New Coronavirus News from 17 Nov 2022

What Was the COVID-19 Recession? Is There an End in Sight? [TheStreet, 17 Nov 2022]

Was it the shortest recession in history? Or is it still ongoing?

What Was the COVID-19 Recession?
According to the National Bureau of Economic Research (NBER), the official arbiter ofrecession, a sharp economic downturn coincided with the onset of the COVID-19 pandemic.

It officially categorized the COVID-19 recession as a two-month contraction between February and April of 2020, after which stay-at-home orders and lockdown restrictions were lifted in many parts of the world.

A stock market crash had ushered in the Covid-19 recession—not just one, in fact, but several:
•　Over the span of three days in March 2020, the New York Stock Exchangeimplemented emergency stops during its trading sessions to avoid a complete meltdown. The Dow Jones Industrial Average lost 37% of its value, while the S&P 500declined 34%. These days would come to be known as Black Monday I (March 9, 2020), Black Thursday (March 12, 2020) and Black Monday II (March 16, 2020).
•　Like the virus itself, the capitulation knew no boundaries, and stock market indexesaround the globe also experienced staggering declines: The Nikkei in Tokyo, FTSE 100 in London, and IBOVESPA in Brazil all posted double-digit losses, marking their worst performance since the Financial Crisis of 2007–2008.Source: BEA.gov

What Caused the Covid-19 Recession?
Back in the 1970s, an economist named Julius Shiskin popularly defined a recession as two quarters of negative GDP growth. While stock market pundits commonly point to that classification, the NBER looks at a host of other indicators to paint a more complete picture on the economy—and when all is said and done, the economy’s continued poor performance just might as well cause the NBER to revise and extend its timeframe for the COVID-19 recession.

The COVID-19 Recession Was So Much More Than GDP Contraction
What’s interesting about the COVID-19 crisis is that it not only fits within Shiskin’s definition, since GDP contracted by an astounding 34.5% in the first two quarters of 2020, and again at the onset of theDelta and Omicron variants but other economic indicators had also pointed to a looming contraction—one not just due to a health crisis. This may explain why the stock market went on to experience turbulence and anxiety well after the lockdowns ended.

The Covid-19 Recession Was Also an Inflation-Triggered Recession
One of the reasons why the Federal Reserve scrutinizes monthly data releases is that it knows that inflation is notoriously hard to control. Inflation alone can trigger a recession because the policy procedures used to rein it in—namely, by raising interest rates—are considered to be a “blunt instrument.” That means that it takes a while for their effects to be felt, and that they leave widespread, instead of targeted, fallout.

When interest rates rise, for example, it’s more difficult for consumers to obtain a car loan or a mortgage from a bank, and thus, the housing and retail sectors suffer. Credit card and student loan repayments also increase, and so consumer confidenceweakens. Businesses can’t afford to expand—and often, many are forced to reduce their workforces, which causes unemployment to rise.

One of the Federal Reserve’s preferred inflation gauges is the Personal Consumption Expenditures index (PCE), which measures the change in prices for the everyday items that make our lives possible. During March and April of 2020, the Core PCE actually declined before it began a steep, two-year ascent that has yet to level off—prices skyrocketed more than 10% in little more than two years! This trend would not be sustainable for any economy.

Remembering how Fed Chair Paul Volcker had to raise the Fed funds rate to an all-time high of 20.0% in order to tame inflation back in the 1980s may explain why its current Chair, Jerome Powell, quickly reacted to inflation’s surge by implementing a series of 0.75% rate hikes throughout much of 2022.

Unfortunately, the effects of these actions will be felt for some time to come.

The COVID-19 Recession Ignited a Series of Economic Shocks
What happens when people are scared for their lives, huddled at home, or even worse—trapped in the grips of a deadly disease with no treatment in sight? Production stops, manufacturing output plummets, businesses fail, and unemployment soars.

The COVID-19 pandemic introduced a series of supply shocks that strangled the economy and left supply chains hopelessly snarled. Borders closed, leaving shipments of raw materials and other items stalled for months. When lockdowns eased, demand for products surged, but manufacturing would take months to come back online, and inventories simply could not keep up fast enough.

COVID-related famines swept the globe, while oil-producing nations declared war on each other. To make matters worse, China reinstituted mandatory lockdowns between February and June of 2022, causing the entire cycle to repeat itself. It’s no wonder global economies continue to feel the malaise.

The COVID-19 Pandemic Popped Wall Street’s Bubble
Stretching from 2009 through February, 2020 the longest bull market in history had to end at some point. It could be argued that an asset bubble had engulfed the entire stock market, and a correction was needed to return stock prices closer to their intrinsic values.

And as anyone who blows a bubble knows, when it finally bursts, the results aren’t pretty. The warnings grew more ominous: The yield curve on US Treasuries inverted between May and October of 2019, which is often thought to be a reliable indicator of recession.

Is There an End to the COVID-19 Recession in Sight?
Controlling the virus itself will finally extinguish the COVID-19 recession, but so long as it has hosts to infect and variants that mutate, a cure remains elusive. Along with each surge, the economy falters, preventing a true recovery from taking form. Until then, investors would be wise to buckle up and follow sound approaches to keep their money as safe as possible—such as this bear market superpower from TheStreet’s Todd Campbell.

'Swarm' of variants is driving up California COVID cases. Is this the start of the next surge? [San Francisco Chronicle, 17 Nov 2022]

By MATT KAWAHARA, AIDIN VAZIRI

As winter looms, so does the question of whether another COVID-19 surge is in store for the Bay Area.

New coronavirus subvariants are rapidly spreading across the country and California, overtaking the strain that led to a U.S. summer wave. Cases have begun to tick upward statewide after a monthslong decline, just ahead of the holidays and a cold weather front that will drive people indoors.

Last winter, the omicron surge took off during the holiday season and peaked in the second week of January, when an astonishing 18,000-plus cases per day were being reported in the Bay Area — nearly four times higher than the peak of the previous winter wave.

While a rise in cases may be expected this winter, public health experts voiced optimism that any wave won’t be as severe as surges the past two winters. The uncertainty stems in part from dealing with an unpredictable virus that continues to evolve, giving rise to new emerging offshoots.

“The BQ.1, BQ.1.1, those are the variants that look like they’re going to predominate,” said Dr. Warner Greene, a senior investigator with the Gladstone Institutes. “They’re more immune-evasive, which means there will probably be more infections. But they don’t appear to have any greater pathogenicity than the original omicron, so that’s good news.”

He added, “There’s going to be a swarm of variants. Which ones take over may be different in different areas. But it’s unclear to what extent there will be a surge.”

On one hand, experts said, levels of immunity in the population are much higher now than during past winters from vaccinations, prior infections or both. The U.S. is reporting lower case and hospitalization rates than at this time in 2020 or 2021, and treatments exist to combat severe cases of the virus.

On the other, people are relaxing prevention measures like distancing and masking and returning to more normal interactions. Uptake of the most recent bivalent booster is low. And some of the newer variants, as Greene noted, appear better at dodging prior immunity.

Bay Area health officials Wednesday said a substantial increase in flu activity and other respiratory viruses, including RSV, since the start of November is already putting a strain on health systems across the region.

As of last week, the Centers for Disease Control and Prevention estimated the BQ.1 and BQ.1.1 omicron subvariants combined make up nearly half of COVID cases, 44%, in the U.S., overtaking the previously dominant BA.5 subvariant.

BQ.1 and BQ.1.1 had accounted for 22% of cases just two weeks earlier, while BA.5 made up over half of cases at that time, per the CDC.

A few other omicron offshoots were also pushing for circulation. BF.7 accounted for an estimated 7.8% of U.S. cases and BA.4.6 for an estimated 5.5% last week. BN.1, a descendent of BA.2.75, made up 4.3% and showed signs of taking off in the West region, where it accounted for 6.2% of cases.

BN.1 includes mutations that could give it “high immune escape,” which means that the virus has evolved to evade antibodies from vaccination or previous infection, according to predictions by infectious disease experts. The subvariant caused a surge of hospitalizations in Austria earlier this year.

In places where BQ.1 has gained prevalence, it has not seemed to cause huge surges or major increases in hospitalizations, said Dr. Robert Wachter, UCSF chair of medicine, citing France as an example. That is one reason Wachter believes a U.S. winter wave would be “mild to moderate, not severe,” he said.

“My suspicion is that it is close enough to the prior virus in terms of its structure and the way the immune system deals with it that the immunity people have from some combination of vaccines, boosters and prior infection is still tamping it down,” Wachter said. “But we’ll have to see.”

While the variants may be highly transmissible, several experts said there is no indication yet that they cause more severe illness than previous strains of the virus.

“So far, it would appear that the variants to date are not on average making us sicker or being very successful at reducing vaccine effectiveness against the severe outcomes we really care about most,” said Dr. Art Reingold, a UC Berkeley epidemiologist.

That said, reinfection could carry its own risks. A study published last week in Nature Medicine found that risk of organ failure, hospitalization and death from COVID-19 increases with repeat infections compared with an initial bout of the virus, regardless of vaccination status.

“Without ambiguity, our research showed that getting an infection a second, third or fourth time contributes to additional health risks in the acute phase, meaning the first 30 days after infection, and in the months beyond, meaning the long COVID phase,” said senior author Ziyad Al-Aly a clinical epidemiologist at theWashington University School of Medicine.

There is also the potential for long COVID and other lingering impacts of infection. The best defense, Reingold and other health experts said, is being vaccinated and boosted.

The bivalent booster is designed to protect against both the original coronavirus and the BA.4 and BA.5 variants, from which many new subvariants are descended.

Yet uptake of the booster, said UCSF’s Wachter, has been “pretty dismal.” Just 10.1% of eligible people in the U.S. age 5 and older have received it, according to the CDC.

“It’s flabbergasting to me that people are choosing not to get the new booster, especially if they haven’t had a jolt to their immunity in the form of a booster or infection any time in the last six-to-eight months or more,” Wachter said. “They could make themselves substantially safer by doing that than not.”

As the virus continues to evolve, staying up to date on available vaccines will be important, said Stanford infectious disease expert Dr. Robert Siegel.

More immune-evasive variants can cause more infections, which in turn increase the chance of new variants arising, Siegel said. This virus has shown the ability to “combine two different strains together and produce a third, unique strain.”

“When that happens, it’ll create lots and lots of variants,” Siegel said. “Most of them will go nowhere. What we see are the ones that have some selective advantage, they’re superior to the previous variant.”

A new variant can win out by being more infectious or better able to skirt protection of vaccines or prior infection. Siegel said rises in variant cases in Europe and on the East Coast are “a concern” as California tends to follow suit, but he also noted those waves have not yet led to high hospitalization rates.

There are early signals of an uptick in California. The state’s positive test rate is up for the second week in a row, growing to 5.3% compared to 4.5% last week. It’s the first time since mid-September that the positivity rate has tipped over 5%, the figure most public health officials consider the baseline for controlling spread of the virus.

Dr. Kim Rhoads, left, places a Covid-19 booster vaccine into a needle during a community health fair at Hayes Valley Playground on Wednesday, October 12, 2022, in San Francisco, Calif. Dr. Rhoads started Umoja Health during the pandemic as a response to fill in some of the voids in healthcare the Black community was facing. ?’So Umoja Health is that first of all, Umoja is a Swahili word, which means unity, but it means much more than unity. It actually refers to the oneness. So a singular focus or a singular mission. And so the idea is to convene the community partners who are concerned about COVID in their neighborhoods. That's how we started with COVID. We've expanded to other things. But to convene all of those community partners who have concerns so that we can, number one, hold our public health institutions accountable and our health care institutions accountable to the health of the public, but also so that we can then bring those resources into their communities and make it easy to access them,?“ Dr. Rhoads said. ?’So we're bringing the resources to provide that along with a little bit of food, a gift card, some goodies in a bag, and just a warm kind of hug in this time of of an unprecedented pandemic.?“

Yalonda M. James, Staff / The Chronicle

In Alameda County, officials are seeing “some increases” in COVID metrics like reported cases, test positivity and wastewater data, said health officer Dr. Nicholas Moss.

“Whether that becomes this fall and winter wave that we have been anticipating or ends up being more of just a bump is hard to know,” Moss said.

The county’s most recent data, from a few weeks ago, showed BA.5 as still the main culprit, though the state is projecting an increase in BQ.1 and BQ.1.1, Moss said. He added that regardless of which variant is taking hold, public health recommendations — getting the vaccines, staying home when sick, handwashing and considering masking in crowded indoor settings — still apply.

“Other viruses do this as well, it’s not a unique feature of COVID that it evolves these new strains,” Moss said. “But really the tools we rely on are going to look very similar no matter what.”

Hospitalizations in California are still relatively low but rising. As of Thursday, there were 1,842 patients hospitalized in the state with confirmed COVID-19, an 8% increase from the prior week, while the number of patients in intensive care unit beds grew by 15% to 225. It reversed a steady decline since late July.

The uptick is following early surges seen nationwide in influenza and respiratory syncytial virus, or RSV, common winter illnesses that saw lower-than-normal transmission the past two years.

“We’re going to be challenged this winter by flu, by RSV,” said Greene, of the Gladstone Institutes. “And the extent that coronavirus will kind of pile on top of these, we’ll just have to wait and see.”

