Covid-19 Vaccine News: Live Updates – The New York Times

In the early 1990s, long before P.P.E., N95 and asymptomatic transmission became household terms, federal health officials issued guidelines for how medical workers should protect themselves from tuberculosis during a resurgence of the highly infectious respiratory disease.

Their recommendation, elastomeric respirators, an industrial-grade face mask familiar to car painters and construction workers, would in the decades that followed become the gold standard for infection-control specialists focused on the dangers of airborne pathogens.

But when the coronavirus swept the globe and China cut off exports of N95s, elastomeric respirators were nowhere to be found in a vast majority of hospitals and health clinics in the United States. Although impossible to know for sure, some experts believe the dire mask shortage early on contributed to the wave of infections that killed more than 3,600 health workers.

The pandemic has generated a bevy of painful lessons about the importance of preparing for public health emergencies. From the Trump administration’s tepid early response to the C.D.C.’s bungled coronavirus testing rollout and its mixed messaging on masking, quarantining and the reopening of schools, the federal government has been roundly criticized for mishandling a health crisis that has left one million Americans dead and dented public faith in a once-hallowed institution.

Three years into the pandemic, elastomeric respirators remain a rarity at American health care facilities. The C.D.C. has done little to promote the masks, and all but a handful of the dozen or so domestic companies that rushed to manufacture them over the past two years have stopped making the masks or have folded because demand never took off.

Most cost between $15 and $40 each, and the filters, which should be replaced at least once a year, run about $5 each. Made of soft silicone, the masks are comfortable to wear, according to health care worker surveys, and they have a shelf life of a decade or more.

“It’s frustrating and frightening because a mask like this can make the difference between life and death, but no one knows about them,” said Claudio Dente, whose company, Dentec Safety, recently stopped making elastomeric respirators that were specifically redesigned at the request of federal regulators for health care workers.

The government’s tentative approach to elastomeric respirators during the pandemic has largely escaped public scrutiny, even as American mask producers, health policy experts and nursing unions have been pressing federal officials to promote them more aggressively. The masks, they note, are an environmentally sustainable and cost-effective alternative to N95s. Worn properly, they offer better protection than N95s, which, as their name suggests, only filter out 95 percent of pathogens. Most elastomerics exceed 99 percent.

The masks have another notable attribute: Most are made in the United States.

Credit…Chinatopix, via Associated Press

Now that hospitals have resumed buying cheap, Chinese-made face coverings and the resurgent American mask industry has imploded, experts warn of the perils of the nation’s continued dependency on foreign-made protective equipment. Many of the U.S. companies calling it quits are start-ups whose founders jumped into the P.P.E. business out of a sense of civic duty.

“It’s sad to see all of this manufacturing capacity come online during a crisis, only to be shut down because hospitals and even our own government would rather save a few pennies buying from China,” said Lloyd Armbrust, president of the American Mask Manufacturers Association. Its membership includes just eight companies that are still producing masks, down from 51 a year ago. He said 17 of the companies have shut down.

Some experts say the C.D.C.’s hands-off approach to elastomeric respirators is unintentionally encouraging a return to the nation’s reliance on disposable masks made overseas. Dr. Eric Feigl-Ding, an epidemiologist who heads the Covid-19 task force at the World Health Network, criticized federal officials for inaction despite compelling evidence that elastomerics provide the highest level of protection against aerosolized viruses. “At a certain point, you need to act on the existing science, and the failure to do otherwise is a dereliction of duty,” he said.

To be clear, federal health experts back the use elastomerics but say they are awaiting additional study results before offering full-throated support for their widespread adoption by medical personnel. Emily Haas, a scientist at the C.D.C.’s National Institute for Occupational Safety and Health, or NIOSH, said researchers were still grappling with the need to regularly disinfect them and complaints about muffled communication, though some newer models make it easier for wearers to be heard.

The bigger challenge, she says, is convincing hospitals and group purchasing organizations to embrace the masks given the abundance of N95s, which offer comparable protection during routine medical care and can be thrown away after each use.

“There’s been so much research in the last 10 years that has really supported elastomerics, so in some ways the issue right now is cultural,” Dr. Haas said. “No one likes change, and introducing a whole new system of respiratory protection can be a heavy lift.”

Experts say such obstacles could be overcome through more muscular federal leadership. Dr. Tom Frieden, who led an unsuccessful effort to fill the Strategic National Stockpile with elastomerics when he was C.D.C. director in 2009, said the advantages of providing them to frontline medical workers were clear, especially given the nation’s ruinous overreliance on single-use masks. He said health authorities could promote elastomerics by highlighting their cost savings for hospitals and the environmental benefits of a reusable mask to help reduce the tsunami of N95s that end up in landfills. “To me, it’s a puzzle why they haven’t become more widespread,” Dr. Frieden said.

Providing an elastomeric respirator to each of the nation’s 18 million health care workers would cost roughly $275 million, according to Nicolas Smit, an expert on elastomerics and executive director of the American Mask Manufacturers Association. By comparison, he noted that the federal government spent $413 million on a disastrous effort to decontaminate N95 masks so they could be safely reused.

Credit…Cooper Neill for The New York Times

James C. Chang, an industrial hygienist, has long been a fan of elastomerics. In 2018, he helped to produce a report on them for the National Academies of Sciences, Engineering and Medicine, and after the short-lived swine flu pandemic of 2009, he persuaded his employer, the University of Maryland Medical Center, to purchase 1,500 masks. The decision was based in part on research that predicted a respiratory pandemic lasting more than a few weeks would lead to catastrophic supply-chain shortages.

“When you ran the numbers, it was pretty clear we’d burn through a six- or seven-digit cache of disposables pretty quickly,” he said. “It’s just not feasible for any hospital to stock that many masks.”

Initially he had a handful of concerns — that their “Darth Vader” look would frighten patients or that disinfecting them would be burdensome. But those fears quickly faded in early 2020 as hospitals across the country scrambled to find N95s, and the C.D.C. issued guidelines saying N95s could be reused up to five times — guidance that evoked widespread skepticism among health professionals.

To deal with the need to disinfect the masks, he set up a system that allowed workers to drop them off after each shift so they could be cleaned before being made available to others.

