A medical worker prepares an injection with a dose of AstraZeneca COVID-19 vaccine, at a vaccination centre in Zagreb Fair hall, amid the outbreak of coronavirus disease (COVID-19), Croatia, April 7, 2021. REUTERS/Antonio Bronic
ZAGREB, Nov 4 (Reuters) - Croatia reported on Thursday 6,310 infections of COVID-19 which is the highest daily number of infections since the beginning of the pandemic, the national health authorities said.
At the moment there are 25,628 active COVID-19 cases in a country of around 4 million people, while 1,680 patients require hospital treatment.
In Croatia a bit over 50% of population is fully vaccinated and experts largely blame such a low vaccination rate for the increase in infections in recent weeks.
In neighbouring Slovenia, the authorities also reported the highest number of daily COVID-19 cases, with 4,511 infections. Also in Slovenia just slightly over 50% of its 2 million inhabitants have been fully vaccinated.
Reporting by Igor Ilic;Editing by Alison Williams
Our Standards: The Thomson Reuters Trust Principles.
Can the Packers beat the Chiefs without Aaron Rodgers?
Sports Seriously: Aaron Rodgers will be out this week after testing positive for COVID-19. Andy Nesbitt and Charles Curtis discuss whether Jordan Love can still lead Green Bay to a win Sunday in Kansas City.
Sports Seriously, USA TODAY
Green Bay Packers quarterback and three-time NFL MVP Aaron Rodgers will miss Sunday's game against the Kansas City Chiefs after testing positive for COVID-19.
Rodgers intimated in August that he had received the vaccine, when he answered a reporter's question with,"Yes, I've been immunized." However, he did not meet the qualifications the NFL and the Players Association have set out for being "fully vaccinated."
As a result of testing positive for COVID-19 this week, Rodgers can't return to the field or team practice facilitiesfor 10 days, even if he is asymptomatic.
Here's what we know at this moment:
NFL.com is reporting Rodgers received homeopathic treatment from his personal doctor before training camp to raise his antibody levels. He thenpetitioned the NFL to have the treatment qualify as equal to the league's approved vaccines.
Rodgers' petition for an exemption was denied.
"Theres guys on the team that havent been vaccinated. I think its a personal decision. Im not going to judge those guys," Rodgers said in August. "Theres guys that have been vaccinated that have contracted COVID. So its an interesting issue."
Star wide receiver Davante Adams and defensive coordinator Joe Barry both missed the team's game against the Arizona Cardinals due to COVID-19.
Allen Lazard, another wide receiver, was forced to sit out five days because he was an unvaccinated close contact of someone who tested positive. He has since been reinstated.
Third-string quarterback Kurt Benkert and cornerback Isaac Yiadomare also on the COVID-19 list.
The NFL will conduct an investigation into whether Rodgers orthe Packers violated any of the league's COVID-19 rules.
Unvaccinated playersare required to wear masks "at all times when inside the Club facility"and are subject to daily PCR testing.
Rodgers has been tested for COVID-19 on a daily basis, a person with knowledge of the situation tells USA TODAY Sports. However,it's unclear whether he has complied with the other regulations, which include not coming within six feet of other unvaccinated players while traveling or eating meals.
Rodgers has not worn amask while speaking to the media at news conferences, which are held inside the team facility.NFL spokesperson Brian McCarthy said the league is "aware of the current situation in Green Bay and will be reviewing with the Packers."
Rodgers' 10-day quarantine runs through Nov. 13. He could rejoin the team after that, but would not be able to take part in any practices leading up to the Packers' game against the Seattle Seahawks on Nov. 14.
Backup quarterback Jordan Love has already been named the starter for this Sunday's game, when the 7-1 Packers take onthe Kansas City Chiefs. It will be his first career regular-season start.
TipicoSportsbook altered the spread a staggering 6.5 pointsto establish the Chiefs as a7.5-point favorite.The over-under total slipped dramatically, too, from 54.5 points to 48.5 points.
Maine is reporting 692 new cases of COVID-19 on Thursday and four additional deaths, as the state ramps up vaccinations for elementary-aged schoolchildren.
Since the pandemic began, Maine has logged 106,473 cases of COVID-19, and 1,197 deaths.
But the prospect of immunizing a new group of people, ages 5-11, means that the states overall vaccination rates should climb in the coming weeks, by up to 7 percent, depending on how many parents bring their children in for their shots. Federal regulators gave the final approval Tuesday evening to Pfizers vaccine for ages 5-11, with schoolchildren receiving one-third of the dose that adults get. Pfizer is a two-shot regimen spaced three weeks apart.
Vaccination is one of the best tools we have available to reduce the spread of COVID-19 and ensure children not only stay safe and healthy but can continue participating in the in-person activities that we know are important for their physical and mental health, Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said during a media briefing on Wednesday.
Some health care providers already were scheduling appointments for younger children on Wednesday, though it will take some time for the rollout to be fully operational at schools and clinics.
Were asking parents for a bit of patience, Shah said. We know youve been waiting so long for your kids to have the chance to get vaccinated. What were asking is you wait just a bit longer while all the pieces come into place.
Some clinics started up as soon as Wednesday, with more expected next week, and many school-based clinics to offer the first shot before Thanksgiving. Vaccinations are available or will soon be available at pharmacies, doctors offices and school-based or community-based clinics.
