As the Cheshire County Department of Corrections adapted to the COVID-19 pandemic over the past two years, the county jail avoided large outbreaks, with only a single inmate hospitalized for the disease, according to the departments superintendent, Douglas Iosue.
Despite the widespread disruption the virus wrought throughout the Monadnock Region and beyond, the local criminal justice system from the courts to the jail has continued to operate mostly unimpeded through much of the pandemic, court and corrections officials said. Thats due in large part to changes in the systems protocols ranging from the lasting, like videoconferencing to help facilitate many court proceedings, to the short-term changes to jail operations designed to protect inmates and staff.
Even as the virus surged through New Hampshire and the country, COVID-19 only reached the general jail population twice in the past two years, according to Iosue, who became the jails superintendent in May 2020, after more than a decade as a case worker there.
He chalks that up to good planning and protocols that were founded in science and medical advice and luck.
The plan the jail has in place today has been refined and updated several times over the past two years, as the scientific understanding of the disease and how it is transmitted changed, Iosue said. The superintendent said he crafted pandemic protocols based on the federal Centers for Disease Control and Prevention and state guidance, as well as with input from the jails consulting medical director, Dr. Andrew Tremblay, and physician assistant, David Segal.
I do think weve done a very good job with this pandemic plan, Iosue said. You might call it best practice for how to manage COVID in a correctional facility.
But as has been proven time and time again the virus is unpredictable and no plan is a guarantee, Iosue said.
It was outright luck because even with the best plan I could never guarantee we could keep COVID out, he said. Its about reducing risk.
The jails pandemic plan is broken into three stages: preventative measures, outbreak-quarantine and extensive outbreak. Reducing risk happens in that first stage, as inmates are booked and admitted into the facility, Iosue said.
The latter two stages are only implemented when the virus moves past newly admitted inmates and into the general jail population, he said, noting the jail has only had to activate the Stage 2 protocols twice. First in September 2021, when 12 inmates and one staff member were infected. Then again in January and February, when 16 inmates six men and 10 women tested positive, the superintendent said.
Stage 3 protocols have never been activated at the Cheshire County Department of Corrections, according to Iosue.
Preventative measures start with R&D, or reception and diagnostics, the phase when inmates first arrive at the jail, Iosue said. That phase has always included a health assessment but with the pandemic it was extended, he said.
The jail population is transitory, with inmates continuously being booked and released. County jails house pretrial inmates and those serving short sentences, while state prisons house those who have been sentenced to significant time behind bars. In 2020, there were a total of 923 bookings at the jail, with the incarcerated population averaging about 100 people at any given time, according to Iosue. The population remained at about the same level in 2021, during which there was a total of 930 bookings, he said.
People coming into the jail from the community including new inmates, staff, attorneys and volunteers where COVID-19 is spreading present the most risk to the incarcerated population at the jail, the superintendent said.
Inmates coming in, we realized early on, are potentially a risk coming in from the community, Iosue said. Once they start to interact with the general [jail] population, thats where the risk increases to the rest [of the inmates] and staff.
The Cheshire County jail
The Cheshire County jail, shown Tuesday morning, on Marlboro Street in Keene.
The Cheshire County jail
One of two video court-hearing rooms, in the booking department at the Cheshire County jail in Keene, as seen Tuesday morning. The jail had one video court-hearing room prior to the pandemic and now has two, due both to COVID-19 and an increased number of federal inmates, according to Superintendent Doug Iosue.
The Cheshire County jail
An arraignment, taking place via video call, as seen in the booking department at the Cheshire County jail in Keene on Tuesday morning.
The Cheshire County jail
A video call station in F Block, for incarcerated females, as seen at the Cheshire County jail in Keene on Tuesday morning.
The Cheshire County jail
F Block at the Cheshire County jail in Keene. Cells F101-F106 are used to house and quarantine newly incarcerated females. This practice was in place prior to the COVID-19 pandemic, but the quarantine length was adjusted. Before, quarantine could last between three and seven days, on the longer end if detox was required. At the peak of the pandemic, quarantine could last up to 14 days, but is currently at 10.
