Dr. Kishwar Tanwir holds up syringes as she shows female health workers in Karachi how to inject the Pfizer COVID-19 vaccine. Pakistan has dispatched some 13,000 teams of female-led vaccinators to bring up the country's vaccination rate. Female health workers are more likely to get access to women in conservative households who don't speak to men. Diaa Hadid/NPR hide caption
Dr. Kishwar Tanwir holds up syringes as she shows female health workers in Karachi how to inject the Pfizer COVID-19 vaccine. Pakistan has dispatched some 13,000 teams of female-led vaccinators to bring up the country's vaccination rate. Female health workers are more likely to get access to women in conservative households who don't speak to men.
KARACHI, Pakistan A doctor gives a pep talk to some two dozen women sitting in a hall of a medical center. "We've got Pfizer. We've got Moderna. We've got Sinovac," says Dr. Kishwar Tanwir, who oversees vaccinations in the Pehlwan Goth district of the Pakistani city of Karachi.
The women were about to go door-to-door to offer COVID-19 jabs on a recent February day part of some 13,000 teams led by women that were dispatched across the southern province of Sindh to vaccinate some 12 million people over the age of 12.
This dramatic intervention by the Sindh government aims to vaccinate a cohort they have struggled to reach: some 25% of residents who have not had their first dose, despite vaccines being widely available for the past year through supplies provided by the U.N.-backed COVAX program, the U.S. and China.
"The objective of the door-to-door campaign was basically to focus on these people," says Dr. Sohail Raza Shaikh, the government's point person for COVID-19. "People who are less literate, less aware about the COVID-19 vaccine."
It's not known how many countries have tried to bring the vaccine to people's doorsteps, but senior Pakistani health officials said they were not aware of any other effort this large anywhere else. If it works, it could be a model for other developing countries, struggling to boost their vaccination rates. Pakistan's eventual goal: bringing the Sindh province's first dose vaccine rate to 90 to 95%.
Pakistan dispatches female health workers for these sorts of public campaigns because they're more likely to get access to women in conservative households who don't speak to men. They have years of experience, frequently fanning out across Pakistan to administer the oral polio vaccine to millions of children.
Female health workers wait for medics to fill their cooler boxes with a variety of vaccines from Pfizer to China's Sinovc to Russia's Sputnik V. Health officials say offering residents a variety of vaccine brands helps them overcome hesitation. Diaa Hadid/NPR hide caption
Female health workers wait for medics to fill their cooler boxes with a variety of vaccines from Pfizer to China's Sinovc to Russia's Sputnik V. Health officials say offering residents a variety of vaccine brands helps them overcome hesitation.
At the medical center in Pehlwan Goth, Namra, a 21-year-old health worker waits for a medic to fill her blue cooler box with a mix of different vaccines stored in a deep freezer. She's only got one name, like many people here.
She jumps into a rickshaw to travel to her assigned area some five minutes away, accompanied by her team two sisters: Sajeela and Sajida. One is a social mobilizer: Her job is to convince residents to get vaccinated. The other sister enters data about the people they're vaccinating.
They reach the Hindubasti, a ramshackle patch of huts dominated by Hindus and Sikhs, wedged between leafy nurseries and a college. They weave through narrow alleyways, stepping around garbage and puddles. The women turn a corner and enter the grounds of a Hindu temple.
Namra is meant to vaccinate door-to-door, but she says she'd rather do it in the temple. The Hindubasti is a small area, she says, and residents can easily find her here, adding "This is a very dirty area this is the only clean place."
She respectfully takes off her shoes and enters the temple, where colorful statues of Gods and flowers adorn a shelf. Her gesture is striking in a Muslim-majority country where Hindus are often looked down upon.
Her two colleagues head to the nearest house to start mobilizing people to come to the temple to get vaccinated. They greet a woman, Kamli, sitting with her husband in a patch of sunlight outside their hut.
Kamli says she's not vaccinated because she's got kidney stones. She's worried the vaccine will make her sicker, and she can't afford a doctor. "My husband is a balloon seller," Kamli says. "We barely eat bread."
A young woman in the informal Hindubasti settlement in Karachi, holds the balloons that her father sells to provide a livelihood for them all. It's scarcely enough, says the woman's mother, Kamli. "We barely eat bread," she says. Diaa Hadid/NPR hide caption
A young woman in the informal Hindubasti settlement in Karachi, holds the balloons that her father sells to provide a livelihood for them all. It's scarcely enough, says the woman's mother, Kamli. "We barely eat bread," she says.
The health workers prod her to get vaccinated at the temple. She shrugs.
In the next hut, Mohammad Shuaib, 38, insists he got his first injection in December but hasn't got around to his second. Health workers find Birma Lal around 40 shaving in his front yard. He says he'll come after he smartens up. His wife promises to go once she finishes hand-washing the laundry in a shallow tub.
None of them turn up.
Then the health workers head next door, where a man in his mid-30s, Kamran, is sitting in front his hut on a charpoy, a bed made of woven rope. He says he's had his first shot, but his relatives gesturing to the men standing around him don't want to be vaccinated at all. "There's a rumor it could affect your sexual powers or even kill you," he says.
As he chats, Namra, the vaccinator, leaves the Hindu temple and passes Kamran's house. "Only one woman came by," she says, for a vaccine dose at the temple.
Then, Namra sees a few people milling around Kamran's house. She puts her cooler box filled with vaccines on Kamran's charpoy right beside him. It might be grubby, but there's people she might be able to convince.
The mood shifts.
Namra starts offering vaccines to one of Kamran's unvaccinated relatives, Prakash. "I've got American vaccines, Chinese vaccines," she says, gesturing to her cooler box. He asks for Pfizer, and Namra quickly gets vial. She injects him, and makes him sit for 15 minutes so she can observe for side effects. Her colleagues take down his details.
