A scathing review has been released evaluating the "failures" of the policies that guided Sweden's response to the COVID-19 pandemic.
The review, published in the journal Humanities & Social Sciences Communications Tuesday, discusses how, throughout the pandemic, Sweden attempted to avoid lockdowns and stay-at-home orders implemented by many of its neighboring countries.
The authors -- from Sweden, Belgium, Norway and the U.S. -- said Sweden was able to achieve this by portraying advice from independent scientists as "extreme," keeping the public in the dark regarding facts about how COVID-19 spreads and not issuing any mandates.
This is despite the country's history of collaboration between authorities and the scientific community and the general public's high level of trust of those in power.
COVID-19 Deaths per Million in Sweden vs. Neighboring Countries
As a result, Sweden had a higher COVID death rate than the surrounding Nordic nations.
"The Swedish response to this pandemic was unique and characterised by a morally, ethically, and scientifically questionable laissez-faire approach, a consequence of structural problems in the society," the team wrote. "There was more emphasis on the protection of the 'Swedish image' than on saving and protecting lives or on an evidence-based approach."
Prior to the COVID-19 pandemic, Sweden's Public Health Agency had published two pandemic planning documents in the last decade to prepare for such an event, according to the review.
Although both focused on the value of antiviral drugs and vaccines to treat and prevent cases, they also emphasized the importance of "limiting the consequences for individuals and society" and how "the negative effects on society must be as small as possible."
So, when COVID-19 was declared a global pandemic by the World Health Organization in March 2020, Sweden was determined to keep its economy up and running and emphasized individual responsibility rather than collective responsibility.
According to the review, the Prime Minister and Minister of Health and Social Affairs "mainly referred to the authority of the Public Health Agency," a stark contrast from past collaboration between the government and scientists.
Unlike the strict lockdowns implemented by most of Europe, the PHA merely recommended staying at home if feeling ill, washing hands regularly, social distancing and avoiding unnecessary travel.
Meanwhile, restaurants, bars and shops remained open; children under 16 were required to attend school in person with no exceptions for those with at-risk family members; and no mask mandates were ever implemented.
The review noted that the PHA did eventually recommend face masks in hospitals and care homes in June 2020, but only when treating confirmed or suspected COVID patients.
The authors said the PHA discouraging the use of masks and claiming they were ineffective helped spread fear in the population and misinformed the public about how COVID spreads, that asymptomatic people can be infectious and that masks protect the wearer and those around them.
People pass by an outdoor restaurant, amid the coronavirus disease (COVID-19) outbreak, in central Stockholm, Sweden, April 20, 2020.
According to the review, there was also a lack of transparency from public health authorities. The number of ICU beds per region was not publicly available and schools often did not inform parents or teachers when students tested positive for the virus.
Then there were efforts to actively squash medical researchers who criticized Sweden's strategy and accused authorities of not being properly prepared.
When researchers voiced their criticisms on social media, in interviews or in scientific papers, they were often reprimanded by their superiors for reasons such as not being allowed to use their university affiliation, even though this is against Sweden's right of Academic Freedom of Speech, according to the review.
Additionally, the PHA also "discredited any critique and national/international scientific evidence" and the authors say the agency "cherry picked" scientific papers that agreed with its viewpoint.
Ultimately, this led to Sweden having worse COVID-19 outcomes than its neighboring Nordic countries.
In late December 2020, Sweden was recording an average of 44 COVID-19 deaths per 1 million people, according to Our World in Data.
By comparison, Denmark was recording 5 deaths per 1 million, Norway was recording 0.5 deaths per 1 million and Finland was recording 0.3 deaths per 1 million, the data shows.
One month earlier, a report from the Swedish Inspectorate of Health and Social Services found half the country's deaths at the time were among nursing home residents.
About one year later in January 2022 -- during the omicron wave -- Sweden was faring better and recording 5 deaths per 1 million.
Daily commuters arrive with the metro at Stockholm's central station, Dec. 3, 2020, during the novel coronavirus COVID-19 pandemic.
However, the other three countries were recording half as many deaths with Denmark recording the highest at 2.4 per 1 million, Our World in Data shows.
"The cost in terms of infections and deaths of this pandemic in Sweden has been larger in some other more densely populated and more centrally located countries, yet is still markedly higher than in the other Nordic countries," the authors wrote. "This Swedish laissez-faire strategy has had a large human cost for the Swedish society."
The worst of the Covid-19 pandemic may be behind us, but pretending that it is over will not make it so. A new Omicron subvariant, BA.2, is driving up coronavirus case counts in Europe and Asia, and experts predict it soon will account for the majority of new cases in the United States. The impact is uncertain. On the one hand, many Americans have already been infected by a similar strain of the virus. On the other hand, BA.2 arrives as people increasingly are resuming prepandemic behaviors, and according to the Centers for Disease Control and Prevention, roughly one-third of Americans have not completed their initial round of vaccinations, and more than 70 percent have not received booster shots.
In the face of this uncertainty, it would be reckless for the government to reduce its efforts to minimize new cases and help those who fall ill. Yet that is exactly what is happening after Congress recently failed to approve $15.6 billion for tests, treatments and vaccines.
Denied the funding it needs, the Biden administration is curtailing its efforts to combat the virus. Last week, the administration said that it would reduce the distribution of highly effective monoclonal antibody treatments by more than 30 percent and that it would be forced to end shipments this spring. It also stopped accepting reimbursement claims for Covid-19 tests and treatments from uninsured Americans; vaccine reimbursements will be accepted only through April 5. And the government said that it lacked sufficient funds to place an order for enough doses of vaccines to ensure the availability of booster shots later this year.
Congress must approve more funding immediately. Ensuring that Covid tests, treatments and vaccines remain readily available is the best way to prevent new waves of infections and to preserve the progress so far toward the end of the pandemic.
Failing to maintain adequate public funding means Americans increasingly will have to rely on their own resources. In effect, the United States is reverting to its usual approach to health care: Those with money and insurance will be able to get tests and treatments; those without may not. The price for a dose of monoclonal antibody treatment can approach $2,000, and even the relatively modest cost of test kits or vaccinations can discourage people from taking the basic steps necessary to protect themselves and others.
