An annual gay ski week in Park City is scheduled to return in February, a year after the 2021 event was canceled out of concern for the novel coronavirus pandemic.
The Elevation: Utah plans to hold the gathering after the cancellation in 2021 are another signal of the Park City areas continuing economic comeback from the broad shutdowns of nearly two years ago. The event is not among the largest or most lucrative on Park Citys calendar, but the intentions to hold Elevation: Utah again in 2022 are more evidence of resiliency in the ski industry and in the wider tourism segment of the Park City-area economy.
Organizers describe the event as the 12th annual Elevation: Utah. It is slated to run from Feb. 23 until Feb. 27. The Park Record was unable to contact the organizers. It was not known early in the week how many skiers and snowboarders are expected to travel to Park City.
The event prior to the pandemic typically drew between 1,000 and 1,500 people. The organizers in 2021 predicted the attendance would drop to between 400 and 600 people with there being widespread worries at the time about the sickness. Elevation: Utah was ultimately canceled last year amid a surge in coronavirus cases across the U.S. The organizers expressed concern that the gathering could have led to a cluster of cases and further transmission.
Elevation: Utah involves skiing and snowboarding in the daytime followed by apres ski events and parties at night. The schedule includes a drag show and a flashback apres ski event.
Last years cancellation of the formal events was devastating, but in 2022, we are back bigger and better than ever! the organizers said online.
The event website indicates the Elevation: Utah events are expected to be sold out. It also says proof of vaccination is required for people to attend the events. A brief policy regarding measures to combat the spread of the coronavirus is included on the website. It reads: It is important to remember that neither Elevation nor the venues where we operate our events are responsible for local, city or state COVID policies and regulations. Elevation and our venues will abide by current local and government regulations for entry to bars/restaurants and public events in effect at the time and date the event is being held.
The website addresses the pandemic in regards to refunds, saying, If an event is cancelled or postponed due to a government order related to COVID in 2022, your ticket or pass will be refunded or honored at a future event and that Elevation: Utah-goers warrant that you already understand the risks associated with attending a public event in 2022 and local vaccination requirements before purchasing a ticket.
The gay ski week in Park City is one of three in North America under the Elevation moniker. The others are in Mammoth Mountain Ski Area in California and Mont Tremblant Ski Resort in Canada. The California event is set in March while the one in Canada is next scheduled to occur sometime in 2023, according to the organizers, who indicate Elevation: Tremblant is planning to return to Tremblant in 2023.
There is usually little evidence of the gay ski week in Park City. Several Main Street businesses sometimes display pride flags to mark the dates of the event, though.
Situation Analysis
The average number of new COVID-19 cases reported per day only increased by 6.7% in the past 7 days compared to the previous week. Although average case numbers are increasing week on week, the steep rise in cases seen in other countries due to the importation of the omicron COVID-19 variant has not been seen in Thailand. This is likely due to previously introduced public health and social measures, strong adherence to personal protective measures by members of the public and increasing vaccination rates.
Bangkok continues to report the highest daily number of COVID cases. However, the average number of new COVID-19 cases reported per day for Bangkok in the past week (1,354) is only 3% higher than the week prior (1314).
The average daily number of all currently active COVID-19 cases (83,624) over the last seven days increased by only 1% compared to the previous week. This number reflects the overall burden of COVID19 cases for the healthcare delivery system since even people isolating at home are being actively monitored by healthcare workers An average of 19 daily deaths were reported in the past week, a 21% increase compared to the average number for the previous week (15).
The average daily number of severe COVID-19 cases over the past seven days (542) represents a 0.7% decrease over the average number reported for the previous week (546). The average daily number of ventilated COVID-19 cases over the past seven days (105) represents a 9.5% decrease over the average number reported for the previous week (116).
Although Thailand is not experiencing the big upsurge in laboratory-confirmed (PCR positive) cases being seen in other countries, the widespread use of rapid antigen tests (including those available over the counter) makes it difficult to accurately monitor the situation. However, the decrease in the number of severe and ventilated cases in hospitals is very encouraging and may reflect the lower levels of illness believed to be associated with omicron infection COVID-19 vaccination rates in Thailand are very likely to be significantly reducing levels of severe illness and deaths caused by circulating COVID-19 strains. High vaccination rates also help to reduce the transmission of COVID-19. However, vaccination rates are still low in some provinces and in some important risk groups.
Two years into the pandemic, the coronavirus is killing Americans at far higher rates than people in other wealthy nations, a sobering distinction to bear as the country charts a course through the next stages of the pandemic.
Cumulative deaths
throughout the pandemic
Cumulative deaths
during the Omicron wave
Cumulative deaths throughout the pandemic
Cumulative deaths during the Omicron wave
Cumulative deaths
throughout the pandemic
Cumulative deaths
during the Omicron wave
The ballooning death toll has defied the hopes of many Americans that the less severe Omicron variant would spare the United States the pain of past waves. Deaths have now surpassed the worst days of the autumn surge of the Delta variant, and are more than two-thirds as high as the record tolls of last winter, when vaccines were largely unavailable.
With American lawmakers desperate to turn the page on the pandemic, as some European leaders have already begun to, the number of dead has clouded a sense of optimism, even as Omicron cases recede. And it has laid bare weaknesses in the countrys response, scientists said.
Death rates are so high in the States eye-wateringly high, said Devi Sridhar, head of the global public health program at the University of Edinburgh in Scotland, who has supported loosening coronavirus rules in parts of Britain. The United States is lagging.
Some of the reasons for Americas difficulties are well known. Despite having one of the worlds most powerful arsenals of vaccines, the country has failed to vaccinate as many people as other large, wealthy nations. Crucially, vaccination rates in older people also lag behind certain European nations.
The United States has fallen even further behind in administering booster shots, leaving large numbers of vulnerable people with fading protection as Omicron sweeps across the country.