COVID in California: Indoor masking 'strongly recommended' again in L.A. County [San Francisco Chronicle, 18 Nov 2022]

BY AIDIN VAZIRI, MATT KAWAHARA

COVID in California: L.A. ‘strongly’ recommends indoor masking as cases rise

Los Angeles County health officials are now “strongly recommending” indoor masking due to a rise in COVID-19 infection rates, county health officials said.

New coronavirus subvariants are rapidly spreading across California, overtaking the strain that led to a U.S. summer wave and fueling concern that the next surge is already here. California COVID cases jumped 36%, according to data from the state health department, a pace of growth alarmingly similar to what the state saw ahead of prior COVID waves.

Latest updates: U.S. virus levels remain stagnant
COVID-19 trends have stopped improving in the U.S. as virus community levels remained stagnant for another week. The proportion of counties nationwide that fell into the “low” tier on Friday, based on hospitalization and case metrics used by the U.S. Centers for Disease Control and Prevention, was about 80.52%. Another 16.68% were in the “medium” category and the remaining 2.8% were categorized as having “high” community levels — numbers that showed little movement from the previous week.

The agency’s community transmission map, based on a separate metric that tracks the rates of new cases and positive tests, also changed little, with 38.61% of U.S. counties in the U.S. in the “high” virus transmission category, 32.84% in the “substantial” tier, 23.12% in “moderate,” and 5.43% of all counties with “low” virus transmission.

Bivalent booster improves immune response to newer omicron subvariants, Pfizer says
Pfizer said Friday that new data shows its bivalent booster shot improves immune response against COVID-19 subvariants that are emerging and circulating in the U.S. The omicron BA.4/BA.5-adapted booster elicited a higher antibody response against subvariants including BA.4.6, BA.2.75.2, BQ.1.1 and XBB.1 in adults aged 55 and older, one month after booster uptake, according to Pfizer and BioNTech.

The company said antibodies increased by about 11 times against BA.4.6, about 9 times against BQ.1.1, by 6.7 times against BA.2.72.2 and about 5 times against XBB.1.The omicron BQ.1 and BQ.1.1 subvariants accounted for about 49.7% of total coronavirus cases in the U.S. last week, according to the U.S. Centers for Disease Control and Prevention.

The BA.4.6 subvariant made up an estimated 4.4% of cases and BA.2.75.2 made up about 0.7% of cases, while XBB.1 was not yet prevalent enough to appear in data, per the CDC. As of Friday, 11.3% of eligible Americans aged 5 and older had received the bivalent booster, according to CDC data.

NFL games with fans last season were associated with COVID-19 spikes, study says
Fan attendance at NFL games during the 2020-21 season, the league’s first of the COVID-19 pandemic, was associated with ensuing increases in COVID-19 cases in areas where the games were held, according to a new study published in the journal Jama Network Open. For that season, some NFL teams played home games with no fans and others with their stadiums at limited capacity. The study looked at 269 games, 117 with no fans and 152 with fan attendance ranging from 748 to 31,700 people, and COVID-19 data for the host county and surrounding ones at 7, 14 and 21 days after games. It found that games with no crowds or fewer than 5,000 fans were not associated with COVID-19 spikes, but games with 20,000 or more fans were associated with 2.23 times the rate of spikes in the ensuing 14- and 21-day windows.

Researchers noted it was “impossible” to state a causal effect between fan attendance and ensuing COVID-19 increases as trends might have been influenced by public health regulations in those areas. “The spikes in COVID-19 for crowds of over 20,000 people suggest that large events should be handled with extreme caution during public health events where vaccines, on-site testing and various countermeasures are not readily available to the public,” researchers wrote.

BQ.1 and BQ.1.1 make up nearly half of U.S. cases
The omicron subvariants BQ.1 and BQ.1.1 made up 49.7% of the total coronavirus cases circulating in the United States last week, two months after they were initially detected, according to data published Friday by the U.S. Centers for Disease Control and Prevention.

BQ.1.1 accounted for 24.2% of circulating variants and BQ.1 made up an estimated 25.5% for the week ending Nov. 19. The proportion of the omicron BA.5 subvariant that drove this year’s summer surge declined to 24% of cases, compared with nearly 33.8% in the week ended Nov. 12. BF.7 also grew to make up 7.6% of the cases, followed by a “variant soup” that includes BN.1, BA.5.2.6, BA.4.6, BA.2.75, BA.2.75.2, BA.4, BA.1.1.529 and several other strains that are circulating.

State HHS Secretary Ghaly shares suggestions for safer holiday gatherings
California is seeing rising rates of COVID-19, flu and other respiratory illnesses just ahead of the holidays. Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, suggested several things people can do try to gather more safely this winter: Those include everyone testing for the coronavirus before the gathering, staying home if sick, doing activities outside if possible and, if traveling, wearing a well-fitting and high-filtration mask en route, Ghaly said on a media call Thursday. “I know not all of these actions are possible, so consider what you might be able to do and do as many as you can,” he said. Ventilation is also important when indoors, so: “If you can’t open your window, at least open the doors in the area so you’re able to have some circulation, that would be beneficial,” Ghaly said.

Among the viruses surging in the U.S. is respiratory syncytial virus, or RSV, which typically resembles a mild cold but can cause more serious illness, especially in infants and elderly adults. There is no available vaccine for RSV. Ghaly cited getting vaccinated for COVID-19 and influenza, handwashing and covering your cough as other practices people can follow to try to help prevent spread of respiratory viruses.

State officials “concerned” with “very low” uptake of bivalent booster With COVID-19 rates rising in California, state officials are “concerned” about low numbers of people receiving the the bivalent booster shot, Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, said on a media call Thursday. As of Thursday, 13.3% of eligible Californians had received the booster, which is designed to protect against both the original coronavirus strain and the BA.4 and BA.5 variants that have given rise to newer subvariants now in circulation, according to the state’s health department.California’s booster uptake was higher than the 10.1% rate across the U.S., according to the Centers for Disease Control and Prevention.

But Ghaly termed it “very low,” adding that: “If you’re inclined to get it, there’s probably no better time than now to give yourself this period of protection over the next many weeks” with the holidays and colder months approaching.

Along with COVID-19 trends, the state is seeing increases in flu and respiratory syncytial virus, or RSV, in “every category we track,” Ghaly said. “Unlike the past two years, when we discussed a COVID and flu collision, this year we’re actually starting to see it,” he said. The state’s COVID-19 test positivity rate was 6.3% as of Thursday, up from 4.5% two weeks earlier. Ghaly noted the state has already seen RSV levels among children “that rival peaks from other years,” straining pediatric hospitals and emergency rooms.

Virus carries higher risk of epilepsy and seizures than influenza A COVID-19 infection carries a substantially greater risk for both seizures and epilepsy compared to an influenza infection, according to a retrospective analysis of over 300,000 people published in the medical journal Neurology.

The incidence of new seizures or epilepsy diagnoses in the six months following COVID-19 was low overall but higher than in matched patients with influenza, the researchers from Oxford University found. “This difference was more marked in people who were not hospitalized, highlighting the risk of epilepsy and seizures even in those with less severe infection,” the authors wrote, noting that children are at particular risk of seizures and epilepsy after COVID-19 “providing another motivation to prevent COVID-19 infection in pediatric populations.”

Oakland airport anticipates 90% of pre-pandemic traffic for Thanksgiving The Port of Oakland projects that 170,000 passengers will use Oakland International Airport during the five-day Thanksgiving holiday travel period from Nov. 23 through Nov. 27.

The figure marks at 10% increase over last Thanksgiving and more than 90% of the 2019 pre-pandemic traffic benchmark officials said. ”The Thanksgiving travel period is always busy, and the airport is ready to welcome holiday travelers,” said Bryant L. Francis, director of aviation at the Port of Oakland. “Travelers can help to make their journey smoother by arriving at the airport early, adhering to airline check-in and carry-on bag requirements and using airline apps for check-in whenever possible.”

Indoor masking ‘strongly recommended’ again in L.A. County Los Angeles County health officials are now “strongly recommending” indoor masking due to a rise in COVID-19 infection rates, county health officer Dr. Muntu Davis said in a media briefing Thursday. The county is seeing a daily rate of 100 new coronavirus cases per 100,000 residents, up from 86 the prior week, triggering the recommendation as per the county’s COVID-19 response plan, Davis said.

Settings where the recommendation applies are public indoor spaces, public transit – including buses, rideshares, taxis and medical transport – correctional and detention facilities and homeless and emergency shelters, Davis said. Masking is already required for people exposed to COVID-19 in the past 10 days, in healthcare settings and congregate care facilities and at any sites that require it, he said.L.A. County’s 7-day average of nearly 1,500 cases per day the past week marked a 13% rise from the previous week and a 52% spike since Nov. 1, Davis said. Hospitalizations are also going up; the county averaged 97 admissions per day the past week, a 26% week-over-week increase and a 54% jump since Nov. 1, Davis said.

Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, said on a media call Thursday the L.A. County decision reflects local conditions but didn’t rule out the state following suit if its COVID-19 trends continue to rise. “Making that move here, again, local decision, definitely makes sense,” Ghaly said. “I think as we see the next weeks evolve, that decision on a statewide basis may be appropriate, and we’ll see.”

No link between vaccine and shingles, UCSF study confirms
There is no association between COVID-19 vaccination and shingles, according to a study of more than 2 million individuals in the U.S. Researchers at UCSF found that the risk of herpes zoster in the month after receiving a dose of COVID-19 vaccine was no different when compared with a control period 60 to 90 days following an individuals' last dose. “There was no increase in risk of herpes zoster after COVID-19 vaccination when individuals were stratified by age, immunocompromised status, or type of vaccine administered," the team wrote in JAMA Network Open.

COVID-19 vaccination was associated with a slightly lower shingles risk than outcomes following influenza vaccination in a period before the pandemic, the research showed.

"Compared with previous work, our study had a larger sample, which enabled us to control for confounders that were not included in other studies, such as measures of healthcare use, history of zoster vaccination, and comorbidity-related risk factors for herpes zoster rather than weighted indices,” lead author Nisha Acharya said in a statement.

California COVID cases jump 36% ahead of anticipated surge
California’s COVID-19 trends have officially reversed ahead of an anticipated winter surge. The state is averaging about 9 new daily cases per 100,000 residents as of Thursday, marking a 36% increase compared to the 6.5 per 100,000 reported two weeks earlier, according to health department data. Before last week, the rate of new cases in California had been on a steady decline since a July peak. The state test-positive rate is also up for the second week in a row, growing to 6.3% compared to 4.5% just two weeks ago.

The pace of growth is similar to what the state saw ahead of previous waves, including the summer BA.5 spike. And it‘s likely that the reported numbers are a severe undercount with so many people taking rapid home tests.Hospitalizations are also rising sharply. There were 2,187 patients hospitalized in California with confirmed COVID-19 as of Thursday, a 19% increase from the prior week and the state’s highest daily total since mid-September.

The number of COVID-19 patients in intensive care units Thursday had risen 28% from last week to 287.San Francisco’s average test-positive rate has also jumped to 6.1%, after falling below 5% for the first time since April last month.The trends coincide with a higher circulation of newer omicron subvariants that are overtaking the BA.5 subvariant that fueled a summer coronavirus surge in the U.S., according to federal data.

While newer subvariants such as BQ.1 and BQ.1.1 are thought to be more immune-evasive, raising the possibility of reinfections, it’s unclear if they cause more severe illness than prior strains of the virus, health experts have said.About 72% of Californians have completed their primary vaccination series, with 13% of those eligible receiving the updated bivalent booster targeting the newer omicron strains of the virus, according to the state dashboard

Expanded airport surveillance program detects an influx of XBB
The U.S. Centers for Disease Control and Prevention on Thursday announced it has expanded its airport genomic surveillance program, which tests international travelers to detect new variants entering the country. The service — which is already up and running in SFO, JFK, Newark-New York and Atlanta — is now available at Washington Dulles International Airport.
More than 60,000 people have voluntarily participated in the program from November 2021 through September 2022, with an average of 1,100 participants per week, per the CDC. Based on the latest data, there is a growing proportion of the omicron XBB subvariant arriving in the U.S., making up about 13% of the samples collected in the most recent week. But the national health agency has not yet flagged it as a variant it is monitoring nationwide.

Global cases up for first time in 4 months, WHO says
Global coronavirus cases increased last week for the first time in four months, the World Health Organization reported on Wednesday. Since mid-July, the U.N. health agency reported that cases were either stable or on the decline. But the trend appears to be reversing now, as the number of infections worldwide rose to 2.3 million infections in the latest tally. The five countries reporting the most cases were Japan, South Korea, Germany, China, and the U.S., where cases increased by 10% over the past two weeks after falling steadily since August, according to data from the Centers for Disease Control and Prevention. Japan's daily COVID-19 cases topped 100,000 for the first time in two months as the country reopened to visitors from other nations, according to Kyodo News

CDC forecasts virus hospitalizations to rise for first time since July
For the first time since July, the U.S. Centers for Disease Control and Prevention’s national ensemble predicts that the number of new daily confirmed COVID-19 hospital admissions will likely increase, with 2,000 to 9,000 new confirmed COVID-19 hospital admissions likely reported on Dec. 9. The health agency’s ensemble forecast for virus-related hospitalizations in the U.S. for the past four months has shown numbers to either remain stable or steadily decline. Some of the biggest increases have been reported in HHS Region 9.

