Palestinian Health Ministry staff members in Nablus receive 300,000 doses of COVID-19 vaccines donated by the United States through through the COVAX vaccine-sharing initiative on Aug. 24, 2021. Jaafar Ashtiyeh/AFP via Getty Images hide caption
Palestinian Health Ministry staff members in Nablus receive 300,000 doses of COVID-19 vaccines donated by the United States through through the COVAX vaccine-sharing initiative on Aug. 24, 2021.
Facing criticism for its plan to give Americans third doses of COVID-19 vaccines while millions in the world's poorest countries are still waiting for a first shot, the White House is planning a virtual summit next week to try to spur efforts to boost the pace of global vaccinations.
The Wednesday meeting is timed for when world leaders are in New York for the United Nations General Assembly, an event which itself has been pared down as officials try to contain the chances to spread the coronavirus.
Global health advocates had been pushing for weeks for the Biden administration to take on a stronger leadership role in getting vaccines distributed around the world.
Administration officials aren't saying exactly who is expected to attend Wednesday, but White House press secretary Jen Psaki said in a statement that the goal is to "rally civil society, NGOs, philanthropists and industry along with world leaders."
The World Health Organization and other groups have urged the United States to hold back on broad plans for booster shots, arguing that poorer countries need the vaccines more. The Biden administration has pushed back on criticism, arguing that the U.S. has enough doses to vaccinate Americans while also sharing more vaccines globally than any other nation.
Low-income countries have gotten less than 1% of all the doses given so far globally in this pandemic.
The White House hasn't confirmed reports that President Biden will set a goal of 70% of the world's population being vaccinated by September 2022, when leaders convene next year for the U.N. General Assembly.
"We are in a race against time," said Carolyn Reynolds of the Pandemic Action Network, one of many advocates who has been pushing the administration to pick up the pace on global vaccine distribution. "We urge all world leaders to commit to the summit targets to vaccinate 70% of the world's population in less than 12 months, save lives now, and ensure the world is prepared for the next pandemic."
The summit will also address shortages of oxygen for COVID patients and personal protective equipment for health workers. The announcement also talks about accountability: setting targets, tracking progress and actually making sure goals are met.
That sort of accountability is something Dr. Krishna Udayakumar at Duke University has been pushing for. Over the course of the pandemic, there have been many promises, but some countries have backtracked or failed to meet goals for vaccine sharing after the delta variant changed the calculation on their domestic needs.
"That is a point we have been pushing on lack of leadership and accountability is the core challenge to global response," said Udayakumar at the Duke Global Health Institute.
So far, the United States has distributed 140 million vaccine doses to approximately 100 countries. The Biden administration has pledged to distribute 500 million doses of the Pfizer vaccine in the coming months and has hinted an even larger pledge may be coming.
White House COVID response coordinator Jeff Zients didn't directly answer when asked by a reporter during a briefing Friday whether an additional large vaccine contract would be announced in conjunction with the summit.
"It's critical that this summit is not just a flash in the pan but the start of a full-force, coordinated effort to combat this pandemic globally," said Jenny Ottenhoff at the One Campaign. "That includes clear, time-bound commitments to get vaccines to Africa and low-income countries everywhere. Everyone is on the hook to deliver."
"We are bracing ourselves for an awfully busy winter ahead," Associate Dean of Public Health at Brown University Dr. Megan Ranney told CNN Tuesday.
And hospitals are straining to keep up with the number of patients coming in. Staff shortages and employee fatigue in Pennsylvania hospitals have reached a point where some health systems are offering signing bonuses, loan forgiveness and other incentives to staff. And in Wyoming, nearly 100 members of the state's national guard were activated Tuesday to assist hospitals dealing with the surge.
And though it isn't clear yet what this year's flu season has in store, it could add additional stress to an already pressed health care system.
"Flu is still a killer, not as much as Covid-19, but between 12,000 and 50,000 Americans lose their lives every year from flu," vaccinologist and dean of the National School of Tropical Medicine at Baylor College of Medicine Dr. Peter Hotez said.
Flu numbers were actually relatively low last year, but experts said that doesn't necessarily foreshadow how this year will turn out.
"Let's be clear on why flu cases were so low last year, it's because we were all masked and we were all distancing," Ranney said. "Those things are not being done anymore in the vast majority of the country."
Now, health officials are asking the public to get both their Covid vaccine and their flu shot.
Pediatricians recommend that both adults and children 6 months and older receive their flu vaccinations by Halloween, Dr. Flor Munoz, a pediatric infectious disease specialist at Texas Children's Hospital, told CNN.
Some vaccine clinics around the country are offering both shots -- and encouraging people who come in for one to make sure they have the other.
"If somebody comes in wanting the flu vaccine and they haven't had a Covid vaccine then we can encourage them to get both, or vice-versa," said Dr. Robert Hopkins, chief of general internal medicine at the University of Arkansas for Medical Sciences and chair of the National Vaccine Advisory Committee.
If health care providers can encourage people to do both, "We potentially are going to have a greater impact on both disease prevention efforts," Hopkins said.