Namra, a 21-year-old health worker, prepares a syringe with COVID-19 vaccine at the house of Kamran, in the informal Hindubasti settlement in Karachi. Diaa Hadid/NPR hide caption
Namra, a 21-year-old health worker, prepares a syringe with COVID-19 vaccine at the house of Kamran, in the informal Hindubasti settlement in Karachi.
Watching this, laborer Sana Tandharam asks to get vaccinated. "I was waiting for other people to get vaccinated first!" he exclaims.
A line gathers. Other health workers turn up to support Namra a young man helps out on entering the data of residents about to be vaccinated. Another support worker comes to encourage more people to come to Kamran's house.
Women wait for their turn as their toddlers cling to their legs. Giggling teenage girls cluster on another charpoy. Then it's the turn of 13-year-old Aarthi. Her shirt is so tattered that Namra injects the vaccine into her arm through a hole in her sleeve.
A young woman clenches her dupatta, or scarf, between her teeth as Namra, a 21-year-old health worker, injects her with a COVID-19 vaccine. Diaa Hadid/NPR hide caption
A young woman clenches her dupatta, or scarf, between her teeth as Namra, a 21-year-old health worker, injects her with a COVID-19 vaccine.
Ten days into the two-week campaign, Shaikh, the Sindh point person for COVID-19, says they're doing well. His data shows that they've vaccinated just over half their target of 12 million people with their first dose. He says they'll run another campaign in late March.
"Now that it's been done here," he says of the door-to-door effort, "it can be replicated in other parts of Pakistan. I would suggest that this is a good model."
This model could be done in other developing countries but it's expensive, says Bill Gates of the Bill and Melinda Gates Foundation (which is a funder of NPR and this blog). He was in Pakistan in mid-February to see the country's polio vaccination efforts firsthand and spoke to reporters.
"The polio campaign has used to house-to-house basically in the entire world, and it's not used for much else," Gates says. "It's expensive. But if you want to get, well over 90% coverage, 95% coverage, certainly in developing countries, that's the only way you'll get to that level."
Young women wait to get vaccinated by Namra, a 21-year-old health worker who's part of a national door-to-door vaccination effort in the informal Hindubasti settlement in Karachi. Diaa Hadid/NPR hide caption
Young women wait to get vaccinated by Namra, a 21-year-old health worker who's part of a national door-to-door vaccination effort in the informal Hindubasti settlement in Karachi.
Back in the slum, it's the late afternoon and Namra thanks Kamran for letting her work in his yard. Her team packs up and walks through a communal square where teenage girls are washing laundry in tubs. When they see Namra and her cooler box, they squeal and line up for a shot: It's the most exciting thing on a day of drudgery. Young men see the women, and they gather too.
Namra walks to the nearest hut, puts down her vaccine cooler box on a charpoy, pulls out a sterile syringe and starts again.
Scientists have identified a new, highly mutated version of the coronavirus in white-tailed deer in southwestern Ontario, one that may have been evolving in animals since late 2020.
They also found a very similar viral sequence in one person in the area who had close contact with deer, the first evidence of possible deer-to-human transmission of the virus.
The virus is evolving in deer and diverging in deer away from what we are clearly seeing evolving in humans, said Samira Mubareka, a virologist at Sunnybrook Research Institute and the University of Toronto and an author of the new paper.
The report has not yet been published in a peer-reviewed journal, and there is no evidence that the deer lineage is spreading among, or poses any elevated risk to, people. Preliminary laboratory experiments suggest that the lineage is unlikely to evade human antibodies.
But the paper was posted online just days after another team reported that the Alpha variant may have continued to spread and evolve in Pennsylvania deer even after it disappeared from human populations.
Together, the two studies suggest that the virus may be circulating among deer for extended periods of time, raising the risk that the animals could become a long-term reservoir of the virus and a source of future variants.
Theres certainly no need to panic, said Arinjay Banerjee, a virologist at the University of Saskatchewan who was not involved in either study.
But, he added, The more hosts you have, the more opportunities the virus has to evolve.
Previous studies have found that the virus is widespread in white-tailed deer. Research suggests that humans have repeatedly introduced the virus to deer, which then transmit it to one another. How humans are spreading the virus to deer remains a mystery, and until now, there has been no evidence that the animals are passing it back to humans.
The Canada study was a collaboration involving more than two dozen researchers at institutions across Ontario. The scientists collected nasal swabs and samples of lymph node tissue from 300 white-tailed deer killed by hunters in Ontario between Nov. 1 and Dec. 31, 2021. Six percent of the animals, all from southwestern Ontario, tested positive for the virus, suggesting that they were actively infected when they died.
The researchers sequenced the full viral genomes from five infected deer and found a unique constellation of mutations that had not been previously documented. Overall, 76 mutations some of which had previously been found in deer, mink and other infected animals set the lineage apart from the original version of the virus.
The deer samples were most closely related to viral samples taken from human patients in Michigan, not far from southwestern Ontario, in November and December 2020. They were also similar to samples taken from humans and mink in Michigan earlier that fall.
Those findings, as well as the rate at which the virus accumulates mutations, suggest that the new lineage may have diverged from known versions of the virus, and been evolving undetected, since late 2020.
But its precise path is unclear. One possibility is that humans might have passed the virus directly to deer, and the virus then accumulated mutations as it spread among the cervids. Alternately, the lineage may have evolved at least partly in another, intermediate species perhaps farmed or wild mink which then somehow transmitted it to deer.
March 5, 2022, 7:14 p.m. ET
We dont have all the pieces in the puzzle, Dr. Suresh Kuchipudi, a veterinary microbiologist at Penn State, who was not involved in the research, said in an email. We cannot rule out the involvement of an intermediate host.
A viral sample collected from one human patient in southwestern Ontario in the fall of 2021 closely matched the deer samples. That person is known to have had close contact with deer, the researchers said.
