As the Omicron variant of the coronavirus drives new waves of COVID infections around the world, some early studies appear to show the risk of reinfection has risen.
According to an analysis by the United Kingdoms Office for National Statistics (ONS), the risk of reinfection is 16 times higher when Omicron was the dominant variant, compared with the period when Delta was dominant.
The analysis also showed that unvaccinated people were twice as likely to be reinfected than those who had their second dose of vaccine in the previous 14 to 89 days.
With infection rates continuing to surge across most regions around the world and as the number of reinfections also climbs, experts have said that protection from previous infections or vaccines declines over time.
A reinfection is a medical condition that usually occurs when a person becomes infected with COVID-19, recovers, and then gets infected again. It could happen with any of the variants of the coronavirus.
According to the United States Centers for Disease Control and Prevention (CDC), a reinfection is considered such if the patient tests positive again 90 days or more after their first positive test. The same standard has been established by the UK Health Security Agency (UKHSA).
The 90-day period has been chosen because some patients continue to have the virus in their systems for longer than the average of about two weeks, making it difficult to distinguish between an infection or a reinfection within this time frame.
The majority of patients with normal immunity do not have the virus beyond 10-14 days, but some harbour it for a longer time and therefore the time has been extended to three months, Dr Pere Domingo, currently senior consultant and HIV/AIDS programme director at the Infectious Diseases Unit of the Hospital de la Santa Creu i Sant Pau, told Al Jazeera.
According to a report published by the UKs ONS in June 2021, reinfections were considered rare, but the rate of reinfections has increased since the Omicron variant became the dominant strain in late 2021.
An analysis published last week by the news agency Reuters, citing data collected by the UKHSA, suggested that suspected reinfections accounted for approximately 10 percent of confirmed cases in England in January. Suspected reinfections made up fewer than 2 percent of cases in the six months prior to December 6. A total of 588,000 possible reinfections have been registered in England.
Meanwhile in Italy, 3 percent of the new cases were reinfections, up from about 1.5 percent before Omicron, a spokesperson for Italys National Institute of Health said last week.
Dr Domingo noted that the Omicron variant has mutated significantly compared with other variants, meaning that protection developed against previous variants could be less effective against Omicron.
Omicron has mutated many times, Dr Domingo said. These mutations have changed the antigens, the proteins are no longer the same as they were in Delta, nor the strain that came out in Wuhan.
Therefore, the antibodies that one could develop against the original strain or against Delta, are no longer useful for Omicron, he added.
According to the research by Imperial College London, the protection afforded by the past infection may be as low as 19 percent.
Viruses are constantly evolving and these changes naturally lead to the emergence of new strains that can lead to new infections.
There is always a struggle between the forces of the individual and immunity on the one hand and the virus on the other, Dr Domingo said.
And the way the virus fights is by changing, by making mutations that will allow it to avoid the patients antibodies, he added.
According to research from South Africa, people infected with Omicron developed an antibody response to the current and previous strains. However, according to the Gavi vaccine alliance, the immunity from a Delta infection provides limited protection against Omicron.
Previous infections or vaccines will provide protection, and the greater the exposure to the virus leads to greater protection, but the immunity is not complete and it declines over time, Dr Domingo said.
And if the virus changes, the protection generated by infection, is overwhelmed.
According to early research, reinfections are generally mild. A study done in the state of Qatar found that reinfections have 90 percent lower odds of resulting in hospitalisation or death than primary infections.
Dr William Schaffner, professor of medicine at Vanderbilt University Medical Center, said the severity of a reinfetion depends on the patients immune system.
If you are immuno-compromised, or if you are a person who is frail, or sick, then I would think a second infection could potentially be serious enough to put you in the hospital, but if you have a normal immune system, the second infection is not likely to be severe, he added.
Experts said a reinfection would provide some level of immunity against any potential reinfection in the future, but the best immunity is the result of a hybrid immunity.
Hybrid immunity is the result of having been both infected and vaccinated against the virus. According to research, this could generate a super-immune response.
However, there is a risk in the long term effects of the infection.
Anyone who recovers from COVID stands or risk of developing so-called Long COVID, Dr Schaffner said.
[And so far] we have no information, on whether second infections are more likely to result in Long COVID than first infections, he added.
Experts have said the current guidance in place to combat COVID-19 are still effective. The World Health Organization (WHO) has recommended people get vaccinated.
It also advised people to maintain physical distance, avoid crowds and close contacts, wear a properly fitted mask, clean your hands frequently, and cover your mouth and nose when coughing or sneezing.
We need people to keep [following] all these measures, Dr Ali Fattom said.
Precautions are very important, not only for the person itself, but you dont want to transmit the virus to others and put them at risk, he added.
As the Omicron variant of the coronavirus drives new waves of COVID infections around the world, some early studies appear to show the risk of reinfection has risen.