Two-dose Johnson and Johnson vaccine 94% effective, company says
Pfizer has suggested a third dose of its vaccine will boost protection for those already vaccinated, and now Johnson & Johnson has announced an extra dose of its vaccine is helpful as well.
Johnson & Johnson's single-dose vaccine was given emergency use authorization by the US Food and Drug Administration on February 27. It has been given to about 14.8 million Americans, according to the CDC.
The company released some details of three studies looking at various aspects of its Janssen vaccine, and said that, taken together, they showed the vaccine provided long-lasting protection that could be boosted with an extra shot.
"Our single-shot vaccine generates strong immune responses and long-lasting immune memory. And, when a booster of the Johnson & Johnson COVID-19 vaccine is given, the strength of protection against COVID-19 further increases," Dr. Mathai Mammen, global head of Janssen Research & Development, said in a statement.
The company's ongoing Phase 2 trial of a two-dose regimen showed giving two doses 56 days apart provided 100% protection against severe Covid-19 and 94% protection against moderate to severe Covid-19 in the US.
A second study showed people given a booster shot six months or longer after their first dose had a 12-fold increase in antibodies -- compared to a four-fold increase for people who got a second dose at two months. So, protection should be stronger if people get boosters later, Dr. Dan Barouch, head of Beth Israel Deaconess' Center for Virology and Vaccine Research, told CNN.
Death rate four times higher in least vaccinated states
The average rate of Covid-19 deaths in the 10 least vaccinated states was more than four times higher over the past week than the rate in the 10 most vaccinated states, according to a CNN analysis.
In the least vaccinated states, roughly eight people out of every 100,000 residents died of Covid-19 over the past week, compared with only about two out of every 100,000 people in the 10 most vaccinated states.
CNN used data from Johns Hopkins University and the CDC for the analysis.
Less vaccinated states tend to have higher hospitalization rates, too.
The latest data from the US Department of Health and Human Services shows an average of 39 Covid-19 hospitalizations per 100,000 people in the 10 least vaccinated states, nearly three times higher than the average rate of 14 per 100,000 people in the 10 most vaccinated states.
The states with the lowest vaccination rates have fully vaccinated less than 45% of their residents. They are Alabama, Arkansas, Georgia, Idaho, Louisiana, Mississippi, North Dakota, Tennessee, West Virginia and Wyoming.
The 10 states with the highest vaccination rates have fully vaccinated more than 62% of their residents. They are Connecticut, Maine, Maryland, Massachusetts, New Jersey, New Mexico, New York, Rhode Island, Vermont and Washington.
CNN's Kiely Westhoff, Andy Rose, Deidre McPhillips, Jacqueline Howard and Maggie Fox contributed to this report.
California officially has the lowest coronavirus case rate of any state, federal figures show, underscoring the progress made in the ongoing battle against the highly infectious Delta variant.
The state has been among the national leaders in that metric for the last week, as the number of newly confirmed coronavirus infections continues to tumble from a peak earlier this summer.
Californias new case rate per 100,000 people is less than half of neighboring states, according to data from the U.S. Centers for Disease Control and Prevention. Some hard-hit states have more than quadruple Californias numbers.
Statewide
As of Monday, Californias seven-day case rate was 95.3 per 100,000 people. The next-closest state was Connecticut, at 126.5.
The comparable rates over the same period were 385.1 cases per 100,000 people in Texas; 287.2 in Florida; 250.1 in Arizona; 234.7 in Oregon; and 202.5 in Nevada, federal data show.
The CDC categorizes states coronavirus transmission levels in one of four tiers: the worst high is color-coded as red, followed by substantial (orange), moderate (yellow) and low (blue).
With the latest update, Californias coronavirus transmission level has once again fallen to substantial. Every other state currently remains in the high transmission category.
The federal figures illustrate the recent success California has had in turning the tide of the Delta variant-fueled coronavirus wave.
Over the last week, the state has reported an average of 8,849 new cases per day down about 33% from two weeks ago, according to data compiled by The Times.
COVID-19 hospitalizations, too, have plummeted lately. At the height of the current surge, more than 8,300 coronavirus-positive patients were hospitalized at one time statewide. Now, that daily census has fallen to just about 6,000, state data show.
But the progress has been uneven. While the Bay Area, in general, experienced the least-severe summer surge and Los Angeles has had success with new measures to slow the Delta variant, the Central Valley and parts of rural Northern California have been harder hit.
L.A. County
Los Angeles County continues to report improvement in weekly COVID-19 cases and hospitalizations.
About a month ago, the county was averaging more than 3,400 new coronavirus infections a day over a one-week period, according to a Times analysis of state data. But over the last week, L.A. County averaged nearly 2,200 new cases a day.
And as of Sunday, 1,034 coronavirus-positive patients were hospitalized countywide down roughly 42% from the month prior.
Nonetheless, coronavirus transmission levels remain at an elevated level.
We cant afford to be complacent with an average of 2,000 new cases and dozens of deaths each day, county Public Health Director Barbara Ferrer said over the weekend. In order to be better prepared for the fall and winter, typically seasons when many viruses thrive, we need to immediately reduce COVID transmission. Given the powerful tools at our disposal that we didnt have last fall rapid antigen tests and highly effective vaccinations the high number of cases is troubling and reflects the unevenness of vaccination coverage and screenings.
