Category Archives: Corona Virus

The coming weeks should bring a new phase in the pandemic, as policy shifts and a supply of up to a billion free, government-issued rapid test kits for home use promise to make diagnosing COVID-19 at home cheaper and easier.

Vaccines are the most effective way to prevent serious illness and death, but variants such as omicron have made breakthrough cases more commonplace, and testing has become an essential companion to vaccination in a COVID-cautious persons toolbox.

Although rapid antigen test results can be done at home and produce results quickly, the gold standard for accuracy remains the PCR lab test though it can take days. Experts say the value of rapid testing varies, depending on circumstances. Some who already feel sick may want to confirm whether they have COVID-19, while others may use the tests to protect themselves or a loved one from potential exposure to the virus. Many are optimistic that the tests will be a passport back to normalcy, adding a new level of confidence that its safe to travel and see family or attend a wedding.

But misunderstanding the usefulness of rapid tests could give people false confidence, possibly leading them to unwittingly transmit the virus.

The general population that uses the test would like a simple, direct, straightforward, easy answer, said William Schaffner, professor of infectious diseases at the Vanderbilt University Medical Center. Unfortunately, life is more complicated than that.

The kits the government provides are rapid antigen tests. Samples are collected with nasal swabs and the instructions included are straightforward. They deliver results in less than a half-hour.

READ MORE: How to get free COVID-19 tests from the federal government

Studies have shown antigen tests have a sensitivity of 80% to 90%, which means that if one shows you have COVID-19, thats very likely accurate. They are more likely than PCR tests to produce a false negative result meaning that you get a negative test result but actually have the virus. Antigen tests were designed to confirm the presence of COVID-19 in highly infectious people, but people recently exposed might not have enough viral particles in their nose for the test to detect, causing a false negative though they might still be contagious.

People may use a negative rapid test result to justify social activities and ignore a recent exposure or symptoms that should keep them at home, said Ryan McCormick, a primary-care doctor at Virtua Health in Marlton.

The binary thinking were all prone to positive or negative it can definitely be problematic, he said. With testing, its important to not think they are 100% accurate.

Omicron appears to show up in the upper airways and saliva a couple of days before it can be detected in the nasal passages, which could partly explain why nasal-swab rapid tests have not been quite as effective in detecting it.

Doctors debate whether swabbing the back of the throat might better detect omicron, but, McCormick said, That would be hard to do at home because it stimulates a gag reflex.

Tests are useful only as part of a fuller strategy to prevent the spread of the virus.

The problem is when people use them and they dont react accordingly, said Karen Coffey, an assistant professor of epidemiology and public health and medicine at the University of Maryland School of Medicine. Its that behavioral component that really has an impact.

European countries had ready access to rapid COVID-19 tests before Americans, but even countries that tested aggressively, such as Germany, werent spared from an omicron surge. People have to make good decisions with the data the tests provide.

With sufficient supply and appropriate frequency of testing, we can actually make a big dent in how many people end up getting infected by this simply by people knowing their status and being able to isolate during that time, said David Walt, a professor of bioinspired engineering at Harvard Medical School. The problem, of course, is if people say, Im infected, but Ill wear a mask and go to the grocery store, its not going to work.

If you have such symptoms as sore throat, fever, or cough, have been around a COVID-19 patient, or youve been in a high-risk environment, hanging out in bars with unmasked friends and you test positive you need to take it seriously.

If they test and they get a positive, they have COVID. No ifs, ands, or buts, Walt said. You dont have to retest. You dont have to go out and get a PCR test. You have COVID.

All those risk factors plus a negative test result, though, should be followed by two days of isolation and another home test. If that test, too, is negative, you can have more confidence youre COVID-free. Until you put yourself at risk again.

If a person is fully vaccinated and boosted, has no symptoms, wears masks, limits indoor contacts, and has had no known exposure to the virus, a single negative test result can offer added assurance before meeting up with friends or family, or attending an event.

If youre vaccinated, youre boosted, youre being careful, Schaffner said, then you do the rapid test and youre negative, youre in pretty good shape.

False positives you test positive but really dont have COVID are rare but possible, Walt said. If you doubt a positive test result, take another test immediately. Two consecutive false positives are extremely unlikely, he said.

At $10 to $15 a test, routine antigen tests quickly become expensive. Every household is eligible for one four-pack of tests, which can be ordered online from the federal government for free, with no shipping charge, through COVIDtest.gov. The first orders are expected to be delivered by early February.

READ MORE: Why is it so hard to find a COVID-19 test? Sites are short-staffed, and rapid supply is low.

With demand for at-home tests outstripping supply since the holiday season, people should take advantage of the free tests, doctors said.

Its important to not stockpile them, but going forward they are such a valuable tool in getting the pandemic under control and resuming life as usual, McCormick said. Take the government up on the offer if you dont have any.

Aside from the governments supply of free tests, insurance companies are required to cover the cost of up to eight at-home rapid tests per member per month. People may be able to use their insurance to pay for tests up front, or they can file a claim with their insurer for reimbursement so dont throw out that receipt.

State-run Medicaid and Childrens Health Insurance Plan programs are also required to cover COVID-19 testing without cost-sharing.

While the tests are widely covered by private health insurance, Medicare, Medicaid, and a federal fund for the uninsured, the rules on payment can be confusing.

Insurance companies cover up to $12 per test. If the ones you buy cost more than that, you will end up paying the difference out-of-pocket.

PCR tests should be free regardless of whether theyre done at a hospital or test site. Private health plans are required to cover PCR tests when ordered by a medical provider or when an individual is symptomatic. As of Jan. 15, insurers must also cover PCR tests taken at home and sent to a lab for analysis without a doctors note.

Health plans do not have to cover the tests when required by schools or employers, though, and people have encountered problems with being billed a copay or for the full cost of the test.

For instance, an insurer could deny covering a test for a person without symptoms or COVID-19 exposure, said Sabrina Corlette, codirector of the Center on Health Insurance Reforms at Georgetown University.

