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Tag: omicron

  • How Bad Could BA.2.86 Get?

    How Bad Could BA.2.86 Get?

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    Since Omicron swept across the globe in 2021, the evolution of SARS-CoV-2 has moved at a slower and more predictable pace. New variants of interest have come and gone, but none have matched Omicron’s 30-odd mutations or its ferocious growth. Then, about two weeks ago, a variant descended from BA.2 popped up with 34 mutations in its spike protein—a leap in viral evolution that sure looked a lot like Omicron. The question became: Could it also spread as quickly and as widely as Omicron?

    This new variant, dubbed BA.2.86, has now been detected in at least 15 cases across six countries, including Israel, Denmark, South Africa, and the United States. This is a trickle of new cases, not a flood, which is somewhat reassuring. But with COVID surveillance no longer a priority, the world’s labs are also sequencing about 1 percent of what they were two years ago, says Thomas Peacock, a virologist at the Pirbright Institute. The less surveillance scientists are doing, the more places a variant could spread out of sight, and the longer it will take to understand BA.2.86’s potential.

    Peacock told me that he will be closely tracking the data from Denmark in the next week or two. The country still has relatively robust SARS-CoV-2 sequencing, and because it has already detected BA.2.86, we can now watch the numbers rise—or not—in real time. Until the future of BA.2.86 becomes clear, three scenarios are still possible.

    The worst but also least likely scenario is another Omicron-like surge around the world. BA.2.86 just doesn’t seem to be growing as explosively. “If it had been very fast, we probably would have known by now,” Peacock said, noting that, in contrast, Omicron’s rapid growth took just three or four days to become obvious.

    Scientists aren’t totally willing to go on record ruling out Omicron redux yet, if only because patchy viral surveillance means no one has a complete global picture. Back in 2021, South Africa noticed that Omicron was driving a big COVID wave, which allowed its scientists to warn the rest of the world. But if BA.2.86 is now causing a wave in a region that isn’t sequencing viruses or even testing very much, no one would know.

    Even in this scenario, though, our collective immunity will be a buffer against the virus. BA.2.86 looks on paper to have Omicron-like abilities to cause reinfection, according to a preliminary analysis of its mutations by Jesse Bloom, a virologist at the Fred Hutchinson Cancer Center, in Washington, but he adds that there’s a big difference between 2021 and now. “At the time of the Omicron wave, there were still a lot of people out there that had never been either vaccinated or infected with SARS-CoV-2, and those people were sort of especially easy targets,” he told me. “Now the vast, vast majority of people in the world have either been infected or vaccinated with SARS-CoV-2—or are often both infected and vaccinated multiple times. So that means I think any variant is going to have a very hard time spreading as well as Omicron.”

    A second and more likely possibility is that BA.2.86 ends up like the other post-Omicron variants: transmissible enough to edge out a previous variant, but not transmissible enough to cause a big new surge. Since the original Omicron variant, or BA.1, took over, the U.S. has successively cycled through BA.2, BA.2.12.1, BA.5, BQ.1, XBB.1.5—and if these jumbles of numbers and letters seem only faintly familiar, it’s because they never reached the same levels of notoriety as the original. Vaccine makers track them to keep COVID shots up to date, but the World Health Organization hasn’t deemed any worthy of a new Greek letter.

    If BA.2.86 continues to circulate, though, it could pick up mutations that give it new advantages. In fact, XBB.1.5, which rose to dominance earlier this year, leveled up this way. When XBB.1.5’s predecessor was first identified in Singapore, Peacock said, it wasn’t a very successful variant: Its spike protein bound weakly to receptors in human cells. Then it acquired an additional mutation in its spike protein that compensated for the loss of binding, and it turned into the later-dominant XBB.1.5. Descendents of BA.2.86 could eventually become more transmissible than the variant looks right now.

    A third scenario is that BA.2.86 just fizzles out and goes away. Scientists now believe that highly mutated variants such as BA.2.86 are probably products of chronic infections in immunocompromised patients. In these infections, the virus remains in the body for a long time, trying out new ways to evade the immune system. It might end up with mutations that make its spike protein less recognizable to antibodies, but those same mutations could also render the spike protein less functional and therefore the virus less good at transmitting from person to person.

    “Variants like that have been identified over the last few years,” Bloom said. “Often there’s one sample found, and that’s it. Or multiple samples all found in the same place.” BA.2.86 is transmissible enough to be found multiple times in multiple places, but whether it can overtake existing variants is unclear. To do so, BA.2.86 needs to escape antibodies while also preserving its inherent transmissibility. Otherwise, Bloom said, cases might crop up here and there, but the variant never really takes off. In other words, the BA.2.86 situation basically stays where it is right now.

    The next few weeks will reveal which of these futures we’re living in. If the number of BA.2.86 cases starts to go up, in a way that requires more attention, we’ll know soon. But each week that the variant’s spread does not jump dramatically, the less likely BA.2.86 is to end up a variant of actual concern.

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    Sarah Zhang

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  • New ‘Eris’ COVID variant is dominant in the U.S., but a shortage of data is making it hard to track

    New ‘Eris’ COVID variant is dominant in the U.S., but a shortage of data is making it hard to track

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    A new variant of COVID-19 dubbed EG.5 has become dominant in the U.S., according to projections made by the Centers for Disease Control and Prevention, although a shortage of data is hampering the agency’s efforts to surveil the illness.

    The CDC said on Friday it was unable to publish its “Nowcast” projections for where EG.5 and other variants are circulating for every region, which it releases every two weeks, because it did not have enough sequences to update the estimates.

    “Because Nowcast is modeled data, we need a certain number of sequences to accurately predict proportions in the present,” CDC representative Kathleen Conley said in a statement to CBS News.

    “For some regions, we have limited numbers of sequences available, and therefore are not displaying nowcast estimates in those regions, though those regions are still being used in the aggregated national nowcast.”

    It is estimated that EG.5, an omicron subvariant, accounted for 17.3% of COVID cases in the U.S. in the two-week period through Aug. 5. That was up from an estimated 11.9% in the previous period and more than any other variant.

    But the data are based on sequencing from just three regions; Region 2, comprising New Jersey, New York, Puerto Rico and the U.S. Virgin Islands; Region 4, comprising Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee; and Region 9, comprising Arizona, California, Hawaii, Nevada, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands and Republic of Palau.

    The next most common variants are XBB.1.16, accounting for 15.6% of cases, and XBB.2.3, accounting for 11.2% of cases.

    All are subvariants of XBB, which COVID vaccines in the fall will be designed to protect against.

    The symptoms of EG.5, which Twitter users have nicknamed “Eris,” are similar to early variants, and it’s not deemed to be more virulent than early variants. It may be more infectious, however, as has been the pattern with new strains. Symptoms include a cough, fever, chills, shortness of breath, fatigue and a loss of taste or smell.

    The World Health Organization said last week that EG.5 increased in prevalence globally to 11.6% in the week through July 30 from 62% four weeks earlier.

    The variant is for now a variant under monitoring, or VUM, for the agency, which is a less serious designation than a variant of interest, or VOI, according to its weekly epidemiological update.

    The WHO is monitoring two VOIs, XBB.1.5 and XBB.1.6.

    It is tracking seven VUMs and their descendent lineages, namely BA.2.75, CH.1.1, XBB, XBB.1.9.1, XBB.1.9.2, XBB.2.3 and EG.5.

    CDC data show that hospital admissions with COVID started to rise again in July after being flat or falling for several months. But the number of deaths continues to decline with 81.4% of the overall population in the U.S. having had at least one vaccine dose.

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  • What Should Go Into This Year’s COVID Vaccine?

    What Should Go Into This Year’s COVID Vaccine?

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    This fall, millions of Americans might be lining up for yet another kind of COVID vaccine:  their first-ever dose that lacks the strain that ignited the pandemic more than three and a half years ago. Unlike the current, bivalent vaccine, which guards against two variants at once, the next one could, like the first version of the shot, have only one main ingredient—the spike protein of the XBB.1 lineage of the Omicron variant, the globe’s current dominant clade.

    That plan isn’t yet set. The FDA still has to convene a panel of experts, then is expected to make a final call on autumn’s recipe next month. But several experts told me they hope the agency follows the recent recommendation of a World Health Organization advisory group and focuses the next vaccine only on the strains now circulating.

    The switch in strategy—from two variants to one, from original SARS-CoV-2 plus Omicron to XBB.1 alone—would be momentous but wise, experts told me, reflecting the world’s updated understanding of the virus’s evolution and the immune system’s quirks. “It just makes a lot of sense,” said Melanie Ott, the director of the Gladstone Institute of Virology, in San Francisco. XBB.1 is the main coronavirus group circulating today; neither the original variant nor BA.5, the two coronavirus flavors in the bivalent shot, is meaningfully around anymore. And an XBB.1-focused vaccine may give the global population a particularly good shot at broadening immunity.

    At the same time, COVID vaccines are still in a sort of beta-testing stage. In the past three-plus years, the virus has spawned countless iterations, many of which have been extremely good at outsmarting us; we humans, meanwhile, are only on our third-ish attempt at designing a vaccine that can keep pace with the pathogen’s evolutionary sprints. And we’re very much still learning about the coronavirus’s capacity for flexibility and change, says Rafi Ahmed, an immunologist at Emory University. By now, it’s long been clear that vaccines are essential for preventing severe disease and death, and that some cadence of boosting is probably necessary to keep the shots’ effectiveness high. But when the virus alters its evolutionary tactics, our vaccination strategy must follow—and experts are still puzzling out how to account for those changes as they select the shots for each year.

    In the spring and summer of 2022, the last time the U.S. was mulling on a new vaccine formula, Omicron was still relatively new, and the coronavirus’s evolution seemed very much in flux. The pathogen had spent more than two years erratically slingshotting out Greek-letter variants without an obvious succession plan. Instead of accumulating genetic changes within a single lineage—a more iterative form of evolution, roughly akin to what flu strains do—the coronavirus produced a bunch of distantly related variants that jockeyed for control. Delta was not a direct descendant of Alpha; Omicron was not a Delta offshoot; no one could say with any certainty what would arise next, or when. “We didn’t understand the trajectory,” says Kanta Subbarao, the head of the WHO advisory group convened to make recommendations on COVID vaccines.

