Corona Virus: It's a Marathon, Not a Sprint

[Smoove_B]

I know people are likely tired of me bumping these threads, but this OpEd is too good - Why are we still playing make-believe?

The pandemic is far from over, as evidenced by the rapid rise to global dominance of the JN.1 variant of SARS-CoV-2. This variant is a derivative of BA.2.86, the only other strain that has carried more than 30 new mutations in the spike protein since Omicron first came on the scene more than two years ago. This should have warranted designation by the World Health Organization as a variant of concern with a Greek letter, such as Pi.

By wastewater levels, JN.1 is now associated with the second-biggest wave of infections in the United States in the pandemic, after Omicron. We have lost the ability to track the actual number of infections since most people either test at home or don’t even test at all, but the very high wastewater levels of the virus indicate about 2 million Americans are getting infected each day.

...

It has taken healthcare systems many weeks after JN.1 showed up in October to recognize the threat. Only very recently have some reinstated mask mandates for healthcare workers and patients. Little has been done across the country to improve indoor air quality, upgrading filtration and ventilation.

Now in its fifth year, SARS-CoV-2 has once again proved to be highly resilient, capable of reinventing itself to infect us. Yet we continue to make-believe that the pandemic is over, that infections have been transformed to common cold status by prior exposure(s), and that life has returned to normal. Sadly, none of this is true.

The massive number of infections in the current wave will undoubtedly lead to more people suffering from long COVID. For a high proportion of people, especially those of advanced age, immunocompromised or with coexisting conditions, getting COVID is nothing close to a straightforward respiratory infection.

...

It’s crickets from the White House on COVID now, with no messaging on getting the updated booster or masking. The Biden administration has done far too little to accelerate research on effective treatments for long COVID.

This passivity reinforces the illusion that the pandemic is behind us when it’s actually raging. And this season will be followed by a more quiescent period, which will, once again, lull us into thinking the pandemic is over. But there is no getting over it until we recognize reality and double down on the research that will allow us to block infections and virus spread, and achieve lasting, variant-proof immunity.

[El Guapo]

Little has been done across the country to improve indoor air quality, upgrading filtration and ventilation.

This is the part that's been driving me nuts lately. Like this should be a public policy layup - the federal government should allocate $10B (or whatever the appropriate figure would be) to provide assistance (possibly through state / local government) to help schools, businesses, and other places of public gathering to upgrade filtration and ventilation. It will help with the current pandemic and future pandemics. It will create jobs. It will help minimize or avoid shutdowns of these places in the future! Like how is that not happening?

[stessier]

I, for one, enjoy the bumps and updates. It's hard to find the important news and I just use you as my filter. Thanks for being my unpaid intern! (Assuming you exist at all and aren't just one of my ALTs)

[Smoove_B]

Like how is that not happening?

Business pressure against - because of the cost. Government would have to fund - so now it's a political football. The GOP won't support feeding school children lunch, you think they're going to agree for billions to improve indoor air quality? Plus, there would also be a legitimization of the idea that the air you breath in the workplace can affect your health. If an employer doesn't upgrade / improve air, now workers have potential legal standing.

Overall you can imagine a scenario where Biden (or any other Democrat) is speaking about improved indoor air quality and the GOP will immediately launch into an attack on "big government" forcing regulations on businesses. And then smaller businesses will fail and bigger companies will just pass the cost to the consumer. Meanwhile, Real Americans (tm) will suffer and no one will benefit. Tax increase!

I have locals currently complaining that one of our electrical service providers is currently undergoing massive upgrades throughout the state in an effort to try and modernize our power grid. They're passing some of the cost on to customers and so of course these trolls are complaining that our taxes our going to increase and that governmental money will end up going "overseas" to help foreigners instead of staying here to help Americans. Because of course these same people refuse to let tax dollars go towards feeding children (the circle is complete).

It's beyond frustrating because you're absolutely correct. It would be like the 21st century version of national infrastructure improvements in the 1950s and 60s. When I see what they have in other countries - businesses that have TV screens or signs broadcasting their indoor air measurements, but here in the United States there's literally nothing going on, it's f-ing ponderous.