(They could not disclose more details about the nature of this contact for privacy reasons, although Dr. Mubareka noted that people should not worry about incidental, indirect encounters, like simply having a deer wander through their backyard.)
The sample size is tiny, scientists cautioned, and there is no conclusive proof that the person caught the virus from deer. We dont have enough information yet to confirm that transmission back to humans, said Roderick Gagne, a wildlife disease ecologist at the University of Pennsylvania School of Veterinary Medicine.
But at the time the human sample was collected, Ontario was sequencing samples of the virus from everyone in the region who tested positive on a P.C.R. test. The researchers did not find any other people who had been infected by similar versions of the virus, making it less likely that it evolved independently in humans.
Had it been circulating widely in humans, even narrowly in humans, I think we would have picked it up, Dr. Mubareka said.
There is also no evidence that the person infected with the lineage passed the virus on to anyone else.
Mask guidance. The Centers for Disease Control and Prevention released updated data that suggests 90 percent of the U.S. population are in a location with low or medium Covid-19 community levels and can now stop wearing masks.
N.F.L. drops protocols. The National Football League and the players union agreed to suspend all Covid-19 protocols, effective immediately. The league, which is not in season, is the first of the major professional sports leagues in the United States to halt its coronavirus-related policies
And early data suggest that existing vaccines should still be able to protect against the lineage. Antibodies from vaccinated people were able to neutralize pseudoviruses harmless, nonreplicating viruses that had been engineered to resemble the deer lineage, the scientists found.
In the second study, scientists from the University of Pennsylvanias veterinary and medical schools analyzed nasal swabs from 93 deer that died in Pennsylvania in the fall and winter of 2021. Nineteen percent were actively infected with the virus. When the researchers sequenced seven of the samples, they found that five of the deer were infected with the Delta variant, while two were infected with Alpha.
At the time the samples were collected, Delta was widespread among the human residents of the United States, but the Alpha wave that hit Americans in the spring of 2021 had long since faded.
Alpha seems to be persisting in the white-tailed deer even during the time when its not circulating in humans, said Eman Anis, a microbiologist at the University of Pennsylvania School of Veterinary Medicine and an author of the study.
Indeed, the Delta samples in deer were genetically similar to those from humans, suggesting that it had crossed species lines relatively recently. But the two Alpha sequences had diverged more significantly from human lineages. (They were also substantially different from each other, suggesting that the variant had been introduced to the deer population at least twice.)
The main implication would be that the deer sustain transmission and infections within their populations, Dr. Gagne, an author of the Pennsylvania study, said. So that is not just, you know, a spillover event from humans, deer get infected and then it fizzles out.
Whether these lineages will continue to circulate and evolve in deer is unknown, as is the risk they may pose to humans and other animals.
Based on current information, Id say that the risk of wildlife, including deer, spreading the virus to people is low, said Jeff Bowman, a research scientist at the Ontario Ministry of Northern Development, Mines, Natural Resources and Forestry and an author of the Canada paper.
But ongoing surveillance is critical, scientists said. Dr. Mubareka suggested that officials should enhance wastewater screening in Ontario and other nearby regions to look specifically for the deer lineage and to ensure that it is not becoming more prevalent.
Experts also urged people to continue to follow guidelines put out by public health agencies, including not feeding deer or other wildlife and wearing gloves while butchering game.
We should also be reducing the biggest reservoir for this virus, which is us, Dr. Mubareka said, to make sure were not continuously spilling into deer and creating these new lineages.
The arc of the pandemic, from the dark beginnings to this new awakening, is efficiently told through the story of the chef Sean Rembold, who has worked in some of Brooklyns best loved kitchens. For him, the past week was clearly a turning point. Mr. Rembold and his wife, the fashion designer Caron Callahan, had Covid in the initial phase of the pandemic, that long, terrifying stretch when you could not be sure that you would get a hospital bed if you needed one. He spent a lot of time worrying, and he lost his taste for four months.
Immediately before that he had been working as a private chef and taught cooking to people who had come out of prison. But when the crisis upended everything, he somehow saw an opportunity to open a restaurant of his own. He had wanted to do that for a long time. During the preceding five years he had looked at every available space in Cobble Hill and Carroll Gardens, but nothing quite worked.
Then, last winter he found something on a residential stretch of Hicks Street on the north end, a block off the water. The space had previously been occupied by a longstanding neighborhood restaurant that closed early in the pandemic.
We said were not going to move upstate; were not going to move to Nashville, he told me. We are going to stay and commit and be a part of whatever was going to happen next in the city. Mr. Rembold had always wanted a neighborhood restaurant, not a concept.
His restaurant, Ingas Bar, quietly opened this week after many months of stops and starts. At one point it was to open in early December and then in February, but supply chain issues, the labor shortage and the increasingly slow pace of the states liquor-licensing apparatus also a result of the shrinking labor pool delayed everything.
On Wednesday, the restaurant received friends and family. Neighbors walked by and took pictures. Mr. Rembold imagined a place where an architect might land at the bar next to a contractor, a writer next to an editor and so on. He was, in his heart, a cross-pollinator.
But at the same time it was true that you might walk several blocks and still find many people wearing masks outside. And why was it that, despite the science about surface viral transmission, some restaurants continued to deal only in those pointless digital menus? For the immuno-compromised, the pandemic is certainly not over but its unclear how a measure like that will help them. It will take a long time for all of us to recalibrate, to shed pandemic worn habits. But for now, at least, it feels like a moment.
After two years, a flood of illness and incalculable losses, is the coronavirus pandemic finally over?
No. But that doesnt mean we are not in a much better place, said Jan Malcolm, state health commissioner, who has guided Minnesota through the last two years of the pandemic. The state reported its first COVID-19 infection March 6, 2020.
We have to stay prepared, Malcolm added. We should be at a point where COVID doesnt dominate everything.
That can already be seen in new guidance from officials doing away with mask and vaccine requirements at bars and restaurants.