“It was a real success story on our end because our staff had respirators to wear and they felt more reassured wearing elastomerics than wearing N95s,” Mr. Chang said.

One of the only other hospital systems in the country to adopt the masks on a large scale was Allegheny Health Network of Western Pennsylvania, which early in the pandemic, distributed more than 8,000 respirators at its 14 hospitals. The decision to do so stemmed from a coincidence of geography: Allegheny’s headquarters in Pittsburgh was not far from the manufacturing plant of MSA Safety, a century-old company that got its start producing coal miner protective gear with help from Thomas Edison.

Prompted by an appeal from hospital administrators, MSA began sending over the industrial-grade masks but they quickly ran into a problem. The protruding filters only screened inhaled air, which meant that exhaled air from an infected wearer could pose a potential health risk to those nearby, according to Dr. Zane Frund, executive director for materials and chemicals research at MSA Safety.

The solution was not exactly rocket science: Product designers simply removed the masks’ exhalation valve, and NIOSH in late 2020 approved the new models. A subsequent design tweak added a mechanical voice amplifier to help ease communication.

Dr. Sricharan Chalikonda, Allegheny’s chief medical operations officer, said he was surprised by just how popular they became among the 2,000 medical personnel who had been outfitted to wear them — a process aimed at ensuring air would not evade the mask’s tight face seal.

Credit…Kirsten Luce for The New York Times

According to a paper he published in the Journal of the American College of Surgeons, none of the employees went back to wearing N95s. The cost benefit of relying almost entirely on elastomerics became irrefutable: Outfitting the workers was one-tenth as expensive than supplying them with disposable N95s. A separate study found that after one year, the filters were still 99 percent effective.

“Elastomerics for us really were a game changer,” Dr. Chalikonda said. “When I think of all the millions of dollars wasted on N95s and then trying to reuse them makes you realize how much elastomerics are a missed opportunity.”

Federal health officials say they are moving as fast as possible to produce stronger guidance on elastomerics. Maryann D’Alessandro, director of the National Personal Protective Technology Laboratory, said scientists were reviewing feedback from a study that distributed nearly 100,000 respirators to hospitals, nursing homes and first-responders across the country. “If we can get a tool kit together to serve as a guide for organizations and educate the users, we hope it can help move the needle,” she said.

Many masks entrepreneurs are not likely to last that long. Max Bock-Aronson, the co-founder of Breathe99, which makes an elastomeric respirator that Time magazine included on its 2020 list of best inventions, has been winding down operations at the company’s Minnesota plant.

He blamed the slump in sales on Covid fatigue and waning public interest in protective gear. The company’s fortunes, he added, were doomed early on by the C.D.C.’s mask guidance, which prompted Amazon, Google and Facebook to limit or bar the sale of medical-grade masks to consumers, even as P.P.E. imports once again began flooding the United States.

“The whole industry has been gutted,” said Mr. Bock-Aronson. “Every time there’s a new variant, we get a small bump in sales, but I haven’t taken a nickel out of the company since last May,”

For now, he is focused on finding a buyer for his company while selling off his inventory online. The masks cost $59 and can be sheathed in washable covers that come in eight colors, among them crimson, linen and royal blue.

All sales, the website points out apologetically, are final.

For Now, US Treads Water with Transformed COVID-19 – Voice of America – VOA News

The fast-changing coronavirus has kicked off summer in the U.S. with lots of infections but relatively few deaths compared to its prior incarnations.

COVID-19 is still killing hundreds of Americans each day, but is not nearly as dangerous as it was last fall and winter.

“It’s going to be a good summer and we deserve this break,” said Ali Mokdad, a professor of health metrics sciences at the University of Washington in Seattle.

With more Americans shielded from severe illness through vaccination and infection, COVID-19 has transformed — for now at least — into an unpleasant, inconvenient nuisance for many.

“It feels cautiously good right now,” said Dr. Dan Kaul, an infectious diseases specialist at the University of Michigan Medical Center in Ann Arbor. “For the first time that I can remember, pretty much since it started, we don’t have any (COVID-19) patients in the ICU.”

As the nation marks July Fourth, the average number of daily deaths from COVID-19 in the United States is hovering around 360. Last year, during a similar summer lull, it was around 228 in early July. That remains the lowest threshold in U.S. daily deaths since March 2020, when the virus first began its U.S. spread.

But there were far fewer reported cases at this time last year — fewer than 20,000 a day. Now, it’s about 109,000 — and likely an undercount as home tests aren’t routinely reported.

Today, in the third year of the pandemic, it’s easy to feel confused by the mixed picture: Repeat infections are increasingly likely, and a sizeable share of those infected will face the lingering symptoms of long COVID-19.

Yet, the stark danger of death has diminished for many people.

“And that’s because we’re now at a point that everyone’s immune system has seen either the virus or the vaccine two or three times by now,” said Dr. David Dowdy, an infectious disease epidemiologist at Johns Hopkins Bloomberg School of Public Health. “Over time, the body learns not to overreact when it sees this virus.”

“What we’re seeing is that people are getting less and less ill on average,” Dowdy said.

As many as 8 out of 10 people in the U.S. have been infected at least once, according to one influential model.

The death rate for COVID-19 has been a moving target, but recently has fallen to within the range of an average flu season, according to data analyzed by Arizona State University health industry researcher Mara Aspinall.

At first, some people said coronavirus was no more deadly than the flu, “and for a long period of time, that wasn’t true,” Aspinall said. Back then, people had no immunity. Treatments were experimental. Vaccines didn’t exist.

Now, Aspinall said, the built-up immunity has driven down the death rate to solidly in the range of a typical flu season. Over the past decade, the death rate for flu was about 5% to 13% of those hospitalized.

Big differences separate flu from COVID-19: The behavior of the coronavirus continues to surprise health experts and it’s still unclear whether it will settle into a flu-like seasonal pattern.

Last summer — when vaccinations first became widely available in the U.S. — was followed by the delta surge and then the arrival of omicron, which killed 2,600 Americans a day at its peak last February.

Experts agree a new variant might arise capable of escaping the population’s built-up immunity. And the fast-spreading omicron subtypes BA.4 and BA.5 might also contribute to a change in the death numbers.