[Smoove_B]

I, for one, enjoy the bumps and updates. It's hard to find the important news and I just use you as my filter. Thanks for being my unpaid intern! (Assuming you exist at all and aren't just one of my ALTs)

Some days I feel like I'm just mainlining information and deciding what to process. Some days it's too much.

[stessier]

Like how is that not happening?

Business pressure against - because of the cost. Government would have to fund - so now it's a political football. The GOP won't support feeding school children lunch, you think they're going to agree for billions to improve indoor air quality? Plus, there would also be a legitimization of the idea that the air you breath in the workplace can affect your health. If an employer doesn't upgrade / improve air, now workers have potential legal standing.

Yeah, this.

Where I work, at the start of the pandemic corporate did calculations and dictated how many air turns per hour were required in each space (I think it was 11). We had to open the air dampers on our HVAC and installed air purifiers all over the place - there were 11 in our biggest conference room. We never upgraded anything, though, and those purifiers are now turned off (except the ones in my office!).

[ImLawBoy]

Little has been done across the country to improve indoor air quality, upgrading filtration and ventilation.

This is the part that's been driving me nuts lately. Like this should be a public policy layup - the federal government should allocate $10B (or whatever the appropriate figure would be) to provide assistance (possibly through state / local government) to help schools, businesses, and other places of public gathering to upgrade filtration and ventilation. It will help with the current pandemic and future pandemics. It will create jobs. It will help minimize or avoid shutdowns of these places in the future! Like how is that not happening?

As someone who works on contracts related to federal funding based on the pandemic, I don't think it would help much for this pandemic. Federal funding, even when (especially when?) filtered through the states, comes with so much red tape that it's a very lengthy process.

[Zaxxon]

Little has been done across the country to improve indoor air quality, upgrading filtration and ventilation.

This is the part that's been driving me nuts lately. Like this should be a public policy layup - the federal government should allocate $10B (or whatever the appropriate figure would be) to provide assistance (possibly through state / local government) to help schools, businesses, and other places of public gathering to upgrade filtration and ventilation. It will help with the current pandemic and future pandemics. It will create jobs. It will help minimize or avoid shutdowns of these places in the future! Like how is that not happening?

As someone who works on contracts related to federal funding based on the pandemic, I don't think it would help much for this pandemic. Federal funding, even when (especially when?) filtered through the states, comes with so much red tape that it's a very lengthy process.

I know it's not the same (not an emergency, for one), but see also: the NEVI funding for BEV charging infrastructure to states. Enacted November, 2021. All states' initial plans approved September, 2022. The first actual, live, real-world station went in... last month. Those initial plans won't be completed until well into 2025.

[El Guapo]

Little has been done across the country to improve indoor air quality, upgrading filtration and ventilation.

This is the part that's been driving me nuts lately. Like this should be a public policy layup - the federal government should allocate $10B (or whatever the appropriate figure would be) to provide assistance (possibly through state / local government) to help schools, businesses, and other places of public gathering to upgrade filtration and ventilation. It will help with the current pandemic and future pandemics. It will create jobs. It will help minimize or avoid shutdowns of these places in the future! Like how is that not happening?

As someone who works on contracts related to federal funding based on the pandemic, I don't think it would help much for this pandemic. Federal funding, even when (especially when?) filtered through the states, comes with so much red tape that it's a very lengthy process.

I agree that this is more likely to be a medium to long term gain as opposed to help with the current pandemic. But you figure there's likely to be *some* short-term benefit as well (like it may motivate some businesses to make similar improvements on their own).

[Smoove_B]

Yes. There was potentially billions available to each state through the CARES act, partially distributed to states through what was known as ESSER (Elementary and Secondary School Emergency Relief). This money was supposed to be used to address shortcomings in remote instruction, however it could have also been used for infrastructure upgrades (broadly) related to health - for example, improving/updating/upgrading a school's HVAC system.