A bill to fund the government, which passed this month, initially included $15.6 billion in Covid aid, which would have provided the administration with much of the $22.5 billion it has requested. But the funding was stripped because House Democrats were unable to resolve an internal squabble. The bill would have repurposed unused money from earlier rounds of Covid aid, but some Democrats resisted, insisting the government should provide new funding.
To pass a new bill, Democrats will need the support of at least 10 Senate Republicans, and those most amenable want to use money from prior appropriations.
That should not be a deal breaker. States have received more federal aid in the past two years than they know what to do with; some state coffers are overflowing. Gov. Brian Kemp of Georgia signed legislation this week that will send up to $500 to Georgia households to help with the rising cost of food, gas and other essentials. About a dozen other states, including California, are considering similar distributions of surplus cash. But while higher prices are a real challenge for many Americans, policymakers must also remain focused on preventing fresh outbreaks of Covid-19, which could be even more economically painful.
A chunk of the funding requested by the Biden administration, for example, was earmarked to help lower-income countries fight the coronavirus. The United States has a moral obligation to provide this humanitarian aid, and there are diplomatic benefits to helping other nations. In addition, it will help the whole world get closer to the end of the pandemic. Allowing the virus to continue to run rampant in some parts of the world increases the chances that new variants will continue to develop and spread.
It is worth underscoring that much of what the Biden administration is requesting should not require emergency funding. The United States ought to maintain funding for public health, including the resources to monitor infectious diseases and to develop new vaccines and treatments, in the same way that it maintains funding for other forms of national defense. The gaping holes in the nations public health infrastructure, which the pandemic exposed, were created by exactly the kind of shortsightedness now on display.
Vaccination near me
Each municipality is responsible for offering coronavirus vaccination to people who live there. Check the website of your municipality to see how vaccination is carried out locally and when you will be offered the vaccine.Find the link to your municipality here:
The offer is available to everyone in recommended groups living in Norway, including foreign citizens. It also applies if you began primary vaccination abroad, but need to take more doses while you are living in Norway. It is not available to Norwegians or others living abroad.
Coronavirus vaccination is free. All vaccination in Norway is voluntary.
The solutions used for appointments vary between municipalities. In some places, drop-in vaccination is available without the need for an appointment. Check your municipality's website for information about the local arrangements.
Do not turn up for vaccination if, on the day:
*See the recommendations that apply for how long you should stay home
Inform the vaccination centre as soon as possible. Your vaccination will be postponed.
Before vaccination you will be asked to answer some questions about your health:
The vaccine is given by an injection in the upper arm.
After you have had the vaccine, you will be asked to wait for 20 minutes in case you experience any reactions.Everyone who administers vaccines has had training and necessary medication will be available to treat possible allergic reactions.
It is not recommended to take another vaccine on the same day as the coronavirus vaccine. There should be at least 1 week between the coronavirus vaccine and other vaccines. If there is a strong need to take several vaccines at the same time, you should consult a doctor.
More information about the vaccines used in Norway, available in many languages:
We distinguish between the primary vaccination series and booster vaccination. For booster vaccines, see the separate section below.
For most groups who are offered the coronavirus vaccine, the primary vaccination series comprises of two doses. The second dose should be given after 3-12 weeks. It is important that you try to take the second dose at the scheduled time. If something unforeseen should arise, contact the vaccination site to arrange a new appointment. The interval between doses can be important both for the degree of protection and for the validity of the COVID-19 certificate.
Vaccine
Number of doses to complete primary vaccination*
Recommended minimum interval between dose 1 and 2
Comirnaty (BioNTech and Pfizer)
2
21 days
Spikevax (Moderna)
2
28 days
Nuvaxovid (Novavax)
2
21 dager
Combination of Comirnaty, Spikevax or Nuvaxovid
2
28 days
For all three vaccines offered in the coronavirus immunisation programme, two doses are required for the primary vaccination series. If it is difficult to give two doses with the same vaccine, or is requested for other reasons, the Norwegian Institute of Public Health recommends combining the vaccines. When combining two different coronavirus vaccines in the primary vaccination series (doses 1 and 2), a minimum interval of 4 weeks between doses is recommended. No upper limit has yet been established for the interval between coronavirus vaccines.
* People who have had COVID-19 only need one vaccine dose to complete their primary vaccination series.
People with severely weakened immune systems (immunosuppressed) often have a poorer effect of vaccines than others. This means that many of these do not get a good enough effect from the first two doses. This group is therefore offered dose 3 in order to complete primary vaccination. For these, an interval between the 2nd and 3rd dose is recommended to be a minimum of 4 weeks. More information about this group can be found here:
Protection after primary vaccination with a coronavirus vaccine may diminish over time. A booster dose gives longer-term protection as well as a broader protection that can make us better prepared against new virus variants. The interval between dose 2 and the booster dose must be at least 20 weeks.
The advice about booster doses applies regardless of whether you have been vaccinated with: (a) two vaccine doses or b) had COVID-19 and one vaccine dose. In Norway, we consider both COVID-19 disease and vaccination to be equivalent "immunological events", as long as at least 3 weeks have passed between each of them. This means that an infection is equivalent to one vaccine dose. The interval between dose 2 (or having COVID-19) and the booster dose must be at least 20 weeks.
The Norwegian Institute of Public Health considers that confirmed COVID-19 disease among people who have had their primary vaccination series (under 65 years) more than 3 weeks after dose 2, can replace the medical need for a booster dose. However, people who want a booster dose despite having had COVID-19 after dose 2 can take it. This may be due to entry requirements to some countries, or for other reasons. For the age group 65 years and older, a booster dose is recommended if COVID-19 is detected before 3 months have passed since dose 2. People with severely impaired immune systems (immunosuppressed) follow a separate vaccination course.
Read more:
Two of the three approved coronavirus vaccines used in the coronavirus immunisation programme are mRNA vaccines; Comirnaty (from BioNTech/Pfizer) and Spikevax (from Moderna).
The vaccines contains the recipe (messenger RNA, or mRNA) for the characteristic spikes on the coronavirus encased in small fat bubbles. The body uses this recipe to make harmless copies of these spikes for the immune system to practise on. In this way, the immune system learns to recognise the coronavirus spikes and can defend the body if it becomes infected with the virus.
The messenger RNA is rapidly broken down by the body and has no effect on genetic material.