“We thought we understood it until these new subvariants emerged,” said Dr. Peter Hotez, an infectious disease specialist at the Baylor College of Medicine in Texas.

It would be wise, he said, to assume that a new variant will come along and hit the nation later this summer.

“And then another late fall-winter wave,” Hotez said.

In the next weeks, deaths could edge up in many states, but the U.S. as a whole is likely to see deaths decline slightly, said Nicholas Reich, who aggregates coronavirus projections for the COVID-19 Forecast Hub in collaboration with the Centers for Disease Control and Prevention.

“We’ve seen COVID hospitalizations increase to around 5,000 new admissions each day from just over 1,000 in early April. But deaths due to COVID have only increased slightly over the same time period,” said Reich, a professor of biostatistics at the University of Massachusetts Amherst.

Unvaccinated people have a six times higher risk of dying from COVID-19 compared with people with at least a primary series of shots, the CDC estimated based on available data from April.

This summer, consider your own vulnerability and that of those around you, especially in large gatherings since the virus is spreading so rapidly, Dowdy said.

“There are still people who are very much at risk,” he said.

CDPH COVID-19 Update: Cook County Remains at High COVID-19 Community Level Based on CDC Metrics – chicago.gov

CHICAGO – Cook County remains at a High COVID-19 CDC Community Level, the Chicago Department of Public Health (CDPH) announced today.  

“Chicagoans are looking forward to celebrating the Independence Day weekend, as am I,” said CDPH Commissioner Allison Arwady, M.D. “If you can hold holiday weekend gatherings with family and friends outdoors, where ventilation is better and the risk of COVID transmission is lower, take advantage of the warm weather and do so. Please remember though, if you are in any crowded, indoor spaces, to wear your mask.” 

Both COVID-19 case and regional hospitalization metrics remain just above the cutoff for the High COVID-19 Level. The number of new COVID-19 cases per 100,000 population in the past seven days across Cook County is 207 (the goal to drop out of the High Level is under 200). The number of new weekly hospital admissions per 100,000 population is 10.7 (the goal to drop out of the High Level is under 10). Will, DuPage, and Lake counties are also at the High Level.  

With the newer and more contagious Omicron subvariants BA.4/.5 now making up the majority of COVID-19 cases in the region,  case rates have increased slightly since last week–though the City continues to see lower COVID-19 case rates and hospitalizations than the county as a whole. Chicago has had 192 new cases and seven new hospitalizations reported over the last week, per 100,0000 population. Other Chicago indicators, including Emergency Department encounters, have also seen some slight increases. Wastewater monitoring continues to remain stable and hospital capacity is not threatened. Less than four percent of hospital beds are occupied with COVID-19 patients across Chicago’s hospitals. 

The CDC determines COVID-19 Community Levels as Low, Medium, or High, based on the number of new local COVID-19 cases, regional COVID-19 hospital admissions, and COVID-19 hospital capacity in the prior week. The Levels were developed to help communities decide what prevention steps to take based on the latest local COVID-19 data.   

At a High COVID-19 Level, people should mask indoors, test in the case of any symptoms or known exposures, and ensure they are up-to-date with COVID-19 vaccines, including boosters. 

Travelers should review CDPH’s travel guidance and check the CDC map to know whether areas they are visiting are Low, Medium, or High risk for COVID-19 and take proper precautions. The CDC recently announced that international travelers to the U.S. are no longer required to show proof of a negative COVID-19 viral test before boarding their flight to the U.S. 

When the CDC updates its COVID-19 Community Levels national map each week, the City of Chicago and suburban Cook County data are combined into one weekly case metric for Cook County. Hospitalization data, in contrast, reflect a burden on the whole federally defined Health Service Area, which includes hospitals in Cook, Lake, DuPage, and McHenry counties. CDPH continues to track and report COVID-19 hospital burden specifically for Chicago hospitals every day on its dashboard and uses this local hospital data to make further mitigation decisions. Visit chi.gov/coviddash for the Chicago COVID-19 daily data dashboard.

Based on the latest data from CDC, Cook County levels are as follows.  

Metrics
 

New Cases (per 100,000 people in last 7 days)

New COVID-19 admissions per 100,000 population (7-day total)

Proportion of staffed inpatient beds occupied by COVID-19 patients (7-day average)

  [GOAL is <200] [GOAL is
<10]
[GOAL is <10%]
City of Chicago 192 7 4.0%
Cook County (including City of Chicago) 208 10.7 3.6%
Cook County metrics are calculated by the CDC and posted on the CDC Community Levels website (data as of 6/30/2022). 

COVID-19 Community Levels in the U.S. by County

Nationwide, the percentage of U.S. counties at either the Medium or High Level has jumped in the past week, from 43 percent to 55 percent this week. The Northeastern U.S. is now predominantly at the Low Level, while Florida, California, Arizona, and Oregon are now predominantly at the High Level.  

A total of 28 of Illinois’ 102 counties are now at a High Level, up from 20 last week. Another 71 Illinois counties are at Medium COVID-19 Level (40 last week). 

  Community Level Number of Counties Percent of Counties % Change from Prior Week
  High

627
(392 last week)

19.5% 7.3%
  Medium

1,142
(997 last week)

35.5% 4.5%
  Low

1,452
(1,832 last week) 

45% -11.8%

For additional COVID-19 news, see CDPH’s weekly update or visit Chicago.gov/COVID.

###

South Florida counties in ‘high’ COVID-19 community category – WFLX Fox 29

All South Florida counties are in the highest of three COVID-19 community levels with Okeechobee County moving up from “medium,” according to the Centers for Disease Control and Prevention in its weekly update posted Thursday.

Palm Beach, Martin, St. Lucie, Indian River, Broward and Miami-Dade areremain listed as “high. Two weeks ago Okeechobee was “high.”

The only other counties medium are Glades, Henry in central Florida along with Calhoun, Marion, Franklin, Washington, Walton. None are now.

The levels have different commendations to halt the spread out coronavirus, including mask wearing indoors recommended for the most severe level and additional measures for high-risk people.

For medium and low, you are encouraged to “wear a mask if you have symptoms, a positive test or exposure to someone with COVID-19.” At the medium level, “if you are at high risk for severe illness, consider wearing a mask indoors in public and taking additional precaution.