Central Valley
But the situation remains grim elsewhere.
Hospitals throughout the San Joaquin Valley which the state defines as Calaveras, Fresno, Kern, Kings, Madera, Mariposa, Merced, San Benito, San Joaquin, Stanislaus, Tulare and Tuolumne counties have reported having less than 10% of their cumulative staffed adult ICU beds available for 19 straight days.
Some healthcare facilities in the region are still so overwhelmed with COVID-19 patients that some critically ill people are waiting days to be transferred into the intensive care unit from the emergency room, officials said.
One Fresno area hospital had nine critically ill patients who were unable to get into the intensive care unit for more than three days, interim health officer Dr. Rais Vohra said at a news conference last week. This forces emergency room staff to treat patients needing ICU care, disrupting the healthcare of other patients with less severe illness.
Were basically really straining what the emergency department has to do, Vohra said. We still anticipate at least a few more weeks of thoroughly impacted operations in ICUs and emergency rooms.
Hospitals in Fresno County are teetering on the need to ration healthcare and implement crisis standards of care, Vohra said. In these situations, hospitals conclude that they no longer can provide the same standard of healthcare to everyone and must choose whose lives to prioritize to keep as many patients alive as possible.
In Fresno County and the greater San Joaquin Valley, hospitals remain extremely busy, said Dan Lynch, director of the Central California Emergency Medical Services Agency. Most of Fresno Countys hospitals are running at 108% to 110% of standard capacity, while Clovis Community Medical Center near Fresno has been running at 130% of capacity.
Vaccines
Officials say unvaccinated Californians continue to be infected at higher rates than their vaccinated counterparts.
During the week of Aug. 29 through Sept. 4, the average case rate among unvaccinated individuals was roughly eight times higher than for those who had been inoculated, according to the California Department of Public Health.
The vaccines continue to be our best tool to put an end to this deadly pandemic, Dr. Toms Aragn, the departments director and state public health officer, said in a statement last week.
Almost 66% of Californians have received at least one dose of COVID-19 vaccine. But the rates vary widely by community.
Eleven of the states 58 counties have seen more than 70% of their residents receive at least one shot to date, according to data compiled by The Times. However, 14 others have yet to partially inoculate even half of their population.
Unvaccinated people are also at far greater risk of being hospitalized. Of the hundreds admitted to L.A. Countys public hospital system since June 15 for a diagnosis primarily linked to COVID-19, 93% have been unvaccinated.
Most of the vaccinated people who have been hospitalized have compromised immune systems, and thus are not able to mount a sufficient immune response after vaccination, according to county Health Services Director Dr. Christina Ghaly.
Confirmed cases of COVID-19 have passed 229 million globally, according to Johns Hopkins University. The number of confirmed deaths stands at more than 4.7 million. More than 5.95 billion vaccination doses have been administered globally, according to Our World in Data.
Pfizer/BioNTech announced yesterday that their COVID-19 vaccine induces a strong immune response in 5 to 11-year-olds. They plan to seek regulatory approval as soon as possible.
Doctors in Thailand have been given the go-ahead to give COVID-19 booster shots under the skin, rather than injecting into muscles, in an effort to strengthen immunity and stretch supplies.
Austria will require protective face masks and COVID-19 passes for the use of its ski lifts this winter.
A certificate showing proof of immunity from COVID-19 will be required to enter the Vatican as of 1 October, the city state has announced.
The German government is not giving a target date for lifting COVID-19 restrictions, as it's unclear how the pandemic will develop over the Northern Hemisphere winter.
Indonesia has reported its smallest daily increase in confirmed new COVID-19 cases since August last year - 1,932.
Australia's New South Wales state has reported its lowest daily rise in COVID-19 cases in more than three weeks.
Daily new confirmed COVID-19 cases per million people in selected countries.
Image: Our World in Data
Shortages of masks and gloves have spread to other medical items in the United States, from exam tables and defibrillators to crutches and IV poles.
It can now take up to five months to get some types of exam tables, for instance, compared to three to six weeks before the pandemic, according to CME Corp, a distributor of medical equipment that handles over 2 million products.
Right now, because of the supply chain stress thats being caused by COVID, almost everything is delayed, said Cindy Juhas, CMEs chief strategy officer. A lot of the stuff we sell is not sitting in a warehouse where you just call and say, 'Send it over'. It needs to be built.
Many of the items in short supply aren't related to COVID-19. For example, heart defibrillators that used to take two weeks to deliver now require three months.
It's part of wider supply chain disruption. The Port of Los Angeles/Long Beach announced last week that a record 60 container vessels were waiting offshore to unload.
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:
The World Health Organization has called on leaders at the United Nations General Assembly to guarantee equitable access to COVID-19 vaccines, ensure the world is better prepared to respond to future pandemics and renew efforts to achieve the Sustainable Development Goals.
Nearly three-quarters of all COVID-19 vaccine doses have been administered in just 10 countries. The WHO warns that the longer this inequity persists, the more the virus will circulate and the longer disruption will continue.