In addition, the vaccines contain substances to keep them stable during production, storage and transport, as well as to provide the right pH, which is important for reducing pain during injection. These substances are water, salts and sugar.
The coronavirus vaccines act to prevent disease. They cannot cure an ongoing illness.
More information about mRNA vaccines:
The coronavirus vaccine Nuvaxovid (from Novavax) is a protein-based vaccine based on a traditional vaccine technology. Similar technology is used in vaccine against hepatitis B and whooping cough. It contains a variant of the characteristic spikes (spike protein) on the coronavirus that the immune system can practise on. This is how the body learns to recognise and defend itself against real coronavirus if you later become infected.
The vaccine also contains a new ingredient (adjuvant) containing saponins from soap bark and fats (cholesterol and phospholipids). This helps to enhance the body's own immune response to get the best possible effect from the vaccine. Nuvaxovid also contains an emulsifier (Polysorbate 80) which ensures that fats and water in the adjuvant remain evenly mixed.
In addition, the vaccine contains water, various salts and sugar compounds that will keep it stable during production, storage and transport, as well as provide the right pH that is important for reducing pain during injection.
The coronavirus vaccine has a preventive effect. It cannot cure an ongoing illness.
Vaccine against coronavirus - Nuvaxovid (Novavax) Coronavirus vaccine from Novavax will be available in week 10 (News, NIPH)
The coronavirus immunisation programme in Norway uses the two mRNA vaccines from BioNTech / Pfizer and Moderna (see above), and the protein-based vaccine Nuvaxovid from Novavax. For most people, two doses are needed to complete the primary vaccination series, and several groups are also recommended to have a booster dose to get the best possible protection. Some will be offered, or request, a different coronavirus vaccine as dose 2 or as a booster vaccine than the one they began with. In principle, you are recommended to accept the vaccine you are offered, but it is also possible to choose which type of vaccine you want to take.
The coronavirus vaccines can cause side effects in many of those vaccinated, but they are mostly mild / moderate and pass after a few days. For some, the symptoms may be more severe. The mRNA vaccines appear to cause more of the common side effects than other vaccines. Nuvaxovid generally has slightly milder side effects with a shorter duration than the mRNA vaccines.The side effects after all three coronavirus vaccines usually occur during the first 1-2 days after vaccination. Common side effects are pain and swelling at the injection site, fatigue, headache, muscle aches, chills, joint pain and fever. Allergic reactions occur in some people. There is good knowledge about common side effects after vaccination, but rare side effects cannot be ruled out.
Among the rarer side effects reported from mRNA vaccines are inflammation of the heart muscle (myocarditis) and inflammation of the pericardium (pericarditis). The condition most often occurs among adolescents and young adults. It also seems to occur more often with the use of Spikevax (Moderna) than with Comirnaty (BioNTech/Pfizer). When offering mRNA vaccines to people under 30 years, the NIPH recommends the use of Comirnaty for both men and women.
Among those who experience these rare symptoms, they usually appear within a week after the second dose, and are temporary so that most people recover within one month. The condition causes chest pain, wheezing, palpitations and fever. In case of such symptoms, consult a doctor for a medical examination. Norwegian cardiologists consider that COVID-19 disease can cause more serious heart effects in some people than after the vaccine, and that this rare side effect should not prevent adolescents from being offered the vaccine.
Cases of menstrual disorders have been reported as a possible side effect in young women following coronavirus vaccination. This is being closely monitored.
If you experience unexpected, severe or prolonged symptoms that you think are due to the vaccine, you should contact your doctor or other healthcare professional for assessment and advice. Healthcare professionals have a duty to report serious or unknown reactions that they suspect are due to a vaccine. You can also send a message via the form via helsenorge.no.
The vaccine can give side effects up to three days after vaccination, so how should you deal with potential symptoms after vaccination?
Symptom
Measure
Symptoms that are typical vaccination side effects:
Fever, headache, fatigue, muscle or joint pain
Stay at home until you are fever-free and have a better general condition
If symptoms persist for more than 48 hours, consider a coronavirus test
Symptoms that are not typical vaccination side effects:
Cough, sore throat, runny nose, wheezing, lost taste / smell
Stay home and arrange a coronavirus test
When vaccines are developed, the goal is always for vaccines to give the best possible effect with the fewest possible side effects. Even if the new vaccines are tested thoroughly, rare side effects cannot be ruled out. Some side effects are only discovered when vaccines are in wider use, and have been given to many more people and to more varied groups than in the studies.
After the vaccines are in use, the Norwegian Medicines Agency, together with the Norwegian Institute of Public Health, will monitor closely whether any unexpected side effects arise. There is also extensive international collaboration with the other countries that use the same vaccines. In addition, the vaccine manufacturers are required to conduct new systematic safety studies.
The Norwegian Institute of Public Health (NIPH) collaborates with the Regional Medicine Information and Pharmacovigilance Centres (RELIS) to process reports of suspected side effects from healthcare personnel. The notifications are entered in the ADR Registry at the Norwegian Medicines Agency.
The Norwegian Medicines Agency publishes regular reports with an overview of reports of suspected adverse reactions after vaccination in Norway.
Notifications from healthcare professionals are thoroughly assessed to find out if the incident may be due to the vaccine, or if it happened at the same time as vaccination. It is important to be aware that events that coincide in time are not necessarily due to vaccination. Therefore, a medical examination is recommended to check for other explanations for the events. In some cases, it can be difficult to conclude whether an event is due to a vaccine or coincidence based on one or a few single events.
All three vaccines used in the coronavirus immunisation programme protect against COVID-19 disease.
The vaccines have a very good effect against a COVID-19 disease course that is so serious that hospital treatment is needed. This means that in those cases where people have COVID-19 despite vaccination, the vaccine can contribute to a milder disease course. This also seems to apply to the omicron variant. However, vaccination does not provide as good protection against infection with the omicron variant. The protection is poorer and shorter in duration than against the delta variant.
We are closely monitoring the duration of protection in different groups. Adults over 45 years and those with underlying conditions are recommended to have a booster dose because protection diminishes over time, see above.
Although vaccinated people have a much lower risk than unvaccinated people of getting COVID-19, vaccinated people could also be infected and transmit infection further. Therefore, it is important that vaccinated people follow the current infection control advice, stay at home and test themselves if they develop symptoms that resemble COVID-19.