But in practice, I think that is hard for many carriers to do with these large testing sites it is burdensome to try to go through each persons claim and figure out the purpose for the test.

As for at-home tests, those done entirely at home must be covered by insurance without cost-sharing and without a doctors note. But if you must send in a sample collected at home to a lab, insurers can require a doctors note, she said.

Clear as mud, right? Corlette said.

To make matters even more confusing, prices for tests can vary widely. In an April 2021 analysis of prices from 93 hospitals, Kaiser Family Foundation found that prices for a PCR test ranged from $20 to $1,419, with a median cost of $148.

The new accessibility to tests is likely coming too late to make a big difference during the omicron surge, Coffey said, which should be subsiding in many parts of the country by the time tests arrive. Having them available will continue to be valuable, though.

I would like to say that this is the last wave that we will get, she said, but I think that is unlikely.

Before the pandemic, using the equivalent of a Q-Tip and some chemicals to diagnose a virus at home was unheard of. Now, its likely the technology will be adapted to hamper the spread of an array of other illnesses. If someone in your home has a fever, its likely youll soon have a test available to tell you whether its the flu.

Youll be able to rule out that you have flu, Walt said, youll be able to rule out that you have COVID, youll be able to rule out that you have RSV.

The government shipping a ration of tests to homes is a cumbersome distribution system, experts said, and ideally tests will become more widely available and easy to pick up.

I think its a good starting place, and maybe itll make people more comfortable with using these tests and encouraging them to buy their own, Coffey said. Its not going to support the entire nation through the entire pandemic.

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At-home COVID-19 tests could be a passport to normalcy. But they can also give us false confidence. - The Philadelphia Inquirer

On Jan. 18, news broke that Czech folk singer Hana Horka had died after intentionally exposing herself to the coronavirus that causes COVID-19.

According to her son, Jan Rek, the 57-year-old entertainer had purposefully exposed herself to the virus with the intention of developing COVID-19 while he and his father were ill.

He said this was because proof of recovery would allow her entry into more social and cultural venues, like bars and theaters.

Horka, who was not vaccinated, had posted on social media that she was recovering. However, 2 days later, she was dead, choking to death while lying in her bed.

Unfortunately, Horkas belief that exposing herself to the coronavirus would help her get it over with is one that seems to be growing in popularity.

Many people are tired and worn down from having to be constantly vigilant about the virus.

Also, there is a growing sentiment that COVID-19 is inevitable, and therefore isnt worth the effort necessary to keep it from spreading.

Experts are cautioning this simply isnt true.

Intentionally exposing yourself to the coronavirus with the hopes of developing COVID-19 can come with severe complications, including death.

Healthline spoke with several experts who all agreed that deliberately exposing yourself to the coronavirus is incredibly risky and has the potential to affect much more than just yourself.

Dr. Nicholas Kman, an emergency medicine physician at The Ohio State University Wexner Medical Center, said one of the biggest reasons that healthcare professionals dont want people to get intentionally sick right now is that they are trying to delay the continued spike in cases as much as they possibly can.

COVID-19 is already affecting our healthcare system, he said.

January tends to be busy for healthcare in the winter with influenza, pneumonia, RSV, and other illness, said Kman. COVID has added much to that.

In addition, Kman said that many healthcare workers are out sick themselves or taking care of sick family members, which further stresses the system.

The current spike of COVID-19 cases has also led to a shortage of available treatments.

There are effective treatments that can be given to patients to keep them out of the hospital, he explained, but they are in extremely short supply.

Kman said there is only one monoclonal antibody that treats infection with the Omicron variant of the coronavirus, and it is extremely scarce right now. Most hospitals dont have any and dont know when they will receive another shipment.

So, while effective treatments do exist, its not always a given that you will be able to get them if many other people are competing for the same limited resources.

As was the case with Horka, you may not be able to recover from COVID-19 as easily as you expect.

While it can be argued that singer Hana Horka likely had fatal COVID complications because she was not vaccinated, the fact remains that COVID is not trivial, said Joseph A. Roche, BPT, Dip. Rehab. PT, PhD, associate professor in the physical therapy program at Wayne State University and member of the American Physiological Society.

Even though vaccination has proven to be a bulwark against complications and deaths, unfortunately, there are still rare breakthrough cases where the acute and chronic symptoms of COVID are worrisome, said Roche, who has also done extended research on COVID-19.

Kman added there is still much we dont know about COVID-19.

We have seen many younger patients during the Delta surge get hospitalized and even put in the ICU. Many with Omicron are being hospitalized as it worsens underlying conditions, he said.

In addition, even though it is still true that people ages 50 and older are more likely to be hospitalized, Kman said that hospitals have seen a surge in pediatric cases.

Kman also pointed out there are many people in the United States with underlying health conditions that are undiagnosed. These people can be at greater risk without even knowing it.

For example, we know obesity is an important risk factor for severe COVID and about [70 percent] of Americans are overweight or obese. Someone could easily be overweight and have undiagnosed high blood pressure, giving them risk factors for severe COVID, he said.

Kman said it is very common to see patients with long COVID in the emergency department.

This has always been one of the biggest reasons to get vaccinated, he said.

According to the World Health Organization (WHO), 10 to 20 percent of people who develop COVID-19 have post-COVID symptoms, including:

In a previous interview with Healthline, Roche said we cant really predict for certain how long these types of symptoms might last. However, data gathered by his team showed that people with SARS had symptoms that lingered even at a 4-year follow-up.

What this means is, even if you recover from COVID-19, you may still have debilitating symptoms long after your infection is gone.

Roche noted that vaccination and other preventive measures are the best way to avoid long COVID.

Roche said some people may feel that getting exposed to the coronavirus versus gaining immunity through a vaccine might give them more comprehensive or long lasting protection against COVID-19.

However, this speculation is not currently supported by strong research evidence, he said.

Dr. Shmuel Shoham, associated professor of medicine at Johns Hopkins University School of Medicine, also raised questions about the safety of intentionally developing COVID-19 with the hopes of gaining immunity.