The organization also urged countries to break the cycle of 'panic and neglect' that's been seen after previous health emergencies. The WHO called on nations to prepare better for future such emergencies.
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.
Boghuma Kabisen Titanji was just 8 years old when the hyper-contagious virus swept through her classroom. Days later, she started to feel feverish, and developed a sparse, rosy rash. Three years after being fully dosed with the measles vaccine, one of the most durably effective immunizations in our roster, Titanji fell ill with the very pathogen her shots were designed to prevent.
Her parents rushed her to a pediatrician, worried that her first inoculations had failed to take. But the doctor allayed their fears: It happens. Shell be fine. And she was. Her fever and rash cleared up in just a couple of days; she never sickened anyone else in her family. It was, says Titanji, now an infectious-disease physician and a researcher at Emory University, a textbook case of modified measles, a rare post-vaccination illness so mild and unthreatening that it doesnt even deserve the full measles name.
The measles virus is ultra-infectious, much more so than SARS-CoV-2, and kills many of the uninoculated children it afflicts. But for those who have gotten all their shots, its a less formidable foe, which weve learned to live with long-term. Thats the direction that many experts hope were headed in with SARS-CoV-2 as it becomes endemic, as my colleague Sarah Zhang has written.
Were not yet at the point where we can officially label post-vaccination COVID-19 cases as modified; maybe we never will be. Some immunized people are still getting dangerously sick. But the shots are softening COVID-19s sharp edges: On average, breakthrough infections seem to be briefer, milder, and less contagious. Among the fully immunized, catching the coronavirus doesnt mean the same thing it did last year. Its a very different kind of infection than in people who are immunologically naive, Lindsey Baden, an infectious-disease physician and COVID-19 vaccine researcher at Brigham and Womens Hospital in Boston, told me.
If this virus becomes as inescapable as the culprits behind the colds and flus that trouble us most years, we could all have to grapple with one of these infections, and learn that lesson on a personal level. Thats the social tax of a forever virus: Nearly everyone may eventually know what it is to get COVID-19but a tamer, more domesticated version of its pre-inoculation self.
Since the start, COVID-19 has been tough to define.
Part of the problem is that COVID-19 is the disease, not the virus. Actual microbes, compared with the problems they cause, are arguably neater conceptual packages. SARS-CoV-2 is a knowable pathogen, a tangle of genetic material swaddled in a protein coat; COVID-19 has fuzzier boundaries, dependent on both the virus and how our bodies react to it. To understand that interaction, researchers had to, unfortunately, wait for a decent number of people to get sickto observe the virus screwing with us in real time.
Next to other airway-loving viruses, such as the ones that cause the flu and common colds, SARS-CoV-2 can be a bit of an oddball. It lopes almost indiscriminately throughout the body, invading a plethora of tissues; it winds up certain immune responses, while dialing others down, sparking bouts of inflammation that can afflict everything from brain to toe. COVID symptom lists that at first focused on the viruss ground zerothe respiratory tracteventually ballooned to include nausea, vomiting, changes in mental status, and chest pain. Infection severity operates on a continuum, and SARS-CoV-2 occupies its spectrum fully. Many people never realize theyre infected; others might have a two-day tickle in their throat, while some weather the disability of long-haul COVID for months; a fraction end up ventilated in the ICU.
The experience of having COVID is now poised to splinter further, along immunological boundaries largely defined by vaccines. Inoculated bodies are less hospitable to SARS-CoV-2, making it harder for the pathogen to infect them; when it still manages to, it seems to be purged much faster, affording it less time to cause symptomsespecially the bad onesand fewer opportunities to hop into other hosts. I think about it as defanging the virus, Natalie Dean, a biostatistician at Emory, told me.
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A recent study from the United Kingdom illustrates this well. Researchers surveyed nearly 4.5 million people through a cellphone app, asking whether theyd tested positive for the virus, and if they were experiencing any of about two dozen symptoms. Roughly 1 million of them had received at least one vaccine dose. Among the fully immunized, nearly all the symptomsincluding fever, nausea, and brain fogwere rarer. Many of the cases were totally asymptomatic. Even rates of long COVID, which can sprout from initially silent infections, seemed to be substantially slashed by shots.
These qualitative shifts arent easy to capture, especially with the studies coming out now that measure vaccine effectiveness in the real world. Most of them gravitate toward metrics at two opposite ends of the SARS-CoV-2 spectrumhow well the vaccines protect against all infections, or against severe disease, hospitalizations, and deathwith less precision around the murky hinterlands of mid-level symptoms that exist in between. (The most serious outcomes are, to be fair, what vaccines are intended to prevent, and what inoculated immune systems are best at staving off, making that metric a pretty good one to concentrate on.)
Focusing on the extremes, though, blurs the texture in the middle. In studies of effectiveness against severe disease, anything too mild to be considered a serious illnesswarranting hospitalization, for instanceends up collapsed into a single category. At the other end of the spectrum, counting all infections equates every positive test to a case of concern, regardless of how gentle the viral encounter was. All of this makes it very difficult to characterize what post-vaccine COVID actually isand to know whether immune responses are diluting the diseases sting. Just looking at the rate loses that point, Holly Janes, a biostatistician at the Fred Hutchinson Cancer Research Center in Seattle, told me. The experience of infection can be considerably different for someone who was vaccinated.