The Cheshire County jail
A cart for hosting Zoom calls, as seen at the Cheshire County jail in Keene on Tuesday morning.
The Cheshire County jail
A cell in R Block a wing designated in the Cheshire County jail's COVID-19 guidelines for single occupancy as seen Tuesday morning. This block of single-occupancy male cells is used mostly for reception and diagnostics in the intake process.
The Cheshire County jail
Doug Iosue, superintendent of the Cheshire County jail in Keene, exits the R housing block there on Tuesday morning. This block is designated for single-cell occupancy under the jail's COVID-19 guidelines.
The Cheshire County jail
The Cheshire County jail on Marlboro Street in Keene.
The Cheshire County jail
The Cheshire County jail, shown Tuesday morning, on Marlboro Street in Keene.
The Cheshire County jail
One of two video court-hearing rooms, in the booking department at the Cheshire County jail in Keene, as seen Tuesday morning. The jail had one video court-hearing room prior to the pandemic and now has two, due both to COVID-19 and an increased number of federal inmates, according to Superintendent Doug Iosue.
The Cheshire County jail
An arraignment, taking place via video call, as seen in the booking department at the Cheshire County jail in Keene on Tuesday morning.
The Cheshire County jail
A video call station in F Block, for incarcerated females, as seen at the Cheshire County jail in Keene on Tuesday morning.
The Cheshire County jail
F Block at the Cheshire County jail in Keene. Cells F101-F106 are used to house and quarantine newly incarcerated females. This practice was in place prior to the COVID-19 pandemic, but the quarantine length was adjusted. Before, quarantine could last between three and seven days, on the longer end if detox was required. At the peak of the pandemic, quarantine could last up to 14 days, but is currently at 10.
The Cheshire County jail
A cart for hosting Zoom calls, as seen at the Cheshire County jail in Keene on Tuesday morning.
The Cheshire County jail
A cell in R Block a wing designated in the Cheshire County jail's COVID-19 guidelines for single occupancy as seen Tuesday morning. This block of single-occupancy male cells is used mostly for reception and diagnostics in the intake process.
The Cheshire County jail
Doug Iosue, superintendent of the Cheshire County jail in Keene, exits the R housing block there on Tuesday morning. This block is designated for single-cell occupancy under the jail's COVID-19 guidelines.
The Cheshire County jail
The Cheshire County jail on Marlboro Street in Keene.
New inmates are screened with a rapid COVID-19 test as part of the initial booking process, according to the jails protocols. Inmates who test positive are placed in holding cells until the medical team clears them. All inmates who do not test positive are moved to one of two blocks designated as single cell occupancy for a minimum quarantine period of 10 days, until they can safely be moved to the general population, the protocols state.
Basically, it is a lot of time spent alone in a cell with only an hour out a day, Iosue said.
Meanwhile, staff, attorneys and visitors entering the jail go through a screening process that includes questions about potential exposure or symptoms. Staff also must undergo temperature checks, he said.
Masking guidance for those visiting the jail has changed periodically throughout the pandemic, Iosue said. At present, people visiting the wings where new inmates are quarantining must wear a mask, while staff in the rest of the facility who are up to date on their vaccinations are not required to wear a mask, he said.
The jail began vaccinating inmates in April 2021. Upon booking, inmates are notified that the jails policy is to vaccinate unless they specifically opt out, according to the pandemic protocols. Inmates who are vaccinated receive $25 on their account as an incentive. About 40 to 50 percent of inmates at the facility are vaccinated, Iosue said. The jail cannot mandate vaccines, he added.
Early in the pandemic, the American Civil Liberties Union and other organizations expressed concern that people who were locked up were going to be super vulnerable to the spread of COVID-19, Iosue said.
At the time, if you remember, there was a lot of unknown, a lot of uncertainty, a lot of paranoia and fear, to some extent, as well, he said.
With incarcerated people forced into a group setting, many had concerns about whether there would be a mass outbreak and certainly, at many correctional facilities across the country there were, the superintendent said. This concern prompted some low-risk inmates about five or six people to be released from jail early or on GPS monitoring during 2020, he said.