The risk that vaccinated people get COVID-19 diseases is small, but can happen. Therefore, it is important to continue to follow the current infection control advice and to be tested if symptoms arise, even if vaccinated.
Until now, the vaccines have had a good effect against the various mutated virus variants. It is currently uncertain how good the protection will be against the omicron variant.
Although recent data suggest a lower vaccine effect against mild disease for some of the virus variants, vaccination may still give good protection against a severe disease course.
If we get virus variants where the vaccines do not work, then the vaccines can be adapted to improve the degree of protection.
Children and adolescents rarely have a severe COVID-19 disease course, although some may be admitted to hospital. Vaccination can reduce this risk.
Of the mRNA vaccines, the vaccine from BioNTech / Pfizer (Comirnaty) is used for people under 30 years. Children 511 years will be offered child doses of the vaccine. Immunity following infection, with or without a single dose of vaccine, can also provide broad and lasting protection in children and adolescents.
The following recommendations (should) and offers (can) for coronavirus vaccination apply to children and adolescents:
How
Adolescents born 2003, 2004 and 2005
Children and adolescents 515 years with severe underlying disease
Children and adolescents born 2006-2009
Children born 2010-2016, and those born in 2017 who have reached 5 years.
Children under 5 years of age
Read more about the recommendation for 16-17-year-olds:
Read more about the recommendation for 5-15-year-olds:
Those who have reached the age of 16 are of legal age and can consent to vaccination themselves. For children who are offered the coronavirus vaccine, but have not yet reached 16 years of age), parents must consent to vaccination. In the case of joint parental responsibility, both must consent. Children and adolescents under 16 should be consulted, based on age and maturity and their opinion should be given weight. Vaccination is voluntary.
Children have the right to receive tailored information. Parents should talk to their children about the decision to vaccinate and help to convey important information about this. The texts below and the links to tailored information material are intended to assist in this.
The NIPH does not have a general recommendation for the coronavirus vaccine for children aged 5-15 years, but it is available. Those who want to take the vaccine can choose whether they want 1 or 2 doses. The NIPH considers that when children have COVID-19, it provides at least as good protection as vaccination. Children who have had an infection therefore do not need a vaccine to protect themselves against a new infection.
The NIPH's assessments for children aged 5-15 where they and their parents want a vaccine, but the child has had COVID-19:
Other countries may have stricter requirements in connection with entry restrictions. If you need a valid COVID-19 certificate for travel, you must check which requirements apply for children at your destination.
The Norwegian Institute of Public Health considers that the societal benefit of vaccinating children should not be given as much weight as the individual benefit. Vaccination of children 5-11 years, and a second dose to 12-15-year-olds may have some effect on transmission. However, the vaccine's effect against transmission of the omicron variant appears to be lower and has a shorter duration than against previous virus variants. Therefore, the effect on transmission by vaccinating the entire child population will be limited, when the infection will transmit regardless among the vaccinated.
The risk of a severe COVID-19 disease course among healthy children is very low. There is no evidence that the omicron variant causes more severe disease among children than previous variants. The immune systems of children in this age group work faster and more effectively than in adults. They therefore become less ill, and recover faster than adults.Severe COVID-19 disease in children is particularly associated with a rare inflammatory condition called MIS-C. It is estimated that the condition occurs in about 1 in 3,000 infected children, and is more common in children of primary school age than in adolescents. The hallmarks of MIS-C are persistent high fever and inflammatory reaction in several organs that occur 2-6 weeks after infection, and the children need hospital treatment. There is effective treatment for the condition, but the most serious cases still need intensive care. Hospital stays for these children last 5 days (median) in Norway. Follow-up 4-9 months after MIS-C internationally indicates a good prognosis, and this is also the experience in Norway.
People who have had COVID-19 disease may, in some cases, have persistent symptoms for a long time afterwards. In adults, a clear correlation has been seen between the severity of acute COVID-19 disease and the severity of long term problems. It may seem that such late effects are less common in children than in adults, but knowledge about this is limited. The most commonly reported symptoms are fatigue, tiredness, difficulty concentrating, stuffy nose, sleep problems and pain. The number of reported symptoms appears to decrease over time.
Immunity following infection, with or without a dose of vaccine, can provide broad and lasting protection in children and adolescents. It may be an advantage for protection against new virus variants in the future as the risk of a severe disease course in this age group is low.
In Norway, children and adolescents are only offered the Comirnaty vaccine from BioNTech and Pfizer, even though Spikevax from Moderna has been approved from the age of 12 and up. This is to minimize the risk of rare side effects in the form of heart inflammation. It is also one of the most widely used coronavirus vaccines in children. Comirnaty is approved from 5 years and upwards and the age group 5-11 years will receive an adapted child dosage.
Children receive very good protection from the coronavirus vaccine. The protection against a severe disease course is good already three weeks after vaccination with one dose. This age group generally has a very good effect of vaccines, and it will probably be better than for older age groups. This also applies to the omicron variant. The vaccine's protection against becoming infected and against mild illness is lower than against serious illness.
The vast majority of side effects occur 1-2 days after vaccination, are mild / moderate and disappear after a few days. For some, the symptoms may be more severe. The coronavirus vaccines cause more of the common side effects than other vaccines. Younger people often have slightly more severe side effects than older people.
Delivery workers passed food over a barrier at the edge of a locked-down Shanghai neighborhood on Wednesday.Credit...Aly Song/Reuters
The surge of Covid cases across China, driven by the highly transmissible Omicron variant, is straining hospitals and prompting lockdowns of neighborhoods in Shanghai, which until recently had been held up as a crown jewel in the governments strategy for fighting the pandemic.
Shanghai, Chinas largest city, has seen few cases until recently. Now, it is reporting more than 1,500 a day, and many residents are expressing anguish and dismay over Chinas zero-tolerance approach to the virus.
On Friday, anger and grief welled up online after a Shanghai hospital confirmed reports that a nurse who worked there, Zhou Shengni, had died from an asthma attack after finding the doors of its emergency department shut because of Covid restrictions.
Due to pandemic prevention needs, the emergency department of our hospitals southern campus had been temporarily closed, Shanghai East Hospital said on its website. Ms. Zhous family rushed her to another hospital, but she died late Wednesday after attempts to save her failed, Shanghai East said.
