New Coronavirus News from 16 Mar 2022

Scalise calls for Fauci to testify at upcoming hearing | TheHill [The Hill, 16 Mar 2022]

BY NATHANIEL WEIXEL

House Minority Whip Steve Scalise (R-La.) invited top infectious diseases doctor Anthony Fauci to testify alongside other administration officials at an upcoming hearing about moving beyond the current COVID-19 crisis.

The House Select Subcommittee on the Coronavirus Crisis is holding a hearing on March 30 featuring other top administration health officials, including Centers for Disease Control and Prevention Director Rochelle Walensky and Surgeon General Vivek Murthy.

Fauci was not included among the witnesses.

Scalise, the panel's ranking member, said the committee has not heard from Fauci directly since a briefing on July 29, 2021.

"Notably, you are missing from this esteemed witness panel, despite being the Chief Medical Advisor to President Biden and the Director of the National Institute of Allergy and Infectious Diseases," Scalise wrote in a letter to Fauci.

Fauci and other administration officials have testified multiple times in the Senate.

The Hill has reached out to the National Institute of Allergy and Infectious Diseases and to the subcommittee's chairman, House Majority Whip James Clyburn (D-S.C.).

According to the subcommittee, the administration officials at the hearing are set to address the progress made as well as how the U.S. is preparing for any new variants.

The subcommittee has been focused on investigating the pandemic response under former President Trump, looking for evidence of political interference. The committee has heard closed-door testimony from a number of Trump officials, including former coronavirus coordinator Deborah Birx.

Fauci has become a top target of congressional Republicans as they conduct their own investigation into the origins of the coronavirus, seeking to find out whether the U.S.
government played a role by funding controversial "gain of function" research in Wuhan, China.

Several Republicans in both the House and Senate allege Fauci has not been transparent and honest about his agency's funding activities, accusations he denies.

New Coronavirus News from 17 Mar 2022

What to Know About a Fourth COVID-19 Vaccine Dose [TIME, 17 Mar 2022]

BY ALICE PARK

A health care administer gives the second dose of the Pfizer-BioNTech COVID-19 vaccine to a person at the L.A. Care Health Plan free testing and vaccination site at the First African Episcopal Church in Los Angeles, California, U.S., January 29, 2022.

Most people ages 12 and older are considered “up to date” with their COVID-19 vaccines if they received either three doses of the mRNA shots from Pfizer-BioNTech or Moderna, or two doses of Johnson & Johnson’s Janssen vaccine. But some public health experts say another dose might be needed in the coming months.

On March 15, Pfizer and BioNTech requested authorization from the U.S. Food and Drug Administration (FDA) for a fourth dose of their vaccine in people ages 65 and older. In the past few days, Albert Bourla, Pfizer’s CEO, has said that he believes everyone will one day need a fourth dose in order to help prevent infections (a move that would have obvious benefits for the company’s bottom line.)

In order to authorize a fourth shot, the FDA will consider still emerging data that don’t paint a definitive picture about whether an additional dose is necessary for most people. One the one hand, there are troubling signs that the immunity provided by the vaccines is starting to wane, which could make people more vulnerable to COVID-19’s more severe effects. Recent data published by the U.S. Centers for Disease Control and Prevention (CDC) show that protection against hospitalization for COVID-19 waned even after a booster dose of either the Pfizer-BioNTech or Moderna vaccines. From Aug. 2021 to Jan. 2022—a time span that includes waves of both Delta and Omicron variants—the booster was 91% effective at protecting against hospitalization in the first two months after people received it, but dropped to 78% four months after the shot. The vaccine efficacy against emergency room and urgent care visits for COVID-19 symptoms followed a similar decline, from 87% up to two months after the booster to 66% four to five months after the booster.

