the clock back to mid-March. One influential model, from the University of Washington, projects an additional 98,000 Americans will die by the start of December, for an overall death toll of nearly 730,000.

The projection says deaths will rise to nearly 1,400 a day by mid-September, then decline slowly.

But the model also says many of those deaths can be averted if Americans change their ways.

“We can save 50,000 lives simply by wearing masks. That’s how important behaviors are,” said Ali Mokdad, a professor of health metrics sciences at the University of Washington in Seattle who is involved in the making of the projections.

Already there are signs that Americans are taking the threat more seriously.

Amid the alarm over the Delta variant in the past several weeks, the slump in demand for COVID-19 shots reversed course. The number of vaccinations dispensed per day has climbed around 80% over the past month to an average of about 900,000.

White House COVID-19 coordinator Jeff Zients said Tuesday that in Alabama, Arkansas, Louisiana and Mississippi, “more people got their first shots in the past month than in the prior two months combined.”

Also, millions of students are being required to wear masks. A growing number of employers are demanding their workers get the vaccine after the federal government gave Pfizer’s shot full approval earlier this week. And cities like New York and New Orleans are insisting people get vaccinated if they want to eat at a restaurant.

Half of American workers are in favor of vaccine requirements at their workplaces, according to a new poll from The Associated Press-NORC Center for Public Affairs Research.

Early signs suggest behavior changes may already be flattening the curve in a few places where the virus raged this summer.

An Associated Press analysis shows the rate of new cases is slowing in Mississippi, Florida, Louisiana and Arkansas, some of the same states where first shots are on the rise. In Florida, pleas from hospitals and a furor over masks in schools may have nudged some to take more precautions.

However, the troubling trends persist in Georgia, Kentucky, South Carolina, Tennessee, West Virginia and Wyoming, where new infections continue to rise steadily.

Mokdad said he is frustrated that Americans “aren’t doing what it takes to control this virus.”

“I don’t get it,” he said. “We have a fire and nobody wants to deploy a firetruck.”

One explanation: The good news in the spring — vaccinations rising, cases declining — gave people a glimpse of the way things used to be, said Elizabeth Stuart of Johns Hopkins Bloomberg School of Public Health, and that made it tough for them to resume the precautions they thought they left behind.

“We don’t need to fully hunker down,” she said, “but we can make some choices that reduce risk.”

Even vaccinated people should stay vigilant, said Doctor Gaby Sauza, 30, of Seattle, who was inoculated over the winter but tested positive for COVID-19 along with other guests days after an Aug. 14 Vermont wedding, even though the festivities were mostly outdoors and those attending had to submit photos of their vaccination cards.

“In retrospect, absolutely, I do wish I had worn a mask,” she said.

Sauza, a resident in pediatrics, will miss two weeks of hospital work and has wrestled with guilt overburdening her colleagues. She credits the vaccine with keeping her infection manageable, though she suffered several days of body aches, fevers, night sweats, fatigue, coughing and chest pain.

“If we behave, we can contain this virus. If we don’t behave, this virus is waiting for us,” Mokdad said. “It’s going to find the weak among us.”

It Finally Peaked: The Delta Of Delta Turns Negative

Authors: BY TYLER DURDENWEDNESDAY, AUG 25, 2021 – 08:26 AM

Ten days ago we said that, according to Morgan Stanley calculations, the Delta wave will peak in 1-2 weeks. Well, golf clap to Morgan Stanley’s Matthew Harrison who, with uncanny precision, was spot on and exactly at the midpoint of “1-2 weeks later” the ascent of Delta variant new cases in the US has now peaked, and it’s all downhill from here. 

According to Bank of America’s Hans Mikkelsen, evidence – such as the University of Washington’s IHME model – suggests “the US is now past the peak level of daily COVID-19 infections caused primarily by the Delta variant.”

To be sure, there are a few caveats here: while daily new cases – a subset of new infections – also showed a small decline yesterday (to 147,294 from 147,550 the prior day on a 7-day average basis), BofA warns that this data is noisier due to varying levels testing activity and potentially Hurricane Henri.

But even the “much cleaner data” for number of people hospitalized with COVID-19 confirms that the peak is now in the rearview mirror: while the number rose “just” 7.8% the past week which, due to its lagged nature and very rapid pace of decline, Mikkelsen notes that this “is consistent with the US being past peak level infections.”

Moreover the recent one-percentage point decline in the COVID-19 test positive rate to 9.32% – another indicator that the US is now past peak level infections – highlights one driver of high daily case counts is merely more testing activity.

