New Jersey on Monday reported four confirmed COVID-19 deaths and 1,012 confirmed positive tests as the seven-day average for cases continues to steadily rise after hitting recent lows in March.
The states seven-day average for confirmed cases increased to 1,419 Monday, up 42% from a week ago and 83% from a month ago. The seven-day average had hit a recent low of 631 on March 17.
Mondays case total marks seven consecutive days of more than 1,000 new confirmed positive tests.
At his first public appearance last week since testing positive, Gov. Phil Murphy urged the public to continue to be smart and safe, and continue to use common sense and common courtesy.
There were 366 patients with confirmed or suspected coronavirus cases across 69 of the states 71 hospitals as of Sunday night. Two hospitals did not report data.
By comparison, hospitalizations hit a recent peak at 6,089 on Jan. 10 during the omicron wave that hit the state this winter.
There were at least 48 people discharged in that same 24-hour period ending Sunday night, according to state data. Of those hospitalized, 38 were in intensive care and 26 were on ventilators.
New Jerseys transmission rate increased to 1.23 on Monday from 1.19 Sunday. When the transmission rate is over 1, that means each new case is leading to at least 1 other new case and the outbreak is expanding.
The statewide daily positivity rate for tests conducted Wednesday, the most recent day available, was 5.3%.
The state on Monday also reported 205 probable cases from rapid antigen testing at medical sites. The daily case counts, however, come with the caveat that many people are now relying on free at-home COVID-19 tests, which are not reported to state health officials.
All of New Jerseys 21 counties were listed as having low rates of transmission, according to recently updated guidelines from the U.S. Centers for Disease Control and Prevention. Healthy people in the low and medium categories are no longer recommended to wear masks.
BA.2, the new strain of COVID-19, has been spreading in New Jersey for weeks, though at much lower rates than the omicron surge in December and January. Officials have said the omicron stealth subvariant appears to spread more easily but generally not cause more severe illness.
For the week ending March 26, BA.2 accounted for 81.2% of the positive tests sampled (up from 70.5% the previous week), while the omicron variant accounted for 18.8% of positive tests sampled.
New Jersey has reported 1,912,503 total confirmed cases out of more than 17.5 million PCR tests conducted in the more than two years since the state reported its first known case March 4, 2020.
The Garden State has also recorded 304,301 positive antigen or rapid tests, which are considered probable cases. And there are numerous cases that have likely never been counted, including at-home positive tests that are not included in the states numbers.
The state of 9.2 million residents has reported 33,308 COVID-19 deaths in that time 30,294 confirmed fatalities and 3,014 probable.
New Jersey has the seventh-most coronavirus deaths per capita in the U.S. behind Mississippi, Arizona, Oklahoma, Alabama, Tennessee and West Virginia as of the latest data reported Monday. Last summer, the state still had the most deaths per capita in the country.
More than 6.83 million of the 8.46 million eligible people who live, work or study in New Jersey have received the initial course of vaccinations and more than 7.76 million have received a first dose since vaccinations began here on Dec. 15, 2020.
While the number of N.J. residents fully vaccinated has reached over 6.8 million, the latest numbers also follow a major study that reveals even a mild case of COVID-19 can significantly affect the brain.
More than 3.38 million people in the state eligible for boosters have received one.
For the week ending March 27, with around 62% of schools reporting data, another 1,910 COVID-19 cases were reported among staff (547) and students (1,363) across New Jerseys schools.
Since the start of the academic year, there have been 106,425 students and 29,063 school staff members who have contracted COVID-19 in New Jersey, though the state has never had more than two-thirds of the school districts reporting data in any week.
The state provides total student and staff cases separately from those deemed to be in-school transmission, which is narrowly defined as three or more cases linked through contact tracing.
New Jersey has reported 557 total in-school outbreaks, including 3,941 cases among students and staff. That includes 21 new outbreaks from data reported last week.
At least 9,422 of the states COVID-19 deaths have been among residents and staff members at nursing homes and other long-term care facilities, according to state data.
There were active outbreaks at 134 facilities, resulting in 2,677 current cases among residents and 3,188 cases among staff as of the latest data.
As of Monday, there have been more than 498.1 million COVID-19 cases reported across the globe, according to Johns Hopkins University, with more than 6.17 million people having died due to the virus.
The U.S. has reported the most cases (more than 80 million) and deaths (at least 985,482) of any nation.
There have been more than 11 billion vaccine doses administered globally.
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Steven Rodas may be reached at srodas@njadvancemedia.com. Follow him @stevenrodasnj.
