New Coronavirus News from 9 Dec 2021

Omicron Wave Heads for U.K., but It’s Not Clear How Bad It’ll Be [The New York Times, 9 Dec 2021]

By Megan Specia

Britain could be a bellwether of what other countries will see from the new coronavirus variant. Officials say Omicron could account for most cases within weeks.

LONDON — With cases of the Omicron variant doubling every three days and the government doing an about-face on restrictions it had long resisted, Britain is bracing for a new coronavirus surge, unsure if it will be a relatively minor event or a return to the dark days of earlier pandemic waves.

So far, the number of Omicron cases — 817 confirmed by Thursday, though officials say the real figure is likely much higher — is small compared with the daily average of 48,000 new coronavirus cases overall. But the government’s Health Security Agency warned that if the recent growth rate continues, “we expect to see at least 50 percent of Covid-19 cases to be caused by the Omicron variant in the next two to four weeks.”

Early evidence in Britain backs up tentative findings elsewhere, notably in South Africa, where the heavily mutated new variant is already widespread: It appears to be the most contagious form of the virus yet, a previous case of Covid-19 provides little immunity to it, and vaccines seem less effective against it. But it also seems to cause less severe illness than earlier variants.

Britain’s experience with Omicron may be a harbinger of what others can expect. Until now, it has been looser about social restrictions than many other nations in Western Europe, and Britain ordinarily has extensive travel to and from South Africa, so it could be the first wealthy country to be hit hard by Omicron. It also has one of the world’s most robust systems for sequencing viral genomes, so it can identify and track new variants earlier and more thoroughly than other countries.

“I think we are looking at a horrible winter,” said Peter English, a retired consultant in communicable disease control, noting the exponential spread of Omicron.

Much remains to be learned about the variant, but experts say that what is known so far is worrying. Jeffrey Barrett, the director of the Covid-19 genomics initiative at the Wellcome Sanger Institute in Britain, said the new data made one thing clear: “It will spread very fast, even in countries that have a very high vaccination rate like the U.K.”

The current estimate that Omicron is doubling roughly every three days, in a country where 70 percent of people are fully vaccinated and 32 percent have had a booster dose, is “really striking,” he added.

“We haven’t seen that kind of rate of growth since I think the March 2020 time when the original virus was spreading in a totally naïve population, when none of us really knew anything about it,” he said.

Even if Omicron infection is less severe on the whole, experts warn that if it leads to an enormous surge in cases, even a small percentage of them resulting in seriously ill patients could once again overwhelm hospitals and cause a spike in deaths.

Dr. Barrett said he was more worried than he was about the previous variants. The possibility that Omicron cases are less severe and that vaccines could still offer some protection mean that the picture could be less pessimistic, he said, but he added, “I don’t think any country should be gambling on that chance right now.”

Michael Ryan, the head of the World Health Organization’s health emergencies program, warned during a news conference that as the world has seen before with other variants, “if they are allowed to spread unchecked even though they are not individually more virulent or more lethal, they just generate more cases, they put pressure on the health system and more people die. That’s what we can avoid.”

The W.H.O. chief, Tedros Adhanom Ghebreyesus, acknowledged that there was some evidence that Omicron caused milder illness then Delta, though it was too early to be definitive.

On Wednesday, Britain adopted a new strategy in response to Omicron, urging people to work from home where possible, introducing new mask mandates and requiring people to show vaccine passports for entry to some venues. It was a striking reversal for Prime Minister Boris Johnson, who had opposed stricter controls that have been adopted around Europe, which was suffering through its biggest coronavirus wave so far before Omicron appeared.

Britain’s Health Security Agency released new data on Wednesday that it said “suggests that Omicron is displaying a significant growth advantage over Delta,” which had previously been the fastest-spreading variant and has become the dominant one worldwide.

Analysis of the data collected in Britain showed increased household transmission risk, a key indicator of how fast the variant can spread. The health agency cautioned that the data was still sparse and the conclusions tentative, with deeper studies underway. But Britain’s genomic sequencing system offers some of the strongest evidence yet on the variant.