Naomi Schucker of Gorham said her daughter, 11-year-old Nora Schucker, jumped at the chance to get vaccinated against COVID-19. Shucker accompanied her daughter to the clinic in Falmouth Wednesday afternoon to get the Pfizer shot.
Its too bad she had to wear a mask. Otherwise, you would have seen her grinning from ear to ear, Schucker joked during a phone interview Wednesday evening. She is super happy and thrilled to get the additional protection.
Schucker said that her daughter, a sixth-grader at Gorham Middle School, suffered no adverse reactions to the vaccination.
She has been doing great, Schucker said. The only side effect has been extreme happiness.
This story will be updated.
Invalid username/password.
Please check your email to confirm and complete your registration.
Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.
Previous
Next
CHICAGO, Nov 3 (Reuters) - As the devastating Delta variant surge eases in many regions of the world, scientists are charting when, and where, COVID-19 will transition to an endemic disease in 2022 and beyond, according to Reuters interviews with over a dozen leading disease experts.
They expect that the first countries to emerge from the pandemic will have had some combination of high rates of vaccination and natural immunity among people who were infected with the coronavirus, such as the United States, the UK, Portugal and India. But they warn that SARS-CoV-2 remains an unpredictable virus that is mutating as it spreads through unvaccinated populations.
None would completely rule out what some called a "doomsday scenario," in which the virus mutates to the point that it evades hard-won immunity. Yet they expressed increasing confidence that many countries will have put the worst of the pandemic behind them in the coming year.
"We think between now and the end of 2022, this is the point where we get control over this virus ... where we can significantly reduce severe disease and death," Maria Van Kerkhove, an epidemiologist leading the World Health Organization's (WHO) COVID-19 response, told Reuters.
The agency's view is based on work with disease experts who are mapping out the probable course of the pandemic over the next 18 months. By the end of 2022, the WHO aims for 70% of the world's population to be vaccinated.
"If we reach that target, we will be in a very, very different situation epidemiologically," Van Kerkhove said.
In the meantime, she worries about countries lifting COVID precautions prematurely. "It's amazing to me to be seeing, you know, people out on the streets, as if everything is over."
COVID-19 cases and deaths have been declining since August in nearly all regions of the world, according to the WHO's report on Oct. 26.
Europe has been an exception, with Delta wreaking new havoc in countries with low vaccination coverage such as Russia and Romania, as well as places that have lifted mask-wearing requirements. The variant has also contributed to rising infections in countries such as Singapore and China, which have high rates of vaccination but little natural immunity due to much stricter lockdown measures.
The transition is going to be different in each place because it's going to be driven by the amount of immunity in the population from natural infection and of course, vaccine distribution, which is variable ... from county by county to country by country, said Marc Lipsitch, an epidemiologist at Harvard T.H. Chan School of Public Health.
Several experts said they expect the U.S. Delta wave will wrap up this month, and represent the last major COVID-19 surge.
"We're transitioning from the pandemic phase to the more endemic phase of this virus, where this virus just becomes a persistent menace here in the United States," former Food and Drug Administration Commissioner Scott Gottlieb said.
Chris Murray, a leading disease forecaster at the University of Washington, likewise sees the U.S. Delta surge ending in November.
"We'll go into a very modest winter increase" in COVID-19 cases, he said. "If there's no major new variants, then COVID starts to really wind down in April."
Even where cases are spiking as countries drop pandemic restrictions, as in the UK, vaccines appear to be keeping people out of the hospital.
Epidemiologist Neil Ferguson of Imperial College London said that for the UK, the "bulk of the pandemic as an emergency is behind us."
'A GRADUAL EVOLUTION'
COVID-19 is still expected to remain a major contributor to illness and death for years to come, much like other endemic illnesses such as malaria.
"Endemic does not mean benign," Van Kerkhove said.
Some experts say the virus will eventually behave more like measles, which still causes outbreaks in populations where vaccination coverage is low.
Others see COVID-19 becoming more a seasonal respiratory disease such as influenza. Or, the virus could become less of a killer, affecting mostly children, but that could take decades, some said.
Imperial College's Ferguson expects above-average deaths in the UK from respiratory disease due to COVID-19 for the next two-to-five years, but said it is unlikely to overwhelm health systems or require social distancing be reimposed.
"It's going to be a gradual evolution," Ferguson said. "We're going to be dealing with this as a more persistent virus."
Trevor Bedford, a computational virologist at Fred Hutchinson Cancer Center who has been tracking the evolution of SARS-CoV-2, sees a milder winter wave in the United States followed by a transition to endemic disease in 2022-2023. He is projecting 50,000 to 100,000 U.S. COVID-19 deaths a year, on top of an estimated 30,000 annual deaths from flu.
The virus will likely continue to mutate, requiring annual booster shots tailored to the latest circulating variants, Bedford said.
If a seasonal COVID scenario plays out, in which the virus circulates in tandem with the flu, both Gottlieb and Murray expect it to have a significant impact on healthcare systems.
"It'll be an issue for hospital planners, like how do you deal with the COVID and flu surges in winter," Murray said. "But the era of ... massive public intervention in people's lives through mandates, that part I believe will be done after this winter surge."
Richard Hatchett, chief executive of the Coalition for Epidemic Preparedness Innovations, said with some countries well protected by vaccines while others have virtually none, the world remains vulnerable.
"What keeps me up at night about COVID is the concern that we could have a variant emerge that evades our vaccines and evades immunity from prior infection, Hatchett said. That would be like a new COVID pandemic emerging even while we're still in the old one."