The first criteria is cases per 100,000 people in the past week with 200 or more considered high. One-week decreases were Palm Beach County, Indian River, Okeechhobee, Broward, Miami Dade. Increases were in St. Lucie and Martin.

Palm Beach County is 300.25, down from 309.52; St. Lucie 317.7 vs. 310.09; Martin 241.61 vs. 237.27, Indian River 273.26 vs. 285.76; Okeechobee 158.89 vs. 175.49; Broward 390.26 vs. 402.09; Miami-Dade 625.52 vs. 632.22.

Another criteria s hospital admissions per 100,000, which is high if 20 or more. Palm Beach, St. Lucie, Martin, Okeechobee are 21.3; Indian River 14.8; Broward and Miami-Dade 23.9.

And the percent of staffed inpatient beds with covid for a weekly average is considered high if 15% or more. Palm Beach, St. Lucie, Martin, Okeechobee 6.1%, Indian River 6.4%; Broward, Miami-Dade 7.5%.

The CDC determines an overall high level by counting the higher of the two hospitalization rates.

Florida, Arizona and Hawaii the only states with counties dominating with “high” categories. States entirely “low” are Maine, Massachusetts, New Hampshire.

This is a visual map of the United States by the CDC:

covid transmission.JPG
covid transmission.JPG

The high categories in Florida counties reflect surging cases, positivty rates and hospitalizations.

Cases statewide are at the highest level since mid-February (74,625 in past week according to CDC), the positivity rate of 17.2% (June 17) is greatest since early February, hospitalizations (3841 Thursday with 6.6% capacity) are the most since Feb. 21 of 4,123 (7.11) and deaths’ increase in a week, 389, is the most in the United Stares and one week after 324, according to CDC.

The current seven-day rolling daily average is 10,660. The figure 1,127 on March 22 is the lowest since 1,106 June 8, 2020. The record: 65,277 Jan. 11 (456,946 in a week).

On Thursday, 12,739 cases were posted for a total of 6,482,295, behind only California and Texas, with 14,015 June 3. One week ago it was 12,741510. The daily record: 76,611 Jan. 8.

The CDC lists overall positivity rates, with the target 5.0% or less, as every South Florida county increased in one wee: Palm Beach 19.87%, St. Lucie 23.9%, Martin 19.7%, Indian River 18.25, Okeechobee 11.29%, Broward 21.66%, Miami-Dade 23.03%%.

One week ago hospitalizations were 3,496 (6.17%) and April 11 it was 892 (1.58%), least since record-keeping began July 2020, according to Department of Health and Human Services. The record was 17,295 (2.35%) on Aug. 29 during the delta variant surge. Florida ranks second behind California, which has 3,860.

Residents’ deaths are 75,800, according to CDC data from Florida, which is in third place behind California and Texas.

The state report doesn’t list county deaths’ data but the CDC issues weekly reports 53 in Palm Beach (17 week ago), 59 in Miami-Dade (26 week ago), 32 in Broward (26 week ago) and less than 10 in Martin, St. Lucie, Indian River, Okeechobee for both weeks.

In March, the CDC started designating “community levels.” Since the pandemic, the CDC had “community transmission,” which is based on cases and tests, and is broken into “low,” “moderate,” “substantial” and “high.” The entire state is listed as “high.”

Scripps Only Content 2022

WHO: COVID-19 cases rising nearly everywhere in the world – ABC News

GENEVA — The number of new coronavirus cases rose by 18% in the last week, with more than 4.1 million cases reported globally, according to the World Health Organization.

The U.N. health agency said in its latest weekly report on the pandemic that the worldwide number of deaths remained relatively similar to the week before, at about 8,500. COVID-related deaths increased in three regions: the Middle East, Southeast Asia and the Americas.

The biggest weekly rise in new COVID-19 cases was seen in the Middle East, where they increased by 47%, according to the report released late Wednesday. Infections rose by about 32% in Europe and Southeast Asia, and by about 14% in the Americas, WHO said.

WHO Director-General Tedros Adhanom Ghebreyesus said cases were on the rise in 110 countries, mostly driven by the omicron variants BA.4 and BA.5.

“This pandemic is changing, but it’s not over,” Tedros said this week during a press briefing. He said the ability to track COVID-19’s genetic evolution was “under threat” as countries relaxed surveillance and genetic sequencing efforts, warning that would make it more difficult to catch emerging and potentially dangerous new variants.

He called for countries to immunize their most vulnerable populations, including health workers and people over 60, saying that hundreds of millions remain unvaccinated and at risk of severe disease and death.

Tedros said that while more than 1.2 billion COVID-19 vaccines have been administered globally, the average immunization rate in poor countries is about 13%.

“If rich countries are vaccinating children from as young as 6 months old and planning to do further rounds of vaccination, it is incomprehensible to suggest that lower-income countries should not vaccinate and boost their most at risk (people),” he said.

According to figures compiled by Oxfam and the People’s Vaccine Alliance, fewer than half of the 2.1 billion vaccines promised to poorer countries by the Group of Seven large economies have been delivered.

Earlier this month, the United States authorized COVID-19 vaccines for infants and preschoolers, rolling out a national immunization plan targeting 18 million of the youngest children. American regulators also recommended that some adults get updated boosters in the fall that match the latest coronavirus variants.

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Follow AP’s coverage of the pandemic at https://apnews.com/hub/coronavirus-pandemic

FDA advisers recommend strain update to Covid-19 boosters ahead of expected fall surge – POLITICO

The FDA’s goal is to make a strain composition recommendation — preferably matched to the variant for which current vaccines are least effective — by early July so companies can manufacture doses in time for a booster campaign to begin in earnest by October, said Peter Marks, director of the agency’s Center for Biologics Evaluation and Research.

“If we want these to be available by early fall, that will have to happen very soon,” Marks said. The agency typically makes a recommendation based on the expert panel’s vote although not always.

Dissent and issues to watch: Still, two panel members opposed the recommendation, with Paul Offit of the Children’s Hospital of Philadelphia taking issue with the dearth of data on the need for updated vaccine recipes when the scientific community has yet to determine their correlate of protection — the level at which a body’s immune response from antibodies and memory cells provides adequate protection against the virus.

