New Coronavirus News from 26 Sep 2022

Long COVID Has Forced the U.S. to Take Chronic Fatigue Syndrome Seriously [The Atlantic, 26 Sep 2022]

By Ed Yong

Only a couple dozen doctors specialize in chronic fatigue syndrome (ME/CFS). Now their knowledge could be crucial to treating millions more patients.

Kira Stoops lives in Bozeman, Montana—a beautiful mountain town where it sometimes feels like everyone regularly goes on 50-mile runs. Stoops, however, can’t walk around her own block on most days. To stand for more than a few minutes, she needs a wheeled walker. She reacts so badly to most foods that her diet consists of just 12 ingredients. Her “brain fog” usually lifts for a mere two hours in the morning, during which she can sometimes work or, more rarely, see friends. Stoops has myalgic encephalomyelitis, or chronic fatigue syndrome (ME/CFS). “I’m considered a moderate patient on the mild side,” she told me.

ME/CFS involves a panoply of debilitating symptoms that affect many organ systems and that get worse with exertion. The Institute of Medicine estimates that it affects 836,000 to 2.5 million people in the U.S. alone, but is so misunderstood and stigmatized that about 90 percent of people who have it have never been diagnosed. At best, most medical professionals know nothing about ME/CFS; at worst, they tell patients that their symptoms are psychosomatic, anxiety-induced, or simply signs of laziness. While ME/CFS patients, their caregivers, and the few doctors who treat them have spent years fighting for medical legitimacy, the coronavirus pandemic has now forced the issue.

A wide variety of infections can cause ME/CFS, and SARS-CoV-2, the coronavirus that causes COVID-19, is no different: Many cases of long COVID are effectively ME/CFS by another name.
The exact number is hard to define, but past studies have shown that 5 to 27 percent of people infected by various pathogens, including Epstein-Barr virus and the original SARS, develop ME/CFS. Even if that proportion is 10 times lower for SARS-CoV-2, the number of Americans with ME/CFS would still have doubled in the past three years. “We’re adding an immense volume of patients to an already dysfunctional and overburdened system,” Beth Pollack, a scientist at MIT who studies complex chronic illnesses, told me.

The U.S. has so few doctors who truly understand the disease and know how to treat it that when they convened in 2018 to create a formal coalition, there were only about a dozen, and the youngest was 60. Currently, the coalition’s website lists just 21 names, of whom at least three have retired and one is dead, Linda Tannenbaum, the CEO and president of the Open Medicine Foundation, told me. These specialists are concentrated on the coasts; none work in the Midwest. American ME/CFS patients may outnumber the population of 15 individual states, but ME/CFS specialists couldn’t fill a Major League Baseball roster. Stoops, who is 39, was formally diagnosed with ME/CFS only four years ago, and began receiving proper care from two of those specialists—Lucinda Bateman of the Bateman Horne Center and David Kaufman from the Center for Complex Diseases. Bateman told me that even before the pandemic, she could see fewer than 10 percent of the patients who asked for a consultation. “When I got into those practices, it was like I got into Harvard,” Stoops told me.

ME/CFS specialists, already overwhelmed with demand for their services, now have to decide how to best use and spread their knowledge, at a time when more patients and doctors than ever could benefit from it. Kaufman recently discharged many of the more stable ME/CFS patients in his care—Stoops among them—so that he could start seeing COVID long-haulers who “were just making the circuit of doctors and getting nowhere,” he told me. “I can’t clone myself, and this was the only other way to” make room for new patients.

Bateman, meanwhile, is feverishly focused on educating other clinicians. The hallmark symptom of ME/CFS—post-exertional malaise, or PEM—means even light physical or mental exertion can trigger major crashes that exacerbate every other symptom. Doctors who are unfamiliar with PEM, including many now running long-COVID clinics, can unwittingly hurt their patients by encouraging them to exercise. Bateman is racing to spread that message, and better ways of treating patients, but that means she’ll have to reduce her clinic hours.

These agonizing decisions mean that many existing ME/CFS patients are losing access to the best care they had found so far—what for Stoops meant “the difference between being stuck at home, miserable and in pain, and actually going out once or twice a day, seeing other humans, and breathing fresh air,” she told me. But painful trade-offs might be necessary to finally drag American medicine to a place where it can treat these kinds of complex, oft-neglected conditions. Kaufman is 75 and Bateman is 64. Although both of them told me they’re not retiring anytime soon, they also won’t be practicing forever. To make full use of their expertise and create more doctors like them, the medical profession must face up to decades spent dismissing illnesses such as ME/CFS—an overdue reckoning incited by long COVID. “It’s a disaster possibly wrapped up in a blessing,” Stoops told me. “The system is cracking and needs to crack.”

Many ME/CFS specialists have a deep knowledge of the disease because they’ve experienced it firsthand. Jennifer Curtin, one of the youngest doctors in the field, has two family members with the disease, and had it herself for nine years. She improved enough to make it through medical school and residency training, which showed her that ME/CFS “just isn’t taught,” she told me. Most curricula don’t include it; most textbooks don’t mention it.

Even if doctors learn about ME/CFS, America’s health-care system makes it almost impossible for them to actually help patients. The insurance model pushes physicians toward shorter visits; 15 minutes might feel luxurious. “My average visit length is an hour, which doesn’t include the time I spend going over the patient’s 500 to 1,700 pages of records beforehand,” Curtin said. “It’s not a very scalable kind of care.” (She works with Kaufman at the Center for Complex Diseases, which bills patients directly.) This also explains why the cohort of ME/CFS clinicians is aging out, with little young blood to refresh them. “Hospital systems want physicians to see lots of patients and they want them to follow the rules,” Kaufman said.
“There’s less motivation for moving into areas of medicine that are more unknown and challenging.”

ME/CFS is certainly challenging, not least because it’s just “one face of a many-sided problem,” Jaime Seltzer, the director of scientific and medical outreach at the advocacy group MEAction, told me. The condition’s root causes can also lead to several distinct but interlocking illnesses, including mast cell activation syndrome, Ehlers-Danlos syndrome, fibromyalgia, dysautonomia (usually manifesting as POTS), and several autoimmune and gastrointestinal disorders. “I’m still amazed at how often patients come in with Complaint No. 1, and then I find five to seven of the other things,” Kaufman said. These syndromes collectively afflict many organ systems, which can baffle doctors who’ve specialized in just one. Many of them disproportionately affect women, and are subject to medicine’s long-standing tendency to minimize or psychologize women’s pain, Pollack told me: An average woman with Ehlers-Danlos syndrome typically spends 16 years getting a diagnosis, while a man needs only four.

People with long COVID might have many of these conditions and not know about any—because their doctors don’t either. Like ME/CFS, they rarely feature in medical training, and it’s hard to “teach someone about all of them when they’ve never heard of any of them,” Seltzer said. Specialists like Bateman and Kaufman matter because they understand not just ME/CFS but also the connected puzzle pieces. They can look at a patient’s full array of symptoms and prioritize the ones that are most urgent or foundational. They know how to test for conditions that can be invisible to standard medical techniques: “None of my tests came back abnormal until I saw an ME/CFS doctor, and then all my tests came back abnormal,” said Hannah Davis of the Patient-Led Research Collaborative, who has had long COVID since March 2020.

ME/CFS specialists also know how to help, in ways that are directly applicable to cases of long COVID with overlapping symptoms. ME/CFS has no cure but can be managed, often through “simple, inexpensive interventions that can be done through primary care,” Bateman told me.
Over-the-counter antihistamines can help patients with inflammatory problems such as mast cell activation syndrome. Low doses of naltrexone, commonly used for addiction disorders, can help those with intense pain. A simple but rarely administered test can show if patients have orthostatic intolerance—a blood-flow problem that worsens other symptoms when people stand or sit upright. Most important, teaching patients about pacing—carefully sensing and managing your energy levels—can prevent debilitating crashes. “We don’t go to an ME/CFS clinic and walk out in remission,” Stoops told me. “You go to become stabilized. The ship has 1,000 holes, and doctors can patch one before the next explodes, keeping the whole thing afloat.”

That’s why the prospect of losing specialists is so galling. Stoops understands why her doctors might choose to focus on education or newly diagnosed COVID long-haulers, but ME/CFS patients are “just so lost already, and to lose what little we have is a really big deal,” she said.
Kaufman has offered to refer her to generalist physicians or talk to primary-care doctors on her behalf. But it won’t be the same: “Having one appointment with him is like six to eight appointments with other practitioners,” she said. He educates her about ME/CFS; with other doctors, it’s often the other way round. “I’m going to have to work much harder to receive a similar level of care.”

At least, she will for now. The ME/CFS specialists who are shifting their focus are hoping that they can use this moment of crisis to create more resources for everyone with these diseases. In a few years, Bateman hopes, “there will be 100 times more clinicians who are prepared to manage patients, and many more people with ME/CFS who have access to care.”

For someone who is diagnosed with ME/CFS today, the landscape already looks very different than it did just a decade ago. In 2015, the Institute of Medicine published a landmark report redefining the diagnostic criteria for the disease. In 2017, the CDC stopped recommending exercise therapy as a treatment. In 2021, Bateman and 20 other clinicians published a comprehensive guide to the condition in the journal of the Mayo Clinic. For any mainstream disease, such events—a report, a guideline revision, a review article—would be mundane. For ME/CFS, they felt momentous. And yet, “the current state of things is simply intolerable,” Julie Rehmeyer, a journalist with ME/CFS, told me. Solving the gargantuan challenge posed by complex chronic diseases demands seismic shifts in research funding, medical training, and public attitudes. “Achieving shifts like that takes something big,” Rehmeyer said. “Long COVID is big.”

COVID long-haulers have proved beyond any reasonable doubt that acute viral infections can leave people chronically ill. Many health-care workers, political-decision makers, and influencers either know someone with long COVID or have it themselves. Even if they still don’t know about ME/CFS, their heightened awareness of post-viral illnesses is already making a difference. Mary Dimmock’s son developed ME/CFS in 2011, and before the pandemic, one doctor in 10 might take him seriously. “Now it’s the flip: Only one doctor out of 10 will be a real jerk,” Dimmock told me. “I attribute that to long COVID.”