All positive coronavirus tests from people arriving in Britain are sent for genomic sequencing, and as part of the country’s routine surveillance, around 15 to 20 percent of all positive P.C.R. tests of people already in the country are also sent for sequencing.
The Coronavirus Pandemic: Key Things to Know

The Omicron variant. The latest Covid-19 variant, which has been detected in dozens of countries, seems to dull the power of the Pfizer vaccine, but the company said its boosters offer significant protection. Omicron appears to spread rapidly, though it may be less severe than other forms of the virus.

Boosters. The F.D.A. authorized Pfizer to provide boosters to 16- and 17-year olds on an emergency basis, six months after receiving their second dose of the Covid vaccine. The C.D.C. promptly signed off on the move. Pfizer recently said that a booster shot of its vaccine offers significant protection against Omicron.

New restrictions. The U.S. is requiring international travelers to provide proof of a negative test taken no more than a day before their flights. In Germany, the government introduced tough restrictions on unvaccinated people, while Britain announced new measures in response to the rise in Omicron cases.

The worldwide vaccination campaign. One year into the global vaccine rollout, the gap in vaccination rates between high- and low-income countries is wider than ever. A Times analysis shows how infrastructure issues and the public’s level of willingness to get vaccinated may pose larger obstacles than supply.

“It’s not going to take long before it becomes obvious in other places, but it’s clearer earlier here,” Dr. Barrett said. “I think other countries should basically assume the same thing is happening.”

The genomic surveillance could also give Britain a head start in determining how severe Omicron cases are, though there will be a lag because it takes days or weeks for a person who gets infected to become seriously ill.

“It is increasingly evident that Omicron is highly infectious and there is emerging laboratory and early clinical evidence to suggest that both vaccine-acquired and naturally acquired immunity against infection is reduced for this variant,” Susan Hopkins, the chief medical adviser to the Health Security Agency, said in a statement.

Experts fear what that could mean for Britain’s already struggling National Health Service.
“A lot of staff have left or are burnt out,” Dr. English said, after months of dealing with the strains of the pandemic. “Now we’ve going to have another big hit — very likely — from Omicron. I am really, really sympathetic toward my poor colleagues working in clinical practice at the moment.”

Chaand Nagpaul, the chair of the British Medical Association, a trade union for doctors and medical students, said the government decision was the right one and had come at a crucial moment.

He said in a statement that the country had been having “increasingly high incidences of Covid-19 for some time,” adding that “health care workers are rightly worried about the impact the Omicron variant could have” on the health system’s ability to function if caseloads rise fast.
Some hospitals have already canceled elective care again, a strategy seen at the start of the pandemic to free up resources for treating coronavirus patients. Patients are already experiencing hourslong waits for ambulances as a result of the existing pressures on the system, Dr. Nagpaul added.

“While the number of Covid hospitalizations today is much lower than last winter, we must not risk complacency by ignoring the rapid doubling of Omicron cases every two to three days,” he said.

How Deadly Is the Omicron Variant? - Has Anyone Died From the New Covid Variant? [Prevention.com, 9 Dec 2021]

By Korin Miller

No deaths have been reported so far, but experts stress that it's early.

New COVID-19 variants have surfaced regularly since the pandemic began. Some have quickly faded away without making much of an impact, while others like Delta have completely taken over.

Now, public health officials around the world are warning about the rise and potential of Omicron, a new variant that was first detected in South Africa last month. The World Health Organization (WHO) said in a brief this week that the “overall global risk” of Omicron is “very high.” The brief continued, “Omicron is a highly divergent variant with a high number of mutations … some of which are concerning and may be associated with immune escape potential and higher transmissibility.”

The Centers for Disease Control and Prevention (CDC) followed by issuing a strong recommendation that Americans over the age of 18 get a booster shot of the COVID-19 vaccine after their primary vaccination. (Previously, the CDC said that people “may” get a booster.) “Early data from South Africa suggest increased transmissibility of the Omicron variant, and scientists in the United States and around the world are urgently examining vaccine effectiveness related to this variant,” CDC Director Rochelle Walensky, M.D., said in a statement about the booster recommendation.

What, exactly, Omicron will do and whether it has the potential to outcompete Delta is still being investigated. But it’s only natural to have questions, like how deadly the Omicron variant is and what this could mean for the future of the pandemic. Here’s everything you need to know.