Virus fight in China leads to 250,000 quarantine beds, iPhone production delays
China’s southern metropolis of Guangzhou announced plans Thursday to build quarantine facilities for nearly 250,000 people to fight surging coronavirus outbreaks even as the national government tries to reduce the impact of anti-disease controls that have confined millions of people to their homes. Guangzhou, a city of 13 million people and the biggest of a series of hot spots across China with outbreaks since early October, reported 9,680 new cases in the past 24 hours, according to the Associated Press.

That was about 40% of the 23,276 cases reported nationwide. China’s infection numbers are low compared with the United States and other major countries, but the ruling Communist Party is trying to isolate every case. Repeated closures of neighborhoods, schools and businesses are fueling public frustration and clashes with health workers. A spike in infections has led officials in areas across China to confine families to cramped apartments or order people into quarantine if a single case is found in their workplace or neighborhood. The Communist Party promised last week to cut the cost of anti-virus controls by reducing the length of quarantines and changing other rules. However, party leaders said they will stick to the “zero COVID” strategy at a time when other countries are easing restrictions and trying to live with the virus. Access to a Zhengzhou industrial zone that is home to the world’s biggest iPhone factory was suspended this month following outbreaks. Apple Inc. said deliveries of its new iPhone 14 model would be delayed

Home births rose in pandemic’s second year
The number of people giving birth at home in the U.S. rose slightly in the second year of the pandemic, according to a CDC report released Thursday.

“The percentage of U.S. home births rose from 1.26% (45,646) in 2020 to 1.41% (51,642) in 2021, an increase of 12% and the highest level since at least 1990,” the report’s authors wrote.

Why the number of at-home births increased during the pandemic wasn’t immediately clear, but the increase corresponded with a time in which vaccines weren’t yet widely available, suggesting some people giving birth may have been reticent to go to the hospital.

New Coronavirus News from 16 Nov 2022

Ireland faces 'cancer epidemic' after 1m cases missed across Europe during Covid [BreakingNews.ie, 16 Nov 2022]

By NINA MASSEY

An estimated one million cancer diagnoses were missed across Europe in the last two years, and a new report suggests the impact of Covid-19 could set back cancer results by almost a decade.

Researchers say the pandemic has exposed weaknesses in cancer health systems and in the research landscape across the continent.

They argue the issues need to be addressed as a matter of urgency.

In the report, researchers emphasise that prioritising cancer research is crucial for the delivery of more affordable, better, and equal care.

The report sets a target of achieving 70 per cent 10-year survival for all European cancer patients by 2035.

Patients treated in research hospitals have better outcomes than those who are not, a new commission from The Lancet Oncology, “European Groundshot—addressing Europe’s cancer research challenges”, reports.

The study also finds Brexit will continue to negatively impact European cancer research unless European funders/research community and the UK government/research community find a way for continued collaboration.

Additionally, it calls for a doubling of the European cancer research budget, as well as prioritisation of underserved cancer research areas, including prevention and early diagnosis, radiotherapy and surgery, action on gender equality, and a deeper focus on survivorship.

Report co-lead, Professor Richard Sullivan at King’s College London, said: “UK cancer research in the post-Brexit world stands at a crossroads where strategic decisions will determine whether we continue to thrive and partner internationally or whether isolationism will reduce our world standing.

“If the UK is not involved in EU collaborative cancer research and not part of Horizon Europe’s research community, this will have an extremely detrimental effect on European cancer research activity.

“Ultimately, patients with cancer will pay the price for this decision in terms of healthcare outcomes.”

'Race against time'
Professor Mark Lawler, Queen’s University Belfast, and chairman and lead author of the commission, said: “With the backdrop of the Covid-19 pandemic, Brexit, and the Russian invasion of Ukraine, it is more important than ever that Europe develops a resilient cancer research landscape to play a transformative role in improving prevention, diagnosis, treatment, and quality-of-life for current and future patients and those living beyond cancer.

He added: “We estimate that approximately one million cancer diagnoses were missed across Europe during the Covid-19 pandemic.

“We are in a race against time to find those missing cancers.

“Additionally, we saw a chilling effect on cancer research with laboratories shut down and clinical trials delayed or cancelled in the first pandemic wave.

“We are concerned that Europe is heading towards a cancer epidemic in the next decade if cancer health systems and cancer research are not urgently prioritised.

“Our European Groundshot Commission provides crucial findings on the current landscape of cancer research, exposes the key gaps, and demands the prioritisation of European cancer research agendas over the next decade.”

Dr Lynn Turner, director of research, Worldwide Cancer Research, said: “We are concerned to see that the Lancet Oncology Commission predicts Europe is heading towards a cancer epidemic in the next decade, but we welcome the call for the European cancer research budget to double in order to address this.

“The report sets an ambitious target of achieving 70 per cent 10-year survival for all European cancer patients by 2035.

“As the only UK charity funding discovery cancer research anywhere in the world, into any cancer type, Worldwide Cancer Research is proud to support innovative new ideas and ensure that the pipeline of future cancer cures doesn’t run dry.”

The commission analysed data on the impact of coronavirus across Europe and found that clinicians saw 1.5 million fewer patients with cancer in the first year of the pandemic.

While one in two patients with cancer did not receive surgery or chemotherapy in a timely manner.

Additionally, 100 million cancer screening tests were missed, and it is estimated that up to one million European citizens might have an undiagnosed cancer due to the backlog, the report published in Lancet Oncology found.

Global disparities in SARS-CoV-2 genomic surveillance [Nature, 16 Nov 2022]

Authored by Anderson F. Brito, Elizaveta Semenova, Gytis Dudas, Gabriel W. Hassler, Chaney C. Kalinich, Moritz U. G. Kraemer, Joses Ho, Houriiyah Tegally, George Githinji, Charles N. Agoti, Lucy E. Matkin, Charles Whittaker, Bulgarian SARS-CoV-2 sequencing group, Communicable Diseases Genomics Network (Australia and New Zealand), COVID-19 Impact Project, Danish Covid-19 Genome Consortium, Fiocruz COVID-19 Genomic Surveillance Network, GISAID core curation team, Network for Genomic Surveillance in South Africa (NGS-SA), Swiss SARS-CoV-2 Sequencing Consortium, Benjamin P. Howden, Vitali Sintchenko, Neta S. Zuckerman, Orna Mor, Heather M. Blankenship, Tulio de Oliveira, Raymond T. P. Lin, Marilda Mendonça Siqueira, Paola Cristina Resende, Ana Tereza R. Vasconcelos, Fernando R. Spilki, Renato Santana Aguiar, Ivailo Alexiev, Ivan N. Ivanov, Ivva Philipova, Christine V. F. Carrington, Nikita S. D. Sahadeo, Ben Branda, Céline Gurry, Sebastian Maurer-Stroh, Dhamari Naidoo, Karin J. von Eije, Mark D. Perkins, Maria van Kerkhove, Sarah C. Hill, Ester C. Sabino, Oliver G. Pybus, Christopher Dye, Samir Bhatt, Seth Flaxman, Marc A. Suchard, Nathan D. Grubaugh, Guy Baele & Nuno R. Faria

Abstract
Genomic sequencing is essential to track the evolution and spread of SARS-CoV-2, optimize molecular tests, treatments, vaccines, and guide public health responses. To investigate the global SARS-CoV-2 genomic surveillance, we used sequences shared via GISAID to estimate the impact of sequencing intensity and turnaround times on variant detection in 189 countries. In the first two years of the pandemic, 78% of high-income countries sequenced >0.5% of their COVID-19 cases, while 42% of low- and middle-income countries reached that mark. Around 25% of the genomes from high income countries were submitted within 21 days, a pattern observed in 5% of the genomes from low- and middle-income countries. We found that sequencing around 0.5% of the cases, with a turnaround time <21 days, could provide a benchmark for SARS-CoV-2 genomic surveillance. Socioeconomic inequalities undermine the global pandemic preparedness, and efforts must be made to support low- and middle-income countries improve their local sequencing capacity.

Nature Communications volume 13, Article number: 7003 (2022)

COVID depression is real. Here's what you need to know. [The Japan Times, 16 Nov 2022]

BY KNVUL SHEIKH

The World Health Organization noted this year that anxiety and depression increased by 25% across the globe in just the first year of the COVID-19 pandemic. And researchers have continued to find more evidence that the coronavirus wreaked havoc on our mental health.

In a 2021 study, more than half of American adults reported symptoms of a major depressive disorder after a coronavirus infection. The risk of developing these symptoms — as well as other mental healthdisorders — remains high up to a year after you’ve recovered.

It’s not surprising that the pandemic has had such a huge impact. “It’s a seismic event,” said Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University in St. Louis and the chief of research and development at the Veterans Affairs St. Louis Health Care System.

Health concerns, grief from losing loved ones, social isolation and the disruption of everyday activities were a recipe for distress, especially early on in the pandemic. But compared with those who managed to avoid infection (while also dealing with the difficult impacts of living through a pandemic), people who got sick with COVID-19 seem to be much more vulnerable to a variety of mental health problems.

“There’s something about the coronavirus that really affects the brain,” Al-Aly said. “Some people get depression, while other people can have strokes, anxiety, memory disorders and sensory disorders.” Still others have no neurological or psychiatric conditions at all, he said.

Why do some people get depressed when they have COVID-19?
Scientists are still learning exactly how the coronavirus alters the brain, but research is beginning to highlight some possible explanations. A few studies, for example, have shown that the immune system goes into overdrive when some people get sick. They can end up with inflammation throughout the body and even in the brain.

There is also some evidence that the endothelial cells lining blood vessels in the brain become disrupted during a bout of COVID-19, which may inadvertently allow harmful substances through, affecting mental function.

And cells called microglia, which normally act as the brain’s housekeepers, may go rogue in some patients, attacking neurons and damaging synapses, Al-Aly said.

It’s possible that COVID-19 may even compromise the diversity of bacteria and microbes in the gut. Since microbes in the gut have been shown to produce neurotransmitters like serotonin and dopamine, which regulate mood, this change could be at the root of some
neuropsychiatric issues.

Who is most at risk?
One of the biggest risk factors for developing depression after COVID-19 — or after any major illness — is having a diagnosed mental health disorder before you get sick. People who had severe COVID-19 symptoms and had to stay at a hospital during their illness also have increased chances of depression, said Megan Hosey, a rehabilitation psychologist who works with ICU patients at the Johns Hopkins Hospital.

According to WHO estimates, young people are disproportionately at risk of suicidal and self-harming behaviors after COVID-19. Women are more likely than men to report mental health effects after COVID-19.

And people with pre-existing physical health conditions, such as asthma, cancer and heart disease, are more likely to develop symptoms of mental disorders after COVID-19.

Additionally, people who experience extensive sleep disruption, social isolation or a significant change in other behaviors, like the amount of alcohol they consume or the type of prescription medications they take, may be more likely to face depression after the physical symptoms of COVID-19 fade away.

“We know that having additional stressors on your plate can predict depressive symptoms later on,” Hosey said. Some studies suggest that people who experience these stressors may be more vulnerable to developing long COVID-19 in general.

When do COVID-19 blues become clinical depression? What are some early signs?
While you are in the thick of things, fighting off viral infection, it is normal to feel tired and headachy.

“When you feel physiologically terrible, it can interfere with your mood,” Hosey said. “I would never diagnose somebody with a clinical depression in the acute phases of a COVID infection.”

But if your exhaustion and feeling of being overwhelmed persist for two to six weeks after your COVID-19 infection and start to interfere with day-to-day activities or negatively affect your relationships with others, it could be a sign of depression, Hosey said.

Some people with depression may also experience persistent sadness, tearfulness, irritability, changes in appetite or weight, trouble thinking or concentrating, or feelings of immense guilt, worthlessness or hopelessness. Those with severe depression may think frequently of death and develop suicidal ideation, Hosey said.

What can you do to treat depression after COVID-19?
If you are concerned that you or a loved one may be experiencing symptoms of depression after a COVID-19 infection, it’s important to talk to a medical or mental health professional.

“Not everyone will need to see a psychiatrist to be evaluated for depression,” Al-Aly said.

People can share what they are going through with their primary care doctor to get help as well, he said. “The most important thing is to seek help. And seek help sooner rather than later.”

Depression is not something you can typically shake off on your own, Hosey said. It can be tempting to use online resources and self-diagnostic screening tools and to order supplements that promise to calm COVID-related inflammation or repair your gut health. But many of these interventions are not reliable or backed by evidence.

It is a good idea to take stock of your diet, sleep and drug and alcohol use. Consuming more nutritious foods and setting up a good sleep routine, for example, may have a small positive impact on your mental health. Research suggests that exercise and meditation may also help heal the mind in some cases.

But if behavioral changes don’t work, a professional can recommend therapy or medication, depending on your needs.

During the pandemic, access to telehealth and mental health services expanded, Hosey said.

Several states now allow licensed psychologists to provide care to patients in other states that are part of the Psychology Interjurisdictional Compact, or PSYPACT. That means you can more easily search for an in-person or online mental health provider even if there is a shortage of specialty care in your area, Hosey said.

It’s not yet clear how long it takes to move beyond depression symptoms after COVID-19.