A recent study posted to the medRxiv* preprint server assessed the impact of face masks on coronavirus disease 2019 (COVID-19) incidence among children aged between 10 and 12 years.
During the period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant predominance in Finland, the use of face masks was recommended across the country in schools. However, there is insignificant data related to the impact of face masks in the prevention of COVID-19 transmission.
In the present study, the researchers compared the incidence of COVID-19 among children aged between 10 to 12 years, residing in different Finnish cities, with different recommendations regarding the usage of face masks in schools.
The team obtained the total number of COVID-19 cases from the National Infectious Disease Registry (NIDR) of the Finnish Institute for Health and Welfare. They also collected demographic information including the patients date of birth, sex, and residential area. The moving averages of 14-day case incidences were employed as a dependent variable. Furthermore, the team calculated the average percent changes (APC) occurring over one month.
The cities of Helsinki with a population of 6,61,887 and Turku with a population of 1,95,818 were compared for the present study since their baseline incidence of COVID-19 was comparable in August and September 2021. Helsinki had implemented face mask usage at schools while Turku had recommended face mask usage for individuals aged 10 years and above.
The team compared the 14-day incidences of COVID-19 among individuals aged seven to nine, 10 to 12, and 30 to 49 years.
The study results showed that there were no significant differences in APC values in August between Helinski and Turku. However, the APC value was higher in Turku in September and November while the APC value was higher in Helsinki in October.
Notably, the incidence of COVID-19 in children aged seven to nine years was similar to that in children aged 10 to 12 years, while no such similarity was observed for adults aged 30 to 49 years in the two cities.
Overall, the study findings showed that there were no substantial differences in the incidence of COVID-19 after wearing face masks in children aged between 10 to 12 years and residing in Helsinki and Turku.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
In a recent study posted to the medRxiv* preprint server, researchers reported that coronavirus disease 2019 (COVID-19) reinfections could occur within 60 days of the initial infection.
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants of concern (VOCs) have been detected in every country. The VOCs exhibit considerable antigen diversity relative to the ancestral SARS-CoV-2 strain.
The SARS-CoV-2 Omicron variant, which appeared in November 2021, has shown high antigenic drift and transmissibility, decreasing the antibody efficacy of sera from convalescent individuals and vaccinees. This waning of immunity has resulted in a significantly increased number of vaccine breakthrough infections and reinfections globally compared to previous COVID-19 waves.
The European Center for Disease Prevention and Control (ECDC) defines reinfections as two positive COVID-19 tests at least 60 days apart. However, many countries recommend against retesting within six months of an initial positive test. Therefore, there is a need to revise the guidelines and establish a consensus on retesting policies.
In the present study, researchers examined a COVID-19-positive patient, previously infected in December 2021 with SARS-CoV-2 Delta sub-lineage AY.43. One parent and a sibling of the patient were also infected. All three patients developed mild symptoms of COVID-19. The other parent was COVID-19-negative twice and received a booster vaccine onemonth ago.
The patient was admitted to a hospital two weeks later for surgery due to an unrelated condition. Systematic screening at the time of admission revealed a low SARS-CoV-2 viral load in the patient. This observation was interpreted as remnants from a previous infection (16 days ago). The patient tested positive during a preprocedural screening for readmission for the second-stage surgery. This time, i.e., 39 days post-Delta infection, the viral load was high, and the infection was due to the Omicron BA.1 variant. The patient was paucisymptomatic, and contact screening identified the patients sibling as positive with a low viral load. The boys mother tested negative, and the father was not (re)tested.
Next, early reinfections with SARS-CoV-2 Omicron BA.1 variant after Delta infection and Omicron BA.2 after BA.1 infection were estimated in Flemish Brabant, Belgium. About 56,831 SARS-CoV-2-positive cases were recorded between December 2021 and February 7, 2021, a period in which the Omicron BA.1 variant replaced the previously predominant Delta variant. Of these, 91 (0.16%) had the spike (S)-gene detected in the first sample suggesting Delta infection. In contrast, the second sample (in the same period) showed S-gene target failure (SGTF) indicative of reinfection with the Omicron variant.
Similarly, between January 1, 2022, and March 7, 2022, a period during which SARS-CoV-2 Omicron BA.2 replaced the BA.1 variant, over 48,820 positive cases were detected. Five patients demonstrated SGTF in the first sample, but S-gene was detected in the second sample. These observations, given the epidemiology, were suspected as Omicron BA.2 reinfection after BA.1 infection. The research team noted that the highest and lowest risks for early COVID-19 reinfections were among the non-vaccinated younger population (aged below 12 years) and among the boosted population, respectively.