Reporting by Julie Steenhuysen; Editing by Michele Gershberg and Bill Berkrot
Our Standards: The Thomson Reuters Trust Principles.
The possibility of COVID-19 transmission introduces an additional margin when it comes to the choice of means of transport for commuters. Modeling from transportation economics can be used to highlight this choice. We will define the concept of value-of-avoiding-transmission (VAT), which captures the tradeoff between a higher dollar or time cost of transportation and a lower likelihood of disease transmission, perhaps as a result of exposure to a smaller number of travelers, resulting in a lower probability of infection. A central concept in transportation economics is the value-of-travel-time (VOT), which quantifies the well-known tradeoff between saved time and money. More precisely, VOT specifies the amount of money that if a commuter had a choice between paying this amount and enjoying a fixed amount of time-savings during his commute, or paying nothing and receiving no time savings, he would be exactly indifferent between the two options. The similar notion of the value of statistical life (VSL) is used in actuarial studies to quantify the tradeoff between reducing the probability of death and a corresponding reduction in income that makes the agent indifferent7,8. VOT is of central importance in transportation demand modeling, as well as in the costbenefit analysis of related public policies. For example, it was found that travel time and reliability account for 45% of the average social variable cost of travel in the US9.
In the age of COVID-19, there is an additional cost associated with public transportation, namely, an increased probability of exposure to the virus, leading to potential illness and the associated economic costs. When it comes to commuting, these costs can be modeled in a way that is parallel to the costs from potential traffic accidents. Exposure to the virus, just like a traffic accident, occur with some probability in every trip. In addition, just as the probability of an accident increases with congestion, so does the likelihood of infection increase with the number of people using the transportation mode under study. The VAT can be used to monetize the desire to reduce the probability of infection by appropriately adjusting the choice of transportation mode.
Transportation studies have explored the relationship between VOT and income, wealth, age, time constraints, etc. Travel demand modeling typically finds that travel time is an important explanatory economic variable, even more so than the direct economic cost of travel. The standard model is based on Lave10, while more involved theories of VOT build on the optimal time allocation framework11. People in this framework choose how much labor to supply given a constraint that total time devoted to work, leisure, and commuting equals the total time available to them. Since time can be transferred between work and leisure, any marginal savings in travel time can be used to increase labor income. Intuitively, optimization implies that travel time is valued at the after-tax wage rate. The commuters budget constraint can be expressed as
$$x + c le left( {1 - tau } right)w cdot h$$
(1)
while the commuters time constraint gives
where T is the total available time, t is the time spent commuting, h corresponds to hours spent at work under after-tax income, (Y = left( {1 - tau } right)w), and (l) denotes time spent on leisure. Finally, x is the expenditure in goods, and c is the direct cost of transportation. If the worker uses public transit, c would be the public transit fare; if the worker uses private transport, c would be the cost of fuel needed for travel; i.e., the price per gallon times miles travelled divided by miles per gallon (or ({{fuel;price times miles;driven} mathord{left/ {vphantom {{fuel;price times miles;driven} { , fuel;efficiency}}} right. kern-nulldelimiterspace} { , fuel;efficiency}})). Letting V denote the optimal value of the utility function, u, the first-order conditions for this problem yield
$$VOT = frac{{{raise0.7exhbox{${partial V}$} !mathord{left/ {vphantom {{partial V} {partial t}}}right.kern-nulldelimiterspace} !lower0.7exhbox{${partial t}$}}}}{{{raise0.7exhbox{${partial V}$} !mathord{left/ {vphantom {{partial V} {partial h}}}right.kern-nulldelimiterspace} !lower0.7exhbox{${partial h}$}}}} = left( {1 - tau } right)w + frac{{{raise0.7exhbox{${partial u}$} !mathord{left/ {vphantom {{partial u} {partial h}}}right.kern-nulldelimiterspace} !lower0.7exhbox{${partial h}$}} - {raise0.7exhbox{${partial u}$} !mathord{left/ {vphantom {{partial u} {partial t}}}right.kern-nulldelimiterspace} !lower0.7exhbox{${partial t}$}}}}{lambda }$$
(3)
where (lambda) is the marginal utility of money. The VOT increases with the after-tax wage rate and decreases with the marginal utility of money. This leads to a self-selection where commuters with a higher opportunity cost of time will tend to choose faster, generally more expensive modes of transport.
The recent events related to COVID-19 highlight additional constraints and concerns in connection to public transport. As noted in Figs.2, 3, 4 and 5 later in "Data visualization" section, there is evidence that the density of public transportation options is highly correlated with an increased probability of transmission of the virus3,4,5,6. This introduces an additional tradeoff. Increased use of public transport might lead to a higher probability of income loss due to infection and subsequent illness.
Consider a commuter during the COVID-19 era. Every time he uses public transportation, there is a probability, (Pleft( n right)), of contracting the virus. This probability is increasing in the number of passengers, n, since commuter contacteither direct or indirectwith other passengers increases the likelihood of contact with a COVID-19 carrier. Travel time, (tleft( n right)), also increases with n, since higher capacity utilization implies greater delays. The expected utility for a commuter is given by
$$U = Pleft( n right) cdot u^{V} left( {Y - F - L} right) + left[ {1 - Pleft( n right)} right] cdot u^{ - V} left( {Y - F} right) - Cleft( {tleft( n right)} right).$$
(4)
In the above expression, Y is the commuters income, while (u^{V}) and (u^{ - V}) stand for the resulting utilities if the commuter is infected and not infected, respectively, during commuting. Infection can lead to medical expenses and lost income from missed work due to mild or severe symptoms, or, in extreme cases, even to death. We denote the resulting expected income loss by L, and the commuting fare as F. Finally, (Cleft( {tleft( n right)} right)) denotes the opportunity costs of commuting travel-time, where ({{partial C} mathord{left/ {vphantom {{partial C} {partial t}}} right. kern-nulldelimiterspace} {partial t}} > 0). Thus, increased commuting time adds to commuting costs.