There are also many unknowns regarding the safety of intentional infection for the person becoming infected and for those around them, he said.

If this virus was a product, would it be approved by a regulatory agency for use in humans? Is our understanding of its safety and efficacy sufficient to recommend it for widespread use? The answer to both is no.

Shoham further added that the best data on immunity that we have is that being vaccinated and boosted or being vaccinated and having had history of infection results in the strongest levels of protection.

The medical experts who spoke with Healthline said it is important to look beyond how COVID-19 will affect you personally.

The risk with Omicron is even worse, as it seems that just about anyone can catch and spread the disease, said Kman.

Although some will have a mild course, many others will get sick, miss work, need to go the hospital, and tax the healthcare system. More still may join the more than 850,000 people who have perished from COVID-19, he added.

We still need to do the best we can to help our fellow humans by doing the infection control measures that we know work, like masking with a high quality mask (surgical or, even better, N95), distancing (3 to 6 feet), hygiene, and staying in when sick.

Continued here:

Why Catching COVID-19 to 'Get It Over With' Is a Terrible Idea - Healthline

WASHINGTON Dr. Rochelle Walensky was stunned. Working from her home outside Boston on a Friday night in late July, the director of the Centers for Disease Control and Prevention had just learned from members of her staff that vaccinated Americans were spreading the coronavirus.

Vaccines had been the core of President Bidens pandemic strategy from the moment he took office. But as Dr. Walensky was briefed about a cluster of breakthrough cases in Provincetown, Mass., the reality sank in. The Delta variant, which had ravaged other parts of the world, was taking hold in the United States. And being vaccinated would not, it turned out, prevent people from becoming infected with the variant or transmitting it.

It was a heart sink moment, Dr. Walensky recalled in a recent interview. The discovery called into question the Biden administrations almost single-minded focus on vaccination as the path out of the pandemic. And it made Mr. Bidens July 4 message that the nation had moved closer than ever to declaring our independence from a deadly virus sound nave.

Mr. Biden took office last January with a 200-page coronavirus response strategy, promising a full-scale wartime effort rooted in science and competence. The C.D.C.s July discovery marked the point at which the virus began ruthlessly exposing the challenges it would present to his management of the pandemic.

Mr. Biden and his team have gotten much right, including getting at least one dose of a vaccine into nearly 85 percent of Americans 12 and older and rolling out life-saving treatments. Those achievements have put the United States in a far better place to combat the virus than it was a year ago, with most schools and businesses open and the death rate lower because the vaccine significantly reduces the chance of illness or death, even from the highly contagious Omicron variant.

But an examination of Mr. Bidens first year of fighting the virus based on interviews with scores of current and former administration officials, public health experts and governors shows how his effort to confront one of the most formidable enemies America has ever faced, as he recently described it, has been marked by setbacks in three key areas:

The White House bet the pandemic would follow a straight line, and was unprepared for the sharp turns it took. The administration did not anticipate the nature and severity of variants, even after clear warning signals from the rest of the world. And it continued to focus almost single-mindedly on vaccinations even after it became clear that the shots could not always prevent the spread of disease.

The administration lacked a sustained focus on testing, not moving to sharply increase the supply of at-home Covid tests until the fall, with Delta tearing through the country and Omicron on its way. The lack of foresight left Americans struggling to find tests that could quickly determine if they were infected.

The president tiptoed around an organized Republican revolt over masks, mandates, vaccine passports and even the vaccine itself, as he worried that pushing certain containment measures would only worsen an already intractable cultural and political divide in the country. The nations precarious economic health, and the political blowback that Mr. Biden and members of his party could face if it worsened, made him all the more cautious. So rather than forcing Americans to get shots, he spent months struggling to accomplish it through persuasion.

Mr. Biden took over the task of distributing vaccines from former President Donald J. Trump, and by all accounts he brought order to a rollout that had been dysfunctional and chaotic in its first month.

But he also inherited a bureaucracy that had been battered by the Trump White House, which undermined the C.D.C., strained the governments credibility with the public and helped foment virulent anger throughout the country over masks, social distancing and other efforts to contain the virus. Mr. Biden has been unable to bridge those divisions.

Two years into the pandemic, even as the Omicron variant has begun to recede in parts of the country, Mr. Biden is facing huge economic and political pressures. He has rejected lockdowns, school closures or other extreme measures that could help contain future mutations but drive the country back into a punishing recession. His decisions will carry a cost no matter which way he turns.

Mr. Biden has battled the virus while also trying to make headway on other priorities: a bipartisan infrastructure deal, appointments to the federal bench and far-reaching social spending legislation. In August and September, as Delta surged, the White House was consumed by a chaotic exit from Americas 20-year war in Afghanistan.

But the pandemic loomed over everything, dragging down Mr. Bidens approval ratings as his handling of it became for many the measuring stick by which to judge his presidency. Since he was inaugurated on Jan. 20 last year, 438,110 people have died from the virus, a number that is still increasing by more than 10,000 people every week.

You cannot fight todays pandemic, said Dr. Luciana Borio, a former acting chief scientist of the Food and Drug Administration who advised Mr. Bidens transition team. You have to prepare for whats next.

On March 2, officials from the C.D.C. and other agencies held a conference call to discuss creating a federal passport to enable airlines, restaurants and other venues to electronically verify vaccination status.

A 27-page presentation prepared for the meeting underscored how critical the issue was: A chaotic and ineffective vaccine credential approach could hamper our pandemic response by undercutting health safety measures, slowing economic recovery and undermining public trust and confidence.

But within weeks, public health officials began hearing a different message from the White House, where Mr. Biden and his team were wary of Republican politicians like Gov. Ron DeSantis of Florida, who railed against such passports as completely unacceptable.

The policy is no policy was the unofficial word from the White House, one federal health official recalled.

The scientists at the C.D.C. dismantled their working group, ceding to a patchwork of state and private efforts to track inoculations and the paper coronavirus vaccination record cards that can be lost or counterfeited.