Other large,
high-income
countries
Share of population
fully vaccinated
Share of population
with booster dose
Other large,
high-income
countries
Share of population fully vaccinated
Share of population with booster dose
Share of population
fully vaccinated
Other large,
high-income
countries
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with booster dose
The resulting American death toll has set the country apart and by wider margins than has been broadly recognized. Since Dec. 1, when health officials announced the first Omicron case in the United States, the share of Americans who have been killed by the coronavirus is at least 63 percent higher than in any of these other large, wealthy nations, according to a New York Times analysis of mortality figures.
In recent months, the United States passed Britain and Belgium to have, among rich nations, the largest share of its population to have died from Covid over the entire pandemic.
For all the encouragement that American health leaders drew from other countries success in withstanding the Omicron surge, the outcomes in the U.S. have been markedly different. Hospital admissions in the U.S. swelled to much higher rates than in Western Europe, leaving some states struggling to provide care. Americans are now dying from Covid at nearly double the daily rate of Britons and four times the rate of Germans.
The only large European countries to exceed Americas Covid death rates this winter have been Russia, Ukraine, Poland, Greece and the Czech Republic, poorer nations where the best Covid treatments are relatively scarce.
The U.S. stands out as having a relatively high fatality rate, said Joseph Dieleman, an associate professor at the University of Washington who has compared Covid outcomes globally. Theres been more loss than anyone wanted or anticipated.
As deadly as the Omicron wave has been, the situation in the United States is far better than it would have been without vaccines. The Omicron variant also causes less serious illness than Delta, even though it has led to staggering case numbers. Together, vaccines and the less lethal nature of Omicron infections have significantly reduced the share of people with Covid who are being hospitalized and dying during this wave.
In Western Europe, those factors have resulted in much more manageable waves. Deaths in Britain, for example, are one-fifth of last winters peak, and hospital admissions are roughly half as high.
But not so in the United States. Record numbers of Americans with the highly contagious variant have filled up hospitals in recent weeks and the average death toll is still around 2,500 a day.
Chief among the reasons is the countrys faltering effort to vaccinate its most vulnerable people at the levels achieved by more successful European countries.
Twelve percent of Americans 65 and over have not received either two shots of a Moderna or Pfizer-BioNTech vaccine or one Johnson & Johnson shot, which the C.D.C. considers fully vaccinated, according to the agencys statistics. (Inconsistencies in C.D.C. counts make it difficult to know the precise figure.)
And 43 percent of people 65 and over have not received a booster shot. Even among the fully vaccinated, the lack of a booster leaves tens of millions with waning protection, some of them many months past the peak levels of immunity afforded by their second shots.
In England, by contrast, only 4 percent of people 65 and over have not been fully vaccinated and only 9 percent do not have a booster shot.
Its not just vaccination its the recency of vaccines, its whether or not people have been boosted, and also whether or not people have been infected in the past, said Lauren Ancel Meyers, the director of the University of Texas at Austins Covid-19 modeling consortium.
Unvaccinated people make up a majority of hospitalized patients. But older people without booster shots also sometimes struggle to shake off the virus, said Dr. Megan Ranney, an emergency physician at Brown University, leaving them in need of extra oxygen or hospital stays.
In the United States, cases this winter first surged in more heavily vaccinated states in the Northeast before moving to less-protected states, where scientists said they worried that Omicron could cause especially high death tolls. Surveys suggest that the poorest Americans are the likeliest to remain unvaccinated, putting them at greater risk of dying from Covid.
Americas Omicron wave has also compounded the effects of a Delta surge that had already sent Covid deaths climbing by early December, putting the United States in a more precarious position than many European countries. Even in recent weeks, some American deaths likely resulted from lengthy illnesses caused by Delta.
But Omicron infections had edged aside Delta by late December in the United States, and epidemiologists said that the new variant was most likely responsible for a majority of Covid deaths in the U.S. today.
These are probably Omicron deaths, said Robert Anderson, the chief of mortality statistics at a branch of the C.D.C. And the increases were seeing are probably in Omicron deaths.
Still, the United States problems started well before Omicron, scientists said. Americans began dying from Covid at higher rates than people in western European countries starting in the summer, after the United States had fallen behind on vaccinations. During the Delta surge in the fall, Americans were dying from Covid at triple the rate of Britons.
By tracking death certificates that list Covid as a cause of death or as a contributing factor, Dr. Anderson said, the C.D.C. is able to ensure that it is counting only those people who died from Covid and not those who might have incidentally tested positive before dying for unrelated reasons.
It is too early to judge how much worse the United States will fare during this wave. But some scientists said there were hopeful signs that the gap between the United States and other wealthy countries had begun to narrow.
As Delta and now Omicron have hammered the United States, they said, so many people have become sick that those who survived are emerging with a certain amount of immunity from their past infections.
Although it is not clear how strong or long-lasting that immunity will be, especially from Omicron, Americans may slowly be developing the protection from past bouts with Covid that other countries generated through vaccinations at the cost, scientists said, of many thousands of American lives.
Weve finally started getting to a stage where most of the population has been exposed either to a vaccine or the virus multiple times by now, said Dr. David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. Referring to American and European death rates, he continued, I think were now likely to start seeing things be more synchronized going forward.
Still, the United States faces certain steep disadvantages, ones that experts worry could cause problems during future Covid waves, and even the next pandemic. Many Americans have health problems like obesity and diabetes that increase the risk of severe Covid.
Share of population not fully vaccinated
Share of population age 65 and older
Share of adult population with obesity
Share of population not fully vaccinated
Share of population age 65 and older
Share of adult population with obesity
More Americans have also come to express distrust of the government, and of each other in recent decades, making them less inclined to follow public health precautions like getting vaccinated or reducing their contacts during surges, said Thomas Bollyky, director of the global health program at the Council on Foreign Relations.