What is the Omicron variant?
The Omicron variant, also called B.1.1.529, is a strain of COVID-19 that was first detected in South Africa on November 9. The WHO reported it on November 24 and classified Omicron as a variant of concern, its most serious classification.

It’s important to note that, while the variant was first detected in South Africa, that doesn’t mean it actually originated there.

Since it was first detected, cases of Omicron have been spotted in several parts of the world, including the U.S. “This variant has been detected at faster rates than previous surges in infection, suggesting that this variant may have a growth advantage,” the WHO said.

Why are experts so concerned about the Omicron variant?
There are a few potential issues that public health experts around the world are concerned about.

Where has the Omicron variant been detected?
Cases of Omicron continue to spread in South Africa and it’s also been detected in Botswana, according to the CDC. The variant has shown up in Hong Kong, the Netherlands, Canada, and Australia, too, per the Associated Press.

The U.S. and other countries have tightened travel restrictions in response to the variant, but cases of Omicron continue to pop up in the U.S. The variant has been detected in 17 states so far, according to CDC surveillance data.

South Africa is facing a huge surge in COVID-19 infections as well. “As the country heads into a fourth wave of COVID-19 infections, we are experiencing a rate of infections that we have not seen since the pandemic started,” President Cyril Ramaphosa said in an open letter to the country. “Nearly a quarter of all COVID-19 tests now come back positive. Compare this to two weeks ago, when the proportion of positive tests was sitting at around 2%.”

How deadly is the Omicron variant?
That’s a big question mark. The WHO says that, “preliminary data suggests that there are increasing rates of hospitalization in South Africa, but this may be due to increasing overall numbers of people becoming infected, rather than a result of specific infection with Omicron.”

Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases and the chief medical advisor to the president went on CNN's "State of the Union" on Sunday and said data does not indicate that Omicron is any more deadly than past strains of SARS-CoV-2, the virus that causes COVID-19. “Thus far, it does not look like there’s a great degree of severity to it,” Dr. Fauci said. “But we have really got to be careful before we make any determinations that it is less severe or it really doesn’t cause any severe illness, comparable to Delta.”

Infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security, agrees. “There is still not enough information to make a definitive evaluation of the variant, but each day we learn more,” he says. “It’s unclear how ‘deadly’ this variant is, because there have not been any reported deaths thus far, but deaths lag.”

Dr. Russo says that more data—and time—is needed. “Overall, the cases have been mild and that’s encouraging,” he says. However, he adds, as Omicron infects more people, doctors will get a better sense of how deadly the variant is in the overall population. “We’re still in waiting mode,” Dr. Russo says.

How to protect yourself against Omicron
Currently, the Delta variant is responsible for 99.9% of COVID-19 cases in the U.S., per CDC data. “Delta is still the big threat,” Dr. Russo says. However, Omicron is starting to surface in areas where Delta is prevalent.

“People should definitely not stress out about Omicron,” Dr. Russo says. “It’s highly likely that, if you’re fully vaccinated—with three shots in your arm—the worst-case scenario is that you’ll get an asymptomatic or mild infection if you happen to be infected.”

Dr. Adalja says that increased testing and doing your own personal risk calculation before you go into crowds and public spaces can help, too.

But Dr. Russo urges people to “use this time judiciously” and to “go ahead and get maximum protection”—especially before the holidays. “If Omicron turns out to be problematic, you’ll be more protected,” he says. “But now is the time to take action.”

CDC chief says Omicron is ‘mild’ as early data comes in on US spread of variant [The Guardian, 9 Dec 2021]

Agency is working on detailed analysis of what the new mutant form of the coronavirus might hold for the US

More than 40 people in the US have been found to be infected with the Omicron variant so far, and more than three-quarters of them had been vaccinated, the chief of the Centers for Disease Control and Prevention (CDC) has said. But she added nearly all of them were only mildly ill.

In an interview with the Associated Press, Dr Rochelle Walensky, director of the CDC, said the data is very limited and the agency is working on a more detailed analysis of what the new mutant form of the coronavirus might hold for the US.