By the summer, Mr. Bidens push to get Americans vaccinated was stalling and a chorus of voices inside and outside the government was urging him to mandate the shots.

Public health experts insisted that pleading with people to get vaccinated was not enough. But most Republican governors fiercely opposed vaccine requirements, and some asserted their own considerable power to prevent schools and businesses in their states from putting them in place.

The president believed federal vaccine mandates would backfire, according to several of his advisers. He shut down the idea of requiring domestic airline passengers to be vaccinated, which Dr. Anthony S. Fauci, Mr. Bidens chief medical adviser for the pandemic, has supported.

Even more modest initiatives drew instant attacks. In early July, when the administration announced an enhanced door-to-door outreach campaign to get Americans vaccinated, Representative Jim Jordan of Ohio, a Trump ally and a frequent Biden critic, was among the many Republicans who pounced.

The Biden Administration wants to knock on your door to see if youre vaccinated, he tweeted. Whats next? Knocking on your door to see if you own a gun?

Throughout the spring, Mr. Biden was relentlessly hopeful, even as ominous signs loomed.

Scientists, including some in the federal government, warned that the world was caught in a sprint between vaccines and variants and the virus was winning. In India, the newly arrived Delta variant pushed Covid cases from 10,000 per day in February to 414,000 in a single day in May. Weeks later, Delta cases spiked across England, too.

But the president and his team thought the United States would be spared Deltas ravages, Dr. Fauci said, because the vaccine push would be able to, for the most part, nullify a Delta surge. At the White House, Jeffrey D. Zients, Mr. Bidens pandemic czar, was counting on it.

The important thing was that the vaccines worked, he recalled in an interview.

In mid-May, Dr. Walensky added to the sense of optimism with an announcement that caught much of the country by surprise: Vaccinated Americans could take their masks off with little to no risk of spreading the virus, she said.

Mr. Biden, Mr. Zients and others in the White House were ecstatic, even as they worried the public would be confused by the sudden change. Being able to drop masks indoors could mean a huge economic boost, a psychological reprieve for the public and an opportunity to ease the fierce cultural battles over Covid.

But three weeks after Mr. Biden declared on July 4 that the country was emerging from the darkness, the outbreak in Provincetown forced Dr. Walensky to confront a painful truth: Her decision about masks had been wrong. Vaccinated people could transmit the virus to others, after all.

Now she had some fast decisions to make. She did not want to put masks on all of America again based on a single outbreak, she recalled in an interview. But soon, outbreak investigations in Texas and elsewhere confirmed the findings.

A July 27 internal assessment at the Department of Health and Human Services delivered grim news: Deaths were up 45 percent from the previous week, hospitalizations were up 46 percent and cases had increased by 440 percent since June 19, when they had reached a low.

Later that day, Dr. Walensky reversed herself, telling Americans they should resume wearing masks in areas where case counts were high.

A highly respected infectious disease expert, Dr. Walensky had been brought on by Mr. Biden to restore faith in an agency that had been battered by his predecessor. But the new guidance, which essentially left it to local health officials to determine where masking was required, based on ever-changing data, only confused the public further.

Most governors and many mayors had abandoned mask mandates by then, and showed little appetite to reinstate them.

Jan. 24, 2022, 7:32 a.m. ET

And still looming over the Biden team was the question of vaccination mandates. With vaccine uptake stalled and the more contagious Delta variant now a serious concern, Dr. Fauci had concluded that the voluntary measures his boss favored would not be enough.

His private message to the president: No way were we going to get people vaccinated unless we mandate.

The president agreed in September, after meeting in the Oval Office with four business leaders who told him they had successfully required all of their employees to get vaccinated. One of them, Greg Adams, the chief executive of the Kaiser Permanente health system, told the president about an unvaccinated colleague who had died of Covid, saying he wished he had required vaccines sooner.

On the Sunday before Labor Day two weeks after the F.D.A. gave formal approval to the Pfizer vaccine Mr. Biden was ready to go beyond pleading with people. He wanted a meeting with his Covid team, planned for the next day, to happen sooner.

Mr. Zients called his deputy and told her to drop everything. Weve got 58 minutes, he said.

Four days later more than seven months into his presidency Mr. Biden announced mandates for health care workers, federal contractors and the vast majority of federal workers, and a requirement that all companies with more than 100 workers require vaccination or weekly testing.

Public health experts said the mandates were appropriate and even long overdue. But the presidents prediction had been correct: The new policy fueled the growing sentiment, especially in conservative parts of the country, that the federal government had become too intrusive in too many areas of American life during the pandemic.

This month, the administration won half a victory: The Supreme Court allowed the health care mandate to stand, even as it struck down the requirement for large employers.

WTF? a senior federal health official scribbled on a note one day in August.

Word had just come down that on Aug. 18, Mr. Biden would announce a plan to roll out booster shots, starting the third week of September with adults who had completed their initial shots at least eight months earlier.

Dr. Janet Woodcock, the acting F.D.A. commissioner, had not wanted the White House to announce a start date, according to two people familiar with her stance. While publicly endorsing the strategy, she privately warned that her regulators most likely could not act that fast, because they were still waiting on data from the vaccine manufacturers that they would then need to review.

Two weeks after Mr. Bidens announcement, she and Dr. Walensky called Mr. Zients with bad news: The booster rollout plan would have to be scaled back. They were met with a long silence, according to one person with knowledge of the call, who spoke on the condition of anonymity.

The episode laid bare a fundamental problem. Some of the administrations most difficult public health decisions are essentially hammered out by a handful of senior health officials who hold roughly the same status, none of whom are in charge. They are overseen by Mr. Zients, a former economic policy adviser to President Barack Obama who is known for his logistical and planning skills but has no public health expertise. No single public health expert has the role of guiding the response, running interference between various players or standing up to the White House when necessary.

There is no formal decision-making process, one senior federal official said, speaking on the condition of anonymity. Who is in charge of all this?

