The number of North Texas patients hospitalized with COVID-19 continues to mount, and health experts worry that the highly contagious omicron variant will strain already overwhelmed hospitals as much as or more than previous variants.
In the last 24 hours, at least 260 North Texas patients were hospitalized with COVID-19, bringing the areas total COVID-19 hospitalization count to 2,516, according to the Dallas-Fort Worth Hospital Council.
The current hospitalizations from COVID-19 have yet to reach the highs seen in previous surges more than 3,600 hospitalizations during the delta surge in September and more than 4,100 in January 2021, according to Texas Department of State Health Services data.
But public health experts say we likely have a few more weeks before the omicron surge hits its peak in North Texas.
To me, this is a much more serious situation [than with delta], because we have much less staffing, said Steve Love, president and CEO of the DFW Hospital Council. In the previous surge with delta, health care workers were staying healthy. Now, many are out. It doesnt mean theyre hospitalized, but they do have to isolate [themselves].
Dr. Philip Huang, director of Dallas County Health and Human Services, said: If we compare [the surge] to some of the other countries, its probably going to be at least another two weeks of increasing cases.
Tuesdays totals represent 18.3% of available hospital bed capacity in North Texas trauma service area, up from around 17% on Monday, Love said.
As part of an executive order issued by Gov. Greg Abbott in September 2020, areas with more than 15% of hospital capacity taken by COVID-19 patients for seven consecutive days were directed to postpone surgeries and procedures that were not medically necessary to diagnose or treat a serious condition.
That order has since been lifted, but passing the 15% threshold is still an important measure to watch, Love said.
Hospitals are doing their very best to balance treating people with COVID but continuing doing all the things we can do to help people with non-COVID, he said. Many times, some of those elective procedures, whether they be diagnostic tests, etc., are so important that we cant continue to postpone and postpone.
Pediatric COVID-19 hospitalizations reached 103 in North Texas on Tuesday, inching closer to a peak of 111 pediatric hospitalizations from the virus seen in previous surges, according to DFW Hospital Council data.
Cook Childrens Medical Center had 26 COVID-19 patients as of Monday, two of whom are in the intensive care unit.
Preliminary research suggests that the omicron variant appears to be causing milder illness in children compared to the delta variant, The New York Times reported.
The increase in pediatric hospitalizations could be explained by the relatively low vaccination rate among children ages 5 and older. About 90% of children ages 5 to 10 are not fully vaccinated against the virus.
Omicron is better than previous variants at evading the protection provided by COVID-19 vaccinations. Booster shots seem to offer more protection, especially against severe disease. On Monday, the Food and Drug Administration expanded Pfizers COVID-19 booster eligibility to include kids ages 12 to 15.
A 54-year-old public-school science teacher on Long Island was arrested on New Years Eve after being accused of giving a teenager an injection of what appeared to be Covid-19 vaccine without his parents consent, the Nassau County police said.
The police said that the teacher, Laura Parker Russo, administered a shot of what appeared to be a coronavirus vaccine to 17-year-old boy in her house in Sea Cliff, N.Y. The youth later went home and told his mother, who called the police and said she had not authorized the vaccination.
Ms. Russo was charged with unauthorized practice of a profession, the police said. She has been removed from her classroom in the Herricks Public Schools system in New Hyde Park and reassigned pending the outcome of the investigation, schools officials said in a statement. A school website, which has been taken down, said Ms. Russo teaches at Herricks High School.
Ms. Russo did not respond immediately to an email sent by The New York Times. She was released after her arrest and is scheduled to appear in criminal court on Jan. 21, the police said. Unauthorized practice of a profession is a felony under the state education law that carries a penalty of up to four years in prison.
The majority of states, including New York, require parental consent for minors to receive Covid vaccinations. Some parents have prevented their children from getting inoculated for various reasons, including concerns about possible side effects and safety.
Scientists say the vaccines are known to be safe for children 5 and older, and they urge vaccinating them because children can both spread the virus to others and become seriously ill themselves. The spread of the highly contagious Omicron variant has led to an increase in pediatric hospitalizations.
And because broad immunity cannot be reached unless minors are vaccinated, federal and state officials hope that more parents will vaccinate their children, especially as many students return to school.
Daily reports of new coronavirus cases have quadrupled in Nassau County over the past two weeks, according to The New York Timess tracker. Hospitalizations in the county have risen 47 percent in that time.
Seventy-six percent of Nassau County residents are vaccinated, according to The Timess tracker, and the rate for 12- to 17-year-olds is only slightly lower, at 72 percent, according to state data.
There is no statewide Covid vaccine mandate for schoolchildren in New York. But some private schools require vaccination, and New York City requires it for certain sports and extracurricular activities.
In September, Los Angeles became the first school district to mandate vaccines for children 12 and older, with a deadline of Jan. 10, but those plans have since been delayed. The Washington, D.C., Council has voted to mandate vaccines for students 16 and older starting March 1.
This is a major source of tension between what is important for public health and what is important in terms of individual liberties and parental autonomy, said Denis Nash, an epidemiologist at the CUNY Graduate School of Public Health and Health Policy.