What does this mean for markets, if not the economy and political propaganda?

Well, if the US has not already seen peak COVID-19 case numbers, BofA is confident that reaching that milestone is “imminent.” More importantly, with the UK as guide, the decline in case numbers on the other side could be rapid.

The IHME model forecasts a 50% decline from peak level daily infections by October 11th, and by September 22 – the timing of the next FOMC meeting – the predicted decline is nearly 40%. This, according to BofA, bodes well for reopening trades that underperformed so far in 2H21 as the US COVID-19 situation deteriorated; it does not bode well for those who are praying that the delta variant will force the Fed to delay tapering.

As for what it means for US society that the media and politicians will no longer be able to scaremonger with the Delta variant, that’s beyond the scope of this post, suffice to say that we fully expect the “independent media” to quickly shift their focus to the “unexpected” emergence of the lambda or some other, even “deadlier” variant, which politicians will immediately weaponize in their neverending quest to convert the US into one giant authoritarian nanny-state.

Delta cases show 300 times higher viral load – S.Korea study

by ReutersTuesday, 24 August 2021 09:11 GMT

Authors: By Sangmi Cha

SEOUL, Aug 24 (Reuters) – People infected with the more transmissible Delta variant have a viral load 300 times higher than those with the original version of the COVID-19 virus, when symptoms are first observed, a South Korea study found.

But the amount gradually decreased over time – to 30 times in four days and over 10 times in nine days – and it matched levels seen in other variants after 10 days, the Korea Disease Control and Prevention Agency (KDCA) said on Tuesday.

The higher load https://www.reuters.com/business/healthcare-pharmaceuticals/people-with-allergic-reaction-mrna-vaccines-can-get-2nd-dose-delta-viral-load-2021-07-26 means the virus spreads far more easily from person to person, increasing infections and hospitalizations, a health ministry official Lee Sang-won told a news conference.

“But it doesn’t mean Delta is 300 times more infectious…we think its transmission rate is 1.6 times the Alpha variant, and about two times the original version of the virus,” Lee said.

The Delta variant of the novel coronavirus was first identified in India and the Alpha variant in the UK.

To avoid the spread of the Delta variant, now the dominant strain https://www.reuters.com/business/healthcare-pharmaceuticals/delta-covid-variant-now-dominant-worldwide-drives-surge-us-deaths-officials-2021-07-16worldwide, the KDCA urged people to immediately get tested when developing COVID-19 symptoms and avoid in-person meetings.

The rapid spread of the Delta variant and low vaccination rates have caught much of Asia off-guard, especially in emerging markets, even as economies in Europe and North America reopen.

The study compared the viral load of 1,848 patients infected with the Delta variant with 22,106 people who had other strains.

South Korea reported 1,509 new coronavirus cases for Monday, raising the total to 239,287 infections, with 2,228 deaths.

It has vaccinated 51.2% of its 52 million population with at least one dose of a vaccine, while 23.9% have been fully vaccinated. (Editing by Jacqueline Wong)

Our Standards: The Thomson Reuters Trust Principles.

Delta variant: What is happening with transmission, hospital admissions, and restrictions?

Authors: Elisabeth Mahase BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1513 (Published 15 June 2021)Cite this as: BMJ 2021;373:n1513

Are covid-19 hospital admissions increasing?

Yes. The number of new cases of covid-19 has been rising in the UK for the past few weeks, and admissions of patients to hospital are following suit. As of 9 June the number of people in hospital each day with covid-19 exceeded 1000, after having fallen to the hundreds in the middle of May after the previous wave.1

Is this because of the delta variant?

Cases were expected to rise at least a little as restrictions eased, but the new delta variant seems to have complicated matters.2 Public Health England figures show that the variant now accounts for 90% of UK cases, with the total number exceeding 42 000. Research indicates that delta is associated with an estimated 60% higher risk of household transmission than the alpha variant, which was already much more transmissible than the original version of the virus. There are also suggestions that delta could carry a much higher risk of hospital admission.

Speaking to the BBC on 13 June, Andrew Hayward, an adviser to the government’s Scientific Advisory Group for Emergencies (SAGE) and professor of infectious disease epidemiology at University College London, said, “I think it’s now very clear that we will have a substantial third wave of covid infections. The really big question is how much that wave of infections is going to translate into hospitalisations. The fact that we’ve got 55% of the adult population double vaccinated means that this will be substantially less bad than it could have been, but we still don’t know exactly how bad it could be.