But being believed is the very least that ME/CFS patients deserve. They need therapeutics that target the root causes of the disease, which will require a clear understanding of those causes, which will require coordinated, well-funded research—three things ME/CFS has historically lacked. But here, too, “long COVID is going to be a catalyst,” Amy Proal, the president of the Polybio Research Foundation, told me. She is leading the Long Covid Research Initiative—a group of scientists, including ME/CFS researchers, that will use state-of-the-art techniques to see exactly how the new coronavirus causes long COVID, and rapidly push potential treatments through clinical trials. The National Institutes of Health has also committed $1.15 billion to long-COVID research, and while some advocates are concerned about how that money will be spent, Rehmeyer notes that the amount is still almost 80 times greater than the paltry $15 million spent on ME/CFS every year—less than any other disease in the NIH’s portfolio, relative to its societal burden. “Even if 90 percent is wasted, we’d be doing a lot better,” she said.

While they wait for better treatments, patients also need the medical community to heed the lessons that they and their clinicians have learned. For example, the American Association for Family Physicians website still wrongly recommends exercise therapy and links ME/CFS to childhood abuse. “That group of doctors is very important to these patients,” Dimmock said, “so what does that say to them about what this disease is all about?”

Despite all evidence to the contrary, many clinicians and researchers still don’t see ME/CFS as a legitimate illness and are quick to dismiss any connection between it and long COVID. To ensure that both groups of patients get the best possible treatments, instead of advice that might harm them, ME/CFS specialists are working to disseminate their hard-won knowledge.
Bateman and her colleagues have been creating educational resources for clinicians and patients, continuing-medical-education courses, and an online lecture series. Jennifer Curtin has spent two years mapping all the decisions she makes when seeing a new patient, and is converting those into a tool that other clinicians can use. As part of her new start-up, called RTHM, she’s also trying to develop better ways of testing for ME/CFS and its related syndromes, of visualizing the hefty electronic health records that chronically ill patients accumulate, and of tracking the treatments they try and their effects. “There are a lot of things that need to be fixed for this kind of care to be scalable,” Curtin told me.

Had such shifts already occurred, the medical profession might have had more to offer COVID long-haulers beyond bewilderment and dismissal. But if the profession starts listening to the ME/CFS community now, it will stand the best chance of helping people being disabled by COVID, and of steeling itself against future epidemics. Pathogens have been chronically disabling people for the longest time, and more pandemics are inevitable. The current one could and should be the last whose long-haulers are greeted with disbelief.

New centers that cater to ME/CFS patients are already emerging. RTHM is currently focused on COVID long-haulers but will take on some of David Kaufman’s former patients in November, and will open its waiting list to the broader ME/CFS community in December. (It is currently licensed to practice in just five states but expects to expand soon.) David Putrino, who leads a long-COVID rehabilitation clinic in Mount Sinai, is trying to raise funds for a new clinic that will treat both long COVID and ME/CFS. He credits ME/CFS patients with opening his eyes to the connection between long COVID and their condition.

Every ME/CFS patient I’ve talked with predicted long COVID’s arrival well before most doctors or even epidemiologists started catching up. They know more about complex chronic illnesses than many of the people now treating long COVID do. Despite having a condition that saps their energy, many have spent the past few years helping long-haulers navigate what for them was well-trodden terrain: “I did barely anything but work in 2020,” Seltzer told me. Against the odds, they’ve survived. But the pandemic has created a catalytic opportunity for the odds to finally be tilted in their favor, “so that neither patients nor doctors of any complex chronic illness have to be heroes anymore,” Rehmeyer said.

New Coronavirus News from 27 Sep 2022

Coronavirus variant Khosta-2 could infect humans, warns scientists. Read here | Mint [Mint, 27 Sep 2022]

According to Senior Scientist of the Indian Council of Medical Research - National Institute of Virology (ICMR-NIV), Pune, Dr Pragya Yadav there are no cases of human infection from the Khosta virus, so far

The recently discovered coronavirus variant, Khosta-2, found in Russian bats, could also infect humans, a team of Health experts from US has warned.

Indian Council of Medical Research - National Institute of Virology (ICMR-NIV), Pune, Dr Pragya Yadav has however, confirmed that there have not been a single reported case of Khosta infection in humans yet.

"There are no cases of human infection with Khosta viruses have been reported yet. Seifert et al. reported that Khosta-2 could infect cells expressing human ACE2," the Senior Scientist told news agency ANI in an exclusive conversation.

"However, the probability of the Zoonotic spillover of the sarbecoviruses from animals to humans could not be denied like, it happened earlier with SARS-CoV-1 and 2 viruses," she said further.

Dr Pragya Yadav further explained to the news agency about Khosta-2 virus, "Khosta-2 virus is a SARS-like coronavirus belonging to the subgenus Sarbecovirus of the genus Betacoronavirus of the family Coronaviridae. The virus was identified in horseshoe bats from Russia."

This virus which has been reported as vaccine restraint, Dr Pragya said, "In a recent study by Seifert et al., chimeric SARS-CoV-2-based spike with the RBD from the Khosta viruses have shown resistance to neutralization with SARS-CoV-2 RBD-specific monoclonal antibody, Bamlanivimab and serum of individuals who received either the Moderna or Pfizer vaccine.

Further studies would be required to determine the effectiveness of Covid-19 vaccines against Khosta-2 virus.

"On India's preparedness to deal with the reemergence of such viral pathogens, she said, "As an apex virology institute, ICMR-National institute of Virology along with the wide network of Virus Research and Diagnostic Laboratories (VRDLs) will be able to handle public health emergency situation related to the emergence or reemergence of any viral pathogen in India. We have already exhibited this strength in past as during the times of Zika, Nipah, and Monkeypox viruses, and the COVID-19 pandemic."

It is to be noted that both Khosta-2 and SARS- CoV-2 belong to the same sub-category of coronaviruses known as sarbecoviruses. Like Covid-19 virus, Khosta-2 also uses the spike protein to enter and infect the human cells.

World Bank slashes economic outlook for Asia over China slowdown [Al Jazeera English, 27 Sep 2022]

The Washington-based lender expects the region to grow 3.2 percent in 2022, down from a 5 percent forecast in April.

The World Bank has slashed its economic outlook for the Asia-Pacific, pointing to China’s ultra-strict “zero-COVID” policy as a drag on regional growth.

The region’s economies are expected to grow 3.2 percent in 2022, down from a 5 percent forecast in April, as China’s lockdowns continue to disrupt factories and dampen spending, the Washington-based financial institution said on Tuesday.

China, the world’s second-largest economy, is projected to grow 2.8 percent this year, according to the bank, and 4.5 percent in 2023.

The lender previously predicted China would grow 5 percent in 2022.

The bank is the latest financial institution to cut its growth forecast for Asian economies after the Asian Development Bank (ADB) last week lowered its growth outlook for the region’s developing economies for 2022 from 5.2 percent to 4.3 percent.

Despite the rest of the world’s moves towards living with the coronavirus, China has stuck to a zero-tolerance strategy aimed at stamping out the coronavirus at almost any cost.

China’s economy barely avoided contraction in the second quarter, with gross domestic product (GDP) expanding just 0.4 percent on year during the April-June period.

The World Bank also pointed to aggressive interest rate hikes by central banks trying to curtail soaring inflation as a risk to the region’s growth.

“As they prepare for slowing global growth, countries should address domestic policy distortions that are an impediment to longer term development,” World Bank East Asia and Pacific Vice President Manuela Ferro in a statement.

Michigan adds 14,678 COVID cases, 160 new deaths [MLive.com, 27 Sep 2022]

By Justin P. Hicks and Scott Levin

Michigan identified another 14,678 new COVID-19 cases and 160 new deaths last week, according to the state’s weekly coronavirus update.

The new confirmed and probable cases added to the total Tuesday, Sept. 27, brought the seven-day average from 1,849 cases per day last week down to 1,615, according to data from the Michigan Department of Health and Human Services. It’s the lowest average since early July.

Meanwhile, the seven-day average for COVID deaths climbed from 17 per day to 18 during that time.

Michigan’s coronavirus environment has held fairly consistent throughout the summer, with weekly reporting seeing ebbs and flows. Case counts are expected to be undercounts due to the rise in at-home testing, but health officials say case counts are still useful in addition to wastewater surveillance and tracking hospitalizations, test positivity and deaths.

The health department has included both probable and confirmed cases in its totals since the spring. A case is confirmed only when there is a positive PCR test. Cases are classified as “probable” when there was no such test but a doctor and/or an antigen test labeled them COVID.

In total, there have been more than 2.8 million confirmed and probable cases, and 38,624 confirmed and probable deaths since the start of the pandemic in Michigan. Of them, 2,451,012 cases and 35,220 deaths are confirmed. About 385,155 cases and 3,404 deaths are probable.

Below is a chart that indicates the seven-day average for new cases reported per day throughout the pandemic. (Can’t see the chart?

Cases by counties
All of Michigan’s 83 counties reported new cases last week.

The following 10 counties have seen the most new, confirmed cases per 100,000 people in the last seven days: Wayne (159), Eaton (157), Ogemaw (149), Schoolcraft (149), Macomb (146), Gogebic (139), Kalamazoo (138), Oakland (133), St. Clair (127), and Washtenaw (123).

Without adjusting for population, these 10 counties have seen the greatest number of new cases over the last week: Wayne (2,848), Oakland (1,690), Macomb (1,286), Kent (496), Washtenaw (456), Kalamazoo (361), Genesee (320), Ingham (307), St. Clair (203) and Saginaw (202).

The arrows and colors on the map below show per-capita cases compared to the previous week in Michigan’s 83 counties. Hover over or tap on a county to see the underlying data.
(Hint: Drag the map with your cursor to see the entire Upper Peninsula.)

The chart below shows new cases for the past 30 days by county based on onset of symptoms. In this chart, numbers for the most recent days are incomplete because of the lag time between people getting sick and getting a confirmed coronavirus test result, which can take up to a week or more.

You can call up a chart for any county, and you can put your cursor over or tap on a bar to see the date and number of cases.

Hospitalization
COVID hospitalizations kept relatively close over the last few weeks.

As of Monday, Sept. 26, there were 1,058 adult and 33 pediatric patients with confirmed or suspected cases of COVID across Michigan’s health systems. That’s compared to 1,134 adult and 40 pediatric patients a week ago.

Deaths
Thirty-eight counties reported at least one new death in the last seven days, led by Wayne with 28. Other leading counties included Oakland with 20, Macomb with 10, Kent with seven, Saginaw with six, St. Clair nd Calhoun with five each, Genesee with four, and Washtenaw and Kalamazoo counties with three each.

Below is a chart that tracks the state’s seven-day average for reported COVID-19 deaths per day over the course of the pandemic. (These are based on the date reported, not necessarily on the date of death.)

Testing
On Monday, 15.1% of the more than 13,400 tests came back positive.