The weaknesses in the command structure have played out in disparate ways. In the case of the booster rollout, the White House appeared to overstep its bounds and left itself open to accusations that political considerations were coloring decision-making. More frequently, Dr. Walensky has announced changes in public health guidance without anyone fully vetting them with colleagues, leading to backtracking and revisions.

The team of docs, as Mr. Biden likes to call them, includes Dr. Walensky; Dr. Woodcock; Dr. Fauci, the director of the infectious disease division at the National Institutes of Health; and Dr. David Kessler, the chief science officer at the Department of Health and Human Services, whose duties include stocking the pandemic toolbox with vaccines and treatments. Mr. Bidens health secretary, Xavier Becerra, a former California attorney general, is their boss, but several current and former White House officials said he plays a limited role in setting pandemic policy a characterization that Mr. Becerra disputes.

Dr. Walenskys announcement in May that fully vaccinated people need not wear a mask or physically distance from others, indoors or outdoors, was an example of uncoordinated policymaking.

Mr. Biden and Mr. Zients had indicated publicly that such a change might be coming. But some White House aides learned of the change only the night before Dr. Walensky announced it to the public, and there was no coordinated strategy in place to explain or defend it.

It wasnt like, OK, lets have a Zoom call tonight about the pros and the cons of the mask mandate. That didnt happen, Dr. Fauci said. Asked whether he tried to modify Dr. Walenskys decision beforehand, he said, You have to know the decision is being made before you modify it.

The C.D.C.s announcement last month that it was shortening the recommended isolation period for people with Covid was another bout of confused messaging. At first, the agency announced that people with resolving symptoms could stop isolating after five days without recommending they get a negative test first. But after that omission drew criticism from outside experts, the agency tweaked its guidance to say that if people have access to tests and want to use them, the best approach is to use an antigen test towards the end of the five-day isolation period.

Whenever there was a proclamation that something had improved, and a public health measure could be eased, it was never framed clearly enough, said Dr. Richard Besser, a former acting C.D.C. director.

Mr. Bidens premature announcement of the booster rollout had its own repercussions, bringing what some saw as political pressure to bear on a fraught scientific debate.

Both Dr. Woodcock and Dr. Peter Marks, a top regulator who oversees the F.D.A.s vaccine division, wanted booster shots to be offered quickly to as many Americans as possible. But two key subordinates, Marion Gruber and Dr. Philip Krause, who had regulated vaccines at the agency for decades, saw little rationale for offering the shots to younger, healthier people, and viewed the White House announcement as political arm-twisting.

They outlined their position in an extraordinary public dissent in the British medical journal The Lancet, days after announcing that they were leaving the agency. Dr. Krause said in an interview that he saw a dismantling of the process of regulation.

Advisers to the C.D.C. and the F.D.A. also argued to scale back Mr. Bidens promise, leading to months of staggered and confusing rollouts of the extra shots to various population groups. Adults were not universally eligible for a booster until late November. Some governors grew so impatient in the meantime that they cleared adults in their states to seek boosters without official federal approval.

To date, just 43 percent of fully vaccinated adults have received a booster. Data published on Friday by the C.D.C. showed boosters were reducing the number of infections from the Omicron variant and keeping infected people out of the hospital.

By the time Omicron emerged in South Africa in late November, Dr. Fauci knew instinctively that it was going to be bad.

He was alarmed by the high number of mutations: more than 50 in all. And the variant was spreading fast. On a chart that South Africas researchers showed him on the rate of infection, the line went straight up, Dr. Fauci said.

The reason soon became clear. The vaccines continued to give robust protection against severe disease and hospitalization from Omicron, but the variant was more agile than Delta in evading the bodys defenses. Even people who had been boosted might get infected.

The revelations made it more important for everyone including vaccinated people to know if they were infected before being around family and friends. That highlighted the administrations failure to ensure a supply of at-home tests that could confirm an infection in 15 minutes.

Amazon, Walmart and other national chains were soon out of stock. Long lines formed outside pharmacies as Americans tried to protect their families over the holidays. And the administration was left scrambling for a quick fix to a long-term supply problem it had mostly ignored until nearly the fall.

The administration had made a calculated bet: Unlike their strategy with vaccines and Covid treatments, officials figured they could allow demand to determine the supply of tests, with manufacturers ramping up production as needed. The Biden team allocated roughly $16.6 billion to buy vaccines and nearly $15 billion for Covid treatments over the year, but signed $3 billion worth of contracts to buy tests only in September and October.

In nine speeches about his pandemic response that Mr. Biden had delivered in May and June, he made no mention of needing tests. With caseloads low at the time, public interest in tests flagged as well.

Over the summer, workers at Abbott Labs in Maine, which made one of the only rapid tests available at the time, were told to take unsold test kits apart and trash them. Then they were laid off.

When Omicron arrived, the administration initially resisted calls to distribute free tests to the public. Natalie Quillian, a top aide to Mr. Zients, said in an interview in December that the White House felt tests should be covered by insurance, not provided free by the government. Dr. Tom Inglesby, a senior adviser in charge of testing, said the administration wanted to target free tests to places that needed them most, like schools and nursing homes.

Its a very, very, very expensive strategy to buy all tests for all people, he said.

As it turned out, the bet was a bad one. By years end, facing a barrage of criticism, Mr. Biden pledged 500 million free tests for all Americans, followed by another 500 million a few weeks later. The first of those tests have just begun to arrive, and the bulk of them most likely will not arrive until after the administrations own experts predict Omicron will have peaked later this month.

Yeah, Mr. Biden told ABCs David Muir in a December interview, I wish I had thought about ordering a half a billion two months ago.

As the administration heads into its second year of battling the pandemic, Omicron and Delta have proved that mutations of the virus have the potential to flood hospitals with patients, turning some into crisis zones. Tens of millions remain unvaccinated, many more lack boosters and officials are anxiously watching for signs that a retooled vaccine might be needed soon. Antiviral pills appear to be a breakthrough in treatment, but remain scarce.