“I’m still not comfortable enough that we have the information we need to essentially support this new product,” he said.

Vaccine manufacturers said manufacturing booster formulations targeting BA.4 and BA.5 would push back their delivery timelines later than if they were tasked with producing BA.1 strain-specific recipes.

Moderna said it could have a subvariant-focused vaccine ready by late October, compared to August for bivalent compositions focused on the original Omicron strain. Pfizer signaled it would have an updated vaccine ready to go by the first week of October.

Committee members signaled concern about implementation confusion among health care providers should a distinct booster formulation be made available alongside the original vaccine recipes that have been used for both primary series and booster vaccinations since December 2020.

What’s next: The FDA must decide whether and how to recommend a strain composition to the Covid-19 vaccines so manufacturers can begin making updated shots.

It’s also unclear which populations will be eligible for booster shots in the coming months. Pfizer’s and Moderna’s data to date has covered adults, particularly those over 50, and the Biden administration has said it’s running out of money to ensure it can keep providing Covid vaccines to all Americans at no cost.

UK unlikely to return to mandatory Covid restrictions despite rising cases – CNBC

More than 1.7 million Brits — or around 1 in 35 people — tested positive for Covid in the week to June 18, the latest data from the U.K.’s Office for National Statistics showed Friday.

Adrian Dennis | Afp | Getty Images

LONDON — Mandatory Covid-19 restrictions are unlikely to be reintroduced in Britain this summer, health researchers and physicians have said, even as the country enters a new wave of infections.

More than 1.7 million Brits — or around 1 in 35 people — tested positive for Covid in the week through to June 18, the latest data from the U.K.’s Office for National Statistics showed Friday.

The surge marks a 75% increase from two weeks prior when the country commemorated Queen Elizabeth II’s Platinum Jubilee. It also comes ahead of a summer of large-scale musical and sporting events, which could push cases higher still.

Yet, health researchers and physicians say they don’t foresee a return to obligatory public health measures unless there is a major shift in the virus’ behavior.

“I don’t think we will have any mandatory restrictions unless the situation looks unmanageable for the health service, and especially the critical care service,” Simon Clarke, associate professor in cellular microbiology at the University of Reading, told CNBC Monday.

The majority of new infections are being driven by omicron BA.4 and BA.5, two newer variants that have now become the dominant strains in Britain, the U.K. Heath Security Agency said Friday.

Though both have been designated “variants of concern,” scientists say there is currently no evidence to suggest either cause more serious illness than previous strains, and they are unlikely to behave drastically differently.

Any shift in approach, if it were to happen, would be if intensive care units were to come under significant pressure, Clarke said. Hospitalizations were up 8.2% over the past week, but ICU and high dependency unit admission rates have so far remained low at 0.2%, according to UKHSA.

“ICU is the bottleneck on this, and that’s where you’re going to see — if you see it — an inability to cope,” Clarke said.

‘Living with Covid’

The U.K. government has been committed to its strategy of “living with Covid” since all restrictions were lifted in England in February this year.

Last week, England’s former deputy chief medical officer, Professor Jonathan Van-Tam, said that the virus had become increasingly like the seasonal flu and that the onus was now on individuals to “frame those risks for themselves.”

“In terms of its kind of lethality, the picture now is much, much, much closer to seasonal flu than it was when [Covid] first emerged,” he told BBC Radio 4’s “Today” program.

Scotland’s national clinical director echoed those comments Sunday, telling the BBC that it would take a “dramatic” change for mandatory restrictions to be brought back.

“People are going back about their business. Glastonbury is on, TRNSMT is on next week,” Professor Jason Leitch said, referring to two U.K. music festivals in Somerset and Glasgow, respectively. “All of those things are really, really important to get back.”

However, he conceded that people would need to accept a few “small prices” to ensure normality continues, such as keeping up-to-date with vaccinations, wearing face coverings where appropriate and staying off work when sick.

The government has already committed to providing additional booster vaccinations to over-65s, frontline health and social workers and vulnerable younger people this autumn.

However, Clarke said it would be prudent to extend the program to over-50s ahead of the winter months when the country could face a more severe spike in infections.

“The immunity from boosters is already beginning to wane and will do more so by the end of the year,” Clarke said, adding that that could be the more important period to watch in terms of restrictions.

Britain’s Health Secretary Sajid Javid suggested last week that the government may be considering expanding the program.

What to know about the newly approved COVID-19 vaccine for children under 5 – The Spokesman Review

COVID-19 vaccines for children under 5 years old were recently approved.

Though the process to get shots in arms is slow across the country and in Washington, parents may soon begin making appointments for their little ones. But many may still have questions.

Here’s what you need to know about the recently approved vaccines:

Who is eligible? The Pfizer-BioNTech and Moderna vaccines have been approved by the U.S. Food and Drug Administration, the Centers for Disease Control and Prevention and the Western States Scientific Safety Review Workgroup for children as young as 6 months old.

The three-dose Pfizer vaccine is available for 6-month-olds to 4-year-olds. The two-dose Moderna vaccine is available for 6-month-olds to 5-year-olds.

The children join the rest of Americans in all other age groups in being eligible for a vaccine.

When can my child receive the vaccine? The new vaccines were approved and recommended just this past weekend. It may take some time for states to receive their doses.

Last week, the Department of Health said it had ordered 151,600 doses for those under 5 from the federal government. Of those, approximately 88,000 had already been ordered by providers and about 63,600 were still available for licensed providers to order.

The department did warn providers may not receive doses until June 21 or later, however.

Dr. Francisco Velázquez, the Spokane Regional Health District’s health officer, told reporters Wednesday that the regional health district had yet to receive any doses. Once available, families can make appointments through their providers.

Because the dosage is different for smaller children, providers can’t just use the doses they may already have for adults.

“Just because it was approved doesn’t mean we have it in our hands,” said Dr. Sarah d’Hulst, pediatrician at MultiCare Rockwood.

Health care staffing shortages and supply chain issues could also result in it taking a bit longer for shots to get into arms.

For her part, d’Hulst said she feels confidently that children will start getting vaccinated against COVID-19 in the next week or so.

How does it differ from adults? For the most part, the COVID-19 vaccine for children is similar to that already approved for adults.