Over the last week, the state’s positivity rate dropped to 14.8%, which is the lowest point in months. A week ago it was 16.3% and two weeks ago it was 18.2%.

Below is a chart of daily test positivity rates for Michigan throughout the pandemic. The data is based on confirmatory testing for SARS-CoV-2.

The interactive map below shows the seven-day average testing rate by county. You can put your cursor over a county to see the underlying data.

COVID-19 vaccinations
There’s been very little change in Michigan’s vaccination efforts in recent weeks. As of Wednesday, Sept. 14, about 63.4% of residents had received at least one COVID-19 vaccine shot, according to Michigan health department data. That’s up less than 0.1% from three weeks ago.

About 58.4% of Michiganders of all ages have completed their initial series, and 36.1% of individuals 5 and older have received a booster dose.

At least 36,481 children ages 6 months to 4 years old have gotten their first dose since mid-June, while about 24,309 of those kids have since gotten their second dose and about 1,781 have gotten their third dose.

Below is a chart that shows vaccination rates by county for people 5 and older.

To find a testing site near you, check out the state’s online test find send an email to [e-mail], or call 888-535-6136 between 8 a.m. and 5 p.m. on weekdays.

Rising Covid-19 cases in the UK may be a warning for the US [CNN, 27 Sep 2022]

By Brenda Goodman

CNN — There are signs that the United Kingdom could be heading into a fall Covid-19 wave, and experts say the United States may not be far behind.

A recent increase in Covid-19 cases in England doesn’t seem to be driven by a new coronavirus variant, at least for now, although several are gaining strength in the US and across the pond.

“Generally, what happens in the UK is reflected about a month later in the US. I think this is what I’ve sort of been seeing,” said Dr. Tim Spector, professor of genetic epidemiology at Kings College London.

Spector runs the Zoe Health Study, which uses an app to let people in the UK and US report their daily symptoms. If they start to feel bad, they take a home Covid-19 test and record those results. He says that about 500,000 people are currently logging their symptoms every day to help track trends in the pandemic.

Spector says the study, which has been running since the days of the first lockdown in England in 2020, has accurately captured the start of each wave, and its numbers run about one to two weeks ahead of official government statistics.

After seeing a downward trend for the past few weeks, the Zoe study saw a 30% increase in reported Covid-19 cases within the past week.

“Our current data is definitely showing this is the beginning of the next wave,” Spector said.
On Friday, that increase was reflected in official UK government data too, although it was not as large as the increases reported by Zoe loggers.


Data from the National Health Service showed that after falling for nearly two months, the seven-day average of new cases in England and Wales rose 13% for the week ending September 17 over the week before. The seven-day average of hospitalizations was up 17% in the week ending September 19 compared with the week prior.

The data aligns with what models have predicted would happen in both the UK and the US.
“They predicted that we’d get a June to July peak and then there’d be a month where nothing happened in August and then it would flatten in in August and September and then start again in October. So it’s exactly matching what the modelers have have been predicting,” Spector said.

In the US, some models have predicted that Covid-19 cases will begin to rise again in October and continue to increase into the winter. Experts are hopeful that because most of the population now has some underlying immunity to the coronavirus, this wave would be less deadly than we’ve seen in previous winters.

Is this a blip or a wave?

It’s not clear what’s driving the increase in the UK or whether it will be sustained.

“These trends may continue for more than a week or two, or they may not,” said Kevin McConway, emeritus professor of applied statistics at the Open University in Milton Keynes, England.

Broken down by age, he says, there are clear increases among adolescents who are around middle school age and younger adults, those 25 through 34.

“It wouldn’t be surprising if there were some increase in infection as people come back from summer holidays and as the schools reopen,” McConway said in a statement to the nonprofit Science Media Centre. “Even if it is, there’s certainly no clear indication yet that it will continue.”


He’s not the only one who needs to see more data before calling this the start of a new wave.

“Question one is, how significant is that rise? Is it, for instance, the beginning of something, a new wave, or is this a temporary blip because of all of the getting together around the Queen’s funeral and other events that have been going on?” said Dr. Peter Hotez, who co-directs the Center for Vaccine Development at Texas Children’s Hospital in Houston.

A second important question will be whether the increase is being driven by a new variant.
“That’s the worst possible situation. Because historically, when that situation occurs in the UK, it’s reflected within a matter of weeks in the United States,” Hotez said. “That was true of the Alpha wave; that was true of the Delta wave; that was true of Omicron and its subvariants.”

The role of new variants
That’s where the US may catch a break this time around.

Instead of new variants, Christina Pagel, a professor of operational research at University College London, thinks cases are going up in the UK because of a combination of waning immunity and behavioral changes.


Many people in the UK are several months past their last Covid-19 booster or infection, and government statistics show that just 8% of adults 50 and older have gotten an Omicron-specific vaccine since the government started its fall vaccination campaign in September.
School and work have fully resumed after the summer holidays, and people are spending more time indoors as the temperature drops.

Immunity is also waning in the United States, and Americans have also been slow to get boosted. Just 35% of those for whom a booster is recommended have had one, according to CDC data.

The updated boosters in the US are slightly different from the ones in the UK. The UK is using vaccines that have been updated to fight the original version of Omicron, which is not circulating anymore. US boosters have been updated to fight the BA.4 and BA.5 subvariants, which are currently causing infections both here and abroad. It’s not clear whether the strain differences will have an effect on cases or disease severity.

There are a mix of new variants – offshoots of BA.4 and BA.5 – that are waiting in the wings. They represent just a small proportion of total cases, but several are growing against BA.5, which is still dominating transmission.

“It is very likely that these will accelerate current increases and cause a substantial wave in October” in the UK, Pagel said in an email to CNN.

Other experts agree with that assessment.

“There is talk about a bunch of lineages with concerning mutations, including BA.2.75, BQ.1.1, etc, but none of these are of high enough frequency in the UK right now to be driving the change in cases,” Nathan Grubaugh, who studies the epidemiology of microbial diseases at the Yale School of Public Health, said in an email to CNN.

He says the mix of variants in the UK seems to be much the same as it is in the US, at least for now.

“We are seeing the increase in many respiratory viruses right now in the US, so it’s not a stretch to think that a new COVID wave (or ripple) will be coming soon,” he wrote.

New Coronavirus News from 15 Sep 2022

Clinical Trials Show Ivermectin Does Not Benefit COVID-19 Patients, Contrary to Social Media Claims [FactCheck.org, 15 Sep 2022]

By Catalina Jaramillo

SciCheck Digest
Randomized clinical trials have repeatedly found that ivermectin does not benefit COVID-19 patients. The National Institutes of Health recommends against its use for COVID-19.

Ivermectin enthusiasts continue to falsely claim the contrary.

Full Story
The latest results of several large, randomized controlled trials show no benefit in using the antiparasitic drug ivermectin to treat COVID-19, the disease caused by the coronavirus, or SARS-CoV-2. The results are consistent with existing evidence that shows the cheap and accessible drug does not work to treat COVID-19.

But a recently published study from Brazil that claims ivermectin decreased COVID-19 hospitalization by 100% and COVID-19 mortality by 92% is giving new wings to those touting ivermectin as a miracle drug. The observational study contains methodological flaws, and is authored by ivermectin activists. And its results are completely inconsistent with stronger studies that did not identify any benefit of using the drug for COVID-19.

“From multiple, large well-conducted, double-blind randomized clinical trials of now thousands of participants, ivermectin has not been shown to have any meaningful clinical benefit for the early, outpatient treatment of COVID-19,” Dr. David Boulware, a professor of medicine at the University of Minnesota Medical School and an adviser for two large trials in the U.S., told us in an email.

“Specifically, two large, multi-site randomized clinical trials (Covid-Out; ACTIV-6) have been completed in the United States. These two trials both failed to detect any statistically significant benefit of ivermectin,” Boulware added.

In addition, the flawed study got intertwined with a false rumor that the National Institutes of Health COVID-19 treatment guidelines website had “now” added ivermectin as a recommended treatment. But that’s not accurate. The drug has been listed on the NIH’s page for antiviral treatments for a while (here’s an archived capture from June 12, 2021) as a medication “that is being evaluated to treat COVID-19.” But the NIH recommends against the use of ivermectin for the treatment of COVID-19 outside of clinical trials.

“Yesterday the National institute of health added Ivermectin to the list of covid treatment,” former martial arts fighter Jake Shields wrote on Twitter. “Looks like the conspiracy theorist were right and the ‘experts’ wrong once again,” he said, later referencing the problematic study. His tweet got over 42,000 likes and 13,000 retweets in three days.

On Sept. 3, the conservative website The Blaze published a story titled “Ivermectin reduces COVID death risk by 92%, peer-reviewed study finds,” which got over 1,000 shares. The same day, Robby Starbuck, a former Republican congressional candidate in Tennessee, referenced both the study and the supposed addition of ivermectin to the NIH’s website in posts across his social media.

“Now’s a good time to think about the mass censorship campaign carried out against those who used it or advocated for the freedom to use it, pharmacists who refused to fill doctors prescriptions and the unending hate people got for treating COVID with it. The attacks on it were all about lining Big Pharma and politicians pockets,” he wrote in a Facebook post. A capture of the post on his Instagram got over 26,000 likes in four days.

Ivermectin pills. The antiparasitic drug has not been approved or authorized by the FDA to treat COVID-19.

As we said, there has been no recent change to the NIH website to recommend ivermectin as a treatment. The page on ivermectin, which clearly states that the agency’s guidelines recommend against the use of the drug to treat COVID-19, was last updated on April 29.

The antiparasitic drug has not been approved or authorized by the Food and Drug Administration to prevent or treat COVID-19. Ivermectin is approved for human use only to treat some conditions caused by parasites, such as intestinal strongyloidiasis and onchocerciasis, head lice, and skin conditions. The FDA has warned that the use of large doses of the drug or of ivermectin for animals is dangerous.

Most Recent Results of Large Clinical Trials Show No Benefit
More than 80 studies around the world have examined the use of ivermectin to treat or prevent COVID-19. But as we’ve reported, over and over, randomized controlled trials have shown no evidence of a clinical benefit for ivermectin.

Here are some of the latest results of large clinical trials we’ve been following.

In May, researchers of the Together trial in Brazil concluded that treatment with a moderate daily ivermectin dose for three days “did not result in a lower incidence of medical admission to a hospital due to progression of Covid-19 or of prolonged emergency department observation among outpatients with an early diagnosis of Covid-19.” This study had a total of 3,515 patients with a SARS-CoV-2 infection, where 679 received ivermectin, 679 got a placebo, and 2,157 received another intervention.