The probability of disease transmission will vary across different means of transport. For example, this probability should be close to zero if one drives their own car to work, especially if not carpooling. The probability will increase when using ride-sharing services or traditional taxis since, although the driver might be the only other person present in the vehicle, disease contagion from previous passengers is still possible. In a bus or train, the probability increases with the number of fellow travelers, n.
The model illustrates how infection risk and travel time are linked to commuting density as captured by the number of people, n, using this particular means of transport. The marginal change from an increase in the number of commuters can be decomposed into an increase in (a) the implied risk of infection, and (b) the commuting time. The expected marginal utility of income is defined as8:
$$lambda = P cdot frac{{partial u^{V} }}{partial Y} + left[ {1 - P} right] cdot frac{{partial u^{ - V} }}{partial Y}.$$
(5)
To avoid an exogenous increase in travel time, commuters would be willing to pay (frac{1}{lambda }frac{partial C}{{partial t}}). This is the standard expression for the VOT discussed earlier. The value of an exogenous increase in infection transmission risk is (- frac{1}{lambda }left( {u^{V} - u^{ - V} } right)). The value of choosing a transportation mode that implies a marginal reduction in the number of people commuting, thus resulting in a lower probability of infection, is given by
$$frac{1}{lambda }left[ {left( {u^{V} - u^{ - V} } right) cdot frac{partial P}{{partial n}} + frac{partial C}{{partial t}} cdot frac{partial t}{{partial n}}} right].$$
(6)
In this context, we will refer to (frac{1}{lambda }left( {u^{V} - u^{ - V} } right) cdot frac{partial P}{{partial n}}) as the value-of-avoiding-transmission (VAT). Equation(6) captures the combined value of the reduced risk and reduced travel time that would be afforded by a small reduction in the number of people commuting. This could be, for example, the result of using a different (or less crowded) mode for transport. Equation(6) can provide an interpretation for our empirical work related to the marginal rate of substitution between transportation modes associated with different likelihoods of infection.
One of eight Latter-day Saint missionaries returning home to Tonga after completing their missions became Tongas first case of COVID-19, sending the country into lockdown even though his second test was negative, according to news reports.
The young man had completed his mission in Africa and was fully vaccinated, according to Sam Penrod, spokesman for The Church of Jesus Christ of Latter-day Saints.
The returning missionary spent several weeks in New Zealand on his way home and twice tested negative for the virus before he boarded a government-sponsored repatriation flight that carried 215 people to Tonga on Oct. 27.
Proper COVID-19 protocols were followed, said Penrod.
The passengers were tested again when they landed in Tonga and placed in a quarantine hotel. The test for the returning missionary returned a weak positive result, a doctor with the ministry of health told the news site MatangiTonga.to. The returned missionary has remained in quarantine.
The doctor announced today that the returned missionarys second test, taken Monday, was negative.
Tonga effectively closed its border when the pandemic began in March 2020. Many Tongans who were away when the pandemic struck have been unable to return home.
That includes hundreds, perhaps thousands of Latter-day Saint missionaries, who have seen their mission service extend well beyond the normal two years for men and 18 months for women, according to Elder Vaiangina Vai Sikahema, a General Authority Seventy of the Church of Jesus Christ.
Some Tongan elders have been on their missions for three years and sisters over two years, he said during the churchs worldwide general conference last month. They wait patiently with the faith for which our people are known.
Latter-day Saints comprise nearly two-thirds of Tongas population of 106,000. The Ministry of Health reported Tuesday that 64% of Tongas eligible adult population is fully vaccinated, and another 25% have received their first dose of vaccines.
About 68% of Tongans ages 12 to 17 have received their first dose of the Pfizer vaccine, which became available for teens on Oct. 21, Matangi Tonga reported.
The report of a positive test drove thousands of people to vaccination centers for COVID-19 shots, the news outlet reported.
The countrys intensive care unit capacity for treating severe COVID-19 cases is limited to about five patients, said the Minister of Health, Amelia Tuipulotu.
Another 20 people could be treated at a health center upgraded to care for COVID-19 patients.
Thats why we need over 90% of the eligible population to be vaccinated, she told Matangi Tonga.
The returned missionary is asymptomatic and remains quarantined, Richard Hunter, regional spokesman for the Church of Jesus Christ told 1News.
He will be tested again on Friday, said Siale Akauola, the doctor with the ministry of health.
We are happy with this result, which we will test again later this week and confirm, and this is good for his family and this person because the weight of the country must have been on him and the difficulty that he was in, Akauola told MatangiTonga.to.
Despite the weak positive first test and the negative second test, Tonga will maintain the seven-day lockdown that began Tuesday, Tuipulotu said.
The lockdown includes a curfew from 8 p.m. to 6 a.m. All residents are ordered to stop working and stay inside their homes, except to obtain food, medical supplies or vaccines, or to engage in banking, attend to livestock or respond to emergencies.