But the Cheshire County Department of Corrections did not encounter its first outbreak until fall 2021, Iosue said. The outbreak in September prompted the facility to activate its Stage 2 protocol for the first time, he said.
During that September outbreak and the subsequent wave in January and February, the virus reached the general jail population, prompting all inmates to be tested and those who tested positive to be moved to temporary quarantine units, the superintendent said.
Those outbreaks mirrored the peaks nationally and in the state and in Cheshire County with COVID cases, Iosue said. Whether it came in from an inmate or staff and what the route of transmission was for the outbreaks, its impossible to say for sure.
Through the outbreaks, staff repeated the testing process until there was no more evidence of COVID-19 in the general inmate population, he said.
At times through the pandemic, staffing at the jail has been strained because of personnel who tested positive or had to quarantine due to close contact with someone who had COVID-19, Iosue said. Quarantine guidelines meant staff could be out of work for days at a time, he said.
There was more mandated overtime to cover openings when COVID was going on, the superintendent said. Because it was not just being out sick a day or two. You had to stay out a minimum of the most recent guidance is five full days after testing positive.
The jail was lucky that only one inmate ever required brief hospitalization due to COVID-19, Iosue said. Depending on the security risk posed by an inmate who has to be hospitalized, one or two staff members are required to monitor them at all times while they are out of the jail, he said, raising concern that this could have strained staff.
It was certainly a concern in the back of my mind: What would we do if we had people who were hospitalized for weeks and months due to COVID? the superintendent asked. What if we were to need to have not only one inmate needing that level of care and staffing? The most negative impact of COVID could have come with that.
Courts, transports and visitation
As the jail quickly adopted new health protocols throughout the pandemic, the courts system also altered operations to make proceedings more COVID-friendly.
At the start of the pandemic in spring 2020, the jail population dipped from about 100 inmates to between 70 and 80, according to Iosue. This was in large part due to the lockdowns that were in place and the population soon rebounded back to about 100 inmates, he said.
When the court system was really shut down, our census went down to the low 70s, the superintendent said. Which is the lowest its been in many, many years. It was clearly related to COVID.
Though court hearings slowed during the beginning of the pandemic, by August 2020, Cheshire County had become one of the first courthouses in the state to resume jury trials, according to Tina Nadeau, the chief justice of the N.H. Superior Court. The pandemic has not caused any lasting backlog at the court, she said.
Throughout the entire pandemic, the New Hampshire Judicial Branch remained open to the citizens of New Hampshire, Nadeau said in an email response to questions from The Sentinel. This was only possible because of the dedication of our court staff and the safety measures the Judicial Branch implemented and amended depending on the stage of the pandemic.
By the end of March 2020, the judicial branch had implemented initiatives to allow court proceedings to continue through the use of WebEx, a video conferencing platform, the chief justice said.
Iosue described the use of WebEx as one of the most important changes prompted by the pandemic.
[The courts] have significantly increased the use of video and a lot of that has continued even during periods of lower COVID-risk and transmission, he said. For the most part it has proved to be efficient without too many drawbacks.
While more significant court hearings require defendants and attorneys to be physically present in the court, this change with technology will never revert to pre-COVID completely, Iosue said.
Prior to the pandemic, use of WebEx was used sparingly, mostly for arraignments, at courts with the proper technology, Nadeau said.
Since the pandemic, the court has conducted listening sessions with members of the New Hampshire Bar Association, and learned that videoconferencing is beneficial in certain instances such as a negotiated plea and sentencing because of reduced travel times for attorneys and litigants, she said.
In other instances, where court proceedings are complex or contested, attorneys and litigants have found that resolving such cases in person is more appropriate, the chief justice said.
Sheriff Eli Rivera heads the Cheshire County Sheriffs Department, which is in charge of most of the regions inmate transports to and from the jail and court. Through the pandemic, the significant number of court hearings being held by video reduced the need to transport inmates, Rivera said.
COVID proved that it does work, that it can be done and a lot of cases were handled by video, he said. Now that restrictions have been lifted, were seeing courts go back to in-person and weve seen the increase in transports to in-person hearings again.