I don't have current numbers, but for my state as of January of 2023:

The state placed 44th in the nation, having spent only 26.6% of the $4.7 billion it received in Elementary and Secondary School Emergency Relief (ESSER) money.

There's some debate over the accounting because of the long lead-time construction projects need, but I can tell you firsthand some school districts absolutely upgraded HVAC systems using this money. It took a few years, but the money was used. I am confident (but can't entirely prove) that a significant amount of that funding went unused over (local) political reasons.

I'm not going to suggest it was easy to acquire, but it also wasn't nearly as difficult as you'd think. If I had kids in school, I'd be asking my local board or the county why they didn't take advantage of the funds -or- ask what they did with the money they did get.

[Zarathud]

Republicans don’t run to be 3elected to do things like fix school air quality or track sickness or promote vaccinations. They run against difficult problems, prevent compromises that might get them solved, and blame Democrats/government for the mess.

[Kraken]

Smoove, don't be such a Nervous Nelly.

The holidays have come and gone, and once again Americans are riding a tide of respiratory ailments, including Covid. But so far, this winter’s Covid uptick seems less deadly than last year’s, and much less so than in 2022, when the Omicron surge ground the nation to a halt.

“We’re not seeing the signs that would make me think that we’re heading into another severe wave,” said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. “So far, we’re in relatively good shape.”

A few screens of qualification follow that lede, but who reads that far? Everything's fine.

[Isgrimnur]

Nearly 17,000 people may have died from hydroxychloroquine: study

Nearly 17,000 people across six countries may have died because they took hydroxychloroquine (HQC) during the first wave of COVID-19 in 2020, according to a new analysis published by French researchers.
...
The analysis found an estimated 16,990 excess deaths across six countries — Turkey, Belgium, France, Spain, Italy and the U.S. — were likely attributed to hydroxychloroquine use.

The researchers analyzed other studies that tracked hospitalizations, exposure to hydroxychloroquine and the relative risk of death from the drug.

The toxicity of hydroxychloroquine in patients with COVID-19 was partially due to cardiac side effects, such as abnormal heart rhythms.

However, the researchers noted their numbers were likely an undercoun, but could also be a significant overcount.

The study period was only from March to July 2020, and there was a general lack of data from most countries. The actual number of deaths related to hydroxychloroquine could be between 3,000 and 30,000, they said.

[Smoove_B]

A few screens of qualification follow that lede, but who reads that far? Everything's fine.

Yeah, sure, things are definitely better than they were in 2021, at least with respect to deaths. But hospitals are once again overwhelmed and no one is really sure what's happening to our overall baseline health (America, globally) after 4+ years of being soaked non-stop in SARS variants. I am still firmly in the camp that believes the virus is damaging us in ways we haven't yet realized and in another ~6 years we're going to look back and realize what we've done.

No, COVID-19 isn't airborne HIV, but I do think it's causing an increase in chronic health conditions, some of which we haven't yet started to experience.

Remember when we were all originally talking about how serious the virus might be back in 2020 and the very first place to show signs of what we might expect here was Italy? History is repeating.

And yes, I know it's not just COVID-19, but it's not "immunity debt" or whatever made up nonsense people are spouting these days. Our populations are not doing well; we are not healthy.

[Isgrimnur]

things are definitely better than they were in 2001

What do you know and when did you know it?

[Smoove_B]

More coffee!

(hides Daehawk's time crystals)

[Victoria Raverna]

https://www.theguardian.com/world/2024/ ... esearchers

Many people with long Covid feel tired, unwell and in pain for lengthy periods after exercise, and researchers say they now know why.

Experts say they have evidence that biological changes are to blame, such as severe muscle damage, mitochondrial problems and the presence of microclots in the body.

“It’s really confirming that there is something inside the body going wrong with the disease,” said Dr Rob Wüst, an author of the study at Vrije Universiteit (Free University) Amsterdam.

Long Covid is thought to affect about 2 million people in the UK alone, and many experience a worsening of symptoms for weeks after a single bout of exercise.