According to an analysis by the United Kingdoms Office for National Statistics (ONS), the risk of reinfection is 16 times higher when Omicron was the dominant variant, compared with the period when Delta was dominant.
The analysis also showed that unvaccinated people were twice as likely to be reinfected than those who had their second dose of vaccine in the previous 14 to 89 days.
With infection rates continuing to surge across most regions around the world and as the number of reinfections also climbs, experts have said that protection from previous infections or vaccines declines over time.
A reinfection is a medical condition that usually occurs when a person becomes infected with COVID-19, recovers, and then gets infected again. It could happen with any of the variants of the coronavirus.
According to the United States Centers for Disease Control and Prevention (CDC), a reinfection is considered such if the patient tests positive again 90 days or more after their first positive test. The same standard has been established by the UK Health Security Agency (UKHSA).
The 90-day period has been chosen because some patients continue to have the virus in their systems for longer than the average of about two weeks, making it difficult to distinguish between an infection or a reinfection within this time frame.
The majority of patients with normal immunity do not have the virus beyond 10-14 days, but some harbour it for a longer time and therefore the time has been extended to three months, Dr Pere Domingo, currently senior consultant and HIV/AIDS programme director at the Infectious Diseases Unit of the Hospital de la Santa Creu i Sant Pau, told Al Jazeera.
According to a report published by the UKs ONS in June 2021, reinfections were considered rare, but the rate of reinfections has increased since the Omicron variant became the dominant strain in late 2021.
An analysis published last week by the news agency Reuters, citing data collected by the UKHSA, suggested that suspected reinfections accounted for approximately 10 percent of confirmed cases in England in January. Suspected reinfections made up fewer than 2 percent of cases in the six months prior to December 6. A total of 588,000 possible reinfections have been registered in England.
Meanwhile in Italy, 3 percent of the new cases were reinfections, up from about 1.5 percent before Omicron, a spokesperson for Italys National Institute of Health said last week.
Dr Domingo noted that the Omicron variant has mutated significantly compared with other variants, meaning that protection developed against previous variants could be less effective against Omicron.
Omicron has mutated many times, Dr Domingo said. These mutations have changed the antigens, the proteins are no longer the same as they were in Delta, nor the strain that came out in Wuhan.
Therefore, the antibodies that one could develop against the original strain or against Delta, are no longer useful for Omicron, he added.
According to the research by Imperial College London, the protection afforded by the past infection may be as low as 19 percent.
Viruses are constantly evolving and these changes naturally lead to the emergence of new strains that can lead to new infections.
There is always a struggle between the forces of the individual and immunity on the one hand and the virus on the other, Dr Domingo said.
And the way the virus fights is by changing, by making mutations that will allow it to avoid the patients antibodies, he added.
According to research from South Africa, people infected with Omicron developed an antibody response to the current and previous strains. However, according to the Gavi vaccine alliance, the immunity from a Delta infection provides limited protection against Omicron.
Previous infections or vaccines will provide protection, and the greater the exposure to the virus leads to greater protection, but the immunity is not complete and it declines over time, Dr Domingo said.
And if the virus changes, the protection generated by infection, is overwhelmed.
According to early research, reinfections are generally mild. A study done in the state of Qatar found that reinfections have 90 percent lower odds of resulting in hospitalisation or death than primary infections.
Dr William Schaffner, professor of medicine at Vanderbilt University Medical Center, said the severity of a reinfetion depends on the patients immune system.
If you are immuno-compromised, or if you are a person who is frail, or sick, then I would think a second infection could potentially be serious enough to put you in the hospital, but if you have a normal immune system, the second infection is not likely to be severe, he added.
Experts said a reinfection would provide some level of immunity against any potential reinfection in the future, but the best immunity is the result of a hybrid immunity.
Hybrid immunity is the result of having been both infected and vaccinated against the virus. According to research, this could generate a super-immune response.
However, there is a risk in the long term effects of the infection.
Anyone who recovers from COVID stands or risk of developing so-called Long COVID, Dr Schaffner said.
[And so far] we have no information, on whether second infections are more likely to result in Long COVID than first infections, he added.
Experts have said the current guidance in place to combat COVID-19 are still effective. The World Health Organization (WHO) has recommended people get vaccinated.
It also advised people to maintain physical distance, avoid crowds and close contacts, wear a properly fitted mask, clean your hands frequently, and cover your mouth and nose when coughing or sneezing.
We need people to keep [following] all these measures, Dr Ali Fattom said.
Precautions are very important, not only for the person itself, but you dont want to transmit the virus to others and put them at risk, he added.
A growing number of governments, politicians and top health officials are saying its time to start living with the virus.
The argument is that the Omicron variant of the coronavirus causes milder illness, which presents less of a threat on an individual level. Additionally, after Omicron, so many people will have some form of immunity through either vaccination or infection that subsequent waves may be smaller and more manageable.