In June, the ACTIV-6 trial, funded by the NIH, reported that a moderate daily ivermectin dose for three days “resulted in less than one day of shortening of symptoms and did not lower incidence of hospitalization or death among outpatients with COVID-19 in the United States during the delta and omicron variant time periods.” The ivermectin arm of the study had 1,591 participants with a SARS-CoV-2 infection, with 817 assigned to the ivermectin group and 774 to the placebo.

Finally, in August, researchers of the University of Minnesota Covid-Out trial, which studied the use of ivermectin, metformin and fluvoxamine for COVID-19 in 1,323 patients with a SARS-CoV-2 infection, reported that none of the three medications “prevented the occurrence of hypoxemia, an emergency department visit, hospitalization, or death associated with Covid-19.”
“At the dose we used, which was a median of 430 micrograms per kilo, per day, for three days, there was no effect on reducing severe COVID-19 in this population — and our population was adults over age 30 with a BMI greater than 25,” said Dr. Carolyn T. Bramante, an assistant professor of medicine at the University of Minnesota, in a video responding to the question of whether ivermectin was effective in reducing the severity of COVID-19.

Boulware, who provided advice for the trial, told us that investigators found there was no difference in the duration of symptoms between the participants who took ivermectin and those who took the placebo, and that numerically the ivermectin group patients had more ER visits and hospitalizations than the placebo group.

Problematic Study
The study that revived claims about ivermectin for COVID-19 used data from a citywide program in Itajaí, a city in southeastern Brazil, in which residents were offered ivermectin to prevent COVID-19 between July and December 2020.

In March, we explained that a previous observational study by the same team, using the same dataset, had multiple methodological flaws. Both papers were published in Cureus, an open-access online medical journal that allows researchers to publish studies faster than the traditional peer-reviewed journals. The peer-review process for the most recent paper took five days. In other journals, the peer-review process typically takes more than a month.

The team reported multiple conflicts of interest: Two of the authors have financial ties with an ivermectin manufacturer, and four of them work for organizations that promote ivermectin as a treatment for COVID-19.

Neither of the studies, the first published in January and the second published in August, were randomized placebo-controlled clinical trials. Instead, the researchers looked back at data collected by clinics and health centers where ivermectin was offered. According to the study’s methodology, people without COVID-19 symptoms could opt to get a prescription to take a low dose (about half of the dose given in the previously mentioned clinical trials) of ivermectin for two consecutive days every 15 days over the course of 150 days. Those who then got COVID-19 were medically followed, and data on hospitalizations and deaths were registered. The study grouped the participants by non-users (residents who didn’t use ivermectin), irregular users (those who took up to 10 tablets), and regular users (took more than 30 tablets), and compared their outcomes.

“The regular use of ivermectin decreased hospitalization for COVID-19 by 100%, mortality by 92%, and the risk of dying from COVID-19 by 86% when compared to non-users,” the paper concluded. “Protection from COVID-19-related outcomes was observed across all levels of ivermectin use, with a notable reduction in risk of death in the over 50-year-old population and those with comorbidities.”

But experts have identified numerous problems with the study, which as an observational study can at most only claim to have found an association between regular ivermectin use and better outcomes — not that the drug reduced hospitalizations or mortality.

“The main flaw is that it’s an uncontrolled epidemiological trial using a small quantity of routinely collected clinical data in a somewhat useless way,” Gideon Meyerowitz-Katz, an epidemiologist from the University of Wollongong in Australia, told us in an email. “In this sort of study, you have to spend a great deal of time looking for alternate explanations for why you might be seeing a relationship, like residual confounding, immortal time bias, or survivorship bias as others have mentioned, but instead the authors simply decided to run a biased analysis and call it a day.” (Click on the links for more information about residual confounding, immortal time bias and survivorship bias.)

The study, for example, attempted to control for some factors that might explain the outcomes of the different groups, such as sex, age and some underlying health conditions — but not for other factors related to infection risk, including income. Those could have skewed the results.

The inability to control for differences in groups is always a problem for observational studies — and that’s why randomized controlled trials, which randomly assign individuals to the treatment and control groups from the start, are considered more reliable and a higher level of evidence.

Perhaps most critically, as Greg Tucker-Kellogg, a biology professor in practice at the National University of Singapore, and Kyle Sheldrick, a medical researcher in Australia, have noted, the study suffers from survivorship bias because once a participant contracted COVID-19 they were advised not to use ivermectin.

This is important because the study’s purported finding is about “regular” ivermectin users who took at least 30 tablets of the drug. This means that most of the people who took ivermectin in the study who got sick were not included in the analysis because they couldn’t have taken enough pills to be considered a “regular” user, Tucker-Kellogg explains in a video. In contrast, no one in the non-ivermectin group was removed from that group if they got sick earlier in the study.

“By definition, ‘regular users’ would almost always be people who didn’t get infected,” Meyerowitz-Katz told us, “that’s simply how the study has been designed.”

Or, as Tucker-Kellogg put it, “This is a way to game the system. This is basically gaming the outcome so that the strictly regular ivermectin users have an extremely low rate of sickness and death, because basically most of the people who got sick are not counted in that group.”

In the study’s comments, Cadegiani, one of the authors, dismissed these issues.

But Meyerowitz-Katz said that even if the paper didn’t have methodology problems, it still wouldn’t be useful at this point, when there is higher-quality evidence that ivermectin doesn’t work.

“I could go on with issues and errors, but there’s not that much point. When it comes to ivermectin, a poorly-conducted study with errors *in the title* is not going to move the dial on what the evidence says at all,” he said on Twitter. “Current best evidence shows that ivermectin is unlikely to have a clinically meaningful benefit in the treatment of COVID-19, and there’s not much evidence for its use as a prophylactic.”

Editor’s note: SciCheck’s COVID-19/Vaccination Project is made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over FactCheck.org’s editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation. The goal of the project is to increase exposure to accurate information about COVID-19 and vaccines, while decreasing the impact of misinformation.

Sources
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Boulware, David. Professor of medicine at the University of Minnesota Medical School. Email sent to FactCheck.org. 12 Sep 2022.
“Why You Should Not Use Ivermectin to Treat or Prevent COVID-19.” Food and Drug Administration. Update 12 Oct 2021.
Clinical Trials.gov. National Institutes of Health. Accessed 14 Sep 2022.
Jaramillo, Catalina. “Evidence Still Lacking to Support Ivermectin as Treatment for COVID-19.” FactCheck.org. Updated 6 Jun 2022.
Jaramillo, Catalina. “Ongoing Clinical Trials Will Decide Whether (or Not) Ivermectin Is Safe, Effective for COVID-19.” FactCheck.org. Updated 29 Oct 2021.
Table 4c. Ivermectin: Selected Clinical Data. NIH. Updated 29 Apr 2022.
Reis, Gilmar, et al. “Effect of Early Treatment with Ivermectin among Patients with Covid-19.” The New England Journal of Medicine. 5 May 2022.
Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV)-6 Study Group, Susanna Naggie. “Ivermectin for Treatment of Mild-to-Moderate COVID-19 in the Outpatient Setting: A Decentralized, Placebo-controlled, Randomized, Platform Clinical Trial.” medRxiv. 12 Jun 2022.
University of Minnesota Medical School. “7. Did your study’s findings prove Ivermectin is not effective in reducing the severity of COVID?”. YouTube. 15 Aug 2022.
Bramante, Carolyn T., et al. “Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19.” The New England Journal of Medicine. 18 Aug 2022.
Packer, Milton. “Does Peer Review Still Matter in the Era of COVID-19?” MedPage Today. 13 May 2020.
Kerr, Lucy, et al. “Ivermectin Prophylaxis Used for COVID-19: A Citywide, Prospective, Observational Study of 223,128 Subjects Using Propensity Score Matching.” Cureus. 15 Jan 2022.
Kerr, Lucy, et al. “Regular Use of Ivermectin as Prophylaxis for COVID-19 Led Up to a 92% Reduction in COVID-19 Mortality Rate in a Dose-Response Manner: Results of a Prospective Observational Study of a Strictly Controlled Population of 88,012 Subjects.” Cureus. 15 Jan 2022.
Meyerowitz-Katz, Gideon. Epidemiologist from the University of Wollongong in Australia. Email sent to FactCheck.com. 12 Sep 2022.
Meyerowitz-Katz, Gideon. “15/n I could go on with issues and errors, but there’s not that much point. When it comes to ivermectin, a poorly-conducted study with errors *in the title* is not going to move the dial on what the evidence says at all.” Twitter thread. 15 Dec 2021.
Tucker-Kellogg, Greg. “The Cureus case of Ivermectin for Covid in Brazil, Part 2.” YouTube. 4 Apr 2022.

New Coronavirus News from 23 Sep 2022

The ‘End’ of COVID Is Still Far Worse Than We Imagined [The Atlantic, 23 Sep 2022]

By Sarah Zhang

Why COVID Is Still Worse Than Flu

Even now, the coronavirus is killing three times as many people as the flu.

When is the pandemic “over”? In the early days of 2020, we envisioned it ending with the novel coronavirus going away entirely. When this became impossible, we hoped instead for elimination: If enough people got vaccinated, herd immunity might largely stop the virus from spreading. When this too became impossible, we accepted that the virus would still circulate but imagined that it could become, optimistically, like one of the four coronaviruses that cause common colds or, pessimistically, like something more severe, akin to the flu.

Instead, COVID has settled into something far worse than the flu. When President Joe Biden declared this week, “The pandemic is over. If you notice, no one’s wearing masks,” the country was still recording more than 400 COVID deaths a day—more than triple the average number from flu.

This shifting of goal posts is, in part, a reckoning with the biological reality of COVID. The virus that came out of Wuhan, China, in 2019 was already so good at spreading—including from people without symptoms—that eradication probably never stood a chance once COVID took off internationally. “I don’t think that was ever really practically possible,” says Stephen Morse, an epidemiologist at Columbia. In time, it also became clear that immunity to COVID is simply not durable enough for elimination through herd immunity. The virus evolves too rapidly, and our own immunity to COVID infection fades too quickly—as it does with other respiratory viruses—even as immunity against severe disease tends to persist. (The elderly who mount weaker immune responses remain the most vulnerable: 88 percent of COVID deaths so far in September have been in people over 65.) With a public weary of pandemic measures and a government reluctant to push them, the situation seems unlikely to improve anytime soon.
Trevor Bedford, a virologist at the Fred Hutchinson Cancer Center, estimates that COVID will continue to exact a death toll of 100,000 Americans a year in the near future. This too is approximately three times that of a typical flu year.