“Recovery from depression is a very individualized process,” Hosey said. Many people recover after a brief course of treatment. Some people experience relapses, where their symptoms get better and worse and they may need to try a different treatment, she said. Sometimes depression resolves without treatment, though that may be more likely to happen for people with mild cases.

“In the wake of a COVID infection, you should give yourself a little bit of a break and be patient,” Hosey said. “An infection can be hard to cope with.”

New Coronavirus News from 15 Nov 2022

Doctors Debate Study That Found Masks in Boston-Area Schools Cut COVID Rates [NBC10 Boston, 15 Nov 2022]

By Mary Markos

Top Boston doctors disagree on whether it's worth putting kids through the challenges that come with masking just to keep the number of COVID cases low

A new study that found masks cut the spread of COVID-19 in Boston-area schools is providing new data for the pandemic-long debate about school mask mandates.

The study, published last week in The New England Journal of Medicine, examines what happened when school districts in Boston and Chelsea kept their mask mandates for 15 weeks after Massachusetts dropped the requirement this February. The researchers determined that those cities avoided about 45 COVID cases for every 1,000 students and staff members, based on the COVID rates of the other 70 school districts in the Greater Boston area.

While there is no debate among top Boston doctors about whether masks are effective at preventing the spread of COVID-19, experts in the field continue to disagree on whether masks should be required in schools.

During NBC10 Boston's weekly "COVID Q&A" series, Tufts Medical Center Hospital Epidemiologist Dr. Shira Doron argued that requiring masks can adversely impact families, while Brigham and Women's Hospital's Dr. Daniel Kuritzkes and Boston Medical Center's Dr. David Hamer countered that they could be used as a tool to prevent missing school.

The observational study was conducted by researchers at a slew of Boston institutions: the Harvard T.H. Chan School of Public Health, the Boston Public Health Commission, Boston University, Massachusetts General Hospital and Brigham and Women's Hospital.

"School districts could use these findings to develop equitable mitigation plans in anticipation of a potential winter Covid-19 wave during the 2022–2023 school year, as well as clear decision thresholds for removing masks as the wave abates," the researchers concluded.

When Massachusetts lifted the school mask mandate this February, as did most other states across the country, "It wasn't because anybody was saying masks don't work," Doron said. "It was because there are downsides and that the virus is here to stay."

The consensus among public health experts at the time, Doron recalled, was that they could either determine whether there was enough immunity in the population to remove the mandate or students could go on wearing masks indefinitely.

Ultimately, the cost of putting children through the challenges that come with masking do not outweigh the benefits of keeping case numbers low at this juncture, Doron said, referring to her experience as an advisor to state government, private and public schools and youth sports camps.

"To me, it's not a question of, you know, does this study prove that masks work? I believe masks work," Doron said. "But given everything I have seen, it would be hard for you to convince me that mandating masks in school again is the right thing to do."

Doron recalled parents, students, teachers and administrators telling her that masks affect socialization and language learning, particularly for people with speech impediments, hearing impairment and those who are neurodivergent. Doron, who has consistently opposed mask mandates in schools during regular appearances on the "COVID Q&A" series, added that students will inevitably miss some school due to respiratory viruses. In her mind, the focus should be on preventing severe hospitalization and death, not preventing positive PCR tests.

Both Hamer and Kuritzkes agreed with the notion that mask mandates can impact students' development. However, Hamer noted, losing more time in school -- or teachers to more sick days -- can also have a negative impact on students' development.

"I think this is a tricky balance," Hamer said, pointing to plunging student test scores during the pandemic. "I think school closures are really a bad thing. Opening schools and having masks, you know, if necessary, may not be such a bad thing. But closing them is really a problem."

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Although a lot of young people tend to have mild cases of COVID-19, Hamer said, they are still forced to miss a certain number of school days if they test positive.

Kuritzkes questioned whether there is sufficient evidence to support that "even some substantial minority" of children are adversely affected by mask mandates.

"There's no question that the masks work. So this is no longer a medical scientific discussion.

This is a political discussion," Kuritzkes said. "And it's about the needs and desires of different groups of people and whose desires and needs take precedence."

Some variables related to the study raised questions for Doron, including that students and staff were not actively screened for infection and that the state’s surveillance testing program was very different from school to school.

But Kuritzkes described the paper as an "incredibly strong study." The research shows that during the initial omicron wave, when Massachusetts saw a surge in cases, the rise in schools was "a blip."

"It was only after the masks were removed that you saw a substantial rise," Kuritzkes said. "This also took place at a time when very few school-aged children were vaccinated, certainly not younger children because that didn't become available until later in the season. And so the only prevailing immunity would have been immunity from prior COVID infection, which was also at that point not as prevalent in the younger population as it subsequently became."

Japan's new daily COVID cases to exceed 100000 for first time in 2 months -Fuji TV [Reuters.com, 15 Nov 2022]

by Rocky Swift & Christian Schmollinger

TOKYO, Nov 15 (Reuters) - New daily COVID-19 infections in Japan will exceed 100,000 on Tuesday for first time in two months, Fuji Television reported.

Cases have been on the rise in recent weeks in what some authorities have called the eighth wave in the course of the pandemic. New daily infections in Japan have not reached 100,000 since Sept. 14, according to health ministry data.

New Coronavirus News from 29 Oct 2022

Forget about a single strain: The new COVID calculus is all about viral families [Fortune, 29 Oct 2022]

BY ERIN PRATER

Gone are the simple early COVID pandemic days of 2020—in terms of viral evolution, at least.

The transfer of power used to be relatively straightforward from variant to variant, from the original strain, to Alpha, to Delta, to Omicron—one washing over the world before another took over.

Now it’s a battle royal between prominent viral “families” warring to keep power within the lineage. No single family—BA.5, XBB, nor BQ—has achieved global success this fall. Not yet, at least.

As the virus behind COVID—namely the Omicron variety—mutates at an unprecedented rate, the focus of scientists has shifted from single strains to related groups of them.

Case in point: XBB, a combination of two different Omicron spawns that began surging in Singapore and Bangladesh in recent weeks. It has yet to arrive in the U.S., at least officially. But its grandchildren, XBB.1.1 and XBB.1.3, have, according to data from GISAID, an international research organization that tracks changes in COVID and the flu virus.

These days, it’s risky to look at one country and assume that because it’s experiencing a certain wave, another country will soon experience the same, Ryan Gregory, a professor of evolutionary biology at the University of Guelph in Ontario, Canada, told Fortune.

“The XBB [surge] Singapore sees may not be the one we see in the U.S.,” he said.

The summer that changed everything
As far as viral evolution goes, all was relatively simple through the “stealth Omicron” surge earlier this year, experts say. A new variant would materialize and the number of cases would surge, vacillate a bit, then fall, like clockwork.

But the calculus changed this summer with BA.5. The new-generation Omicron spawn surged globally—then surged again in some places like Germany and France. Meanwhile, in other countries, fellow Omicron strains XBB or BQ—or their descendants—began to swell.

Today, there are hundreds of Omicron strains, all with mutations that provide increased transmissibility, the ability to escape immunity, the potential to cause more severe disease, or a combination thereof.

The scene differs depending on where you are. BA.5 variants are still dominant in the U.S., according to GISAID data, while infections involving BQ variants are also rising.

France’s largest proportion of cases are also BA.5 family members. But the strains that are dominant there differ slightly from those that are most common in the U.S.

In Chile, “stealth Omicron” is still going strong, making up nearly 44% of cases, with descendants of itself and the original Omicron on its heels. And oft-locked-down China is a different world altogether, with one of the original COVID strains accounting for 31% of cases, followed by Delta at nearly 19%.

The story of COVID is no longer “one variant rising, doing its thing, we mitigate again, it comes back down, we brace for the next one,” Gregory said. “Things are coexisting at the same time, moving around. The longer they circulate, the more you get combinations.”

Not only are multiple viral families warring it out, with different levels of success in different regions, but battles are occurring within families. In effect, relatives are fighting among themselves to lead lineages, Gregory says.

Victories in turn?
The extremely immune evasive BQ family will almost certainly become dominant in the U.S. in the coming weeks, according to multiple experts. But that doesn’t mean the U.S.—or any other country with rising levels of BQ—has dodged the other variants.

XBB will likely fuel the following U.S. wave, then perhaps XBC, a Delta-Omicron hybrid, Gregory and Raj Rajnarayanan, assistant dean of research and associate professor at the New York Institute of Technology campus in Jonesboro, Ark., tell Fortune.

That could mean the U.S.—and other countries—are in for a winter during which multiple viral families are briefly dominant before receding. There may not be one COVID peak in late 2022, but overlapping surges fueled by different variants that create a wide “ugly peak” with a jagged top, Rajnarayanan says.

Prior to this summer’s BA.5 surge, COVID was in a constant “predator-prey cycle,” according to Gregory.

Those days are gone.

“It’s an ecology now,” Gregory said. “It was, ‘How many rabbits and how many wolves?’ Now, it’s a whole ecosystem.”

New Coronavirus News from 11 Nov 2022

Protection from previous natural infection compared with mRNA vaccination against SARS-CoV-2 infection and severe COVID-19 in Qatar: a retrospective cohort study [The Lancet, 11 Nov 2022]

Authored by Hiam Chemaitelly, Houssein H Ayoub, Sawsan AlMukdad, Peter Coyle, Patrick Tang, Hadi M Yassine, Hebah A Al-Khatib, Maria K Smatti, Mohammad R Hasan, Zaina Al-Kanaani, Einas Al-Kuwari, Andrew Jeremijenko, Anvar Hassan Kaleeckal, Ali Nizar Latif, Riyazuddin Mohammad Shaik, Hanan F Abdul-Rahim, Gheyath K Nasrallah, Mohamed Ghaith Al-Kuwari, Adeel A Butt, Hamad Eid Al-Romaihi, Mohamed H Al-Thani, Abdullatif Al-Khal, Roberto Bertollini and Laith J Abu-Raddad.

Summary
Background
Understanding protection conferred by natural SARS-CoV-2 infection versus COVID-19 vaccination is important for informing vaccine mandate decisions. We compared protection conferred by natural infection versus that from the BNT162b2 (Pfizer–BioNTech) and mRNA-1273 (Moderna) vaccines in Qatar.

Methods
We conducted two matched retrospective cohort studies that emulated target trials. Data were obtained from the national federated databases for COVID-19 vaccination, SARS-CoV-2 testing, and COVID-19-related hospitalisation and death between Feb 28, 2020 (pandemic onset in Qatar) and May 12, 2022. We matched individuals with a documented primary infection and no vaccination record (natural infection cohort) with individuals who had received two doses (primary series) of the same vaccine (BNT162b2-vaccinated or mRNA-1273-vaccinated cohorts) at the start of follow-up (90 days after the primary infection). Individuals were exact matched (1:1) by sex, 10-year age group, nationality, comorbidity count, and timing of primary infection or first-dose vaccination. Incidence of SARS-CoV-2 infection and COVID-19-related hospitalisation and death in the natural infection cohorts was compared with incidence in the vaccinated cohorts, using Cox proportional hazards regression models with adjustment for matching factors.

Findings
Between Jan 5, 2021 (date of second-dose vaccine roll-out) and May 12, 2022, 104 500 individuals vaccinated with BNT162b2 and 61 955 individuals vaccinated with mRNA-1273 were matched to unvaccinated individuals with a documented primary infection. During follow-up, 7123 SARS-CoV-2 infections were recorded in the BNT162b2-vaccinated cohort and 3583 reinfections were recorded in the matched natural infection cohort. 4282 SARS-CoV-2 infections were recorded in the mRNA-1273-vaccinated cohort and 2301 reinfections were recorded in the matched natural infection cohort. The overall adjusted hazard ratio (HR) for SARS-CoV-2 infection was 0·47 (95% CI 0·45–0·48) after previous natural infection versus BNT162b2 vaccination, and 0·51 (0·49–0·54) after previous natural infection versus mRNA-1273 vaccination. The overall adjusted HR for severe (acute care hospitalisations), critical (intensive care unit hospitalisations), or fatal COVID-19 cases was 0·24 (0·08–0·72) after previous natural infection versus BNT162b2 vaccination, and 0·24 (0·05–1·19) after previous natural infection versus mRNA-1273 vaccination. Severe, critical, or fatal COVID-19 was rare in both the natural infection and vaccinated cohorts.

Interpretation
Previous natural infection was associated with lower incidence of SARS-CoV-2 infection, regardless of the variant, than mRNA primary-series vaccination. Vaccination remains the safest and most optimal tool for protecting against infection and COVID-19-related hospitalisation and death, irrespective of previous infection status.

Nearly 60% in Japan unaware of relaxed COVID-19 mask guidelines [Kyodo News Plus, 11 Nov 2022]

By Eduardo Martinez

Nearly 60 percent of people in Japan were unaware of government guidance that wearing masks outdoors for protection against the coronavirus is unnecessary in most cases, recent survey results have shown.

Although the guidelines were issued in May and the government's position on mask-wearing has since remained unchanged, the survey found that 18.4 percent of respondents had no knowledge the guidance even existed, while 40 percent knew of it but not the specific details, according to data by polling firm Laibo Inc.

Compared with the 58.4 percent overall who were unaware, 41.6 percent said they knew of the guidance and its content, according to the survey.