Schools require other vaccines for enrollment, like vaccination against measles.
Thats the big question: Does Covid-19 fall into the same category as some of these other vaccine preventable diseases that we do require for school entry, or does it not? Dr. Nash said.
James C. McKinley Jr. contributed reporting.
Scientists say that the IHU variant contains 46 mutations, which makes it even more resistant to vaccines. It has not been spotted in other countries or labelled a variant under investigation by the World Health Organization.
A new variant of coronavirus named IHU - has been identified by researchers in France amid the rapid spread of the Omicron strain across the globe. The study, which is yet to be peer-reviewed, suggests that the new virus strain has more mutations than the Omicron variant.
Omicron is still new and a lot of research has been going on across the world to understand its behaviour and capacity to infect. So far, 32 mutations have been identified in Omicron, which is believed to be more resistant to existing vaccines.
But now, this new strain of lineage B.1.640.2 contains 46 mutations.
The IHU was discovered in France on December 10, and since then, the scientists there have been conducting research on it.
Here is a list of things known about the new IHU variant so far:
Its presence was first detected by experts at the IHU Mediterranee Infection in Marseille.
It has been linked to travel to Cameroon, a country in Africa. Omicron was also discovered in southern part of Africa on November 24 and rapidly took the world in its grip.
At least 12 cases of the new IHU variant were reported near Marseilles in France early in December. They are believed to be linked to the index case who returned from Cameroon. The research began after the discovery of the cluster.
According to a paper posted on medRxiv, the genomes were obtained by next-generation sequencing with Oxford Nanopore Technologies on GridION instruments. It further said that the mutations have caused 14 amino acid substitutions and 9 amino acid deletions - which are located in the spike protein.
The B.1.640.2 has not been spotted in other countries or labelled a variant under investigation by the World Health Organization (WHO).
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As the very infectious Omicron variant of COVID-19 surges around the country, you need to know what kind of tests to take to protect yourself and your community.
Emily Landon, infectious disease expert and executive medical director for infection prevention and control at University of Chicago Medicine, answers common questions about COVID-19 tests.
These include when to get a COVID-19 test, what kind you should use, what to do if you cant get one at all, and why its still important to get vaccinated and boosted.
Q: When should I get a COVID-19 test?
Isolate and get a COVID-19 test if you have any symptoms of COVID-19, even if theyre mild and even if youre fully vaccinated and/or boosted. Symptoms may include sniffles, congestion or a cough, and might resemble a mild cold, especially in fully vaccinated and boosted people.
Even if you have minor symptoms, you are still contagious. People who are unvaccinated or immunocompromised may still get severe disease. Stay isolated if you have any symptoms, even if you cannot quickly get a COVID-19 test.
Q: How are rapid antigen tests different from PCR tests? Is one better than another?
Rapid antigen tests, which you can buy in most pharmacies, are great in specific circumstances and less good in others. Rapid antigen tests detect COVID-19 when people have a higher amount of virus particles in their system and are more contagious. But a negative antigen test doesnt necessarily mean you arent contagious. If someone has COVID-19, but hasnt yet reached the tests threshold of viral particles, they may still test negative with an antigen test but positive on a PCR test. Thats why I tell people they should trust a positive antigen test, but be more skeptical about a negative one.
PCR tests, which are still mostly done at hospitals and other testing facilities rather than at home, are far more sensitive than antigen tests. Theyre able to detect smaller quantities of the virus and detect them sooner (and for more time) than antigen tests.
While theyre considered the gold standard for a COVID-19 diagnosis, PCR tests are unnecessary for those who have already tested positive on an antigen test. Thats important to know as wait times for PCR tests grow due to increased demand.
In short: any positive test counts as a positive, but a negative antigen test needs to be confirmed with a PCR test.
Q: When should I use an at-home test?
A rapid, at-home antigen test is a useful tool to have in your COVID-19 arsenal. But you need to know when and how to use these tests.
If you have symptoms:
If you have COVID-19 symptoms and test positive on an at-home test, you have COVID-19. You dont need to get another test to confirm the results.
But if you have symptoms and you test negative, you should not rule out COVID-19 just yet. In this case, we recommend getting a more sensitive PCR test. If you cant get in for a PCR test quickly, its recommended to repeat the antigen test the following day, being sure to isolate until you get your PCR test and results. If you cant get a PCR test at all, isolate for 10 days.
If you dont have symptoms:
For those without COVID-19 symptoms, using these tests before a gathering will reduce (but not eliminate) the risk that someone attending has COVID-19. Remember: antigen test results can change quickly, and a negative result is really only trustworthy for eight to 12 hours.
In other words, you shouldnt rely on a negative test in the morning if you want to get together in the evening with friends or family. Make sure everyone whos attending an event uses an at-home test as close as possible to the time theyre gathering and understands that a negative test doesnt guarantee safety or completely prevent exposure.
If youve had a known COVID-19 exposure, no test is going to make it safe for you to gather unmasked with high-risk individuals. Stay home.
Q: How do I interpret at-home tests?