Here is the full statement from Penrod, the church spokesman:
A member of The Church of Jesus Christ of Latter-day Saints who had completed his missionary service in Africa, tested positive for COVID-19 after arriving in Tonga. He was part of a group of eight missionaries who were returning to their home country on a government-sponsored repatriation flight from New Zealand. Proper COVID-19 protocols were followed. The missionary was fully vaccinated and was tested twice before boarding the repatriation flight. While quarantining in Tonga on his arrival, he was retested and tested positive. He remains in quarantine.
Go behind the scenes on whats happening with The Church of Jesus Christ of Latter-day Saints and its members.
Azita Ghahramani worried she wouldnt survive Covid-19 because of her health conditions, including high blood pressure. So she and her husband, Scott Downing, and their son became hypervigilant. They moved to a remote part of Maine and avoided most social interactions. Even so, all three got Covid-19 in March 2021, possibly from exposure during a family funeral. But it wasnt Ms. Ghahramani who nearly died of the disease; it was her husband.
Despite being in his 50s and an avid tennis player, eating healthfully and having no medical conditions, Mr. Downing ended up in the intensive care unit. Nearly eight months later, he remains out of work on sick leave and only recently started weaning off supplemental oxygen at night.
Ms. Ghahramani is an acquaintance of my family, and her husbands case is a good example of a persistent pandemic issue. Men are much more likely than women to die of Covid-19 and are more likely to be intubated and have long hospitalizations. This disparity in Covid-related deaths has existed since early in the pandemic, before there were any vaccines. Men are also more likely to develop certain rare complications from some Covid-19 vaccines and to experience a faster decline in measures of immunity once vaccinated. The reasons remain unclear.
Historically, women have been largely excluded from medical studies, and health issues that predominantly affect women have been underresearched. This is both morally wrong and medically foolish because it limits physicians ability to deliver optimal care. Rather than ignore sex differences in Covid-19 outcomes, scientists should pay attention to them to better understand the disease and how to treat it.
Data from the Centers for Disease Control and Prevention shows that in the United States, women account for 45.6 percent of Covid-19 deaths so far and men account for 54.4 percent. (Men make up slightly less than half the U.S. population.) Among Americans ages 65 to 84 the group at highest risk for severe Covid-19 the gap is even larger: 57.9 percent of deaths have occurred among men and 42.1 percent among women. According to the Brookings Institution, at least 65,000 more men than women have died of Covid-19 in the United States. Globally, the death rate has been about 50 percent higher for men.
A July 2021 study found that compared to women, men with Covid-19 had an almost 50 percent higher rate of respiratory intubation and a 22 percent longer hospital stay.
Certain complications from Covid-19 vaccines, though rare, seem to happen more often among men than women. A recent study from Israel on the Pfizer-BioNTech vaccine showed that the incidence of myocarditis inflammation of the heart muscle was nearly 18 times as high among men as among women over age 16.
There is also evidence that immunity from the Pfizer vaccine wanes more rapidly among men. Another recent study from Israel found that six months after the second dose of the vaccine, levels of antibodies were substantially lower among men than among women. Among men age 65 and older, certain antibody levels after vaccination were 46 percent lower than among vaccinated women of the same age.
What might account for these differences?
Some think the higher Covid-19 death rates among men are due to lower vaccination rates. Just over 50 percent of American men are fully vaccinated, compared to 55 percent of women. However, vaccination rates alone cannot account for all the worse Covid-19 outcomes among men, since the disparities in deaths and other complications predate the availability of the vaccines.
Some researchers suggest that the higher death rate among men is spurious, an unrelated curiosity. Others contend that factors like adherence to mask wearing or underlying health conditions most likely explain the differences. Early on, for example, it was suggested that this sex difference might be traced to higher rates of smoking among men in China, where the disparity was first observed.
Work and other social factors like masking might have a role, though women make up a very high proportion of essential workers and are more likely to hold jobs as home health aides and nursing home caregivers, which can expose them to Covid-19.
There are also biological explanations for differences that must be elucidated or at least deserve further study.
Yale University researchers noted that there are well-established differences in immune responses to infections between men and women. Diseases like tuberculosis are more common among men, for example, and men tend to have higher viral loads of hepatitis C virus and H.I.V. The same researchers found differences in mens and womens immune responses to Covid-19. Men with Covid-19 had higher blood levels of inflammatory proteins that regulate immune responses, for example. This could lead to an overexuberant immune response to the coronavirus.
Other researchers argue that hormonal factors might be at play. Testosterone may tamp down mens immune response, while estrogen may play a role in womens tendency to have more immune B cells, which produce antibodies. Estrogen may inhibit the kind of immune cells that are thought to play a role in myocarditis.
Still, the reasons men seem to fare worse remain mostly a mystery. Much more research is needed to understand it, and there are most likely several factors at play.
The medical community needs to be more open to exploring sex differences in disease. One way to respond to the Covid-19 death-rate disparity now is to target men for vaccines and boosters.
The National Institutes of Health recently awarded $470 million to over 30 institutions to support research into long Covid, another pandemic phenomenon. Much could be gained from an equivalent research effort into the higher rate of Covid-19 deaths, complications and waning immunity among men. Rigorously looking at the differences in Covid-19s toll and discovering the underlying causes is imperative to better understanding this disease as well as other infectious diseases and how to treat it.
