Daily Archives: June 22, 2022

In the last two years, COVID-19 has followed a predictable, if painful, pattern: When coronavirus transmission has rebounded, California has been flooded with new cases and hospitals have strained under a deluge of seriously ill patients, a distressing number of whom die.

But in a world awash in vaccines and treatments, and with healthcare providers armed with knowledge gleaned over the course of the pandemic, the latest wave isnt sticking to that script.

Despite wide circulation of the coronavirus the latest peak is the third-highest of the pandemic the impact on hospitals has been relatively minor. Even with the uptick in transmission, COVID-19 deaths have remained fairly low and stable.

And this has occurred even with officials largely eschewing new restrictions and mandates.

In some ways, thats what is supposed to happen: As health experts get better at identifying the coronavirus, vaccinating against it and treating the symptoms, new surges in cases shouldnt lead to excessive jumps in serious illnesses.

But todays environment is not necessarily tomorrows baseline. The coronavirus can mutate rapidly, potentially upending the public health landscape and meriting a different response.

The one thing that is predictable about COVID, in my mind, is that its unpredictable, said UCLA epidemiologist Dr. Robert Kim-Farley.

While its too soon to say for certain, there are signs the current wave is starting to recede. Over the weeklong period ending Thursday, California reported an average of just over 13,400 new cases per day down from the latest spikes high point of nearly 16,700 daily cases, according to data compiled by The Times.

By comparison, last summers Delta surge topped out at almost 14,400 new cases per day, on average.

And more than 8,300 coronavirus-positive patients were hospitalized statewide on some days at the height of Delta almost three times as many as during the most recent wave.

The difference in each surges impact on intensive care units has been even starker. During Delta, there were days with more than 2,000 coronavirus-positive patients in ICUs statewide. In the latest wave, however, that daily census has so far topped out at around 300.

That gap in hospitalizations illustrates how the pandemic has changed.

At the very beginning of the pandemic, we noted right away the game-changers were going to be vaccines, easy access to testing and therapeutics and now we have all those things, said Los Angeles County Public Health Director Barbara Ferrer.

It doesnt say the pandemics over. Thats not what weve accomplished, she stressed. What weve accomplished is weve reduced the risk, but we havent eliminated the risk.

And though hospitalizations have been lower, in the aggregate, during the latest wave, Ferrer noted that each infection still carries its own dangers not just severe illness, but the chance of long COVID, as well. Taking individual action to protect yourself, she said, carries the added benefit of helping safeguard those around you, including those at higher risk of serious symptoms or who work jobs that regularly bring them into contact with lots of people.

For me, it makes clear that layering in some protection is still the way to go while enjoying just about everything you want to enjoy, she said.

Californias most restrictive efforts to rein in the coronavirus ended almost exactly a year ago, when the state celebrated its economic reopening by scrapping virtually all restrictions that had long provided the backbone of its pandemic response.

Roughly a month later, with the then-novel Delta variant on the rampage, some parts of the state reinstituted mask mandates in hopes of blunting transmission.

Toward the end of the year, another new foe would arise: the Omicron variant. This highly transmissible strain brought unprecedented viral spread, sending case counts and hospitalizations soaring and prompting officials to reissue a statewide mask mandate for indoor public spaces.

The fury with which those two surges struck left some fearing, and others advocating for, the return of the stringent orders that restricted peoples movements and shut down broad swaths of the economy. However, both waves came and went without California officials resorting to that option.

And during this latest wave fueled by an alphanumeric soup of Omicron subvariants, including BA.2 and BA.2.12.1 such aggressive action seems off the table.

I think, deep in my heart, unless we see a new variant that evades our current vaccine protection, we are not going to need to go back to the more drastic tools we had to use early on the pandemic when we didnt have vaccines, when we didnt have access to testing, when we didnt have therapeutics, Ferrer said in an interview.

During both Delta and the initial Omicron surge, California carefully evaluated the unique characteristics of each variant to determine how to best handle the changes in the behavior of the virus, and used the lessons of the last two years to approach mitigation and adaptation measures through effective and timely strategies, according to the state Department of Public Health.

These lessons and experiences informed our approach to manage each surge and variant. In addition, there were more tools available for disease control during each subsequent surge, including the Delta and Omicron surges, the department wrote in response to an inquiry from The Times. So, rather than using the same mitigation strategies that had been used previously, CDPH focused on vaccines, masks, tests, quarantine, improving ventilation and new therapeutics.

The state has also eschewed its previous practice of setting specific thresholds to tighten or loosen restrictions in favor of what it calls the SMARTER plan which focuses on preparedness and applying lessons learned to better armor California against future surges or new variants.