Experts like Dr. Tom Frieden, the C.D.C. director under Mr. Obama, have predicted three possible scenarios ahead: that the nation reaches a kind of truce with the virus, with clusters of outbreaks; that the virus weakens to a threat more akin to a common cold; or that, in the worst case, a variant emerges that combines the contagiousness of Omicron with the virulence of Delta.

Dr. Frieden said the White House must plan for them all. Some former Biden advisers have called for the president to plan for the new normal and accept that Covid-19 is here to stay.

Inside the West Wing, there is little evidence that Mr. Biden is shifting strategies. He is keeping his public health team intact as his second year begins, and continues to project a sense of optimism.

Some people may call whats happening now the new normal, he said on Wednesday during a formal news conference in the East Room of the White House. I call it a job not yet finished.

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Bidens Pandemic Fight: Inside the Setbacks of the First Year - The New York Times

Health officials on Saturday reported more encouraging signs that the Omicron wave may be past its peak in Los Angeles County, though the coronavirus is still circulating widely and a large number of people are becoming seriously ill with COVID-19.

The county saw 39,117 new infections Saturday, pushing the total for the week above the quarter-million mark, officials said. Thats a roughly 13% decline from the 291,000 infections of the previous week.

Hospitalizations continued their downward trend, falling to 4,698 on Saturday. Thats down from 4,814 on Thursday and 4,792 on Friday.

Officials also reported 72 COVID-19 deaths Saturday, the second-highest figure in the last seven days. L.A. County recorded 415 COVID-19 deaths in the last week. Deaths tend to lag behind increases in new cases and hospitalizations by several weeks.

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The test positivity rate remains high at 16%, though its slightly below last weeks figure, officials said.

The small decreases in new cases, hospitalizations and the test positivity rate suggest the coronavirus is no longer spreading exponentially, officials said. However, they added, the Omicron variant is highly transmissible and thousands of people are still becoming seriously ill.

We will need to remain cautious these next few weeks while transmission remains at the highest levels we have ever seen, L.A. County Public Health Director Barbara Ferrer said in a statement. With an average of 35,000 new cases identified each day, it is very easy for any one of us to encounter an infected person during the week.

Ferrer advised Angelenos to avoid crowds, stay a safe distance from others, wash or sanitize hands frequently and wear a high-quality mask an N95, KN95 or KF94.

Unvaccinated people remain at highest risk of hospitalization and death due to COVID-19, but those who are vaccinated can still get breakthrough infections and suffer severe illness, particularly if they have chronic health conditions that make them more vulnerable to start with. Studies show that booster shots are essential for maximizing ones protection against Omicron.

During the week that ended Jan. 9, the risk of getting COVID-19 was 4.1 times higher for unvaccinated Californians than for those who got the shots. In addition, unvaccinated residents were six times more likely to be hospitalized and 17.8 times more likely to die of the disease, according to the most recent data from the state Department of Public Health.

Since the beginning of the COVID-19 pandemic, L.A. County has confirmed nearly 2.5 million coronavirus cases and 28,417 COVID-19 deaths.

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COVID-19 spreads widely in L.A. County on Saturday - Los Angeles Times

In less than two months, the Omicron variant of the coronavirus has spread around the globe and caused a staggering number of new infections.

Omicron now accounts for more than 99.5 percent of new infections in the United States, according to estimates from the Centers for Disease Control and Prevention. The nation reported as many as 800,000 new cases a day in mid-January, more than three times as many as at any previous point in the pandemic.

Scientists have been working overtime to study Omicron. Many questions remain unanswered, but heres what theyve learned so far.

Omicron moves fast. It spreads swiftly through populations, and infections develop quickly in individuals.

The time that elapses between when someone is first exposed to the virus and when they develop symptoms is known as the incubation period.

average incubation period

average

incubation period

Research suggests that the original version of the coronavirus and early variants had an incubation period of about five days, on average. The Delta variant seems to move faster, with an average incubation period of about four days. Omicron is swifter still, with an incubation period of roughly three days, according to a recent C.D.C. study.

The amount of virus that builds up in someones body is known as viral load. In general, people are thought to be most infectious when their viral loads are high.

In a recent study of the Alpha and Delta variants, researchers found that people tended to reach their peak viral loads about three days after infection and clear the virus about six days after that, on average.

Whether Omicron follows the same pattern remains to be seen. In one preliminary study, researchers found that Omicron infections were about a day shorter than Delta infections and resulted in slightly lower peak viral loads, on average. But the difference might be due to higher rates of pre-existing immunity as a result of vaccination or prior infection among the people who were infected with Omicron. Another research team found that among vaccinated people with breakthrough infections, Omicron and Delta produced similar levels of infectious virus.

Other data suggest that Omicron may not act like previous variants. Animal and laboratory studies indicate that it may not be as good at infecting the lungs as Delta, but that it may replicate more quickly in the upper respiratory tract.

The variant may have other unique characteristics, too. One small study found that antibodies produced after an Omicron infection seem to protect against Delta, but Delta infections offer little protection against Omicron. If the finding holds up, it means that Delta may soon have trouble finding hospitable hosts and that Omicron is likely to replace Delta rather than co-exist with it.

Omicron appears to cause less severe disease than Delta. In one recent study, researchers found that people with Omicron infections were less likely to be hospitalized, end up in the I.C.U. or require mechanical ventilation than those with Delta infections.

One possible explanation is that Omicron is less likely to damage the lungs than previous variants. A variant that proliferates primarily in the upper respiratory tract may cause less severe disease in most people. One indication of reduced severity is that unvaccinated people seem less likely to be hospitalized with Omicron than with Delta.

But Omicrons apparent mildness may also stem from the fact that it is infecting far more vaccinated people than Delta did. Omicron is skilled at evading the antibodies produced after vaccination, which is leading to more breakthrough infections, but vaccinated people are still protected from the most severe disease. Booster shots of mRNA vaccines are 90 percent effective against hospitalization with Omicron, according to the C.D.C.

Still, doctors cautioned, although the variant may be milder on average, some patients, especially those who are unvaccinated or have compromised immune systems, may become severely ill from Omicron infections. And its too early to know whether breakthrough cases of Omicron might result in long Covid.