While the current picture looks good, Malcolm noted theres still a lot of risk for people who are vulnerable.
When we say back to normal, thats not true for everyone, she said. We are in a way better place. A lot has changed for the good.
Heres a detailed look at how far weve come since that first case was diagnosed, what the long-term impact has been and what to expect next.
Diagnosing coronavirus infections quickly, easily and accurately was one of the first big challenges of the pandemic and it remains an intermittent frustration two years in.
At first, it was nearly impossible to get a test and the initial kits sent to states by the Centers for Disease Control and Prevention didnt work.
Gov. Tim Walzs Minnesota moonshot, including a partnership with the Mayo Clinic and the University of Minnesota, gave the state strong testing capacity by summer 2020. By that fall, as one of the worst surges in cases of the pandemic was taking hold, a new lab in Oakdale was shipping saliva tests to peoples front doors.
Minnesota has now administered almost 19 million COVID-19 tests, roughly three tests for each of the states 5.7 million residents. At its peak, the state was processing more than 60,000 tests per day.
Almost 1.4 million residents have tested positive for COVID-19 about a quarter of the states population. More than 98 percent of them recovered enough they no longer need to be isolated, while 61,000 have gotten sick multiple times.
For much of 2021, getting tested was easy and there were a growing number of options. Then, when the omicron variant hit, cases soared and tests were once again nearly impossible to find.
Early stumbles on testing by the federal government and the relative free-for-all between the states for accurate methods and supplies encouraged unusual players to come to the field. GS Labs was one of them it was spun off of a testosterone replacement clinic in Omaha, Neb.
If the government hadnt stumbled, there would be no GS Labs, said Dr. Darin Jackson, the labs medical director. We filled a void.
GS Labs provides rapid antigen tests for most people and follows up with genetic tests for symptomatic patients who need them. It has eight locations in the Twin Cities and about 25 testing sites across the U.S.
Minnesota, like much of the U.S., has experienced an ebb and flow of infections that has been hard to predict. Cases hit the most vulnerable early on, then were widespread when the weather got colder and the delta variant brought months of high case rates.
Finally, the omicron-driven surge hit quickly and drove rates to unprecedented heights. Jackson says his labs were testing 10,000 people a day right around Christmas. That type of sudden and renewed demand is proof that quick, easy and accurate tests will likely be needed for a while.
Thats the million-dollar question, Jackson said. I dont think it will be going away any time soon.
Ensuring everyone with COVID-19 who needed a hospital bed was able to get one was the key medical aim of the states early response and it never really changed. But the way those patients were cared for has been dynamic throughout the pandemic.
The early concerns were about space and equipment. Ventilators and protective gear were in short supply. There was talk of triage hospitals in empty buildings or public spaces like the Mall of America.
It never came to that, but hospitals have been full for much of the pandemic with more than 60,000 needing treatment. Once prepared, doctors and nurses were able to handle an influx of cases in the fall of 2020.
Then, vaccines helped lessen the demand until the delta variant began driving up cases again. From summer 2021 until the end of the year, hospitals were hit with an unprecedented number of patients.
The first six months was running fast, said Rahul Koranne, president and CEO of the Minnesota Hospital Association. The last year and a half has been nothing but exhaustion and crisis upon crisis.
The lasting shortages have been staffing. Thousands of nurses and other care providers have left their jobs during the pandemic because of burnout, fear of infection and exhaustion.
Calli Pettigrew, a nurse at Childrens Hospital in St. Paul, says the pandemic had a catastrophic impact on her and her colleagues. Early on, she was furloughed to help the hospital save money, and when she came back six months later, many of her colleagues had left and there were staffing shortages.
The past two years has felt like being crushed from all sides, she said. It is unsustainable. Im so tired of being called a hero. I just want to be treated like a human being.
Pettigrew said systemic reforms to better protect nurses and patients are desperately needed.
If more nurses decide to leave the bedside, our system will crumble, she said.
The Minnesota Department of Employment and Economic Development estimates there are 40,000 open medical jobs in the state. Nationally, about one in five medical workers has quit and another one in three is considering it.
To fill the gap, Walz had to call in the Minnesota National Guard, get help from the U.S. Department of Defense and spend $40 million on temporary medical workers.
Nevertheless, hospital capacity remains strained in parts of Minnesota even as COVID-19 cases have fallen. Many are filled with patients who delayed care for other conditions during the pandemic.
About 38 percent of the states hospitals still dont have any available intensive care beds.
Koranne says hospitals and state leaders must do more to address staffing shortages or there could be dire consequences.
It could mean a Minnesotanshows up in an emergency room and we dont have the staff to care for them, he said.
Koranne says the pandemic left the states hospitals in dire financial shape. That makes it more challenging for institutions to rebalance how they provide care when they need to respond to COVID-19 outbreaks.
Minnesotas hospitals went from tight 1.4 percent margins prior to the pandemic to losing more than $3 billion in the early months of the pandemic. We are really worried about next year, he said.
From the start, Minnesotas elderly and vulnerable adults have been hit hardest by the pandemic. More than 81 percent of 12,183 deaths have been people 65 or older and about 46 percent of fatalities were residents of nursing homes or long-term care.
The majority of those who died in Minnesota had pre-existing health conditions that put them at higher risk. After vaccines became widely available, health officials say the average age of those who died began to trend younger because of fatalities among the unvaccinated.
But overall the young were least likely to have a fatal outcome with COVID-19. Just 110 Minnesotans under the age of 35 died of COVID-19, less than 1 percent of all the states deaths.
Minnesota has a team that investigates every fatality and COVID-19 has to be a cause of death to be included in the states tally. In addition to the confirmed COVID-19 deaths, there are 190 others that are suspected to have been caused by the coronavirus, but the person never had a positive test.