Each surge and each variant brings with it unique characteristics relative to our neighborhoods and communities specific conditions, the Department of Public Health said in its statement to The Times.

Chief among those, the department added, are getting vaccinated and boosted when eligible and properly wearing high-quality face masks when warranted.

The U.S. Centers for Disease Control and Prevention recommends public indoor masking in counties that have a high COVID-19 community level, the worst on the agencys three-tier scale. That category indicates not only significant community transmission but also that hospital systems may grow strained by coronavirus-positive patients.

We certainly are not at a level at these numbers where you would say, OK, its now, quote, endemic, and we just go about business as usual, Kim-Farley said. I think, though, it is probably indicative of what we might see in the future going forward, that we will see low levels in the community, people can relax and let their guard down a bit. But there will then be other times when we might see surges coming in. ... Thats a time when we mask up again. So I think there may be some on and off a little bit, and hopefully these surges become fewer, more spread out and less intense as we go forward.

As of Thursday, 19 California counties were in the high community level Alameda, Butte, Contra Costa, Del Norte, El Dorado, Fresno, Kings, Lake, Madera, Marin, Monterey, Napa, Placer, Sacramento, San Benito, Santa Clara, Solano, Sonoma and Yolo. However, only Alameda County has reinstituted a public indoor mask mandate.

Ferrer has said Los Angeles County would do the same should it fall in the high COVID-19 community level for two consecutive weeks.

L.A. County, like the state as a whole, continues to strongly recommend residents wear masks indoors in public. But Ferrer acknowledged its a very tough needle to thread and said an unintended consequence of years of health orders might be that people dont grasp the urgency of a recommendation.

People are now assuming if we dont issue orders and require safety measures then its because its not essential, and thats not what we meant, she said. We have always benefited from having folks that are able to listen, ask questions and then, for the most part, align with the safety measures. And I think because its been such a long duration, because theres so much fatigue at this point and desperation in some senses to get back to customary practices, people are waiting for that order before they go ahead and take that sensible precaution.

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This new California coronavirus wave isn't sticking to the script: Big spread, less illness - Los Angeles Times

With recent UK data suggesting that the BA.4 and BA.5 Covid variants are kicking off a new wave of infections, experts answer the key questions about reinfection and prevention.

Though rare at the start of the pandemic, reinfections have become increasingly common as the months and years wear on particularly since the arrival of Omicron, which prompted a 15-fold increase in the rate of reinfections, data from the Office for National Statistics suggests.

In part, this is because of a decline in protective antibodies triggered by infection and/or vaccination over time, but the virus has also evolved to evade some of these immune defences, making reinfection more likely.

The original Omicron BA.1 variant was itself massively immune-evasive, causing a huge breakthrough caseload, even in the vaccinated, said Danny Altmann, a professor of immunology at Imperial College London. It is also poorly immunogenic, which means that catching it offers little extra protection against catching it again. On top of that, theres now further evidence of the very marginal ability of prior Omicron to prime any immune memory for BA.4 or 5, the sub-variants that seem to be driving the latest wave of infections.

The virus has also evolved to become more transmissible, meaning even fleeting exposure to an infected person means you may inhale enough viral particles to become infected yourself.

There are definitely a lot of people who got Covid at the start of the year who are getting it again, including some with BA.4/5 who had BA.1/2 just four months ago, who thought they would be protected, said Prof Tim Spector, who leads the Zoe Health Study (formerly known as the Zoe Covid Study).

We still dont have enough data to work out exactly when the susceptible periods [for reinfection] are, which is one reason why we need people to keep logging their symptoms. We do know its still quite rare within three months, and it used to also be rare within six months, but thats not the case any more.

According to unpublished data from Denmark, which looked at reinfections with the BA.2 Omicron sub-variant within 60 days of catching BA.1, such reinfections were most common among young, unvaccinated people with mild disease. Other studies have similarly suggested that Covid-19 vaccination provides a substantial added layer of protection against reinfection by boosting peoples immune responses.

However, Omicron infection in itself appears to be a poor booster of immunity, meaning that if you were infected during earlier pandemic waves, your immune response is unlikely to have been strengthened by catching it again earlier this year.

In general, infections should be less severe the second, third or fourth time around, because people should have some residual immunity particularly if theyve also been vaccinated, which would further raise their levels of immune protection. However, there are always exceptions to this. Anecdotally, some people are getting it for longer this time around than they did the last time, Spector said.

It is also too early to know about the risk of long Covid associated with BA.4/5, he added.