    And so the experts played it safe. Including an Omicron variant in the shot felt essential, because of how much the virus had changed. But going all in on Omicron seemed too risky—some experts worried that “the virus would flip back,” Subbarao told me, to a variant more similar to Alpha or Delta or something else. As a compromise, several countries, including the United States, went with a combination: half original, half Omicron, in an attempt to reinvigorate OG immunity while laying down new defenses against the circulating strains du jour.

    And those shots did bolster preexisting immunity, as boosters should. But they didn’t rouse a fresh set of responses against Omicron to the degree that some experts had hoped they would, Ott told me. Already trained on the ancestral version of the virus, people’s bodies seemed to have gotten a bit myopic—repeatedly reawakening defenses against past variants, at the expense of new ones that might have more potently attacked Omicron. The outcome was never thought to be damaging, Subbarao told me: The bivalent, for instance, still broadened people’s immune responses against SARS-CoV-2 compared with, say, another dose of the original-recipe shot, and was effective at tamping down hospitalization rates. But Ahmed told me that, in retrospect, he thinks an Omicron-only boost might have further revved that already powerful effect.

    Going full bore on XBB.1 now could keep the world from falling into that same trap twice. People who get an updated shot with that strain alone would receive only the new, unfamiliar ingredient, allowing the immune system to focus on the fresh material and potentially break out of an ancestral-strain rut. XBB.1’s spike protein also would not be diluted with one from an older variant—a concern Ahmed has with the current bivalent shot. When researchers added Omicron to their vaccine recipes, they didn’t double the total amount of spike protein; they subbed out half of what was there before. That left vaccine recipients with just half the Omicron-focused mRNA they might have gotten had the shot been monovalent, and probably a more lackluster antibody response.

    Recent work from the lab of Vineet Menachery, a virologist at the University of Texas Medical Branch, suggests another reason the Omicron half of the shot didn’t pack enough of an immunizing punch. Subvariants from this lineage, including BA.5 and XBB.1, carry at least one mutation that makes their spike protein unstable—to the point where it seems less likely than other versions of the spike protein to stick around for long enough to sufficiently school immune cells. In a bivalent vaccine, in particular, the immune response could end up biased toward non-Omicron ingredients, exacerbating the tendencies of already immunized people to focus their energy on the ancestral strain. For the same reason, a monovalent XBB.1, too, might not deliver the anticipated immunizing dose, Menachery told me. But if people take it (still a big if), and hospitalizations remain low among those up-to-date on their shots, a once-a-year total-strain switch-out might be the choice for next year’s vaccine too.

    Dropping the ancestral strain from the vaccine isn’t without risk. The virus could still produce a variant totally different from XBB.1, though that does, at this point, seem unlikely. For a year and a half now, Omicron has endured, and it now has the longest tenure of a single Greek-letter variant since the pandemic’s start. Even the subvariants within the Omicron family seem to be sprouting off each other more predictably; after a long stint of inconsistency, the virus’s shape-shifting now seems “less jumpy,” says Leo Poon, a virologist at the University of Hong Kong. It may be a sign that humans and the virus have reached a détente now that the population is blanketed in a relatively stable layer of immunity. Plus, even if a stray Alpha or Delta descendant were to rise up, the world wouldn’t be caught entirely off guard: So many people have banked protection against those and other past variants that they’d probably still be well buffered against COVID’s worst acute outcomes. (That reassurance doesn’t hold, though, for people who still need primary-series shots, including the kids being born into the world every day. An XBB.1 boost might be a great option for people with preexisting immunity. But a bivalent that can offer more breadth might still be the more risk-averse choice for someone whose immunological slate is blank.)

    More vaccination-strategy shifts will undoubtedly come. SARS-CoV-2 is still new to us; so are our shots. But the virus’s evolution, as of late, has been getting a shade more flu-like, and its transmission patterns a touch more seasonal. Regulators in the U.S. have already announced that COVID vaccines will probably be offered each year in the fall—as annual flu shots are. The viruses aren’t at all the same. But as the years progress, the comparison between COVID and flu shots could get more apt still—if, say, the coronavirus also starts to produce multiple, genetically distinct strains that simultaneously circulate. In that case, vaccinating against multiple versions of the virus at once might be the most effective defense.

    Flu shots could be a useful template in another way: Although those shots have followed roughly the same guidelines for many years, with experts meeting twice a year to decide whether and how to update each autumn’s vaccine ingredients, they, too, have needed some flexibility. Until 2012, the vaccines were trivalent, containing ingredients that would immunize people against three separate strains at once; now many, including all of the U.S.’s, are quadrivalent—and soon, based on new evidence, researchers may push for those to return to a three-strain recipe. At the same time, flu and COVID vaccines share a major drawback. Our shots’ ingredients are still selected months ahead of when the injections actually reach us—leaving immune systems lagging behind a virus that has, in the interim, sprinted ahead. Until the world has something more universal, our vaccination strategies will have to be reactive, scrambling to play catch-up with these pathogens’ evolutionary whims.

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    Katherine J. Wu

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  • Omicron Much Less Likely to Cause Long COVID, Study Finds

    Omicron Much Less Likely to Cause Long COVID, Study Finds

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    March 10, 2023 – Health care workers infected with the COVID-19 Omicron variant were far less likely to experience significant long COVID symptoms than those who contracted the original SARS-CoV-2 virus, according to new research out of Switzerland.

    The results, which will be presented at the European Congress of Clinical Microbiology & Infectious Diseases conference in April and have been peer reviewed, showed that those infected with the original, “wild-type” virus circulating in the early months of the pandemic still had persistent post-COVID symptoms 18 months later. At the same time, a reinfection with Omicron among this group did not appear to increase their long COVID risks.

    “In a young and healthy population, the risk of long COVID after Omicron infection, independent of vaccination status, is very low,” Philipp Kohler, MD, with the Cantonal Hospital St Gallen and principal investigator of the study, says in an email. 

    “These data suggest that the long COVID wave after Omicron infection will not be as devastating as has been feared by many.”

    The latest findings build on previous research, including an article published in The Lancet, that showed the risk of long COVID was lower with Omicron compared with the Delta variant. Another study published in Nature Communications comparing the same variants also saw lower risks of long-term symptoms with Omicron 3 months after testing positive.

    In the Swiss study, which has yet to be submitted to a medical journal for publication, Kohler and his colleagues tracked 1,201 health care workers from nine domestic health care networks. Their vaccination status was tracked and symptoms were compared with an uninfected control group.

    “Adjusting for this ‘background noise’ is very important because it allows to disentangle the effect of long COVID from other conditions, which are common in the general population and which cause similar symptoms as long COVID, such as fatigue,” Kohler said.

    Health care workers completed online questionnaires three times over the next 2 years to say if they were experiencing any long COVID symptoms as well as how bad their fatigue was. Eighteen symptoms were covered, with loss of smell or taste, tiredness and weakness, burnout and exhaustion, and hair loss the most common issue reported.

    In the study, those who tested positive with the original virus had a 67% higher risk of developing long COVID symptoms when surveyed in March 2021 compared with the control group of participants who remained uninfected. While symptoms declined over time, they were still present 18 months later.

    Meanwhile, the chances of developing long COVID among workers whose first infection was with Omicron did not appear to be greater than those who had never contracted COVID-19, researchers found. The participants’ rates of fatigue were also comparable between the infected and uninfected groups.

    “We can only speculate as to why this was,” Carol Strahm, MD, an infectious disease specialist and one of the researchers involved in the study, said in a statement. She added that it could be due to Omicron being less likely to cause severe illness than the original virus, as well as immunity acquired through previous exposure, including asymptomatic infections that never resulted in the development of antibodies.

    Kohler did note that their sample size was not very large and that the group  studied is not reflective of the broader general population. Older individuals, those with other health issues, and the unvaccinated may not have the same outcomes, he said.

    Linda Geng, MD, co-director of the Post-Acute COVID-19 Syndrome Center at Stanford University, who was not involved in the Swiss study, said while there is research suggesting that long COVID risks may be lower following infections with Omicron compared with earlier variants, she is still seeing many new patients.

    “In our Long COVID clinic, we still see plenty of cases of long COVID that developed after more recent infections,” Geng, who is also a clinical assistant professor of medicine with the university’s Primary Care and Population Health, says in an email.

    “We also don’t know what the future will hold in terms of the evolution of the virus and its impact on long COVID risk. The only guarantee against long COVID is to not get COVID.” 

    Going forward, the Swiss team plans to continue following up with participants to see whether those infected with the original strain are still reporting symptoms nearly three years later.

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  • WHO counted nearly 20 million new COVID cases in latest month as it shifts from weekly reporting schedule

    WHO counted nearly 20 million new COVID cases in latest month as it shifts from weekly reporting schedule

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    The World Health Organization said nearly 20 million new COVID cases were recorded in the 28 days through Jan. 29, down 78% from the previous 28 days.

    The WHO counted more than 114,000 deaths in the period, up 65% from the previous one.

    The agency is switching to a 28-day interval to smooth out weekly fluctuations in cases and deaths, but it continues to caution that a reduction in testing and delays in reporting in many countries are distorting the numbers.

    “Current trends in reported COVID-19 cases are underestimates of the true number of global infections and reinfections as shown by prevalence surveys,” the WHO said in its weekly epidemiological update. 

    The WHO is now prioritizing four omicron descendent lineages, including XBB.1.5, which is dominant in the U.S., according to data from the Centers for Disease Control and Prevention.

    The other three are BF.7, BQ.1 and BA.2.75, along with their sublineages. These are currently the ones showing a growth-rate advantage in some countries compared with other circulating variants.

    U.S. cases are still declining. The seven-day average of new cases stood at 41,771 on Wednesday, according to a New York Times tracker. That’s down 23% from two weeks ago.

    The daily average for hospitalizations was down 22% at 31,593. The average for deaths was 453, down 6% from two weeks ago, but still an undesirably high number heading into the third year of the pandemic and ahead of President Joe Biden’s plan to end the twin COVID emergencies on May 11.

    Coronavirus update: MarketWatch’s daily roundup has been curating and reporting all the latest developments every weekday since the coronavirus pandemic began

    Other COVID-19 news you should know about:

    • Quest Diagnostics Inc.
    DGX,
    -1.55%
    is the latest healthcare company to report a steep drop in revenue from COVID-related products, in this instance a 74.6% slide in tests in its fourth quarter. Revenue from COVID tests fell to $184 million in the quarter from $722 million a year ago, when the omicron wave was about to crest. But the company still posted better-than-expected earnings, raised its quarterly dividend and added $1 billion to its share-buyback authorization, which has $311 million already available. 