The researchers reported early SARS-CoV-2 reinfections, classed as less than 60 days from initial infection, particularly among non-vaccinated, younger people. They confirmed early reinfection with Omicron BA.1 after Delta infection and reinfection with BA.2 post-BA.1 infection.
Moreover, in the older age group, non-vaccinated and vaccinated (non-boosted) individuals were at an increased risk of reinfections compared to boosted individuals. Based on these findings, the authors suggested a reconsideration of the duration of immunity offered by past SARS-CoV-2 infections, especially when a shift occurs between two sequential SARS-CoV-2 variants.
Further, the authors believed that retesting within 60 days of an initial positive test should not be deemed unnecessary, especially for young people.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
Journal reference:
Anthony Fauci predicts that the U.S. will eventually get to the point where COVID-19 vaccines are administered yearly, as the flu vaccine is. Kevin Dietsch/Pool/AFP via Getty Images hide caption
Anthony Fauci predicts that the U.S. will eventually get to the point where COVID-19 vaccines are administered yearly, as the flu vaccine is.
The U.S. could follow the trend of the United Kingdom and see a surge in COVID-19 cases driven by the BA.2 subvariant of the coronavirus, according to Dr. Anthony Fauci.
The chief medical adviser to President Biden said that though cases are still trending down across the U.S., some states are seeing a rise.
"I think without a doubt that we are going to see a turnaround as people get out more and into the inside venues without masks," he said. "That's going to be certainly resulting in infections, even in people who are vaccinated."
New modeling from the Commonwealth Fund shows the vaccination campaign in the U.S. has saved more than 2 million lives and has prevented 17 million hospitalizations.
Fauci said that a second booster shot may be needed for Americans by the fall and that eventually vaccination could shift to a yearly injection, like with the flu vaccine.
Speaking to All Things Considered, Fauci walks through what he sees coming for the U.S., the thinking behind boosters and the advice for masking indoors.
This interview has been edited for length and clarity.
On what the BA.2 subvariant will do in the U.S.
I think we're going to be seeing an uptick of cases that we are already seeing in certain states. We had a very sharp and steady decline in everything from cases to hospitalizations to deaths, and in general, on a countrywide basis, we're still seeing that. But there are some areas, particularly in the Northeast, where we are seeing a turnaround and an uptick in cases.
If our pattern follows that of the U.K., which we usually do and are usually about three to four weeks behind them, they are having a significant upsurge in the number of cases. We are hoping that if that does happen, the degree of background immunity that we have in the country ... [means] we will not see an increase in severity in the sense of a concomitant increase significantly in the number of hospitalizations.
On the need for a second booster shot by the fall
It's difficult to predict. But I would think, given the fact that immunity wanes over a period of time ... that we will need a boost by the time we get to the fall.
I don't foresee the need to boost every four months. But what I would imagine might happen, as all of this turns around, we will get into what might be a yearly, seasonal type of an approach. We have something perhaps similar to flu.
I'm saying this merely as extrapolations. No one knows for certain what will be required. We will have to just look at the data and make decisions.
On not masking at indoor events
The CDC was very clear when they modified their metrics to make recommendations for indoor masking and said that when the level of infection in the community gets low enough so that it's in what we call the green zone, you could do that with indoor events.
But if it changes and the cases go up, I for one will go back to masking indoors if we go with a high uptick of cases.
This interview was produced by Linah Mohammad and edited by Amy Isackson.
Several weeks into a new phase of living with the coronavirus, the U.S. is getting a first glimpse of the reality of what its like to experience COVID-19 outbreaks and the roster of the newly infected is studded with stars.
Cabinet members, House Speaker Nancy Pelosi, Broadway actors and the governors of New Jersey and Connecticut have all tested positive. Outbreaks at Georgetown University and Johns Hopkins University are bringing back mask requirements to those campuses as officials seek out quarantine space.
The known infections likely reveal only the tip of the iceberg, since actors and politicians are regularly tested at work. Official case figures are certain to be vast undercounts of how widely the coronavirus is circulating because the results of home tests dont always make it into official tallies, and many who are mildly sick dont bother to test at all.
Across the nation, mask-wearing is at its lowest level since April 2020, said Ali Mokdad, a professor of health metrics sciences at the University of Washington in Seattle. For every 100 infections, only seven are recorded in official counts, according to the latest estimate from his modeling group.