“What we generally know is the more mutations a variant has, the higher level you need your immunity to be … we want to make sure we bolster everybody’s immunity. And that’s really what motivated the decision to expand our guidance,” Walensky said, referencing the recent approval of booster shots for all adults.

She said “the disease is mild” in almost all of the cases seen so far, with reported symptoms mainly cough, congestion and fatigue. One person was hospitalized, but no deaths have been reported, CDC officials said.

Some cases can become increasingly severe as days and weeks pass, and Walensky noted that the data is a very early, first glimpse of US Omicron infections. The earliest onset of symptoms of any of the first 40 or so cases was 15 November, according to the CDC.

The Omicron variant was first identified in South Africa last month and has since been reported in 57 countries, according to the World Health Organization.

The first US case was reported on 1 December. As of Wednesday afternoon, the CDC had recorded 43 cases in 19 states. Most were young adults. About a third of those patients had traveled internationally.

More than three-quarters of those patients had been vaccinated, and a third had boosters, Walensky said. Boosters take about two weeks to reach full effect, and some of the patients had received their most recent shot within that period, CDC officials said.

Fewer than 1% of the US Covid-19 cases genetically sequenced last week were the Omicron variant; the Delta variant accounted for more than 99%.

Scientists are trying to better understand how easily it spreads. British officials said Wednesday that they think the Omicron variant could become the dominant version of the coronavirus in the UK in as soon as a month.

The CDC has yet to make any projections on how the variant could affect the course of the pandemic in the US. Walensky said officials are gathering data but many factors could influence how the pandemic evolves.

“When I look to what the future holds, so much of that is definitely about the science, but it’s also about coming together as a community to do things that prevent disease in yourself and one another. And I think a lot of what our future holds depends on how we come together to do that,” she said.

The CDC is also trying to establish whether the Omicron variant causes milder – or more severe – illness than other coronavirus types. The finding that nearly all of the cases so far are mild may be a reflection that this first look at US Omicron cases captured mainly vaccinated people, who are expected to have milder illnesses, CDC officials said.

Another key question is whether it is better at evading vaccines or the immunity people build from a bout with Covid-19.

This week, scientists in South Africa reported a small laboratory study that found antibodies created by vaccines were not as effective at preventing Omicron infections as they were at stopping other versions of the coronavirus.

On Wednesday, vaccine manufacturer Pfizer said that while two doses may not be protective enough to prevent infection, lab tests showed a booster increased levels of virus-fighting antibodies by 25-fold.

What Is The Meaning Of Omicron? [Forbes, 9 Dec 2021]

By William A. Haseltine

The data on Omicron is still too sparse to allow us to make clear predictions on the exact nature of this new variant, but we know enough about this strain to understand its essential meaning. Omicron is sending a message, loud and clear: this virus is capable of far more changes and far more variation than most ever thought possible and it will keep coming back to haunt us again and again.

From an evolutionary biology point of view, Omicron was to be expected. Coronaviruses in general have adapted to develop a wide variety of strategies to continue their replication and to infect and reinfect multiple species over millions of years. Coronaviruses evolved in bats and other long-lived, highly immunocompetent creatures. To survive, the virus had to learn a wealth of tricks — dampening immunity, evading early immune defenses, and shapeshifting to allow for multiple reinfections. Bats, in behavior at least, are a species quite similar to humans, living in densely packed communities but able to travel from one community to another, interacting with other animals and species along the way. Coronaviruses have learned how to thrive not only in a host species but how to infect neighboring species as well.

At least seven coronaviruses have made the jump from animals to humans, but SARS-CoV-2 has shown that it can make the jump back into animals to reemerge and invade us again — a process called reverse zoonosis. But that’s not all this virus can do. If we look closely at the genomes of the coronaviruses that have emerged from bats and other species, we see that these viruses can readily recombine amongst each other, in addition to the point mutations we have seen in Omicron and in other known SARS-CoV-2 variants. Recombination, we know from influenza, can lead very quickly to much more virulent variants by picking up components that our immune systems have not previously seen.