“Sixty per cent more infectious is extremely worrying—that’s the main thing that will drive the speed with which the next wave comes along. And the fact that the level of hospitalisations from this infection appear to be maybe up to double those of the previous infection is of course also extremely concerning.”

Another concern is that the covid vaccines seem to be less effective against the delta variant, especially after one dose. A PHE preprint found that the Pfizer-BioNTech vaccine was 88% effective and the Oxford-AstraZeneca 60% effective against the delta variant two weeks after the second dose, but both vaccines were only 33% effective against symptomatic disease from delta three weeks after the first dose.3 However, the most recent PHE analysis of 14 019 delta cases (14 June) indicates that two doses of either vaccine are still highly effective against hospital admission: 96% for Pfizer-BioNTech and 92% for Oxford-AstraZeneca.4

Speaking at a Science Media Centre briefing on 9 June, Neil Ferguson, director of the Medical Research Council’s Centre for Global Infectious at Imperial College London, said, “There’s still quite a lot of uncertainty about what the vaccine efficacy against the delta will be for those more severe forms of disease. It’s well within the possibility that we could see another third wave, at least comparable in terms of hospitalisations, maybe not as severe as the second wave.

“Almost certainly I think that deaths probably will be lower. The vaccines are having a highly protective effect, and cases in hospital are milder, but still it could be quite worrying. There is a lot of uncertainty.”

What is different about the delta variant?

In some ways the delta variant is an “improved” version of the alpha variant, making it more easily transmissible and more of a concern.

Speaking at the Science Media Centre briefing, Wendy Barclay, professor of virology and head of infectious disease at Imperial College London, explained, “The delta variant has got two important mutations in its spike protein, or sets of mutations. One is at the furin cleavage site, which we think is quite important for the fitness of the virus in the airway. The virus that emerged in Wuhan was suboptimal in that respect, so it transmitted, but perhaps not as well as it might. The alpha variant took one step towards improving that with a certain mutation, and the delta variant has built on that and taken a second step now, a bigger step, towards improving that feature.”

Why is delta able to transmit more easily?

Barclay said that the current data indicated that the virus was “fitter in human airway cells,” meaning an increased amount of the virus in the infected person, and so they may expel more virus out into the air to pass on to the next person. This is supported by the testing data, which show that the CT value (cycle threshold)—the number of amplification cycles needed for the virus to be detected—seems to be lower in samples from delta infected people, meaning they contain more virus.

Another suggestion is that if this variant is better at infecting human airway cells, people may become infected after a lower exposure.

Does delaying the easing of covid-19 restrictions make a difference?

Yes, because it allows more people to receive two doses of the vaccine. Barclay said, “Any delays, just from a purely scientific basis, will help, because they will allow more time for people to get the second dose. And also just having the second dose is not quite enough. You need to get around seven days after the second dose for the vaccine to really boost the immune response up to the levels that you’d like it to be.”

The final stage of lockdown easing in England, which had been expected to be on 21 June, has now been delayed to 19 July.

Even if the death rate with delta is lower, could the healthcare system still be overwhelmed?

Absolutely. Rising hospital admission rates would increase pressure on the already exhausted health system and could overwhelm it. Writing in BMJ Opinion, the chief executive of NHS Providers, Chris Hopson, said, “Given current NHS pressures, any increase in covid-19 admissions will set back progress on tackling the care backlog. Are we ready to accept this trade off?”5

This message has been echoed by other health leaders, including NHS Confederation deputy chief executive Danny Mortimer, who told the media the current situation was “extremely precarious.”

He said, “Health leaders are all too aware that rising infections, and especially at such a rapid rate, can easily lead to major rises in hospital admissions. Even a slight increase in admissions will affect capacity and could put recovery efforts at risk. Covid-19 hospital admissions are already going up, and that will put capacity under strain, especially as the latest performance figures showed 5.1 million people are waiting to start treatment.”

Are more children becoming ill?

There are no official figures on this, although leaders in the area of child health have refuted suggestions made by members of the Scottish government that children were now more at risk from covid-19 and that many had been admitted to hospital.

Steve Turner, Royal College of Paediatrics and Child Health registrar and consultant paediatrician at Royal Aberdeen Children’s hospital, said, “As it stands there are very few children in hospital in Scotland and across the whole of the UK due to covid. We’re not seeing any evidence of an increase in paediatric admissions with covid. A very small number of admissions who test positive for covid is what we’d expect.

“Our experience over the last 15 months is that many children who test positive have come into hospital for something else, like broken bones. At the moment the situation in the UK is stable. The number of children in hospital with covid remains very low.”6