I keep returning to the flu because, back in early 2021, with vaccine excitement still fresh in the air, several experts told my colleague Alexis Madrigal that a reasonable threshold for lifting COVID restrictions was 100 deaths a day, roughly on par with flu. We largely tolerate, the thinking went, the risk of flu without major disruptions to our lives. Since then, widespread immunity, better treatments, and the less virulent Omicron variant have together pushed the risk of COVID to individuals down to a flu-like level. But across the whole population, COVID is still killing many times more people than influenza is, because it is still sickening so many more people.

Bedford told me he estimates that Omicron has infected 80 percent of Americans. Going forward, COVID might continue to infect 50 percent of the population every year, even without another Omicron-like leap in evolution. In contrast, flu sickens an estimated 10 to 20 percent of Americans a year. These are estimates, because lack of testing hampers accurate case counts for both diseases, but COVID’s higher death toll is a function of higher transmission. The tens of thousands of recorded cases—likely hundreds of thousands of actual cases every day—also add to the burden of long COVID.

The challenge of driving down COVID transmission has also become clearer with time. In early 2021, the initially spectacular vaccine-efficacy data bolstered optimism that vaccination could significantly dampen transmission. Breakthrough cases were downplayed as very rare. And they were—at first. But immunity to infection is not durable against common respiratory viruses. Flu, the four common-cold coronaviruses, respiratory syncytial virus (RSV), and others all reinfect us over and over again. The same proved true with COVID. “Right at the beginning, we should have made that very clear. When you saw 95 percent against mild disease, with the trials done in December 2020, we should have said right then this is not going to last,” says Paul Offit, the director of the Vaccine Education Center at Children's Hospital of Philadelphia. Even vaccinating the whole world would not eliminate COVID transmission.

This coronavirus has also proved a wilier opponent than expected. Despite a relatively slow rate of mutation at the beginning of the pandemic, it soon evolved into variants that are more inherently contagious and better at evading immunity. With each major wave, “the virus has only gotten more transmissible,” says Ruth Karron, a vaccine researcher at Johns Hopkins. The coronavirus cannot keep becoming more transmissible forever, but it can keep changing to evade our immunity essentially forever. Its rate of evolution is much higher than that of other common-cold coronaviruses. It’s higher than that of even H3N2 flu—the most troublesome and fastest-evolving of the influenza viruses. Omicron, according to Bedford, is the equivalent of five years of H3N2 evolution, and its subvariants are still outpacing H3N2’s usual rate. We don’t know how often Omicron-like events will happen. COVID’s rate of change may eventually slow down when the virus is no longer novel in humans, or it may surprise us again.

In the past, flu pandemics “ended” after the virus swept through so much of the population that it could no longer cause huge waves. But the pandemic virus did not disappear; it became the new seasonal-flu virus. The 1968 H3N2 pandemic, for example, seeded the H3N2 flu that still sickens people today. “I suspect it’s probably caused even more morbidity and mortality in all those years since 1968,” Morse says. The pandemic ended, but the virus continued killing people.

Ironically, H3N2 did go away during the coronavirus pandemic. Measures such as social distancing and masking managed to almost entirely eliminate the flu. (It has not disappeared entirely, though, and may be back in full force this winter.) Cases of other respiratory viruses, such as RSV, also plummeted. Experts hoped that this would show Americans a new normal, where we don’t simply tolerate the flu and other respiratory illnesses every winter. Instead, the country is moving toward a new normal where COVID is also something we tolerate every year.

In the same breath that President Biden said, “The pandemic is over,” he went on to say, “We still have a problem with COVID. We’re still doing a lot of work on it.” You might see this as a contradiction, or you might see it as how we deal with every other disease—an attempt at normalizing COVID, if you will. The government doesn’t treat flu, cancer, heart disease, tuberculosis, hepatitis C, etc., as national emergencies that disrupt everyday life, even as the work continues on preventing and treating them. The U.S.’s COVID strategy certainly seems to be going in that direction. Broad restrictions such as mask mandates are out of the question. Interventions targeted at those most vulnerable to severe disease exist, but they aren’t getting much fanfare. This fall’s COVID-booster campaign has been muted. Treatments such as bebtelovimab and Evusheld remain on shelves, underpublicized and underused.

At the same time, hundreds of Americans are still dying of COVID every day and will likely continue to die of COVID every day. A cumulative annual toll of 100,000 deaths a year would still make COVID a top-10 cause of death, ahead of any other infectious disease. When the first 100,000 Americans died of COVID, in spring 2020, newspapers memorialized the grim milestone. The New York Times devoted its entire front page to chronicling the lives lost to COVID. It might have been hard to imagine, back in 2020, that the U.S. would come to accept 100,000 people dying of COVID every year. Whether or not that means the pandemic is over, the second part of the president’s statement is harder to argue with: COVID is and will remain a problem.

First signs of new COVID-19 wave seen in colder countrie [POLITICO Europe, 23 Sep 2022]

B Y HELEN COLLIS

Cases and hospitalizations are rising in Belgium, the UK and Denmark.

COVID-19 cases and hospitalizations are creeping up in Northern Europe where the colder and wetter weather is first being felt across the bloc.

Latest data from Belgium, the U.K. and Denmark points to a gradual uptick in the number of cases and hospitalizations.

Belgium's health authority said its modeling points to a new COVID-19 wave hitting in mid-October. Its data published on Friday suggests the first ripples of this wave have already arrived.

Belgium reported a 17 percent increase in the number of new cases of coronavirus in the week to September 19 from the previous week. Hospitalizations in the week to September 22 were more stable, rising 4 percent, the public health authority said.

Denmark's infectious disease institute reported first data indicating a reversal in infection rates, which after a long period of decline are now stabilizing or rising slightly across the regions.

The institute also noted that hospitalizations rose 6 percent over the last week, compared with the week before. “People aged 70 to 89 remain the largest group among the newly admitted, as has been the case since the beginning of the year,” the institute said.

And in the U.K., the number of new cases in the week up to September 17 was 13 percent higher than the previous week, while hospitalizations were up 17 percent in the week up to September 19.

Public health authorities including the World Health Organization have been warning for some months of the likely rise in cases again this cold season. Of particular concern is the pressure on health systems, especially with an anticipated surge in other respiratory viruses like flu this winter.

“While COVID-19 rates are still low, the latest data for the last seven days indicate a rise in hospitalizations and a rise in positive tests reported from the community,” said Susan Hopkins, chief medical advisor at the U.K. Health Security Agency.

Hopkins urged those eligible to come forward for their fall vaccine booster, "sooner rather than later," to build up immune protection ahead of the winter.

Europe has authorized boosters that target two types of the Omicron variant, including the one that is dominant now. The U.K. has so far approved one new booster that targets the first Omicron strain, and has bought enough for almost the entire population.

“All of the available boosters provide good protection against severe illness from COVID-19,” Hopkins said.

New Coronavirus News from 22 Sep 2022

WHO chief says end of Covid pandemic ‘still a long way off’ [FRANCE 24 English, 22 Sep 2022]

The head of the World Health Organization on Thursday tempered his assertion that the end of the Covid-19 pandemic was near, warning that declaring the crisis over was "still a long way off".

Last week, Tedros Adhanom Ghebreyesus told reporters that the world had "never been in a better position to end the pandemic... The end is in sight."

And US President Joe Biden went further in an interview broadcast Sunday, declaring that the pandemic in the United States "is over".

But speaking to the media again Thursday from the sidelines of the UN General Assembly in New York, Tedros appeared less upbeat, making clear that "being able to see the end, doesn't mean we are at the end."

He reiterated that the world was in the best position it had ever been in to end the pandemic, with the number of weekly deaths continuing to drop -- and now just 10 percent of what they were at the peak in January 2021.

Tedros pointed out that two-thirds of the world's population has been vaccinated, including three-quarters of health workers and older people.

"We have spent two-and-a-half years in a long, dark tunnel, and we are just beginning to glimpse the light at the end of that tunnel," he said.

But, he stressed, "it is still a long way off, and the tunnel is still dark, with many obstacles that could trip us up if we don't take care."

"We're still in the tunnel."

In its latest epidemiological update, the WHO said over 9,800 fatalities were reported last week, down 17 percent from a week earlier, while 3.2 million new cases were reported.

The UN health agency has warned that the falling number of reported cases is deceptive, since many countries have cut back on testing and may not be detecting less serious cases.

Maria Van Kerkhove, the WHO's technical lead on Covid, told reporters the virus is still "circulating at an intense level," although the situation varied in different countries.

But she pointed out that the world has the tools needed to rein in the spread.

"Our goal is to end the emergency in all countries. And we will keep at this until we reach that goal," she said.

Since the start of the pandemic, the WHO has tallied more than 609 million cases and some 6.5 million deaths, though the true toll is believed to be substantially higher.

A WHO study published in May based on excess mortality seen in various countries during the pandemic estimated that up to 17 million people may have died from Covid in 2020 and 2021.

New Coronavirus News from 20 Sep 2022

EU: COVID pandemic 'far from over,' health regulator warns [DW (English), 20 Sep 2022]

The European Medicines Agency considers the coronavirus pandemic as "ongoing." Meanwhile, Germany is set to roll out booster shots adapted to tackle the omicron variant.
The European Union's drug regulator said on Tuesday that although infections and death rates were down, the COVID-19 pandemic was still "ongoing" and that a planned vaccination campaign would gather pace as winter approaches.

EMA last week approved the first vaccine to specifically target the highly infectious BA.4 and BA.5 types of the coronavirus' omicron variant.

The vaccine also targets "the original strain of SARS-CoV-2" and comes 11 days after the drug watchdog approved vaccines by Pfizer and Moderna against the omicron BA.1 variant.

"We in Europe still consider the pandemic as ongoing and it's important that member states prepare for rollout of the vaccines and especially the adaptive vaccines to prevent further spread of this disease in Europe," the European Medicines Agency's Chief Medical Officer Steffen Thirstrup said at a media briefing.

The announcement comes as last week US President Joe Biden declared the pandemic "over."

Also on Tuesday, France's HAS health authority followed the EMA's lead by clearing two separate COVID vaccine boosters — updated ones developed by Moderna and BioNTech-Pfizer in order to target the Omicron variant.

Germany to roll out omicron-adapted shots
Meanwhile, Germany's official vaccination body has recommended giving Omicron-orientated booster shots to those eligible.