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Mokdad expects the high level of U.S. immunity built up from previous infections and vaccinations will protect the nation from a large surge.
Were going to have some infections here and there, but its not going to shut down the country, Mokdad said. Life has to go on. We have to be vaccinated and boosted. We need to protect the vulnerable, but we have to get used to it.
On Broadway, several performances of the comedy Plaza Suite were canceled after Matthew Broderick tested positive, followed by his wife and co-star, Sarah Jessica Parker. Daniel Craig too has been sidelined from his revival of Macbeth.
Large indoor gatherings with masks optional have led to infections, with a high-profile party in Washington, D.C., now seen as a possible super-spreader event. Other infection clusters outside of groups that are regularly tested might go undetected, said Josh Michaud, associate director of global health policy with the Kaiser Family Foundation in Washington.
Its harder now than it was before to know whats happening. The future is a little fuzzier because we dont have as much information at our fingertips, Michaud said. If youre not an actor in a Broadway play or a politician you might fall through the testing cracks.
The public health response will vary from community to community based on whats happening locally, Michaud said.
Were fighting smaller fires instead of a raging blaze across the country and those smaller fires can be disruptive, Michaud said. It leaves everyone to choose their own adventure when it comes to pandemic response and individual behaviors.
In Washington, the outbreak has been particularly high-profile striking multiple Cabinet secretaries and Congress members along with Mayor Muriel Bowser and the president of Georgetown University.
At least a dozen of those infections can be traced to the Gridiron Club dinner, an annual fixture of the D.C. social calendar that took place Saturday for the first time in three years. The dinner is an example of a return to near-total normality thats taking place around the country, leading to a spike in positive tests, but not necessarily a corresponding spike in serious illnesses or hospitalizations.
Washington, like much of the rest of the country, has greatly relaxed its COVID-19 stance in recent weeks. Bowser has allowed vaccination and indoor masking mandates to expire, and the city health department stopped reporting daily virus numbers in early March. Attendees at the Gridiron Club dinner, which Bowser did not attend, had to provide proof of vaccination, but otherwise no masking or social distancing protocols were observed.
And other staples of the D.C. social calendar are also back to normal. The citys annual Cherry Blossom Festival has been going for weeks with dozens of associated events, including a parade scheduled for Saturday.
Amid that general return to pre-pandemic behavior, there are a few cautionary steps backward. Georgetown University announced it would reintroduce its indoor mask mandate amid rising infection numbers that include university President John DeGioia.
Georgetowns Chief Public Health Officer Ranit Mishori, in announcing the new restrictions, described the infection spike as significant particularly among undergraduates. Thankfully, with the vast majority of our community up to date on vaccination, we are not seeing cases involving severe illness, Mishori wrote.
D.C. health chief Dr. LaQuandra Nesbitt, in comments to reporters this week, has pointed to the ongoing low level of hospitalizations as proof that the vaccinations have successfully limited the severity of the illness.
Virus metrics in Washington have crept up in the past month, according to the city health department. The weekly case rate per 100,000 residents climbed from 51 at the beginning of March to 110 at the end of March. But thats still far below the weekly case rate of 865 per 100,000 residents reported in the second week of January during the Omicron surge.
Nesbitt said there were no immediate plans to reinstitute any of the lapsed virus protocols, but that always remained an option in the future.
We need to remember that living with the virus does not mean forgetting about the virus. Its still out there, its still causing people to get sick and some people to die, Michaud said. If were not prepared, we could be in a bad situation quickly again.
AP writer Ashraf Khalil in Washington, D.C., contributed to this report.
LONDON
In the latest Senate package targeted at stopping the coronavirus, U.S. lawmakers dropped nearly all funding for curbing the virus beyond American borders a move many health experts slammed as dangerously short-sighted.
They warn the suspension of COVID-19 aid for poorer countries could ultimately allow the kind of unchecked transmission needed for the next worrisome variant to emerge and unravel much of the progress achieved so far.
The U.S. has been the biggest contributor to the global pandemic response delivering more than 500 million vaccines and the lack of funding will be a major setback.
The money has paid for numerous interventions, including a mass vaccination campaign in the Cameroonian capital that saw hundreds of thousands of people get their first dose, as well as the construction of a COVID-19 care facility in South Africa and the donation of 1,000 ventilators to that country. Other U.S.-funded vaccination campaigns in dozens of countries, including Uganda, Zambia, Ivory Coast and Mali, could also come to a grinding halt.