Through the heights of the pandemic, only one inmate would be transported per vehicle with staff and the inmate donning personal protective equipment, such as masks, for the duration, Rivera said. The sheriffs department has only recently returned to transporting multiple inmates at once, he said.
Even as the pandemic wore on many jail operations continued, including family and friend visitations and attorneys meeting with their clients, Iosue said.
Family and friend visitations had been done through on-site video conferencing even prior to the pandemic, with the visitor coming into the lobby and visiting their loved one at a booth with a small screen, the superintendent said. With the pandemic, more visitors used the option to video conference with inmates from home, he said.
As for lawyers visiting their incarcerated clients, that continued through the pandemic, Iosue said. When there were outbreaks in the jail, the courts were notified and some lawyers chose to use video conferencing options, he said.
Now two years into the pandemic, the jail has firm protocols in place but nonetheless remains vigilant, the department of corrections superintendent said.
I dont think any of us can be assured well be done with COVID, he said.
BATON ROUGE, La. (AP) Louisiana Gov. John Bel Edwards encouraged state residents to stay up to date on COVID-19 vaccinations and boosters as hurricane season approaches, saying at a Wednesday afternoon news conference that he was about to get his second booster his fourth COVID-19 shot overall.
Edwards said COVID-19 cases have been increasing but hospitalizations and deaths have remained low. He said two deaths were reported Wednesday.
Im still waiting for the very first day since March of 2020 that I get a report from the Department of Health telling me that weve had none, Edwards said.
The Centers for Disease Control says adults age 50 and older are eligible for second boosters.
For the third year in a row we are entering hurricane season while COVID-19 remains a real threat to individuals and to families especially in the event that we have to do congregate sheltering, Edwards said.
Edwards noted that five hurricanes made landfall in Louisiana over the last two seasons and encouraged residents to be ready with plans for evacuation or sheltering and stockpiling supplies.
Among other officials speaking at Wednesdays news conference was Fire Marshal Butch Browning. He stressed the importance of making sure generators are well maintained and that they are operated a safe distance from a building to guard against carbon monoxide poisoning, a cause of death after storms.
MILWAUKEE -- The Cincinnati Reds put slumping first baseman Joey Votto on the COVID-19 injured list Tuesday, making the move before a game against the Brewers.
Manager David Bell said Votto hasn't tested positive for the virus.
"We're precautionary as far as being able to put him on that COVID IL, which is really a day-to-day thing until we know more," Bell told Cincinnati reporters.
1 Related
Votto was in the original starting lineup to face the Brewers, but showed symptoms.
The six-time All-Star is hitting just .122 with no home runs and three RBIs, and had played in all 22 Cincinnati games this season. He has struck out 29 times in 74 at-bats.
Cincinnati is struggling with the worst record in the major leagues at 3-19. The Reds had lost six in a row and 17 of 18 going into the series opener against the Brewers.
The 38-year-old Votto tested positive for COVID-19 in March 2021.
On Monday, Votto linked to a blog post on Fangraphs.com that carried this headline: "Is This the End for Joey Votto?" On his Twitter account, he posted: "Five months to go. Enjoy the show."
He didn't offer any explanation for his tweet.
The Reds are scheduled to hold a Star Wars Joey Votto bobblehead giveaway at Great American Ball Park on Saturday night when they play Pittsburgh.
Plant husbandry has been crossing plants longer than there have been scientists. I'm not a fan of GMO anything, but hopefully it's better than thealternative.
Clinical trials of the vaccine started in Japan last autumn, so I'll be looking forward to reading more about this.
edit on400000099America/Chicago311 by nugget1 because: sp
Global Smallpox Vaccine Marketwas worth ofUSD 63.46 Million in 2020and it is expected to reachUSD 78.58 Million by the end of 2027with theCAGR of 3.1%during the Forecast Period.
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Smallpox is a very infectious disease which is caused by the 2-virus called variolae major and variolae minor. This variolae virus belongs to the orthopoxvirus genus. Symptoms of smallpox are skin rashes, fever, vomiting, and ulcers. Smallpox is spread between people and through contaminated objects. Contaminated clothing and beds linens can also spread smallpox. The disease mainly survives in dry and cool conditions, and it spreads even faster in winter and early springs.