Read: Were asking the impossible of vaccines
This isnt an easy dilemma to solve. During the vaccine makers clinical trials, researchers were able to study participants closely enough to examine how well the shots were blocking any symptomatic cases of COVID-19. (Studying only the severest disease, which are relatively rare events, wouldnt have been feasible without making the trials even larger, or stretching them out longer.) Real-world studies are like the wild, wild West, Dean told me. Researchers often have to wrestle evidence out of electronic medical records, which arent logged consistently, or they have to depend on people to seek out tests and accurately remember their symptoms. They might monitor only the worst infections, because theyre more likely to prompt people to seek clinical care and are easier to document and study. Milder cases, meanwhile, are squishier, more subjective; not everyone will interpret an ache or a pain in the same way, or follow up on it with a professional. The studies that have tackled the task of measuring real-world vaccine effectiveness against all symptomatic disease may not always count the same COVID-19 symptoms, experts told me, potentially inflating or deflating numbers. Thorniest of all may be the data investigating long COVID, which still lacks a universal case definition, after vaccination, Lekshmi Santhosh, a critical-care physician at UC San Francisco, told me. Most studies arent even looking, she said.
Important variations exist, even at SARS-CoV-2s extremes. Some hospitalized patients might be admitted for just a couple of days, while others need weeks of critical care or die. Early evidence hints that vaccines are batting away the worst blows here as well, another nuance lost when hospitalizations are lumped together. Positive test results, too, can be misleading. Tests, which hunt for precise pieces of the pathogen, cant distinguish between viruses that are intact, or that have been blown to smithereens by a protective immune response; SARS-CoV-2 carnage, especially in a person whos immunized and asymptomatic, doesnt guarantee disease or transmission. It doesnt mean the same thing to test positive if youre vaccinated, Julie Downs, a health-communications expert at Carnegie Mellon University, told me.
Still, some infections among immunized people will pose a low-but-not-nonexistent transmission risk, especially to the vulnerable among us, and we cant yet afford to tune the milder cases out. A much larger fraction of the global population will need protection before COVID-19 can truly be considered mellower than before. But the fates of the inoculated and the uninoculated are clearly already forking, a potential preview of whats to come, Baden, the Boston physician, told me. If I were a betting man, Id say, years from now, this will be another common cold. Titanji, of Emory, has already confronted the likelihood that her childhood bout of modified measles might foreshadow her experience with the coronavirus. When she sees patients in her clinic in Georgia, she tells them, Were all very likely going to have COVID, including myself. But it is okay. I have a vaccine that will prevent me from landing in the hospital.
COVID-19s march toward diminution wont be linear or uniform. Immune cells forget; viruses shape-shift; our vaccines will need touch-ups or boosts. Behavioral slipupsvaccine refusals, spotty masking during outbreakswill create cracks for the pathogen to wriggle through. But on a population level, our future could look quite good. Most people will end up getting COVID-19 in their lifetime. In most cases, it wont be so bad. Eventually, silent or mild infections will feel less catastrophic, because many of us will have confidence that they are unlikely to progress. Outbreaks might be smaller and slower-spreading, and breakthroughs will no longer be headline-making news. Positive test results, in the absence of symptoms, could generally be shrugged off, and infection will no longer feel quite so synonymous with disease. Our bodies will come to see the virus as familiarnot necessarily a welcome guest, but not quite the intruder it was before.
Data alone wont define our experience here; our understanding of post-vaccination infection will need to come firsthand, too. For me, the pandemic anxiety that dominated much of 2020 is slow to fade, and the idea of getting COVID-19 still feels far worse than getting the flu, even if the symptoms were identical. It takes time to get over that, Downs told me.
Read: Your vaccinated immune system is ready for breakthroughs
A small number of post-vaccination infections are now trickling into my social circles, and its actually been sort of comforting to hear some of the stories. A few days ago, I talked with Jayne Spector, who just became mother-in-law to one of my best friends. Spector tested positive for the coronavirus a couple of weeks agoshortly after attending her grandmothers funeral, where shed hugged and kissed dozens of family members. Among them was her daughter, who was, at the time Spector received her test result, about to have her wedding, just 11 days later.
I was really worried I had infected my soon-to-be-married daughter, Spector told me. And had Spector not been vaccinated, I think it would have been a disaster. But Spector was vaccinated. So were almost all the family members she mingled with at the funeralher daughter includedand not a single one of her contacts has tested positive. (They also kept a lot of the interactions outdoors, and wore masks inside.) Spector isolated at home, where she dealt with what she compares to a nasty but relatively fast-resolving colda paltry echo, she suspects, of the sickness she would have had, if not for her shots. The fact that Im vaccinated means that its tolerable, she told me. I took the precautions; I stayed away from others. Now Im going back to my life. Her daughters wedding was this past Saturday. All 18 people in attendance were fully vaccinated, and tested negative before the ceremony. Spector was one of them.
Nearly 5,000 new COVID-19 cases have been reported statewide, the Pennsylvania Health Department said Tuesday.