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Any stoppage of funds will affect us, said Misaki Wayengera, a Ugandan official who heads a technical committee advising the government on the pandemic response. He said Uganda has leaned heavily on donor help it received more than 11 million vaccines from the U.S. and that any cuts would make it very difficult for us to make ends meet.
This is a bit of a kick in the teeth to poor countries that were promised billions of vaccines and resources last year in grand pledges made by the G7 and the G20, said Michael Head, a global health research fellow at Britains Southampton University.
Given how badly weve failed on vaccine equity, its clear all of those promises have now been broken, he said, adding that without concerted effort and money to fight COVID-19 in the coming months, the pandemic could persist for years.
While about 66% of the American population has been fully immunized against the coronavirus, fewer than 15% of people in poorer countries have received a single dose. Health officials working on COVID-19 vaccination in developing countries supported by the U.S. say they expect to see a reversal of progress once the funds disappear.
Vaccination will stop or not even get started in some countries, said Rachel Hall, executive director of U.S. government advocacy at the charity CARE. She cited estimates from USAID that the suspended funding would mean scrapping testing, treatment and health services for about 100 million people.
Although vaccines are more plentiful this year, many poorer countries have struggled to get shots into arms and hundreds of millions of donated vaccines have either expired, been returned or sat unused. To address those logistical hurdles, U.S. aid has financed critical services in countries across Africa, including the safe delivery of vaccines, training health workers and fighting vaccine misinformation.
For example, in November the U.S. Embassy in the Cameroonian capital set up a tent for mass vaccination: Within the first five days, more than 300,000 people received a dose. Those kinds of events will now be harder to conduct without American funds.
Hall also noted there would be consequences far beyond COVID-19, saying countries struggling with multiple disease outbreaks, like Congo and Mali, would face difficult choices.
They will have to choose between fighting Ebola, malaria, polio, COVID and more, she said.
Jeff Zients, the outgoing leader of the White House COVID-19 task force, expressed regret the legislation doesnt include resources for the international pandemic fight, noting that would also compromise efforts to track the virus genetic evolution.
It is a real disappointment that theres no global funding in this bill, he said. This virus knows no borders, and its in our national interest to vaccinate the world and protect against possible new variants.
Still, Zients announced the U.S. would be the first to donate tens of millions of doses for children to poorer countries and said more than 20 nations had already requested the shots.
J. Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies in Washington, lamented that lawmakers were erring on the side of optimism about the pandemic precisely when another surge might be arriving. In recent weeks, coronavirus cases caused by the hugely infectious Omicron subvariant BA.2 have surged across Europe, and American officials say they expect a U.S. spike soon.
Weve made that mistake several times in this pandemic, Morrison said. And we may be making that mistake again.
Other experts worried the suspension of U.S. global support for COVID-19 might prompt officials to drop current vaccination goals. The World Health Organization had set a target of immunizing at least 70% of people in all countries by the middle of this year, but with nearly 50 countries vaccinating fewer than 20% of their populations, hitting that target is highly unlikely.
Instead, some organizations like the Rockefeller Foundation have pushed for officials to refocus vaccination goals away from vaccinating 70% of all adults by summer to vaccinating 90% of those most at-risk in each country, in what some critics say is an implicit acknowledgment of the worlds repeated failures to share vaccines fairly. Others point out there shouldnt be competing vaccine targets and that health authorities simply need to do more, rather than adjusting global goals.
In Nigeria, which has so far received at least $143 million in COVID-19 aid from the U.S, authorities dismissed suggestions their coronavirus programs would suffer as a result of lost funding. The Nigerian presidents office said help from the U.S. was mostly in kind via capacity building, research support and donations of laboratory equipment and vaccines. We are confident that this will not cause any disruption of our current programs, it said.
However, others warned the U.S. decision set an unfortunate precedent for global cooperation to end the pandemic at a time when fresh concerns like the Ukraine war are drawing more attention.
President Biden originally planned to convene a virtual summit in the first quarter of this year to keep international efforts on track, but no event has been scheduled.
In light of the ongoing war in Ukraine, we dont yet have a final date for the summit, but we are working closely with countries and international partners to advance commitments, said a senior Biden administration official who was not authorized to comment publicly.
As of this month, WHO said it had gotten only $1.8 billion of the $16.8 billion needed from donors to speed access to COVID-19 vaccines, medicines and diagnostics.
Nobody else is stepping up to fill the void at the moment and the U.S. decision to suspend funding may lead other donor countries to act similarly, said Dr. Krishna Udayakumar, director of Duke Universitys Global Health Innovation Center.