Confirmed cases of COVID-19 have passed 247.7 million globally, according to Johns Hopkins University. The number of confirmed deaths has now passed 5.01 million. More than 7.1 billion vaccination doses have been administered globally, according to Our World in Data.
South Korea has announced it will ramp up COVID-19 testing at schools after a sharp rise in infections among children - weeks ahead of a plan to fully reopen schools.
The Health Council of the Netherlands has recommended that adults aged 60 and over receive COVID-19 vaccine booster shots.
Unvaccinated people in Greece will need to show proof of a negative COVID-19 test to access state services, banks, restaurants and retail shops. It comes as cases hit a new daily record on Tuesday.
Indonesia's economic growth is expected to have slowed significantly in the third quarter as restrictions imposed to prevent the spread of the Delta COVID-19 variant put the brakes on any recovery, a Reuters poll found.
Britain has reported its highest daily COVID-19 death toll since March - 293 - although authorities warned that it could include two days' worth of data.
Ukrainians who knowingly use or manufacture fake COVID-19 vaccine certificates face fines or jail under new legislation passed in parliament yesterday.
Several Russian regions are considering imposing additional restrictions or extending a workplace shutdown to fight a surge in COVID-19 cases. A partial nationwide lockdown has already been reintroduced.
The director of the US Centers for Disease Control and Prevention has backed the broad use of the Pfizer/BioNTech COVID-19 vaccine in children aged 5-11.
Daily new confirmed COVID-19 cases per million people in selected countries.
Image: Our World in Data
The Dutch government yesterday announced the reintroduction of some COVID-19 measures, including the wearing of face masks. The measures come in an effort to slow the spread of new COVID-19 cases, Prime Minister Mark Rutte said.
The use of a 'corona pass', showing proof of a COVID-19 vaccination or recent negative coronavirus test, would be broadened as of 6 November to public places including museums, gyms and outdoor terraces, Rutte said.
COVID-19 cases have reached their highest level since July in the past week, with many hospitals forced to cut back on regular care, to make room for urgent COVID-19 cases.
Rutte called on residents to stick to basic hygiene rules - whether vaccinated or not - and to stay at home if they had possible symptoms. "Our own behaviour is crucial, a very large part of our coronavirus policy depends on it," he said.
A zero-tolerance approach to local COVID-19 cases in China is set to remain in place, some experts have said.
To stop local cases from turning into wider outbreaks, China has developed and continually refined its COVID-fighting arsenal - including mass testing, targeted lockdowns and travel restrictions.
"The policy (in China) will remain for a long time," Zhong Nanshan, a respiratory disease expert who helped formulate China's COVID strategy in early 2020, told state media. "How long it will last depends on the virus-control situation worldwide."
He said the current 2% death rate of the disease globally is not tolerable in China: "Zero tolerance costs a lot indeed, but letting the virus spread costs more."
Each of our Top 50 social enterprise last mile responders and multi-stakeholder initiatives is working across four priority areas of need: Prevention and protection; COVID-19 treatment and relief; inclusive vaccine access; and securing livelihoods. The list was curated jointly with regional hosts Catalyst 2030s NASE and Aavishkaar Group. Their profiles can be found on www.wef.ch/lastmiletop50india.
Top Last Mile Partnership Initiatives to collaborate with:
Written by
Joe Myers, Writer, Formative Content
The views expressed in this article are those of the author alone and not the World Economic Forum.
COVID-19 vaccines continue to work, even in the face of the highly infectious Delta variant especially when it comes to protecting against severe illness and death.
Fully vaccinated people are also less likely to contract the coronavirus than unvaccinated people. If they dont contract an infection, they cant transmit the virus to others.
However, a recent study shows that when fully vaccinated people do contract the coronavirus, they can still transmit it.
Experts say these new results, which were published Oct. 29 in The Lancet Infectious Diseases, should not deter people from getting vaccinated.
Instead, they emphasize that wider vaccine coverage is needed to ensure that when people have an infection, they are well protected against severe COVID-19.
In the new study, researchers focused on the transmission of the Delta variant within households, a common setting for coronavirus transmission.
Researchers analyzed data from 204 household contacts of 138 people with a Delta infection.
They found that household contacts who had received two doses of a COVID-19 vaccine were less likely to contract an infection with the Delta variant than unvaccinated people.
According to the analysis, 25 percent of vaccinated contacts exposed to a household member with an infection contracted one themselves.
In contrast, 38 percent of unvaccinated contacts got an infection.
This is in a household setting, where people are in close contact for extended periods.
These results underpin the key message that vaccinated contacts are better protected than the unvaccinated, Dr. Annelies Wilder-Smith, a member of The Lancet Commission on COVID-19 and a consultant to the World Health Organization, wrote in an accompanying editorial.
The study was carried out in the United Kingdom, so all study participants were vaccinated with either the Pfizer-BioNTech or AstraZeneca COVID-19 vaccine.
Although fully vaccinated people were less likely to contract an infection, when they did whats known as a breakthrough infection they can transmit the Delta variant at a similar level as unvaccinated people.
Researchers found that 25 percent of household contacts exposed to a fully vaccinated person in the household contracted an infection themselves.
Of those exposed to an unvaccinated household member, 23 percent contracted an infection.
Breakthrough infections in fully vaccinated people can efficiently transmit infection in the household setting, wrote the study authors.
Researchers suspect this has to do with the coronavirus replicating similarly in vaccinated and unvaccinated people at least at the start of the infection.