“We don’t know when you get to six months, seven months, or eight months after the third dose whether that 78% is going to go down to 60%, 50%, or 40%,” says Dr. Anthony Fauci, the White House’s chief medical advisor on COVID-19 and director of the National Institute of Allergy and Infectious Diseases. “For that reason, you are going to hear serious consideration for giving a fourth boost to the elderly and those with certain underlying health conditions.
What we might be seeing in the reasonable future is that individuals, merely on the basis of age, and perhaps some underlying health conditions yet to be determined, would get an immediate boost.”

On the other hand, another small study published in the New England Journal of Medicine among younger health care workers in Isreal showed that adding a fourth dose for people vaccinated and boosted with the Pfizer-BioNTech shot may only have “marginal benefits,” according to the researchers. While the additional dose raised levels of antibodies that can neutralize the virus, including Omicron, slightly, those levels were relatively similar to peak amounts of antibodies people generated after the first booster, or third dose. The study did not focus on elderly people or those with compromised immune systems.

The U.S. CDC already recommends a fourth mRNA vaccine dose for people with weakened immune systems, including transplant patients and those undergoing chemotherapy for cancer, and other countries have similar guidelines. Israeli health officials have gone one step further; on Jan. 22, as cases and hospitalizations crept upward, the country authorized a fourth dose of the Pfizer-BioNTech mRNA vaccine for health care workers and people over 60 years old. The decision was based on early data from Israel’s Ministry of Health and researchers at several Israeli universities showing that among nearly a million vaccinated people over age 60, a fourth dose of the vaccine offered up to twice the protection against getting infected, and up to three times the protection against severe illness, compared to those who received three doses.

There is also growing evidence that all types of vaccine-induced protection continue to wane. Scientists have long known that the antibodies people make immediately after getting vaccinated are relatively short-lived, but the vaccine triggers the body to also produce other immune defenses, including T cells, which tend to be more durable. Even those responses, however, start to taper after several months, says Dr. Otto Yang, professor of medicine, infectious diseases, microbiology, immunology, and molecular genetics at the University of California, Los Angeles. That means existing vaccine regimens may need to be supplemented with yet another booster dose to keep both antibody and T cell numbers high enough to protect people from severe disease, he says.

But whether everyone needs an additional vaccine dose, and whether or not we can anticipate getting one every year or every few years, depends on what we want the vaccines to accomplish. The vaccines were not designed to prevent people from getting infected by the virus, but to protect them from getting extremely sick with COVID-19, and to keep them from needing hospitalization and intensive care. Remembering that goal, says Dr. Paul Offit, director of the Vaccine Education Center and professor of pediatrics at Children’s Hospital of Philadelphia, is useful when thinking about whether a fourth dose is necessary for most people.
“We got hung up using the word ‘breakthrough’ in describing mild illness,” he says, referring to the term for any infection occurring among vaccinated and boosted people (most of which were mild or even asymptomatic). “But that’s a win—it meant the vaccine was working for you and protected you from serious illness. We have developed a zero tolerance strategy that we are going to have to get over: the idea that it’s not okay to have mild illness after you’ve been vaccinated.”

If the goal of a COVID-19 vaccine is to protect people from severe disease, Offit says that there is still insufficient data supporting the need for a booster for most healthy adults. “I think we have to accept the notion that this is a three-dose vaccine in certain groups and a two-dose vaccine in others,” Offit says.

Offit, who serves on the FDA vaccine advisory committee of independent experts that reviews data and makes recommendations to the FDA about whether or not a vaccine is safe and effective, says that trying to protect the world’s population from mild disease with continued booster doses isn’t a realistic or practical public health goal. The question becomes one of balancing any marginal benefit in protecting against mild illness against potential side effects, which for the mRNA vaccines include the risk of inflammation of heart tissue. “Everything has costs, including boosting,” he says. “If it doesn’t benefit you in terms of protection against serious illness, then you have to consider the side effects.”

Fauci says health officials will be watching the hospitalization rate among vaccinated and boosted people closely in coming weeks and months; if it creeps upward, then it would signal a concerning waning of protection even against severe disease, which could warrant another booster dose. “We don’t know now if we are going to need it, but as long as this virus hangs around, I would not be surprised if we are going to need one more shot than we have had,” he says.