If youre taking an at-home COVID-19 test, consider any positive result to mean you have COVID-19. You dont need to confirm with a PCR test. (Even if its an extremely faint line, you should consider yourself infected and isolate.) If youre unclear about what your test result says, isolate and repeat the test in six to 12 hours. Youll likely see a clearer line on the test strip next time.
Dont forget: a negative at-home test is only reliable for eight to 12 hours and still doesnt guarantee youre COVID-free. You should get a PCR test if you have symptoms.
Q: What should I do if I cant get a COVID-19 test?
Given the widespread transmission of the Omicron variant, if you have symptoms, you should assume you are infected with COVID-19, regardless of your vaccination status. Isolate for the amount of time thats recommended by the health department.
Q: What should I do if Ive been exposed?
If youve been exposed, but have no symptoms and you are fully vaccinated and boosted, you dont need to quarantine. But you should get a test on Day 4, 5, or 6 following your exposure. (For example, if you were exposed on Monday, you should get tested on Thursday, Friday or Saturday.) If you develop symptoms, assume youre infected and begin isolation.
If youve been exposed and are vaccinated but not boosted, you need to quarantine for five days after an exposure and wear masks for another five days after that. You are still at high risk of infection, especially from the quickly spreading Omicron variant. You should wear a mask around other people, and get tested four to six days after the exposure and anytime you develop symptoms. Avoid gatherings and do your best to limit contact with people who are immunocompromised or who are unvaccinated.
If youve been exposed, have no symptoms, but are NOT vaccinated, stay home and quarantine for five days. Youll need to wear a mask for another five days after that.
Q: Im vaccinated and boosted. Why did I still get COVID-19?
COVID-19 vaccines and boosters are hugely valuable. In addition to providing protection from the virus, vaccines and boosters reduce the chances of serious illness, hospitalization and death. But people can still get infected when theyre fully vaccinated and boosted. This may be because the vaccines protection has decreased over time or because a new variant (like the Omicron variant) is better at getting around the vaccines protective properties.
COVID-19 infections in fully vaccinated people are called breakthrough infections, which usually result in milder symptoms versus infections in the unvaccinated. Your bodys memory B cells and T cells, which developed after your vaccine, respond quickly to stop the infection and prevent severe damage. Immunocompromised people may not have strong B cell- and T cell-immunity even after vaccination, so they remain at higher risk. If you are immunocompromised and have a breakthrough infection, you should contact your doctor even if you only have mild symptoms.
Unvaccinated people dont have existing antibodies or memory B cells or T cells waiting to fight off COVID-19, so they have to start their immune response from scratch if they become infected. Infections typically cause more damage to their organs and tissues, which can lead to complications like having low oxygen levels, as well as problems with the lungs, kidney and heart. Unvaccinated individuals are also much more likely to need intensive care support or have lingering symptoms known as long COVID-19.
Q: If I have a breakthrough infection after my COVID-19 vaccine, will I still be contagious for the same amount of time?
Theres a good amount of evidence showing most fully vaccinated and boosted people with breakthrough infections are both less contagious, and contagious for a shorter time. Theyre also more likely to get mild infections.
Q: Can I report my positive at-home test results to public health officials?
At-home antigen test results are not typically reported to public health agencies, nor are they usually included in official case tallies. This means statistics are significantly under-reported. In some communities, local health departments are setting up portals for people to self-report at-home results, but youll need to check to see whats available in your area.
The most important thing to do is stay home and isolate. If you have certain health conditions especially if youre immunocompromised contact your doctor ASAP so they are aware of your diagnosis.
Q: When can I get the new medicine thats received emergency use authorization to fight or prevent COVID-19?
The good news is that new antiviral medication and a preventative monoclonal antibody treatment have received emergency use authorization from the U.S. Food & Drug Administration. Theyll be very important resources for doctors and high-risk patients. Even so, these treatments will be extremely limited at first. They will first be distributed by public health agencies and will only be available to the highest-risk patients.
If you are a transplant recipient, have a primary immunodeficiency, take immunosuppressive medication, or are undergoing active chemotherapy, and you test positive for COVID-19, you should contact your doctor right away to see if any of these treatments are available to you.
Q: Do COVID-19 booster shots offer added protection against the Omicron variant?
A: Boosters offer the best protection from catching Covid, but they arent perfect. Scientists are still gathering data on the effectiveness of vaccines against Omicron, but existing data show people who are vaccinated and boosted have additional protection and are less likely to be hospitalized than those who are unvaccinated. Read more about booster shots and third doses here: What to know about booster shots and third doses of the COVID-19 vaccine.
Adapted from an article published by UChicago Medicine.
Covid news live: Testing rules to be relaxed amid staff shortages as NHS forced to delay surgeries The Independent
Listen and subscribe on Apple, Stitcher, Spotify, and Google. And if you like what you hear, a five-star rating goes a long way in helping us "Track the Vax!"
We did it all. We social distanced, masked, got vaccinated, masked some more, and got boosted. But still, with Omicron -- a much more contagious variant spreading like wildfire -- infections are at an all-time high.