As the UK heads into a period dominated by BA.4 and 5, the potential for reinfection seems high. Were in quite a serious situation due to a convergence of factors: a country where a moderately successful third booster campaign is now long past, with immunity waned and successive large waves of Omicron through to the emerging dominance of BA.4/5, said Altmann.

The bottom line is that we should all consider ourselves essentially unprotected, except perhaps from intensive care unit admission and death, and then, as before, with the risks increasing with age.

Face masks and ventilation continue to provide important additional layers of protection especially in crowded settings. I still wear a mask, but not a cheap mask I wear a proper FFP2 or 3 mask, said Spector. These new variants are still very much airborne and you need an even smaller amount to get infected, so I think a mask is definitely a good idea when as many as one in 30 people have it again.

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Covid reinfections in the UK: how likely are you to catch coronavirus again? - The Guardian

THE HAGUE, NETHERLANDS: Director of the Dutch RIVM (Center for Infectious Disease Control) Jaap van ... [+] Dissel. (Photo by Niels Wenstedt/BSR Agency/Getty Images)

The Dutch RIVM (Center for Infectious Disease Control - CDC counterpart in the Netherlands) is conducting a long-term study on long Covid. The agency released interim results on Tuesday, June 21st, which show that approximately 50% of patients enrolled in a large ongoing study still have one or more symptoms three months after becoming infected with the coronavirus SARS-CoV-2. In addition, among adults under the age of 65, researchers detected no difference between those who are vaccinated and unvaccinated in terms of most long Covid symptoms, except for sense of smell and taste. Vaccinated adults reported less loss of smell and taste than than those who were unvaccinated.

Long Covid is a hotly debated subject. In particular, some experts have worried about lack of clarity around long Covids characterization, and causal inferences which arent necessarily well established. And so, the key questions become, what exactly are long Covid symptoms, and how likely is it that a coronavirus infection caused them?

There isnt a firm consensus on long Covids precise definition, and causality is still being analyzed by clinical researchers. Yet, since fairly early in the pandemic, a broad set of symptoms we now refer to as long Covid the literature used to label sufferers as long-haulers has been very well documented. The Dutch RIVM, in particular, has meticulously collected data on long Covid, both to characterize the syndrome and attempt to figure out whats causing symptoms.

Its evident that many people who contract the coronavirus struggle for months with lingering Covid-19 symptoms which can be debilitating. Patients exhibit shortness of breath, extreme fatigue, intermittent fevers, cough, concentration issues, chest pressure, headaches, and heart palpitations, among other symptoms.

There is a very wide range in estimates of long Covid prevalence among those who recover from a symptomatic coronavirus infection. A University of California Davis study found that 10% of Covid-19 patients suffer from long Covid symptoms. In a CDC-sponsored study, it was estimated that around 20% of adults under 65 who recover from Covid-19 experience at least one health condition that could be considered long Covid. Here, CDC researchers identified persistent health problems in different organs of the body, including the heart, lungs, and kidneys. Yet another study suggested that 30% develop at least one long Covid symptom over time.

Fatigue, shortness of breath, brain fog, and loss of smell are particularly common long-term effects of Covid-19. This is apparent from the studies mentioned above, but also the interim results of the RIVM's study released on June 21st. For some, symptoms are relatively minor. For others, however, they can be disabling and life-altering.

The preliminary findings from the RIVM investigation refer to data gathered from May to December 2021. As such, they concern people who became infected with the Alpha or Delta variants of the coronavirus.

The results derive from a health survey questionnaire taken by a total of 14,572 participants. 9,166 people took the survey shortly after testing positive for SARS-CoV-2. The control group consisted of 5,406 people who tested negative for the coronavirus and applied to take part in the survey or were invited by letter from the general population. RIVM requested that all survey participants fill out questionnaires about their health at intervals of three months.

Around 33% of study participants who became infected with coronavirus still suffer from fatigue three months later. Persistent shortness of breath occurs in 16% of respondents, 15% have ongoing brain fog, and 12% have chronic loss of their normal sense of smell and taste for at least three months after their initial infection.

Whats striking is that these reported symptoms are 1.5 times more common among Covid-19 patients than among those who have had other (non Covid-19) respiratory infections.

The Dutch research also demonstrates that fully vaccinated people under 65 years of age who contracted coronavirus have fewer problems with smell and taste after three months. For other symptoms, however, no difference was found between vaccinated and unvaccinated people.

The RIVM will continue to follow up with study participants for at least one year. And, the agency will eventually include results from those who became infected with the Omicron variant.

The Dutch investigation not only shows that a large percentage of Covid-19 patients continue to have symptoms after recovery from the acute, initial coronavirus infection, but also suggests that the constellation of long Covid symptoms is much more common in these patients than in people in the general population, and in patients who experienced other (non Covid-19) respiratory infections.