While the world is now appropriately concerned about Omicron, many continue to overlook what more this virus may have in store for us. The variations we have seen in SARS-CoV-2 variants across the viral genome show us that this virus has many more tools still at its disposal to increase infectivity. Changes to the regulatory proteins can increase the virus’ ability to suppress our immune system. Mutations in structural and non-structural proteins can help the virus increase its ability to replicate. Changes in the spike, as we’ve already seen, can increase its affinity and allow it to bind more easily to our cells.

I believe we can expect a continual barrage of variants for the indefinite future unless we are able to bring this virus under control through a systematic application of public health measures and medical interventions, including vaccines, drugs, and diagnostic tests. I’ve written numerous times about a multimodal approach to Covid control but I fear, still today, not enough countries are taking heed.

White House Mandates Pfizer Vaccines for Millions of Citizens ...Before the FDA Clinical or Safety Reviews Have Been Made Public

Our first and best line of defense has and will always be public health, which requires leadership and a culture of understanding and acceptance of tough measures when the situation dictates. Widespread testing, at home and in all public spaces like schools, businesses, and major public events is a basic necessity, which must be tied to rigorous contact tracing and notification of those exposed. When new outbreaks occur, stringent public health measures need to be enforced to control the virus spread: mask-wearing, improved ventilation, social distancing, mandatory quarantine and isolation, and — as challenging as they may be — even lockdowns if necessary. China has proven that this approach can work against the original virus and every known variant.

Beyond public health, we have our vaccines — the full three-dose regimen of top-of-the-line mRNA vaccines. Even if they cannot neutralize a new variant like Omicron completely, they will still offer some degree of added protection and, in those who mount a particularly robust antibody response, that protection may still be quite high initially.

But beyond vaccines, whose potency will no doubt fade against some variants and may fade quite considerably for all variants over time, we need other protections. Right now, our best bet lies with the wider use of monoclonal antibodies for early treatment of COVID-19 and for long-term prevention and protection from the disease. The latest generation of these therapies can be administered by injection after exposure to Covid-19 or shortly after symptoms first appear.

One single dose of monoclonal antibodies could not only prevent someone infected from a severe case of Covid, but it could also prevent that person from becoming infected again, for up to eight months potentially. Consider what this could mean for long-term care centers, naval ships, or people living in university dorms — if one person in your residence fell ill, all others could take a shot to prevent themselves from getting Covid and from spreading it to others. Eventually, oral antivirals may be used in place of an injection, but for now, we know too much about the dangers of molnupiravir, the antiviral drug currently being considered for approval, to allow for its widespread use.

It may not seem like it today, but we do have the tools at hand to control the trajectory of this pandemic. The challenge, from the very beginning, has been in not using them as effectively and rigorously as needed.

To beat Omicron, the race is on to tweak existing vaccines [National Geographic, 9 Dec 2021]

BYMERYL DAVIDS LANDAU

Experts say that updating available vaccines for the worrisome new variant is not that hard and will still yield safe shots.

Almost exactly a year ago, on December 11, 2020, the U.S. Food and Drug Administration authorized the country’s first COVID-19 vaccine. That Pfizer-BioNTech shot and the ones from other companies that followed have strengthened our collective armor against all the coronavirus variants that have evolved since.

But now scientists fear that the mutations in Omicron alter the virus so significantly that the recipes for the vaccines may need to be adjusted.

As soon as Omicron was characterized in late November, companies rushed to declare that they are on the case. In addition to testing how well their current shots hold up against the new variant; Moderna vowed to “rapidly advance an Omicron-specific booster candidate;” Pfizer said it would have one available by March; and Johnson & Johnson announced it “is pursuing an Omicron-specific variant vaccine.”

Novavax, which has filed for authorization but whose vaccine is not yet available in the U.S., said in a statement that its Omicron-targeted offering will be “ready to begin testing and manufacturing within the next few weeks.”

In some ways, the race to reformulate the shots is striking. “We don’t have many vaccines that we change regularly: measles hasn’t changed, rubella hasn’t changed, hepatitis hasn’t changed,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Compared to those more stable pathogens, though, this coronavirus evolves quickly. Experts closely watching Omicron’s spread say drug companies’ efforts to tailor a vaccine to this variant are warranted, because it seems to evade immunity better than prior ones.