He and others also don’t anticipate continuing to boost as new variants crop up. Up to this point, that strategy came out of the urgent need to tamp down the virus as quickly as possible in as many people as possible. But it’s not a durable or practical game plan over the long term. “We’ve been chasing our tails with every variant, and we will perpetually be behind [the virus],” says Dr. Kirsten Lyke, professor of medicine at University of Maryland, who spearheaded studies about mixing and matching different types of COVID-19 vaccines.

But now that a good portion of the U.S. population has some degree of immunity through infection, vaccination, or both, the National Institutes of Health is launching new studies in search of a more targeted approach to potential booster shots. Rather than responding to new variants as they emerge and hoping the existing vaccines continue to protect against severe disease, scientists there are mapping out SARS-CoV-2’s mutations and trying to design vaccines against broad collections of changes that would ideally quell a number of different, but related strains that the virus may generate in the future. The study will involve up to 1,500 people at 25 sites. “By mid-summer, we would like to put all the data together so we can make a more scientific assessment as to whether additional boosters will work, whether we will need them, and which one we might need to use,” says Lyke.

Whether a fourth dose will be recommended for most Americans likely depends on future hospitalization rates among vaccinated and boosted people; if they continue to increase, that might push health officials to consider recommending another booster dose. In the meantime, Fauci says scientists at the National Institute of Allergy and Infectious Diseases’ Vaccine Research Center are investigating whether that additional dose should come from the same vaccine people have been receiving, or whether that additional dose should be with a new vaccine that targets a specific variant, such as Omicron. So far, the original booster produces similar immune responses to those generated by a variant-specific boosters in non-human primates. “Given the fact we have waning immunity, we may need a regular boost at intervals yet to be determined,” Fauci says.

70% of COVID survivors in UK study had impaired memory, focus [CIDRAP, 17 Mar 2022]

by Mary Van Beusekom

An online UK study finds that about 70% of 181 adult COVID survivors had memory and concentration problems several months after infection, 75% reported persistent symptoms so severe that they couldn't work, and 50% said that medical professionals didn't take their symptoms seriously.

In the ongoing COVID and Cognition study, published as two papers today in Frontiers in Aging Neuroscience, a team led by University of Cambridge researchers report on the baseline characteristics and cognitive test performance of 181 long COVID patients and 185 never-infected peers.

Participants were recruited from the United Kingdom, Ireland, the United States, Canada, Australia, New Zealand, and South Africa, although 70% were White UK patients. Most COVID-19 survivors were infected 6 or more months before, and only a few had been ill enough to be hospitalized. Data collection on patients infected from March 2020 to February 2021 (when the Delta and Omicron variants were uncommon in the study countries) took place from October 2020 to March 2021.

Long COVID can be debilitating, affecting multiple organ systems, including the brain, and causing highly individual symptoms in the months after infection. Neurologic symptoms may include "brain fog," disorientation, headache, and forgetfulness.

Severe infection portends severe long COVID
In the first paper, the team found that the severity of acute illness was a significant predictor of the presence and severity of long COVID symptoms.

Six initial symptoms were associated with progression to long COVID, including limb weakness, brain fog, chest pain or tightness, dizziness, cough, and breathing problems. Those with more severe fatigue and neurologic symptoms such as dizziness and headache during infection were more likely than others to have severe lingering symptoms.

Among the 126 participants with long COVID, 77.8% reported problems with concentration, while 69% reported brain fog, 67.5% cited forgetfulness, 59.5% reported tip-of-the-tongue word-finding problems, and 43.7% said they struggled with saying or typing the correct word.

Participants who had been ill for longer were more likely to report having had cognitive symptoms throughout the ongoing illness and to still have them.

Among those with ongoing symptoms, upwards of 54.6% had experienced long periods in which they were unable to work, while 34.5% had lost their job due to illness, 63.9% reported difficulty coping with day-to-day activities, 49.6% had had difficulty getting medical professionals to take their symptoms seriously, 43.7% felt that they had experienced a trauma, and 17.6% had experienced financial problems owing to their illness.