A study published in the scientific journal The Lancet on Tuesday by Mr. Bollyky and Dr. Dieleman of the University of Washington found that a given countrys level of distrust had strong associations with its coronavirus infection rate.
What our study suggests is that when you have a novel contagious virus, Mr. Bollyky said, the best way for the government to protect its citizens is to convince its citizens to protect themselves.
While infection levels remain high in many states, scientists said that some deaths could still be averted by people taking precautions around older and more vulnerable Americans, like testing themselves and wearing masks. The toll from future waves will depend on what other variants emerge, scientists said, as well as what level of death Americans decide is tolerable.
Weve normalized a very high death toll in the U.S., said Anne Sosin, who studies health equity at Dartmouth. If we want to declare the end of the pandemic right now, what were doing is normalizing a very high rate of death.
Eightmore Mainers have died and another 1,340coronavirus cases reported across the state, Maine health officials said Wednesday.
Wednesdays report brings the total number of coronavirus cases in Maine to 177,099,according to the Maine Center for Disease Control and Prevention. Thats up from 175,359 on Tuesday.
Of those, 130,471have been confirmed positive, while 46,628were classified as probable cases, the Maine CDC reported.
Two men and six women have succumbed to the virus, bringing the statewide death toll to 1,759.
Three were from Cumberland County, one from Franklin County, one from Penobscot County, two from Somerset County and one from York County.
Of those, three were 80 or older, three were in their 70s, one in their 60s and one in their 50s.
The number of coronavirus cases diagnosed in the past 14 days statewide is 14,159. 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 14,364 on Tuesday.
The new case rate statewide Wednesday was 10.01 cases per 10,000 residents, and the total case rate statewide was 1,323.21.
Maines seven-day average for new coronavirus cases is 1,015.4, down from 1,041.6 the day before, down from 1,028.9 a week ago and up from 706.4 a month ago.
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, 3,949Mainers have been hospitalized at some point with COVID-19, the illness caused by the new coronavirus. Of those, 344 are currently hospitalized, with 83 in critical care and 38 on a ventilator. Overall, 57 out of 376 critical care beds and 245 out of 322 ventilators are available.
The total statewide hospitalization rate on Wednesday was 29.51 patients per 10,000 residents.
Cases have been reported in Androscoggin (17,847), Aroostook (8,475), Cumberland (36,607), Franklin (4,396), Hancock (5,174), Kennebec (17,044), Knox (4,223), Lincoln (3,720), Oxford (8,758), Penobscot (19,959), Piscataquis (2,242), Sagadahoc (3,700), Somerset (7,472), Waldo (4,384), Washington (3,128) and York (19,969) counties. Information about where an additional case was reported wasnt immediately available.
An additional 1,105 vaccine doses were administered in the previous 24 hours. As of Wednesday, 977,044 Mainers are fully vaccinated, or about 76.3 percent of eligible Mainers, according to the Maine CDC.
As of Wednesday morning, the coronavirus had sickened 75,355,265 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 890,939 deaths, according to the Johns Hopkins University of Medicine.
More articles from the BDN
As COVID-19 vaccination rates increased and COVID-19 cases began to decrease across New York, the need for a daily update on the states positive case numbers, hospitalizations and deaths started to feel unnecessary earlier this year.
However, as COVID-19 infections begin to increase again and omicron, a new coronavirus variant, continues to spread, keeping track of the states coronavirus numbers feels pertinent once again.
The state and city government are continuing to provide data that can help put the past, present and future of the pandemic in context. Were aggregating some key numbers here, with the caveat that state data on both COVID-19 cases and vaccinations has been called into question, both under the administration of former Gov. Andrew Cuomo and under Gov. Kathy Hochul.
These numbers were last updated on Feb. 2.
New York state
66,391 The number of New York residents who have died after testing positive for the coronavirus, as reported to the CDC on Feb. 1. There were 136 deaths on Feb. 1.
9,342 Number of positive tests for the coronavirus reported on Feb. 1. There were 8,781, 5,115 and 7,119 positive tests on the three previous days.
6,628 The number of people hospitalized with the coronavirus, as reported on Feb. 1. At the height of the first wave on April 12, 2020, there were 18,825 people hospitalized with COVID-19.
1,094 The number of patients in intensive care units, as reported on Feb 1. At the height of the first wave on April 13, 2020, there were 5,225 people in intensive care units.
16,206,765 Total number of people whove received at least one coronavirus vaccine dose in New York state, as reported on Feb. 1.
14,405,423 Total number of people whove received two doses in New York state, as reported on Feb. 1.
New York City
26,894 Number of confirmed coronavirus deaths of New York City residents according to the state, as reported on Feb. 1. The states figure includes only deaths that occur in health care facilities such as hospitals and nursing homes. The city reported 33,087 confirmed deaths and 5,482 probable deaths (where there was no positive test, but symptoms were consistent with COVID-19) as of Feb. 2. City data has a three-day lag.
3,090 The seven-day average of daily positive tests reported on Feb. 2 according to the city.
7,042,356 Total number of New York City residents whove received at least one coronavirus vaccine dose in New York City, as reported on Feb. 2.
6,262,813 Total number of New York City residents whove received two doses in New York City, as reported on Feb. 2.
Elsewhere
888,784 The number of deaths from the coronavirus across the United States, as of Feb. 2, according to the CDC.
Total vaccine doses distributed: 667,094,365
Patients who've received the first dose: 250,184,240
Patients whove received the second dose: 211,954,555
% of population fully vaccinated: 63.8%
% of infections tied to the Omicron Variant: 99.9%
% of infections tied to the Delta Variant: 0.1%
COVID-19 case counts are beginning to fall again in the San Francisco Bay Area. But for many of the hundreds of thousands of residents infected in the past month, a huge question lingers: Am I going to develop long COVID?