Keri Althoff, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, described the U.S. suspension of funding as devastating.
How could this possibly be what were debating right now? she asked. Its a moral obligation to the rest of the world to continue to contribute to this global pandemic response, not only to protect ourselves but to protect people from around the world.
Megerian reported from Washington. AP writers Rodney Muhumuza in Kampala, Uganda; Mogomotsi Magome and Andrew Meldrum in Johannesburg, and Chinedu Asadu in Lagos, Nigeria, contributed to this report.
As the BA.2 wave reaches its peak in the UK and begins subsiding in some European countries, US health officials are looking to an uncertain future even as American lawmakers have delayed renewing funds to address the pandemic.
While the Omicron subvariant now makes up an estimated 72% of Covid cases, the US has not seen a country-wide increase in cases. Covid hospitalizations are now at the lowest point of the pandemic.
But scientists warned this week that the coronavirus will continue evolving to evade immunity, causing future surges that will be difficult to predict.
Covid-19 has evolved faster than expected, and we should expect a lot of evolution going forward, Trevor Bedford, a professor of biostatistics at the Fred Hutchinson Cancer Center, told a panel of independent FDA advisers on Wednesday. Those viruses will do better and will spread locally and perhaps regionally and perhaps globally.
The US has generally followed surges in the UK three or four weeks later, but reported cases are holding steady at an average of about 26,000 a day. Although deaths have declined significantly from the Omicron peak, more than 500 Americans are still dying every day.
I think we are going to see some rising cases in some places, said Benjamin Linas, professor at the Boston University School of Medicine. Lifting precautions will probably result in future upticks, he and others wrote in a study published earlier this month.
Were not in the crisis that we were back in 2020, but we need to be realistic that were also not completely over and done, Linas said.
Some regions in the north-east, including New York and Massachusetts, are beginning to see ticks upward. Philadelphia is considering a return to indoor masking next week.
In Washington DC, where confirmed cases have increased by 135% in the past two weeks, several high-level politicians have tested positive, including the House speaker, Nancy Pelosi, on Thursday.
Its difficult to parse the extent to which surges elsewhere have been driven by changes in behavior, BA.2s increased transmissibility, and waning immunity, and whether factors in the US could suppress such a wave.
As the pandemic wears on, changes to how cases are reported and counted may also cloud the picture.
Home tests are frequently not counted in official tallies, making it increasingly difficult to understand how widespread infections are. Wastewater monitoring could be useful to fill in the gaps, but many places are still ramping up such programs.
Several states have moved to weekly or twice-weekly, instead of daily, reporting of cases, mirroring a similar shift in June 2021 during a lull before the Delta surge. Oklahoma is changing how it reports its seven-day average of cases.
Changes to definitions of Covid hospitalizations and deaths may also complicate pandemic tracking.
Some states have also narrowed their definitions of Covid hospitalization to focus only on patients receiving Covid-specific medications, while others have changed how they define Covid deaths.
Last Monday, US lawmakers reached a deal for $10bn in Covid funding, some of which has already lapsed. But on Thursday, several senators confirmed that the vote will not take place until after the upcoming two-week spring break.
This amount was lower than the $15bn previously cut from an omnibus spending bill or the $22.5bn requested by the White House.
The new bill will not cover tests and treatments for those without insurance, who lost that coverage in March. More than 30 million Americans arent insured, and the lack of affordable, accessible testing and treatments could further affect the countrys ability to track and address cases and severe illness.
The new funding package would also cut spending for global Covid campaigns, including vaccination, which could prolong the pandemic by allowing new variants to emerge and spread.
This is a global health problem, and if we continue to cut the budget for vaccines in developing countries, were going to get the next Omicron, Linas said. Because we have these pockets where the virus goes to reproduce, its already extended the epidemic by at least a year and if it keeps on happening, were going to chase our tail indefinitely.
An estimated half of Americans may have been infected with Omicron in a 10-week period a remarkable number, Bedford said. In comparison, influenza usually infects perhaps 10-20% of the population in about 20 weeks.
But that would also mean that about half of Americans werent infected in the first Omicron wave, potentially leaving them vulnerable to another surge now. The coronavirus, as it swept the globe and infected millions, mutated two to 10 times faster than influenza usually does, Bedford said.
Its likely that future variants will still emerge from Omicron, even overcoming immunity from previous cases of Omicron, he added.
But theres also the potential for the wildcard emergence of a new variant from a previous strain, like Delta. Omicron seems to have evolved from a much earlier version of the virus in summer 2020 before exploding across the globe in late 2021.