Among the 109 participants who sought medical care, the most common diagnoses were hypoxia (low oxygen levels, 14.7%), blood clots (5.5%), and inflammation (4.6%). Number of weeks since infection was positive correlated with severity of ongoing cardiopulmonary symptoms and fatigue.

While the exact pathways haven't been elucidated, the study authors said that a dysfunctional or outsized immune response may lead to chronic inflammation and long COVID.

"There are a number of mechanisms by which COVID-19 infection may lead to neurological symptoms and structural and functional changes in the brain, and it is reasonable to expect that many of these may translate into cognitive problems," the researchers wrote. "Indeed, cognitive problems are one of the most commonly reported symptoms in those experiencing 'Long COVID'—the chronic illness following COVID-19 infection that affects between 10 and 25% of patients."

Memory loss may predict dementia
In the second paper, the researchers evaluated participants' performance on multiple tasks related to areas such as memory, language, and executive function.

They identified a significant negative influence of COVID-19 infection on memory, even after adjusting for age, sex, country, and education level, with poorer performance and slower reaction time on the Word List Recognition Memory Test than the non-COVID group. A much weaker pattern was seen with the Pictorial Associative Memory Test, which suggested poor performance among COVID group members but no difference in reaction time.

Pairwise analyses showed that participants with severe ongoing symptoms scored significantly lower on the percentage of correct answers and reaction time. Pairwise tests also revealed that those with severe ongoing symptoms had fewer correct words on the category fluency test than recovered participants, but no pairwise comparisons were significant for word repetitions. There was no difference on executive function testing.

"Given these findings, we suggest that, as others have found… 'objective' cognitive differences do exist between those that have and have not experienced the COVID-19 infection," the authors wrote.

They added that accumulating evidence, including previous findings of a loss of gray matter in the temporal lobe of the brain and reduced memory performance in this study, suggests that COVID-19 survivors may be at increased risk for future neurodegeneration and dementia.

"It is thus notable that, in this study, self-reported memory issues were associated with measurable reductions in memory ability and that these are linked with other neurological symptoms," the researchers wrote. "This suggests that neurological and neuropsychological assessment should be made more widely available to patients with Long COVID reporting cognitive deficits."

Cognitive symptoms are real
The researchers said that the results indicate that long COVID cognitive symptoms need to be taken seriously.

"This is important evidence that when people say they’re having cognitive difficulties post-COVID, these are not necessarily the result of anxiety or depression," study coauthor Muzaffer Kaser, MD, PhD, said in a University of Cambridge news release. "The effects are measurable—something concerning is happening."

Senior author Lucy Cheke, PhD, said that long COVID has garnered little political or medical attention, which belies its potential long-term impact on the workforce. "When politicians talk about 'Living with COVID'—that is, unmitigated infection, this is something they ignore," she said. "The impact on the working population could be huge."

Covid-19 surge in South Korea, Hong Kong. How worried should we be? [Firstpost, 17 Mar 2022]

There’s a jump in infections with 11 million new cases reported from 7 March to 13 March.

The WHO is calling it the “tip of the iceberg”

The pandemic is far from over. There has been a spike in cases in several countries across the world, especially in Asia, where lockdowns are back.

The World Health Organisation (WHO) sounded a warning to nations, as they become lackadaisical with a drop in testing. After more than a month of decline, COVID-19 cases have started to increase around the world last week, the WHO said on Tuesday.

New infections jumped by eight per cent globally compared to the previous week, with 11 million new cases and just over 43,000 new deaths reported from 7 March to 13 March. It is the first rise since the end of January, reported news agency Reuters.

“These increase are occurring despite reductions in testing in some countries, which means the cases we’re seeing are just the tip of the iceberg,” warned WHO’s head Tedros Adhanom Ghebreyesus while talking to the media.

Which are the countries which are seeing a rise in coronavirus cases? And how worried should India be? We answer a few questions.