This infectious disease is only prevented through smallpox vaccine. The various types of vaccines that are used for the treatment of smallpox are Dryvax, ACAM2000, Calf Lymph, and MVA- BN. The smallpox vaccine is made up of live vaccinia virus which is a pox type virus. Edward Jenner introduced the modern smallpox vaccine in 1796. In 1959 WHO, also stared a program to eradicate smallpox. The 33rd World Health Assembly declared the world is free of this smallpox disease on May 8, 1980.
COVID-19 pandemic has a negative impact on the global smallpox vaccine market. This is due to the rising demand of the coronavirus vaccine and most of the key players were focused on manufacturing the vaccine for pandemic, the less transport and no labors also created a gap between the supply chains. Furthermore, the vaccines were generated to control the corona virus all over the world. According to world o meter, the confirmed cases of corona virus are 267,435,552 in which almost 5,287,411 died by 8thDec2021.
Global smallpox vaccine market is segmented on the basis of vaccine type, end user, and region and country level. Based on the vaccine type the global smallpox vaccine market is classified into first generation, second generation, and third generation. Based on the end user the global smallpox vaccine market is classified into hospitals, clinics, and others.
The regions covered in this global smallpox vaccines market report are North America, Europe, Asia-Pacific and Rest of the World. On the basis of country level, the market is sub divided into U.S., Mexico, Canada, U.K., France, Germany, Italy, China, Japan, India, South East Asia, Middle East ,GCC, (UAE, Saudi Arabia, Kuwait) Africa, etc.
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Secretary of State Antony J. Blinken has tested positive for the coronavirus, the State Department announced on Wednesday, nearly a week before he was scheduled to travel to diplomatic meetings in Europe and Morocco.
A spokesman, Ned Price, said Mr. Blinken, 60, had mild symptoms, and had not seen President Biden in several days.
Mr. Blinken, who is fully vaccinated and boosted, will work at home and looks forward to returning to the department and resuming his full duties and travels as soon as possible, Mr. Price said in the statement.
Mr. Blinken joins a handful of other prominent figures who have tested positive after attending the White House Correspondents Dinner on April 30. Among them are Steve Herman of Voice of America and, according to a person familiar with the matter, Jonathan Karl of ABC News.
Many people wondered whether it was advisable to gather a crowd of 2,600 into the packed hotel ballroom of the Washington Hilton hotel. Proof of vaccination and a same-day negative test were required; boosters were strongly encouraged; and masks were optional.
A spokesperson for the union representing Washington Hilton workers, Unite Here Local 25, said members were not subject to the dinners vaccination or testing requirements but wore masks and were allowed to choose whether they wanted to work the event.
The union was so far unaware of any members testing positive after working the dinner, the spokesperson, Benjy Cannon, said on Wednesday.
President Biden also attended the dinner. At a White House news conference, the press secretary, Jen Psaki, said Mr. Biden had most recently tested negative for the virus on Tuesday.
Mr. Blinken was expected to travel to Marrakesh, Morocco, for a meeting on May 11 of the international campaign against the Islamic State. That was to be followed by a meeting of the Group of 7, the worlds wealthiest democracies, in Germany. It was not immediately clear Wednesday whether Mr. Blinken would be able to travel to either event.
He was also notifying officials with whom he came into close contact over the last several days, Mr. Price said. Mr. Blinken met with Foreign Ministers Ann Linde of Sweden on Wednesday and Marcelo Ebrard of Mexico on Tuesday, for example.
Mr. Blinken tested positive on a P.C.R. test after feeling symptomatic on Wednesday afternoon even though he had a negative result on an antigen test just hours earlier, Mr. Price said.
He has young kids in the house. As you know, he was around a number of people this weekend, Mr. Price told reporters at the State Department. So a matter of precaution, he does regularly test.
The State Department confirmed Mr. Blinken has received a second booster shot.
Last week, Vice President Kamala Harris tested positive for the virus, but returned to work on Tuesday after testing negative on Monday and following Centers for Disease Control and Prevention guidance on isolating. She attended a gala on Tuesday night for Emilys List, the fund-raising powerhouse that has helped elect hundreds of women who support abortion rights.