But are you ready?
Were asking readers how they feel about being asked to start living with the virus and what that phrase means to them. If youd like to participate, you can fill out this form below. We may use your response in an upcoming newsletter.
Good evening. Im Karen Kaplan, and its Tuesday, Feb. 8. Heres the latest on whats happening with the coronavirus in California and beyond.
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Thousands of unvaccinated Californians are hoping that divine intervention will spare them from having to comply with their employers COVID-19 vaccine mandates. As some have discovered, divine intervention can be had for $195.
Thats what it costs to get an official-looking letter stating that any rule forcing a worker to get vaccinated is an affront to a Christian. The same goes for coronavirus testing requirements and even policies that say employees must wear face masks, the pastor of True Hope Ministry in San Clemente explained.
An employee of the Los Angeles Department of Water and Power gave the letter to his bosses to justify his request for exemption from the agencys vaccine mandate. Granting the exemption is the only way to comply with federal laws against religious discrimination in the workplace, the pastor wrote.
My colleagues Laura J. Nelson and Connor Sheets obtained the letter through public records requests to the DWP and other public employers. The more than 2,200 pages of letters, emails and other records they received make clear that a cottage industry has sprung up to help people evade the COVID-19 vaccine by citing their religious beliefs.
The tactic works because both state and federal laws have created strong protections for religious freedom in the workplace. As weve discussed, the U.S. Equal Employment Opportunity Commission says employers should take reasonable steps to eliminate a conflict between religion and work if doing so wont create an undue hardship. The laws apply even if an employee isnt devout and isnt associated with a mainstream faith. All that really matters is that their religious belief is sincere.
Thats what makes things tricky. Even if a professed religious belief isnt sincere and it often isnt, legal experts say proving that can be tricky and expensive. Skeptical employers may conclude that challenging a workers claim isnt worth the hassle.
The result is a giant loophole that plenty of organizations are happy to exploit.
It is ripe for abuse, and it is being abused, said Nancy Inesta, a labor and employment partner at the BakerHostetler law firm in Los Angeles.
Calvary Chapel Chino Hills took just 13 minutes to respond to a teacher who sought help requesting a religious exemption. The church sent a link to a sample letter, an invitation to pick up a signed exemption form from its office, and contact information for a lawyer with the conservative Pacific Justice Institute. The church declined to discuss its response.
An email from Liberty Counsels Horatio Mihet with advice about requesting a religious exemption to a COVID-19 vaccine mandate.
Horatio Mihet, vice president of legal affairs with Liberty Counsel, sent a five-paragraph statement to a vaccine-resistant hospital worker the day after he reached out for help.
Cut and paste the statement below, assuming it correctly states your religious beliefs, Mihet wrote. Do not put anything on it that identifies me or that the statement came from me. It needs to be YOUR statement.
Mihet told my colleagues its normal for lawyers to draft statements that clients can claim as their own.
David Hall, the pastor from True Hope Ministry, said the letter obtained by the DWP employee wasnt for sale. The $195 fee covers a package of services that includes weekly group calls. The church also offers a class that advises students how to respond if they say, You got this off the internet, among other topics.
Some form letters cite objections that arent rooted in religion. And some include arguments that arent factually correct. Among the false claims: that COVID-19 vaccines are a form of gene therapy, and that they contain animal parts or the DNA of a male aborted baby.
To be sure, there are people who find form letters a useful tool for articulating their complicated yet sincere religious beliefs. But Dorit Reiss, a professor at UC Hastings College of the Law who studies legal issues related to vaccines, said theres little doubt that many of the people submitting cut-and-paste exemption requests see them as a means to an end.
They didnt want to vaccinate and went looking for something that sounds convincing as a way to get out of it, she said.
California cases and deaths as of 5:40 p.m. Tuesday:
Track Californias coronavirus spread and vaccination efforts including the latest numbers and how they break down with our graphics.
Los Angeles Countys public health order includes a 17-page document focused entirely on K-12 schools. It details the steps schools must take to protect students, teachers and other staffers, including rules about vaccination, testing, physical distancing, air filtration and disinfection, among many other topics. Theres also an entire page devoted to rules about masks.
All students 2 and older are required to wear face masks at all times while indoors on school property except while eating, drinking, or carrying out other activities that preclude use of face masks, the order reads. All students 2 and older are also required to wear masks while outdoors on campus when in crowded settings, and in other outdoor spaces where distancing is not possible or practical.
So when an L.A. County health inspector spotted unmasked students at Trinity Classical Academy in Santa Clarita, the school was fined $500. The financial penalty was surely intended to coerce the school into following the rules. But it looks like Trinity simply treated it as a cost of doing business, my colleague Emily Alpert Reyes reports.