The main difference is the dosage levels, d’Hulst said. Kids may also see different side effects than adults.

What are the risks or side effects? For the most part, the side effects for babies and toddlers are similar to that of adults.

According to the Centers for Disease Control and Prevention, younger children may experience fewer side effects after the COVID-19 vaccine than teens or young adults.

Children 4 years and older are more likely to see common side effects, such as fever, tiredness, pain where the shot was given, headache, chills, swollen lymph nodes or muscle pain. Children 3 years and younger may experience side effects such as pain where the shot was given, swollen lymph nodes, irritability or crying, sleepiness or loss of appetite.

In studies, kids who got Moderna were slightly more likely to have a post-injection fever than those who got Pfizer, d’Hulst said.

A small number of kids in the older age group already approved for vaccines had a very rare, very mild myocarditis. Researchers were very careful to look for that in the younger age group, d’Hulst said.

“They did not find that,” she said. “Parents don’t need to be concerned about that.”

If so many kids have likely already been exposed or infected, why should I still get my child vaccinated? It is true that many children have likely already been exposed or infected with COVID-19, but getting the vaccine can still boost the number of antibodies against future COVID-19 infections, d’Hulst said.

“Having lots of antibodies helps our body to recognize if it’s been exposed to it again and quickly mount a response to that infection,” she said.

There is still a lot of transmission in the community, Velázquez told reporters Wednesday. Even if a child or an adult has been infected with COVID-19, vaccines still work really well to prevent another infection.

Although children who get COVID-19 often get a milder illness, d’Hulst said vaccines are still the best protection to prevent serious and life-threatening illness from COVID-19.

As of Wednesday, Velázquez said about 70 people were in county hospitals, including four pediatric patients.

Some children can also get “long COVID,” which is when symptoms, such as fatigue or brain fog, continue long after infection.

“What we don’t know is long term how that will affect kids,” d’Hulst said.

Why did it take so long to be approved? When any new vaccine comes out, it is quite common that studies start with adults, d’Hulst said. It’s often much easier for adults to consent to a research study than for kids.

“It’s just a normal progression that we do for many vaccines,” she said.

For the COVID-19 vaccine in particular, researchers learned very quickly that older people were at a much higher risk of death or serious disease than children, so it became important to quickly get those people a vaccine, d’Hulst said.

This week’s local numbers In Spokane County, there were 852 new cases this week. The case rate for the past seven days is 157.2 per 100,000.

The hospital admission rate is 4.1 per 100,000 for the past seven days. Two more people died of COVID-19 in the past week, bringing the county’s total to 1,368.

The Panhandle Health District reported 319 new cases in the last week. There are 11 people hospitalized with the virus in the district.

Devi Sridhar’s ‘Preventable’ Review: The Countries That Handled COVID-19 Best – Foreign Policy

A pedestrian passes artwork by the artist known as the Rebel Bear

A pedestrian passes artwork by the artist known as the Rebel Bear on a wall on Bath Street in Glasgow, England, in April 2020. Andrew Milligan/PA Images via Getty Images

During a recent trip to London, I saw almost no one wearing a mask—except for American tourists, who were easily identifiable because they wore them even when they were outside. Restaurants have recovered and are packed; reservations are down only 13 percent from before the pandemic, compared with 40 percent in New York. For me, a visiting American comparing London to his homeland, the impression is that the city—and the country—has moved on from COVID-19.

Preventable: How a Pandemic Changed the World & How to Stop the Next One, Devi Sridhar, Viking, 432 pp., .95, July 2022

Preventable: How a Pandemic Changed the World & How to Stop the Next One, Devi Sridhar, Viking, 432 pp., $32.95, July 2022

But England has not moved on from its failed initial response to COVID-19 and the decisions surrounding it, which remain controversial. Starting in February 2020, the country pursued a libertarian strategy of trying to reach herd immunity, before lurching to a severe lockdown in late March. England cycled through lockdowns of varying severity over roughly the next year. People were ordered to stay at home, and nonessential businesses were closed; at times, it was an offense to leave your home without a reasonable excuse. The National Health Service (NHS) attempted an effort at test and trace from May 2020 to January 2021, but this proved to be completely useless.

I happened to be marooned in London throughout most of 2020, having arrived only days before the initial lockdown was imposed on March 23. I remember how empty London’s streets were during that period, except for the speeding ambulances. While I never caught COVID-19, my doctor did—perhaps because of the NHS’s lack of personal protective equipment and overall lack of preparedness for a pandemic. Prime Minister Boris Johnson nearly died from the virus. And it was recently revealed, in a scandal known as Partygate, that during lockdown, when group gatherings were forbidden, Johnson hosted parties in the prime minister’s residence at No. 10 Downing St. Wine was wheeled in from a nearby shop in a suitcase. Johnson survived a recent no-confidence vote by his own Conservative Party but so narrowly that his premiership remains threatened.

The debate in England about these COVID-19 policies is immensely sensitive—given the staggering number of deaths—and highly politicized, with the Labour press arguing the government did not do enough during COVID-19 and some of the Tory press arguing the government did too much by enacting lockdowns.

Devi Sridhar’s Preventable: How a Pandemic Changed the World & How to Stop the Next One is a notable contribution to the still-raging debate. Sridhar, a professor of global public health at the University of Edinburgh, is broadly associated with the Labour-aligned stance—that is, the need to suppress the virus even if this was achieved through the curtailment of individual liberties such as freedom of movement. She has advised Scottish First Minister Nicola Sturgeon, as well as the World Health Organization, on COVID-19 and is a divisive figure in the U.K. because of these associations and her support for strict border closures.

Preventable itself is a wide-ranging book. It is in part a work of advocacy for a more muscular response by governments to pandemics and a work of analysis, comparing different countries’ methods of trying to control the spread of COVID-19.