LONDON -- The World Health Organization estimates that nearly 15 million people were killed either by coronavirus or by its impact on overwhelmed health systems during the first two years of the pandemic, more than double the current official death toll of over 6 million.
Most of the deaths occurred in Southeast Asia, Europe and the Americas, according to a WHO report issued Thursday.
The U.N. health agencys director-general, Tedros Adhanom Ghebreyesus, described the calculated figure as sobering, saying it should prompt countries to invest more in their capacities to quell future health emergencies.
WHO tasked scientists with determining the actual number of COVID-19 deaths between January 2020 and the end of last year. They estimated that between 13.3 million and 16.6 million people died either due to the coronavirus directly or because of factors somehow attributed to the pandemics impact on health systems, such as cancer patients who were unable to seek treatment when hospitals were full of COVID patients.
Based on that range, the scientists came up with an approximated total of 14.9 million.
The estimate was based on country-reported data and statistical modeling, but only about half of countries provided information. WHO said it wasn't yet able to break down the data to distinguish between direct deaths from COVID-19 and those related to effects of the pandemic, but the agency plans a future project examining death certificates.
This may seem like just a bean-counting exercise, but having these WHO numbers is so critical to understanding how we should combat future pandemics and continue to respond to this one, said Dr. Albert Ko, an infectious diseases specialist at the Yale School of Public Health who was not linked to the WHO research.
For example, Ko said, South Koreas decision to invest heavily in public health after it suffered a severe outbreak of MERS allowed it to escape COVID-19 with a per-capita death rate around a 20th of the one in the United States.
Accurately counting COVID-19 deaths has been problematic throughout the pandemic, as reports of confirmed cases represent only a fraction of the devastation wrought by the virus, largely because of limited testing. Government figures reported to WHO and a separate tally kept by Johns Hopkins University show more than 6.2 million reported virus deaths to date.
Scientists at the Institute of Health Metrics and Evaluation at the University of Washington calculated for a recent study published in the journal Lancet that there more than 18 million COVID deaths from January 2020 to December 2021.
A team led by Canadian researchers estimated there were more than 3 million uncounted coronavirus deaths in India alone. WHO's new analysis estimated that missed deaths in India ranged between 3.3 million to 6.5 million.
In a statement following the release of WHO's data, India disputed the U.N. agency's methodology. India's Health and Family Welfare Ministry called the analysis and data collection methods questionable and complained that the new death estimates were released without adequately addressing India's concerns.
Samira Asma, a senior WHO director, acknowledged that numbers are sometimes controversial and that all estimates are only an approximation of the virus' catastrophic effects.
It has become very obvious during the entire course of the pandemic, there have been data that is missing," Asma told reporters during a press briefing on Thursday. "Basically, all of us were caught unprepared.
Ko said the new figures from WHO might also explain some lingering mysteries about the pandemic, like why Africa appears to have been one of the least affected by the virus, despite its low vaccination rates.
Were the mortality rates so low because we couldnt count the deaths, or was there some other factor to explain that? he asked, citing the far higher mortality rates in the U.S. and Europe.
Dr. Bharat Pankhania, a public health specialist at Britains University of Exeter, said the world may never get close to measuring the true toll of COVID-19, particularly in poor countries.
When you have a massive outbreak where people are dying in the streets because of a lack of oxygen, bodies were abandoned or people had to be cremated quickly because of cultural beliefs, we end up never knowing just how many people died, he explained.
Pankhania said that while the estimated COVID-19 death toll still pales in comparison to the 1918 Spanish flu pandemic, which experts estimate caused up to 100 million deaths, the fact that so many people died despite the advances of modern medicine, including vaccines, is shameful.
He also warned that the cost of COVID-19 could be far more damaging in the long term, given the increasing burden of caring for people with long COVID.
With the Spanish flu, there was the flu and then there were some (lung) illnesses people suffered, but that was it, he said. There was not an enduring immunological condition that were seeing right now with COVID."