As part of the study, researchers also measured the viral load how much virus is in the body of people who contracted an infection.
The peak viral load was similar for both vaccinated and unvaccinated people. It was also similar for people with an infection with different variants.
However, there was a slight increase in viral load with increasing age. This suggests a weaker immune response in older people.
Even though the peak viral load was similar for vaccinated and unvaccinated people, the viral load decreased faster for fully vaccinated people with a Delta infection than for unvaccinated people.
This study confirms that COVID-19 vaccination reduces the risk of delta variant infection and also accelerates viral clearance in the context of the delta variant, Wilders-Smith wrote.
Viral load is directly related to infectiousness. Higher viral loads are more likely to lead to transmission of the virus.
The study results suggest that because the viral load of vaccinated people drops off more quickly, their infection may be infectious for a shorter time than for unvaccinated people.
The researchers, though, didnt look specifically at how likely people were to transmit the virus during the later stages of their infection.
The new study looked only at people with mild COVID-19, along with their risk of transmitting the coronavirus to other household members.
But other research shows that while COVID-19 vaccines may be less protective against infection caused by the Delta variant compared with earlier variants they still protect against severe disease.
What were seeing in the hospital especially in our critically ill patients, and even in those that are not critically ill, but are hospitalized is that theyre primarily unvaccinated patients, said Dr. Mohammad Sobhanie, an infectious disease physician at The Ohio State University Wexner Medical Center.
COVID-19 vaccines could have kept many of these people out of the hospital.
A report by the Kaiser Family Foundation estimates that more than 280,000 COVID-19 hospitalizations in the United States between June and August 2021 could have been prevented by vaccination.
Regularly updated data from the Centers for Disease Control and Prevention (CDC) also shows that unvaccinated people are 11.3 times more likely to die from COVID-19 than fully vaccinated people.
Most experts are not surprised that the current COVID-19 vaccines do not prevent transmission of the coronavirus.
That was never the main purpose of these vaccines.
Instead, they are intended to prevent severe illness and death which they continue to do well.
But several groups of researchers are working on vaccines that they hope will block infection from the start whats called sterilizing immunity.
These vaccines are delivered intranasally (in the nose). Animal and early clinical trials show that this type of vaccine can provide local immunity against the coronavirus.
Intranasal COVID-19 vaccines still have to be tested in larger clinical trials, so it will be a while before we can block all coronavirus transmission.
In the meantime, Sobhanie said the best way for people to protect themselves and others is to get vaccinated with the COVID-19 vaccines that are already available.
This will make for a safer holiday season, when many people will be gathering indoors with family and friends for meals and festivities.
With the Pfizer-BioNTech pediatric vaccine now available in the United States for kids ages 5 to 11, more people at family gatherings can be protected.
But infants and toddlers are still not eligible. Results from vaccine clinical trials for this age group may not be available until early next year.
In addition, some people who are fully vaccinated may still be at a higher risk of COVID-19 due to their age or underlying medical condition.
While gathering for the holidays, we do have to be cognizant of relatives who may be elderly, Sobhanie said. We also need to be cognizant of relatives or family members who are immunocompromised, [such as] those who are undergoing active chemotherapy.
But what happened next sets off alarm bells for biosafety advocates: Agency staff adopted language that EcoHealth Alliance crafted to govern its own work. The agency inserted several sentences into grant materials describing immediate actions the group would take if the viruses they created proved to become more transmissible or disease-causing as the result of the experiments.
Although the experiments demonstrate a lack of oversight and present dangers to public health, according to several scientists contacted by The Intercept, none of the viruses involved in the work are related closely enough to SARS-CoV-2 to have sparked the pandemic.
In December 2017, the funding for some gain-of-function research was resumed under carefully constructed guidelines for Potential Pandemic Pathogen Care and Oversight, or P3CO but the language suggested by Daszak helped the group evade this oversight as well. In July 2018, NIAID program officers decided that the experiments on humanized mice which had been conducted a few months earlier would get a pass from these restrictions as long as EcoHealth Alliance immediately notified appropriate agency officials according to the circumstances that the group had laid out.
While it is not unusual for grantees to communicate with their federal program officers, the negotiation of this matter did not appropriately reflect the gravity of the situation, according to Jesse Bloom, a virologist at the Fred Hutchinson Cancer Research Center. The discussions reveal that neither party is taking the risks sufficiently seriously, said Bloom. MERS-CoV has killed hundreds of people and is thought to pose a pandemic risk, so its difficult to see how chimeras of MERS-CoV with other high risk bat coronaviruses shouldnt also be considered a pandemic risk.
In a written response to questions submitted in September and October, an NIH spokesperson told The Intercept that the rule that was supposed to trigger a stop to the research was added out of an abundance of caution. Similarly, in a letter sent to the House Committee on Oversight and Reform last month, NIH principal deputy director Lawrence Tabak called the rule an additional layer of oversight, implying that the agency had devised the rule itself. But the notes reviewed by The Intercept show that the language was inserted at Daszaks suggestion and that the NIH and EcoHealth Alliance worked together to evade additional oversight.
Daszak responded to the NIH on June 8, 2016, arguing that, because EcoHealth Alliances proposed hybrid viruses were significantly different from the SARS virus, which was already known to infect humans, the experiments were not gain-of-function research and should not be restricted.
Daszak also pointed out that WIV1, the parent of the proposed chimeric SARS-like viruses, has never been demonstrated to infect humans or cause human disease, according to the transcribed emails. And he said that previous research strongly suggests that the chimeric bat spike/bat backbone viruses should not have enhanced pathogenicity in animals. The NIH would go on to accept these arguments.