On three subsequent occasions, health inspectors returned to the private school to see whether it was complying with COVID-19 rules. Instead of giving them a chance to find out, the school refused to let them on campus. Each snub triggered an additional $500 fine, but those fines havent had any apparent deterrent effect. Neither has a cease-and-desist letter sent to the school in December.
In fact, the countys attempts to enforce its health order may have spurred greater resistance. On its website, Trinity acknowledges that its required to ask both students and employees to follow rules regarding masks, but it also assures people that the school will aim not to exclude any student from in-person learning for a failure to mask.
Its also in the market for a lawyer.
Trinity Classical Academy is one of three private schools in Santa Clarita cited for students or staffers failing to wear masks as required under county orders.
(Myung J. Chun / Los Angeles Times)
Trinity isnt the only school challenging the health departments authority to protect the children (and workers) in its jurisdiction.
Legacy Christian Academy, also in Santa Clarita, has racked up a dozen citations for disregarding the county health order, the health departments records show. In a September visit, multiple school employees were seen without face coverings. On two subsequent visits, the inspector couldnt tell whether any improvement had been made because the school wouldnt allow the inspector on campus.
And at Santa Clarita Christian School, administrators wouldnt let an inspector look around unless the school could have a lawyer on hand. Santa Clarita Christian racked up seven fines by mid-January, county records show.
The three schools are all part of the Assn. of Christian Schools International, a group that supports its members in challenging health regulations they believe are not in their students best interests or that infringe on their rights.
Apparently, the schools have made their own determination that mask mandates do more harm than good. The COVID-19 protocols issued by Santa Clarita Christian in August say the wearing of face coverings will not be enforced. In the schools view, the authority of the parents to make the decision regarding face coverings trumps the authority of the public health department.
This despite the fact that studies show masks reduce coronavirus spread, including in schools. For instance, a team led by members of the Centers for Disease Control and Preventions COVID-19 Response Team found that when kids went back to school last fall, coronavirus cases among children rose less in counties where districts had masking requirements. Results like these are why the American Academy of Pediatrics recommends universal masking in school, with an emphasis on indoor masking.
The current standoff makes it impossible to ignore the fact that theres not much L.A. County can do to enforce its health order. It took a year for officials to file suit against a Westlake Village restaurant that refused to comply with health rules and racked up tens of thousands of dollars in citations.
In theory, the L.A. County Sheriffs Department could take an aggressive stance, but Sheriff Alex Villanueva has been very clear that he wont expend our limited resources on enforcing the countys health order and would instead ask for voluntary compliance. (In related news, the L.A. County Board of Supervisors took steps Tuesday to relieve Villanueva of his responsibility for enforcing the countys COVID-19 vaccine mandate since he wont fire deputies who refuse to comply.)
County Supervisor Kathryn Barger, whose district includes Santa Clarita, is on record saying she thinks the health department should relax its mask rules. But she said as long as the rules are there, they ought to be enforced.
There are laws that are on the books that lots of people dont like, Barger said, but that doesnt mean you can just ignore them.
See the latest on Californias vaccination progress with our tracker.
Californias Omicron wave is solidly on the decline, and state officials are acknowledging this hard-won progress by allowing their universal mask mandate for indoor public places to expire next week.
The rule will remain in place through Feb. 15, as previously scheduled. After that, people who are fully vaccinated will be allowed to shed their masks in many indoor settings in counties that dont have mask orders of their own. That list includes Orange, San Diego, Riverside and San Bernardino counties, as well as much of the San Joaquin Valley.
You may have noticed that L.A. County isnt on that list. The county has its own indoor mask mandate, and it wont be lifted until its coronavirus transmission falls to moderate levels as defined by the CDC and remains there for two consecutive weeks.
To meet that threshold, the countys case rate will need to fall below 50 new cases per 100,000 residents per week. As of Tuesday, its just above 824 new cases per 100,000 people per week, according to the CDCs COVID Data Tracker. (The county will also have to keep its positive test rate below 8% for two weeks in a row; as of Monday, it was 5%.)
Nor has L.A. County announced plans to relax its mask rules for schools. Currently, everyone on a school campus is required to wear a mask both indoors and outdoors. Some district superintendents are eager to change that, if the science says its safe to do so.
This would be welcome news to many students and families, said one of them, Supt. Alex Cherniss of Palos Verdes Peninsula Unified School District. Those students and staff who would want to continue to wear masks could, of course, do so.
The governors of Connecticut, Delaware, New Jersey and Oregon announced Monday they would lift their statewide mask requirements for schools by late February or March. The four governors, all of them Democrats, cited the rapid easing of the Omicron surge.
But there are still signs of hesitation in Los Angeles. Many people, including L.A. Unified school board member Jackie Goldberg, suggested that mask rules could be eased for outdoor activities before considering changes for indoor settings.
Nobody likes masks, Goldberg said, but COVID-19 is not disappearing, and there is no way to avoid close contact in most classrooms.