Germany's Standing Committee on Vaccination (STIKO) — an independent panel of experts that advises the government during the pandemic — on Tuesday advised that it is preferable to receive a booster adapted to target the Omicron variant if the individual has to receive a third or fourth jab.

STIKO's draft recommendation says that a first booster vaccination — or third dose — is still recommended for people 12 years of age and older — "usually six months after basic immunization is complete or infection has been passed."

WHO: 17 million in Europe experienced long COVID-19

The World Health Organization found up to 20% of Europeans with COVID-19 developed long-term effects like fatigue and cognitive dysfunction, with women are twice as likely to develop long COVID as men.


Oktoberfest kicks off in Munich after 2-year break
The world-famous beer festival opened in Germany after two years of hiatus due to the COVID pandemic. Amid economic pressure, beer prices at the event are about 15% higher than in 2019.

New Coronavirus News from 13 Sep 2022

News - Beyond the Bier: Oktoberfest 2022 [DVIDS, 13 Sep 2022]

by Megan Beatty

When many service members are notified they have been selected for an assignment overseas they may be excited about a variety of things, like the prospect of traveling and experiencing a new culture.

Unfortunately, COVID-19 has put a damper on some of this excitement and limited opportunities to truly experience their host nation. This is true for some service members at Ramstein Air Base, Germany who may have missed the chance to experience an authentic Oktoberfest.

While the annual festival is known world-wide, it is possible many do not know the history behind it and how it came to be the event celebrated today.

Oktoberfest originates from Munich with the marriage of Ludwig I, the future king of Bavaria, and Princess Therese von Sachsen-Hildburghausen, Oct. 12, 1810 where celebrations lasted five days. Citizens of Munich were invited to attend the royal wedding, participate in festivities, and watch horse races.

According to the city of Munich’s website the celebration was so popular it was brought back the following year and included an agriculture fair. Many new additions were made in following years including horse races and food and drink vendors. These vendors eventually moved to beer halls in the 20th century.

Today, Oktoberfest celebrations throughout the world pay homage to the Oktoberfest in Munich. The festival is traditionally a 17 to 18-day celebration, ending on the first Sunday in October. Since 1935, the first official event of the festival has been the of the Wiesn landlords and breweries featuring bands and carriages and carts covered in flowers drawn by draft horses. 1950, the mayor of Munich has kicked-off the festival by tapping a keg following the parade.

Oktoberfest will be held Sept. 17 to Oct. 3 this year. Members planning to attend Oktoberfest celebrations – locally or across the country – should ensure they have a plan for transportation if drinking alcohol. Members are encouraged to have a plan and use resources available like local cab companies, public transportation, a designated driver, and their immediate supervisor.

Armed Forces Against Drunk Driving is available in the Kaiserslautern Military Community Fridays and Saturdays between 10 p.m. and 6 a.m. Members should call AADD at 0152-5172-3356 if their original plan falls through.

Oktoberfest in recent years has yielded six million visitors, including Germans and other tourists, and roughly two million gallons of beer.

China's Mid-Autumn Festival tourism hit by COVID curbs [Reuters, 13 Sep 2022]

BEIJING, Sept 13 (Reuters) - The number of trips taken over China's three-day Mid-Autumn Festival holiday shrank, with tourism revenue also falling, official data showed, as strict COVID-19 rules discouraged people from travelling.

The number of trips made by tourists fell 16.7% from a year earlier to 73.4 million trips during the holiday, which ended on Monday, according to the Ministry of Culture and Tourism.

Tourism earnings slumped 22.8% to 28.68 billion yuan ($4.14 billion), the data showed.

China has been battling to contain the highly transmissible Omicron variant, imposing lockdowns of various degrees to stop its spread this year and stepping up curbs and restrictions when necessary.

In the Chinese capital Beijing, people returning to work on Tuesday needed to show negative results from tests taken within 48 hours, compared with 72 hours previously.

Authorities in general have also urged people to refrain from non-essential trips in the run-up to a week-long National Day holiday next month and a Communist Party Congress in mid-October.

"We believe travel for family gatherings, tourism and retail sales will be severely hit in coming months including the National Day Golden Week holiday from Oct. 1 to Oct. 7," said Japanese brokerage and investment bank Nomura.

"The worsening tourism data may prompt more cuts of GDP growth forecasts on the Street," Nomura wrote in a note on Tuesday.

During the busy Mid-Autumn Festival, a holiday that typically involves family reunions, trips by road were down 37% at 48.18 million and those by boat fell 15% to 1.54 million, state television reported on Monday.

People took 1.28 million trips within China by air, according to the CCTV report, a level nearly 60% lower than the corresponding holiday last year.
($1 = 6.9229 Chinese yuan)

New Coronavirus News from 1 Sep 2022

Anthony Fauci, loved and hated, plots his next move: 'I'm not going ... [Science, 1 Sep 2022]

HOMENEWSSCIENCEINSIDERANTHONY FAUCI, LOVED AND HATED, PLOTS HIS NEXT MOVE: ‘I’M NOT GOING TO SIT IN MY HOUSE’

Anthony Fauci, loved and hated, plots his next move: ‘I’m not going to sit in my house’
In a candid exit interview, the NIAID head reflects on the seven presidents he served, controversial decisions, and feuding with Rand Paul

In 1984, when Anthony Fauci took over as head of the National Institute of Allergy and Infectious Diseases (NIAID), his wife gave him a plant for the new office. Both the palm and the 81-year-old physician are still there, the giant plant now crowding the office of one of the most celebrated—and polarizing—scientific figures in U.S. history. But not for much longer. Fauci announced on 22 August that he would step down at the end of the year from both NIAID and his post as the chief medical adviser to President Joe Biden.

“What am I going to do with this plant? It’s a monster. I can’t fit it in any other place,” he joked this week from his NIAID office to Science Senior Correspondent Jon Cohen, who has conducted many candid interviews with the institute chief, starting more than 30 years ago with the emergence of an earlier pandemic, AIDS.

For many people in the United States, Fauci became the public figure trusted above all others to guide them through COVID-19. The hero worship was evident in Fauci bobbleheads, “In Fauci We Trust” yard signs, and baseball cards that feature him throwing out a first pitch. But many others—including former President Donald Trump and some of his top advisers—turned on Fauci. They saw his advice as inconsistent and misleading, and portrayed him as a threat to the social order, the economy, and the health of the public. In this alternative world, the yard signs say “Fauci for Prison,” T-shirts declare “Even My Dog Hates Fauci,” and ballcaps call him a fraud or worse. He and his family have faced death threats, and his house has had a Secret Service detail stationed outside for protection.

In a 2021 webcast interview at the annual meeting of AAAS (publisher of Science), Fauci said he wouldn’t retire until there were vaccines for HIV, malaria, and tuberculosis (TB). In his interview with Science this week, Fauci explained his change of mind, acknowledged some missteps during the pandemic, and discussed what he might do next. The interview has been edited for brevity and clarity.

Q: What triggered your decision to leave at the end of this year? You had a much longer range view when we spoke in February 2021 for the AAAS meeting, and then you later said you would retire at the end of Biden’s first term.

A: No, no, I never said that I would retire at the end of Biden’s first term. Please go back and look at my words. Somebody asked me on television, if Donald Trump was the next president, would you stay and work with him? And I said, it doesn’t matter if he’s the next president or if there’s another Republican or even if Joe Biden has a second term. I don’t plan to be here at the end of the day.

I walked onto the National Institutes of Health (NIH) campus as a 27-year-old guy who just finished his medical residency at the New York hospital, and it’s 6 decades years later. I’ve accumulated an unprecedented amount of experience. One of the things I had wanted to do deep down was to be here at the end of the discovery of an HIV vaccine. And this is the truth—and I’m telling you and I haven’t told anybody—I said, you know, we’re not going to get an HIV vaccine for another decade at least. I was joking when I said malaria and TB.

Q: You really haven’t answered the question precisely. Was it the threats to your three daughters and your wife? The attacks in the media and Congress? What is it that finally just made you say, I’m done with this job?

A: It was none of the above. As a guy whose known me for decades, I don’t lie to you. As the Trump administration was ending, I was vaguely considering wanting to have at least a few years when I’m still energetic, enthusiastic, and passionate about doing something outside of the realm of the government. Then the president calls me up right after being elected and says, one of the first things I’m going to do, Tony, is ask you to be my chief medical adviser. I said yes, fully thinking that at the end of that first year of the Biden administration, we’d be done with COVID, it really would be in the rearview mirror.

At the end of that year, it became clear that that’s not going to happen. And I had long conversations with my best adviser, namely my wife, who said, you know, this is not going to disappear. [Fauci’s wife, Christine Grady, heads the bioethics division at NIH’s Clinical Center.]

So I said to myself, you know, I’m going to be 82 in December, what do I have further to offer?

Despite the knives and the slings and the arrows, I’ve achieved a degree of being kind of a hero to some people. So let me use that to inspire people. So I said, when can I do that? I decided over the spring and summer that the best time to do it is when you’re getting somewhat of a steady state with this disease, so I could transition out of here.

Q: Is some of the vitriol toward you about being a flip-flopper with your pandemic advice a result of having to make public health decisions in public in real time?

A: When you’re doing an experiment, you collect data, you validate it, you scrub it, you analyze it, and then you write something that’s based on science that’s not dynamic, but is immutable.

When you’re dealing with a pandemic response, it’s very dynamic, and a somewhat mysterious evolution of a process that has a lot of consequences, because people’s lives are involved. The public expects you to analyze the situation and come out with daily proclamations about what should be done. When you’re humble and scientific enough to say, you know, we were saying this a week, a month, 2 months ago, but now things have really changed, that’s taken as flip-flopping, being wrong, and having made a mistake.

The classic one I know that you’re referring to is about masks, right? How many times are we gonna go over that? The surgeon general tweets, please do not buy masks, the Centers for Disease Control and Prevention says, masks are unnecessary. I, as one spokesman, say, you know, we don’t know if it works outside of the health care setting. Nobody is fully aware of the aerosol spread. And we had no real idea that 60% of the transmissions were by an asymptomatic person. So, right then, we shouldn’t necessarily be wearing a mask. As soon as [the known facts] changed. I said, whoa, wait a minute, we better be wearing a mask in an indoor setting. And that becomes flip-flopping arrogance.

Q: In retrospect, do you think you could have framed it more cautiously in the early days and said, we don’t really know enough right now, it doesn’t look like we need masks, and there’s a shortage of N95s?