There remain more than 100 different vaccines in human trials and development for COVID-19, from protein subunits to inactivated coronavirus vaccines, as well as another 70-plus in animal trials.
So, is boosting with our existing authorized vaccines going to be our "new normal?" Or, are there new vaccines still in development that would allow us to truly be "one and done."
On this week's episode, Dial Hewlett Jr., MD, the medical director for Westchester County, New York, and deputy to the commissioner for the Westchester County Department of Health, joins us to explain what future vaccines are coming down the pike and where research will lead us.
The following is an abridged transcript of his interview with "Track the Vax" host, Serena Marshall:
Marshall: Despite vaccines, despite the strides we've made with them, we are still looking at a really bleak winter here. Is that because it's not that the vaccines aren't working, it's that the virus is sort of evolving?
Hewlett: That's fair to say. I think this new Omicron variant, unfortunately, seems to be much more transmissible than some of the earlier variants, including the Delta variant. And as a result of that, we have a larger number of people who are becoming infected. Certainly it has run rampant among those who are unvaccinated. But it has now led to a lot more of what we call breakthrough infections among people who are fully vaccinated.
Fortunately, those individuals who are fully vaccinated are experiencing only mild symptoms, similar to say, a common cold. So, I think that that's the good news, in that the vaccines are preventing serious illness and hospitalizations and deaths.
Marshall: But they're not bulletproof, and boosters are going to be what's necessary in order to really up that antibody protection?
Hewlett: That is correct. I think that we have understood now clearly the benefit of the boosters and we are encouraging everyone who is fully vaccinated, if they are eligible, to come into either their health departments or to their physicians' offices, or other places where they can get the boosters, because we believe the boosters are going to be very, very helpful in preventing further infections.
Marshall: But how often will boosting or this reboost be necessary when it comes down to it? Especially with these mRNA vaccines, which is what is being used in the U.S. the most, and what's being recommended now, even over the adenovirus vector vaccine.
Hewlett: I don't think that we can really answer that question accurately at this time. This is really a moving target. We don't know whether this virus ultimately is going to behave like the influenza virus, which requires a shot every year, because there are variants that occur -- not really variants, but there are changes in that particular virus that necessitate revaccination every single year.
So, we don't know if that may be the case with this virus at all, just like the others. I think we have to wait and see what's happening as far as that's concerned. We don't have to wait and see with regard to the effectiveness of these vaccines at preventing serious disease, because we've seen that that's definitely occurring.
Marshall: So, we don't know how often we'll have to get boosted with these mRNA vaccines, but we're hearing some good news about future vaccines -- like Novavax.
Hewlett: Yes, we are. And I think that one of the good things about that vaccine is that it does use a different type of platform. It uses what we call a protein subunit platform, so it's a protein-based vaccine, which is very similar to the platforms that are used for some of the other types of vaccines. I think the influenza vaccine is on a similar platform.
One of the good news pieces of this is that the availability of this new vaccine is going to increase the supply. And so it's going to allow for some of the underserved parts of the world to be supplied with vaccine, which, according to studies that were recently published over the summer in the New England Journal, this vaccine is close to 90% effective in preventing serious illness and hospitalization. So, that's very good news.
It may well be that if this vaccine is tested further, that it may be something that will be added to the armamentarium here in the United States. We don't have approval for this vaccine yet here in the U.S. and we don't have a COVID vaccine as of now that's in this class of vaccines that's available to us.
Marshall: So, you said it's a subunit protein vaccine. Explain for us how that's different from the mRNA vaccines.
Hewlett: Yes. If I can, not being a basic scientist. The mRNA vaccines actually couple the material from the virus, that is, they actually take pieces of the spike protein, and it's coupled with the messenger RNA. And that is actually the platform by which the vaccine operates.
With protein subunits, they are actually using what they call nanoproteins, which are just small amounts of protein, and what they call an adjuvant. They are using essentially the entire protein subunit, as I understand it, from the spike protein of the coronavirus. And so, in that way, it's a bit different. At the end of the day, all of the vaccines, whether it's an mRNA vaccine or a protein subunit vaccine as this one is, or a viral vector vaccine, which is what the J&J vaccine is, or the AstraZeneca -- all of these vaccines will generate what we call an antibody response. So, antibodies will be generated, which will neutralize the virus and hopefully prevent the person from getting sick.
But the other part that we don't talk about that much is that they will all also generate what we call a memory response through what we call the T cells or some of the white cells in our body. And this is probably very, very important -- not probably -- but is very important in terms of the duration of the protection that a person has.
Marshall: Do we know, though, if the subunit protein vaccines create longer protection memory?
Hewlett: We don't, we really don't. We really are going to have to wait and see what happens to the individuals who were involved in these initial trials. The trials that were reported in the New England Journal back in July involved about 15,000 participants. And so in order to know exactly how long protection is going to last, you have to follow these individuals longitudinally. And you have to look at their antibody responses over time and you expect the antibody levels to go down, but you also want to look at the percentage of individuals who may develop symptoms that would then be attributable to the coronavirus infection. And that's really the only way that we'll know how long the protection is going to last.