    • Hong Kong will give away air tickets and vouchers to woo tourists back to the international financial hub as it races to catch up with other popular travel destinations in a fierce regional competition, the Associated Press reported. During the pandemic, the city largely aligned itself with mainland China’s zero-COVID strategy and has relaxed its entry rules months later than rival destinations such as Singapore, Japan and Taiwan. Even after it reopened its border with mainland China in January, tourism recovery was sluggish. On Thursday, Chief Executive John Lee launched a tourism campaign, “Hello Hong Kong,” saying the city will offer 500,000 free air tickets to welcome tourists from around the world in what he called “probably the world’s biggest welcome ever.”

    • Washington state Gov. Jay Inslee has tested positive for COVID-19 for the second time, the AP reported separately. Inslee’s office said in a statement Wednesday that he had tested positive and was experiencing very mild symptoms, including a cough. He is consulting with his doctor about whether to receive Paxlovid antiviral treatments, according to the statement. He plans to continue working. Trudi Inslee, his spouse, has tested negative.

    Here’s what the numbers say:

    The global tally of confirmed COVID-19 cases topped 671.1 million on Monday, while the death toll rose above 6.83 million, according to data aggregated by Johns Hopkins University.

    The U.S. leads the world with 102.5 million cases and 1,109,687 fatalities.

    The CDC’s tracker shows that 229.6 million people living in the U.S., equal to 69.2% of the total population, are fully vaccinated, meaning they have had their primary shots.

    So far, just 51.4 million Americans, equal to 15.5% of the overall population, have had the updated COVID booster that targets both the original virus and the omicron variants.

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  • FDA Panel Backs Shift Toward One-Dose COVID Shot

    FDA Panel Backs Shift Toward One-Dose COVID Shot

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    Jan. 26, 2023 – A panel of advisers to the FDA unanimously supported an effort today to simplify COVID-19 vaccinations, with the aim of developing a one-dose approach — perhaps annually — for the general population.

    The FDA is looking to give clearer direction to vaccine makers about future development of COVID-19 vaccines. The plan is to narrow down the current complex landscape of options for vaccinations, and thus help increase use of these shots. 

    COVID remains a threat, causing about 4,000 deaths a week recently, according to the CDC. 

    The 21 Members of the Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted unanimously “yes” on a single question posed by the FDA: 

    “Does the committee recommend harmonizing the vaccine strain composition of primary series and booster doses in the U.S. to a single composition, e.g., the composition for all vaccines administered currently would be a bivalent vaccine (Original plus Omicron BA.4/BA.5)?”

    In other words, would it be better to have one vaccine potentially combining multiple strains of the virus, instead of multiple vaccines – such as a two-shot primary series then a booster containing different combinations of viral strains.

    The FDA will consider the panel’s advice as it outlines new strategies for keeping ahead of the evolving virus.

    In explaining their support for the FDA plan, panel members said they hoped that a simpler regime would aid in persuading more people to get COVID vaccines.

    Pamela McInnes, DDS, MSc, noted that it’s difficult to explain to many people that the vaccine worked to protect them from more severe illness if they contract COVID after getting vaccinated. 

    “That is a real challenge,” said McInness, a retired deputy director of the National Center for Advancing Translational Sciences at the National Institutes of Health.

    “The message that you would have gotten more sick and landed in the hospital resonates with me, but I’m not sure if it resonates with” many people who become infected, she said.

    The Plan

    In the briefing document for the meeting, the FDA outlined a plan for transitioning from the current complex landscape of COVID-19 vaccines to a single vaccine- composition for the primary series and booster vaccination. 

    This would require:

    • Harmonizing the strain composition of all COVID-19 vaccines;

    • Simplifying the immunization schedule for future vaccination campaigns to administer a two-dose series in certain young children and in older adults and persons with compromised immunity, and only one dose in all other individuals;

    • Establishing a process for vaccine strain selection recommendations, similar in many ways to that used for seasonal influenza vaccines, based on prevailing and predicted variants that would take place by June to allow for vaccine production by September.

    During the discussion, though, questions arose about the June target date. Given the production schedule for some vaccines, that date might need to shift, said Jerry Weir, PhD, director of the division of viral products at FDA’s Center for Biologics Evaluation and Research. 

    “We’re all just going to have to maintain flexibility,” Weir said, adding that there is not yet a “good pattern” established for updating these vaccines. 

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  • China takes first steps to punish countries that imposed testing mandates for Chinese travelers

    China takes first steps to punish countries that imposed testing mandates for Chinese travelers

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    China on Tuesday suspended visas for South Koreans to enter the country for tourism or business in apparent retaliation for South Korea’s COVID-19 testing requirements for Chinese travelers, the Associated Press reported.

    No other details were given, although China has threatened to retaliate against countries that require travelers from China to show a negative result for a test taken within the previous 48 hours.

    That has not stopped about a dozen countries from following the U.S. in requiring Chinese travelers produce a test after China lifted most of its strict COVID-related restrictions for the first time since the start of the pandemic. The end of those restrictions has resulted in a surge of new cases.

    The World Health Organization and several nations have accused China of withholding data on its outbreak. The testing requirements are aimed at identifying potential virus variants carried by travelers.

    Separately on Tuesday, the head of the WHO for Europe said the surge of cases in China is not likely to have a big impact on Europe, although he cautioned against complacency.

    Hans Kluge told reporters it was “not unreasonable for countries to take precautionary measures to protect their populations” but called for such measures “to be rooted in science, to be proportionate and nondiscriminatory,” as AFP reported.

    Tens of thousands of people resumed travels in and out of China after the country lifted almost all of its border restrictions, ending three years of strict pandemic controls. Photo: Tyrone Siu/Reuters

    In the U.S., the seven-day average of new cases stood at 67,012 on Monday, according to a New York Times tracker. That’s up 2% from two weeks ago and below the recent peak of 70,508 on Christmas Eve.

    The daily average for hospitalizations was up 18% to 47,503. The average for deaths was 467, up 10% from two weeks ago. 

    Cases are currently rising in 21 states, along with Guam, Washington, D.C., and the U.S. Virgin Islands. They are led by Florida, where cases are up 90% from two weeks ago. On a per-capita basis, New York, New Jersey and Rhode Island are seeing the highest rates. New York has 37 cases per 100,000 people, New Jersey 35 and Rhode Island 31.

    Coronavirus Update: MarketWatch’s daily roundup has been curating and reporting all the latest developments every weekday since the coronavirus pandemic began

    Other COVID-19 news you should know about:

    • Thailand sent three cabinet ministers to welcome Chinese tourists with flowers and gifts as they arrived Monday at Bangkok’s Suvarnabhumi Airport after China relaxed travel restrictions, the AP reported. The high-profile event reflected the importance Thailand places on wooing Chinese travelers to help restore its pandemic-battered tourism industry. Before COVID, Chinese visitors accounted for about one-third of all arrivals.

    • Moderna Inc.
    MRNA,
    +3.10%
    is considering pricing its COVID vaccine at $110 to $130 per dose, the Wall Street Journal reported. That’s the same price range as mooted by Pfizer Inc.
    PFE,
    -1.59%
    and German partner BioNTech SE
    BNTX,
    +3.30%
    once their vaccine moves to the commercial market. For now, vaccines are being purchased and distributed by the U.S. government.

    Getting the flu can increase the risk of getting a second infection, such as strep throat. The Wall Street Journal’s Daniela Hernandez explains the science behind that, plus what it means for the rest of the winter and how we can protect ourselves from the tripledemic. Illustration: David Fang

    • India has detected the presence of all the COVID omicron subvariants in the community after testing more than 300 samples since late December, the health ministry said in a statement, Reuters reported. “No mortality or rise in transmission were reported in the areas where these variants were detected,” the ministry said.

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  • CDC calls out China for ‘lack of adequate and transparent’ COVID data

    CDC calls out China for ‘lack of adequate and transparent’ COVID data

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    China is facing an international backlash amid reports of an unchecked surge in COVID-19 cases in the country, as well as criticism over the government’s decision to stop providing daily COVID data.

    A growing number of countries, including the U.S., have announced COVID-testing requirements for people traveling from China, as the outbreak there increases the risk that new coronavirus variants could emerge and spread.

    Read: MarketWatch’s daily ‘Coronavirus Update’ column

    Don’t miss: Lack of data on China’s COVID-19 surge stirs global concern

    The U.S. Centers for Disease Control and Prevention said Wednesday that it was implementing a requirement for a negative COVID-19 test or documentation of recovery for passengers from China, Hong Kong and Macau boarding flights to the U.S.

    “CDC is announcing this step to slow the spread of COVID-19 in the United States during the surge of COVID-19 cases in the [People’s Republic of China] given the lack of adequate and transparent epidemiological and viral genomic sequence data being reported from the PRC,” the agency said in a statement. “These data are critical to monitor the case surge effectively and decrease the chance for entry of a novel variant of concern.”

    Japan said that starting Dec. 30, a COVID-19 test will be required on arrival for those who have stayed in China. excluding Hong Kong and Macau, within seven days of arrival, and for all who arrive directly from China, again excluding Hong Kong and Macau. Those who do test positive will be required to isolate at a government-designated facility.

    The European Union said it is assessing the surge in cases in China and would be will ready to use the “emergency brake” if necessary, the Associated Press reported. The EU tried to soothe fears, however, by saying the BF.7 omicron variant that was prevalent in China was already active in Europe and does not pose an immediate danger.

    Italy is already requiring COVID tests for all airline passengers arriving from China. More than half of those tested on arrival at Milan’s Malpensa Airport in recent days have tested positive, the AP reported.

    On the bright side, Italy said the positive tests of people arriving from China didn’t include any new coronavirus variants of concern, Bloomberg reported.

    India and South Korea have also announced test mandates for airline passengers arriving from China.

    Meanwhile, in the U.S., new cases and deaths have been falling, while hospitalizations and test-positivity rates are increasing.

    The seven-day average of new COVID cases fell to a three-week low of 64,410 on Wednesday, according to a New York Times tracker. That’s down from a recent peak of 70,508 on Christmas Eve and down 2% from two weeks ago.

    The daily average of COVID-related deaths fell to 345 on Wednesday, also a three-week low, and is down 24% from two weeks ago.

    The New York Times tracker cautioned that reports for cases and deaths could be artificially low this week as U.S. officials who track the data take time off over the holidays. Hospitalization data, which is not typically affected by holiday breaks, is more reliable.