“My optimism about Omicron has waned over the past week,” as more—albeit preliminary—data comes in from South Africa, says Vaughn Cooper, professor of microbiology and molecular genetics at the University of Pittsburgh School of Medicine. “The rate of infection [among] previously sick or vaccinated individuals contracting Omicron is really high.”
Rewriting genetic code

Omicron’s ability to infect people who should have immunity likely results from the whopping number of mutations—more than 30—in its spike protein, the part of the virus that helps it enter human cells.

Most concerning are several mutations in what is known as the receptor binding domain, the region of the spike responsible for attaching to our cells, Cooper says. One part of our immune system, its B cells, generate three main types of antibodies that each target a unique section of the spike protein’s surface. Prior variants have had mutations in one or two of these antibody targeting regions, but Omicron has mutations in all three, he notes.

Other variants of concern, especially Beta, have shared some of Omicron’s potentially antibody-evading mutations, but no others have as many, or in the same combinations. “It’s possible that some of the mutations might work in concert with other mutations. Or maybe they cancel each other out. We don’t yet know,” says Katelyn Jetelina, assistant professor of epidemiology at the University of Texas Health Science Center at Houston and the author of the popular Your Local Epidemiologist blog.

The key question is whether the mutations or some combination of them confuse an immune system trained to spot the spike protein, whether from prior vaccinations or from contracting COVID-19.

“Significant alterations in the shape or structure of spike might change how effectively our immune cells neutralize the virus,” says Jill Weatherhead, assistant professor of tropical medicine and infectious diseases at Baylor College of Medicine. She emphasizes, however, that nobody yet knows if that’s the case.

Should changes be needed in the vaccines, the new mRNA vaccines will be easier to modify than most non-COVID vaccines. The process should take only a few months, says Onyema Ogbuagu, a Yale Medicine infectious diseases specialist and a principal investigator of the Pfizer COVID-19 vaccine trials.

The active ingredient in an mRNA shot is genetic code that provides the instructions for human cells to produce the virus’s spike protein. The mRNA is fashioned in a lab from four chemical building blocks called nucleotides. To target new mutations in the spike, you simply remove a few of the old blocks and replace them with new ones, Ogbuagu explains.

Altering the Johnson & Johnson vaccine, where the genetic code is delivered by an adenovirus vector, may be a bit more challenging. But it too fundamentally involves rewriting a bit of code, Weatherhead says.
In a vaccine with a lot of genetic instructions, these alterations would be small, which is why new side effects from refashioned shots are unlikely, Ogbuagu adds. “It’s not creating a new vaccine. It’s more like taking a dress and hemming it to give it a new length,” he says.
Lessons from flu shots

Scientists point to seasonal flu as the model for how to potentially modify COVID-19 vaccines. Each February the World Health Organization uses data from circulating influenza in the Southern Hemisphere, combined with laboratory studies, to make an educated guess about which flu strains will dominate the following season.

Licensed vaccine manufacturers need only prove to the FDA that changes they make to target these strains trigger an adequate number of antibodies to fight them. Companies can test this in a small group of people. They are not required to conduct large clinical trials each year, as they must before getting approval for a novel vaccine.

Updated guidance from the FDA issued in February 2021 outlines similar steps for COVID-19 variants, a process known in the industry as “plug and play.” Manufacturers who tweak their shots can test immune response in a modest number of people—likely several hundred, experts expect. The guidance recommends including people who have various COVID-19 vaccine histories, from no prior shots to all recommended boosters. But it doesn’t mandate testing the vaccine in all age groups, such as children or older people.

Should a strain change be needed for COVID-19, the FDA will need to move even faster than it does for influenza. “With flu they have six months to develop new shots; with the coronavirus pandemic, they’ll need it now. But no shortcuts will be taken,” Osterholm insists.

Companies will have to follow their current manufacturing processes identically for any tweaked shot they put forward. This is the key to keeping them safe, he says. Large numbers of unexpected side effects in flu shots haven’t turned up since the swine flu vaccine in 1976, when dozens of people developed the neurological disorder Guillain-Barré syndrome.
Osterholm attributes that to shifts in how the flu shots were manufactured, not to the change in strain.

To gauge whether Omicron will require changes in our vaccines and boosters, scientists in the U.S. are closely watching the variant’s behavior in other countries, including Israel and the United Kingdom, where nationalized health systems allow them to quickly link vaccination records with COVID-19 cases.