Because Omicron replicates so fast and the incubation period is so short, there is a narrower window in which to catch infections before people begin to transmit the virus.

Earlier in the pandemic, people were advised to use a rapid test five to seven days after a potential exposure to the virus. Given Omicrons shorter incubation period, many experts now recommend taking a rapid test two to four days after a potential exposure. (They also recommend taking at least two rapid tests, about a day apart, in order to increase the odds of detecting an infection.)

People who are testing to reduce the risk of transmitting the virus to others, for example at an upcoming gathering, should test as close as possible to the event itself, experts said.

There is still debate over whether rapid antigen tests might be less sensitive to Omicron than other variants. P.C.R. tests are more sensitive than rapid tests, which means they are likely to detect the virus earlier in the course of infection, but they take longer to return results.

The C.D.C. recently loosened its isolation guidelines for people who are infected with the virus. Previously, the agency recommended that people who test positive for the virus remain isolated for 10 days.

The new guidelines say that infected people can leave isolation after five days if they are asymptomatic or their symptoms are resolving and they are fever-free. People should wear well-fitting masks for an additional five days when around other people.

avoid travel,

wear a mask

The agency said these changes were prompted by data suggesting that transmission of the virus is most likely in the day or two before symptoms appear and the two or three days after.

But scientists have noted that some people may be infectious for longer than that, and some criticized the agency for not recommending that people receive a negative result on a rapid test before ending their isolation periods.

The agency subsequently updated its guidelines to note that people who wanted to test should take a rapid antigen test towards the end of the five-day isolation period but stopped short of formally recommending it.

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How Omicron Is Different Than Delta - The New York Times

AMSTERDAM, Jan 16 (Reuters) - Thousands of protesters packed Amsterdam's streets on Sunday in opposition to the government-imposed COVID-19 measures and vaccination campaign as virus infections hit a new record.

Authorities were granted stop and search powers at several locations across the city and scores of riot police vans patrolled neighbourhoods where the demonstrators marched with banners and yellow umbrellas.

Regular anti-coronavirus protests are held across the country and Sunday's large gathering was joined by farmers who drove to the capital and parked tractors along the central Museum Square.

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The crowd played music, chanted anti-government slogans and then marched along thoroughfares, blocking traffic.

The Netherlands had one of Europe's toughest lockdowns for a month through the end-of-year holidays.

Amid growing public opposition, Prime Minister Mark Rutte on Friday announced the reopening of stores, hairdressers and gyms, partially lifting a lockdown despite record numbers of new COVIC-19 cases. read more

Infections reached another record high above 36,000 on Sunday, data published by the Netherlands Institute for Health (RIVM) showed. The Netherlands has recorded more than 3.5 million infections and 21,000 deaths since the start of the pandemic.

Rutte's government ordered the lockdown in mid-December as a wave of the Delta variant forced the health system to cancel all but the most urgent care and it appeared rising Omicron cases would overwhelm it. read more

Non-essential stores, hairdressers, beauty salons and other service providers were allowed to reopen on Saturday under strict conditions.

Bars, restaurants and cultural venues have been instructed to remain closed until at least Jan. 25 due to uncertainty about how the Omicron wave will impact hospital capacity.

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Reporting by Piroschka van de Wouw, Writing by Anthony Deutsch, Editing by Angus MacSwan

Our Standards: The Thomson Reuters Trust Principles.

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Protest in Netherlands against coronavirus measures - Reuters

Cases, hospitalisations and deaths

If you don't see your state or territory yet, don't worry - these numbers are updated throughout the day.

NSW:17deaths and 29,504cases; 2,776people in hospital, including 203in ICUs

Victoria: Sixdeaths and22,429cases;1,229people in hospital, including 129in ICUs

Tasmania: 1,037cases; sevenpeople in hospital (being treated specifically for COVID), including one in ICU

Queensland:Seven deaths and 15,122 cases;702 people in hospital, including 47 in ICUs

Northern Territory:284 cases,39 people are in hospital, 25 are classified as acute, including onein ICU

South Australia:3,829 cases;227 people in hospital, including 26 in ICUs

ACT:One death and 1,601 cases; 52 people in hospital, including four in ICU

Western Australia: three local cases (all reported yesterday), nine overseas cases and3,728 peoplewere swabbed at testing clinics. One person is in hospital with COVID

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COVID live updates: All the coronavirus news you need in the one place - ABC News

On the occasion of one-year anniversary of the commencement of vaccination programme in the country, Prime Minister Narendra Modi saluted "each and every individual" associated with it and said the programme added great strength to the fight against Covid-19. "Today we mark 1 year of vaccination drive. I salute each and every individual who is associated with the vaccination drive. Our vaccination programme has added great strength to the fight against Covid-19. It has led to saving lives and thus protecting livelihoods," he tweeted.

Delhi's Sarojni Nagar market wears a deserted look during the weekend curfew. (PTI)

Meanwhile, Delhi on Sunday reported 18,286 COVID-19 cases and 28 deaths, while the positivity rate dropped to 27.87 per cent from 30.64 per cent a day ago, according to health department data.

Delhi Health Minister Satyendar Jain sought to allay concerns over "fewer" Covid tests being conducted in the national capital, saying the diagnostic tests being conducted in the city is three times the number recommended by the Indian Council of Medical Research (ICMR).

After logging over 10,000 COVID-19 cases per day for the last 11 days, the daily tally in Mumbai dropped to 7,895 on Sunday. A total of 11 people died of the COVID-19 infection, the city civic body said in a bulletin.

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Coronavirus Omicron India LIVE: Vaccination for 12-14 age group likely from March, says top govt expert - The Indian Express

Two startlingly different figures for what is ostensibly the same count have been released within days of each other: the government reported 150,000 Covid-19 deaths days before the UKs lead statistical agency reported a death toll of more than 175,000.

The difference between the two figures is stark but easily explained: the governments figures count only those deaths that are known to have occurred within 28 days of a positive coronavirus test. The Office for National Statistics, on the other hand, counts all deaths where the virus was mentioned on the death certificate.