And lets not forget: Retiring the states universal indoor mask mandate doesnt mean masks will become obsolete, even in the more permissive counties. Theyll still be required for everyone in hospitals and other healthcare settings; in long-term-care facilities; on buses, trains and other forms of public transport; and in shelters and correctional facilities. Plus, people who are unvaccinated will still have to wear them inside restaurants, stores, theaters and other public venues.
When the rules change on Feb. 16, the state will also change the thresholds for mega events like concerts, conventions and baseball games. Indoor events will trigger rules about coronavirus testing and vaccination verification when they have at least 1,000 attendees (up from 500), and outdoor events will do so when they have 10,000 attendees (up from 5,000).
Heres some more good news from Sacramento: State lawmakers passed a package of bills Monday that will provide most workers with up to two weeks of paid sick leave if they come down with COVID-19 or are caring for a family member with the disease. The paid time off can also be used to get a COVID-19 vaccine and to ride out any short-term side effects.
The sick leave policy applies to all workers at companies with at least 26 employees, and is intended to slow the virus spread by making it easier for people to stay home when they might be contagious. Other bills in the package will restore some tax credits for businesses that were suspended and capped two years ago, at the start of the pandemic. Newsom will also get $1.9 billion to spend on coronavirus testing, vaccinations, hospitals and other COVID-19 emergency needs.
The governor is expected to sign the bills this week. Once that happens, the sick leave policy will remain in effect through Sept. 30.
On to Canada, where thousands of people have paralyzed downtown Ottawa to protest the countrys COVID-19 restrictions. The so-called freedom truck convoy, which began more than a week ago, got a huge boost over the weekend, prompting Ottawas police chief to describe the demonstration as a siege.
Residents of the capital city are fed up with the traffic disruption, blaring horns and generally un-Canadian behavior. Ottawa Mayor Jim Watson declared a state of emergency Sunday and requested nearly 2,000 additional police officers to help deal with the mess.
The Canadian protesters have become a cause clbre for former President Trump and other prominent Republican politicians in the U.S., including Florida Gov. Ron DeSantis and Texas Atty. Gen. Ken Paxton. Among other things, they blasted the crowdfunding site GoFundMe after it said it would return millions of dollars raised by demonstrators because its platform cant be used to engage in unlawful activity.
Canadian officials asked the Americans to butt out of their domestic affairs.
It is certainly not the concern of the Texas attorney general as to how we in Canada go about our daily lives in accordance with the rule of law, said Canadian Public Safety Minister Marco Mendicino. Whatever statements may have been made by some foreign official are neither here nor there. Were Canadian. We have our own set of laws. We will follow them.
Farther afield, many Asian countries are experiencing a spike in coronavirus cases in the wake of their Lunar New Year celebrations and considering how transmissible Omicron is, they expect things to get even worse in the coming weeks.
Indonesia recorded 36,057 new cases on Sunday, up from just 533 a month earlier. Daily deaths also climbed to 57, nearly four times higher than they were a week before.
Singapore has seen cases triple since the holiday, with a total of 13,000 on Friday. After new restrictions were put in place, that figure dipped to 7,752 by Sunday.
Hong Kong set a new record for local infections Monday, with 614. More than 600 additional cases were reported Tuesday as the citys leader announced the toughest social-distancing restrictions seen since the start of the pandemic.
Starting Thursday, public gatherings will be restricted to two people, and gatherings on private premises will be limited to two families. Hair salons and places of worship will be closed until Feb. 24; on that date, the city will implement a system to require proof of vaccination to enter shopping malls, markets and restaurants.
The strict new rules will remain in place until vaccination rates rise and the Omicron wave subsides, said Hong Kong Chief Executive Carrie Lam. Then of course we will continue to revisit our strategy, she said. But nothing will change our commitment to safeguard the life and the safety of the people of Hong Kong.
Todays question comes from readers who want to know: Are there any special COVID-19 rules for Super Bowl visitors?
Football fans who travel here from Cincinnati or anywhere else for Super Bowl LVI at SoFi Stadium in Inglewood wont have to jump through any extra hoops in the name of pandemic safety. But they will have to follow all local laws while theyre here.
If theyre attending the game itself, theyll need to show proof that theyre fully vaccinated that is, they got the single-dose Johnson & Johnson vaccine or their second dose of Pfizers Comirnaty or Modernas Spikevax at least two weeks earlier or else present a recent negative coronavirus test. The rule applies to everyone age 5 and up.
At-home tests wont cut it; authorities require a PCR test (which can be taken up to 48 hours before the game) or an antigen test from a lab or official testing clinic (which must be taken up to 24 hours prior to the game). SoFi will run an on-site testing clinic on Saturday that promises results within 30 minutes. The fee is $59.