To get answers, we reached out to several experts who are working with long COVID patients in the Bay Area and beyond. They helped us understand what, exactly, researchers know so far and what there still is to find out.
There isnt a good definition of long COVID yet. The U.S. Centers for Disease Control and Prevention starts the clock on long COVID four weeks after people are infected, while the World Health Organization defines it as symptoms that stick around longer than four months. Many researchers also believe extended symptoms can be separated into several distinct syndromes.
One issue is post-intensive care syndrome, a serious condition related to post-traumatic stress disorder that can affect people in the ICU for any reason.
Whether or not you end up in the ICU, COVID can cause injuries that take a long time to heal. Some of those are common to other respiratory illnesses. If you develop severe pneumonia from any virus or bacteria, including COVID, it can take as long as six months to get back to normal; in the meantime, you might have shortness of breath, coughing and fatigue.
Severe COVID also increases your risk of heart disease. In one study before vaccines were widely available, about 1 in 1,000 people diagnosed with COVID-19 also developed a type of heart inflammation called myocarditis within a month. In another pre-vaccine study, which has yet to complete peer review, 15% of people with confirmed COVID infections were diagnosed with heart disease within the next year. When researchers looked at data from 2017, only 10% of similar people had developed cardiac problems.
Some people develop symptoms that look very similar to chronic fatigue syndrome, also known as myalgic encephalomyelitis. That kind of post-viral syndrome can develop after all kinds of infection, including after mild or even asymptomatic cases of COVID. People may feel extremely tired, no matter how much they sleep; have extreme difficulty concentrating, also known as brain fog; and get exhausted just from walking across the room.
There are likely connections between the immune response to the virus and all these diverse symptoms, according to Mady Hornig, an associate professor of epidemiology at Columbia Universitys Mailman School of Public Health, who specializes in myalgic encephalomyelitis. She developed long COVID herself about four months after being infected. For more than a year, even mild exertion could trigger her heart to race and her blood oxygen to drop.
Infection-triggered syndromes are certainly not a surprise, she told SFGATE. Theres so much that we really need to understand about what is actually wrong.
That all depends on the symptoms, said Dr. Lekshmi Santhosh, medical director of UCSFs post-COVID clinic. Someone who was hospitalized and on a ventilator will have different needs than someone who was never hospitalized, who has significant fatigue and post-exertional symptoms. Treating respiratory symptoms is different than treating headaches and brain fog, she told SFGATE by email.
Dr. Linda Geng is the co-director of the Post-Acute COVID Syndrome Clinic at Stanford in Palo Alto, and said the most common symptoms she sees in her clinic include fatigue, brain fog, exertional intolerance and sleep issues.
"Encouragingly, we do see many patients get better over time, though there are patients who have now had symptoms lasting longer than a year, so we need to make sure we continue to provide support and resources for all long COVID patients," Geng wrote in an email.
Even though its now the dominant variant in the U.S., omicron hasnt been around long enough for researchers to get a handle on what happens long-term. Its clear, though, that omicron results in less severe disease than delta does. Thats true even for unvaccinated people, although theyre still much more likely to get very sick, or even die, than people who have been immunized.
Since vaccinated people are much less likely to get very sick, theyre also less likely to have injuries that take a long time to heal, like lung and heart damage. Even if you do get sick enough to go to the hospital, its extremely unlikely youll have to be treated in the ICU. (People infected with the omicron variant are unlikely to need the ICU, whether or not theyve been vaccinated.)
Most of our patients had acute COVID prior to vaccination, Geng said. Thus far we have not seen many new patients who have long COVID from breakthrough vaccinations, but we will need to see as time passes how the patterns emerge.
One of the only published studies looking at vaccination status was published in September 2021, when delta was the dominant strain, and before booster shots were widespread. Researchers in the United Kingdom asked people to self-report COVID symptoms through an app. A month after being infected, people who had received two vaccine doses were about 50% less likely to report symptoms than people who hadnt received any shots.
"We need more data to continue to evaluate the impact of vaccines, specifically boosters in the age of Omicron and whether the probability of infection is the same," said Dr. Peter Chin-Hong, an infectious diseases expert at UCSF, via email.
Research on the prevalence of long COVID is hugely varied, with peer reviewed reports claiming anywhere from 3% to 80% of people will have extended symptoms. (Chin-Hong estimated that number is about 10% to 20%, noting that vaccination significantly reduces the risk.) Obviously, theres a huge disparity between those numbers, even accounting for differing definitions of long COVID.
The biggest issue is that it takes a long time to do this kind of research. Most of the work now being published uses data from patients infected before vaccines were widely available. While lots of vaccinated people with long-term symptoms are being followed, most were infected when the most common strain of SARS-Cov-2 was delta, which causes more severe disease than the now-dominant omicron variant.
Its also very hard to conduct public health research in America, because our medical data is scattered across tens of thousands of systems that cant talk to one another. That means a lot of this research is being conducted in countries with national health systems like the UK, where the most common vaccine uses a different technology than the Pfizer or Moderna shots.
Its hard to say. Vaccines have done such a good job at preventing serious disease that many immunized people either dont know theyve been infected or use at-home tests without reporting positive results to anyone. That means it may take a long time for people to connect long-term symptoms to a COVID infection.
The federal National Institutes of Health has pledged to spend $1.15 billion on research into long COVID.
To Hornig, the pandemic represents an enormous opportunity and obligation to learn as much as we can about this and other post-viral syndromes. So many people got this at the same time, were finally looking at all sorts of nervous system disorders, she said. But we have so far to go before we know what to do.
LONDON A gaggle of masked nurses and doctors in blue paper gowns shuffled from one coronavirus patient to the next offering lifesaving care. Some patients had lingered for days or weeks. Others counted their stays in months.
If there was an end in sight to two years of pandemic, health care workers lamented, youd hardly know it here.