“Throughout the pandemic, these countries have been turning around large data sets in seven to 10 days,” Osterholm says. Information from South Africa, where the variant is widely spreading, will also reveal whether Omicron has infected a higher percentage of seriously ill patients who were vaccinated compared to Delta.

Tests on the blood of vaccinated people are also used to determine how well antibodies might take down Omicron. These preliminary lab studies have already shown that three doses of Pfizer’s vaccine are effective against the variant, the company says. But these “viral neutralization assays” have limited value, Osterholm says. “This can potentially demonstrate that there is a substantial decrease in neutralization, but you still have to translate that to clinical care,” he says.

Even if the original vaccines are found to be less effective against Omicron, they may still prove potent enough, especially because vaccines stimulate our immune system’s T-cells as well as the antibody-producing B-cells. The problem is they don’t mobilize as quickly. “This cellular immune response takes time, so more people might get sick while it is gearing up—what we’ve been calling breakthrough infections,” Cooper says.

Still, getting one of the currently available shots, including all recommended boosters, “is the best tool we have now,” so everyone should do that, Weatherhead says.

Eventually, manufacturers might come up with a universal vaccine, one that would be effective against all of the variants that might arise. The idea is that it would target several essential features of the SARS-CoV-2 virus, rather than only one, around which the virus could evolve, Cooper says.

This technique may once have seemed pie-in-the-sky, Cooper says. But the success of the mRNA technology and the amount of science learned about virus-host interactions from this pandemic “has bolstered the idea of universal vaccines against major viruses like coronavirus and flu enough that we could see clinical trials start within a few years.”

730 fully-vaccinated Missourians have died from COVID-19, a fraction of all recorded deaths [KTVI Fox 2 St. Louis, 9 Dec 2021]

by Kevin S. Held

JEFFERSON CITY, Mo. – The latest data and information from the Missouri health department says 730 people who were fully vaccinated against COVID-19 still died from the virus. However, this proves the efficacy of the vaccines, since those deaths make up far less than a tenth of all vaccinated people in the state.

According to the Missouri Department of Health and Senior Services (DHSS), the state has recorded 760,035 cumulative cases of SARS-CoV-2—an increase of 2,475 positive cases (PCR testing only)—and 12,708 total deaths as of Thursday, Dec. 9, an increase of 14 over yesterday. That’s a case fatality rate of 1.67%.

It’s important to keep in mind that not all cases and deaths recorded occurred in the last 24 hours.

The state has administered 181,338 doses—including booster shots—of the vaccine in the last 7 days (this metric is subject to a delay, meaning the last three days are not factored in). The highest vaccination rates are among people over 65.

Vaccination is the safest way to achieve herd immunity. Herd immunity for COVID-19 requires 80% to 90% of the population to have immunity, either by vaccination or recovery from the virus.

Just 2.07% of 3.2 million fully vaccinated Missourians have tested positive for COVID. And only 730 people (or 0.02%) of fully vaccinated people have died.

The first doses were administered in Missouri on Dec. 13, 2020.

Joplin, St. Louis City, and Kansas City, as well as St. Louis, St. Charles, Boone, Atchison, and Jackson counties are the only jurisdictions in the state with at least 50% of their population fully vaccinated. Thirty-five other jurisdictions in the state are at least 40% fully vaccinated: Cole, Franklin, Greene, Cape Girardeau, Jefferson, Nodaway, Cass, Ste. Genevieve, Carroll, Andrew, Callaway, Gasconade, Christian, Benton, Adair, Clinton, Dade, Livingston, Ray, Lafayette, Montgomery, Shelby, Osage, Henry, Clay, Camden, Warren, Howard, Cooper, Phelps, Stone, St. Francois, Holt, and Chariton counties, as well as the city of Independence.

The Bureau of Vital Records at DHSS performs a weekly linkage between deaths to the state and death certificates to improve quality and ensure all decedents that died of COVID-19 are reflected in the systems. As a result, the state’s death toll will see a sharp increase from time to time. Again, that does not mean a large number of deaths happened in one day; instead, it is a single-day reported increase.