Published in the journal Nature Communications, the study involved 25 patients with long Covid who reported experiencing malaise after exercising, and 21 people who had had Covid but made a full recovery. None of the participants had been hospitalised with Covid, while all had been fit and healthy before catching the virus and were of working age.

Each participant spent about 10-15 minutes on an exercise bicycle, and blood samples and skeletal muscle biopsies were taken a week before and the day after the task.

While there was considerable variation between patients, on average, people with long Covid had a lower exercise capacity than healthy participants.

When the researchers analysed the biopsies taken before exercise, they found that those with long Covid had a greater proportion of white fibres in their muscles than healthy participants. These fibres have fewer power-producing structures, known as mitochondria, within their cells, and fewer capillaries.

The team also found signs that the mitochondria in people with long Covid did not work as well as those in healthy participants.

Wüst said the findings partly explained why people with long Covid had a lower capacity for exercise.

The team also found that people with long Covid had more clumps of a protein called amyloid in their skeletal muscles, although there was no evidence that these “microclots” were blocking blood vessels as some researchers have previously proposed.

Comparison of the biopsies taken before and after cycling revealed the function of the mitochondria worsened after exercise in those with long Covid, and these participants had far more tissue damage after exercising and signs of the body attempting repairs.

“That can explain, for instance, the muscle pain that these patients are experiencing after exercise,” said Wüst.

He said the findings highlighted that people with long Covid should not undertake intense exercise.

“It damages your muscles, it worsens your metabolism, and it can explain why you feel muscle pain and fatigue up to weeks after the exercise,” he said.

Prof Betty Raman, of the University of Oxford, who was not involved in the study, said her own research suggested that mitochondrial dysfunction might play a role in the fatigue that some people with long Covid experience. The latest study adds weight to the idea that treatments that improve mitochondrial health could be beneficial, she said.

But, Raman noted, this might not be the full story: “While it is plausible that fatigue is associated with these metabolic abnormalities, other contributing factors, such as persistent inflammation, may also play a role.”

[Smoove_B]

Yes, more and more studies coming out with similar findings.

Dr. Topol published an update yesterday, summarizing where we're at now, using the only source of data left - wastewater:

Without any current ability to directly track the number of new cases, wastewater is the only reliable metric that we have to work to derive estimates. Jay Weiland has been closely following the Biobot.io and CDC wastewater data and modeling the number of infections that data represent. As of December 30th data, his work showed there were 1.6 million new infections per day with a steep slope of rise, to get to the estimate of ~2 million infections each day at peak of the JN.1 wave, which we’re approaching soon, hopefully.

Regarding hospitalizations:

While infections have clearly surged, the increase in Covid hospital admissions has fortunately not gone up proportionately, as updated by CDC today to 30 December.

But you can see in the graph above that among people age 70+ Covid hospital admits are still on the way up and getting close to what occurred in the BA.X (BA.2, BA.5) waves following Omicron in January 2022. Unfortunately, less than 37% of people age 70+ have had the updated XBB.1.5 booster. The lack of an overall major spike in hospitalizations is encouraging and likely reflects cumulative exposure to the virus over the past 4 years, whether it be through vaccinations and boosters, or infections, or their combinations. There’s certainly some level of population-based immunity. Yet persistent vulnerability in people of advanced age is notable.

On Long Covid:

There isn’t adequate acknowledgement of the risk of Long Covid—or the protection from vaccination. When you think of up to 2 million Americans getting infected in a day, even if only 1% go on to suffer from chronic Covid, which can be profoundly debilitating, that’s 20,000 eventual new long haulers added to the millions here already affected. In one day. The current wave has gone on for weeks and estimates are that 4-5% of Americans have Covid now and up to 1 in 3 will have been infected during the wave cumulatively.

A recent meta-analysis of 24 studies looking at whether Covid vaccines protect from Long Covid provides encouraging evidence that there’s about 70% reduction of risk. That’s second only to not getting Covid, which of course provides 100% protection from Long Covid.