We live in this parallel universe, said Lucy Jenkins, who leads the team of critical care nurses at Homerton University Hospital in East London, comparing what health care workers on the frontline were experiencing with what the general public sees.
Political leaders have moved onto heralding the mild symptoms of the Omicron variant and declaring the pandemic all but over. The British government lifted nearly all coronavirus restrictions in mid-January as infection and hospitalization rates dropped steeply compared with early last year and as vaccines slashed the number of people falling seriously ill.
But for doctors and nurses a return to a normal rhythm of work is still a long way off. While Homertons intensive care units are no longer overflowing, as they were early last year, like many in England, they still face a steady influx of coronavirus patients.
So many people were infected by the coronavirus this winter a record of around 186,000 new daily cases in the first week of January that even if fewer of them ended up gravely ill, hospitals have remained under intense pressure.
In intensive care units like Homertons, which treat the most seriously ill, nearly all of those being tended are unvaccinated.
Since the start of the pandemic, the hospital has treated more than 2,000 coronavirus patients. Nearly 500 died from Covid, according to hospital data. The pandemic has by now engendered a lasting change in the way its intensive care unit, and many others in the country, work. We visited Homerton on Jan. 21.
10:30 a.m.: Morning ward rounds.
A team of doctors and nurses made their way around the escalation ward of the intensive care unit, set aside for treating coronavirus patients. They hover over charts and compare notes on the five patients. Each needs near constant care.
Four of them are hooked up to ventilators, and the rhythmic beeping of the machines hums steadily in the background.
This area was set up at the height of the pandemic to treat the most critically ill Covid patients. The space was originally a reception area for surgery and was never intended to be used for this specialized care. But since the spring of 2020, it has never closed.
Dr. Susan Jain, a specialist in anesthesia and intensive therapy, and a lead doctor, said it was like trying to set up a specialist unit in a living room. The area wasnt fit for the purpose.
Things have slowed, she said, but the staff are still on emergency footing.
We havent seen a point yet where were convinced that the number of Covid cases that are seriously ill are petering out, she said. So theres a sort of unpredictability hanging in the air, about how much and for how long the pressures continue, but it is there for the foreseeable future.
Mary Connolly, a senior nurse who has worked here for 32 years, moved with ease from bed to bed, rattling off vital details of the care of each patient. Nearly all they are now treating are unvaccinated, she explained. A handful deny that the virus even exists.
Its the new thing now, people are refusing to be tested at all, she says, shaking her head. A man with a tracheotomy moans as she and another nurse slide him up the bed to prepare him for an X-ray.
Dont pull it out, she says gently, as he grabs for the plastic pipe protruding from his neck.
One of the patients being cared for in the unit is Dean Gray, 47. He has been there for five days and is the only patient not on mechanical ventilation. Tubes run from the cannula inserted in his heavily tattooed hand. An oxygen mask is fixed over his nose and mouth.
Feb. 2, 2022, 9:06 p.m. ET
I sit at his bedside as he tells me how he had traveled to London to see his family for Christmas. He and his mother became sick with the coronavirus around the same time. She was admitted to the hospital first. He was brought in on the day she died.
I never got to see her, he said.
Mr. Gray chose not to get vaccinated and said his reluctance comes from distrust of the government and worries that the true scale of the pandemic was exaggerated.
Youve got Boris Johnson going to parties, and its really sort of put me against it, he said, pointing to the recent government scandal amid allegations that the prime minister lied about attending parties during lockdown. If all of these problems hadnt arose, I probably would have been vaccinated. But if the milk seems to be sour, I am not going to drink it.
Visitors are not allowed in areas where coronavirus patients are treated, but an exception has been made in Mohammed Tahirs case. He has been hospitalized for the last six months after contracting the coronavirus in August.
For a time he was doing better and was moved out of intensive care, but he returned in December. His bed stands alone in a separate bay. Unlike everyone else on the ward today, he was vaccinated before getting sick.
When his son, Omar Tahir, arrived for an hour visit, Mohammeds expression immediately eased. He gets anxious without his family by his side, Omar explained. So Omar quit his job and moved home to be closer to the hospital and to be with his mother, he said.
A job can be replaced, but you cant replace him, he said.
Omar rubs his fathers frail legs with lotion, his hand moving with care over the sharp angle of his shin bone. Mohammed signals to him to drive safely on his motorbike, his hands gesturing as if gripping handlebars, and he cracks a smile.
Around the world. Several European nations are easing their pandemic protocolsand starting to treat the virus as endemic. However, Tonga went into lockdownafter recording its first community transmission of the coronavirus, weeks after being battered by a volcanic eruption and tsunami.
Mohammed looks deep into his sons eyes and smiles, rarely breaking eye contact. When it comes time to say goodbye, Omar wipes away tears.
As evening comes, Ms. Jenkins, who leads the nurses here, finds out they will be getting three more patients. Its always a logistical stretch.
Adding to the difficulty is the fact that coronavirus patients are treated in a separate part of the unit and the nurse-to-patient ratio is higher in intensive care than other parts of the hospital.
An uptick in patients coupled with a staff shortage caused mainly by the pandemic, Brexit and burnout have meant the hospital has to rely on more temporary I.C.U. nurses. So even as patient numbers have dropped, the pressures remain.
I think people are exhausted, they are burned out, Dr. Jain said. The incentive to work in any of these environments is very little, thats a big problem.
Still, things have improved compared with this time last year when my colleague, Andrew Testa, visited the unit. It was the height of the second wave of coronavirus infections battering Britain, and the unit was brimming with patients. Every bed was full, with 22 Covid patients in total.
Now, there are typically between a half dozen to a dozen coronavirus patients on any given day, the hospital said.
But many health care workers are still grappling with months of observing illness and death on a scale they had never experienced, with some suffering from post-traumatic stress disorder.
It was the sheer volume, Dr. Jain said, adding that it was the same in hospitals across the country. It was mass death and also it felt like it could have been avoided.