While there continue to challenges regarding how to precisely define long Covid and how to determine cause and effect, ignoring or downplaying the long Covid syndrome isnt going to make it go away. Its vital that more research is carried out to determine causality and to find therapies that work for long-haulers.

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Dutch Research On Long Covid Shows 50% Of Study Participants Have 1 Or More Symptoms 3 Months After Becoming Infected With Coronavirus - Forbes

Mike Stucka USA TODAY NETWORK| The Gaston Gazette

North Carolina reported 24,464 new cases of coronavirus in the week ending Sunday, down 8.7% from the previous week. The previous week had 26,785 new cases of the virus that causes COVID-19.

North Carolina ranked 10th among the states where coronavirus was spreading the fastest on a per-person basis, a USA TODAY Network analysis of Johns Hopkins University data shows. In the latest week coronavirus cases in the United States decreased 0.7% from the week before, with 730,572 cases reported. With 3.15% of the country's population, North Carolina had 3.35% of the country's cases in the last week. Across the country, 15 states had more cases in the latest week than they did in the week before.

Gaston County reported 443 cases and two deaths in the latest week. A week earlier, it had reported 450 cases and 11 deaths. Throughout the pandemic it has reported 67,978 cases and 865 deaths.

Across North Carolina, cases fell in 55 counties, with the best declines in Wake County, with 3,831 cases from 4,879 a week earlier; in Durham County, with 1,165 cases from 1,348; and in Cumberland County, with 740 cases from 922.

>> See how your community has fared with recent coronavirus cases

Within North Carolina, the worst weekly outbreaks on a per-person basis were in Mitchell County with 454 cases per 100,000 per week; Jones County with 372; and Durham County with 362. The Centers for Disease Control says high levels of community transmission begin at 100 cases per 100,000 per week.

Adding the most new cases overall were Wake County, with 3,831 cases; Mecklenburg County, with 2,708 cases; and Guilford County, with 1,260. Weekly case counts rose in 41 counties from the previous week. The worst increases from the prior week's pace were in Onslow, Cleveland and Haywood counties.

In North Carolina, 46 people were reported dead of COVID-19 in the week ending Sunday. In the week before that, 434 people were reported dead.

A total of 2,823,979 people in North Carolina have tested positive for the coronavirus since the pandemic began, and 25,140 people have died from the disease, Johns Hopkins University data shows. In the United States 86,246,101 people have tested positive and 1,013,413 people have died.

>> Track coronavirus cases across the United States

USA TODAY analyzed federal hospital data as of Sunday, June 19.

Likely COVID patients admitted in the state:

Likely COVID patients admitted in the nation:

Hospitals in 29 states reported more COVID-19 patients than a week earlier, while hospitals in 25 states had more COVID-19 patients in intensive-care beds. Hospitals in 31 states admitted more COVID-19 patients in the latest week than a week prior, the USA TODAY analysis of U.S. Health and Human Services data shows.

The USA TODAY Network is publishing localized versions of this story on its news sites across the country, generated with data from Johns Hopkins University and the Centers for Disease Control. If you have questions about the data or the story, contact Mike Stucka at mstucka@gannett.com.

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Gaston County reported 443 additional COVID-19 cases this week - Gaston Gazette

During COVID, the level of several enzymes in the liver elevates. Presence of these enzymes in a higher amount in the liver means it is damaged.

As per a study, COVID-19 associated hepatic injury should be defined as Alanine amino transaminase or Aspartate amino transaminase exceeding 3 times the upper limit of the normal value, and ALP, -Glutamyl transpeptidase or total bilirubin of these enzymes the patients were categorised as hepatocellular, cholestatic and mixed type.

In addition to this, people with chronic liver conditions can be severely affected by the viral attack. With serious health complications already in the body, the immune system which is already highly compromised is unable to protect the body and thus the risk of the infection increases.

Apart from these, the medications that are administered to treat COVID can also pose a serious risk for the health of the liver.

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Coronavirus explainer: Potential effects of COVID on liver health; know the key indicators - Times of India

WASHINGTON President Joe Biden on Wednesday will call on Congress to suspend federal gasoline and diesel taxes for three months an election year move meant to ease financial pressures at the pump as the public is increasingly concerned about high gas prices and inflation.

The Democratic president will also call on states to suspend their own gas taxes or provide similar relief, the White House said.

At issue is the 18.4 cents-a-gallon federal tax on gas and the 24.4 cents-a-gallon federal tax on diesel fuel. If the gas savings were fully passed along to consumers, people would save roughly 3.6% at the pump when prices are averaging about $5 a gallon nationwide.