The department reported 4,939 new cases Tuesday and the state has regularly approached or exceeded 5,000 cases per day over the last week. Earlier this summer, the number of new cases had dwindled to less than 200 a day.
Hospitalizations continue to rise. Across Pennsylvania, 2,421 people are being treated for COVID-19 in hospitals, including 609 patients in intensive care units, the health department reported. In July, the number of hospitalizations had dropped to about 250.
Penn State Health reported Monday 92 patients are being treated for COVID-19 in its hospitals, including 7 in the pediatric unit. The hospitals include the Penn State Milton S. Hershey Medical Center, Holy Spirit Medical Center in Cumberland County and St. Joseph Medical Center in Berks County.
The health department reported 68 new deaths Tuesday, raising the statewide total to 28,932. About half of the states COVID-19 deaths have occurred in long-term care facilities, such as nursing homes.
Health officials said nearly all the states hospitalizations and deaths since the beginning of the year have occurred among those who arent fully vaccinated.
Doctors and health officials continue to stress the COVID-19 vaccines offer the best protection against serious illness and death. As of Monday, 67.8% of Pennsylvanians age 18 and older are fully vaccinated.
Since the pandemic began, the state has reported 1,387,872 COVID-19 cases.
Every county in Pennsylvania continues to show high transmission of COVID-19, according to the U.S. Centers for Disease Control and Prevention.
The states positive test rate for COVID-19 was 8.9% from Sept. 10-16, down from 9.1% the previous week. That marked the first dip in the positive test rate in weeks.
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BANGKOK, Sept 22 (Reuters) - With demand for taxis drying up in Thailand and thousands of drivers leaving town, one Bangkok cab company has turned its vehicles into mini vegetable gardens, hoping to take the edge off the coronavirus crunch.
The Ratchapruek Taxi Cooperative has taken hundreds of cars off the road in the past year amid a slowing economy worsened by months of lockdown to prevent the spread of COVID-19, which has left many drivers with insufficient income to pay the lease on their vehicles.
The cooperative grows vegetables on the roofs and bonnets of 300 of the disused cabs, providing its drivers and members with food to share while sending a message to the government to do more to help with the hardship.
"We discussed among each other and decided to grow vegetables to eat because there is no use for these taxis," said Thapakorn Asawalertkul, a business consultant for the company.
"They have become just metal as they've been parking for over a year now."
Thailand has recorded more than 1.5 million coronavirus cases and 15,600 deaths, 99% of those since April this year. Just 21% of the population has been vaccinated.
On hundreds of pink and orange taxis, chilis, eggplants, cucumbers and basil leaves sprout from soil contained in black plastic sheeting reinforced with bamboo or wooden poles.
Kamolporn Boonnitiyong, an administrator with the company, said though the gardens keep people occupied, they are only a temporary fix.
"To a certain extent, it has helped with lessening our stress but it isn't really the answer," Kamolporn said.
"The government should also step in to help us too."
Writing by Martin Petty; Editing by Christian Schmollinger
Our Standards: The Thomson Reuters Trust Principles.
Winter is coming, again.
A year ago, experts warned that the United States faced a grim winter if Americans didnt mask up and social distance to slow transmission of the SARS-CoV-2 virus before indoor weather aka winter settled in for its long stay. We all know how well that warning was heeded. In January, cases topped 300,000 a day; Covid ended the lives of about 95,000 Americans before the month was out.
Now indoor weather again looms in many parts of this country, and daily case counts are rising well into the six figures. The highly transmissible Delta variant is driving spread, even among fully vaccinated people. Children are back in classrooms that can function as germ incubators. As you walk around in public you see noses poking out of masks, masks under chins, faces that are mask free.
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So what should we expect as we head into our second Covid autumn and winter?
The bottom line is, I think, uncertainty, said Jeffrey Duchin, health officer for the Seattle and King County public health department, who has been mired in the Covid response since the earliest days of the U.S. outbreak.
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Were experiencing a new virus, a newly emerged pathogen, and were trying to fight it with new tools that we dont have a lot of experience with, he said. And were dealing with unpredictable human behavior which is a very important factor as well, and environmental factors that may influence the severity of Covid outbreaks and how well it transmits.
Theres a lot of moving parts, said Duchin, who is also an infectious diseases professor at the University of Washington. Among them: the questions of when Covid vaccines will be approved for use in children and what percentage of parents will agree to vaccinate their kids.
While the crystal ball may be cloudy, who can resist taking a peek? Lets talk about some things we might face in the months ahead.
The high, high crests of Delta transmission are subsiding in some parts of the country, as they have in countries where Delta took off before it did in the U.S.
Ccile Viboud, an infectious diseases epidemiologist at the National Institutes of Healths Fogarty International Center, said nine modeling efforts her group is monitoring suggest that by the end of November, the Delta wave will have waned and new cases will be down at quite a low level. How low? Down to where the country was in late June and early July, before Delta took off. At that point the country was reporting somewhere between 7,500 to 15,000 new cases most days.
Sounds heavenly, doesnt it? So does what Viboud said next. Were probably going to stay there, because there is quite a bit of immunity in the population, she told STAT.