Just think, this happened in Shanghai, and it was a medical worker treated like this, read one of many comments about Ms. Zhous death on Weibo, a popular Chinese social media platform. What about regular folks? Not just in Shanghai, but other parts too.
The outbreak has fanned a rising debate in China over whether the government should rethink its stringent zero Covid strategy of eliminating all infections with relentless force, rather than finding a way to cope with higher levels of infection, as most countries have.
But officials across China have given no indications that the government is reworking its strategy. Instead, they insist that any easing of restrictions could exacerbate the surge of infections and further strain the medical system.
We hope that everyone slows down their life at this time, cutting down on outings and moving around, Wu Jinglei, the director of the Shanghai Municipal Health Commission, said at a news conference on Thursday. Pandemic prevention in our city has entered the most critical stage.
On Friday, Shanghais health commission reported that it had identified 1,609 Covid cases the previous day, 1,580 of which were asymptomatic. China has recorded over 29,000 cases so far in March. That represents a significant spike for the country, which has kept cases low since quashing the worlds first outbreak, which began in the city of Wuhan, in 2020.
The current outbreak has strained Shanghais medical system as hospitals and isolation hotels are crowded with patients, residents have said on social media. The city government has started issuing a daily list of hospital clinics that have suspended outpatient and elective treatments and surgeries in order to cope with the Covid cases.
Zhang Wenhong, one of Shanghais leading infectious disease experts, told residents on Thursday to be patient while the authorities worked to curb the outbreak.
All of a sudden medical resources are under strain in Shanghai, Dr. Zhang wrote in a long post on Weibo. If we dont counter its speed with our own, we wont have a chance to beat the Omicron race, he wrote, adding that the government would need to ramp up its vaccination campaign.
Beneath his post, many commenters insisted that China rethink its approach to the virus.
Exhausting social resources, degrading the quality of life and existence, dragging down economic development and urban vitality wheres the sense in this pandemic prevention, one commenter wrote. The zero-infection strategy needs thinking over.
What is the Omicron variant?
First identified in Botswana and South Africa in November, the Omicron variant has surged around the world over the past few months, faster than any previously known form of the coronavirus. The variant has caused a rapid rise in new cases that pushed some hospital systems to the breaking point.
Scientists first recognized Omicron thanks to its distinctive combination of more than 50 mutations. Some of them were carried by earlier variants such as Alpha and Beta, and previous experiments had demonstrated that they could enable a coronavirus to spread quickly. Other mutations were known to help coronaviruses evade antibodies produced by vaccines.
Based on those mutations, along with a worrying rise in Omicron cases in South Africa, the World Health Organization designated Omicron a variant of concern on Nov. 26, warning that the global risks posed by it were very high. Since then, the variant has been identified in at least 175 countries. Omicron quickly surged to dominance in many parts of the world, living up to the potential that scientists recognized when it was first discovered.
At the beginning of December, a California resident who returned home from South Africa was identified as the first American infected with Omicron. By Dec. 25, it made up three-quarters of all new infections in the United States, according to the Centers for Disease Control and Prevention. Today, the variant accounts for essentially all infections.
There are several genetically distinct versions of Omicron. Initially, the subvariant known as BA.1 was the most common. In the United States this winter, BA.1 and the highly similar BA.1.1 drove an enormous surge in new cases, which peaked at an average of more than 800,000 a day in mid-January, more than three times as high as the nations previous peak. Since then, cases have steadily declined, as have hospitalizations and deaths.
In the late winter and early spring, a different subvariant, known as BA.2, gained steam, becoming increasingly prevalent worldwide. It was causing slightly more than a third of infections in the United States as of March 22, the C.D.C. estimated. BA.2, which is even more transmissible than BA.1, might also have fueled new surges in China, Hong Kong and South Korea, where cases spiked in March.
[Whats known about BA.2 and whether it will spur a new wave in the U.S.]
Yes. It is two to three times as likely to spread as Delta.
The earliest evidence for Omicrons swift spread came from South Africa, where Omicron rapidly grew to dominance in one province after another. In other countries, researchers were able to catch Omicron earlier in its upswing, and the picture was the same: Omicron cases doubled every two to four days a much faster rate than Delta.
For a closer look at how well Omicron spreads, British researchers also observed what happened in the households of 121 people who had been infected with the variant. They found that Omicron was 3.2 times as likely to cause a household infection as Delta was.
Scientists dont yet know what makes Omicron so good at spreading, but a few clues have emerged from preliminary research. A team of British scientists found that Omicron is particularly good at infecting cells in the nose, for example. When people breathe out through their noses, they can release new viruses.
But several studies suggest that people with Omicron infections do not have higher viral loads than those infected by Delta.
Instead, many scientists believe that Omicron may spread so swiftly because it is adept at dodging antibodies produced by vaccines and previous infections. That allows it to spread quickly even in highly vaccinated populations.
Omicron also appears to have a shorter incubation period than other variants do. People who are infected with Omicron typically develop symptoms just three days after infection, on average, compared with four days for Delta and five days for earlier variants.
Much of the research to date has focused on the BA.1 subvariant, but evidence suggests that BA.2 is even more transmissible than BA.1.
Some symptom differences have emerged from preliminary data. For instance, one possible difference is that Omicron may be less likely than earlier variants to cause a loss of taste and smell.
Data released in December from South Africas largest private health insurer, for instance, suggest that South Africans with Omicron often develop a scratchy or sore throat along with nasal congestion, a dry cough and muscle pain, especially low back pain.
But these are all symptoms of Delta and of the original coronavirus, too. Its likely that the symptoms of Omicron will resemble Deltas more than they differ.
While it likely provides protection against severe disease, immunity from previous infections does little to hinder infections with Omicron. The first clues that Omicron could evade immunity came from South Africa, where scientists estimate that at least 70 percent of people have had Covid-19 at some point in the pandemic. An unexpectedly large fraction of Omicron cases involved people who had previously been infected.
When Omicron surged in England, British researchers similarly found that many people infected with the new variant had already survived Covid. The researchers estimated that the risk of reinfection with Omicron was about five times that of other variants.
Similar results came from Denmark, where scientists compared more than 2,200 households where someone got infected with Omicron to some 6,300 Delta-infected households. Omicron was 3.6 times more likely to infect people with boosters sharing the same house than Delta. But it was barely more likely to infect unvaccinated people.