For much of the pandemic, Minnesota had one of the nations highest rates of deaths in long-term care. At its worst point, there were more than 700 long-term care facilities with cases among residents or staff.
Kristine Sundberg, executive director of Elder Voice Family Advocates, says it was a travesty that Minnesota didnt have a licensure system for assisted living until August 2021. She believes better oversight at the start of the pandemic could have saved lives.
Sundberg noted that isolation was also a killer for many vulnerable patients because it prevented families from monitoring the care being given.
In other incidents, people died of outright loneliness. Social isolation and failure to thrive were listed on several Minnesota death certificates at the height of the pandemic.
Long-term care facilities have defended their actions during the outbreak. The industry has long suffered from staffing shortages and the pandemic created many other unprecedented challenges.
Cases and deaths among long-term care residents dropped dramatically once vaccines became available and facilities had the staff and supplies to control the spread of the virus.
The three vaccines that won emergency approval less than a year into the pandemic were a game changer. Shots from Pfizer and Moderna tapped an emerging technology that uses mRNA genetic material.
Remarkable, said Malcolm. The scientific progress that has been made in two years is nothing short of breathtaking.
Minnesota administered 5.5 million doses of vaccine in the first six months they were available. By summer 2021, demand waned considerably. A lot of the hesitancy was driven by misinformation being spread on social media about vaccine effectiveness and safety.
To encourage more residents to get the jab, Walz offered incentives like cash, event tickets and even opportunities for college scholarships.
Through January, Minnesota spent more than $10 million on vaccine incentives. About 66 percent of the states 5.7 million residents have completed their initial series of vaccines.
Unfortunately, that may not be enough. Research of patients receiving care through veterans hospitals found vaccine protection waned considerably after six months.
To restore protection, boosters are recommended for anyone 12 and older. More than 2.1 million boosters have been administered so far.
Vaccine makers are creating variant-specific versions of their shots in order to try to keep up with the evolving SARS-CoV-2 virus that causes the illness COVID-19. Health experts believe a seasonal shot, much like those already manufactured for influenza, may be needed to keep the coronavirus in check.
The arrival of variants, specifically the delta strain that became dominant last summer, upended the pandemic fight. While some variants were not of consequence, delta and later omicron were much more contagious and vaccines did little to prevent infections.
But health officials say the shots still protect against severe illness and death.
Nonetheless, breakthrough infections climbed dramatically during the delta wave. Omicron drove them even higher.
Since widespread vaccination began in January 2021, there have been more than 367,000 COVID cases in people who were fully vaccinated, roughly 37 percent of the almost 996,000 cases diagnosed during that time.
Of those, 9,836 were hospitalized and 1,777 died.
Furthermore, when the highly-contagious omicron variant hit the state in December and January, the majority of infections, close to 60 percent, were in people who were vaccinated.
Laura Kirk and her family in Southwest Minneapolis were among them. After a Christmas celebration, where everyone who was eligible was vaccinated and most had a booster, 12 of the 16 attendees eventually tested positive. Luckily, no one had a severe illness.
It made it clear that omicron presented a whole new ballgame, said Kirk, who is a professor of nursing at the University of Minnesota. I think our experiences, while it was awful and sobering, it also demonstrated how truly effective these vaccines are.
The coronavirus pandemic led to unprecedented restrictions on nearly every aspect of life in order to slow the virus spread.
In March 2020, Gov. Walz issued a peacetime state of emergency that was in place for more than a year. It didnt end until summer 2021 when lawmakers included it in a deal for the current two-year state budget.
Under the emergency, Walz was able to close businesses and schools and require people to stay home except for necessary trips. It was controversial from the start and Minnesota Republican lawmakers tried repeatedly to end it.
Even after the statewide restrictions ended, many local communities and schools kept coronavirus mitigation measures in place.
That lead to ruckuses at school board meetings, like one in the Rosemount-Apple Valley-Eagan district on Feb. 14 where residents chanted for the masks requirement to be lifted and shouted down school board members.
It has been a challenging two years for everyone, Superintendent Mary Kreger said at a follow-up meeting Tuesday when the board voted to follow new CDC guidance and end mask requirements. Understandably, people are exhausted.
With unprecedented restrictions also came a flood of state and federal aid to offset the impact on the economy. More than $72 billion has come to Minnesota through a series of aid packages since the pandemic began, according to recent testimony by Minnesota Management and Budget officials to the state Senate finance committee.
Much of that, more than $52 billion, was various types of economic assistance sent to workers and businesses through stimulus payments, enhanced unemployment and aid to businesses to keep employees on the payroll. For context, the states latest two-year budget is about $52 billion.
More than $7 billion was sent to Minnesota state and local governments in flexible funds that could be used for a variety of programs. Another $3.4 billion was earmarked for education, $4 billion was for human service programs and $1 billion was for housing aid.
Minnesota will be dealing with the impact of the pandemic for years, if not decades, to come. One of the most persistent and mysterious impacts is those who were sickened with COVID-19 and never fully recovered.
The so-called long-haulers, or those with long COVID, can experience symptoms for months after they normally would have expected to recover. The most common are brain fog, fatigue, shortness of breath, as well as joint and muscle pain.
Dr. Greg Vanichkachorn, director of Mayo Clinics COVID-19 Activity Rehabilitation Program, says its hard to know how many people have long COVID, but estimates suggest it could be almost 30 percent of those who were infected. Most of those who experience lasting impacts after infection were not seriously ill in the first place.
There are still a lot of questions about what causes long COVID, but some clues are beginning to emerge as the condition is studied at Mayo and elsewhere. How the immune system reacts to a coronavirus infection is a key focus of research.
We think a lot of the symptoms come from that robust immune inflammatory response, Vanichkachorn said. Theres also been some studies showing perhaps pieces of the virus still floating around in the body that could be causing this immune effect.
The good news is that many long-haulers eventually recover, Vanichkachorn says. But it is important that anyone suffering from prolonged symptoms contact their health care provider.