According to WHO, the highly transmissible Omicron variant and its BA.2 sublineage have been fast-spreading, as countries relax social-distancing measures and other public health norms.

Parts of China under lockdown
The situation is worsening in China and South Korea, where deaths have risen by 27 per cent and cases by 25 per cent.

On Tuesday, China witnessed 5,280 new infections, two times more than the previous day. It forced the country to put more than 30 million under lockdown – 13 cities were fully locked down and in other cities partial restrictions were imposed.

The worst-hit was the northeastern province of Jilin; Shenzhen – the southern tech hub of 17.5 million people – was forced to shut factories, and China's largest city Shanghai has partial restrictions.

After the flare-up, new symptomatic local cases have declined. The country reported 1,226 new domestically transmitted COVID-19 infections with confirmed symptoms on 16 March.

South Korea records 6 lakh daily cases
The country recorded more than 600,000 new infections on Thursday, the most in the world. However, it has one of the lowest death rates globally.

On Thursday, the daily cases were at 621,320; hospitalisations have doubled but the intensive care unit capacity is at 65 per cent.

Yet the outbreak is not out of control and it’s because of the consistent deployment of mass-testing. Combined with an 88 per cent vaccination rate – and one of the highest booster shot take-ups in the world, especially among the elderly – South Korea has delivered a fatality rate of 0.14 per cent, reports news agency Bloomberg.

Half of Hong Kong infected
In Hong Kong, the Omicron wave has hit late. On 16 March, the country had over 14,000 cases.

The city with “zero-Covid” policy is now seeing the highest death rate in the word, according to Our World in Data. The death rate in Hong Kong has soared this month, surpassing 25 per 100,000 residents in the past week, reports The New York Times.

Since the end of December, over 760,000 infections have been reported, with more than 4,300 deaths. Now almost half of Hong Kong’s population of 7.4 million has been affected as of 14 March.

Hospitals and morgues are overflowing. The low vaccination rates among Hong Kong’s older people is making matters worse.

The lack of business has forced many shops to down shutters. Gyms and bars have been shut since January and won’t open until mid-April, reports The Associated Press.

It’s a big setback for the city which has gone for months without falling prey to the pandemic.

A surge from Africa to Europe
Africa has seen a 12 per cent rise in new cases and 14 per cent rise in deaths, according to a Reuters report. Cases are also rising in New Zealand and Singapore.

Europe has often been a few weeks before the US with Covid trends — and cases are now rising in Britain, Germany, Italy and some other parts of Europe. The main cause appears to be an even more contagious version of omicron, known as BA.2, reports NYT.

India on alert mode
With a surge in cases in Asia, Union Health Minister Mansukh Mandaviya chaired a high-level meeting on Wednesday. He has reportedly asked authorities to do some aggressive genome sequencing of samples to detect new variants if any. Local bodies have been instructed to intensify surveillance to identify hotspots early on.

For now, India is reporting a decline in cases. On Wednesday, the country reported 2,539 new cases.

COVID: S Korea reports record cases as Omicron wave nears peak [Al Jazeera English, 17 Mar 2022]

Country long hailed as a pandemic success story reports more than 621,000 cases and 429 deaths.

South Korea has reported new daily records for coronavirus cases and deaths as the Omicron variant continues to spread rapidly across the country.

The Korea Disease Control and Prevention Agency (KDCA) reported a staggering 621,328 new COVID-19 infections on Thursday, including 62 among arrivals from overseas, according to the Yonhap news agency.

Deaths also reached a record for a single day with 429 people confirmed to have lost their lives, bringing the overall toll since the start of the pandemic to 11,481.

The surging caseload comes as South Korea eases curbs designed to contain the spread of the virus, amid pressure from small businesses and others hit hard by the pandemic.

The government is due to announce on Friday whether it will further relax restrictions, which currently include a late-night business curfew and a ban on private gatherings of more than six people.

Yonhap noted that the number of critically-ill patients, which is being used to guide the official pandemic response, had dropped to 1,159 from 1,244 on Wednesday.