The stadium will also require all attendees age 2 and older to wear a mask whenever they are not actively eating or drinking. No mask? No problem. SoFi will hook you up with a high-quality KN95 when you enter the stadium.
The mask rule applies to everyone, regardless of their vaccination status. It even applies to governors, mayors and fans who happen to be in the NBA Hall of Fame.
When visitors are out and about in L.A. County before and after the game, theyll also need to wear their masks if they enter businesses or other public indoor settings; if they take public transit (including taxis and ride-hailing services); if they attend other gatherings or large outdoor events; if they have to visit a healthcare facility; if they swing by a school or other youth setting; or if their trip goes terribly awry and they wind up in a prison, jail or shelter.
Proof of vaccination will be required for service inside breweries, wineries, distilleries, nightclubs, lounges and gambling establishments like card rooms throughout the county. Unvaccinated patrons may be served outdoors.
In the city of Los Angeles, proof of vaccination is also required for indoor service at restaurants, fitness centers, and personal care establishments like salons and tattoo shops.
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The coronavirus has changed the way we live, so where do we go from here? - OPB
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Signs at Richmond Elementary in southeast Portland require masks to enter the school.
Elizabeth Miller
The omicron surge seems to have crested and case rates are decreasing in Oregon, though hospitalizations are at their peak. Many people are asking: What comes next?
How long will we need to keep wearing masks? What will vaccinating kids under 5 mean for everyone? What have we learned from the omicron and delta surges that could help prepare us for the next variant? And what does it mean for a disease to move from pandemic to endemic? There are no easy answers to these questions. In fact, each one seems to bring up 10 more.
OPBs Think Out Loud recently tried to get some clarity on our COVID futures with three guests: Bill Messer, a physician and scientist specializing in viral, infectious diseases at Oregon Health & Science University (OHSU); Fikadu Tafesse, an assistant professor of molecular microbiology and immunology at OHSU; and Katherine Wu, who covers science as a staff writer for The Atlantic and also holds a Ph.D in microbiology and immunobiology from Harvard University. To listen to the entire conversation, use the audio player at the top of this story.
Endemic is this relatively simple seeming word ... It seems like a logical way to say: oh, an end to a pandemic! But it really is actually a coincidence that it has the word end in it, said Wu, who recently co-authored an Atlantic story about the very squishy nature of the word.
Wu points out that, while endemic describes a relationship between disease and host, there are many different iterations of what that relationship could look like.
Human behavior is one of the largest factors dictating what sort of cast endemicity takes on, said Wu. Its so easy to say, a virus can go endemic. Where are we in that equation? Really, its about what endemic future could we be shaping for this virus?
She uses the flu as an example.
We managed to really stamp that out during our first full pandemic winter, and that was remarkable. Flu levels plummeted to pretty much zero across the board. It was totally unprecedented, Wu explained. Imagine what we could do if we put in place even a fraction of those same measures going forward. We could really change the picture of a lot of these diseases we assumed to just be a normal part of life, a burden that we have to shoulder for decades on end.
COVID-19 vaccine preparation at a drive-thru vaccination clinic at Portland International Airport, April 9, 2021. The clinic is a joint operation hosted by Oregon Health & Science University, the Port of Portland and the American Red Cross.
Kristyna Wentz-Graff/ OPB
Tafesse was part of a team that conducted a recent study on immune responses in vaccinated individuals who also got infected with COVID-19.
The finding was quite profound, he said.
When compared to people who had been vaccinated but never infected, those who had both received a COVID-19 vaccine and been infected with the virus, either before or after being vaccinated, had higher antibody levels. According to Tafesse, the potency of the antibodies was also higher in people who had experienced both a vaccine and an infection, meaning they were better protected against a wider array of variants.
The improvement of immunity that we found was significant ... We called it superimmunity, Tafesse explained. The vaccines are based on one element of the virus, that is the spike protein, but when youre exposed to the live virus the body is exposed to not only the spike proteins but other components of the virus, which are critical in terms of adjusting and training your immunity.
Wu points out that this makes vaccine equity even more of a pressing issue.
Distributing high-quality durable immunity equitably, that has I think really profound implications, she said.
Messer, who also works as a clinician, said he recognizes that people with compromised immune systems are facing a different level of risk when it comes to COVID-19. These are people who may have weak immune systems for a number of reasons or be immune-suppressed because of an organ or bone marrow transplant.
In the patients that Ive interacted with who are in that population, there is an incredible amount of anxiety, probably for some of them it borders on severe clinical anxiety, with the emergence of yet another pathogen that they have to be wary of that is demonstrably dangerous for those people, and at the same time, acknowledging that theyve been living with these sorts of risks already and adapting to them, said Messer.