For a deeper understanding of this increased risk of reinfection, a number of teams of scientists have studied the antibodies produced by people who recover from Covid-19. If they mix those antibodies in a dish with other variants, the antibodies do a good job of preventing the viruses from infecting human cells.
But if they mix those antibodies with Omicron, it still manages to get inside the cells much of the time. That means that the mutations carried by Omicron are changing the shape of its surface proteins, where antibodies lock onto the coronavirus.
Several studies indicate that full vaccination plus a booster shot provides strong protection against infection with Omicron, at least in the short term. Without a booster, however, two doses of a vaccine like Pfizer-BioNTechs or Modernas provide much less protection. (Still, two doses of a vaccine do appear to protect against severe disease from Omicron.)
March 25, 2022, 10:30 p.m. ET
Scientists drew blood from fully vaccinated people and mixed their antibodies with Omicron in a petri dish loaded with human cells. Every vaccine tested so far has done a worse job at neutralizing Omicron than other variants. And antibodies from people who received two doses of the AstraZeneca or one dose of Johnson & Johnson vaccines dont seem to do anything at all against Omicron.
But when researchers tested antibodies from people who had received boosters of Moderna or Pfizer-BioNTech vaccines, they saw a different picture. Boosted antibodies blocked many Omicron viruses from infecting cells.
Researchers found a similar response when they looked at people who had been fully vaccinated with two doses after a Covid-19 infection: Their antibodies were extremely potent against Omicron.
Real-world studies support the results of these experiments. In South Africa, researchers found that two doses of the Pfizer-BioNTech vaccine had effectiveness against Omicron infection of just 33 percent. Against other variants, they found its effectiveness is 80 percent.
In Britain, researchers found that people who had received two doses of the AstraZeneca vaccine enjoyed no protection at all from infection from Omicron six months after vaccination. Two doses of Pfizer-BioNTech had effectiveness of just 34 percent. But a Pfizer-BioNTech booster had effectiveness of 75 percent against infection.
Results like these reinvigorated vaccination efforts and have spurred widespread booster campaigns.
But booster shots may lose some of their effectiveness against infection over time. In one British study, scientists found that the protection boosters offer against symptomatic Omicron infections wanes within 10 weeks. And data from Israel suggest that a fourth shot may not offer much additional protection against Omicron infections, according to a study published in mid-March.
Yes. In a large study of more than a million cases of Covid, British researchers found that people who had received booster doses were 81 percent less likely to be admitted to the hospital, compared with unvaccinated people. The risk of being admitted to a hospital for Omicron cases was 65 percent lower for those who had received two doses of a vaccine.
And booster doses of the Pfizer and Moderna shots are 90 percent effective at preventing hospitalization from Omicron infections, the C.D.C. reported in January. The benefits were especially pronounced for older adults.
The protection that vaccines afford against severe disease with Omicron has left its mark on hospitals. When Omicron fueled a new surge of cases, the people coming to hospitals in New York City were overwhelmingly unvaccinated.
Vaccinated people are at risk of infection with Omicron because the variant can evade antibodies produced by vaccines and start multiplying in the nose and throat. But vaccines do more than just trigger the production of antibodies against coronaviruses. They also stimulate the growth of T cells that help fight a particular disease. T cells learn to recognize when other cells are infected with specific viruses and then destroy them, slowing the infection.
Scientists have also examined the T cells produced by Covid-19 vaccines to see how well they fare against Omicron. Early studies suggest that these T cells still recognize the Omicron variant.
This preliminary evidence suggests that Omicron infections cannot get past the T-cell line of defense. By killing infected cells, T cells may make it harder for Omicron to reach deep into the airway, where it can cause serious disease.
While Omicron can cause deadly infections in some people, it is less severe overall than the Delta variant.
Scientists measure the severity of a coronavirus variant by examining how many people infected by it end up in the hospital. The Delta variant turned out to be substantially more severe than earlier variants. But the reverse is true for Omicron. A British study found that the risk of hospitalization due to Omicron is half that of Delta.
When the Omicron variant began surging in the United States, hospitals observed the same reduced risk. A study from California found that compared with Delta, Omicron infections were less likely to send people to the hospital or the I.C.U. And despite record-breaking new cases, new hospitalizations rose at a slower rate during the Omicron surge. Although its a relief that Omicron is not as severe as Delta, the new variant still put tremendous strain on hospitals, thanks to its extraordinary contagiousness.
The lower severity of Omicron likely has several causes. Many of the people that Omicron is infecting are vaccinated or recovered from previous infections. Their immunity lowers their chances of ending up in a hospital with Covid.
But preliminary studies on animals and cells also suggests that Omicron has a different biology than other variants. Its strategy for infecting cells works well in the upper airway, but not in the lungs.
Yes. In late December, the Food and Drug Administration authorized two new antiviral pills for Covid, called Paxlovid and molnupiravir. Preliminary experiments indicate that both treatments should work against Omicron. People who are at high risk of developing severe Covid can be prescribed either drug in the first few days after a diagnosis.
A drug called sotrovimab, made by GSK and Vir, is effective against BA.1. It is a monoclonal antibody that can attach to the Omicron variant and prevent it from infecting cells. Unlike Paxlovid and molnupiravir, which are packaged as pills, sotrovimab has to be given as an infusion in a hospital or clinic.
Two other widely used monoclonal antibodies, made by Regeneron and Eli Lilly, wont work because Omicron is resistant to them. As Omicron came to dominate in the United States, the federal government scrambled to secure more doses of sotrovimab.
But some laboratory studies suggested that sotrovimab may be less effective against the BA.2 subvariant.
The F.D.A. recently authorized another monoclonal antibody treatment, bebtelovimab, that appeared to work against both BA.1 and BA.2 in laboratory studies.
Another option for people infected with Omicron is an antiviral drug called remdesivir. Like sotrovimab, it is effective at preventing severe Covid.
For people hospitalized with Omicron infections, a wide range of other treatments are also available. For example, a steroid called dexamethasone has been demonstrated to be very effective at reining in lung-damaging inflammation.
When the W.H.O. began to name emerging variants of the coronavirus, they turned to the Greek alphabet Alpha, Beta, Gamma, Delta and so on to make them easier to describe. The first variant of concern, Alpha, was identified in Britain in late 2020, soon followed by Beta in South Africa.