The big takeaway is that its not rare, he said. Outside of acute illness, just helping people survive, the long-COVID scenario is the one I am worried about most.
As Minnesotans prepare for what they hope will be a new normal in the months ahead, it is clear the state has been dramatically changed by the pandemic. Everything from child care to schools, shopping to work, housing to health care is different in ways large and small.
Commissioner Malcolm says thats a good reason not to discount the SARS-CoV-2 virus going forward. New variants are bound to emerge, and some of them may require an aggressive response.
This virus is unpredictable and still evolving, Malcolm said. We have to keep the tools in the toolbox and be ready to use them. This virus has surprised us multiple times and it should keep us humble.
Two years after the first wave of COVID-19 prompted an unprecedented shutdown of offices, factories, and schools, it looks like the U.S. economy is finally moving beyond the coronavirus. Last month, employers added close to seven hundred thousand jobs on a seasonally adjusted basis, according to Fridays monthly employment report. The over-all unemployment rate dipped to 3.8 per centthe lowest level since the onset of the pandemic. Economists had been expecting positive news, owing to the decline in the Omicron wave, but the report was far stronger than expected. Hiring was healthy across a broad range of industries, and the labor force expanded by more than three hundred thousand people, as more Americans returned to work.
As always, it is important to note that month-to-month job figures bounce around quite a bit. But the February report showed that the economy has displayed sustained strength: the employment figures for December and January were revised upward, and the updated figures show that the economy has created almost 1.75 million jobs over the past three months. Thats close to six hundred thousand a monthroughly three times the rate before the pandemic. Since November, the employment-to-population ratio, which is a broad measure of the labor markets strength, has risen by six-tenths of a percentage point to 59.9%, the highest since the pandemic began. That, too, is a positive signespecially during a period when the Omicron wave spread across the country.
The recent job gains have been largest in some of the sectors that the pandemic hit hardest, including travel, leisure, and hospitality. In February alone, bars and restaurants added 124,000 jobs; over the past three months, they have added more than three hundred thousand jobs. Strength in hiring has spread to other parts of the economy as well. Last month, manufacturing added 36,000 positions; retail added 37,000; construction added 60,000; health care added 64,000; professional and business servicesa broad category that includes temp agencies, management consulting, and technical servicesadded an impressive 95,000.
From a human perspective, one particularly positive development is that the number of people who have been out of work for six months or more continues to fall. The long-term unemployed are often the ones who suffer the most from economic downturns, partly because the chances of finding a new job drop the longer you are out of work. During the first year of the pandemic, the number of long-term unemployed rose to more than four million. That figure has now dropped by about sixty per centto 1.7 million.
Despite these gains, the labor market hasnt fully recovered from the unprecedented contraction at the start of the pandemic. In February of 2020, the total number of Americans employed outside the farming sector was 152.5 million; two months later, that figure had fallen to 130.5 million. Last month, it climbed back to 150.4 million. These figures indicate that much of the economic damage that the pandemic wreaked has been repaired, but also that there is still plenty of scope for further job gains in the months and years ahead. According to the Harvard economists Jason Furman and Wilson Powell III, the economy would need to add about another 3.5 million jobs to catch up with the pre-pandemic projections. Its not clear yet what impact the war in Ukraine, and its economic fallout, will have on the global economy. But the jobs report confirms that the U.S. economy started the year with a great deal of momentum.
The one bleak element of the report was that average hourly earnings barely rose in February, which means that, during this period of high inflation, workers real wages fell as earnings lagged behind rising prices. Its not clear yet whether this is a statistical blip or a more lasting trend. Over the past year, average hourly earnings have increased by 5.1 per cent, as employers in many industries have been forced to raise wages to attract workers. On the upside, the slowdown in wage growth suggests that the recent surge in inflation isnt producing a wage-price spiral, which should ease the fears of inflation hawks whose panicked calls for drastic interest-rate hikes could inadvertently spark a recession.
Over-all, though, the jobs report was very positive, and President Biden could hardly be blamed for crowing about it. (Todays report shows that my plan to build an economy from the bottom up and the middle out is working to get America back to work, he said in a statement.) To be sure, we dont know what the future may bring in terms of new variants of the coronavirus. The fact that the Omicron variant proved somewhat less deadly than previous variants, especially to the vaccinated, undoubtedly helped to mitigate its impact on the economy. But it is also true that the measures developed to mitigate the pandemic, including vaccinations, testing, and remote workingand also the large-scale financial support that Congress provided in 2020 and 2021have greatly enhanced the economys ability to coexist with the virus. After all weve been through in the past two years, that is a very encouraging development indeed.
NASHVILLE, Tenn. (WKRN) Saturday marks two years since the Tennessee Department of Health announced the first COVID-19 case in Tennessee.
Health officials confirmed the first case in Tennessee on March 5, 2020. The patient was a 44-year-old man from Williamson County who had traveled out of state on a nonstop round-trip flight between Boston, Massachusetts and Nashville International Airport.
The announcement came just one day after Governor Bill Lee announced the creation of the coronavirus task force.
Since the first case of COVID-19 was reported, there have been more than 2 million cases of COVID-19 in Tennessee and more than 24,000 deaths, according to data provided by the Tennessee Health Department.
Tennessee Department of Healths Dashboard shows that 9,216,645 vaccines have been given out in Tennessee. Currently, 52.7 percent of the Volunteer States population is fully vaccinated.
With COVID-19 mandates and restrictions slowly declining, many Tennesseans may think the days of worrying about COVID-19 are over. However, some health professionals warn not so fast.
Dr. Britt Maxwell, an internal medicine specialist at Ascension Saint Thomas West in Nashville, says although numbers are showing a downward trend, the future of COVID-19 still remains uncertain.