But regardless of the counting method, the numbers represent individual human tragedies. So, what do we know about the 175,000 people whose deaths have been recorded to date?

The pandemic has taken the greatest toll on elderly people: across the UK since the start of the pandemic more than seven in 10 registered deaths have been among those aged 75 or older. Meanwhile, deaths among those aged 44 or younger made up under 2% of the total.

Nevertheless, the proportion of deaths made up by older people has changed over the course of the pandemic.

During the first wave, which continued for most of 2020, three-quarters of all deaths were among those aged 75+. In subsequent waves this fell, in part thanks to vaccinations, decreasing to 59% of all deaths during the period where Delta dominated.

Vaccination rates are highest among elderly people, NHS figures show.

Connected to this metric is the stark difference in the number of deaths that occurred in care homes as the pandemic progressed. In England and Wales more than 20,000 Covid deaths were registered in care homes between early March and the end of 2020, equivalent to 68 deaths per day.

The vaccine rollout, which prioritised care home residents and staff, brought these figures down dramatically. With just over 13,000 deaths registered in nursing homes in 2021, the average death toll in English and Welsh nursing homes fell to 36 deaths per day that year.

ONS analysis covering the first 10 months of 2021 shows risk of death involving Covid-19 to be 28 times higher among unvaccinated people than among the vaccinated population.

The data shows that deaths involving Covid-19 have been consistently lower for vaccinated people, which the ONS defines as people who received their vaccine at least 21 days beforehand, compared with unvaccinated people a trend apparent across all age groups.

Throughout the whole of the pandemic, gender disparities regarding coronavirus deaths have been evident. According to ONS figures regarding coronavirus deaths registered up to 31 December 2021, men made up 94,433 or 54% of total coronavirus deaths within this period, despite the fact that men make up only 49% of England and Wales population.

The theories as why this is include differences in lockdown behaviour between the sexes, men being more likely to drink, smoke and experience obesity; and differing immune responses.

Although these percentages remained roughly similar throughout the pandemic, there were variations of this disproportionality between the different waves.

Within the Delta wave, 58% of deaths were of males, whereas the lowest proportion of male deaths took place within the Alpha wave at 53%. These calculations were made by using provisional ONS data regarding weekly coronavirus deaths registered.

The spread of Covid deaths has not been even across the country: the crude death rate remains highest in the north-west, driven by the high number of deaths in 2020 after high case rates in the UK in the early part of the pandemic.

Across the entire pandemic the virus has claimed 23,659 lives in the region, equivalent to a crude death rate of 321 per 100,000 population, higher than any other both by absolute numbers and rate.

Among the four nations of the UK, Wales recorded the highest death rate of 291 coronavirus deaths per 100,000 population, driven partly by the fact that it has the highest proportion of people aged 65-plus of the UKs constituency countries. The UK-wide crude death rates stood at 262 deaths per 100,000 registered deaths at the end of 2021.

At the start of the pandemic with essential workers going out to work while anyone who could stayed home research focused on the link between occupation and Covid mortality risk.

The ONS last published data on this topic in early 2021, analysing close to 8,000 deaths involving coronavirus within the working age population across England and Wales to the end of 2020, showing that those working in close proximity to others had higher death rates.

Again, men were more exposed, making up nearly two-thirds of these deaths, with male workers in the care and leisure sectors and other public-facing jobs experiencing higher death rates. Female death rates were highest among machine operatives, those in the caring and leisure industries, and other customer-facing occupations.

Among healthcare occupations, nurses had statistically significantly higher rates of death involving Covid-19 when compared with those of the same age and sex in the population.

The ONS conducted provisional analysis, looking at deaths involving coronavirus between 2 March and 15 May 2020. The analysis found that, when taking into account size and age variations across different ethnicities, the mortality rate was highest among black men.

After adjusting for region, population density and other sociodemographic characteristics, the raised risk of death for black people was two times greater for men and 1.4 times greater for women compared with white people.

The analysis was updated in May 2021 and found that the mortality risk for black people relative to white British people was reduced in the second wave. Nevertheless, most black and South Asian groups remained at higher risk than white British people in the second wave even after adjustments, according to the ONS.

Although the ONS data does not cover the whole of the pandemic, there remains evidence that minority ethnic people were at a higher risk of contracting and dying from Covid-19 compared with their white counterparts. Factors as to why this may be the case include socio-economic factors, and the prevalence of pre-existing health conditions. For example, people from a south-Asian background are already up to six times more likely to have type-2 diabetes than the general population.

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What do we know about the 175,000 people who died of Covid in the UK? - The Guardian

Posted: Jan 16, 2022 / 03:01 PM CST / Updated: Jan 16, 2022 / 03:42 PM CST

LITTLE ROCK, Ark. Testing for COVID-19 continues to see high numbers as COVID-19 in Arkansas numbers start to slowly come down from record highs reported over the past week.

Testing remained high Saturday with much lower cases reported. This is a hopeful sign we are close to a peak. The best way we can come back down is to get vaccinated and boosted, Governor Hutchinson said on social media.

Data from the Arkansas Department of Health show the total number of active cases in the state jumped by 2,113 in just 24 hours, making that number 96,379. The figures show there have now been 681,176 total cases of COVID-19 since the pandemic began, with new cases increasing by 5,386.

The data reported on Wednesday show there are now 9,434 Arkansans who have died because of COVID-19, an increase of four from the previous day.

The ADH also reported that there are 1,385 patients currently hospitalized with COVID-19, rising by 28 from the day before. The figures show 168 patients currently on ventilators, three more than the previous day and 12 more patients added to the ICU putting that number at 385.

According to the Arkansas Department of Health, 3,170 doses of the vaccine were given in the last 24 hours, changing the total number of doses given to 3,818,575. There are now 1,528,168 Arkansans who are fully immunized.

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COVID-19 in Arkansas: Governor cites continued high COVID-19 testing with lower cases reported as hopeful sign - KLRT - FOX16.com