Public-health officials say they expect cases of Covid-19 to rise in the U.S. in the coming weeks as a new variant of the virus becomes dominant here. Whether an increase in hospitalizations and deaths follows is, so far, unknowable.
The Omicron subvariant known as BA.2 is the most widespread variant globally, and is now thought to be causing the majority of cases in some parts of the U.S.
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Wayne, Ashland and Holmes counties have reached COVID-19 case lows not seen since mid-2021 and theearliest days of the pandemic.
In mid-March,Wayne County cases dropped by nearly 50%while Holmes and Ashland county cases increased, thoughstill remained low, according to the Ohio Department of Health. Holmes County cases increased by 19 to 30 cases; Ashland County went up by three to 27 cases.
Ohio cases as a whole dropped by 25% in mid-March and cases nationwide dropped by nearly 30%, according to the Centers for Disease Control and Prevention.
COVID: Wayne County's COVID cases fall 42.9%; Ohio cases plummet 25%
This sudden lull comes after Wayne and Ashland counties experienced a record-breaking phase of the pandemic over the holidays when cases reached new heights.
In recent weeks, the CDC downgraded the three counties from high rates of transmission to moderate. All three counties were listed as high since late summer and early fall of 2021.
And as the pandemic seemingly winds down in the U.S., cases are on the rise in Europe and Asia a possible foreshadowing of the next wave to strike North America.
"We're learning a lot about the next wave that's going to happen in the U.S.," Dr. Eric Topol,director of the Scripps Research Translational Institute in La Jolla, California, told USA Today."It's going to happen. It's unavoidable."
Two years of the deadly disease outbreak killed over 6 million people with nearly 4.7 million cases worldwide, according to John Hopkins University.
More than 970,000 people have died in the U.S. out of the nearly 8 million confirmed cases since March 2020, per John Hopkins statistics.In other words, 1.2% of those confirmed cases resulted in deaths.
In the tri-county area, Wayne County has the largest population of approximately 115,710. Of that total, 23,068 people or nearly 20% of the population caught COVID-19 with 432 dying of virus-related complications, according to Ohio Department of Health data.
Education in the age of COVID: Preschool, community center plans in Rittman pick back up after COVID delayed progress
With53,484 people, Ashland County has the second largest population of the three counties. Nearly 22% of the population or 11,930 people caught COVID; 212 died.
Wayne and Ashland county COVID-related death rates are around 1.8%, slightly above the national percentage, according to the CDC.
Holmes County has the smallest population with 43,960 people andhad the highest percentage of coronavirus deaths in the tri-county area. Of the 5,098 people who caught COVID,180 or 3.5% died.
Vaccination rates have remained stagnant in each county. Wayne County has the most fully vaccinated residents at 48%. Ashland County sits at 45% while Holmes County, where roughly half of the population is Amish or Mennonite, remains at 19%, according to the Ohio Department of Health.
Looking back over the past two years, Wayne County Health Commissioner Nick Cascarelli remembers when the first cases hit Ohio in March 2020 and the shortage of masks and PPE that followed.
Ahead of the closures, Cascarelli said he and the staff at the health department tried to meet organizations like schools and nursing homes to give them guidance ahead of the inevitable rise of cases.
Once supplies were more readily available for people other than first responders, more people began venturing out. Things like mask-wearing, clear dividers and social distancing became the new normal.
Business: Area businesses find workers through Ashland, Holmes and Wayne career center schools
Cascarelli remembers the COVID vaccine becameavailable in December of 2020, in limited quantities, with roll-out phases based on occupation, age and health conditions.
As cases continue to diminish and businesses relax masking, distancing and other rules, Cascarelli believes some changes experienced during the pandemic willstick around.
With the rising popularity of video conferencing services like Zoom and Microsoft Teams, more people are likely to hold virtual meetings or work from home, especially if they are sick.
Although the pandemic has brought welcomed attention to increased cleaning and personal hygiene, it's also divided some who have angrily disagreed at public meetings, in schools andin businesses about mask wearing and vaccinations.
"We need to be kinder to each other," Cascarelli said. "There's so much divisiveness that occurred over (the pandemic). We need to be kinder to one another, even if we don't think the same way about things."
The pandemic left no community untouched. Villages and cities in the tri-county area mighthave fared better than their larger, more urban counterparts, but some businesses still struggled.
For Holmes County manufacturers, the impact varied based on theproduct produced at a certain company, saidHolmes County Economic Development Council Executive Director Mark Leininger
"Companies that manufactured jarred goods and shelf-stable food items saw significant increases in demand for their products, particularly during the early stages of the pandemic," Leininger said.
Outdoor furniture and structure manufacturers saw increased demand as people remained home, opting for staycations, he said. Many customers took the time at home to renovate or redecorate.
Other companies like Berlin Gardens, a manufacturer of outdoor poly furniture in Holmes County, used its manufacturing facility to help produce emergency equipment early on in the pandemic.
Now they are back to regular production of their furniture.
Leininger said some companies suffered during the pandemic and are working to build back up.
"Manufacturers of restaurant furniture suffered from decreased product demand, as dining spaces were closed and restaurant seating was limited," he said. "It is my understanding that, as restaurants began resuming normal operations, this industry sector has started to recover and continues to build momentum."
Despite many businesses closing in the cities of Ashland and Wooster in 2020, most quickly reopened with hybrid business models. Instead, of in-person dining, eateries provided curbside pick-up or offered delivery options.
While some businesses permanently closed due to the pandemic, others have weathered the storm and look forward to growth.
Ashland Main Street ExecutiveDirector Sandra Tunnell saidthe city opened some new businesses with a focus on second-story apartments above shops and eateries.
Two buildings remain unoccupied in downtown Ashland after two years of COVID-19. One is under renovationand the second is changing owners, she said.
In Ashland and Wooster, main street organizations noted that remote work affected business by limiting foot traffic.
"Remote work did have a significant impact on Downtown Wooster restaurants and retailers in 2020, but for the most part, their business traffic fully rebounded in 2021," said Shannon Waller, executive director of Main Street Wooster.
Despite office jobs returning to in-person work, remote labor continues to leave office space empty in downtown Wooster, Waller said.