A paramedic pushes a patient near a line of ambulances outside the Royal London Hospital Jan. 5, 2021. JUSTIN TALLIS/AFP via Getty Images

A paramedic pushes a patient near a line of ambulances outside the Royal London Hospital on Jan. 5, 2021. JUSTIN TALLIS/AFP via Getty Images

Because these different responses come not only from state capacity but also ideology, reaction to Sridhar’s book has been accordingly split. The U.K. progressive, anti-populist press is mostly supportive. The Guardian, where she is a contributor, was glowing. The Financial Times, which seems to advocate trusting the experts—particularly one as establishment as Sridhar (she co-wrote a book with Chelsea Clinton)—as an almost moral duty, was even more positive, getting straight to the political point in its review: “Preventable argues that … the poor leadership skills of populist leaders (such as Johnson, Donald Trump and Brasil’s Jair Bolsonaro) condemned some of the countries best equipped to fight the pandemic to failure in 2020.”

The story in the Tory press, which tends to be skeptical of COVID-19 lockdown measures—and Sturgeon—was very different. The Spectator, in an article titled “‘Please don’t do a hit job’: An interview with Devi Sridhar,” proceeded to do exactly that and was personal in its conclusion: “Now virtually the whole world—with the exception of hermit kingdom China—is living with Covid, being a former pin-up for Zero Covid is no longer quite such good box office.” A pre-publication article in the Spectator was even nastier, listing the book in a “guide to all the titles which won’t be flying off the bookshelves in the forthcoming months.” (It actually was a bestseller.) The article concluded: “With such an avalanche of epidemiological musing … remember the words of Christopher Hitchens: ‘Everyone has a book in them and that, in most cases, is where it should stay.’”

The truth however is that Sridhar’s book is highly nuanced and the author too intellectually heterodox and empirically oriented to be constrained by a single ideological perspective. There is no doubt she felt countries should have developed a COVID-19 control strategy. But unlike lockdown true believers, Sridhar is very candid that containment policies such as school closures involve trade-offs and can cause harm. As she writes, “School closures have far reaching and detrimental effects. Many children, especially in poorer countries, will never return to formal schooling again.”

It is tempting to now relitigate COVID-19 policy decisions made then by citing recent academic research questioning the efficacy of lockdowns. Both pro- and anti-lockdown camps have become amateur epidemiologists. Though they argue endlessly about science, neither side acknowledges the glaring political contradictions in each of their approaches: Zero-COVID adherents tend to be globalists who dream of a borderless world (for people, goods, services, and finance)—except when it comes to COVID-19, where free movement and activity must be tightly prescribed. Anti-lockdown populists pretty much feel the opposite in every respect.

One could read and critique Sridhar’s initial policy advice—favoring a more aggressive response to the pandemic, including tight border controls, social distancing, and the banning of nonessential travel—with the benefit of hindsight, but this would not be a very fruitful approach or a good use of the reader’s time. For one, Sridhar changes her thinking in response to changing evidence. As an example, she updated her analysis of the cost and benefits of school closures as more data came in showing the developmental harm closures caused to children and the limited risk of COVID-19 transmissions from schools.

More broadly, it is a fact that countries differed in the efficacy of their initial policy response to COVID-19 even if these policies didn’t always work in the long term. Some, like Taiwan, were able to contain the virus and had low early death rates. Others, such as the United States, which devotes more resources to health care than any other country in the world, could not mount an effective response at all.

Indeed, the core of Preventable, and what I believe will be its lasting contribution, is how and why countries responded to COVID-19 differently. Rich countries did not necessarily handle the pandemic better than poor ones, showing that something else is at work besides money. The specifics are complex, which is why the book exceeds 400 pages.


Sridhar’s framework is essentially political. “[W]ith the right politics and leadership, much of the suffering and death [from COVID-19] was largely preventable,” she writes. It is worth looking more closely at the initial policy successes of some countries and failures of others, as detailed in Preventable.

South Korea. South Korea’s response to COVID-19 was informed by its recent experiences with another virus: MERS (Middle East respiratory syndrome) in 2015. That experience did not go well: South Korea had the largest outbreak outside of the Middle East. As a result of MERS, South Korea put policies and planning in place for pandemics that proved critical when COVID-19 hit.

South Korea’s plans did not rely on a national lockdown, and schools were largely kept open, though social distancing was deployed. Instead, Sridhar writes, “the core of the South Korean response has been the test/trace/isolate system … and by March 2020 it had the highest per capita test rate in the world with results back within twenty-four hours.” In comparison, she notes, during this period the U.K. was only offering testing in hospitals.

If someone tested positive, South Korean public health teams traced that person’s activity over the previous week using phone and credit card data and closed-circuit TV. They were then asked to isolate at home or in specialized isolation centers, where their symptoms were continuously monitored to see if they required hospitalization. South Korea, according to Sridhar, attributed its low death rate to this monitoring system. The low oxygen levels stemming from COVID-19 may not be detectable by patients themselves, and so often in the United States patients showed up at hospitals when they were already gravely ill.

Sridhar terms the South Korean model, which is based on testing rather than lockdowns, “reasonably effective.” But, as she points out, it also involved something else: trust in the government and that it wouldn’t misuse the personal data it had gathered.

Senegal. Senegal is another one of the book’s case studies of success and one barely known in the global north. As of March 2021, it ranked second, right after New Zealand, in FP Analytics’ COVID-19 Global Response Index.

“President [Macky] Sall knew to go early, go hard and keep it simple,” Sridhar writes. Once COVID-19 was confirmed in the county, Sall closed schools and air travel and shut down large gatherings. This applied to mosques, with many choosing to worship from home.

Sridhar praises the country’s messaging efforts, including the use of religious leaders and musicians who released a single about beating the virus, “Daan Corona.” Senegal’s success also built on a more traditional disease management and surveillance infrastructure developed for infectious diseases such as Ebola.

As Sridhar writes, “What Senegal’s story shows is that even in the context of limited resources and scientific uncertainty, certain countries reacted quickly and effectively to prevent a crisis.”  Senegal’s success rested on leadership, messaging, testing, but also financial support for those who were impacted by COVID-19 restrictions and had no way to earn a living, allowing them to isolate.

Italy.
Two regions in Italy, Lombardy and Veneto, make for a clear case study within the same country of differing COVID-19 policy responses and their impact. Veneto took a strict containment approach accompanied by mass testing. Lombardy’s focus was on treating cases once they occurred rather than trying to prevent them. The results of these different strategies: Lombardy’s case fatality rate was three times that of Veneto, as of April 2020.