Wearing a mask remains the norm in Japan, despite 72.7 percent saying they are in favor of dropping the practice. Among the respondents, 33.9 percent said they were in favor of shedding masks, while 38.8 answered they were "somewhat" in favor.

The survey conducted online from Oct. 12 through 17 garnered sample responses from 1,011 working adults, with 52.5 percent saying that government explanations on guidance have been insufficient, including information that mask-wearing is also optional in quiet and spacious indoor areas.

Among the reasons why people favored mask-wearing, some cited the ongoing pandemic and coronavirus-related deaths. Others said they wear a mask for protection against influenza in winter and hay fever in spring as well as COVID-19.

Coronavirus cases have been recently rebounding throughout Japan.

Meanwhile, some responded that they were now "uncomfortable" taking their mask off in public as they have been accustomed to wearing masks for more than two years.

While Japan no longer has an official mask mandate in place, some respondents said they would be more encouraged to stop wearing masks if the government issued a uniform rule on their usage.

Masking up is still commonplace in other Asian countries such as Singapore and South Korea, despite their governments fully lifting outdoor mask mandates in March and September, respectively.

In China, which still has a strict "zero-COVID" policy in place, people are asked to wear masks on subway trains and in shopping malls.

In contrast, some Western nations were quick to forego masks due to the improving pandemic situation in many parts of the world.

Some survey respondents felt that Japan should keep in step with other countries, with the increase in international arrivals due to borders reopening to individual foreign tourists.

Daniel Barter, an Australian tourist currently visiting Tokyo, said masks were rarely seen anymore in his home country.

The 30-year-old said people "knew pretty quickly" that wearing a mask was no longer mandatory thanks to "really clear messaging" from the authorities through social media as well as on television.

On making sense of mask etiquette upon arriving in Japan, Barter said "it was not made clear at all," eventually assuming it would be best to wear one by observing those around him.

"It was announced as we landed that you need to wear (a mask) on the train and in the airport terminal, and that was the last I heard of it," he said.

Chinese are criticizing zero-Covid — in language censors don't understand [CNN, 11 Nov 2022]

By Jessie Yeung

Hong KongCNN —
In many countries, cursing online about the government is so commonplace nobody bats an eye. But it’s not such an easy task on China’s heavily censored internet.

That doesn’t appear to have stopped residents of Guangzhou from venting their frustration after their city – a global manufacturing powerhouse home to 19 million people – became the epicenter of a nationwide Covid outbreak, prompting lockdown measures yet again.

“We had to lock down in April, and then again in November,” one resident posted on Weibo, China’s restricted version of Twitter, on Monday – before peppering the post with profanities that included references to officials’ mothers. “The government hasn’t provided subsidies – do you think my rent doesn’t cost money?”

Other users left posts with directions that loosely translate to “go to hell,” while some accused authorities of “spouting nonsense” – albeit in less polite phrasing.

Such colorful posts are remarkable not only because they represent growing public frustration at China’s unrelenting zero-Covid policy – which uses snap lockdowns, mass testing, extensive contact-tracing and quarantines to stamp out infections as soon as they emerge – but because they remain visible at all.

Normally such harsh criticisms of government policies would be swiftly removed by the government’s army of censors, yet these posts have remained untouched for days. And that is, most likely, because they are written in language few censors will fully understand.

These posts are in Cantonese, which originated in Guangzhou’s surrounding province of Guangdong and is spoken by tens of millions of people across Southern China. It can be difficult to decipher by speakers of Mandarin – China’s official language and the one favored by the government – especially in its written form.

And this appears to be just the latest example of how Chinese people are turning to Cantonese – an irreverent tongue that offers rich possibilities for satire – to express discontent toward their government without attracting the notice of the all-seeing censors.

In nearby Cantonese-speaking Hong Kong, anti-government demonstrators in 2019 often used Cantonese wordplay both for protest slogans and to guard against potential surveillance by mainland Chinese authorities.

Now, Cantonese appears to be offering those fed-up with China’s strict zero-Covid policies an avenue for more subtle displays of dissent.

Jean-François Dupré, an assistant professor of political science at Université TÉLUQ who has studied the language politics of Hong Kong, said the Chinese government’s shrinking tolerance for public criticism has pushed its critics to “innovate” in their communication.

“It does seem that using non-Mandarin forms of communication could enable dissenters to evade online censorship, at least for some time,” Dupré said.

“This phenomenon testifies to the regime’s lack of confidence and increasing paranoia, and of citizens’ continuing eagerness to resist despite the risks and hurdles.”

Perfect for satire, and protest Though Cantonese shares much of its vocabulary and writing system with Mandarin, many of its slang terms, expletives and everyday phrases have no Mandarin equivalent. Its written form also sometimes relies on rarely used and archaic characters, or ones that mean something totally different in Mandarin, so Cantonese sentences can be difficult for Mandarin readers to understand.

Compared to Mandarin, Cantonese is highly colloquial, often informal, and lends itself easily to wordplay – making it well-suited for inventing and slinging barbs.

When Hong Kong was rocked by anti-government protests in 2019 – fueled in part by fears Beijing was encroaching on the city’s autonomy, freedoms and culture – these attributes of Cantonese came into sharp focus.

“Cantonese was, of course, an important conveyor of political grievances during the 2019 protests,” Dupré said, adding that the language gave “a strong local flavor to the protests.”
He pointed to how entirely new written characters were born spontaneously from the pro-democracy movement – including one that combined the characters for “freedom” with a popular profanity.

Other plays on written characters illustrate the endless creativity of Cantonese, such as a stylized version of “Hong Kong” that, when read sideways, becomes “add oil” – a rallying cry in the protests.

Protesters also found ways to protect their communications, wary that online chat groups – where they organized rallies and railed against the authorities – were being monitored by mainland agents.

For example, because spoken Cantonese sounds different to spoken Mandarin, some people experimented with romanizing Cantonese – spelling out the sounds using the English alphabet – thereby making it virtually impossible to understand for a non-native speaker.

And, while the protests died down after the Chinese government imposed a sweeping national security law in 2020, Cantonese continues to offer the city’s residents an avenue for expressing their unique local identity – something people have long feared losing as the city is drawn further under Beijing’s grip.

Falling silent
For some, using Cantonese to criticize the government seems particularly fitting given the central government has aggressively pushed for Mandarin to be used nationwide in education and daily life – for instance, in television broadcasts and other media – often at the expense of regional languages and dialects.

These efforts turned into national controversy in 2010, when government officials suggested increasing Mandarin programming on the primarily-Cantonese Guangzhou Television channel – outraging residents, who took part in rare mass street rallies and scuffles with police.

It’s not just Cantonese affected – many ethnic minorities have voiced alarm that the decline of their native languages could spell an end to cultures and ways of life they say are already under threat.

In 2020, students and parents in Inner Mongolia staged mass school boycotts over a new policy that replaced the Mongolian language with Mandarin in elementary and middle schools.
Similar fears have long existed in Hong Kong – and grew in the 2010s as more Mandarin-speaking mainlanders began living and working in the city.

“Growing numbers of Mandarin-speaking schoolchildren have been enrolled in Hong Kong schools and been seen commuting between Shenzhen and Hong Kong on a daily basis,” Dupré said. “Through these encounters, the language shift that has been operating in Guangdong became quite visible to Hong Kong people.”

He added that these concerns were heightened by local government policies that emphasized the role of Mandarin, and referred to Cantonese as a “dialect” – infuriating some Hong Kongers who saw the term as a snub and argued it should be referred to as a “language” instead.

In the past decade, schools across Hong Kong have been encouraged by the government to switch to using Mandarin in Chinese lessons, while others have switched to teaching simplified characters – the written form preferred in the mainland – instead of the traditional characters used in Hong Kong.

There was further outrage in 2019 when the city’s education chief suggested that continued use of Cantonese over Mandarin in the city’s schools could mean Hong Kong would lose its competitive edge in the future.

“Given Hong Kong’s rapid economic and political integration, it wouldn’t be surprising to see Hong Kong’s language regime be brought in line with that of the mainland, especially where Mandarin promotion is concerned,” Dupré said.

Speaking ‘without fear’
It’s not the first time people in the mainland have found ways around the censors. Many use emojis to represent taboo phrases, English abbreviations that represent Mandarin phrases, and images like cartoons and digitally altered photos, which are harder for censors to monitor.

But these methods, by their very nature, have their limits. In contrast, for the fed-up residents of Guangzhou, Cantonese offers an endless linguistic landscape with which to lambast their leaders.

It’s not clear whether these more subversive uses of Cantonese will encourage greater solidarity between its speakers in Southern China – or whether it could encourage the central government to further clamp down on the use of local dialects, Dupré said.

For now though, many Weibo users have embraced the rare opportunity to voice frustration with China’s zero-Covid policy, which has battered the country’s economy, isolated it from the rest of the world, and disrupted people’s daily lives with the constant threat of lockdowns and unemployment.

“I hope everyone can maintain their anger,” wrote one Weibo user, noting how most of the posts relating to the Guangzhou lockdowns were in Cantonese.

“Watching Cantonese people scolding (authorities) on Weibo without getting caught,” another posted, using characters that signify laughter.

“Learn Cantonese well, and go across Weibo without fear.”

China Return to Normal to Take at Least a Year, Analysts Say [Bloomberg, 11 Nov 2022]

• Most analysts expect reopening to begin sometime after March
• Likely to be at least six months of adjustment after that

China’s exit from the Covid pandemic could run through the end of next year, with reopening only starting sometime from April and a slow return to normality likely weighing on investors’ hopes for a quick economic recovery, according to a survey of economists.

Almost half of the 23 economists surveyed by Bloomberg News said they think reopening from Covid Zero will begin in the second quarter of 2023, after the parliamentary meeting which usually happens in early March. Another seven said it will start in the July-September period, while two don’t expect change until sometime in 2024, which would be at least four years after the virus was first reported in Wuhan.

China Covid News: Beijing Cases Jump to the Most in More than a Year [Bloomberg, 11 Nov 2022]

China Covid Cases Top 10,000, Beijing Highest in Over a Year
• Local infections nationwide are the highest since late April
• Country’s leaders unveiled a new policy easing restrictions

China’s daily infection rate exceeded 10,000 for the first time since April, with Beijing’s cases at the highest level in more than a year, as the country’s top leaders unveiled a new policy easing its strict Covid Zero measures.

The capital reported 114 new cases for Thursday, the municipal health commission said in a statement. Four of the infections were found outside the government-run quarantine system, stoking concern the virus continues to circulate within the community. Nationwide, there were 10,243 new infections, the highest since April 28.

China Covid: Beijing eases some curbs despite rising cases [BBC, 11 Nov 2022]

By Frances Mao

China has slightly relaxed some of its Covid restrictions even as case numbers rise to their highest levels in months.

Quarantine for close contacts will be cut from seven days in a state facility to five days and three days at home.

Officials will also stop recording secondary contacts - meaning many people will avoid having to quarantine.

The slight easing comes weeks after Xi Jinping was re-instated as party leader for a historic third term.

Mr Xi held his first Covid meeting with his newly elected Standing Committee on Thursday.

China's zero-Covid policy has saved lives in the country of 1.4 billion people but also dealt a punishing blow to the economy and ordinary people's lives.

There is increasing public fatigue over lockdowns and travel restrictions.

Stories of suffering and desperation have also circulated on social media, fuelling many outbursts of civic anger.

China's National Health Commission (NHC) insisted the changes did not amount to "relaxing prevention and control, let alone opening up", but were instead designed to adapt to a changing Covid situation.

The NHC also said it would develop a plan to speed up vaccinations.
• The politics driving China's hellish lockdowns
• China outcry over death of girl sent to quarantine
• Lockdown delayed potentially life-saving treatment

On Friday, the changes were announced even as the country grapples with its worst wave of Covid in months.

The cities of Beijing, Guangzhou and Zhengzhou are currently seeing record numbers.

On Thursday, China recorded over 10,500 new Covid cases - the highest daily total since April when China shut down its largest city Shanghai to combat a wave there.

People in China, and analysts watching the country, have been waiting for some indication from the government that strict Zero-Covid measures might be eased.

On the one hand, Beijing is not officially backing down from its commitment to its current strategy, but it has announced a series of measures it has described as "adapting" to the situation rather than "relaxing" the policy.

For Chinese people who have become exhausted by Zero-Covid it doesn't really matter if the government finds the need to save face semantically, as long as the changes are real and that they are.

The moves announced today may not seem like much if you are not living in China but, inside the country, three years into a crisis, with no indication of when or how an off ramp may appear, any steps towards re-opening are steps which are not going backwards.

Ending the punishment for airlines carrying infected passengers will mean more flights, more seats, cheaper inbound tickets, and an end to abrupt Covid-induced cancellations. This is significant.

A reduction of seven days in hotel quarantine plus three days at home to five days plus three is only a small alteration but the expectation is that this could continue to come down at some point in the future.

Again, for a country with an economy being smashed by Zero-Covid, baby steps are better than no steps.

Raising the bar for centralised quarantine inside China will also ease tensions for ordinary people, if only because it provides a glimmer of light at the end of the Covid tunnel.

It is hard to explain to people in other countries just how fed up with Zero-Covid locals have become. They were living through this crisis well before the rest of the world and while other countries have now found a way to move on, they're still stuck with it, as if China has been frozen in a massive 2020 time block.