    The daily average of COVID-related hospitalizations rose to 40,497 from 39,880 on Tuesday and has increased 1% from two weeks ago. And more worrisome, the number of COVID patients in intensive-care units jumped 10% from two weeks ago to 4,997, the most since early August.

    The test-positivity rate rose to above 14% on Wednesday, a four-month high, and has increased by 18% in two weeks. Higher test-positivity rates suggest that many new COVID cases, such as those found through at-home testing, are not being reported to official case trackers, the New York Times said.

     

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  • Is Long COVID Less Likely With Omicron Strains?

    Is Long COVID Less Likely With Omicron Strains?

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    SOURCES:

    Jonathan Whiteson, MD, co-director, NYU Langone Health Post COVID Care Program.

    American Academy of Physical Medicine and Rehabilitation: “Long COVID/PASC.”

    Lancet: “Risk of Long COVID Associated With Delta Versus Omicron Variants of SARS-CoV-2.”

    Nature Communications: “Post-Covid Medical Complaints Following Infection With SARS-CoV-2 Omicron vs Delta Variants.”

    Karin Magnusson, PhD, researcher, Norwegian Institute of Public Health, Oslo, and Lund University, Sweden.

    FDA: “COVID-19 Bivalent Vaccine Boosters.”

    medRxiv: “Long COVID Risk and Pre-COVID Vaccination: An EHR-Based Cohort Study From the RECOVER Program.”

    Antimicrobial Stewardship & Healthcare Epidemiology: “The Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccine in the Prevention of Post-COVID Conditions: A Systematic Literature Review and Meta-Analysis.”

    Alexandre Marra, MD, researcher, Hospital Israelita Albert Einstein, São Paulo, Brazil; researcher, University of Iowa Carver College of Medicine, Iowa City.

    FDA: “Coronavirus (COVID-19) Update: FDA Authorizes Moderna, Pfizer-BioNTech Bivalent COVID-19 Vaccines for Use as a Booster Dose.”

    FDA: “Coronavirus (COVID-19) Update: FDA Authorizes Updated (Bivalent) COVID-19 Vaccines for Children Down to 6 Months of Age.”

    Daniel Brannock, research data scientist, RTI International.

    CDC: “Respiratory Infections.”

    European Center for Disease Prevention and Control: “Prevalence of Post COVID-19 Condition Symptoms: A Systematic Review and Meta-Analysis of Cohort Study Data, Stratified by Recruitment Setting.”

    Journal of Internal Medicine: “Post COVID-19 Condition Diagnosis: A Population-Based Cohort Study of Occurrence, Associated Factors, and Healthcare Use by Severity of Acute Infection.”

    Akiko Iwasaki, PhD, director, Center for Infection and Immunity, Yale University.

    American Academy of Physical Medicine and Rehabilitation: “PASC Dashboard.”

    National Center for Health Statistics: “Identification of Deaths With Post-acute Sequelae of COVID-19 From Death Certificate Literal Text: United States, January 1, 2020–June 30, 2022.”

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  • Rise of ‘Alarming’ Subvariants of COVID Predicted for Winter

    Rise of ‘Alarming’ Subvariants of COVID Predicted for Winter

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    Dec. 16, 2022 – It’s a story perhaps more appropriate for Halloween than the festive holiday season, given its troubling implications. Four Omicron subvariants of the virus that causes COVID-19 will be the most common strains going from person to person this winter, new evidence predicts.

    Not too dire so far, until you consider what else the researchers found. 

    The BQ.1, BQ1.1, XBB, and XBB.1 subvariants are the most resistant to neutralizing antibodies, researcher Qian Wang, PhD, and colleagues report. This means you have no or “markedly reduced” protection against infection from these four strains, even if you’ve already had COVID-19 or are vaccinated and boosted multiple times, including with a bivalent vaccine. 

    On top of that, all available monoclonal antibody treatments are mostly or completely ineffective against these subvariants.

    What does that mean for our immediate future? The findings are definitely “worrisome,” Eric Topol, MD, founder and director of the Scripps Translational Research Institute in La Jolla, CA, and editor-in-chief of Medscape, WebMD’s sister site for health care professionals. 

    But evidence from other countries, specifically Singapore and France, show at least two of these variants turned out not to be as damaging as expected, likely because of high-numbers of people vaccinated, or who survived pervious infections, Topol says. 

    Still, there is little to celebrate in the new findings, except COVID-19 vaccinations and prior infections can still reduce the risk of serious outcomes such as hospitalization and death, the researchers say. 

    The “Alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants” study was published online this week in the journal Cell. 

    It comes at a time when BQ.1 and BQ.1.1 account for about 70% of the circulating variants, CDC data shows. In addition, hospitalizations are up 18% over the past 2 weeks and COVID-19 deaths are up 50% nationwide, The New York Times reports. 

    Globally, in many places, an “immunity wall” that has been built, Topol says. That may not be the case in the United States.  

    “The problem in the U.S., making it harder to predict, is that we have a very low rate of recent boosters, in the past 6 months, especially in seniors,” Topol says. For example, only 36% of Americans 65 and older, the group with highest risk, have received an updated bivalent booster.

    An Evolving Virus

    The subvariants are successfully replacing BA.5, which reigned as one of the most common Omicron variants over the past year. The latest CDC data show BA.5 now accounts for only about 10% of circulating virus. The researchers write, “This rapid replacement of virus strains is “raising the specter of yet another wave of infections in the coming months.” 

    The story sounds familiar to the researchers. “The rapid rise of these subvariants and their extensive array of spike mutations are reminiscent of the appearance of the first Omicron variant last year, thus raising concerns that they may further compromise the efficacy of current COVID-19 vaccines and monoclonal antibody therapeutics,” they write. “We now report findings that indicate that such concerns are, sadly, justified, especially so for the XBB and XBB.1 subvariants.”

    The BQ.1 subvariant was six times more resistant to antibodies than BA.5, its parent strain, and XBB.1 was 63 times more resistant compared to its predecessor, BA.2. 

    This shift in the ability of vaccines to stop the subvariants “is particularly concerning,” the researchers write.

    Wiping Out Treatments, Too

    Wang and colleagues also tested how well a panel of 23 monoclonal antibody drugs might work against the four subvariants. The therapies all worked well against the original Omicron variant and included some approved for use through the FDA Emergency Use Authorization (EUA) program at the time of the study. 

    They found 19 of these 23 monoclonal antibodies lost effectiveness “greatly or completely” against XBB and XBB.1, for example. 

    This is not the first time that monoclonal antibody therapies have gone from effective to ineffective. Previous variants have come out that no longer responded to treatment with bamlanivimab, casirivimab, cilgavimab, etesevimab, imdevimab, sotrovimab, and tixagevimab. Bebtelovimab now joins this list and is no longer available from Lilly under EUA due to this lack of effectiveness. 

    The lack of an effective monoclonal antibody treatment “poses a serious problem for millions of immunocompromised individuals who do not respond robustly to COVID-19 vaccines,” the researchers write, adding “the urgent need to develop active monoclonal antibodies for clinical use is obvious.”

    Going forward, the challenge remains to develop vaccines and treatments that offer broad protection as the coronavirus continues to evolve. 

    In a scary ending to a scary story, the researchers write: “We have collectively chased after SARS-CoV-2 variants for over 2 years, and yet, the virus continues to evolve and evade.”

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  • White House preps fresh push to urge COVID preparedness ahead of holidays, including free tests for all households

    White House preps fresh push to urge COVID preparedness ahead of holidays, including free tests for all households

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    The White House has unveiled a fresh push to increase COVID preparedness heading into the holidays and will again make free tests available to Americans, after a three-month hiatus.

    Starting Thursday, households can order four rapid virus tests through covidtest.gov, a senior administration official told the Associated Press.

    Cases of COVID-19…

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  • U.S. COVID cases are climbing again as new omicron variants spread

    U.S. COVID cases are climbing again as new omicron variants spread

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    COVID-19 cases and hospitalizations in the U.S. are rising and intensive-care-unit beds are being filled again, in a trend that may spell an end to the stable period the country experienced during the fall months.

    The daily average of new cases was up 22% on Thursday from two weeks ago, to 49,070, according to a New York Times tracker. Cases are rising in 40 states, led by Oklahoma, where they are up 89% from two weeks ago.

    The daily average for hospitalizations is up 21% from two weeks ago to 33,708, although as always, the trend is not uniform across the nation. Louisiana is the state with the highest increase in hospitalizations, up 109% from two weeks ago, followed by California, where they have climbed 66%.

    Visits to the ICU are up 17%, while test-positivity rates are up 29%, to 10%, the tracker shows. On a brighter note, the daily average for deaths is down 3% to 274. 

    Experts are warning that new omicron subvariants are on the rise and are quickly replacing earlier ones.

    The most recent data release from the Centers for Disease Control and Prevention showed that the BQ.1.1 and BQ.1 sublineages of BA.5 accounted for 62.8% of all cases in the U.S. in the week through Dec. 3, exceeding the 13.8% of cases caused by BA.5.

    That was up from 57.3% of cases in the week through Nov. 26, when 19.4% of cases were caused by BA.5.

    In the New York region, which includes New Jersey, Puerto Rico and the U.S. Virgin Islands, those numbers were even higher, with BQ.1 and BQ.1.1 accounting for 72.4% of all cases, compared with 6.9% for BA.5.

    That was up from the prior week, when BQ.1 and BQ.1.1 accounted for 70.8% of all cases, compared with 10.4% for BA.5.

    See now: Elon Musk may want employees back in the office, but 29% of Americans still work from home

    For now, the new sublineages have not been shown to be likely to cause more severe disease than earlier ones, but they are more transmissible, which is why they have become dominant.

    Experts continue to urge people to get their updated booster, which is the best protection against developing severe COVID or dying of it.

    Coronavirus Update: MarketWatch’s daily roundup has been curating and reporting all the latest developments every weekday since the coronavirus pandemic began

    Other COVID-19 news you should know about:

    • Local governments in China are facing a new challenge in the battle against COVID: They are running out of cash needed to finance mass testing and enforce quarantines, CNN reported on Friday. The zero-COVID policy kept China out of recession in 2020, but now the bills are mounting, placing financial strain on municipal authorities across the world’s most populous nation, said CNN. For nearly three years, local governments have borne the brunt of enforcing pandemic controls. 