No one really knows what the future is going to bring at this point, said Dr. Maxwell. We would love to think that what we are seeing now means the end of the pandemic and that we could move forward, but what weve learned is that coronavirus has surprises for us all.
Data presented by the Tennessee Department of Healths County Data Snapshot shows Shelby County accounts for the most COVID-19 cases in Tennessee with 11.5 percent of COVID-19 cases statewide. Pickett County accounts for the least COVID-19 cases in Tennessee with 0.1 percent of COVID-19 cases statewide.
Twenty-six more Mainers have died and another 447 coronavirus cases reported across the state, Maine health officials said Friday.
Fridays report brings the total number of coronavirus cases in Maine to 230,720,according to the Maine Center for Disease Control and Prevention. Thats up from 230,273 on Friday.
Of those, 167,059have been confirmed positive, while 63,661were classified as probable cases, the Maine CDC reported.
Eleven men and 15 women have succumbed to the virus, bringing the statewide death toll to 2,135.
Four were from Androscoggin County, two from Aroostook County, two from Cumberland County, three from Kennebec County, two from Knox County, one from Lincoln County, one from Oxford County, four from Penobscot County, one from Piscataquis County, two from Somerset County, two from Waldo County and two from York County.
The number of coronavirus cases diagnosed in the past 14 days statewide is16,950. This is an estimation of the current number of active cases in the state, as the Maine CDC is no longer tracking recoveries for all patients. Thats down from 23,514 on Friday.
The new case rate statewide Friday was 3.34cases per 10,000 residents, and the total case rate statewide was 1,723.84.
The most cases have been detected in Mainers younger than 20, while Mainers over 80 years old account for the largest portion of deaths. More cases have been recorded in women and more deaths in men.
So far, 4,401Mainers have been hospitalized at some point with COVID-19, the illness caused by the new coronavirus.
Of those, 154 are currently hospitalized, with 33 in critical care and 12 on a ventilator. Overall, 56 out of 352 critical care beds and 257 out of 328 ventilators are available
The total statewide hospitalization rate on Saturday was 32.88patients per 10,000 residents.
Cases have been reported in Androscoggin (22,186), Aroostook (12,050), Cumberland (47,414), Franklin (5,572), Hancock (7,088), Kennebec (22,195), Knox (5,739), Lincoln (5,031), Oxford (10,918), Penobscot (26,711), Piscataquis (2,910), Sagadahoc (4,902), Somerset (9,333), Waldo (5,877), Washington (4,133) and York (38,634) counties. Information about where an additional 27 cases were reported wasnt immediately available.
An additional 698 vaccine doses were administered in the previous 24 hours. As of Saturday, 989,196 Mainers are fully vaccinated, or about 77.24 percent of eligible Mainers, according to the Maine CDC.
As of Saturday morning, the coronavirus had sickened 79,251,010 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 958,170 deaths, according to the Johns Hopkins University of Medicine.
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Cameron County reported a total of five coronavirus-related deaths and 124 positive cases of COVID-19 in the last two days.
On Thursday, the county reported 81 total cases, 56 of which were confirmed by PCR tested. The county also reported four people who died due to the virus, none of whom were fully vaccinated, the county reported.
On Friday, the county reported 43 cases of COVID-19, 28 of which were confirmed based on PCR testing. The county also reported a Brownsville man in his 60s who was not vaccinated against the disease died from the virus.
Since the pandemic began, 2,192 people have died due to the coronavirus in Cameron County.
Vaccination efforts continue across Cameron County; currently, 84.91% of the population, five years and older, is fully vaccinated.
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The coronavirus vaccine made by Pfizer-BioNTech is much less effective in preventing infection in children ages 5 to 11 years than in older adolescents or adults, according to a large new set of data collected by health officials in New York State a finding that has deep ramifications for these children and their parents.
The Pfizer vaccine is the only Covid shot authorized for that age group in the United States. It still prevents severe illness in the children, but offers virtually no protection against infection, even within a month after full immunization, the data, which were collected during the Omicron surge, suggest.
The sharp drop in the vaccines performance in young children may stem from the fact that they receive one-third the dose given to older children and adults, researchers and federal officials who have reviewed the data said.
The findings, which were posted online on Monday, come on the heels of clinical trial results indicating that the vaccine fared poorly in children aged 2 to 4 years, who received an even smaller dose.
Experts worried that the news would further dissuade hesitant parents from immunizing their children. Other studies have shown the vaccine was not powerfully protective against infection with the Omicron variant in adults, either.
Its disappointing, but not entirely surprising, given this is a vaccine developed in response to an earlier variant, said Eli Rosenberg, deputy director for science at the New York State Department of Health, who led the study. It looks very distressing to see this rapid decline, but its again all against Omicron.
Still, he and other public health experts said they recommend the shot for children given the protection against severe disease shown even in the new data set.
We need to make sure we emphasize the doughnut and not the hole, said Dr. Kathryn M. Edwards, a pediatric vaccine expert at Vanderbilt University.
In their study, Dr. Rosenberg and his colleagues analyzed data from 852,384 newly fully vaccinated children aged 12 to 17 years and 365,502 children aged 5 to 11 years between Dec. 13, 2021, and Jan. 31, 2022, the height of the Omicron surge.
The vaccines effectiveness against hospitalization declined to 73 percent from 85 percent in the older children. In the younger children, effectiveness dropped to 48 percent from 100 percent. But because few children were hospitalized, these estimates have wide margins of error.
The numbers for protection from infection are more reliable. Vaccine effectiveness against infection in the older children decreased to 51 percent from 66 percent. But in the younger children, it dropped sharply to just 12 percent from 68 percent.
The numbers change drastically between ages 11 and 12. During the week ending Jan. 30, the vaccines effectiveness against infection was 67 percent in 12-year-olds but just 11 percent in 11-year-old children.
The difference between the two age groups is striking, said Florian Krammer, an immunologist at the Icahn School of Medicine at Mount Sinai.