That heartening prediction comes with a big but. That assumes that no new variant comes in. Because if you get a new variant that either has a higher transmissibility or immune escape potential, then we will see a resurgence.
Late November coincides with Thanksgiving, Americas favorite week for cross-country travel. Last year, Thanksgiving and Christmas turbo-charged Covid spread. Can transmission levels remain low if large family gatherings occur across the nation this year?
Viboud said all the models factor in events like Thanksgiving. The expectation of low transmission by around that time is predicated on the amount of immunity there will be by then in the country, antibodies generated by vaccination 63.9% of eligible Americans are fully vaccinated or acquired the hard way, through Covid infection.
Trevor Bedford, a computational biologist at the Fred Hutchinson Cancer Research Center in Seattle, thinks the massive summer wave the country has been experiencing will have taken some of the loft out of the balloon when it comes to fall and winter spread. By crashing over the country in the summer, Delta pulled forward in time some infections that otherwise would have occurred later, he said.
It is likely that well see some wave, Bedford said. I would like to think its very unlikely to be as big as it was last year.
The World Health Organizations top coronavirus expert is less hopeful in her prognostication. Maria Van Kerkhove thinks people are making the mistake of trying to interpret SARS-2s behavior and predict its path by looking through the prism of influenza. SARS-2 may one day behave much more like that seasonal scourge, which causes a wave of illness in winter months in temperate climes but its not there now, she said.
I feel that a lot of people want it so badly to behave like flu. So that we can get into this pattern of OK, in the summer everybody can relax. And then we just need to gear up for the fall. We need to get the vaccines underway. Get people vaccinated and just ride it out through that peak, that winter peak, Van Kerkhove said. But I dont see that in the data that we have.
She believes human behavior whether thats wearing masks, social distancing, or getting vaccinated has much more to do with declines of Covid transmission still than built-up immunity. The Delta variant hasnt run through all the unprotected people, she insisted.
Delta still has a lot more energy in it, Van Kerkhove said. I think we should expect more ups and downs. I think we should expect more peaks and troughs. I think the peaks could become less [lofty]. Potentially. But I think those peaks will be very sharp in specific populations like unvaccinated, unprotected populations. That should be expected.
As peoples immune systems have acquired experience grappling with SARS-2 again, via vaccine or infection deaths as a percentage of overall cases have declined. That trend will hopefully continue.
Its not clear how long immunity lasts following infection. It can be pretty transient with human coronaviruses, but so far there havent been huge numbers of people reporting their second or third case of Covid. Were going to learn how long infection-induced protection lasts as time goes on as well as how long protection lasts after vaccination. When immunity levels in communities start to subside, that could trigger a new resurgence of cases, Viboud said, but she added the expectation is that with further waves of cases, hospitalization and deaths will not resemble the earlier waves of Covid.
Bedford agreed. You could also imagine a large Covid wave this fall-winter, but with much lower morbidity and mortality than it was last year, he said, noting that it seems almost certain that the infection fatality rate the percentage of infected people who die from the disease will remain lower than it was earlier in the pandemic.
Early in the pandemic, coronavirus experts confidently opined that this family of viruses mutates far more slowly than, say, influenza, and major changes werent likely to undermine efforts to control SARS-2. But no one alive had watched a new coronavirus cycle its way through hundreds of millions of people before. (The global estimate has now passed a quarter of a billion cases.) Our baseline assumptions didnt figure on Delta.
Whatever comes next will almost certainly be some new twist of this now-dominant variant, Bedford said. Thats because Delta has so effectively swept the globe it has crowded out almost all the other lineages of viruses; about 88% of recent viruses that have been sequenced belong to the Delta family. Basically everything that is circulating is Delta, so then the only avenue for evolution becomes mutations on top of Delta, he said.
As effective as the Delta variant is, Bedford assumes it could acquire more tricks. It seems unlikely that Delta is the ceiling, but there is going to be some ceiling, he said.
Barney Graham, who led the vaccine design work that laid the foundation for many of the current Covid vaccines, is hopeful, though, that in Delta the virus has hit a sweet spot that will eventually undermine it.
Im hoping the virus has gotten itself to a point where its basically trapped now, said Graham, who was deputy director of the NIHs Vaccine Research Center until his retirement at the end of August. That it cant get any better at transmission, and any adaptation it makes in the immune response is going to make it less transmissible.
If the virus effectively stands still, the increase in the rollout of vaccines worldwide that is projected to take place over the next half year or so could start to hem the virus in.
Im hoping now that were going to level out on the nature and the amount of change thats going to be happening, especially if we can get people immunized and as the number of new infections diminishes, the less the chance that new mutations will occur, Graham said.
Fingers crossed, everyone.
One of the amazing things about the control measures countries used to slow Covid transmission is the effect they had on the swarm of other viruses that cause colds and flu-like illnesses every fall and winter. Rhinoviruses, the most common cause of the common cold, continued to spread. But respiratory syncytial virus (RSV), human coronaviruses, adenoviruses, and mother of all influenza-like illnesses, influenza itself, all but disappeared.
With kids back in school, mask-wearing more sporadic, and people abandoning Covid controls because theyre frankly just sick of them, these bugs are coming back. They may hit us especially hard when they do, because our immune systems are out of shape from the 20-month hiatus.