Outside, banners line the street facing the main entrance with messages for the staff: Thank you to all the hard workers at Homerton Hospital. We love you, reads one.
The banners edges are now tattered and blackened by the exhaust of the cars that have passed by since they were first hung in 2020, when the pandemic began.
In many ways, the staff inside feel far from those early days. In some ways, little has changed, but what has changed is profound.
You know, in Wave 1, we were heroes, said Ms. Jenkins, the leader of the nursing team. By Wave 2, we were the enemy. And thats hard.
Researchers have discovered a mechanism that may explain why people with COVID-19 lose their sense of smell.
Published online February 1 in the journal Cell, the new study finds that infection with the pandemic virus, SARS-CoV-2, indirectly dials down the action of olfactory receptors, proteins on the surfaces of nerve cells in the nose that detect the molecules associated with odors.
Led by researchers from NYU Grossman School of Medicine and Columbia University, the new study may also shed light on the effects of COVID-19 on other types of brain cells and other lingering neurological effects of COVID-19 such as brain fog, headaches, and depression.
Experiments showed that the presence of the virus near nerve cells (neurons) in olfactory tissue brought an inrushing of immune cells, microglia, and T cells that sense and counter infection. Such cells release proteins called cytokines that changed the genetic activity of olfactory nerve cells, even though the virus cannot infect them, say the study authors. Where immune cell activity would dissipate quickly in other scenarios, in the brain, according to the teams theory, immune signaling persists in a way that reduces the activity of genes needed for the building of olfactory receptors.
Our findings provide the first mechanistic explanation of smell loss in COVID-19 and how this may underlie long COVID-19 biology, says co-corresponding author Benjamin tenOever, PhD, professor in the Departments of Medicine and Microbiology at NYU Langone Health. The work, in addition to another study from the tenOever group, also suggests how the pandemic virus, which infects less than 1 percent of cells in the human body, can cause such severe damage in so many organs.
One unique symptom of COVID-19 infection is loss of smell without the stuffy nose seen with other infections like the common cold, researchers say. In most cases, the smell loss lasts only a few weeks, but for more than 12 percent of people with COVID-19, olfactory dysfunction persists in the form of ongoing reduction in the ability to smell (hyposmia) or changes in how a person perceives the same smell (parosmia).
To gain insight into COVID-19induced smell loss, the current authors explored the molecular consequences of SARS-CoV-2 infection in golden hamsters and in olfactory tissue taken from 23 human autopsies. Hamsters represent a good model, being mammals that both depend more on the sense of smell than humans, and that are more susceptible to nasal cavity infection.
The study results build on the discovery over many years that the process that turns on genes involves complex 3D relationships, where DNA sections become more or less accessible to the cells gene-reading machinery based on key signals, and where some DNA chains loop around to form long-range interactions that enable the stable reading of genes. Some genes operate in chromatin compartmentsprotein complexes that house the genesthat are open and active, while others are compacted and closed, as part of the nuclear architecture.
In the current study, experiments confirmed that SARS-CoV-2 infection, and the immune reaction to it, decreases the ability of DNA chains in chromosomes that influence the formation of olfactory receptor building to be open and active, and to loop around to activate gene expression. In both hamster and human olfactory neuronal tissue, the research team detected persistent and widespread downregulation of olfactory receptor building. Other work posted by these authors suggests that olfactory neurons are wired into sensitive brain regions, and that ongoing immune cell reactions in the nasal cavity could influence emotions, and the ability to think clearly (cognition), consistent with long COVID.
Experiments in hamsters recorded over time revealed that downregulation of olfactory neuron receptors persisted after short-term changes that might affect the sense of smell had naturally recovered. The authors say this suggests that COVID-19 causes longer-lasting disruption in chromosomal regulation of gene expression, representing a form of nuclear memory that could prevent the restoration of olfactory receptor transcription even after SARS-CoV-2 is cleared.
The realization that the sense of smell relies on fragile genomic interactions between chromosomes has important implications, says Dr. tenOever. If olfactory gene expression ceases every time the immune system responds in certain ways that disrupts inter-chromosomal contacts, then the lost sense of smell may act as the canary in the coal mine, providing early signals that the COVID-19 virus is damaging brain tissue before other symptoms present, and suggesting new ways to treat it.
In a next step, the team is presently seeing whether treating hamsters with long COVID with steroids can restore restrain damaging immune reactions (inflammation) to protect nuclear architecture.
Along with Dr. tenOever, authors of the current study from the Department of Microbiology at NYU Langone Health were Justin Frere, Rasmus Moeller, Skyler Uhl, and Daisy Hoagland. Also leading the study were corresponding authors Jonathan Overdevest and Stavros Lomvardas from the Mortimer B. Zuckerman Mind Brain Behavior Institute at Columbia University. Additional contributors included Marianna Zazhytska, Albana Kodra, Hani Shayya, Stuart Firestein, Peter Canoll, and James Goldman. Also making important contributions were study authors John Fullard and Panos Roussos of the Icahn School of Medicine at Mt. Sinai; Arina Omer of Baylor Genetics in Houston; and Qizhi Gong of the Department of Cell Biology and Human Anatomy, School of Medicine, University of California at Davis.
Funding for the study was provided by National Institutes of Health grants NIDCD 3R01DC018744-01S1 and U01DA052783, as well as a Howard Hughes Medical Institute Faculty Scholars award and the Zegar Family Foundation.
Greg WilliamsPhone: 212-404-3500gregory.williams@nyulangone.org
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After an anxious January marked by a wave of COVID-19 infections that pushed Texas hospitals and intensive care units to their limits, the number of Texans in the hospital with COVID-19 across the state has been in a steady decline for about a week, according to state health data.
The decrease is the latest in a series of hopeful signs that the surge driven by the highly contagious omicron variant may be starting to abate, forecasters and health officials say.