Marshall: I mean, it sounds like the Novavax vaccine is using more of traditional vaccination approaches than the mRNA, which is relatively, for all intent and purpose, brand new.
Hewlett: Well, yes. The mRNA vaccines have been used previously, but certainly the mRNA technology is much newer than the protein subunit technology. The advantage of the mRNA technology was that it allowed scientists to develop and produce the vaccine much more rapidly than the traditional protein subunit vaccine.
Marshall: But the protein subunit -- we have to just, to be clear here -- don't infect you either. There's no way you can get COVID from the vaccine?
Hewlett: That's correct. And that's true with all of them. So, you're not being injected with the virus. You are receiving protein parts of or either the entire spike protein, if you will, of the virus. And that is what generates the immune response.
Marshall: There's another vaccine, Dr. Hewlett, that's just out of phase I. So it's really early. And it's being called an umbrella vaccine, protecting not just against COVID, but all SARS infections. It is coming out of Walter Reed's medical center, U.S. Army. And that one they're saying is using a spike ferritin nanoparticle COVID-19 vaccine. Can you explain for us what that is?
Hewlett: Unfortunately, I don't know a lot about this. I do know that the principle is one that has also been applied to the influenza vaccines. That is, if you can develop a vaccine that is going to offer universal protection against a whole array of coronaviruses, that of course is going to be much better in the long run than the vaccines that we have now that seem to have maybe a narrower range of protection.
And I think what they're talking about here is this umbrella, if you will, would allow for coverage of a broader range. And they can do this, if they can recognize a portion of the virus that is consistent across the entire range of coronaviruses and direct a response against that one particular portion of the virus, which might be in addition to, of course, the spike protein, which has been the focus up until now.
Marshall: I mean, that sounds like a really cool option, but for the flu, are we getting one that targets 24 or 20, however many different units ...?
Hewlett: I think that they have been working on that for many years. The flu virus has two major targets, the hemagglutinin and the neuraminidase, and those are targets for the currently used flu vaccines. And there's a lot of interest in trying to develop flu vaccines, influenza vaccines, which will be directed at some of the other proteins, which are more consistent, which don't seem to change from year to year.
Marshall: Okay, so, the goal then here would really be to prevent any other variants from being able to infect with this singular vaccine. That sounds pretty great.
Hewlett: Yes. If that can be accomplished. And I have confidence in our colleagues who are working in the laboratories. The technology is improving every single day. They are able to come up with novel ways of developing new vaccine products. And so I'm confident that they will come up with something very soon.
Marshall: How long do you think we're going to have to wait, though, for that to really come out of phase II, phase III and be distributed for something like that?
Hewlett: That's a good question. I think that if we look at our previous experience with the mRNA vaccines, where they were able to come up with a viable vaccine within a period of about a year, of course, that was based upon some of the previous work that was done. Who knows, maybe within another year or so there might be something that will be available. It's really pure conjecture on my part. But it's certainly possible.
Marshall: But a little hope/light at the end of the tunnel.
Hewlett: Yes, for sure.
Marshall: Now there's another type of vaccine that are being worked on, and those are non-injectable vaccines. So, can you tell us how those work? Those are inhalers. We've heard about this inhaler use for things like the flu in the past. And is that a legitimate option here for COVID?
Hewlett: Well, yes, they are. Again, not being a basic scientist it's difficult for me to go through all of the details, but I think that whether you are injecting a vaccine or if you are inhaling the vaccine, if you can basically expose the body's immune system to a high enough volume of the antigens, as we call it, then the body is going to generate a response. And it will generate a response not only by producing what we call antibodies, but it will also generate a response through the memory cells or the T-lymphocytes as we like to call them. And I think that these types of vaccines are not totally new. There are other types of vaccines that have been administered via the inhaled route, so this certainly is exciting.
Marshall: So, explain for us, though, how that would work. So, a vaccine, it gets into your arm, it goes into your immune system via the bloodstream. But when you inhale it, it goes into your lungs. So how has that response different?
Hewlett: It does, but it also is going to be absorbed through the small blood vessels that are present. And the same is true when you receive an intramuscular injection. And it then is going to cause a response as far as your immune system is concerned, so it really doesn't matter the route by which the vaccine enters the body.
The thing that is important is whether there's enough stimulation of the immune system. So, there are vaccines which are administered orally, that you take by mouth, and, so, it certainly is plausible. And it makes sense since this particular infection, we primarily acquire it through the respiratory route, it is logical that you could use a vaccine that was administered via the same route.
Marshall: But one wouldn't be necessarily better than the other?
Hewlett: No, it wouldn't be. However, I think that as time goes on they will have to look at the profile in terms of how effective the vaccines are when they're administered via this route. And also, the safety and the tolerability, there are many people who do not tolerate taking things via inhalation. Individuals who have respiratory disorders might not tolerate this route as well.
Marshall: I mean, this all sounds really promising, a promising future for COVID as we deal with this continued outbreak. And, in principle, it seems like it would be fantastic, but access is still going to be an issue. I mean, initially it was with the vaccines, now it's with tests, and we're learning about new types of tests, molecular analyses that can be used at home as well. Is that a way to really then kind of get ahead of this, as we continue to ramp up those vaccine technologies?