Last fall Hong Kong, which has had much more success controlling Covid than the U.S. has, resumed in-person teaching for children. Schools were quickly hit with large outbreaks of rhinoviruses. These ubiquitous viruses are generally just pests, but some of the infected children became so sick they needed to be admitted to hospitals.
We could see similar outbreaks here. And when kids, parents, and teachers start to get sick, there will be a lot of scrambling to figure out whats the cause.
Before Covid, people rarely got tested if they came down with a respiratory infection, unless they got really sick. But now, much more is at stake. Is this a cold or the early stages of Covid? There are ramifications, depending on the answer to that question.
How do you distinguish between Covid and flu or Covid and RSV in a child? You cant without a diagnostic, said Van Kerkhove, whose youngest son had a series of three severe respiratory illnesses in the spring. He was so sick she and her husband took him to the hospital, but Switzerland doesnt test children for Covid and they still dont know what made him so ill.
Kids will get sick, and I think that these other viruses that are circulating will complicate these matters, she said.
Duchin worries were not ready for whats coming when influenza-like illnesses and Covid collide. Its going to put a lot of stress on the health care system to help people figure out whether they have Covid-19 or not and what they need to do next, he said. Cheap and easy-to-access Covid rapid tests could fill this gap, but tests are still too expensive and havent yet been adopted widely enough, he and others argue. Its a huge gap, I think, in our national preparedness still, Duchin said.
Influenza activity hasnt yet rebounded globally from the coma induced by Covid control measures. But flu will be back. Whether that happens this season isnt in the realm of knowable things.
Respiratory viruses each have their own patterns and there may be interactions among them spread of one, for instance, may delay spread of another. What happens to that ballet when a new prima ballerina takes center stage? No one knows.
I wonder what the role of the co-circulation of other pathogens will be in the dynamics of Covid transmission and/or the manifestations of Covid-19 illness, Duchin said. Will influenza facilitate the spread of Covid? Will RSV or parainfluenza viruses or adenoviruses facilitate Covid or will they possibly crowd it out?
These are things somebody smarter than me needs to figure out, he said.
Viboud doesnt have answers either, but sees an enormous opportunity ahead. Its going to be a really interesting season to watch. Well learn a lot.
Nicole Lurie fears that what were about to learn is that flu plus Covid is going to make winters miserable and deadly.
Lurie, who was the assistant secretary for preparedness and response in the Department of Health and Human Services during the Obama administration, notes that in pre-Covid times, between 20,000 and 60,000 Americans died each winter from influenza. Covids toll could be higher than that still, because people have largely given up on changing their lifestyles to avoid becoming infected, and a substantial portion of people remain unvaccinated.
I feel like we have to be giving this some thought and preparing the public for some kind of a steady state that minimizes morbidity and mortality and has a set of actions that you can take to mitigate the bad consequences, said Lurie, who is now the U.S. director for the Coalition for Epidemic Preparedness Innovations.
Bedford shares her concerns.
My expectation would be that it will become a seasonal respiratory disease, but it will be the worst of our seasonal respiratory diseases, he said. Im imagining something that circulates at three times the level of flu and has a similar [infection fatality rate] to flu. So maybe causing three times flus deaths every year.
But Ben Cowling of Hong Kong University voiced some optimism. People may be fed up with Covid restrictions, but they have learned that respiratory illnesses dont have to be inevitable features of winter. In the face of surges of virus, they may choose to protect themselves, he said. Certainly Covid has changed the perception of respiratory infections. People are much more concerned about them than they used to be.
The ban, European officials point out, has kept families separated since early 2020, when the coronavirus was erupting across Europe. European countries have weathered a third wave of infections propelled by the Delta variant. But in several countries, including Britain, infection rates have begun to level off and even decline.
British newspapers played up the fact that the parents of Emma Raducanu, the British woman who won the U.S. Open tennis tournament, could not travel to New York to watch her play.
Europe is the largest market for passenger flows to and from Britain, according to the International Air Transport Association, but North America is the second biggest, accounting for 10.1 million passengers.
Constantin Film, one of Germanys biggest production and distribution companies, is based in Munich and has an office in Los Angeles, according to the companys chief executive, Martin Moszkowicz.
During the 18 months of the travel ban, the companys investment in the U.S. economy was basically zero, Mr. Moszkowicz said. The company had to move the production of two feature films and one show to Canada and South Africa, he said.
For many, the travel ban meant losing time with family.
I am trying not to cry because its such a beautiful day, said Giovanni Vincenti, 42, an Italian professor who lives in Baltimore. Mr. Vincentis daughter, who was born last May, has never met her grandparents because of the travel restrictions.
Cristina Garbarino, 55, a babysitter in Genoa, Italy, said the travel ban put on hold her visa and her plan to get married, and kept her apart from her fianc, who lives in New Hampshire, for almost two years.
At my age, I dont have much time to lose, she said, and I lost two years like this.
Reporting was contributed by Emma Bubola from Rome, Stephen Castle from London, Ceylan Yeginsu from Istanbul and Patrick Wehner from Washington.