Its also difficult to understand if Covid-19 will eventually become a seasonal virus, like influenza or respiratory syncytial virus (RSV).
Its not clear to me that its actually tied to the months of the year, or if thats just confounded by the virology thats been happening, Linas said. Influenza, for example, is highly seasonal but I dont think we know that yet about Sars-CoV-2.
One major treatment has been halted in the US amid questions of its efficacy. The US Department of Health and Human Services (HHS) pulled its authorization of sotrovimab, a monoclonal antibody, as studies reveal it is less likely to be effective against Omicron. Recent research also indicates that this treatment might create resistance a major concern with other monoclonal antibodies and antivirals.
Vaccines and treatments help, but they arent sufficient to halt the pandemic on their own, and they must be accompanied by measures like ventilation and masking during times of high transmission, Linas said.
Surges are also highly dependent on human behavior.
There is no virus epidemic outside the context of the way people behave, Linas said. It would be a big mistake to let off on ourselves and our leaders The actions we take or dont take matter a ton.
JOHANNESBURG
The World Health Organization says up to 65% of people in Africa have been infected with the coronavirus and estimated that the number of actual cases may have been nearly 100 times more than those reported.
In a new analysis released Thursday, the U.N. health agency reviewed 151 studies of the virus in Africa based on blood samples taken from people on the continent between January 2020 and December 2021. WHO said that by last September, about 65% of people tested had some exposure, translating into about 800 million infections. In contrast, only about 8 million cases had been officially reported to WHO during that time period.
This undercounting is occurring worldwide and its no surprise that the numbers are particularly large in Africa, where there are so many cases with no symptoms, WHOs Africa Director Matshidiso Moeti said in a statement. WHOs analysis found that two-thirds of those infected showed no symptoms of COVID-19, a higher percentage than other world regions.
Despite repeated warnings from WHO Director-General Tedros Adhanom Ghebreysus that the coronavirus would devastate Africa, the continent has been among the least affected by the pandemic. In its new analysis, WHO said the milder cases seen in Africa were attributable in part to the continents much smaller proportion of people with underlying risk factors like high blood pressure, diabetes and heart disease.
Africas youthful population is also a protective factor, the U.N. health agency said. Some studies have also suggested that previous infection with diseases including malaria may offer people some protection against the coronavirus, although those hypotheses have yet to be confirmed.
To date, Africa has reported 11.5 million cases including more than 250,000 deaths. WHO said the virus has been trending downward since January, although some countries, including South Africa, have been hit particularly hard during successive waves of disease. Last week, WHO said the number of COVID deaths fell by about 30% on the continent.
Despite Africas declining infections and high exposure to the virus, we cannot declare victory yet against COVID-19, said WHO Africa chief Moeti.
The risks of more lethal variants emerging which overwhelm immunity gained from past infections cannot be brushed aside, she said, calling for increased vaccination rates across the continent.
To date, only about 15% of people in Africa have been immunized against COVID-19.
More than a year after they started going into arms, coronavirus vaccines are still working remarkably well, credited with saving millions of lives and keeping many more people from getting seriously sick.
But like some other vaccines, COVID-19 shots have a potential weakness. Without frequent boosters, they dont appear to provide long-lasting protection against infection caused by variants like omicron that have strayed far from the virus original genetic composition often called the Wuhan or ancestral strain, which the current vaccines were designed to target.
So, scientists are pushing to do even better. Ultimately, theyd like to develop a vaccine that would work against hundreds of different coronaviruses, including SARS 1 and 2, MERS and the versions that cause the common cold. A pan-coronavirus vaccine is considered a holy grail that many researchers believe may not happen for years or decades, if ever.
That would be absolutely wonderful, said Dr. John Swartzberg, a professor emeritus of vaccinology and infectious diseases at UC Berkeley School of Public Health. Weve been trying to do this for 30 years with influenza, ... But we havent been able to do that yet. I have every confidence in the world we will find it and it will work. I just dont know when.
A more realistic scenario, he said, would be to make second-generation COVID vaccines that cover a few more variants of SARS-CoV-2 than the current versions. Then, build on those to make third-generation vaccines that would cover a few more. And so on.
The idea is if a vaccine works against many relatives of the same genetic family now, itd also work at least in part against future relatives, even if scientists dont know yet what those are.