Each patient has their own experience, and so I dont want to generalize too much, he continued. I have encountered exhaustion, fatalism, desire for vaccination and other interventions that could protect them from getting sick, like monoclonal antibody therapy on top of vaccination In many cases, the vaccines dont work really well in these immune-compromised people because they have to have an immune system to react ... There are a suite of different reactions, but I think theyre all predicated on the fact that a lot of them have already been living with that risk to a certain degree.
Messer called it a unique experience and a unique perspective and encouraged people with intact immune systems to consider this population with empathy moving forward.
Restaurants shut down at the start of the pandemic in March of 2020.
Tim Mossholder/Unsplash
We all remember the sudden change that came in March of 2020 with the first lockdown, school closures and subsequent mask mandates. Coming out of the pandemic wont be so abrupt, and it will look different for different people.
I think the only thing that is probably safe to say is that everyone has already been embarking on their own behavioral trajectory for a very long time now, and I expect those fates to sort of continue splintering, Wu said. I think some people have already accepted that they are probably never going to go back to the full slate of 2019 behaviors, and thats just kind of going to be it from now on. Maybe the degree to which they follow pandemic behaviors will toggle up and down, maybe its with local case rates or what have you, whatever theyre doing to sort of gauge their level of safety. But yeah, it may just fundamentally affect the way they live their lives for the rest of this. Others have effectively gone back to 2019, with varying results. This is very complicated and I think for people who are trying to decide which lane they want to be in for the foreseeable future, or anything beyond that, it is really difficult.
Wu says individual choices about risk dont always have to be at odds with the greater good, and she used the decision to get vaccinated as an example of something that helps individuals and communities at the same time.
I think it all just has to come together in a really complicated decision matrix, she said. I dont want people to feel like theyre being extremely selfish by giving themselves bits of happiness. All of these things can be compatible with each other. I think we just all need to reset our risk thresholds and reset our thresholds for what sorts of behaviors are safe for us and the people around us.
Jemma Skarphol, 8, prepares to receive a pediatric COVID-19 vaccine during a clinic held at Clackamas Town Center, Nov. 10, 2021 in Happy Valley, OR. The clinic was offered by the Clackamas Countys Department of Public Health and offered Pfizer-BioNTech vaccines for children ages 5 through 11 years old.
Kristyna Wentz-Graff / OPB
News broke last week that COVID-19 vaccines could soon be available for kids younger than 5 years old. Wu said shes concerned that some parents may feel like its already too late to get their young children vaccinated.
Im sorry the wait has been so long, but it absolutely is still worth getting kids vaccinated, she said. It is never too late to get your kids protection because COVID is going to be with us for a very long time. Getting vaccinated now is not just an investment in the omicron surge, but an investment in our future and that will really impact where this pandemic goes. I hope it makes an enormous difference.
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Pfizer is asking U.S. regulators to authorize extra-low doses of its COVID-19 vaccine for children under 5.
Going back to school after winter break is not lasting very long. Omicron is forcing some schools across Oregon back online.
More than 700 days have passed since the first confirmed case of COVID-19 in Oregon. Deep into the second year of the pandemic, the staff at Salem's only hospital are fighting to keep serving all the patients that come through their doors, without breaking under the pressure.
Tags:Think Out Loud, COVID-19, Vaccines, Public Health
Cameron County on Tuesday reported four coronavirus-related deaths and 439 positive cases of COVID-19.
Of the four people who died, none were vaccinated against the virus. The youngest person who died was a Brownsville woman in her 30s.
Since the pandemic began, 2,104 people have died due to the virus in Cameron County.
Of the 439 positive cases reported in the county, 169 were confirmed reports based on PCR testing, 266 were probable reports based on antigen testing, and four were self-reported based on at-home testing.
The 169 confirmed cases are in the following age groups:
Age: 0-19
Vaccination efforts continue across Cameron County; currently, 82.90% of the population five years and older is fully vaccinated.
Washington, DC The Districts reported data for February 4-6, 2022 includes 627 new confirmed positive coronavirus (COVID-19) cases, bringing the Districts overall confirmed positive case total to 132,170. The District also reports 74 new probable tests, bringing the overall positive probable tests since October 15, 2021 to 9,154.
The District reported that eleven additional residents lost their lives due to COVID-19.
Tragically, 1,304 District residents have lost their lives due to COVID-19.Visit coronavirus.dc.gov/data for interactive data dashboards or to download COVID-19 data.Below is the Districts current Key Metrics Summary Table.
Below is the Districts aggregated total of confirmed positive COVID-19 cases, sorted by age and gender.
Below is the Districts aggregated total of confirmed positive COVID-19 cases, sorted by ward of residence.
Below is the Districts aggregated total of confirmed positive COVID-19 cases, sorted by neighborhood of residence.
Below is the Districts aggregated total of confirmed positive COVID-19 cases, sorted by race.
Below is the Districts Hospital Census and hospital bed availability at District hospitals.
Below is the ventilator use and availability at District hospitals.