A: Yeah, probably so but that’s not what people want to hear. They want to hear what should we do? I probably should have retrospectively couched it in a way that was a little bit more flexible. But I can tell you, Jon, if I did, it’s likely I would have been labeled as a wallflower, he didn’t know what he was talking about.

Q: So what are you going to do? You’ve said you’re going to write a memoir. You’ve never been much motivated by money.

A: If I was motivated by money, I would have taken the 100 jobs I’ve been offered for 20 times my salary.

I don’t know, Jon, and I’m being very honest with you. Let me tell you what I did. I went to the Office of the General Counsel, and I said, I want to know what I can plan [for my post-NIAID retirement]. And they said, if you want to stay pristine, you plan nothing until you walk out the door. Then no one can accuse you of any conflicts of interest, of letting out little signals about what I’m going to do. Why are you looking so skeptically at me?

Q: I just imagine you have some dreams.

A: I don’t know what that’s going to be. It may be hooking up with a university that’s willing to make me a senior professor on their faculty. It may be going with a foundation. I can tell you one thing I’m not going to do. I’m not going to sit in my house with a Gmail address.

Q: You’ve published more than 1100 papers. Your first one was in 1965 on celiac disease, and then over the next 15 years, you published 62 papers on Wegener’s granulomatosis. That could have been your career. You never broke into Nature or Science with those papers. It isn’t until AIDS surfaced that you started regularly publishing in high-impact journals. You were already well into your career before you found what became your deep passion and focus.

A: When I started seeing desperately ill young gay men, it turned me around. That moved me like I never was moved before in medicine. And I decided I was going to pivot. I had had a very successful career that had already gotten me into most of the societies, the young Turks, the old Turks, but then I said, this is really something that I want to devote my career to. From the fall of 1981, right up through the time that we had very successful antiviral drugs, I was taking care of very, very sick people who had HIV. And that inspired me with a passion that we really have got to learn about this disease. And that’s what got me being fanatically a workaholic, about research on that.

Q: Looking back, who was the easiest president to work with? I know who the most difficult one was.

A: I wouldn’t want to say who was the easiest. They were very different. And the difference often was dictated by the circumstances that defined their presidency. I had a very, very warm, almost grandfather-to-grandson relationship with George H.W. Bush. A fine, fine gentleman. I had probably the most impactful relationship with George W. Bush, because he allowed me to be the chief architect of the President’s Emergency Plan for AIDS Relief [PEPFAR]. If you want to look at my career, in lives saved, the most important thing I’ve done might be PEPFAR.

[PEPFAR has invested $100 billion in helping more than 50 countries prevent and treat HIV infections.] But I wouldn’t have been in a position to do what I did with PEPFAR unless I had the president trusting me as I did in [Bill] Clinton’s administration.

Q: Do you think NIH directors should stay in the same position for decades, the way you have? Or should NIH set term limits?

A: It should be flexible. And it depends on the individual and on what’s going on. I don’t buy those kinds of broad statements. I think you should be evaluated the way we are, every 4 years, by an outside group. I’m all for performance-based longevity.

Q: Do you have any advice for NIH about who they should look for or what type of person?

A: The type of person but not a person—that would not be appropriate. You need somebody who clearly has scientific credibility and really understands the science. It also has to be somebody who is articulate enough to be able to navigate the degree of public exposure you will have, because you will be involved in the next outbreak and the next public health crisis, which very often is an infectious disease.

Q: What do you want to accomplish between now and December?

A: I’d like to guide the good research being done in the arena of both mucosal, nasal vaccines for respiratory diseases, as well as more durable vaccines that protect against entire families of viruses. I’m a pusher. We meet as a group at least three, four times a week and I go OK, what are we doing? I try to be not a pain in the ass, but I’d like to keep my foot on the pedal between now and then to keep that thing going.

Q: I’ve seen loads of people confront you over more than 30 years. No one seems to get under your skin as much as Senator Rand Paul (R–KY). Why does that guy piss you off so much? [Paul has accused Fauci of helping trigger the pandemic by funding scientists in Wuhan, China, whom Paul and others allege either created SARS-CoV-2 or had an accidental lab leak of a bat virus they had collected.]

A: I came into what I thought was a good faith, oversight hearing where politicians ask questions for the purpose of improving the situation, for the purpose of protecting and preserving the health of the country. When you start off by saying, how do you explain the fact that you are responsible for the death of 5 million people? No way am I going to stand for that on public television, on C-SPAN. Sorry, Jon. No way.

Q: You got into a debate with him about the meaning of gain of function. [The Wuhan scientists combined a bat coronavirus growing in culture with a piece from another one, and the chimeric virus, in mouse experiments, was more deadly than the original one—but it could not have been used to create SARS-CoV-2.] The Tony Fauci I know, who’s very calm under pressure, would have said, yes, the virus in this experiment gained some function, but that’s not what we’re talking about here. We’re talking about whether it met a definition of gain of function that put the public at risk.

A: You’re absolutely right. If I had to do it over again, I would have done it a little differently. Instead of responding to his accusatory tone, I should have just said, that’s irrelevant to the safety of the country. It stunned me when he publicly called me a murderer of 5 million people. I just should have dropped back off and said, this guy’s a jerk.

There’s an important difference between that kind of attack versus when the AIDS activists were attacking me in the ’80s. What they were saying was based on real suffering, reaching out to get my attention. So when they put my head on a spike outside this window, those were people who were hurting, and they wanted me to listen to them. And I did listen to them. And it was one of the best things that I’ve ever done. I never, ever got angry with the activists.

Q: If the House of Representatives becomes Republican-majority, and they hold hearings, will you testify?

A: If I’m asked to testify, I’ll testify. I have nothing to hide. I can explain everything I’ve done and I could defend everything I’ve done. But if it becomes clear that it’s not an in-good-faith oversight, but a character assassination, I might not play ball.

Q: A last question for you. Do you have a motto that you told your kids, like, this is what I learned in life?

A: Yeah, it’s what I go by. It’s called precision of thought and economy of expression. Know what your message is, know your audience, and say it in as few words as possible.

No, NIH doesn’t recommend using ivermectin to treat COVID-19 [PolitiFact, 1 Sep 2022]

The National Institutes of Health has recommended against using ivermectin to treat COVID-19 except in clinical trials, but recent social media posts claim the federal agency has quietly OK’d the drug.

"NIH adds ivermectin to list of COVID approved treatments," a Sept. 1 Instagram post from One America News said.
In a Sept. 7 Facebook post, comedian Russell Brand said "yesterday, the National Institutes of Health added ivermectin to the list of COVID treatments."

The posts were flagged as part of Facebook’s efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Facebook.)

Brand’s post included an image of a page about "COVID-19 treatment guidelines" and "antiviral therapy" on the NIH’s website.

"These sections summarize the data on ritonavir-boosted nirmatrelvir, remdesivir, and other antiviral medications," the original page says. Among the medications listed is ivermectin.

"Ivermectin is an antiparasitic drug that is being evaluated to treat COVID-19," it reads.

But its inclusion here isn’t new.

We searched archived versions of this page and found one from as long ago as June 2021.

The same language about ivermectin was on the page then, too.

PolitiFact emailed the National Institute of Allergy and Infectious Diseases press office about this. The statement the agency sent back confirmed there had been no change.

"The inclusion of ivermectin to the treatment guidelines is not new," the statement read.
"Importantly, the COVID-19 Treatment Guidelines panel recommends against the use of ivermectin for the treatment of COVID-19." This recommendation largely hinges on the results of recently published randomized controlled trials. "The primary outcomes of these trials showed that the use of ivermectin for the treatment of COVID-19 had no clinical benefit," NIH wrote.

These guidelines are updated regularly as new data becomes available, the institute said, but this is not such a case.

We rate this post False.

Japan records over 300 COVID-19 deaths for 3rd consecutive day [Xinhua, 1 Sep 2022]

TOKYO, Sept. 1 (Xinhua) -- Japan's daily COVID-19-related deaths surpassed 300 for the third consecutive day, amid a strain on the country's medical system fueled by the seventh wave of infections.

Japan reported 303 new coronavirus-related deaths over the last 24 hours, pushing the national death toll to 40,258, exceeding 40,000 for the first time. Meanwhile, the country logged 149,906 new coronavirus cases, bringing the total number to 19,117,599.

Despite the fast-spreading new wave of infections across the country, the government has not imposed any anti-virus restrictions. Moreover, Japan will raise its daily entry cap on arrivals to 50,000 from the current 20,000 from Sept. 7 in a further easing of strict COVID-19 border controls, Prime Minister Fumio Kishida said Wednesday.

Japan's Ministry of Health, Labor and Welfare said on Wednesday that although the number of newly confirmed cases has begun to decrease nationally, the COVID-19 infection level remains high and the hospital bed occupancy rate hovers at a high level.

In terms of medical treatment, there have been many cases of difficulty in emergency transportation and the absence of medical staff, which has caused a great burden on the general medical system as well, the ministry added.

According to Kyodo News, the World Health Organization said on Wednesday that in the week from Aug. 22 to 28, the number of new COVID-19 cases in Japan reached 1,258,772, the highest number in the world for six consecutive weeks. During the same period, Japan's death toll from the coronavirus increased by 23 percent from the previous week to 1,990, ranking second in the world after the United States. ■

Japan endures its worst COVID-19 wave, as strict entry rules deter tourists [ABC News, 1 Sep 2022]

By Joshua Boscaini

Japan, which was praised for keeping its coronavirus cases and deaths largely under control earlier in the pandemic, is experiencing its most severe coronavirus wave so far and has become a hotspot for the virus in East Asia.

Key points:
• Japan's latest COVID-19 wave has been driven by the Omicron variant, low immunity and transmission among young people
• The country's strict border restrictions are impacting Japanese businesses reliant on foreign tourists
• Experts say if the strict measures continue for long, it could impact Japan's reputation as a business and tourism hotspot

The country still has restrictions on the number of foreign tourists allowed to enter and has only just announced it will relax strict rules that limit movement for those willing to visit.

At 1,476,374, Japan reported the world's highest number of weekly cases during the week to August 21, according to the World Health Organization's (WHO) latest epidemiological update on the COVID-19 pandemic.

It also recorded the second-highest number of deaths in the world after the United States, with 1,624, the WHO said in its weekly update.

Kentaro Iwata, a professor of infectious diseases at Kobe University, told the ABC the seventh wave has been driven by the BA.5 Omicron variant, a lack of immunity and low vaccination among young people.

Professor Iwata said Japan managed to keep outbreaks of previous Omicron variants under control, unlike the US and many European countries, meaning there was less immunity in the community.