It's unclear, though, if Biden could push such a proposal through Congress, where many lawmakers, including some in his own party, have expressed reservations. And even many economists view the idea of a gas tax holiday with skepticism.

Barack Obama, during the 2008 presidential campaign, called the idea a "gimmick" that allowed politicians to "say that they did something." He also warned that oil companies could offset the tax relief by increasing their prices.

Biden energy adviser Amos Hochstein pushed back on Wednesday, saying consumers could save about 50 cents per gallon if Congress and the states heed the president's call.

"That's not a gimmick," Hochstein, senior adviser for global energy security at the State Department, said on CNN. "That's a little bit of breathing room for the American people as we get into the summer driving season."

It was not immediately clear if the White House has the votes in Congress to suspend the federal tax.

High gas prices pose a fundamental threat to Biden's electoral and policy ambitions. They've caused confidence in the economy to slump to lows that bode poorly for defending Democratic control of the House and the Senate in November.

Biden's past efforts to cut gas prices including the release of oil from the U.S. strategic reserve and greater ethanol blending this summer have done little to produce savings at the pump, a risk that carries over to the idea of a gas tax holiday.

Biden has acknowledged how gas prices have been a drain on public enthusiasm when he is trying to convince people that the U.S. can still pivot to a clean-energy future. In an interview with The Associated Press last week, Biden described a country already nursing some psychological scars from the coronavirus pandemic that is now worried about how to afford gas, food and other essentials.

"If you notice, until gas prices started going up," Biden said, "things were much more, they were much more optimistic."

The president can do remarkably little to fix prices that are set by global markets, profit-driven companies, consumer demand and aftershocks from Russia's invasion of Ukraine and the embargoes that followed. The underlying problem is a shortage of oil and refineries that produce gas, a challenge a tax holiday cannot necessarily fix.

Mark Zandi, chief economist at Moody's Analytics, estimated that the majority of the 8.6% inflation seen over the past 12 months in the U.S. comes from higher commodity prices due to Russia's invasion and continued disruptions from the coronavirus.

"In the immediate near term, it is critical to stem the increase in oil prices," Zandi said last week, suggesting that Saudi Arabia, the United Arab Emirates and a nuclear deal with Iran could help to boost supplies and lower prices. Republican lawmakers have tried to shift more blame to Biden, saying he created a hostile environment for domestic oil producers, causing their output to stay below pre-pandemic levels.

Senate Republican leader Mitch McConnell mocked the idea of a gas tax holiday in a February floor speech. "They've spent an entire year waging a holy war on affordable American energy, and now they want to use a pile of taxpayers' money to hide the consequences," he said.

Congressional Democrats largely appeared cool to the idea of a gas tax holiday, which Speaker Nancy Pelosi and others have long worried would simply allow oil companies to reap additional profits with no guarantee the savings would be passed along to consumers at the pump.

Rep. Peter DeFazio, D-Ore., chairman of the House Transportation and Infrastructure Committee, said late Tuesday that he is urging colleagues to see the gas tax holiday "for what it is: a short-sighted proposal that relies on the cooperation of oil companies to pass on miniscule savings to consumers."

But Dan Kildee, D-Mich., said he is a longtime supporter of a federal gas tax holiday.

"I admit to some frustration because I think it would have been more effective if we had done this a few months ago," Kildee said. "But it's never too late to do the right thing."

One Democratic aide, who insisted on anonymity to frankly discuss the situation Wednesday, said it appears unlikely the proposal could pass the House without first clearing the evenly split Senate.

Administration officials said the $10 billion cost of the gas tax holiday would be paid for and the Highway Trust Fund kept whole, even though the gas taxes make up a substantial source of revenue for the fund. The officials did not specify any new revenue sources.

The president has also called on energy companies to accept lower profit margins to increase oil production and refining capacity for gasoline.

This has increased tensions with oil producers: Biden has judged the companies to be making "more money than God." That kicked off a chain of events in which the head of Chevron, Michael Wirth, sent a letter to the White House saying that the administration "has largely sought to criticize, and at times vilify, our industry."

Asked about the letter, Biden said of Wirth: "He's mildly sensitive. I didn't know they'd get their feelings hurt that quickly."

Energy companies are scheduled to meet Thursday with Energy Secretary Jennifer Granholm to discuss ways to increase supply.

___

Associated Press writers Lisa Mascaro, Matthew Daly and Kevin Freking contributed to this report.

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Biden to call for 3-month suspension of gas and diesel taxes - Star Tribune