The District currently has 53 intensive care unit (ICU) beds available in hospitals out of 345 total ICU beds.
Below is the Districts total lives lost due to COVID-19, sorted by race.
Below is the Districts total lives lost due to COVID-19, sorted by sex.
Below is the Districts total lives lost due to COVID-19, sorted by age.
Below is the Districts total lives lost due to COVID-19, sorted by ward of residence.
Guidance has been published for healthcare providers, employers and the public to provide information on what to do if you have been diagnosed with or are a contact of someone who has COVID-19. Residents are encouraged to get vaccinated at one of our free walk-up vaccination sites located throughout the District. For more information, please visit vaccines.gov.
There are signs that the omicron variant wave of the novel coronavirus is dropping off, which could be a sign that a return to normal isnt too far away.
Yes, but: The novel coronavirus is still mutating, and there is no guarantee that future variants will be mild. There is a high chance that more surges are in our future, particularly for unvaccinated people, Dr. Megan Ranney, professor of emergency medicine and academic dean of public health at Brown University, recently wrote for NBC News.
Why it matters: The coronavirus could mutate again, which would once again delay a return to normal. Thats why it might be better to prepare now for any future variants.
Potential new variants: The World Health Organization recently said that its too soon to declare victory against COVID-19 as it continues to monitor the subvariants of the omicron variant, as I reported for the Deseret News.
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Pfizer projects it will generate record-high revenue in 2022, saying Tuesday it expects to sell $32 billion of its Covid-19 shots and $22 billion of its antiviral coronavirus treatment pill Paxlovid this year.
However, the company posted mixed fourth-quarter results, beating on earnings but missing on revenue. Pfizer's stock was down more than 5.7% in morning trading.
Here's how the company performed compared to what Wall Street expected, based on analysts' average estimates compiled by Refinitiv:
Pfizer CEO Albert Bourla said sales of Paxlovid could be higher than the company's guidance, but the expectations are based on deals signed or close to being signed. Angela Hwang, head of biopharmaceuticals, said Pfizer is an active discussions with over 100 countries around the world on Paxlovid.
Pfizer's miss on revenue was driven by lackluster sales in its internal medicine and hospital segments. Fourth-quarter internal medicine sales fell 3% year-over-year to $2.24 billion, while hospital sales were largely flat at $1.88 billion. Pfizer's oncology sales expanded 7% to $3.24 billion compared with the year-earlier period.
However, Pfizer's fourth-quarter revenue more than doubled overall to $23.84 billion year-over-year, driven by $12.5 billion in sales of its Covid vaccine. The company's antiviral pill that fights Covid, Paxlovid, contributed $76 million in U.S. sales during the fourth quarter. The Food and Drug Administration gave the pill emergency approval in December.
On an unadjusted basis, Pfizer's fourth-quarter profit increased more than fourfold to $3.39 billion from $847 million during the same three months in 2020. Pfizer expects $98 billion to $102 billion in sales for 2022, and adjusted earnings per share of $6.35 to $6.55.
Bourla said the company plans to aggressively expand the use of the Covid vaccine's underlying technology, messenger RNA, to treat rare genetic diseases of the liver, muscle and central nervous system through a collaboration with Beam Therapeutics. Bourla said the company also hopes to reduce the time to produce new vaccines from three months to two months as it explores automated solutions to produce mRNA in collaboration with Codex DNA. Pfizer is also developing a shingles vaccine with BioNTech.
Chief Scientific Officer Mikael Dolsten said a phase two or three study of an mRNA flu vaccine could start this year and conclude in 2023. Pfizer could also have a readout of clinical trials from its respiratory syncytial virus, or RSV, vaccine sometime in the second quarter.
Pfizer started a clinical trial late last month of a Covid vaccine that targets the omicron variant in adults ages 18 to 55. Dolsten said Pfizer expects data in the coming weeks on the omicron vaccine. Bourla has previously said the company expects to have the vaccine ready by March.
Pfizer and its partner BioNTech also are working with the FDA to expedite authorization of their Covid vaccine for children under 5 years old this month, the last age group left in the U.S. that is not eligible for immunization. The companies expect kids under 5 will ultimately need three doses, but they are working to get the first two shots FDA authorized while they finish trials on the third dose.
Bourla said the eradication of Covid is unlikely because the global spread of the virus makes it difficult to contain and it mutates often. Data also indicates that natural infection does not lead to durable protection needed to prevent transmission and mutations, he said.
In addition, the company also working to ramp up production and delivery of Paxlovid. Bourla said Pfizer expects to produce 6 million courses in the first quarter and 120 million by year-end.
The U.S. government has ordered 20 million courses, with 10 million expected by June. The U.S. allocated 265,000 courses since the FDA approved Paxlovid in December and 85% of the treatments have been ordered by the states, according to Hwang. Bourla said the states are immediately placing new orders after using the treatments.