"Our Economic Development Committee plans to give office space vacancies some additional attention in 2022," she said.
Like in Ashland, residential housing demand remains high, Waller said, with many availabledowntown apartments and condos filling fast.
"All of the new downtown businesses that opened during the pandemic continue to thrive, and we anticipate steady, sustainable growth going forward," she said.
The Daily Record writers Rachel Karas and Kevin Lynch contributed to this report.
Reach Bryce by email at bbuyakie@gannett.com
On Twitter: @Bryce_Buyakie
Currently, Ohio's COVID-19 cases and hospitalizations are the lowest they've been since last summer.
COLUMBUS, Ohio Coronavirus cases in Ohio are the lowest health officials have reported since last summer, though the state's health director warned of the possibility for another rise in infections in the coming weeks.
Currently, Ohio's COVID-19 cases and hospitalizations are the lowest they've been since last July and August, Ohio Department of Health Director Dr. Bruce Vanderhoff said Thursday.
Eighty of Ohio's 88 counties are in the green level on the Center for Disease Control and Prevention's community map, indicating the lowest level of concern.
"This is a significant improvement from two weeks ago," said Vanderhoff.
Even so, Vanderhoff said it's still important to pay attention to virus trends in other parts of the world.
Subvariant BA.2, which has largely driven Europe's omicron surge, has made far fewer appearances in Ohio. Data collected from Jan. 7 to March 8 shows only 2% of the state's omicron cases were linked to the BA.2 subvariant.
Vanderhoff said this subvariant appears to be more contagious than the BA.1 behind the omicron surge in the United States. That said, both react similarly to the vaccine, Vanderhoff said.
While BA.1 fades, its counterpart continues to make appearances. According to Vanderhoff, BA.2 cases could potentially increase in the U.S. in the coming weeks and months. Vanderhoff said vaccines remain the best bet to offer protection from the virus.
Chris Cook, assistant health commissioner for the Clark County Combined Health District, says he and his team are actively working to protect vulnerable community members by providing vaccine services.
"We work to prevent sickness before it happens, so we continue to vaccinate because we still have an opportunity to decrease the number of people getting sick," said Cook.
Currently, health officials in Clark County have partnered with a grocery store, as well as at the Women, Infants and Children offices, to offer COVID-19 vaccines to immunocompromised individuals.
Vanderhoff announced that state health officials would transition to reporting cases only once a week during the health departments last briefing. Updated cases, hospitalizations, deaths and vaccination numbers will now be reported at 2 p.m. every Thursday. Additionally, schools will only be required to report a COVID-19 case if district health officials perform a test and it comes back positive.
Vanderhoff has discussed shifting Ohios focus to turning the pandemic into an endemic. Despite the potential for a rise in reported BA.2 cases, Vanderhoff said it's highly unlikely the U.S. will see a surge similar to what was reported this past winter, adding those who were infected with the BA.1 variant do not appear to become re-infected with BA.2.
You can watch Thursdays briefing in the player below:
As part of The Red & Blacks health news coverage, we are publishing weekly reports on news relating to COVID-19 and its recent statistics.
COVID-19 cases have increased slightly at the University of Georgia, according to the universitys reporting system. UGA reported 20 new cases during the week of March 14-20 compared to the 13 cases during March 7-13.
The surveillance testing positivity rate increased during the week of March 14-18 to 1.15% compared to 0.00% during the week of March 7-11.
The university conducted 262 surveillance tests during the week of March 14-18 compared to the 95 tests the week of March 7-11.
Because students may have tested positive off-campus and not reported it, the actual number of COVID-19 cases in the UGA community may be higher.
Many Georgia counties are classified as high or moderate transmission geographical areas for COVID-19, according to the Centers for Disease Control and Prevention. Athens-Clarke County is classified as a moderate transmission geographic area.
According to the Georgia Geospatial Information Office, Georgias hospitals have about 24% of their intensive care unit beds left for sick patients. The percentage of intensive care unit beds left in Region E which includes ACC and several surrounding counties is about 16%.
From March 13-19, the majority of the COVID-19 cases in the southeastern U.S. were omicron cases, according to the CDC. About 21.5% were BA.2 cases.
The majority of people hospitalized with COVID-19 are unvaccinated.
There were two positive tests reported at the University Health Center. There were no positive tests reported through Athens testing sites, three positive tests from UGA surveillance testing and 15 positive tests from UGA community members reporting from other testing sites.
Students that test positive for COVID-19 off-campus are required to report it through DawgCheck, UGAs monitoring tool.
For the week of March 14-18, the UHC administered 70 vaccines. Cumulatively, the UHC has administered 33,555 vaccines.
Students and faculty may book a vaccine appointment through the UHC Vaccine Portal or get vaccinated at any University System of Georgia school. Students may also get tested for COVID-19 at the UHC with walk-in appointments. Appointments can be scheduled here. Due to vaccination status being verified on-site, individuals should bring their original vaccine card to the appointment.
From March 18-23, the county reported eight new confirmed cases, compared to 17 cases from March 12-17, according to the Georgia Department of Public Health. The countys seven-day average positivity rate was 5.8%. The World Health Organization recommends communities maintain a positivity rate below 5%.
This week, ACC reported one confirmed COVID-19 death.
According to the Georgia Geospatial Information Office, the number of current hospitalizations in Region E which includes ACC and several surrounding counties was eight as of March 23.
According to the Georgia DPH, about 49% of the county is fully vaccinated.
Statewide, the weekly number of new confirmed COVID-19 cases decreased.
According to the DPH, Georgia reported 3,435 confirmed COVID-19 cases between March 18-23. This is a decrease from the 5,317 cases recorded between March 12-17. The states seven-day average positivity rate as of March 23 was 3.4%.
The number of confirmed deaths in the state decreased. Georgia recorded 183 confirmed COVID-19 deaths between March 18-23, compared to 233 between March 12-17.
On March 23, about 600 individuals were hospitalized due to COVID-19 in the state.
According to the Department of Public Health, approximately 5.8 million Georgians have been fully vaccinated, or about 56% of the state. In comparison, the U.S. has a current full vaccination rate of 65%. Approximately 6.6 million Georgians, or 63% of the state, have received at least one dose of the vaccine.
The CDC has also released guidelines advising vaccinated individuals in areas of high transmission to still wear masks when in public, indoor settings.