Despite the small changes however, most restrictions still remain in place. Mr Xi has insisted on sticking to a stringent zero-Covid policy involving lockdowns even as the rest of the world has moved on.

That means in many cities residents have been subject to sudden restrictions on their movement and disruptions to work and schooling.

For example, this week in Guangzhou - the current epicentre of the Covid wave in China - locals in one district were barred from venturing outside and only one member of each household was allowed outside to grocery shop.

Public transport has been suspended while schools and workplaces are also shut down.

In Zhengzhou, another Covid centre at the moment, lockdowns there prompted many workers living at a vast factory owned by Taiwanese iPhone-maker Foxconn to flee the area on foot to escape restrictions.

New Coronavirus News from 11 Oct 2022

A COVID-19 Surge Could Come This Winter After Europe Spike [TIME, 11 Oct 2022]

BY JAMIE DUCHARME

We May Be in for Yet Another COVID-19 Surge This Fall and Winter
Fall and winter have always been peak seasons for respiratory viruses. As the weather cools in many parts of the U.S., people are forced into indoor environments where viruses can spread more easily. Holiday gatherings and travel can also become breeding grounds for disease.

That’s one reason why experts are worried that COVID-19 case counts may rise in the U.S. in the coming weeks. But there’s also another. To help forecast COVID-19 rates for the U.S., experts often look to Europe—and the data there aren’t promising. More than 1.5 million COVID-19 diagnoses were reported across Europe during the week ending Oct. 2, about 8% more than the prior week, according to the World Health Organization’s (WHO) latest global situation report, published Oct. 5. More than 400,000 of those diagnoses came from Germany, and almost 265,000 came from France.

“We’re concerned,” said Maria Van Kerkhove, the WHO’s technical lead on COVID-19, at an Oct. 5 press briefing. “In the Northern Hemisphere, we’re entering autumn and the winter months, so we will see co-circulation of other viruses like influenza….We need health systems to be prepared.”

The U.S. doesn’t always follow in Europe’s footsteps. The Alpha variant, for example, caused a larger spike in Europe than in the U.S. But European outbreaks related to Delta and Omicron predated similar surges in the U.S.

COVID-19 in the U.S. has been at a “high-plains plateau” for months, says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. Since the spring, roughly 300 to 500 people have died from COVID-19 each day—a rate that is still tragically high but relatively stable.

The situation in Europe “may be a harbinger of things to come,” Osterholm says. He fears a “perfect storm” may be brewing, threatening to turn that U.S. plateau into another surge.

Waning immunity, low booster uptake, ever-evolving subvariants that are increasingly good at evading the immune system, and people behaving as if the pandemic is over all suggest “we are headed to the end of the high-plains plateau,” Osterholm says. “I just don’t know what [the next phase] looks like.”

Federal case counts aren’t showing an uptick in the U.S. yet; in fact, daily diagnoses and hospitalization rates have fallen steadily since July. But case counts have become increasingly unreliable as more people rely on at-home tests and states pull back on reporting. Osterholm says he pays closer attention to death and hospitalization rates, but both lag behind actual spread of the virus, since it can take time for infections to become serious enough to result in hospitalization or death.

Meanwhile, the CDC’s wastewater surveillance dashboard, which tracks the level of virus detected in wastewater samples across the country, suggests circulation is increasing in multiple parts of the country, including portions of the Northeast and Midwest.

Taken together, the signs suggest a surge is coming, says Arrianna Marie Planey, an assistant professor of health policy and management at the University of North Carolina’s Gillings School of Global Public Health.

“I don’t like to use the word ‘inevitable’ because all of this is preventable,” Planey says. “It’s just that prevention is harder and harder at this stage of the pandemic,” when mitigation measures like mask mandates have fallen away and many people either don’t know about or don’t want to get the new Omicron-specific boosters.

Planey has been encouraging people she knows to get boosted and making sure they know about tools like Evusheld (a vaccine alternative for people who are immunocompromised or unable to get their shots) and the antiviral drug Paxlovid. She says she’d like to see more urgency from the government, including stronger communication about the need to get boosted and a continued push for those who haven’t been vaccinated at all to get their primary shots.

The problem, Osterholm says, is getting people to actually heed those warnings. Many polls show that Americans are ready to leave the pandemic behind, even if the virus continues to spread and mutate in the future.

That leaves public-health experts with the frustrating job of repeating the same advice they’ve given for the last several years, to an increasingly detached audience. “There’s no joy in saying, ‘I told you so,’” Planey says, “because people are sick and dying.”

New Coronavirus News from 15 Oct 2022

Covid Cases Rise In Europe As France Enters Eighth Wave [Forbes, 15 Oct 2022]

By Cecilia Rodriguez

With winter approaching, France has “officially” entered its eighth wave of Covid-19. Over 50,000 daily cases have been confirmed and French health officials are considering whether to once again impose masks in public places and transport.

The Health Ministry warned last month that a new wave was imminent after cases jumped by 55.5%. The figures from the Health Ministry and health authority Santé publique France show the daily average of contagion at around 17,000 and rising.

The situation in France reflects the resurgence of the epidemic brewing in Europe as cooler weather arrives, “with public health experts warning that vaccine fatigue and confusion over types of available vaccines will likely limit booster uptake,” Reuters explains.

The European Center for Disease Prevention and Control (ECDC) has reported that fifteen countries in the region are reporting increasing cases with the highest new infection rates in Austria, Belgium, France, Germany, Latvia and Liechtenstein.

Behind most of the cases is the Omicron subvariants BA.4/5 that dominated this summer but the World Health Organization is tracking many new subvariants that are gaining ground.

According to its most recent data, the number of cases in the European Unionreached 1.5 million last week, up 8% from the prior week as the number of hospitalizations across the member nations and Britain continue to mount.

“In the week ended October 4, Covid-19 hospital admissions with symptoms jumped nearly 32% in Italy, while intensive care admissions rose about 21%, compared to the week before, according to data compiled by independent scientific foundation Gimbe,” Reuters report.

Although ECDC launched new vaccine campaigns with Omicron-adapted formulas addressing subvariants alongside first-generation vaccines, the rate of vaccination is lower—between 1 million and 1.4 million in September, compared with 6-10 million per week during the year-earlier period, ECDC data shows.

According to data from the British Office for National Statistics (ONS), about one in 65 people in England—an estimated 1,105,400 individuals—had Covid at the end of September.

The perception that the pandemic is over, creating a false sense of security, is among the causes for the lowest interest in vaccination. Some experts blame governments for being ill prepared for the autumn/winter season, along with spreading social media campaigns by anti-vaccine movements.

French complacency? The Covid-19 pandemic still seems far from over, writes Le Progres, “At the start of autumn, the contamination figures in France are soaring, specially among young people.”

"All the indicators are on the up," Brigitte Autran, a leading health official and president of Covars, the Committee for Monitoring and Anticipating Health risks in France, told the agency.

She also announced that the committee is considering the possibility of making the use of masks compulsory again in certain spaces, “with different models.”

“The incidence rate — number of cases per 100,000 inhabitants — was 293 per 100,000 inhabitants, an increase of 57% last week compared to the additional 12% reported the previous week,” Public Health France acknowledged. It’s more extended among children aged under 10, which is thought to be linked to September’s return to school.“The increase in contamination is mainly driven by those under 20,” the institution said.

Same as last year
This is not an unprecedented situation, according to Le Point. “At this same time in 2021, with the return to school, the Delta variant, which had also caused a summer wave, had returned to trigger an autumn/winter wave.”

The majority of the current cases are from sub-variants of the Omicron strain BA5, which are more contagious but generally less virulent.

“It seems that the current dominant sub-variant of Omicron, BA.5, which hit Europe this summer, has been spreading again since the start of the school year and is progressing in all regions of metropolitan France (except Corsica), and in almost all Western European countries,” the magazine reports.

An expected wave
“Incidence rates have begun to rise again with the beginning of the school year, but the impact of this new episode is hard to predict,” wrote Le Monde.

“This eighth wave has indeed been expected for a long time. The last two years have shown the seasonality of the coronavirus, whose circulation favors the arrival of the cold seasons.”

The fall wave “was inevitable,” Giles Pialoux, head of the infections and tropical diseases at Tenon hospital in Paris told the paper and enumerated several factors: “all the elements that reinforce social interactions in closed places, the increase in time since the last vaccine injection, and the insufficient vaccine coverage for the second boost."

The Health Minister François Braun explained that the government is following “the potential evolution of this epidemic” and recommended people in France “to take responsibility,” and think about bringing back their social distancing and hygiene measures where appropriate.

Currently, mask-wearing is not mandatory in outdoor public areas, nor on different public transport means. Mask-wearing is recommended only for vulnerable people accessing indoor places and large gatherings, Schengenvisainfo reports.
Extended vaccination
“It is believed that the rules continue to remain relaxed as the majority of the population has already completed vaccination.”

The ECDC shows that France has administered a total of 153,347,334 coronavirus vaccines as of September 22. According to ECDC, 92.2% of the entire adult population in France have already completed primary vaccination, 74.7 % have received the first booster shot, and 11.6 % have taken the second booster shot.

ECDC has recommended that all member countries start offering newly-authorized and adapted vaccines to support the planning of vaccination campaigns for autumn and winter.

The health institution has urged that boosters be directed first to people over the age of 60, vulnerable people with underlying conditions, pregnant women and the immunocompromised.

The new COVID-19 wave looming on the European continent could signal what's to come for the United States.

The CDC has reported the rise of virus levels in various regions of the country including the Northeast and Midwest.

New Coronavirus News from 9 Nov 2022

Brace Yourself for a Triple Wave of Seasonal Viruses [Wired, 9 Nov 2022]

Many people haven’t been exposed to common respiratory viruses following the pandemic, meaning they might be more vulnerable to getting ill this year.

Every year it’s the same. As soon as it starts to get cold, people gather indoors. Windows are pulled shut. Commuters forgo walking or cycling, opting for packed buses and subways. Our whole world retreats to where it’s warm, our breath condensing on the windows of homes, offices, schools, and transport, showing just how well we’ve sealed ourselves off from the outside. We create, in short, the perfect breeding ground for viruses.

When the respiratory virus season begins, it’s usually quite predictable. Patients start being admitted to hospitals with influenza or respiratory syncytial virus (RSV) around October in the northern hemisphere. Thousands of people get ill, and many die, but the odd extreme year aside, health systems across Europe and North America aren’t typically at risk of being overwhelmed.

But the pandemic has derailed this predictability. It has added another virus to the seasonal mix, and flu and RSV are returning this year with a vengeance. A “twin” or even “tripledemic” could be on the way, with all three viruses hitting at once, illnesses soaring, and health systems creaking under the pressure. Already there are signs this is happening.

Many hospitals in the US are at capacity, caring for large numbers of children infected with RSV and other viruses, many more than would be expected at this time of year. The US Centers for Disease Control and Prevention (CDC) doesn’t track RSV cases, hospitalizations, and deaths as it does for flu, but hospitals across the country have been reporting peak levels typically observed in December and January. Nearly one in fivePCR tests for RSV came back positive in the week ending October 29, with this rate having doubled over the course of a month. Generally speaking, the higher the proportion of tests that come back positive, the more common a virus is in the wider community. In the three years before the pandemic, an average of just 3 percent of tests came back positive in October.

This is a hangover from the pandemic. Over the past two years, RSV and flu were kept down thanks to the protective measures people took against the coronavirus: mask wearing, hand washing, and isolating. Between the beginning of the pandemic and March 2021, the weekly positivity rate for RSV tests remained below 1 percent, according to the CDC—down where it was in pre-pandemic times.

In July of this year, health specialists warned in The Lancet that the benefits of these pandemic precautions could end up having a negative effect this winter season. Reducing exposure to common endemic viruses such as RSV and flu, experts argued, risked creating an “immunity gap” in people either born during the pandemic or who hadn’t previously built up sufficient immunity against these viruses.

That prediction now appears to be coming true, as children are catching these viruses for the first time, without having built up any prior immunity, and falling badly ill. “We’re seeing kids at older ages getting RSV that would have previously got it at a younger age,” says Rachel Baker, an assistant professor of epidemiology at Brown University in Rhode Island, who was a coauthor of the Lancet comment piece. “That’s putting some pressure on hospitals.”

RSV typically causes mild cold-like symptoms, but infections can be dangerous for infants. Their tiny lungs and muscles cannot muster the strength to cough up or sneeze out the mucus in their airways. Deaths are rare, but the virus can kill. Adults with weaker immune systems are vulnerable too, such as those with underlying health conditions or who are very old. Unlike for Covid-19 and flu, there are currently no approved RSV vaccines (Pfizer has one in trials, given to pregnant people to protect infants, that may become available next year).

Flu hospitalizations have also been higher than usual for this time of year—13,000 adults and children have been hospitalizedin the US so far, and 730 people have died. “We’re seeing the highest influenza hospitalization rates going back a decade,” José Romero, director of the CDC’s National Center for Immunization and Respiratory Diseases, said on November 4. And a similar picture is emerging across Europe. The United Kingdom’s Health Security Agency said in late October that hospital admissions for respiratory diseases are rising, and they’re climbing fastest in children under 5.