Hewlett: Well, yes. And I think that we have to look back on some of the errors that were made in the past. Many years ago there was, I think, a withdrawal of support for our response to things like pandemics and natural disasters. And this was recognized by many of the experts in the field.
And even during recent years, the public health infrastructure has been pretty much dismantled and we've had dismantling of some of the areas like our National Institutes of Health. There were draconian cuts to the Centers for Disease Control. And, unfortunately, as these cuts were starting to take effect, we were faced with the pandemic.
And so we were ill-prepared to deal with this pandemic. And I think now there has been an awakening and I think that now the support to some of these infrastructure areas is being renewed. And hopefully as we move forward, we will be in a better position. But things like home tests are certainly going to be very, very helpful in terms of improving access, and, of course, the technology for the tests. So, I think that these are certainly steps in the right direction that the administration is taking in terms of dealing with this testing issue.
Marshall: Is the problem or is the solution, I guess, going to be these new kinds of vaccines and figuring out how to boost and have that protection last? Or is it going to be that with a variant like Omicron, everyone will slowly get infected? And then it turns into more of a flu-like illness and we use testing to return to normal?
Hewlett: Well, that's a difficult question. I think that all of us are hoping that maybe -- and we have to keep in mind that coronaviruses have been around for a long, long time. They've been known as pathogens in animals since the 1930s. And they were identified as pathogens in humans in the late 1960s. And we know that the coronaviruses are responsible for about 30% of the common colds in certain parts of the world -- and so it is hopeful that as a result of many of the measures that are being taken, that it may return to that status.
Before we had SARS 1 and then MERS, the coronaviruses were felt to be rather benign. And so what happened to us in 2020 was totally unexpected, but possibly with a lot of the measures that have been taken already, combined with testing, we will be able to achieve normalization or at least a level of control.
But it may well be that in the future, we may have to include vaccinations for coronaviruses along with vaccinations for influenza, that's certainly a possibility on the horizon.
Marshall: And that's another vaccine that's being worked on, combining the two?
Hewlett: Yes. If you could combine them, that would really be a very good thing for people, so that when they got their flu vaccines every year, they could also get protection against coronaviruses.
Marshall: In the short term, though, just two arms, right? Roll up both sleeves.
Hewlett: That's pretty much where we are right now. We have to emphasize to everyone that the COVID-19 vaccines and boosters do not protect you against influenza. And the influenza vaccine does not protect you against COVID-19.
Marshall: Okay, well, I guess it sounds like COVID is here to stay for at least the long term and vaccines do remain our best weapon against them. But is the idea now that we reframe the goal to COVID testing and care?
Hewlett: Well, I guess we're going to have to ... there's no one solution. I think we can't get rid of testing just because we have vaccines. And just because we have testing, we can't stop vaccinating and encouraging everyone to be vaccinated and to have boosters. I think we have to have a multifaceted approach.
And I think while we're in this outbreak of the Omicron variant, we also have to emphasize the other things that we know are helpful in preventing infection, like masking and distancing, and also, unfortunately, avoiding large indoor gatherings, until this is under better control.
The resurgence of Covid-19 is again leading health care systems across the globe to brace themselves. And with deep scars from early in the pandemic, leaders are again calling on people to get vaccinated. One prominent reason they cite for vaccination is to protect hospitals and health care workers.
In the U.S., this message is not working.
In his recent speech to the nation, President Biden pleaded, Let me say again and again and again: Please get vaccinated. Its the only responsible thing to do. Those who are not vaccinated are causing hospitals to become overrun again. A day earlier, Dr. Anthony Fauci described a very strong urge to get people vaccinated because, There will be a big stress on the hospital and health care system. In Cleveland, six medical systems took out a striking full-page newspaper ad to beg Help.
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These messages are collectivist in principle, but also appeal to self-interest. Protecting your own hospital and its workers means they will be available to serve you if you get Covid-19. While such a message seems to fall on deaf ears in the U.S., it appears to resonate elsewhere.
In the U.K., for example, which began seeing the effects of Omicron ahead of the U.S., officials from Englands prime minister to managers of top soccer clubs have called on the public to protect the NHS. The NHS, or National Health Service, is the U.Ks taxpayer-funded, government-run health system. Although it is impossible to attribute success to a single message, England has been vaccinating people at a rate three to four times greater than the U.S since mid-December.
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The British public loves the NHS. People who use it pay little or nothing at the point of care, and it is among the highest performing health care systems in the world. In fact, more than half the population identified the NHS as the thing that makes them most proud to be British above the armed services, the royal family, and the BBC. It is held in such high esteem culturally that it was featured in the opening ceremony of the 2012 Summer Olympics in London.
Most of the criticism the NHS faces is about underfunding. More than three-quarters of the public wants funding for the NHS protected above all other government activities. During Covid-19, this concern heightened into public worry about whether services would be available. U.K. residents know that Covid-19 can overwhelm the system they rely on and want protected.