    • Former NBA star Jeremy Lin, who plays for a Chinese team, was fined 10,000 yuan ($1,400) for criticizing quarantine facilities, according to China’s professional league and a news report Friday, the AP reported. The ruling Communist Party is trying to crush criticism of the human cost and disruption of its zero-COVID strategy, which has confined millions of people to their homes.

    Large protests erupted across China as crowds voiced their frustration over nearly three years of COVID-19 controls. Here’s how a deadly fire in Xinjiang sparked domestic upheaval and a political dilemma for Xi Jinping’s leadership. Photo: Thomas Peter/Reuters

    • Formula One confirmed Friday that the Chinese Grand Prix will not take place in 2023, making it the fourth year in a row the race has been canceled because of the coronavirus pandemic, the AP reported separately. “Formula One can confirm, following dialogue with the promoter and relevant authorities, that the 2023 Chinese Grand Prix will not take place due to the ongoing difficulties presented by the COVID-19 situation,” Formula One said in a statement.

    • German doctors are warning that pediatric units are stretched to the breaking point in some hospitals in part due to rising cases of respiratory infections among infants, the AP reported. The intensive-care association DIVI said the seasonal surge in cases of respiratory syncytial virus and a shortage of nurses was causing a “catastrophic situation” in hospitals. RSV is a common, highly contagious virus that infects nearly all babies and toddlers by age 2, some of whom can fall seriously ill. Experts say the easing of coronavirus pandemic restrictions means RSV is currently affecting a larger number of babies and children whose immune systems aren’t primed to fend off the infection.

    Physicians are reporting high numbers of respiratory illnesses like RSV and the flu earlier than the typical winter peak. WSJ’s Brianna Abbott explains what the early surge means for the winter months. Photo illustration: Kaitlyn Wang

    Here’s what the numbers say:

    The global tally of confirmed cases of COVID-19 topped 644.1 million on Friday, while the death toll rose above 6.63 million, according to data aggregated by Johns Hopkins University.

    The U.S. leads the world with 98.9 million cases and 1,081,147 fatalities.

    The Centers for Disease Control and Prevention’s tracker shows that 228.4 million people living in the U.S., equal to 68.8% of the total population, are fully vaccinated, meaning they have had their primary shots.

    So far, just 39.7 million Americans have had the updated COVID booster that targets the original virus and the omicron variants, equal to 12.7% of the overall population.

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  • U.S. unlikely to see another late-year omicron wave, but Fauci urges people to get new COVID booster

    U.S. unlikely to see another late-year omicron wave, but Fauci urges people to get new COVID booster

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    The U.S. is unlikely to suffer the same surge of COVID-19 infections this winter as it did last year, when the omicron variant first emerged and swept across the country, senior health officials said Tuesday.

    On Tuesday, Anthony Fauci, President Joe Biden’s chief medical adviser, addressed reporters for the last time ahead of his retirement, saying that the current combination of infections and vaccinations means there’s “enough community protection that we’re not going to see a repeat of last year at this time.”

    But Fauci urged those Americans who have not yet gotten their updated booster to do so quickly, telling them it’s the best one so far. Only 35 million Americans have received the bivalent booster since it was rolled out in September.

    “[What] may be the final message I give you from this podium is that please, for your own safety, for that of your family, get your updated COVID-19 shot as soon as you’re eligible,” Fauci said.

    The Centers for Disease Control and Prevention has estimated that the new boosters, which target the original virus as well as the latest omicron variants, provide an additional 30% to 56% protection against symptomatic infection, depending on a person’s age, how many prior vaccine shots they have had and when they had them, as the Associated Press reported.

    The people who get the greatest benefit from the new booster are those who got two doses of the original COVID-19 vaccine at least eight months earlier and never got a prior booster, said the CDC’s Ruth Link-Gelles, who led the study.

    The original shots have offered strong protection against severe disease and death no matter the variant, but their protection against mild infection wanes. The CDC’s analysis has tracked only the first few months of the new boosters’ use, so it’s too early to know how long the added protection against symptomatic infection will last.

    But “certainly as we enter the holiday season, personally I would want the most possible protection if I’m seeing my parents and grandparents,” Link-Gelles said. “Protection against infection there is going to be really helpful, because you potentially would stop yourself from getting a grandparent or other loved one sick.”

     The Biden administration announced a six-week campaign urging people — especially older people — to get the boosters, saying the shots could save lives as Americans gather for the holidays.

    Physicians are reporting high numbers of respiratory illnesses like RSV and the flu earlier than the typical winter peak. WSJ’s Brianna Abbott explains what the early surge means for the winter months. Photo illustration: Kaitlyn Wang

    Don’t miss: Confused about COVID boosters? Here’s what the science and the experts say about the new generation of shots.

    In the U.S., known cases of COVID are rising again, with the daily average standing at 42,220 on Tuesday, according to a New York Times tracker, up 7% from two weeks ago. Cases are rising in 25 states, led by Washington state, where they are up 279% from two weeks ago.

    The daily average for hospitalizations is flat at 27,923, while the daily average for deaths is up 3% to 319.

    Coronavirus Update: MarketWatch’s daily roundup has been curating and reporting all the latest developments every weekday since the coronavirus pandemic began

    Other COVID-19 news you should know about:

    • Employees at the world’s biggest Apple
    AAPL,
    +0.59%
    iPhone factory were beaten and detained in protests over contract disputes amid antivirus controls, according to witnesses and videos posted on social media Wednesday, as tensions mount over Beijing’s severe zero-COVID strategy, the AP reported. Videos reportedly filmed at the factory in the central city of Zhengzhou showed thousands of people in masks facing rows of police in white protective suits with plastic riot shields. Police kicked and hit one protester with clubs after he grabbed a metal pole that had been used to strike him. Frustrations have boiled over into protests in some parts of China where shops and offices have been closed and millions of people confined to their homes for weeks at a time with little warning. Videos on social media show residents in some areas tearing down barricades set up to enforce neighborhood closures.

    Footage shows police in protective suits beating workers at the Foxconn facility in Zhengzhou, China. The world’s biggest Apple iPhone factory had been under COVID-19 lockdowns in recent weeks. Screenshot: Associated Press

    • The Ohio Supreme Court has dismissed a lawsuit challenging Gov. Mike DeWine’s authority to end Ohio’s participation in a federal pandemic unemployment aid program ahead of the federal government’s 2021 deadline for stopping the payments, the AP reported. The court’s unanimous decision on Tuesday called the case “moot” without any additional explanation. At issue before the court was a weekly $300 federal payment for Ohioans to offset the economic impact of the coronavirus pandemic. The federal government ended that in September of last year, but DeWine stopped the payments two months earlier, saying the need was over.

    • Infections from antibiotic-resistant pathogens known as superbugs have more than doubled in healthcare facilities in Europe, an EU agency said on Thursday, providing further evidence of the wider impact of the COVID pandemic, Reuters reported. The European Center for Disease Prevention and Control said reported cases of two highly drug-resistant pathogens increased in 2020, the first year of the COVID-19 pandemic, then sharply jumped in 2021.

    • The National Institutes of Health has set up a website for people to anonymously self-report the results of at-home COVID-19 tests, whether positive or negative. The site, MakeMyTestCount.org, will gather the data and then share the information, stripped of personal identifiers, with the public-health systems that track COVID-19 test results provided by healthcare providers and laboratories. The widespread use of at-home COVID tests in 2022 meant the U.S. had a more limited understanding of COVID surges than in the past.

    Here’s what the numbers say:

    The global tally of confirmed cases of COVID-19 topped 639.1 million on Wednesday, while the death toll rose above 6.62 million, according to data aggregated by Johns Hopkins University.

    The U.S. leads the world with 98.4 million cases and 1,077,800 fatalities.

    The Centers for Disease Control and Prevention’s tracker shows that 228.2 million people living in the U.S., equal to 68.7% of the total population, are fully vaccinated, meaning they have had their primary shots.

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  • Confused about COVID boosters? Here’s what the science and the experts say about the new generation of shots.

    Confused about COVID boosters? Here’s what the science and the experts say about the new generation of shots.

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    As we head into the third winter of the pandemic, only about 13% of American adults — less than 11% of Americans overall — have received the bivalent COVID-19 booster. 

    Only about 34 million adults in the U.S. have opted to get the new shot, which became available in September. The bivalent boosters, which were developed by Moderna and BioNTech/Pfizer, are designed to better protect people against the forms of the virus that are currently circulating.

    Medical experts say the lackluster interest in the new boosters is due to several factors: pandemic fatigue, mixed messages from public-health officials, confusion about how the new boosters are different from previous shots, and the government’s decision to authorize the updated boosters without first getting clinical data in humans. 

    “It’s hard for people to wade through that,” said Robert Wachter, chair of the department of medicine at the University of California, San Francisco. “Some of them are just throwing up their hands and saying, ‘I got vaccinated, and that’s all I need to do.’ Which, unfortunately, is not.”

    A lot has changed since 2020. We now have vaccines that do a pretty good job of keeping most people from getting so sick that they end up in the hospital or die. You can now pick up at-home tests from pharmacies, and there are antiviral drugs that help treat COVID and may help prevent long COVID, in which symptoms can linger long after an infection. And now we also have the updated boosters, which are another way to ward off the worst of the virus.

    Those boosters, however, don’t confer total protection from getting sick, leading some people, particularly those who are young and healthy, to ask: Why get one, then?

    With new variants like BQ.1 and BQ.1.1 now the dominant strains circulating in the U.S., and with the coming holidays bringing more people together to spend time socializing indoors with friends and family, it’s important to understand that your immunity, whether from an infection or vaccination, wanes within four to six months. In fact, immunity to all coronaviruses wanes over time “for reasons that we don’t quite understand,” Kami Kim, director of infectious-disease research at Tampa General Hospital’s Global Emerging Diseases Institute, told me.

    “If you’re past three months [after vaccination or infection], you don’t want to rely on you having a BA.5 infection, because BQ.1.1 still can hit you,” said Eric Topol, chair of innovative medicine at Scripps Research in La Jolla, Calif.

    Here are answers to some common questions about COVID.

    1. What’s the difference between this booster and the shots that were available last year? 

    The earlier booster shots were simply additional, smaller doses of the original vaccine. But now there are two bivalent COVID-19 boosters available in the U.S.: Moderna’s
    MRNA,
    +1.61%
    MRNA-1273.222 and the BNT162b2 Bivalent from BioNTech
    BNTX,
    +0.20%
    and Pfizer
    PFE,
    +1.87%    .
     