We do not know the extent to which people with long COVID will have their lives cut short and if they will have repeated infections that will cause them even more problems, Pankhania said.
Krutika Pathi and Ashok Sharma in New Delhi contributed to this report.
Follow APs coverage of the pandemic at https://apnews.com/hub/coronavirus-pandemic
Getting sick with a common cold doesn't make you immune to COVID-19, but a COVID-19 infection might, at least temporarily, boost the number of antibodies you have against common cold-causing coronaviruses and the SARS-CoV-1 and MERS-CoV viruses, all of which are closely related. Scientists at Scripps Research have now characterized coronavirus antibodies isolated from 11 people to reveal how COVID-19 impacts the immune system's ability to recognize other coronaviruses.
"Getting a better understanding of how immunity against this broad family of coronaviruses changes with COVID-19 infection is an important step toward developing better coronavirus vaccines, both for COVID-19 and for future, related pathogens," says Andrew Ward, PhD, professor of Integrative Structural and Computational Biology at Scripps Research and senior author of the new paper, published online this week in Science Advances.
The SARS-CoV-2 virus that causes COVID-19 is just one in a large and diverse family of coronaviruses. A few of its relatives are equally contagious and virulent -; causing Middle East respiratory syndrome (MERS) and the 2002-2004 SARS outbreak -; while others, considered common cold viruses, cause much milder symptoms. Overall, many of these coronaviruses have only one quarter to one half of their genetic material in common with SARS-CoV-2, but individual sections of the viruses' structures-;most notably the spike protein that juts out of each coronavirus-;are considered relatively similar between family members.
Since the outset of the COVID-19 pandemic, scientists have wondered whether people's previous exposure to those common cold viruses impacts their immunity to SARS-CoV-2 and, likewise, whether infection with COVID-19 might change how the immune system recognizes the more common coronaviruses. The immune system's antibodies against one coronavirus spike protein could, potentially, also recognize other similar spike proteins as disease-causing.
In the new study, Ward's group studied serum samples from eleven people. Eight of the samples dated to before the COVID-19 pandemic to ensure the donors had never been exposed to the SARS-CoV-2 virus, while three samples were from donors who recently had COVID-19. In each case, the researchers measured how strongly the samples reacted to isolated spike proteins from different coronaviruses-; OC43 and HKU1, both associated with common colds, along with SARS-CoV-1, MERS-CoV and SARS-CoV-2.
Not surprisingly, only the serum from recovered COVID-19 patients reacted to the SARS-CoV-2 spike proteins. However, these COVID-19 patient samples also reacted more strongly than the pre-pandemic samples to the other spike proteins as well.
Most people have this baseline immunity to common coronaviruses and exposure to SARS-CoV-2 increases the levels of these antibodies."
Sandhya Bangaru, first author of the new paper, Scripps Research postdoctoral research associate
Ward, Bangaru and their colleagues performed high-resolution structural studies on serum antibodies from three of the healthy donors and the two COVID-19 patients to determine where on the spike proteins each antibody attached. They found that most coronavirus antibodies from before the pandemic recognized a section of the OC43 and HKU1 spike proteins known as the S1 subunit, which tends to vary greatly between coronaviruses. In COVID-19 patient samples, however, the researchers identified a broader swatch of antibodies, including ones that recognized the S2 subunit-;which varies less between different coronaviruses. Indeed, some antibodies from the COVID-19 patients not only bound to the common cold coronaviruses, but to SARS-CoV- and MERS-CoV spike proteins as well.
"The end goal of this would be to rationally design vaccines that can recognize many different coronaviruses," says Bangaru. "Our results reveal certain conserved patches on the S2 subunit targeted by antibodies naturally induced during infection, which we want to focus on."
Since these studies were done directly on serum antibodies, the researchers don't know whether the presence of these antibodies, in any of the cases, is enough to provide full immunity to coronaviruses in the more complex setting of the human immune system. The increased ability of convalescent sera to react to common coronaviruses appears to be the result of both increased production of new antibodies that can recognize several coronaviruses and also an increase in levels of pre-existing antibodies that are specific to each virus. However, it is not clear how much each of these phenomena contribute to the overall increase and how they would influence the natural course of COVID. In the future, they'd like to compare antibodies from the same individuals pre- and post-infection with COVID-19.