That loyalty is what makes a message like protect the NHS ring true. The system is nearly universally seen as a public good, and in need of protecting. Most people in the U.K. understand that getting vaccinated benefits the NHS precisely because the public has an equal stake in its success. An unvaccinated person who ends up in the hospital takes resources such as beds, doctors, and nurses away from others.
In the U.S., we like our doctors but are not loyal to the health care system. Many Americans valorize the doctors and nurses working on the frontlines of Covid-19, but you would be hard pressed to find someone who wants to protect the medical groups, HMOs, and other complex insurance convolutions undergirding our system. In fact, just 19% of the public believes the health care system works at least pretty well, less than in every other country studied.
That lack of loyalty to the system is reasonable. Many families, even those with health insurance, have been financially harmed by a system they pay increasingly unreasonable amounts to support. In 2019, about 20% of Americans with private insurance reported being contacted by a collection agency about a medical bill. And nearly 60% of all people in the U.S. who declare bankruptcy identify medical expenses as a contributor. This is unheard of in most other high-income countries.
It is also difficult for the public to justify protecting a health care system that has, in parts, profited from the pandemic. The five largest private health insurance plans in the nation made more than $11 billion in profits in early 2021, after record profits a year earlier. And some private, wealthy hospital systems reportedly made millions of dollars and a few made billions in the past two years. Some might reasonably ask, what exactly needs protecting?
Perhaps Americans trust in their own physicians will outweigh attitudes towards the larger health care system in making vaccine decisions. But without underlying fixes to the health care system that create a recognized, legitimate public good, broad vaccine messages about protecting our hospitals and health care system may continue to give Americans little reason to act.
Gregory Stevens is a professor of public health at California State University Los Angeles, co-editor of The Medical Care Blog, and co-author, with Leiyu Shi, of Vulnerable Populations in the United States (Wiley, 2021).
ROCKFORD It's been over a year since the coronavirus vaccines were made available, and within the ever-changing climate of the pandemic questions are inevitable.
In December 2020, the U.S. Food and Drug Administration issued an emergency use authorization for thePfizerandModernavaccines, likewise in February for the Johnson & Johnson version.
Since then local hospitals, pharmacies, community centers, and churches have played host to vaccination sites.
Despite recommendationsfrom local officials and health professionals,a large number of area residents have not gotten the vaccine.According to the Illinois Department of Public Health, about 52%or148,902 people in Winnebago County have been vaccinated as of Monday.
More: Some Black health care workers aim to lead by example as vaccine skepticism resurfaces
Here's whatDr. Kavitha Subramanian, infectious disease specialist for OSF HealthCare had to say about the vaccines.
What does the COVID-19 vaccine offer in terms of protection? Does it mitigate contracting the virus? Mitigate developing severe symptoms or prevent death?
Subramanian: COVID-19 vaccines protect everyone from the ages of five years and older from getting infected and becoming severely ill. Evidence shows that it significantly reduces the likelihood of hospitalization and death.
Getting vaccinated is the best way to slow the spread of COVID-19 and to prevent infection from delta and other variants. Avaccinated person can still contract the virus and when vaccine breakthrough infections happen they can still transmit the virus. So even if you are vaccinated, taking the extra steps including hand washing, social distancing, and wearing a mask in indoor public places will assist in controlling the transmission.
Does the COVID-19 vaccine offer any guarantees to those who take it?
Subramanian: I will not call it a guarantee, but there is enough research to back up the recommendation. The CDC, WHO, and other organizations continue to actively monitor vaccine safety and effectiveness against new and emerging variants for all FDA-authorized COVID -19 vaccines. So far the evidence shows that the vaccines offer protection against severe disease hospitalization and death against currently circulating variants in the United States.
How effective is the COVID-19 vaccine against the different types of variants?
Subramanian: Scientists monitor all variants, some spread more easily and quickly than other variants.
The current variants of concern are omicron (B.1.1.529) and delta (B.1.617.2).Among these two, omicron may spread more easily than other variants including delta. Breakthrough infections in people who are vaccinated can happen, but we do know the booster dose offers increased protection against these variants, and the vaccine is still effective in preventing severe disease. Omicron data is still early but available information is encouraging enough to recommend that we continue getting the vaccine and the booster dose.
How long will booster shots be needed? Should people expect to need to get a shot routinely?
Subramanian: Data from clinical trials showed that a booster shot increased the immune response in trial participants. With an increased immune response we expect more protection against severe disease. ... Regarding future boosters, we need to continue to monitor how this particular virus evolves. If the disease continues in the community and causes severe disease then there is a possibility that we may need further boosters, but if the disease goes away we wont need boosters.
Are there things people can do in conjunction with the vaccine in order to build up their immune system?
Subramanian: Yes, since we are currently seeing a case spike and vaccine breakthrough infections, the general population needs to take all extra steps including hand washing, social distancing, and indoor masking. There is also a correlation between severe disease and underlying chronic respiratory conditions so this would be a good time to quit smoking, vapingand other habits that lead to lung disease.