If the trend continues, the state would have passed its peak hospitalizations for this wave on Jan. 20, when Texas hospitals reported 13,371 patients with COVID-19 a number that has decreased daily since then. That falls short of the record 14,218 hospitalizations the state saw a year ago on Jan. 11, 2021.
On Monday, the number of Texans in the hospital with COVID-19 was 11,997, the lowest number the state has seen in nearly three weeks. Forecasters and health officials feared last month that hospitalizations could reach new pandemic highs, but now say its likely the state wont reach that mark during this surge.
The decline is a welcome development for doctors, nurses and other officials in the states overwhelmed hospitals at the tail end of what, in some areas, was the fifth wave of infections in the past two years.
In the harder-hit metro areas such as Austin and Houston, hospitals reported record-breaking numbers of patients with COVID-19 last month but the situation is improving.
At Texas Childrens Hospital in Houston, the number of young patients with COVID-19 and the percentage of positive tests in the past six weeks far outpaced any records set during the prior two years, said Dr. James Versalovic, the hospitals pathologist-in-chief.
Now, positivity rates are down by a third, and the number of patients with COVID-19 is down by about 70%, he said. Those numbers are still higher than records set in the hospital during the delta surge, but they are dropping steadily albeit slowly, he said.
We are optimistic. We are breathing a bit more easily this week, Versalovic said. We do see light at the end of the tunnel, but its a long tunnel. We are looking forward to March.
Dr. James McCarthy, a chief physician executive and executive vice president for Memorial Hermann Health System in Houston, said in a recent TV interview that the surge appears to be easing up at those facilities.
"We're feeling very optimistic that weve crested this wave, he said. We feel like the hospitals have weathered this storm again."
The state has also seen daily new COVID-19 cases decline by more than a third since last week, as well as a drop in positivity rates. And the number of ICU beds available in the state has started to increase again after it reached its lowest level since the start of the pandemic.
But with more than 25% of tests still coming out positive, the levels of virus still surpass what was seen during the delta surge and would have been mind-boggling at any point before December, said Chris Van Deusen, spokesperson for the Texas Department of State Health Services.
So people should still be cautious, he said.
Experts also say its hard to predict whether another variant may arise that could cause another surge, or how long the natural immunity from an omicron infection might last.
But the downward trend should continue as long as people dont get too confident too fast, drop their guards and start acting like the pandemic is over, said Anass Bouchnita, a researcher at the University of Texas COVID-19 Modeling Consortium, which uses data and research to project the path of the pandemic.
All of that is a good sign, but of course its not the end, he said. We know that around half of the infections and hospitalizations and deaths will occur after the peak, so this is not the finish line. Its not time to let our guard down. We need to keep up the vigilance.
That means to get vaccinated but also, he said, to continue masking up, hand-washing and social distancing so the transmission continues to subside.
The number of hospitals reporting full ICUs last week was at 73, still well under the pandemic record of 100 over the summer, and a decrease from the week before.
Still increasing, however, are the daily reported deaths, which dont usually start declining until a few weeks after hospitalizations peak.
The deadliest wave of the pandemic hit over the holidays in December 2020 and January 2021, just weeks after the vaccine was given emergency use authorization in the United States and very few people had access to it. The numbers of hospitalizations and deaths from COVID-19 hit highs that the state hadnt seen before and has not seen since.
During the delta wave of last summer, the state put record numbers of children in the hospital with COVID-19 but missed the previous pandemic record for statewide hospitalizations by only a few hundred.
The most recent surge, which started in December, shortly after the omicron variant was detected in Texas, saw case counts and positivity rates in Texas top previous pandemic records, as well as pediatric hospitalizations. The same thing happened nationally.
Compared with the deadlier delta variant surge last September, the most recent wave brought about by the more contagious omicron variant comes with some important caveats, experts say.
Omicron is more easily spread than any of the other versions, taking down vital health employees for days at a time when more people are becoming infected.
Nearly 60% of the state is fully vaccinated, which experts say protects against hospitalization, and the omicron variant itself appears to produce less-serious symptoms than previous iterations. And while treatments are in short supply, there are more approved now than there were during the last surges.
But omicron is still leaving chaos in its wake.
Were in a different situation now than we were a year ago, said Dr. David Lakey, vice chancellor for health affairs and chief medical officer at the University of Texas System, and former state health commissioner. Having some tools out there, having experience with the virus, having the most vulnerable individuals immunized that helps a lot. On the other hand, the hospitals have been doing this a long time and theyre very burned out and theyre very short-staffed right now and they are going as hard as they can to care for individuals.
ICU admissions for people with COVID are lower than they were during the last peak a year ago, and fewer of those patients need ventilators, according to state data. Smaller percentages of patients who test positive are being admitted into the hospital for COVID treatment, and hospital stays are getting shorter, according to hospital officials.
Those trends signal that the virus is making Texans less sick, overall, which officials hope will not only reduce deaths and suffering but also, eventually, the pressure on hospitals.
That is a bright spot, Lakey said.
At the height of the delta surge, more than 100 hospitals in Texas reported that their ICUs were full to capacity. By comparison, at least 73 hospitals reported that their ICUs were full last week.
In Dallas-Fort Worth-area hospitals, even though most of the areas major hospitals were reporting ICU capacity filled to more than 95%, about half of those patients have COVID-19, similar to the share during delta, said Steve Love, president and CEO of the DFW Hospital Council.
Meanwhile, the number of ICU patients needing ventilators dropped by roughly 50% in the region compared with the other two surges, Love said.
At Houston Methodist The Woodlands Hospital, north of Houston, theyre seeing fewer ICU beds used by COVID patients than they did during the delta surge. But chief medical officer Jason Knight said unvaccinated patients and those with preexisting medical conditions are still at risk.