But the groups argument that its viral research did not pose a risk of infection appears to contradict the justification for the work: that these pathogens could potentially cause a pandemic. The entire rationale of EcoHealths grant renewal on SARS-related CoVs is that viruses with spikes substantially (10-25%) diverged from SARS-CoV-1 pose a pandemic risk, said Bloom. Given that this is the entire rationale for the work, how can they simultaneously argue these viruses should not be regulated as potential pandemic pathogens?
The NIH has not made the correspondence public. Instead, the agency arranged for an in camera review for select congressional staff. The staffers were allowed to read and take notes on printed copies of the written exchange an unusual approach for grant communications that are in the public interest. The Intercept reviewed notes taken by congressional staff.
Given the importance and interest in this topic, its important for the NIH to be fully transparent about the research they support and how they make crucial decisions about the regulation of research on potential pandemic pathogens, said Bloom.
Regulating risky research is the NIHs role. But Daszak gave his group a way out. If the recombinant viruses grew more quickly than the original viruses on which they were based, he suggested, EcoHealth Alliance and its collaborators would immediately stop its research and inform their NIAID program officer. Specifically, he suggested a threshold beyond which his researchers would not go: If the novel SARS or MERS chimeras showed evidence of enhanced virus growth greater than1 log (or 10 times) over the original viruses and grow more efficiently in human lung cells, the scientist would immediately stop their experiments with the mutant viruses and inform their NIAID program officer.
In a July 7 letter to EcoHealth Alliance, NIHs Greer and Stemmy formally accepted Daszaks proposed rule. The chimeric viruses were not reasonably anticipated to have enhanced pathogenicity and/or transmissibility in mammals via the respiratory route, the administrators concluded, according to the transcribed emails.
The language that the NIH later inserted into the grant was strikingly similar to what Daszak proposed: Should any of the MERS-like or SARS-like chimeras generated under this grant show evidence of enhanced virus growth greater than 1 log over the parental backbone strain you must stop all experiments with these viruses.
But when the scientists conducted the experiments in 2018, one of the chimeric viruses grew at a rate that produced a viral load of log 4 or10,000 times greater than the parent virus. Even so, the work was allowed to proceed.
Despite the careful wording meant to assure the agency that the research would be immediately halted if it enhanced the viruses pathogenicity or transmissibility, EcoHealth violated its own rule and did not immediately report the concerning results to NIH, according to the letter from NIHs Tabak.
In a letter sent to NIH on October 26, Daszak insisted EcoHealth Alliance did comply with all the requirements of its NIH grant, pointing out that the group reported the results of its experiment in its year four progress report, which it submitted to the agency in April 2018 and that no one at the agency responded to the description of the experiment. At no time did program staff indicate to us that this work required further clarification or secondary review, hewrote.
Daszak also argued intheletterthat the viral growth reported in the year four progress report did not correspond to the viral growth outlined in the rule he himself had devised. The experiment we reported to NIH actually shows genome copies per gram not viral titer.
Daszak emphasized that the growth of the chimeric viruses in the genetically engineered mice was enhanced only in the early part of the experiment. By day 6-8, there was no discernably significant difference among the different viral types, he wrote.
Yet virologists contacted by The Intercept dismissed both the distinction between viral titer and viral growth and the focus on the latter part of the mouse experiment, when the rate of growth between the viruses had evened out.
I dont agree with their interpretation, said Wain-Hobson, of the Pasteur Institute. He described the EcoHealth Alliances response as hairsplitting and said that viral growth inevitably peters out. Every growth of a virus comes to a plateau. This has been known since time immemorial, said Wain-Hobson, who explained that the eventual cessation of viral growth is due to a lack of nutrients. They have chosen this interpretation because it suits them.
NIH officials have previously stated unequivocally that the agency did not fund any gain-of-function research in Wuhan. The NIH has not ever and does not now fund gain-of-function research in the Wuhan Institute of Virology, said Anthony Fauci, the head of the NIAID, during a Senate hearing in May. Fauci is scheduled to testify before the Senate health committee tomorrow morning.
In its statement to The Intercept, an NIH spokesperson wrote, the Agency did not support the kind of gain of function research warranting the additional and unique P3CO oversight identified by stakeholders during extensive prior policy development. To claim otherwise is incorrect and irresponsible. And in his letter last month, Tabak reiterated the claim that the research was not gain-of-function.
But the correspondence with Daszak makes clear that at least some at the agency were concerned that EcoHealth Alliances proposed experiments met the criteria for gain-of-function research of concern as early as 2016.
According to Richard Ebright, a molecular biologist at Rutgers University who has criticized the lack of federal oversight of gain-of-function research, the fact that the NIH allowed EcoHealth Alliance to write its own rules is further evidence of the NIHs regulatory failure. This is like the teacher giving you the opportunity to write your own homework problem and grade your own homework when you turn it in. Then you decide the teacher is so lenient, theres no need to hand it in, said Ebright. The oversight process clearly failed.
Beyond the question of oversight, others question whether these experiments should be conducted at all.
In addition to the legalistic questions of whether EcoHealth and NIH were adhering to current guidelines, said Bloom, we urgently need a broader discussion about whether its a good idea to be making novel chimeras of coronaviruses that are at this point universally acknowledged to pose a pandemic risk to humans.