The fact that the southern hemisphere is coming off a pretty bad winter season—Australia experienced its worst flu season in five years—is another signal that the northern hemisphere is in for a rough one. Flu viruses that circulate during the southern hemisphere winter often end up infecting people in the north six months later, so more illness in Australia suggests this winter’s flu in the US and Europe will be particularly virulent. “For many healthy adults this will predominantly be an inconvenience, but for vulnerable groups this could be a concern,” says Neil Mabbott, professor of immunopathology at the University of Edinburgh in the UK.

This winter will be the first time that these three respiratory viruses can circulate completely freely, meaning there is a real prospect of things getting worse. But SARS-CoV-2, because of its ability to mutate, is a wildcard when trying to guess exactly what will happen. “It’s like a dream and a nightmare for someone doing prediction,” says Mary Krauland, a research assistant professor who models SARS-CoV-2 and influenza outbreaks at the University of Pittsburgh.

Because there are no plans to reintroduce control measures, Krauland says it is quite possible that SARS-CoV-2 infections will surge again this winter, ratcheting up pressure on health services. It is unclear whether that surge would collide with the influenza and RSV peaks. “You can imagine many scenarios, but it’s very difficult to pin down which one is the most likely,” she says. At the moment, most Covid cases are caused by lineages of the Omicron variant that seem to cause milder disease than earlier forms of the virus but which are able to dodge immunity from vaccines and previous infections. These variants and subvariants also compete with each other for human hosts. Should a new, more infectious variant emerge and outcompete the others, Krauland says, infections could rise sharply again. Hospitals could then feel the effects, because as infections accumulate, the number of hospitalizations and deaths also increase.

For the health system, two or three simultaneous epidemics is a worrying scenario, but so too is the prospect of contracting more than one virus at the same time. Scientists are not sure how the viruses interact, but there is evidence that simultaneously catching SARS-CoV-2 and influenza increases the risk of severe illness and death. In a study of nearly 7,000 hospitalized patients with Covid-19, researchers in the UK found that 227 patients had also tested positive for the flu, and they were more likely to require ventilation.

But how the influenza and RSV viruses interact and influence the course of disease is not clear: There have been few studies investigating this, with conflicting results, says Pablo Murcia, professor of integrative virology at the University of Glasgow. This is due to various confounding factors that muddy the water in coinfections, such as a patient’s preexisting conditions or their immunological status, the strains of viruses involved, or the time that’s elapsed between the first and second viral infection.

Catching both viruses at the same time is a troubling possibility. In a lab experiment, Murcia and his team deliberately infected human lung cells with both viruses and found that they fused together to form a palm-tree-shaped hybrid virus—with RSV forming the trunk and influenza the leaves—which could infect new cells even in the presence of flu antibodies, in essence using its new form to bypass existing flu immunity. Their findings were published in the journal Nature Microbiology in October. But it’s not known whether hybrid viruses form in people, and if they do, whether they cause disease, says Murcia.

Krauland expects that few people will contract multiple viruses at once, provided they stay at home as soon as they notice any symptoms of infection, even if mild. “The three are kind of competing for hosts at this point,” she says, and if they are, this could lead to all three viral waves being flattened. But whether this will happen—and if so, if it will keep hospitals from buckling under the pressure—we probably won’t know until spring.

China's manufacturing hub Guangzhou locks down millions as Covid outbreak widens [CNN, 9 Nov 2022]

By Nectar Gan

Editor’s Note: A version of this story appeared in CNN’s Meanwhile in China newsletter, a three-times-a-week update exploring what you need to know about the country’s rise and how it impacts the world

Hong KongCNN —
China’s southern metropolis of Guangzhou has locked down more than 5 million residents, as authorities rush to stamp out a widening Covid outbreak and avoid activating the kind of citywide lockdown that devastated Shanghai earlier this year.

Guangzhou reported 3,007 local infections on Wednesday, accounting for over one third of new cases across China, which is experiencing a six-month high in infections nationwide.

The city of 19 million has become the epicenter of China’s latest Covid outbreak, logging more than 1,000 new cases – a relatively high figure by the country’s zero-Covid standards – for five straight days.

As the world moves away from the pandemic, China still insists on using snap lockdowns, mass testing, extensive contact-tracing and quarantines to stamp out infections as soon as they emerge. The zero-tolerance approach has faced increasing challenge from the highly transmissible Omicron variant, and its heavy economic and social costs have drawn mounting public backlash.

The ongoing outbreak is the worst since the start of the pandemic to have hit Guangzhou. The city is the capital of Guangdong province, which is a major economic powerhouse for China and a global manufacturing hub.

Most cases in Guangzhou have been centered in Haizhu district – a mostly residential urban district of 1.8 million people on the southern bank of the Pearl River. Haizhu was locked down last Saturday, with residents told not to leave home unless necessary and all public transport – from buses to subways – suspended. The lockdown was initially supposed to last for three days, but has since been extended to Friday.

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Two more districts – with a combined population of 3.8 million – were locked down on Wednesday as the outbreak widened.

Residents in Liwan, an old district in the west of the city, woke to an order to stay at home unless absolutely necessary. College and universities in the district were told to lock down their campuses. Restaurant dining was banned and businesses ordered to shut, apart from those providing essential supplies.

On Wednesday afternoon, a third district, the outlying Panyu, announced a lockdown that will last till Sunday. The district also banned private vehicles and bicycles from the streets.
Starting from Thursday, all primary and middle schools in the city’s eight urban districts are moving class online, with kindergartens closed. Tutoring classes, training institutions and daycare centers will also suspend services, the city’s education officials told a news conference Wednesday.

Mass testing has been rolled out in nine districts across the city, and more than 40 subway stations have been closed. Residents deemed close contacts of infected persons – which in China can range from neighbors to those living in the same building or even residential compound – have been transferred en masse to centralized quarantine facilities.

The outbreak has also led to mass cancellations at the Guangzhou Baiyun International Airport, one of the busiest in the country. As of Thursday morning, 85% of the nearly 1,000 flights arriving and departing from Guangzhou had been canceled, according to data from flight tracking company Variflight.


“At present, there is still the risk of community spread in non-risk areas, and the outbreak remains severe and complex,” Zhang Yi, deputy director of the Guangzhou municipal health commission, told a news conference Tuesday.
So far, the lockdown appears to be more targeted and less draconian than those seen in many other cities. While residents living in neighborhoods designated as high-risk cannot leave home, those in so-called low-risk areas within locked down districts can go out to buy groceries and other daily necessities.
But many fear a blanket, citywide lockdown could be imminent if the outbreak continues to spread. On WeChat, China’s super app, residents share charts comparing Guangzhou’s surging caseload with that of Shanghai’s in late March, in the days before the eastern financial hub’s bruising two-month lockdown.
Shanghai officials initially denied a citywide lockdown was necessary, but then imposed one after the city reported 3,500 daily infections.
Anticipating that worse is to come, many residents in Guangzhou have stocked up on food and other supplies. “I’ve been buying (groceries and snacks) online like crazy. I’ll probably end up eating leftovers for a month,” said one resident, whose area of Haizhu district was categorized as low-risk by authorities.
Others, angered by the restrictions and testing edicts, have taken to social media to vent their frustration. On Weibo, China’s Twitter-like platform, posts using slang and expletives in the local Cantonese dialect to criticize zero-Covid measures have proliferated, seemingly largely evading the eyes of online censors who do not understand it.
“I learn Cantonese curse words in real-time hot search everyday,” one Weibo user said.
Meanwhile local authorities nationwide are under pressure to ramp up Covid control measures despite mounting public frustration.
This week, videos of Covid workers dressed head to toe in hazmat suits beating up residents went viral online. Following an outcry, police in Linyi city, Shandong province said in a statementTuesday that seven Covid workers had been detained following a clash with residents.

Japan braces for 8th wave as COVID-19 spreads again | The Asahi Shimbun: Breaking News, Japan News and Analysis [Asahi Shimbun, 9 Nov 2022]

Japan’s health minister said the government is taking every precaution to contain a possible eighth wave in the COVID-19 pandemic this winter following a spike in cases nationwide.

Speaking after a Nov. 8 Cabinet meeting, Katsunobu Kato called on the public to stock up on COVID-19 antigen test kits as well as fever and pain relief medicines to prepare for the risk of concurrent influenza and novel coronavirus outbreaks in the weeks ahead.

Health ministry figures show that the number of new COVID-19 patients across Japan in the week through Nov. 7 was 1.42 times that of the preceding seven-day period.

The increase was especially notable in Hokkaido and the Tohoku region of northern Japan, ministry officials said.

“We will be proactive and do what we have to do without fail,” Kato said at a news conference, adding that the government is asking prefectural authorities to ensure they have the necessary medical backup.

Asked whether the government will continue to bear all costs needed for administering COVID-19 vaccines when its policy of free jabs expires at the end of March, Kato said, “We intend to make an appropriate decision, taking into account such factors as how the infection is spreading and the law on infectious diseases.”

Members of a subcommittee of the Fiscal System Council, an advisory panel to the finance minister, said at its meeting Nov. 7 that COVID-19 shots should be recategorized as “regular vaccinations,” just like those for influenza.

That would likely require recipients to shoulder part of the cost from the new fiscal year starting April 1.

On Nov. 8, Hokkaido marked a record daily tally of new COVID-19 patients at 9,136.

The same day, new cases in Tokyo topped 8,000 for the first time in about six weeks at 8,665.

Haruo Ozaki, chairman of the Tokyo Medical Association, told a Nov. 8 news conference the capital is “on the verge of entering the eighth wave.”

The Osaka prefectural government the same day raised its alert level from green to yellow based on its own barometer, which it calls the “Osaka model.”

A yellow signal means the prefectural government is urging residents to be on the alert for a surge in infections.

The last time the prefectural government issued the yellow alert was Oct. 10.

As of Nov. 6-7, the occupancy rate of hospital beds in Osaka Prefecture set aside for COVID-19 patients reached 20 percent, one of the thresholds that prefectural officials use to consider issuing a yellow alert.

Members of a task force set up by the prefectural government to tackle the health crisis were unable to decide during a Nov. 8 meeting whether Osaka has entered the eighth wave.

But they agreed that anti-COVID-19 measures should be escalated to prepare for the possibility of simultaneous influenza epidemics and the COVID-19 pandemic.

New Coronavirus News from 7 November 2022

Why New COVID-19 Variants Have Such Confusing Names [TIME, 7 Nov 2022]

BY JAMIE DUCHARME

If you can name the currently circulating coronavirus variants without looking them up, your memory is better than most people’s—even those who are still paying attention to COVID-19.

At the moment, the top five variants in the U.S. are called BA.5 (making up about 39% of new cases, per the latest data from the U.S. Centers for Disease Control and Prevention), BQ.1.1 (almost 19%), BQ.1 (16.5%), BA.4.6 (9.5%), and BF.7 (9%). Meanwhile, the XBB variant has been detected in at least 35 countries, and the European Centre for Disease Prevention and Control is monitoring a variant called B.1.1.529.

This alphabet-soup nomenclature feels like a marked departure from the World Health Organization’s (WHO) Greek letter system, which was instituted in May 2021 to give people an easy and location-neutral way to refer to new variants. While the Greek lettering system, which yielded names like Alpha, Beta, and Delta, did not replace existing scientific naming systems—such as those responsible for labels like BA.5 and XBB—it was meant to simplify public communication about important viral strains.

The WHO only assigns a new Greek letter to a variant if it’s significantly different from previous versions. And for the last year, we’ve seen flavor after flavor of Omicron, rather than totally new iterations of the virus, explains Maria Van Kerkhove, the WHO’s technical lead for COVID-19. That’s why we haven’t yet had a strain called Pi.

Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital, has nicknamed the newer strains “Scrabble variants,” because many of them contain high-scoring Scrabble letters like Q and X. And, he adds, because they “kind of scrabble your brain.”

“I’m a scientist who’s been developing coronavirus vaccines for the last decade, and it’s even challenging for people like myself” to follow them, Hotez says. They’re not just hard to remember. The names are enough to make the average person’s eyes glaze over—which isn’t great, considering that much of the public has already checked out of the pandemic.

Van Kerkhove, however, argues that the public probably doesn’t need to know all the granular details of BQ.1 versus BQ.1.1 versus BF.7. “What the general public really needs to know is, what does it mean for me in terms of risk? We will give new names using the Greek letters when these variants are substantially different to each other” in terms of severity, immune evasion, or transmission, she says.

Read More: How to Stay Safe from COVID-19 During the 2022 Holiday Season
But some experts say variant names do have real-world implications for average people. Hotez points to the new bivalent boosters, which were formulated to target the BA.4 and BA.5 variants. BQ.1 and BQ.1.1 are descendants of BA.5, so the vaccines probably also provide some amount of protection against them, and that knowledge would perhaps provide extra motivation to get the new shots. But, in part because of their names, the average person likely doesn’t know that BQ.1 is related to BA.5, Hotez says.

T. Ryan Gregory, a professor of integrative biology at Canada’s University of Guelph, says the alphabet-soup names are important for scientists to know, because they communicate information about how the virus has evolved. But he thinks there should also be common names that the general public can use, just as there are scientific and common names for animal species. He’s even promoted (unofficial) nicknames for recent variants, calling BQ.1.1 “Cerberus,” BQ.1 “Typhon,” and XBB “Gryphon.”