    Both shots are designed to protect against the original strain of the virus in addition to the BA.4 and BA.5 omicron subvariants. The bivalent boosters were designed to better protect people against the forms of the virus that are currently circulating, as well as future variants. It’s a similar approach to the way influenza strains are selected for flu shots every year. 

    “It’s the same exact mRNA technology [as the original vaccine], but each dose now has half of the [original] variant,” said Jennifer Beam Dowd, an epidemiologist and professor of demography and population health at the University of Oxford in the U.K.

    In June of this year, the U.S. Food and Drug Administration asked drugmakers to design the next generation of COVID boosters using this formula. (In Europe, regulators took a slightly different approach, first opting for bivalent boosters that equally protect against the original virus and the BA.1 subvariant of omicron before adding a recommendation for the same bivalent formula that’s being used in the U.S.) 

    “Part of the rationale for keeping the old version and BA.4/BA.5 is that if you put all your eggs in the basket, as far as BA.4/BA.5, then the virus will change to turn into more like the original version,” said Tampa General Hospital’s Kim. “It’s hedging your bets.”

    Up until last week, BA.5 had been the dominant variant in the U.S. But as of Friday, BQ.1 and BQ.1.1, which are sublineages of BA.5, now make up the majority of new infections in the U.S., according to the Centers for Disease Control and Prevention. 

    This isn’t all bad news. BQ.1.1 is closely related to BA.5, according to Dowd, and that means many of the protective qualities of the bivalent booster will also guard against the new variants. 

    2. What does the science say about the new boosters?

    There is preliminary data about both bivalent boosters that appears to indicate they work against BQ.1.1 as well as BA.5. However, scientists and physicians say they are still waiting to see peer-reviewed research from the clinical trials to fully gauge the effectiveness of both shots.

    • Moderna’s booster: Early clinical data shows that Moderna’s bivalent booster produced a 5- to 6-fold increase in neutralizing antibodies against the BA.4 and BA.5 variants in about 500 adults who were previously vaccinated and boosted, according to a Nov. 14 news release. The Phase 2/3 clinical trial compared the new booster’s response against the company’s original booster. Moderna also said that the bivalent shot increased antibodies protecting against BQ.1.1, though not as much as it did against BA.4 and BA.5, based on an analysis of about 40 participants in the same study.

    “It’s not orders of magnitude more protection — but at least 5- to 6-fold more protection against BA.5, that’s good,” Topol said.

    • BioNTech and Pfizer’s booster: In a preprint published Nov. 17, the two companies said their bivalent booster led to an 8.7-fold increase in neutralizing antibodies against BQ.1.1 after 30 days, compared with the original booster’s 1.8-fold increase in antibodies against the same subvariant. The study assessed the immune responses in adults 55 years or older who had been previously vaccinated and boosted, regardless of infection history. 

    3. What if I had COVID this year? Does it matter when I get the booster?

    Most experts interviewed for this story say immunity can last anywhere from three to six months, though the official CDC recommendation is that the bivalent boosters should be given three months after a COVID infection or two months after an individual’s last shot. 

    “We used to say, just go ahead and get vaccinated as soon as you recover,” Dowd said. “But there has been subsequent evidence that suggests it’s a little better to probably wait at least three months. Not because it’s harmful to get it sooner, but you really won’t be getting much of the benefit of that boost. You reach a ceiling.”

    There are other considerations, as well. The timing of your last infection does matter if you have an idea what variants were circulating when you got sick. If you had an omicron infection last winter, you’re probably due for a booster. If you got sick within the past month or so, presumably with BA.5 or one of its subvariants, you may want to wait a month or two.  

    “As good as the vaccine is and as good as post-infection protection is, the immunity and protection wanes over time,” Dr. Anthony Fauci, chief medical advisor to President Joe Biden, told journalists at a White House briefing on Tuesday.

    You also have to assess your underlying immune status, whether you have medical conditions that put you at higher risk for severe disease, and how concerned you are about long COVID.

    “Most of the deaths that we’ll see from COVID could have been prevented if people stayed up to date with their boosters,” said the University of California’s Wachter. “And many cases of long COVID could [also] have been prevented if people stayed up to date with their boosters.”

    Finally, if you’re planning to spend Christmas with family or take a trip at the end of December, remember that it takes a few weeks to build up antibodies from the new shots. 

    4. Do I really need to get a booster if I’m young and healthy?

    We are long past the stage in the pandemic when the approach to vaccination was one size fits all, and not all medical experts think that people who are young and healthy need a booster right now.

    Dowd said that people who are “younger and in good health” can wait up to six months after a previous infection to get another shot.

    “If we go by the CDC data or the U.K. data, the people who seem to benefit from the boost fall into three categories: people who are immunocompromised, people who are elderly — mostly over 75 — and people who have high-risk medical conditions,” said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.  

    It’s unclear whether that thinking has influenced people’s decisions about whether to get a booster. But the bivalent shots have been available to children older than 5 years old and all adults in the U.S. for months, and that availability hasn’t led to much interest.

    “It’s for the same reason that 19,500 people pour into Wells Fargo Center [in Philadelphia] to watch the Sixers play, screaming their heads off, without a mask on,” Offit said. “They don’t feel compelled to get a booster dose.”

    That may be due in part to the fact that COVID hospitalizations and deaths have largely remained stable. There is no longer the kind of urgency that drove people to book appointments for the original vaccine or to wear masks. With the annual peak in COVID cases occurring during the first two weeks of January in 2021 and 2022, the question now is: Will that comfort level change as we get further into winter and the holiday season?

    “People want [a booster] to be like flipping a switch, like I’m 100% protected or not,” Dowd said, “but we know from the first couple of years that when the vaccine is well matched to the variants, which the BA.5 is a decent match right now, it really lowers transmission substantially and your chances of getting infected at all. We should take advantage of that.”

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  • All eyes on China as Apple and Foxconn outline zero-COVID issues. Meanwhile, cases are rising again in the U.S.

    All eyes on China as Apple and Foxconn outline zero-COVID issues. Meanwhile, cases are rising again in the U.S.

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    China’s strict zero-COVID policy was making headlines Monday after Apple and iPhone manufacturer Foxconn said over the weekend that restrictions are crimping production and will delay shipments of the high-end iPhone 14.

    “We continue to see strong demand for iPhone 14 Pro and iPhone 14 Pro Max models,” Apple
    AAPL,
    -0.82%
    announced in a Sunday evening press release. “However, we now expect lower iPhone 14 Pro and iPhone 14 Pro Max shipments than we previously anticipated and customers will experience longer wait times to receive their new products.” 

    Also read: Will Apple’s latest production issues destroy demand?

    Foxconn, meanwhile, which trades as Hon Hai Precision Industry Co.
    2317,
    -0.50%    ,
    lowered its fourth-quarter guidance and said anti-COVID measures were affecting some of its operations in Zhengzhou, China, as Dow Jones Newswires reported.

    Foxconn said that the Henan provincial government had made it clear that it would fully support the company. Foxconn’s most advanced iPhone plant, located in the provincial capital of Zhengzhou, has been battling a COVID outbreak.

    Foxconn said it is working with the government to halt the outbreak and resume production at full capacity as quickly as possible.

    Workers at the world’s biggest assembly site for Apple’s iPhones walked out last week as Foxconn struggled to contain a COVID-19 outbreak. The chaos highlighted the tension between Beijing’s rigid pandemic controls and the need to keep production on track. Photo: Hangpai Xinyang/Associated Press

    Investors have been closely watching China for signs that its government would start to lift the tough pandemic restrictions that have been in place for almost three years. The Wall Street Journal reported Monday that the country’s leaders are considering steps but have not yet set a timeline.

    Chinese  officials have become concerned about the costs of their zero-tolerance approach to COVID, which has resulted in lockdowns of cities and whole provinces, crushing business activity and confining hundreds of millions of people to their homes for weeks and sometimes months on end.

    But they are weighing those concerns against the potential costs of reopening on public health and on support for the Communist Party. On Saturday, officials from China’s National Health Commission again reaffirmed their commitment to a firm zero-COVID strategy, which they described as essential to “protect people’s lives.”

    Still, there are plans in Beijing to further cut the number of days incoming travelers must quarantine in hotels from 10 to seven, followed by three days of home monitoring, the paper reported, citing people involved in the discussions.

    And officials have told retail businesses that they intend to reduce the frequency of PCR testing as soon as this month, partly because of the cost.

    In the U.S., known cases of COVID and hospitalizations are climbing again for the first time in a few months.

    The daily average for new cases stood at 39,954 on Sunday, according to a New York Times tracker, up 6% compared with two weeks ago. But cases are sharply higher in several states, led by Nevada, where they are up 96% from two weeks ago, followed by Tennessee, where they are up 69%; Louisiana, where they are up 68%; Utah, where they have climbed 61%; and New Mexico, where they are up 56%.

    Cases are climbing in 30 states and in Washington, D.C.

    The daily average for hospitalizations was up 2% to 27,419, while the daily average for deaths was down 11% to 320.

    Physicians are reporting high numbers of respiratory illnesses like RSV and the flu earlier than the typical winter peak. WSJ’s Brianna Abbott explains what the early surge means for the winter months. Photo illustration: Kaitlyn Wang

    The Centers for Disease Control and Prevention said the BQ.1 and BQ.1.1 variants accounted for 35.3% of new cases in the week through Nov. 5, up from 27.1% a week ago.

    The two variants accounted for 52.3% of all cases in the New York region, which includes New Jersey, Puerto Rico and the Virgin Islands, up from 42.5% the previous week. That was more than the BA.5 omicron subvariant, which accounted for 24.9% of new cases in the New York area in the latest week.

    The BA.5 omicron subvariant accounted for 39.2% of all U.S. cases, the data show.

    BQ.1 and BQ.1.1 were still lumped in with BA.5 variant data as recently as three weeks ago, because at that time, their numbers were too small to break out. BQ.1 was first identified by researchers in early September and has been found in the U.K. and Germany, among other places. 