A possible theory as to what's happening in some people:

On the mechanistic front of Long Covid, a new paper advanced the mitochondrial dysfunction hypothesis with demonstration from muscle biopsies (and compared with healthy controls) of exercise-induced myopathy and abnormal muscle metabolomics, no less infiltration of amyloid-containing deposits in muscle tissue. This provocative report aligns with a previous Ground Truths I wrote on the importance of mitochondrial dysfunction with Long Covid. In the last week, an open-access Nature feature on Long Covid in low and middle income countries was published along with an extensive interview I did at The Sick Times on where we are headed.

I'd seen the study but it's way to technical for me to translate. I am hoping we get a bit more from a popular science communicator - something that is easily understandable. In short, the study suggested that our cellular powerhouses (the mitochondria) are being impacted by the virus.

His closing thoughts:

While the virus will continue to find new entrance mechanisms to get into our upper airway, we have no meaningful exit strategy to protect against these infections, their spread, and future variants. That can potentially be achieved with the mucosal immunity provided by nasal or oral vaccines, as I recently reviewed here and here. Unless we can block infections with such new vaccines, we’re stuck in the mosaic state of vulnerability, denialism, and false hope that the pandemic is over. Not to get overly anthropomorphic, but JN.1 has once again spoken that it’s not over. Or the Yogi Berra aphorism. Nevertheless, I remain optimistic that this off-ramp will eventually get done—just not soon enough.

He's definitely hopeful we can get a different style of vaccines that will cut transmission (so we're not constantly soaking in new variants every few months as transmission continues non-stop for 5 years), but I'm not sure how to translate that to a population of people where only 19% are willing to vaccinate.

[Kraken]

I'm not sure how to translate that to a population of people where only 19% are willing to vaccinate.

A nasal spray vaccine would have a much better uptake. Persuading people to get a shot that might make them feel sick for a day is a tall order.

Thanks for that update. The mitochondrial hypothesis is quite worrisome.

[Smoove_B]

A nasal spray vaccine would have a much better uptake. Persuading people to get a shot that might make them feel sick for a day is a tall order.

That's the thing - there's more risk for symptoms with what I'm going to assume would be an attenuated (weakened) virus. The vaccines we've been receiving for COVID-19 are either virus parts (J&J, Novavax) or have coded information to help us create protection (mRNA from Pfizer and Moderna). These nasal vaccines would be closer to something like an MMR shot (which are live, attenuated viruses) and typically less than pleasant.

I haven't been following the research too closely because it's so far off from being used, but if it's like the nasal sprays for influenza, that's what I'd expect. You can read up on the nasal flu vaccine here, but note it's not something you're giving to people over 50 or people with weakened immune systems. So again, you'd be relying on healthy adults (presumably) to get a nasal COVID-19 vaccine with the hopes then that they'd stop spreading it like wildfire to susceptible people (that are hopefully getting the traditional vaccines).

The mitochondrial hypothesis is quite worrisome.

It sure is. It also explains quite a bit (potentially), but hopefully they can get more information or rule things out, because yeah, that would be terrible.

[Blackhawk]

We're already at above 5% of the population with it, and we're still cycling through variant infection after variant infection. I can't help but wonder what it's going to be like once a majority of the population has developed it (and if we keep going like we have been, it may just happen.)

[Smoove_B]

You're going to have a larger and larger cohort suffering from chronic illness. Some will recover in a month, another group will recover in 3 months. Maybe another group will recover after a year. Some will never recover. These are going to be people potentially unable to work and/or potentially unable to take care of themselves (or others). Quality of life will diminish. Life expectancy will dip. We might see an increase in other diseases that we didn't realize had viral risk factors.

This is why there are so many researchers and scientists pushing for studies to be done to try and figure out what's happening - who is at highest risk? Why? What treatments work?

I think it was yesterday? Today? that the White House Press Secretary was asked whether or not she thought hospitals should be reconsidering masking in light of the number of cases America is seeing. Her response:

"Make your own decisions, that’s not something we get involved in”

There is no more public health. This is the most batshit insane timeline and the idea that the White House is saying they're not getting involved in disease prevention is beyond inexplicable.