Take all the prescribed medications for your chronic conditions including asthma, hypertension, and cardiac conditions as per your doctor's instructions so that you can stay healthy at a baseline. If you have family members who have low immunity due to chronic conditions, make sure you are vaccinated and boosted so that you dont transmit the disease to them, because immunosuppressed individuals can get a severe disease even if they have received the vaccine.
Other tips include: get your seasonal flu vaccine, eat healthily,and include vitamin C-rich foods like fruits and fresh vegetables in your diet. If you develop any upper respiratory symptoms you should quarantine and get tested. If the test is positive then reach out to your doctor regarding available early interventions including monoclonal antibodies.
Shaquil Manigault: smanigault@gannett.com; @RRstarShaquil
Contributed| District Health Department Four
District Health Department Four is offering a number of COVID-19 testing and vaccination sites in multiple places over its four county service area during the month of January, in cooperation with Honu Management Group.
The health department provides services to people who live and work in Cheboygan, Alpena, Montmorency and Presque Isle Counties. Anyone who has any questions regarding the COVID-19 testing results from these events can call Honu Management Group at 866-809-8282, or email covid19help@honumg.com.
There will be several events in Alpena and Montmorency counties where people will be able to receive their COVID-19 vaccine or booster shots.
In Alpena at the Alpena County Fairgrounds on Tuesdays throughout the month of January, there will be vaccine and booster shots available from 10 a.m. until 3 p.m. In Lewiston at the St. Francis of Assisi Church vaccines will be available 1-7 p.m. Jan. 10 and 24.
All three brands of the COVID-19 vaccine will be available: Pfizer, Moderna and Johnson and Johnson.
No preregistration is required. There will not be any pediatric vaccines or boosters given for children who 5-11 years old.
Appointments may be scheduled, if a patient prefers, by calling 800-221-0294.
Visit dhd4.org/covid19 for other testing and vaccination providers.
Four locations around the health department's service area will also offer rapid antigen testing which returns results in 15 minutes and PCR testing, which returns results in two to three days.
From 10 a.m until 3 p.m. Saturday, Jan. 8, Thunder Bay Junior High in Alpena will be offering these tests. It is hoped these tests will be offered each week throughout January, but at this time, the health department has only confirmed the one day.
From 10 a.m. until 3 p.m. on every Tuesday throughout the month, the Alpena County Fairgrounds will also be offering testing. The Cheboygan Knights of Columbus Hall will offer these tests from 10 a.m. until 3 p.m. each Thursday throughout the month.
St. Francis of Assisi Church in Lewiston will be offering the testing events 1-7 p.m. Mondays in January, on Jan. 10 and 24.
Individuals who have been infected with coronavirus are still recommended to get vaccinated -- including booster doses -- as a means to reduce risk of reinfection, according to local and federal health officials.
But how long should they wait after infection? Doctors say it varies based on severity of infection and if you received antibody treatment.
For individuals who dont require hospital care for their COVID-19 illness, the recommendation is to be vaccinated as soon as youre symptom free and beyond your 10-day quarantine window. The main reason to delay is to avoid infecting others at the vaccination site.
Patients who need hospital care for COVID-19 should wait 10 days after they are released from the hospital, according to Dr. Asha Shajahan, medical director of community health for Beaumont Hospital in Grosse Pointe. Additionally, those who needed to be intubated in the ICU should wait 20 days after they leave the hospital.
If an individuals received monoclonal antibodies or convalescent plasma as a means to treat COVID-19, they should delay receiving a COVID vaccine for 90 days, according to the CDC.
The reason for that is that your immune system is not functioning at its highest capacity and we want you to get vaccinated when your immune system is working the best because then you will provide yourself with the best protection, Shajahan said.
Linda Vail, health officer for Ingham County, said monoclonal antibodies already provide some protection against coronavirus, delaying the need for immediate vaccination as an avenue for protection.
For everyone else?
You can get vaccinated as soon as youve recovered, Vail said. If youre well and out of isolation, you can get vaccinated.
As of Dec. 30, nearly 6.34 million Michiganders had gotten at least one dose of COVID-19 vaccine, or about 63.5% of residents 5 years and older. About 5.3 million had been fully vaccinated, and about 2.2 million received a booster/third dose.
The CDC acknowledges that it doesnt have enough data to know the optimal timing to receive a vaccine after infection. However, it notes protection from a COVID-19 vaccine is more reliable, consistent and predictable than protection from previous infection, which can vary by age and severity of illness. There is also evidence that vaccination reduces risk of reinfection.
To find a vaccine near you, eligible residents can visit Michigans COVID-19 vaccine website or go to VaccineFinder.org. Shots are available through health systems, pharmacies, health departments, physicians offices and other enrolled providers.
If you have any COVID-19 questions that youd like answered, please submit them to covidquestions@mlive.com to be considered for future MLive reporting.
Read more on MLive:
Omicron variant of coronavirus now in 18 Michigan counties, latest data shows
Michigan COVID-19 cases skyrocket, hitting record seven-day average of 12,442
One year later: COVID vaccines brought relief, protection to Michiganders in 2021
Why vaccinating your child for COVID is erring on the side of caution
Demand for monoclonal antibodies to treat COVID-19 is high, supply is low and omicron is coming