    Coronavirus Update: MarketWatch’s daily roundup has been curating and reporting all the latest developments every weekday since the coronavirus pandemic began

    Other COVID-19 news you should know about:

    • BioNTEch SE
    BNTX,
    +2.84%    ,
    the German biotech that has partnered with Pfizer
    PFE,
    -0.53%
    on a COVID vaccine, posted earnings early Monday, showing a roughly 50% drop in profit that sent its stock lower, despite beating consensus estimates. The Mainz-based company said it had invoiced about 300 million doses of its bivalent vaccine, which targets the omicron variant as well as the original virus. The company chalked up €564.5 million ($563.9 million) in direct COVID vaccine sales in the quarter, down from €1.351 billion a year ago. BioNTech raised the lower end of its full-year COVID vaccine revenue range to €16 billion to €17 billion, from a previous €13 billion to €17 billion.

    • Thousands of runners took to the streets of the Chinese capital on Sunday for the return of Beijing’s annual marathon after a two-year hiatus, the Associated Press reported. However, the good news was offset by anger about another death related to COVID restrictions, this time of a 55-year-old woman in a sealed building. An investigation report released Sunday in Hohhot, the capital of China’s Inner Mongolia region, blamed property management and community staff for not acting quickly enough to prevent the death of the woman after being told she had suicidal tendencies.

    • The U.S. flu season is off to an unusually fast start, contributing to an autumn mix of viruses that have patients filling hospitals’ and physicians’ waiting rooms, the AP reported separately. Reports of flu are already high in 17 states, and the hospitalization rate hasn’t been this high this early since the 2009 swine flu pandemic, according to the Centers for Disease Control and Prevention. So far, there have been an estimated 730 flu deaths, including at least two children. The winter flu season usually ramps up in December or January.

    Here’s what the numbers say:

    The global tally of confirmed cases of COVID-19 topped 632.6 million on Monday, while the death toll rose above 6.60 million, according to data aggregated by Johns Hopkins University.

    The U.S. leads the world with 97.7 million cases and 1,072,598 fatalities.

    The Centers for Disease Control and Prevention’s tracker shows that 227.3 million people living in the U.S., equal to 68.5% of the total population, are fully vaccinated, meaning they have had their primary shots.

    So far, just 26.3 million Americans have had the updated COVID booster that targets the original virus and the omicron variants, equal to 8.4% of the overall population.

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  • New omicron subvariants accounted for more cases in New York region in latest week than BA.5, CDC data shows

    New omicron subvariants accounted for more cases in New York region in latest week than BA.5, CDC data shows

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    The omicron sublineages named BQ.1 and BQ.1.1 continued to spread in the U.S. in the week through Oct. 29, accounting for 27.1% of new cases nationwide, according to Centers for Disease Control and Prevention data.

    The two accounted for 42.5% of all cases in the New York region, which includes New Jersey, Puerto Rico and the Virgin Islands, up from 37% the previous week. That was more than the BA.5 omicron subvariant, which accounted for 35.7% of new cases in the New York area in the latest week.

    The BA.5 omicron subvariant accounted for 49.6% of all U.S. cases, the data show.

    BQ.1 and BQ.1.1 were included in BA.5 variant data as recently as three weeks ago, because their numbers were too small to break out. BQ.1 was first identified by researchers in early September and has been found in the U.K. and Germany, among other places.

    Last week, the World Health Organization said that BQ.1 and another sublineage dubbed XBB do not appear to have immune-escape mutations that warrant being designated as variants of concern. However, BA.5 is still a variant of concern that is being closely monitored, said a statement from the WHO’s Technical Advisory Group on SARS-CoV-2 Virus Evolution.

    Workers in a manufacturing facility that assemble Apple Inc.’s
    AAPL,
    -1.66%
    iPhone in the Chinese city of Zhengzhou appear to have left to avoid COVID-19 curbs, with many traveling on foot for days after an unknown number of employees were quarantined in the facility after a virus outbreak, the Associated Press reported. 

    Videos circulating on Chinese social media platforms showed people who are allegedly Foxconn workers climbing over fences and carrying their belongings down a road.

    Separately, visitors to Shanghai Disneyland were left stranded at the park on Monday after the resort halted operations to comply with COVID-19 restrictions amid a new outbreak of the virus.

    In the U.S., known cases of COVID are continuing to ease and now stand at their lowest level since mid-April, although the true tally is likely higher given how many people overall are testing at home, where data are not being collected.

    The daily average for new cases stood at 36,869 on Sunday, according to a New York Times tracker, down 2% from two weeks ago. The daily average for hospitalizations was up 3% to 27,415, while the daily average for deaths was down 6% to 352. 

    Coronavirus Update: MarketWatch’s daily roundup has been curating and reporting all the latest developments every weekday since the coronavirus pandemic began

    Other COVID-19 news you should know about:

    • With a downcast earnings season passing the halfway mark, results from financial-technology companies and vaccine makers will arrive this week amid questions about consumer spending as well as demand for COVID drugs, MarketWatch’s Bill Peters reported. Pfizer Inc.
    PFE,
    -1.82%
    will report earnings on Tuesday, followed by Moderna Inc.
    MRNA,
    -0.47%
    on Thursday. Analysts will have their eye on the state of COVID-19 vaccine and treatment sales and on what executives are anticipating for the full year, as they prepare for a private market for COVID medications and as more people shrug off the pandemic. Pfizer executives, during a call last week, said they intended to charge between $110 and $130 for a single-dose vial of the vaccine for U.S. adults when government purchases end. But they said they believe anyone who has health insurance shouldn’t have to pay anything out of pocket.

    The FDA authorized newly modified COVID-19 boosters to target the latest versions of the omicron variant. But as WSJ’s Daniela Hernandez explains, a key part of the decision-making process was changed with these new shots. Photo: Laura Kammermann

    • A number of young children are being hospitalized because of respiratory syncytial virus, or RSV, and it’s happening at an unusual time of year and among older children than in years past, MarketWatch’s Jaimy Lee reported. COVID may be a contributing factor, in part because many children were not exposed to RSV last season and also because a prior COVID infection or exposure may change the way a baby’s immune system responds to RSV and may lead to more severe illness from an RSV infection, according to Asuncion Mejias, a principal investigator with the Center for Vaccines and Immunity at the Research Institute at Nationwide Children’s Hospital in Columbus, Ohio.

    • On Saturday, more than 3,000 people took part in the first Pride march in South Africa since the COVID pandemic , celebrating the LGBT community and defying a U.S. warning of a possible terror attack in the area, the AP reported. The U.S. government this week warned of a possible attack in the Sandton part of Johannesburg, where the march took place. The South African government expressed concern that the U.S. had not shared enough information to give credibility to the alleged threat. Police said all measures had been taken to ensure safety in the area.

    Here’s what the numbers say:

    The global tally of confirmed cases of COVID-19 topped 630.2 million on Monday, while the death toll rose above 6.58 million, according to data aggregated by Johns Hopkins University.

    The U.S. leads the world with 97.5 million cases and 1,070,266 fatalities.

    The Centers for Disease Control and Prevention’s tracker shows that 226.9 million people living in the U.S., equal to 68.4% of the total population, are fully vaccinated, meaning they have had their primary shots.

    So far, just 22.8 million Americans have had the updated COVID booster that targets the original virus and the omicron variants, equal to 7.3% of the overall population.

     

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  • New COVID Subvariants Rising: How Concerned Should We Be?

    New COVID Subvariants Rising: How Concerned Should We Be?

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    Oct. 18, 2022 – Move over, BA.5. There are some new kids in town and no one is sure yet if we should be worried.

    But there is concern that COVID-19 virus subvariants BQ.1 and BQ1.1 will become a major threat in the U.S. and that XBB could alter the COVID picture globally. 

    At this point, infectious disease experts have only predictions. 

    A worst-case scenario would be a surge of one or more strains that evade our immune protections just as a predicted fall and winter surge hits the United States.

    At the same time, we know a lot more about SARS-CoV-2 than we did when COVID first became a household name. And despite some widespread pandemic fatigue, people know the basics of protection at this point should it be necessary – gulp — to go back to masking, obsessive handwashing, and keeping a safe distance from our neighbors. 

    The most recent CDC data shows BQ.1 and BQ.1.1 subvariants have grown to about 12% of circulating virus strains in the U.S., doubling in the past week, compared to only 1% a month ago. 

    “I don’t think we should panic, but I am little concerned,” says Hannah Newman, MPH. “I would not be surprised to see a surge of infections as we enter respiratory season and in light of the emergence of new subvariants.”

    “We are already seeing COVID on the rise in some European countries, in part due to these circulating subvariants,” adds Newman, director of infection prevention at Lenox Hill Hospital in New York City.

    The emergence of BQ.1 and BQ1.1 in the U.S. and XBB globally is not completely unexpected, says Amesh Adalja, MD. “This is a virus that’s going to continue to evolve to become more able to infect us, and so these variants should not be surprising.”

    Better Protection From Bivalent Boosters?

    One unanswered question is how well the new bivalent mRNA vaccine boosters could work against these specific subvariants.

    “The new booster is a better match to what is circulating than the old booster, but we don’t know what that means in real life,” says Adalja, senior scholar at the Johns Hopkins Center for Health Security in Baltimore. It’s difficult to answer that question because no one is planning to compare the two booster types in a clinical trial. 

    Newman is more optimistic. “A bit of good news is that the bivalent COVID booster will provide some protection against these strains, and we really just need people to roll up their sleeves and receive it,” she says.

    The XBB subvariant, currently surging in Singapore, could be a cautionary tale for the U.S., says Eric Topol, MD, founder and director of the Scripps Research Translational Institute in La Jolla, CA, and executive editor of Medscape, WebMD’s sister site for medical professionals.

    For example, prior to XBB emerging, the COVID reinfection rate in Singapore was 5%. Now it is 17%. “So that means a lot of people who had an infection are going to get hit again,” Topol says. Furthermore, Singapore reports 92% of their population is vaccinated and their uptake of boosters is twice the U.S. rate. 

    “And despite that, they have a very significant wave, which is going to be bigger than anything except the original Omicron,” he says. 

    Fewer Treatment Options

    The drug Paxlovid will continue to play an important role in preventing more severe COVID outcomes, Adalja says. This is because “Paxlovid works on a whole different area of the virus, different from these mutations that get around immunity.”

    In contrast, evidence so far suggests that monoclonal antibody therapies will not be effective against these new subvariants. “The ability to evade monoclonal antibody treatments is a concern for me, because it could leave our most vulnerable open to more severe outcomes,” Newman says. 

    “If strains are able to escape antibody immunity and monoclonal antibodies aren’t effective, we can expect to see more severe symptoms in high-risk individuals who would otherwise benefit from these treatments,” she says. 