On the other hand - she's also totally right. No one cares about your health anymore other than you. Just understand that when you are chronically ill from COVID-19, that also applies.

[Blackhawk]

I think it was yesterday? Today? that the White House Press Secretary was asked whether or not she thought hospitals should be reconsidering masking in light of the number of cases America is seeing. Her response:

"Make your own decisions, that’s not something we get involved in”

There was no other answer to that question that wouldn't have resulted in disaster. That's the thing - the conspiracy theorists created a situation in which this has become an untouchable issue for the government. Any attempt at being proactive on this is immediately shut down by political opponents and used as a bludgeon against them. Nothing to gain, much to lose.

They aren't staying out of it because they want to. The Press Secretary likely agrees with you. There's just no winning answer that they can give, and no action they can take openly that isn't detrimental.

[Smoove_B]

They aren't staying out of it because they want to. The Press Secretary likely agrees with you. There's just no winning answer that they can give, and no action they can take openly that isn't detrimental.

Which I (sorta) get. But there are still plenty of people like me (there are dozens of us!) that want to encourage healthier conditions and certainly many have indicated they'll follow best guidance when it is coming from state and local officials. But instead they're bowing to the vocal minority and making it really difficult for people like me to support the administration over this single issue. It's especially frustrating when he ran on things like wearing masks and lowering transmission and fighting infection. Instead he's now been President during a time when like 60% of the deaths have occurred along with 2 of the highest transmission peaks.

Unrelated, but Charlotte, North Carolina is...not doing great, apparently.

Charlotte, NC just hit their highest level of COVID hospital admissions for the pandemic.

[Blackhawk]

They aren't staying out of it because they want to. The Press Secretary likely agrees with you. There's just no winning answer that they can give, and no action they can take openly that isn't detrimental.

Which I (sorta) get. But there are still plenty of people like me (there are dozens of us!) that want to encourage healthier conditions and certainly many have indicated they'll follow best guidance when it is coming from state and local officials. But instead they're bowing to the vocal minority and making it really difficult for people like me to support the administration over this single issue.

There are thousands of you. Millions if you include non-professionals (like me.)

But what happens if they don't bow to the vocal minority? What happens if they push this issue? What would you have them do that doesn't cause more harm than good in the long run?

[Smoove_B]

What would you have them do that doesn't cause more harm than good in the long run?

I would hope behind the scenes they're doing the opposite of what is being communicated during a press conference, at a minimum.

All she had to say was something like:

"We have been in touch with Director Cohen at the CDC and she knows that she should be providing guidance to state and local officials to help them decide what's best for hospitals in their area."

You know how everyone is currently gobsmacked that the Secretary of Defense was in the hospital for a week before it was determined that the President apparently found out? Guess who also has seemingly disappeared from public life right after Xmas and hasn't been seen or heard from?

The first time the CDC director disappeared like this it was because she had COVID. Then second time it was right before she resigned.

[Smoove_B]

From last night:

Weekly U.S. COVID update:

- New cases: 388,084 est.
- Average: 320,432 (+35,809)
- States reporting: 50/50
- In hospital: 25,430 (+3,833)
- In ICU: 2,577 (+306)
- New deaths: 2,090
- Average: 1,724 (+102)

Note:

Today's total is up 22% from last week.

Where does that 2k+ weekly death total put us?

More than 2,000 new deaths were reported. This is the 17th week in a row with more than 1,000 new deaths, or nearly 26,000 during the same period, and the first week since March with more than 2,000 deaths.

Overwhelmingly from the data the CDC releases, deaths are still highest in ages 70+, and overwhelmingly happening in hospitals. Given the low vaccination rate for the latest round, I'm not sure yet I've seen current data on vaccination rates for folks that are 65+. It had been high, but I don't know if it took a dip after this latest (Fall 2023) round as they were only tracking it through the bivalent vaccinations, because that makes sense.