"We protected ourselves from the infections up until recently, which means we lacked the immunity given by the natural infection. Therefore we are very susceptible to many infections," he said.

He said most of the cases were spreading among young adults who have generally been more complacent and have lower vaccination rates than other age groups.

On Japan's COVID-19 death rate during this wave, Professor Iwata said Japan struggled to distribute enough anti-viral medication, like Paxlovid, to vulnerable people, resulting in a higher death rate.

"Japan's government failed to distribute this medicine very well. So we use this medicine only for 60,000 people, whereas in Korea more than 300,000 received this medicine by now with about half the population size comparing to Japan."

Can I travel to Japan?

As the country experiences another wave of coronavirus cases, the government has made cautious moves to relax border restrictions that came into place at the start of the pandemic.

In June, Japan started allowing foreign tourists back in but capped the total number of travellers at 20,000 a day.

Visitors can only travel in small organised tours, must strictly follow their guides and can only leave their accommodation for planned outings.

But overnight, Japan's Prime Minister Fumio Kishida announced the cap would be lifted to 50,000 and the requirement to travel on organised tours only would be dropped from September 7.

Some travellers are still required to be vaccinated and provide a negative PCR test on arrival, depending on which country they are coming from.

But the requirement to present a negative PCR test will be dropped entirely from September 7.

Australian passport holders, unlike previously, also need a valid visa to enter.

But the moves to slowly open up aren't enough to attract large groups of people back, according to one local business dependent on tourists.

'We don't need a babysitter'
Omakase Tour CEO, Takeshi Sakamoto, told the ABC foreigners enquiring for trips to Japan with his company had postponed trips or were put off travelling there altogether after learning about the country's strict tourist travel rules.

He said his company has only been able to take a few tourists, because most had either postponed or reconsidered travelling to Japan.

"[It is] completely not sustainable and helpful. Due to those kind of rules, we have been losing a lot of business opportunities," Mr Sakamoto said.

"In an email, some American customers said 'we don't need a babysitter' … so it's really annoying for them."

Mr Sakamoto said he welcomed an announcement last week from the Prime Minister that removed the need to have a PCR test on arrival.

He told the ABC, before yesterday's announcement on group tours, that while testing was one less thing for tourists to worry about at the border, he hoped other rules forcing guides to accompany customers throughout their trip would end soon.

Alcohol sales fall and so does government revenue
Monica Chien, senior lecturer in tourism and business at the University of Queensland, told the ABC that the restricted number of tourists filtering through Japan's tightly controlled border wasn't enough to support businesses, like Mr Sakamoto's, that relied heavily on international travellers.

Dr Chien said the Japanese government's "test tourism" was a compromise that aims to balance economic recovery with voter concerns about reintroducing foreigners and the risk of further spreading COVID-19.

"While it may benefit some tour companies, it doesn't really have a widespread impact on the entire tourism community … because test tourism is very restricted," Dr Chien said.

She said the rules ended up actually resulting in a decrease in the number of in-bound tourists.
"[They] actually discouraged people from coming to Japan," she said.

She said if the measures drag on for too long, it could have an impact on the country's reputation as a business and tourism destination.

COVID-19 restrictions have also led to a drop in alcohol sales in Japan, so the National Tax Agency has invited people to help them find ways of encouraging younger Japanese people to drink more alcohol.

Japanese bars and Izakayas have been hit hard by the pandemic — alcohol sales halved from 2019 to 2020, according to the Ministry of Economy, Trade and Industry.

The ministry said nearly 8 per cent of people in their 20s drank regularly, compared with 30 per cent of people aged in their 40s to 60s.

Revenue from alcohol sales is decreasing, so the government wants the the "Sake Viva!" campaign to "stimulate demand among young people" for alcohol, according to CNN.

New Coronavirus News from 1 Sep 2022

Japan endures its worst COVID-19 wave, as strict entry rules deter tourists [ABC News, 1 Sep 2022]

By Joshua Boscaini

Japan, which was praised for keeping its coronavirus cases and deaths largely under control earlier in the pandemic, is experiencing its most severe coronavirus wave so far and has become a hotspot for the virus in East Asia.

Key points:
• Japan's latest COVID-19 wave has been driven by the Omicron variant, low immunity and transmission among young people
• The country's strict border restrictions are impacting Japanese businesses reliant on foreign tourists
• Experts say if the strict measures continue for long, it could impact Japan's reputation as a business and tourism hotspot

The country still has restrictions on the number of foreign tourists allowed to enter and has only just announced it will relax strict rules that limit movement for those willing to visit.

At 1,476,374, Japan reported the world's highest number of weekly cases during the week to August 21, according to the World Health Organization's (WHO) latest epidemiological update on the COVID-19 pandemic.

It also recorded the second-highest number of deaths in the world after the United States, with 1,624, the WHO said in its weekly update.

Kentaro Iwata, a professor of infectious diseases at Kobe University, told the ABC the seventh wave has been driven by the BA.5 Omicron variant, a lack of immunity and low vaccination among young people.

Professor Iwata said Japan managed to keep outbreaks of previous Omicron variants under control, unlike the US and many European countries, meaning there was less immunity in the community.

"We protected ourselves from the infections up until recently, which means we lacked the immunity given by the natural infection. Therefore we are very susceptible to many infections," he said.

He said most of the cases were spreading among young adults who have generally been more complacent and have lower vaccination rates than other age groups.

On Japan's COVID-19 death rate during this wave, Professor Iwata said Japan struggled to distribute enough anti-viral medication, like Paxlovid, to vulnerable people, resulting in a higher death rate.

"Japan's government failed to distribute this medicine very well. So we use this medicine only for 60,000 people, whereas in Korea more than 300,000 received this medicine by now with about half the population size comparing to Japan."

Can I travel to Japan?

As the country experiences another wave of coronavirus cases, the government has made cautious moves to relax border restrictions that came into place at the start of the pandemic.

In June, Japan started allowing foreign tourists back in but capped the total number of travellers at 20,000 a day.

Visitors can only travel in small organised tours, must strictly follow their guides and can only leave their accommodation for planned outings.

But overnight, Japan's Prime Minister Fumio Kishida announced the cap would be lifted to 50,000 and the requirement to travel on organised tours only would be dropped from September 7.

Some travellers are still required to be vaccinated and provide a negative PCR test on arrival, depending on which country they are coming from.

But the requirement to present a negative PCR test will be dropped entirely from September 7.

Australian passport holders, unlike previously, also need a valid visa to enter.

But the moves to slowly open up aren't enough to attract large groups of people back, according to one local business dependent on tourists.

'We don't need a babysitter'
Omakase Tour CEO, Takeshi Sakamoto, told the ABC foreigners enquiring for trips to Japan with his company had postponed trips or were put off travelling there altogether after learning about the country's strict tourist travel rules.

He said his company has only been able to take a few tourists, because most had either postponed or reconsidered travelling to Japan.

"[It is] completely not sustainable and helpful. Due to those kind of rules, we have been losing a lot of business opportunities," Mr Sakamoto said.

"In an email, some American customers said 'we don't need a babysitter' … so it's really annoying for them."

Mr Sakamoto said he welcomed an announcement last week from the Prime Minister that removed the need to have a PCR test on arrival.

He told the ABC, before yesterday's announcement on group tours, that while testing was one less thing for tourists to worry about at the border, he hoped other rules forcing guides to accompany customers throughout their trip would end soon.

Alcohol sales fall and so does government revenue
Monica Chien, senior lecturer in tourism and business at the University of Queensland, told the ABC that the restricted number of tourists filtering through Japan's tightly controlled border wasn't enough to support businesses, like Mr Sakamoto's, that relied heavily on international travellers.

Dr Chien said the Japanese government's "test tourism" was a compromise that aims to balance economic recovery with voter concerns about reintroducing foreigners and the risk of further spreading COVID-19.

"While it may benefit some tour companies, it doesn't really have a widespread impact on the entire tourism community … because test tourism is very restricted," Dr Chien said.

She said the rules ended up actually resulting in a decrease in the number of in-bound tourists.
"[They] actually discouraged people from coming to Japan," she said.

She said if the measures drag on for too long, it could have an impact on the country's reputation as a business and tourism destination.

COVID-19 restrictions have also led to a drop in alcohol sales in Japan, so the National Tax Agency has invited people to help them find ways of encouraging younger Japanese people to drink more alcohol.

Japanese bars and Izakayas have been hit hard by the pandemic — alcohol sales halved from 2019 to 2020, according to the Ministry of Economy, Trade and Industry.

The ministry said nearly 8 per cent of people in their 20s drank regularly, compared with 30 per cent of people aged in their 40s to 60s.

Revenue from alcohol sales is decreasing, so the government wants the the "Sake Viva!" campaign to "stimulate demand among young people" for alcohol, according to CNN.

New Coronavirus News from 10 Sep 2022

Japan's COVID-19 cases more than doubled in 2 months [Xinhua, 10 Sep 2022]

TOKYO, Sept. 10 (Xinhua) -- Japan reported a total of 20,000,343 COVID-19 cases as of Friday, more than doubled in less than two months from that logged on July 14, statistics showed.

The country registered 99,491 new COVID-19 cases on Friday. A total of 211 people were reported dead, bringing the total death toll to 42,363, according to data from the country's public broadcaster NHK.

Japan has seen its seventh wave of COVID-19 infections since July, and the number of new confirmed cases and deaths in a single day remains at a high level.

The rapid rise in the number of deaths has made it difficult to cremate the dead in some parts of Japan, local media has reported.

In Japan, the number of new infections in the latest week was 69 percent higher than the previous week, Japan's Ministry of Health, Labor and Welfare said in a report Wednesday.

Most of the country's new coronavirus deaths in July and August were among people over 70 years old. People aged 70 and above accounted for about 91 percent of COVID-19 deaths between June 29 and Aug. 30, Japanese newspaper Yomiuri Shimbun reported, citing data from the ministry.

Japan's Asahi Shimbun said that the average life expectancy of Japanese men and women was shortened by 0.1 years and 0.07 years in 2021 due to the COVID-19 pandemic.

This was the first time in 10 years that the average life expectancy of Japanese people has been shortened since the March 11 earthquake in 2011.

The World Health Organization said that in the week from Aug. 29 to Sept. 4, the number of new COVID-19 cases in Japan surpassed 1,160,000, the highest number in the world for the seventh consecutive week. During the same period, Japan's death toll from the coronavirus reached 2,059, ranking second in the world after the United States.