    In particular, the monoclonal antibody bebtelovimab and the monoclonal combination Evusheld may be less effective against the new subvariants, Adalja says. 

    Does Recently Infected Mean Protected?

    Most people who had COVID-19 within the past 3 to 6 months will likely have antibody levels to protect them, at least against severe disease, Adalja says. That’s one reason U.S. officials suggest people wait 3 months to get a booster after infection and Canadian officials recommend 6 months. 

    “You’re certainly going to be protected against severe disease,” Adalja adds. “How long you’re going to be protected, how immune-evasive these variants are, and the degree to which their immune-evasiveness reaches, that’s going to determine if you’re susceptible to infection.”

    After natural immunity wanes, these immune-evasive variants could infect someone again, but they are more likely to experience a mild case, Adalja says. 

    Newman agrees. “There is a level of natural immunity that is gained with recent infection. However, it wanes over time. Staying up to date with vaccinations and boosters is the most proven and effective way to achieve uniform protection.”

    What is known is that COVID is likely to be with us for a while, Adalja says. “I was someone who was very forthright about this, that this was never going away. I wasn’t thinking this is like a hurricane that is going to leave one day. I thought this is a new normal,” he says.

    He adds we’re making progress on COVID being managed as an outpatient illness.

    The Future Is Uncertain

    It’s difficult to predict exactly what will happen this fall and winter based on current evidence, says Gregory Poland, MD, an internal medicine doctor at Mayo Clinic in Rochester, MN. 

    Throughout the pandemic, however, what happens in the U.K. and India has consistently signaled what happens in the U.S. And these other countries are experiencing “significant upticks in the subvariants,” he says. 

    “Unfortunately, there is no crystal ball that will predict for sure what a future wave might look like at this moment,” Newman says. “It will really depend on whether a variant will outcompete other strains and the prevention measures taken.” 

    She is also concerned about a convergence of COVID and flu over the winter.

    “Prevention fatigue paired with upcoming holiday gatherings could be a potential for more superspreading events,” Newman says.

    One concern is the relatively low uptake of the bivalent boosters among Americans, Topol says. “This is going to be really bad because a few weeks from now, we will face a very significant wave.” 

    The relaxation of pandemic protection measures and the waning of immunity as more and more Americans go more than 6 months from their last immunization also are concerning, Topol says. “Our immunity wall is just developing more and more holes in it.”

    “We’ll see a wave even before the BQ1.1 really takes effect,” Topol predicts. “And then the two together could make for a very bad December or January.”

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  • Large number of U.S. COVID deaths could be prevented if patients would take Pfizer’s Paxlovid, White House coordinator warns

    Large number of U.S. COVID deaths could be prevented if patients would take Pfizer’s Paxlovid, White House coordinator warns

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    A large number of U.S. COVID deaths could be prevented if patients would take Paxlovid, the antiviral developed by Pfizer
    PFE,
    -1.79%
    that helps reduce the risk of hospitalization and death, according to White House COVID coordinator Dr. Ashish Jha.

    Jha told the New York Times that the average daily death count could be reduced to about 50 a day from 400 currently, if every American aged 50 and above that tests positive for the virus took a course of either Paxlovid or used monoclonal antibodies.

     “The public doesn’t seem to understand that the evidence around hospitalization and deaths is really powerful,” Dr. Robert Wachter, chair of medicine at the University of California in San Francisco told the paper.

    The issue seems to be a combination of worry about certain issues that Paxlovid can cause, including a strange metallic taste and the potential for “rebound COVID,” where patients quickly become reinfected after the five-day course of pills has been completed. That happened to both President Joe Biden and first lady Jill Biden recently.

    The second reason is that many Americans — and Republicans, in particular — have refused to take COVID seriously and are not willing to take steps to reduce its impact. Trials have found Paxlovid to be effective across all age groups, but mostly among older patients. But as the COVID death rate for people under 50 is already close to zero, reducing it in a statistically significant way is difficult.

    See now: CDC scraps travel health notices as countries slow testing, and study confirms Republican-leaning counties suffered more COVID deaths than Democrat-leaning ones

    “I think almost everybody benefits from Paxlovid,” Jha said. “For some people, the benefit is tiny. For others, the benefit is massive.” 

    Yet a smaller share of 80-year-olds with COVID in the U.S. is taking it than 45-year-olds, Jha said citing data he has seen.

    From the CDC: Stay Up to Date with COVID-19 Vaccines Including Boosters

    The news comes as U.S. known cases of COVID are continuing to ease and now stand at their lowest level since late April, although the true tally is likely higher given how many people are testing at home, with data generally not being collected.

    The daily average for new cases stood at 41,605 on Thursday, according to a New York Times tracker, down 25% from two weeks ago. Cases are declining in northeastern states including New York and New Jersey, while cases are rising in the western states Montana, Washington and Oregon.

    The daily average for hospitalizations was down 11% at 27,021, while the daily average for deaths is down 8% to 391.

    Coronavirus Update: MarketWatch’s daily roundup has been curating and reporting all the latest developments every weekday since the coronavirus pandemic began

    Other COVID-19 news you should know about:

    • Molnupiravir, the COVID pill developed by Merck
    MRK,
    +0.18%
    and privately held Ridgeback Therapeutics, produced mixed results in two recent studies, the companies said Thursday. Early data from a trial conducted in the U.K. by the University of Oxford found no evidence of a difference when molnupiravir was added to usual care in reducing hospitalizations and death. A second study conducted in Israel found a benefit in patients who were 65 and older, but no benefit for 40- to 60-year-olds.

    • Homelessness is surging in the U.S. again as pandemic programs that halted evictions are being phased out, the Associated Press reported. The overall number of homeless people in a federal report to be released in the coming months is expected to be higher than the 580,000 unhoused before the coronavirus outbreak, the National Alliance to End Homelessness said. The AP tallied results from city-by-city surveys conducted earlier this year and found the number of people without homes is up overall compared with 2020 in areas reporting results so far.

    • The idea was to have China in stable and tip-top shape when thousands of delegates gather in Beijing to usher in a historic third term in power for Xi Jinping, BBC News reported. However, the coronavirus is not playing nicely. In recent weeks, tens of millions of people have again been confined to their homes in lockdowns across 60 towns and cities, and this is bringing political pressure on the man who has become the most powerful Chinese figure since the first communist-era leader, Mao Zedong.

    Covid-19 lockdowns, corruption crackdowns and more have put China’s economy on a potential crash course. WSJ’s Dion Rabouin explains how China’s economic downturn could harm the U.S. and the rest of the world. Illustration: David Fang

    • A new COVID-19 wave appears to be brewing in Europe as cooler weather arrives, with public health experts warning that vaccine fatigue and confusion over types of available vaccines will likely limit booster uptake, Reuters reported. The omicron subvariants BA.4 and BA.5 that dominated this summer are still behind the majority of infections, but newer omicron subvariants are gaining ground. Hundreds of new forms of omicron are being tracked by scientists, the World Health Organization said this week.

    Here’s what the numbers say:

    The global tally of confirmed cases of COVID-19 topped 620.5 million on Friday, while the death toll rose above 6.55 million, according to data aggregated by Johns Hopkins University.

    The U.S. leads the world with 96.6 million cases and 1,062,130 fatalities.

    The Centers for Disease Control and Prevention’s tracker shows that 225.8 million people living in the U.S., equal to 68% of the total population, are fully vaccinated, meaning they have had their primary shots. Just 110.5 million have had a booster, equal to 48.9% of the vaccinated population, and 24.8 million of those who are eligible for a second booster have had one, equal to 37.9% of those who received a first booster.

    Some 11.5 million people have had a shot of the new bivalent booster that targets the new omicron subvariants.

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  • The Pandemic Isn’t Over, Fauci Says, but It’s Getting Better

    The Pandemic Isn’t Over, Fauci Says, but It’s Getting Better

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    Oct. 5, 2022 – Anthony Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to President Joe Biden, said this week that he isn’t ready to say that we are nearing the end of COVID-19. But as a country, we seem to be on the right track, Fauci said during a virtual conversation for the University of Southern California’s Annenberg’s Center for Health Journalism. 

    This comes just 2 weeks after Biden said that “the pandemic is over” on CBS’s 60 Minutes. Last month, the World Health Organization also said the end of COVID is in sight. 

    “It’s obvious that [the president’s statement] could be problematic because people would interpret it as ‘it’s completely over and we’re done for good,’ which is not the case, no doubt about that,” Fauci said. 

    Instead, he interpreted the comment as a reference to the country’s improvement in case numbers and death rates over the last several months — that the worst is likely behind us. 

    Fauci, who has been the subject of harsh criticism for his public messaging, chooses his words carefully, even with the promise of a brighter future ahead.

    “I think it would be cavalier to all of the sudden say we’re through with [COVID],” he said. “Because remember, we were going in the right direction in the summer of 2021, and along came Delta. Then in the winter, along came Omicron. And since then, we’ve had sublineages of Omicron.” 

    Especially as the winter months approach, Fauci said, precautions still need to be taken to reduce the chances of yet another spike. When asked about the precautions that he himself takes, Fauci explained that he still doesn’t go to indoor, sit-down dinners. He continues to attend receptions — noting that most of them are outdoors — without a mask on, but if he’s in an indoor setting “for a considerable period of time,” he keeps a mask on. 

    A large portion of the conversation also reflected on the lessons that can be learned from mixed messages delivered by public health experts, including Fauci, during both the COVID pandemic and the more recent developments in monkeypox. 

    “I have tried always to give the hard truth, but very often the hard truth is not heard under the circumstance under which it’s given,” Fauci said. He blames social media for the misrepresentation of public comments and the spread of misinformation for the overall lack of clarity that many have attributed to his and the CDC’s statements regarding COVID. 

    Fauci said that if he could go back and do certain things differently, he would. If he had the choice, he would have tried to be much more careful during the early months of the pandemic in underlining the uncertainty of the situation we were going through. 

    The major shortcoming the U.S. continues to face regarding the pandemic is the resistance to getting vaccinated and ultimately boosted for COVID, Fauci added. And when it comes to vaccines, he doesn’t see the message as polarizing. 

    “People say [I’m a] polarizing figure,” Fauci said. “Well, when I say we should get vaccinated because it saves lives, and someone says no, am I the polarizing figure? Or is the person who is saying something that’s completely untrue creating the polarization?” 

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