[LawBeefaroni]

Shhhhh! It's an election year! No one wants to hear that stuff.

Overwhelmingly from the data the CDC releases, deaths are still highest in ages 70+, and overwhelmingly happening in hospitals. Given the low vaccination rate for the latest round, I'm not sure yet I've seen current data on vaccination rates for folks that are 65+. It had been high, but I don't know if it took a dip after this latest (Fall 2023) round as they were only tracking it through the bivalent vaccinations, because that makes sense.

FWIW, Chicago is around 30% for that demographic (28.6% for 65-74; 32.7% for 75+). I'm going to guess that's higher than the national average. This is for the round available starting 9/13/2023.

https://www.chicago.gov/city/en/sites/c ... erage.html

[Smoove_B]

Shhhhh! It's an election year! No one wants to hear that stuff.

You joke, but I absolutely think it's a factor here. They're gambling that we emerge (again) in the Spring with fewer cases and have a relatively quiet summer. There will be a increase in September because of kids going back to school, but maybe there are plans to have the 2024 vaccinations out earlier (I doubt it). Either way, they know the increase in cases won't compare to all the attention the national elections will be getting, so nothing will be done or said. By the time cases start rapidly increasing again (post Thanksgiving 2024), it'll either be part of the new normal or the least of our collective worries.

I'm going to guess that's higher than the national average. This is for the round available starting 9/13/2023.

I bet you're right as the regional / state data looks like you'd expect (following politics).

[stessier]

but maybe there are plans to have the 2024 vaccinations out earlier (I doubt it).

Would that even be wise? Given we know the protection fades relatively quickly, wouldn't we want it released so most people are near full strength for Thanksgiving and Christmas?

[Smoove_B]

Yeah, that's a good question. I wouldn't expect them to have it available sooner than the middle of August, but it maybe that will be the plan - hope enough people get it in early October to carry us through Winter 2025. That said, given the current vaccination acceptance rate, I'd imagine Fall 24 numbers will be the same or worse unless something changes with the virus - either legal requirements or severity. We've seemingly hit the point where an infectious, vaccine preventable disease will be a Top 5 cause of death each year and collectively shrugged our shoulders.

[stessier]

unless something changes with the virus - either legal requirements

Sorry, but that's a good one. The only change likely in the future is in a direction that's going to give you nightmares.

[Smoove_B]

Oh, I know. I was just trying to be clear that there were a few different things in play. I don't expect anything to change at all. I do expect things to get worse. I am not sure what it would take at this point for there to be any change, but I've honestly given up on seeing it in my lifetime.

I think what hits the hardest is the medical community - hospital / clinic / nursing home staff members that don't mask. If they aren't taking this seriously, there's zero chance the average American ever will. I had nothing but sympathy for anyone working front-line medical; it has vaporized.

Regardless, I'm sure something much more pressing will occur and Covid-19 will just be something always in the mix now. Kinda like how there's apparently an outbreak right now in parts of Gaza. Because that's what they need.

[Smoove_B]

Oh hey, look at that - things might be getting worse:

Highly mutated COVID variant BA.2.86—close ancestor of globally dominant “Pirola” JN.1—may lead to more severe disease than other Omicron variants, according to two new studies published Monday in the journal Cell.

In one study, researchers from Ohio State University performed a variety of experiments using a BA.2.86 pseudovirus—a lab-created version that isn’t infectious. They found that BA.2.86 can fuse to human cells more efficiently and infect cells that line the lower lung—traits that may make it more similar to initial, pre-Omicron strains that were more deadly.

In the other study, researchers in Germany and France came to the same conclusion. “BA.2.86 has regained a trait characteristic of early SARS-CoV-2 lineages: robust lung cell entry,” the authors wrote. The variant “might constitute an elevated health threat as compared to previous Omicron sublineages,” they added.

While illness caused by the initial Omicron strain was typically considered more mild than that caused by earlier variants, it’s impossible to say definitively, experts say. That’s because those sickened by Omicron had generally already been infected with an earlier version of the virus, likely softening the blow. Additionally, many had been vaccinated, to the same effect.