Much of this research is already under way. Vaccine manufacturers are testing formulations of their products that cover multiple variants, and some of these updated versions could come to fruition in coming months. One major National Institute of Allergy and Infectious Diseases trial started just last week at 24 U.S. sites to test various combinations of the current vaccine with others tailored to beta, delta and omicron. One of the locations is San Francisco General Hospital, which began recruiting volunteers Friday.
Even better, and one step closer to a pan-coronavirus vaccine, would be vaccines that work on many sarbecoviruses, a subset of coronaviruses that includes SARS 1 and 2, as well as others that originate in bats and pangolins.
Do we really need a variant-proof or a pan-coronavirus vaccine? The virus that causes COVID-19 will keep mutating, and we may need shots better tailored to target future variants if the goal is to prevent infections, which many say is secondary to preventing severe illness and deaths. The current vaccines, when followed by a booster, already do the latter quite well.
But looking beyond this pandemic, there is a good chance another coronavirus could transmit from animals to humans and once again cause global calamity. A pan-coronavirus vaccine could help contain that early.
Weve had three coronavirus epidemics in the last 20 years, said Dr. Drew Weissman, a leading vaccine researcher at the University of Pennsylvania Perelman School of Medicine, whos working on pan-coronavirus vaccines, referring to SARS, MERS, and COVID-19. That tells us were going to have more. We have no idea when or how severe. We can wait for the next one to appear and rush to make a new vaccine and shut the world down for a year and a half. Or we can make one now so its ready to go.
Weissmans lab is among at least half a dozen U.S. academic research institutions, biotech companies and groups of government scientists who are working on variations of such future-looking vaccines. At least one has begun human clinical trials, and several have found promising early results in monkey or mice studies. Many are focusing on the spike protein, the signature feature of coronaviruses, but some are also examining other parts of the virus that dont mutate as quickly.
Stanford immunologist Bali Pulendran is working with researchers at the University of Washington to develop a vaccine that protects against many variants of SARS-CoV-2. This could help pave the way for pan-sarbecovirus and ultimately pan-coronavirus vaccines.
In a study Pulendran and his Stanford colleague Prabhu Arunachalam conducted last year on monkeys, the vaccine when given with an adjuvant, a chemical that jump-starts the immune system elicited a strong immune response against the Wuhan strain and the alpha and beta variants.
The vaccine tested in that study is now in large phase 3 clinical trials. More recently, Pulendrans work shows that this vaccine elicits a strong and durable immune response against not just the Wuhan strain, beta and delta but also robust protection against omicron for at least six months.
Most researchers in this area are working with one of two vaccine technologies. One is mRNA, the same as that used by Pfizer and Moderna, where the idea is to take hybrid spike proteins from many different viruses and deliver them in a single shot, therefore protecting against all those viruses.
The other technology is a nanoparticle vaccine. The idea is analogous to a soccer ball, where each of the black pentagons can be linked with a spike protein from the virus. When the immune system sees the viral proteins in the nanoparticle, the immune response is really good, said David R. Martinez, an immunologist at the University of North Carolina whos developing an mRNA vaccine that could work against multiple coronaviruses.
Both approaches share the same goal to get the immune system to ramp up against what it thinks is a threat. But they go about it differently. The nanoparticle approach involves injecting patients directly with proteins seen by the immune system. They typically take longer to develop because the proteins must be made and purified in a lab. mRNA vaccines can skip this step because they essentially use the bodys cells to make proteins.
Walter Reed Army Institute of Research is considered to be one of furthest along in developing a nanoparticle vaccine that works against multiple coronaviruses. Researchers there started phase 1 human clinical trials in April 2021 for a pan-SARS vaccine that in early studies appeared to protect monkeys against SARS 2 and SARS 1. Its not clear when they expect to report results.
Its good to have multiple approaches because ultimately you dont know which one will be the most successful, so its important to have multiple of these things move forward, Martinez said. At the end of day you dont know which one will yield the best result.
Catherine Ho (she/her) is a San Francisco Chronicle staff writer. Email: cho@sfchronicle.com Twitter: @Cat_Ho
The novel coronavirus can infect immune cells that will trigger a massive inflammatory response and create severe COVID-19 symptoms, according to new research.
Details: Two new studies one published in the journal Nature and another available on a preprint server found that the immune cells infected by the coronavirus can cause severe inflammation.
What they said: The viruses not only get taken up, but once they get taken up, the virus starts replicating, so that was surprising, research leader Dr. Judith Lieberman, a pediatric immunologist at Boston Childrens Hospital, told CNN.
Worth noting: The researchers found that the coronavirus could not produce new viruses as it spread throughout people, according to Genetic Engineering and Biotechnology News.