The country has scaled back the test, track, tracing, and quarantine strategy that helped keep earlier waves in check and despite Thursday’s record deaths, the country’s fatality rate of 0.14 percent remains low relative to other countries.

Health authorities also believe the Omicron wave could be close to its peak although the number of daily cases is far in excess of earlier predictions.

About 87 percent of South Korea’s 52 million people have been fully vaccinated with 63 percent having received a booster shot, according to the KDCA.

A government analysis of some 141,000 Omicron cases reported in the country over the past year showed that there were no deaths among people under 60 who had received a booster shot, Son Young-rae, a health ministry official, said on Wednesday, adding that the disease could be treated like the seasonal flu.

“We see this could be the last major crisis in our COVID responses, and if we overcome this crisis, it would bring us nearer to normal lives,” Son told a briefing.

A survey released earlier this week by Seoul National University’s graduate school of public health, showed the number of South Koreans who worry about a serious health impact from COVID-19 had dropped to about 48 percent, the lowest since the surveys began in January 2020.

At the same time, those who think they are likely to contract the virus was at its highest.
“People’s awareness about the virus’ danger has clearly changed,” said professor Yoo Myung-soon who led the study.

“Despite the Omicron variant’s much higher infectivity than Delta, its relatively low fatality appears to have alleviated people’s concerns.”

ABC 10News Exclusive: One-on-One With Dr. Fauci [ABC 10 News San Diego KGTV, 17 Mar 2022]

by Jared Aarons

Nation's top doc discusses Pandemic at 2-year mark

SAN DIEGO (KGTV) — For two years, he's been the face of the COVID-19 pandemic response in the US, for better or worse.

Now, as the country passes the two-year mark since the CDC declared COVID-19 an official pandemic, Dr. Anthony Fauci says the toll it has taken on Americans is "devastating."

"No one, in their wildest dreams, two years ago today, would have predicted that we have close to a million deaths in this country alone, and six or so million deaths worldwide," he says. "It never would have been imagined that we would have such a devastating impact of this virus."
The latest CDC data says the US is at 963,244 deaths and 79.4 million cases.

But, Fauci points out the number of cases, hospitalizations, and deaths have been declining since the peak of the most recent Omicron surge.

In an exclusive, one-on-one interview with ABC 10News Reporter Jared Aarons, he says the declines give him hope, even as the National Institute for Allergy and Infectious Diseases keeps an eye on the new BA.2 sub-variant of Omicron, also called "Stealth Omicron."

That variant has fueled a surge of cases in the UK and Europe. Meanwhile, wastewater testing in the US shows its presence increasing along the East Coast and throughout the Midwest.

"I would expect that we might see an uptick in cases here in the United States," he says. "Over the coming weeks, it will become more dominant (than Omicron)."

A week ago, Fauci says, the BA.2 variant accounted for 11% of the sequenced positive cases in the US. Now, that number is closer to 25-26%.

"It's more likely to transmit," Dr. Fauci says. "The somewhat encouraging news is that BA.2 variant doesn't appear to make the disease any more severe than BA.1 (Omicron) and doesn't seem to evade immune responses any more than BA.1."

Dr. Fauci adds if cases begin to surge again in the US, we may have to go back to mitigation strategies like masking indoors.

He says the CDC's new guidelines allow for that.

"We have to be careful that if we do see a surge as a result of that, that we're flexible enough to re-institute the kinds of interventions that could be necessary to stop an additional surge."

When Aarons asked Dr. Fauci about booster shots, he said older Americans and people who are immuno-compromised will "likely" need a 4th shot. But, he says there is no need for variant-specific boosters, as the original vaccine is still doing a good job preventing hospitalizations and deaths.

"It's holding pretty strong at around 78% efficacy against hospitalization," he says. "But if it goes any lower than that, you certainly would consider the possibility of a 4th dose boost."

And, like he's done for more than a year, Dr. Fauci stressed the need for everyone to get a vaccine and a booster shot once their eligible. He says that's the only way we'll beat COVID and end the pandemic.