Still, Omicron had a penchant for infecting the upper airway versus the lower airway, where prior versions of the virus tended to accumulate, causing more severe disease. The new studies offer proof that this trend may very well be reversing, the authors contend. If true, it’s bad news for those who hoped the virus was slowly attenuating to the equivalent of a common cold.

“We cannot ignore the evidence” that Omicron may be evolving into a more severe form of itself, Dr. Shan-Lu Liu—professor and co-director of the Viruses and Emerging Pathogens Program at Ohio State University, and lead author on the first study—told Fortune.

What about JN.1?

As for what the studies might mean regarding the severity of JN.1 infection, the jury is still out. But the new findings—combined with expert speculation that JN.1 may be showing a preference for infecting the GI tract—warrant more study into the evolving nature of the virus, according to Liu.

Another concern of his: the possibility of COVID recombining with another coronavirus in animals, then transitioning back over to humans—throwing another viral plot twist into the pandemic’s narrative.

Some experts contend that Omicron—highly mutated compared to previous strains—originated in animals, then spilled back over into humans (as opposed to developing in a human with a long-term infection, as others contend). Regardless, animals serve as an underappreciated wild card, Liu contends. Case in point: Nearly every white-tailed deer in Ohio has tested positive for COVID, affording the virus an entire additional population in which to mutate.

Another, perhaps larger concern of Liu: the possibility that COVID recombines with another, more deadly coronavirus like SARS or MERS, which had case fatality rates around 10% and 34%, respectively. In contrast, COVID’s case fatality rate, among unvaccinated Americans, sat around 1% prior to Omicron, and around 0.11% after.

Once again, this is why I wake up at 3am and stare at the ceiling:

“Anything can happen,” Liu said. “It’s really hard to predict what’s going to come next, but nature can do amazing things.”

The bottom line when it comes to the power of animals to further evolve the virus and send another curveball flying humanity’s way: “Humans, watch out.”

[em2nought]

Hospitals requiring masks again. Here we go again "two weeks to flatten the in person voting curve".

[Victoria Raverna]

Hospitals requiring masks again. Here we go again "two weeks to flatten the in person voting curve".

And also reduce GOP voters by the voting day because of hospitalization or death.

[em2nought]

Hospitals requiring masks again. Here we go again "two weeks to flatten the in person voting curve".

And also reduce GOP voters by the voting day because of hospitalization or death.

Worked indirectly with my mother last time.

[Kraken]

Hospitals requiring masks again. Here we go again "two weeks to flatten the in person voting curve".

And also reduce GOP voters by the voting day because of hospitalization or death.

Worked indirectly with my mother last time.

Covid does take out fractionally more righties than lefties, but with a fatality rate of about 1 in 1,000 it doesn't really move the needle.

[em2nought]

Hospitals requiring masks again. Here we go again "two weeks to flatten the in person voting curve".

And also reduce GOP voters by the voting day because of hospitalization or death.

Worked indirectly with my mother last time.

Covid does take out fractionally more righties than lefties, but with a fatality rate of about 1 in 1,000 it doesn't really move the needle.

Covid didn't directly take my mom as she never ventured outside, and I was ultra safe when out doing her errands. What got her was dying in the emergency room, and then having her DNR not followed which they'd had on record since the last time they(religious affiliated hospital) wanted to not follow it. Then she lingered with now cracked ribs for weeks with no visitation allowed. I think she finally died being hopeless of escaping from them and getting back to her nice little home and loved ones. We were scheduled to bring her home that day, but I think they just pumped mom full of morphine and mercy killed her as I think they knew there was no way she was going to be able to stay at home. If that's what they did I'm actually thankful to them for that part.

I wore the mask then and ever since because I suspected we'd be going back "there" again before this November. Still use my own device that covers shopping cart handles too. I'm certain the mask is more about preventing you from touching your face with your grubby virus mitts than breathing in virus.

[Kraken]

Jeez, that's sad. Sorry to hear it.