At the state level, DHSS is not tracking probable or pending COVID deaths. Those numbers are not added to the state’s death count until confirmed in the disease surveillance system either by the county or through analysis of death certificates.

The 7-day rolling average for cases in Missouri sits at 2,260; yesterday, it was 2,259. Exactly one month ago, the state rolling average was 846.

The 10 days with the most reported cases occurred between Oct. 10, 2020, and Nov. 18, 2021.

Approximately 50.0% of all reported cases are for individuals 39 years of age and younger. The state has further broken down the age groups into smaller units. The 18 to 24 age group has 91,402 recorded cases, while 25 to 29-year-olds have 64,217 cases.

People 80 years of age and older account for approximately 41.7% of all recorded deaths in the state.

Missouri has administered 8,018,605 PCR tests for COVID-19 over the entirety of the pandemic and as of Dec. 8, 17.1% of those tests have come back positive. People who have received multiple PCR tests are not counted twice, according to the state health department.

According to the state health department’s COVID-19 Dashboard, “A PCR test looks for the viral RNA in the nose, throat, or other areas in the respiratory tract to determine if there is an active infection with SARS-CoV-2, the virus that causes COVID-19. A positive PCR test means that the person has an active COVID-19 infection.”

The Missouri COVID Dashboard no longer includes the deduplicated method of testing when compiling the 7-day moving average of positive tests. The state is now only using the non-deduplicated method, which is the CDC’s preferred method. That number is calculated using the number of tests taken over the period since many people take multiple tests. Under this way of tabulating things, Missouri has a 12.8% positivity rate as of Dec. 6. Health officials exclude the most recent three days to ensure data accuracy when calculating the moving average.

The 7-day positivity rate was 4.5% on June 1, 10.2% on July 1, and 15.0% on Aug. 1.

As of Dec. 6, Missouri is reporting 1,672 COVID hospitalizations and a rolling 7-day average of 1,600. The remaining inpatient hospital bed capacity sits at 19% statewide. The state’s public health care metrics lag behind by three days due to reporting delays, especially on weekends.
Keep in mind that the state counts all beds available and not just beds that are staffed by medical personnel.

On July 6, the 7-day rolling average for hospitalizations eclipsed the 1,000-person milestone for the first time in four months, with 1,013 patients. The 7-day average for hospitalizations had previously been over 1,000 from Sept. 16, 2020, to March 5, 2021.

On Aug. 5, the average eclipsed 2,000 patients for the first time in more than seven months. It was previously over 2,000 from Nov. 9, 2020, to Jan. 27, 2021.

The 2021 low point on the hospitalization average in Missouri was 655 on May 29.

Across Missouri, 387 COVID patients are in ICU beds, leaving the state’s remaining intensive care capacity at 19%.

If you have additional questions about the coronavirus, the Missouri Department of Health and Senior Services is available at 877-435-8411.

As of Dec. 9, the CDC identified 49,458,520 cases of COVID-19 and 790,766 deaths across all 50 states and 9 U.S.-affiliated districts, jurisdictions, and affiliated territories, for a national case-fatality rate of 1.60%.

How do COVID deaths compare to other illnesses, like the flu or even the H1N1 pandemics of 1918 and 2009? It’s a common question.

According to the Centers for Disease Control and Prevention (CDC), preliminary data on the 2018-2019 influenza season in the United States shows an estimated 35,520,883 cases and 34,157 deaths; that would mean a case-fatality rate of 0.09 percent. Case-fatality rates on previous seasons are as follows: 0.136 percent (2017-2018), 0.131 percent (2016-2017), 0.096 percent (2015-2016), and 0.17 percent (2014-2015).

The 1918 H1N1 epidemic, commonly referred to as the “Spanish Flu,” is estimated to have infected 29.4 million Americans and claimed 675,000 lives as a result; a case-fatality rate of 2.3 percent. The Spanish Flu claimed greater numbers of young people than typically expected from other influenzas.

Beginning in January 2009, another H1N1 virus—known as the “swine flu”—spread around the globe and was first detected in the US in April of that year. The CDC identified an estimated 60.8 million cases and 12,469 deaths; a 0.021 percent case-fatality rate.