With omicron, were seeing a lot more people with complex medical problems, where even though the [COVID] infection is mild, its pushing them over and causing their complex medical problems to result in ICU admissions and potentially deaths, he said.
The waves of people showing up at Texas hospitals come at a time when the health care industry is experiencing a historic staffing crisis two years into a pandemic that has killed more than 78,000 people in the state.
And while hospital stays are growing shorter, they are still extended in some cases by the lack of nursing home beds available for patients who are in postoperative recovery or need long-term care a problem exacerbated by staffing shortages at long-term care facilities.
The total number of hospital beds available statewide for all patients is lower than it was when hospitalizations peaked a year ago. Thats due to a combination of staff members and their families being out sick with omicron, nurses leaving for contract work, and employees quitting the industry altogether because of burnout or fears of infection.
At the height of last years January surge, the state had some 14,000 medical staffers deployed in the hardest-hit hospitals. During the delta wave last summer, about 8,000 nurses were sent to help.
So far during this surge, the state has contracted with about 4,400 travel nurses for hospitals that need them.
In mid-January at the Golden Plains Community Hospital in the Panhandle town of Borger, nurses were absent in the medical-surgical department as well as the emergency room, the lab and the clinic, while the hospital sees a surge in cases and hospitalizations. Only a third of that countys residents are vaccinated.
All 10 of the employees who were absent on a recent day last month were out with COVID-19, said CEO Don Bates.
Every day is a new battle, Bates wrote in an email. If it comes to shutting down surgery and pulling nurses from our clinics or OB which there arent many left well do what we have to do to care for the COVID sick, until we absolutely cant take any further admissions. Then our docs will have to focus on what the Panhandle Regional Advisory Council has been calling the salvageable.
Not my words, he added. By the end of January, Bates was home sick with COVID-19, too.
Nationwide, 81% of ICU capacity is being used, with 29% of those patients diagnosed with COVID-19, according to federal data. Texas ICUs are at a 92% occupancy rate, with about 39% of patients positive for COVID-19.
People ages 5-17 are eligible to receive the Pfizer-BioNTech vaccine. People ages 18 and older are eligible to get the Pfizer-BioNTech or Moderna vaccines, which are now preferred over the Johnson & Johnson vaccine, according to the Centers for Disease Control and Prevention.
All vaccines in the United States must go through three phases of clinical trials to make sure they are safe and effective. During the development of COVID-19 vaccines, phases overlapped to speed up the process, but all phases were completed, according to the Centers for Disease Control and Prevention. State data shows that unvaccinated Texans made up 85% of coronavirus cases and deaths from Jan. 15 to Oct. 1, 2021.
Yes. Research has not yet shown how long you are protected from getting COVID-19 again after recovering from COVID-19, according to the Centers for Disease Control and Prevention, and vaccination will boost protection. If you were treated for COVID-19 with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine. Talk to your doctor if you are unsure what treatments you received or if you have more questions about getting a COVID-19 vaccine.
Most chain pharmacies and many independent ones have a ready supply of the vaccine, and many private doctors' offices also have it. Texas has compiled other options for finding vaccine appointments here, and businesses or civic organizations can set up vaccine clinics to offer it to employees, visitors, customers or members. The vaccine is free, and you dont need health insurance to get it.
The protection the vaccine offers can wane over time, so medical experts recommend getting a booster shot. People ages 18 and older are eligible for booster shots, according to recommendations from the CDC. Recipients ages 12-17 who received the Pfizer vaccine as their initial two-dose treatment are eligible to receive the Pfizer vaccine as their booster.
The influx of omicron cases has created a vicious cycle for many hospitals, where administrators fear that the increased demands on nursing staff may lead to more of them burning out or leaving the profession.
At Houston Methodist The Woodlands Hospital, patients are staying in the emergency department far longer than usual, waiting for a bed to open up.
Were trying to take care of essentially an inpatient unit down in our emergency department in addition to [nurses] trying to do their normal jobs, said Knight, the chief medical officer there. A lot of nurses are getting stretched really thin. Thats why a lot of them are getting frustrated. Thats why some people are leaving.
Knight said the current staffing crunch has created a competitive environment for health care, with an increase in frustrated and occasionally rude patients.
Prevention protocols such as masking, social distancing and limiting travel play a big role in lowering hospital rates, officials and experts say.
But the big weapon against overwhelming hospitals with severe cases is vaccination, which has been proven highly effective at keeping those who are inoculated out of the hospitals and intensive care units.
About 58% of Texans are fully vaccinated. Nationwide, that number is nearly 63%.
One thing Lakey, the University of Texas System chief medical officer, credits with keeping severe illnesses down and ICU numbers lower than they could be is the high vaccination rate Texas is reporting among its most vulnerable residents ages 65 and older. Some 84% of them have been fully vaccinated.
The really at-risk individuals of having severe disease, weve given them some protection so theyre less likely to go to the ICU and less likely to die because theyve been immunized, Lakey said. You are seeing breakthrough infections, but the vaccines do protect from the severe disease, a significant amount of protection.
In Montgomery County, where Houston Methodist The Woodlands is based, only 53% of residents are vaccinated, which is the lowest rate for Texas counties with populations exceeding 500,000. Roughly 17% of residents have received booster shots.
Nurses and doctors say that after nearly two years on the front lines, their empathy for the unvaccinated patients who will require their care is diminished.
The tragedy of COVID is, its happening behind the doors of our critical care rooms, in our [ER], in our ICU. Theres very few people in the community that has ever seen somebody suffocate and die from COVID, Knight said. That is totally and completely preventable. I just think that that is incredibly tragic, and thats hard emotionally on our nurses and its hard emotionally on our staff.
Eleanor Klibanoff contributed to this report.
Disclosure: Texas Childrens Hospital, Memorial Hermann Health System, the University of Texas at Austin and the University of Texas System have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribunes journalism. Find a complete list of them here.