In Sridhar’s telling, these outcomes were not surprising, and what happened next in Lombardy was almost inevitable: As the pandemic worsened and Lombardy became a death zone, it implemented almost medieval extreme lockdown measures. There was almost no exit from or entry into afflicted areas. She was not surprised by this turn of events: Around the world, before vaccines became widely available, “mitigation strategies [allowing the virus to spread] … have always resulted in lockdown measures.”

New Zealand. New Zealand was distinctive in the Anglophone world for successfully pursuing a COVID-19 elimination strategy—of trying to eliminate the virus altogether rather than just flattening the curve through containment. (Australia attempted this, too.) To accomplish this, New Zealand closed its borders to everyone but citizens and long-term residents, who themselves were forced to quarantine in hotels if they chose to enter the country. In March 2020, the country entered a state of emergency with a stay-at-home lockdown.

The elimination strategy was successful: The country went 102 days without cases. But Sridhar also points out that it was not “without its challenges,” which she itemizes: Not everyone cooperated with lockdown and test and trace; lockdown took a psychological toll; and the closed border ruined tourism and separated families. Despite these misgivings, Sridhar titles her section on the country, “The Paradise of New Zealand.”

Sweden. Sridhar contrasts New Zealand’s approach with that of Sweden, which is typically held up as the poster child for the success of a laissez-faire or anti-lockdown approach. Underlying its hands-off approach to COVID-19 was the public health authorities’ belief that “the only sustainable way to deal with this kind of respiratory pathogen would be to let it flow through the population and avoid the economic and social costs of lockdown.”

Hence, Sweden did not pursue lockdowns or test and trace for that matter. Schools and restaurants stayed open and so did the border. These policies were in stark contrast to the containment measures deployed by other Scandinavian countries.

Did the Swedish lax approach work? Sridhar writes: “The debate is polarized.” In her analysis, Sweden’s “gamble” did not pay off. “Swedes paid a heavy price in that lives were lost unnecessarily. And, as the year progressed, Sweden went the same way as its Scandinavian neighbors—into suppression,” she writes.


Doctors and medical students wearing protective equipment as a preventive measure against COVID-19 attend a rally against the government medical plan in Seoul on Aug. 14, 2020.

Doctors and medical students wearing face masks and shields as a preventive measure against COVID-19 attend a rally against the government medical plan in Seoul on Aug. 14, 2020.Chung Sung-Jun/Getty Images

Among the analyses in Preventable of COVID-19 responses across countries and regions, one consistent finding is that poorer countries that took the approach of aggressively trying to contain the pandemic—such as Greece or the Czech Republic—fared better than richer countries, such as France, that were more hands-off, at least initially.

It is true that many of the countries that handled the first wave well, such as South Korea, New Zealand, and Senegal, struggled as time went on. But their strategies bought time until vaccines were available. And their economies were not as devastated as those of countries with laxer policies, according to Sridhar: “[T]hose countries that responded effectively and controlled the virus, like Taiwan, South Korea, Denmark and Norway, had faster economic recovery compared with countries like Britain, Spain and Sweden.”

But there is a puzzle in these overall patterns of response. It is clear from Sridhar’s telling that countries that undertook a coordinated national response involving test and trace and isolation handled the initial outbreak much better than the disorganized response of the United States and the U.K. Yet it is the latter two countries that were first able to develop effective vaccines.

Is this just a coincidence?

There is a reason to think not. The answer to this puzzle is found outside of Preventable, or even epidemiology writ large, and instead is provided by a niche area of political science studying economic development and varieties of capitalism.

Chalmers Johnson in his book MITI and the Japanese Miracle describes two economic systems, plan-rational vs. market-rational economies, a distinction common in the literature on the varieties of capitalism. Plan-rational economies are characterized by their governments’ focus on planning, with economic growth the overarching goal. (The Soviet Union was “plan ideological,” according to Johnson, so not part of this grouping.) In plan-rational economies, the state has a developmental orientation, and there is a great deal of state intrusion into the economy. Market-rational economies, in contrast, are centered on market efficiency, with the government playing primarily a regulatory rather than a planning role.

For Johnson, Japan was the exemplifier of the plan-rational system, with the United States the standard-bearer of the market-rational system. There are strengths and weaknesses in each system.

When there is a crisis where there is no consensus about what the long-term goal should be, and therefore how to plan for it, the plan-rational system stumbles. The market-rational system is better at coming up with new answers. Johnson writes that “the great strength of the market-rational system lies in its effectiveness with dealing with critical problems. … [Its approach] helps to promote action when problems of an unfamiliar or unknown magnitude arise.”

Johnson doesn’t discuss pandemics, but his dual-system typology, which is found elsewhere in political science, applies in this case. Plan-rational economies were distinguished by their planning and state effectiveness at controlling the pandemic—but only initially. In contrast, the more flexible market-rational U.S. and U.K. systems came through when it came to developing vaccines.

This typology of plan rational vs. market rational doesn’t map precisely to countries’ responses to the pandemic, but it roughly does, with COVID-19 control standouts of Taiwan and South Korea falling into the camp of plan rational.

The typology can be seen again in countries’ behavior once vaccines were developed. The United States and U.K. reverted to type—or rather, continued as type—with no planning for the next crisis. There were to be no more Operation Warp Speeds in the United States. In alignment with market efficiency, the U.K. made aggressive moves to rapidly sell off its vaccine manufacturing and innovation center, which had proved so useful in vaccine development. (Kate Bingham, who led the U.K. vaccine task force, denounced the government’s overall approach.)

And China, too, continues on its pre-chosen path. Even though vaccines are now readily available, it insists on pursuing a zero-COVID strategy, an authoritarian policy imposed at great cost.

The question is whether the United States can broaden its market-efficient economic approach, which has many strengths, to include planning capabilities, too. As Preventable demonstrates, planning was critical for early pandemic control, though in the long run it was not sufficient. Both approaches are needed. If the United States had added a bit more planning to the mix, many lives could have been saved during the initial outbreak.

The risks facing the United States going forward go well beyond just pandemics. Coronaviruses aren’t the only threat emanating from China. China poses unprecedented economic and military challenges to the United States. It is moving to a new economic model, one that combines state planning with market forces. By expanding its own economic model, the United States can respond more effectively to these new threats. Losing this competition is preventable.