The biological difference between the two ages is likely to be minimal, but while 12-year-old children got 30 micrograms of the vaccine the same dose given to adults children who were 11 received only 10 micrograms, he noted.
This is super interesting because it would almost suggest that its the dose that makes the difference, he added. The question is how to fix that.
There have been at least 851 deaths involving Covid-19 in children under 17, and nearly 7,000 cases of multisystem inflammatory syndrome in children, a rare but serious condition associated with Covid. More children were hospitalized during the Omicron surge than at any other point in the pandemic.
The findings underscore the need to gather more information on the best dose, number and timing for the shots given to children, Dr. Rosenberg said. They also underscore vaccines as just one measure of protection from the virus, along with masks and social distancing, he said.
March 5, 2022, 7:14 p.m. ET
Dr. Rosenbergs research was posted just days after the Centers for Disease Control and Prevention released new recommendations that would allow the majority of Americans to stop wearing masks, including in schools.
The new data also raises important questions about the Biden administrations strategy for vaccinating children. Only about one in four children aged 5 to 11 years has received two doses of the vaccine. (The C.D.C. has not yet recommended booster doses for this age group.)
The vaccine has not yet been authorized for children younger than 5. Scientific advisers to the Food and Drug Administration were scheduled to meet on Feb. 15 to evaluate two doses of the vaccine for the youngest children, while three doses were still being tested. But the meeting was postponed after Pfizer submitted additional data suggesting two doses were not strongly protective against the Omicron variant of the virus.
Dr. Rosenberg briefed top C.D.C. officials, including Dr. Rochelle P. Walensky, the agencys director, with findings in early February. F.D.A. leaders learned of the data around the same time. Some federal scientists pushed for the data to be made public ahead of the F.D.A. expert meeting scheduled for Feb. 15, viewing it as highly relevant to the discussion about dosing in children under 5, federal officials and others familiar with their responses to it said.
The data is generally consistent with a report from Britain showing that vaccine effectiveness against symptomatic infection in adolescents aged 12 to 17 years drops to 23 percent after two months. The C.D.C. has been compiling its own data on the vaccines effectiveness in younger children and is expected to release at least some of it as early as this week, according to people familiar with the agencys plans.
Israeli researchers have also been assessing the vaccines performance in young children since the country made it available to them in November.
We continue to study and assess real-world data from the vaccine, Amy Rose, a spokeswoman for Pfizer, said in response to queries about the new data.
Mask guidance. The Centers for Disease Control and Prevention released updated data that suggests 90 percent of the U.S. population are in a location with low or medium Covid-19 community levels and can now stop wearing masks.
N.F.L. drops protocols. The National Football League and the players union agreed to suspend all Covid-19 protocols, effective immediately. The league, which is not in season, is the first of the major professional sports leagues in the United States to halt its coronavirus-related policies
Dr. Philip Krause, who recently retired from the F.D.A. as a senior vaccine regulator, said assumptions about certain antibody levels being predictive of vaccine effectiveness should be re-evaluated in light of the new results.
It certainly weakens the argument for mandating that people get that lower dose, he said.
It is not unusual for experts to revisit the dosing and interval for pediatric vaccines as more evidence becomes available. But in this case, giving the children a higher dose to kick up the immune response may not be an option because some data suggest that it may cause too many fevers, an unwelcome and potentially dangerous side effect in young children.
There are other alternatives that may improve immunity in young children, said Deepta Bhattacharya, an immunologist at the University of Arizona.
Pfizer and BioNTech are testing a third dose in children under 5, as well as in those aged 5 to 11, with the idea that, as in adults, an extra shot may significantly augment immunity. Results from these trials are expected in several weeks. Studies in adults suggest that three doses of the vaccine were more protective against the Omicron variant than two doses.
Dr. Bhattacharya said he and his wife spaced the two doses for their children, who are 8 and 10, by eight weeks rather than the currently recommended three, based on studies suggesting that a longer gap between doses may improve protection. The C.D.C. last week encouraged some people older than 12, especially boys and men between 12 to 39 years, to wait eight weeks between the first and second shot.
Another option may be a version of the vaccine designed to thwart the Omicron variant, or one that has a mix of several variants. Pfizer-BioNTech, Moderna and Johnson and Johnson are all testing Omicron-specific versions of their vaccines.
The next variant may differ widely from Omicron, much as Omicron did from the Delta variant. But training the body to recognize multiple versions would still offer a better chance at preventing infection with newer forms of the virus. Deciding when and how best to update these vaccines, I think thats really still the key conversation going forward here, Dr. Bhattacharya said.
Newer vaccines that use different approaches than the ones currently authorized in the United States may also work better for children. A protein-based vaccine made by Novavax is under review at the F.D.A., and the pharmaceutical companies Sanofi and GSK said this month that they plan to submit their vaccine for evaluation soon.
Many parents want to vaccinate their children to prevent them from spreading the virus to vulnerable relatives, to keep them in school or to avoid the possibility of long Covid, the poorly understood set of lingering symptoms that can occur even after a mild infection. Experts acknowledged that the vaccines low effectiveness against infection does not ease those concerns.
Still, the vaccines provide more protection than we think, said Jessica Andriesen, a vaccine data expert at the Fred Hutchinson Cancer Research Center in Seattle.
They may also make it so that your kid who brings home Covid isnt shedding virus as much as they would be if they werent vaccinated, and they also may have it for a shorter amount of time, she said.
The virus is here to stay, and childrens risk of severe outcomes increases with age. So inoculating children early is a good idea, said Paul Offit, director of the Vaccine Education Center at Childrens Hospital of Philadelphia and an adviser to the F.D.A.
The argument I make to parents when I talk to them about this vaccine is, your children are going to grow up, he said. Theyre going to need to be protected against this virus for years.
Sharon LaFraniere and Isabel Kershner contributed reporting.