If all the variants start to blend together in the public consciousness, people might not register the emergence of new strains that may be able to dodge immunity they’ve acquired from vaccinations or prior infections, Gregory says. A clearer understanding of circulating variants could also be important in health-care settings, since some monoclonal antibody therapies don’t work well against certain variants, he adds.

Van Kerkhove says the WHO’s Technical Advisory Group on SARS-CoV-2 Virus Evolution is working on a “more robust” method of assessing when a variant should get a new name, with a particular focus on immune evasion. The jump from Delta to Omicron was so dramatic that it was an easy call to give Omicron a new name, Van Kerkhove says. But now that the virus is mutating in subtler ways, it’s a more complicated decision. In late October, the advisory group voted against assigning new labels to XBB and BQ.1 because they are not sufficiently different from previous forms of Omicron.

For variants that don’t meet the WHO’s threshold for a new Greek letter, the agency could at least use a more understandable naming system, Hotez suggests—perhaps starting with Omicron, and then moving on to Omicron 1, Omicron 2, and so on. Van Kerkhove says the WHO has discussed doing so, but even that system comes with problems. There are about 300 Omicron sublineages currently under surveillance, she says, and “Omicron 300 sounds like a movie franchise.”

The public probably doesn’t need to know and discuss all of those variants, Gregory says. But for the strains that spread widely and account for a significant portion of infections, it’s worth having easily comprehensible names.

Right now, most people either feel like, “‘Wow, this is alphabet soup, and I can’t keep track,’ or ‘Well, it’s all Omicron,’” so it doesn’t matter when there’s a new variant, Gregory says. What the public is missing—and what it needs, he says—is a shared vocabulary that would help everyone understand the pandemic as it continues to evolve.

New Coronavirus News from 6 November 2022

COVID-19 world weekly cases down 18% but Japan, South Korea spiking [Gephardt Dailyk, ６ Nov 2022]

Nov. 6 (UPI) — The coronavirus situation is still easing worldwide with a weekly 18% cases and 23% deaths drop, though Asia is experiencing a surge in infections, especially Japan and South Korea, amid two new Omicron subvariants.

Like the past week, cases are rising significant in only Japan and South Korea over seven days among nations with at least 25,000 infections.

The seven-day world moving average for cases was 295,062, the lowest since late September 2020, according to Worldometers.info. In one week infections declined to 2,065,438 with the cumulative 637,695,929 so far Sunday. Cases on Saturday were 225,753, the lowest number since 207,137 Sept. 7, 2020, with last Sunday at 244,956. The last time cases were above 1 million was July 31.

The seven-day moving average for deaths was down to 1,158, the fewest since 1,073 March 21, 2020, 10 days after the World Health Organization declared COVID-19 a pandemic, according to Worldometers.info. In one week deaths declined to 8,101 with the cumulative 6,605,464 so far Sunday.

Daily deaths worldwide dropped to 545 Sunday, the least since 424 March 14, 2020, with 1,050 last Sunday.

Some nations do not report data on weekends. The U.S. Centers for Disease Control and Prevention has gone to weekly updates.

The records were 3,847,809 cases on Jan. 21, during the height of the Omicron subvariant, and 16,890 deaths on Jan. 21, 2021, when the Delta subvariant was at its peak.

The World Health Organization has been concerned about Omicron sub-variants.

“Right now, we’re in a situation where we have more than 300 subvariants of Omicron that are in circulation and these subvariants are quite similar to each other,” Dr. Van Kerkhove, the WHO’s technical lead on COVID-19, said at a briefing last week. “It is confusing in terms of the subvariant names, we recognize that, but the names that are in use are the scientific names by the different groups who analyse these from a technical point of view.”

About 95% of the subvariants are of BA.5 and about 20% of those are BQ.1. And XBB, which is a recombinant of two BA.2 sublineages, accounts for about 1% of the sequences circulating worldwide.

He noted that “surveillance for SARS-CoV-2 has declined drastically around the world, which means testing has declined, sequencing has declined and without the ability to understand what is circulating, to share these viruses, to share the knowledge about these viruses, we’re not in a situation to assess them as rapidly and robustly as we would like.”

Amid the new variants, South Korean Prime Minister Han Duck-soo said Friday the number of daily infections could reach up to 200,000 cases, but less than one-third of the daily record. The government has recently expanded booster shots against Omicron variants to all people aged over 18.

Japan, South Korea and Australia reported increases in both deaths and cases in the past week.

Japan posted the most weekly cases, 375,907 in a 38% increase and was seventh in deaths at 387, a 6% gain.

South Korea’s 297,276 infections were second in the world, with a 27% rise, and deaths were 223, a 42% increase in 12th.

Germany, which posted the most weekly cases last week, dropped to third at 252,641 in a 37% decrease, five weeks after a 60% gain, and the second-most deaths at 1,062, with no change two weeks after a 88% gain. Germany is the second-most deaths at 991, with a 7% gain and 88% rise two weeks ago.

The only other cases’ increase among nations with at least 25,000: Australia 18% at No. 9 38,875.

Decreases in the past week in descending order were Taiwan 16% at No. 4 243,770, United States 31% at No. 5 189,609, France 32% at No. 6 153,609, Italy 47% at No. 7 110,988, Russia 20% at No. 8 42,362, Cjhile 15% at No. 10 35,423, Hong Kong 12% at No. 11 33,945, Austria 21% at No. 12 33,975, Indonesia 60% at No. 13 29,725, Brazil 26% at No. 14 26,916, Malaysia 57% at No. 15 26,616.

Among nations reporting more than 100 deaths with increases in the past week: Taiwan 5% at No. 5 455, Indonesia 52% at No. 11 236, Chile 17% at No. 14 137, Australia 24% at No. 15 119, India 109% at No. 16 115.

Other decreases were United States 32% at No. 1 1,548, Britain 27% at No. 3 737, Russia 14% at No. 4 497, France 20% at No. 6 404, Italy 40% at No. 8 335, Brazil 42% at No. 9 276, Philippines 3% at No. 10 245, Spain 35% at No. 12 138.

In the past week, Asia reported 50.5% of the world’s cases, one week after 36.9% and it rose 14% for a cumulative 194,676,035, according to Worldometers.info. The continent has 59% percent of the world’s population.

Also increasing: Africa 19% for 12,679,708.

Decreases were Europe 40% for a world-high 235,084,861, North America 34% for 118,096,293, South America 16% for 64,498,584, Oceania 15% for 12,659,727.

Three continents reported an increase in deaths: Asia 17% for 1,490,576, Oceania 3% for 21,707, Africa 1% for 257,935.

Decreasing were North America 38% for 1,555,478, Europe 29% for a world-high 1,946,407, South America 23% for 1,333,346.

The United States leads with 1,098,221 fatalities and 99,639,207 infections. The nation also holds the world record for daily cases at 906,816 on Jan. 7. Brazil is second in deaths at 688,419, including 35 Saturday and fifth in cases at 34,892,134, including 1,891 most recently.

India is second in cases at 44,660,579, including 1,122 Sunday and third in deaths at 530,500 including 14 Sunday with single deaths reported in April and zero the last time on March 24, 2020.

India has the daily deaths record at 4,529 on May 18, 2021, with no adjustments from regions.
In the top 10 for deaths, Russia is fourth with 390,588 including 62 Sunday, Mexico is fifth with 330,415 and no weekend data, Peru sixth with 217,069 including seven Saturday, Britain seventh with 194,704, Italy eighth with 179,436, Indonesia ninth with 158,829 including 22 Sunday and France 10th with 157,277.

In the top 10 for cases, France is third with 36,946,904 including 26,840 Saturday, Germany fourth with 35,823,771, South Korea sixth with 25,838,239 including 36,675 Sunday, Britain seventh with 23,930,041, Italy eighth with 23,642,011, Japan ninth with 22,273,251 including 66,397 Sunday, Russia 10th with 22,674,944 including 4,566 Sunday.

In Japan, cases have been surging as restrictions ease. Japan’s seven-day moving case average is 53,701 compared with 26,325 Oct. 12 and under 20,000 in early July with the daily record 255,316 Aug. 18.

Japan’s spike is occurring during colder weather.

Atsuo Hamada, a Tokyo Medical University specially appointed professor in infectious diseases, said people tend to ventilate indoor spaces less often in cold weather and there is crowding in public spaces.

“We want people to get vaccinated for the omicron variant and influenza early while taking basic measures to prevent infections,” he told The Mainichi. He also urged people to wear masks in crowded spaces.

And like in other nations, there is the one-two punch of coronavirus and influenza.

Throughout the pandemic Japan has had a low deaths rate.

Japan has 375 deaths per million, which is 145th in the nation, with the world at 847.4 and Peru No. 1 at 6,376. In cases, Japan’s rate is 180,574 per million in 890th place with the world 81,810 and Austria the highest among large countries at 598,934 with France 563,117, Portugal 545,139 and Denmark 537,465. Japan’s population is 125 million.

For the first time since the beginning of the pandemic, Japan resumed regular international sea route travel, a ferry service connecting Fukuoka in southwest Japan with South Korea’s Busan.

South Korea cases’ seven-day average is 42,468, compared with 20,355 on Oct. 14, the lowest since mid-July. In late June it was around 7,000. The daily record was 621,328 on March 17.

China, where COVID-19 emerged, has reported 5,226 deaths. Before a spike in April, it was 4,636, which stayed at that number since early February 2021. On Sunday, China reported 588 cases with 5,659 on April 29. Those are confirmed cases with illness. Asymptomatic ones are reported separately in Mainland China.

On Saturday, China reported 4,420 new locally transmitted infections on Saturday, the National Health Commission said, the most since May 6.

The situation could become “more severe and complex” as the country entered the winter flu season, said Hu Xiang, an official with China’s National Health Commission said Saturday.

In China’s zero-Covid policy, most international visitors are barred from entering China and cities can be locked down.

“Practice has proved that our pandemic prevention and control strategy . . . [is] completely correct, and such measures are proven the most economical and effective,” Hu said.

The annual Beijing marathon took place on Sunday morning under strict Covid protocols, after being canceled the previous two years.

In the central city of Zhengzhou, Apple’s largest iPhone assembly factory Foxconn went to a lockdown Wednesday of the area after an outbreak. The plant employs 200,000 the plant and account for 85% if the iPhone assembly.

Hong Kong, like China, has adopted a “zero tolerance” for coronavirus with strong restrictions eased, including hotel quarantine for arrivals from other nations.

Hong Kong reported 18 deaths and 5,111 cases Saturday with the record 79,876 on March 3.

“The worst is behind us,” Hong Kong leader John Lee said at Wednesday’s summit, attended by more than 200 investors from 20 countries.

But a mask mandate remains in effect indoors and outdoors. And international visitors must take tests for seven straight days after arrival In Hong Kong, and for the first three days barred from restaurants, bars and gyms.

The government lifted flight bans with certain countries and shortened hotel quarantine in March.

In the United States, the CDC has classified 2% of counties, districts and territories with a “high” category level, compared with 20.1% “medium” and 77.5% “low.” In “high” locations, masks are urged indoors with areas in scattefred places in the United Stated.

In its weekly update Thursday, the CDC reported 273,110 cases one week after 260,830, the lowest since 226,498 April 13. The record was 5,553,528 Jan. 19.

And the deaths average fell to 2,504, the lowest since 2,406 July 6 and the record 23,375 Jan. 13, 2021.

“We’re still in the middle of this — it is not over,” White House chief medical advisor Dr. Anthony Fauci said Thursday on the Conversations on Health Care radio show. “Four hundred deaths per day is not an acceptable level. We want to get it much lower than that.”

BQ.1 and BQ.1.1 represent 27% of infections combined and BA.5 has declined to 50%, according to the CDC.

And hospitals could face a “negative trifecta” this winter from emerging Covid variants, resurgent flu and respiratory syncytial virus, Fauci said.

“It’s going to be very confounding and might even stress the hospital system, particularly for the pediatric population,” Fauci said.

New weekly hospitalizations in the United States for one week were 3,272, which is a 1% weekly decline. A total of 5,469,077 have been hospitalized with COVID-19 since its inception with a population of 332 million. The U.S. total reported Sunday was 27,181, which is 3.87% capacity, and far below the record 160,113 (20.6%) on Jan. 20, according to the Department of Health and Human Services.

Also Thursday in its weekly report, the CDC said the U.S. adult one-shot vaccination rate was 91.2% with completed primary service at 78.3% and updated booster doses 9.9%. The full population rates are 80.2% for one shot, 68.5% for completed primary and 8.4% updated booster 5 and older.

The CDC recently switched from a breakdown of one and two boosters to one with the updated bivalent booster.

On Friday, Pfizer and BioNTech said immune responses against BA.4/BA.5 subvariants were “substantially higher” in people who got its new bivalent booster compared with people who received the companies’ original Covid-19 vaccine. The new one became available in September.

The booster has four times higher levels of neutralizing antibody against the Omicron BA.4/BA.5 variants in people older than 55 compared with the original vaccine.

Fauci also recommended testing before going to social gatherings, especially where vulnerable people are.

“That is a very good way of making sure you don’t spread infections, so utilization of tests, wearing masks where appropriate and getting vaccinated,” he said.