"Our work provides a baseline characterization of people's antibody responses to endemic coronavirus prior to SARS-CoV-2 exposure but there are a lot of open questions," says Bangaru. "We hope this leads to a lot more research."
Source:
Journal reference:
Bangaru, S., et al. (2022) Structural mapping of antibody landscapes to human betacoronavirus spike proteins. Science Advances. doi.org/10.1126/sciadv.abn2911.
A mask lies on the ground at John F. Kennedy International Airport in New York City on April 19. Spencer Platt/Getty Images hide caption
A mask lies on the ground at John F. Kennedy International Airport in New York City on April 19.
If it feels like everyone you know has COVID-19 right now, you're not alone. In many parts of the U.S., case numbers are going up, and much of that increase is being driven by subvariants of the omicron variant of the coronavirus.
And this new wave of cases might be a glimpse into what the endemic stage of COVID-19 will look like, according to Andy Slavitt, a former senior adviser to President Biden on COVID-19 and a former head of Medicare and Medicaid in the Obama administration.
The U.S. is not in an endemic phase just yet, Slavitt said, and the country likely won't know until after it's in it because, as he put it, "the best definition of endemic that I've heard is just when the surprises are gone and it becomes predictable."
"Endemic doesn't necessarily mean everybody's safe, and endemic doesn't necessarily mean people are no longer losing their lives. It just means it's following a predictable pattern. And what we don't know, but we may be witnessing, are some clues as to what a predictable pattern will look like when we settle into one."
Slavitt outlines the tools the U.S. has to handle COVID-19 going forward, the factors that could change his assessment and the shift vs. drift calculation.
This interview has been edited for length and clarity.
On the tools that the U.S. has that can help people live as normal a life as possible
The best news of all is that we have incredible scientific tools, vaccines, boosters, oral therapeutics. And while none of them are perfect, down the road when you combine them with what our own immune system does and the continued kind of improvement of these tools, the layered immunity we have, COVID should become less and less fatal.
It will still be dangerous and still dangerous for people who are frail, people who are immunocompromised. But even in those situations, the tools are better and better. So what we really want to know is, is it going to get any more severe? And is it going to get any more frequent? And are the vaccines and tools we have going to continue to work? And if we are in a situation where we need to update our vaccines once or twice a year, we need to be prepared to do that.
On the unknowns that could change his assessment of how close the U.S. is getting to an endemic phase of COVID-19
So scientists talk about this notion of drift versus shift, and what they mean by that is a drift virus would indicate that we will just continue to see more progressions, almost laddering up of new omicron, with 1.1, 1.2, 1.3, 1.4. And a drift is a better scenario than a shift. A shift is where we would get an entirely new Greek letter in this case, with completely different mutations and characteristics.
What's better about a drift is that our body is, generally speaking, forming better immunity in prior versions that protect us against newer versions. And our vaccines will, generally speaking, be more aligned to what we see next than they would be if we were to see a shift.
So the big question is, are we going to be in drift mode? And for how long will we be in drift mode? Or are we going to go back to shift mode where we'll see a delta and omicron, et cetera? No one knows the answer, but there are a number of scientists who say that the number of times we'll see a major shift could be pretty rare could be as infrequently as once a decade.
On whether reaching the endemic phase of COVID-19 will discourage other precautions, including masks and vaccines
Well, predictability will be a good thing. You know, if we knew that we were going to see COVID-19 every June and every December, we might not like that, but at least it would tell us that we can take the kinds of precautions that we need to take then, and we don't need to take them in other parts of the year. What bothers people is feeling like they're taking precautions in periods of time when it doesn't matter. So, you know, we don't give people flu shots in April, May and June because the risk of the flu is quite low then.
So if we understand this well enough and it becomes predictable enough, I think you can then create targeted campaigns to say, "Hey, every time that this happens, these are the precautions we have to take. We have to wear masks. We have to stay away from these types of crowds and these types of situations if we're immunocompromised. But other times of the year, go on, live your life, things will be more or less safer."
