December 24, 2021

For the next several days, the folks who keep up with COVID statistics are taking off work for the holidays. This comes at a bad time; the East Texas numbers are now going up.

Even vaccinated people should wear masks, space out, avoid crowds — especially indoor crowds in buildings with poor ventilation.

If you don’t feel well, don’t go out. When in doubt, test if you can find a test.

Avoid immunocompromised folks. Avoid sick folks. We still have hospital beds in this area at this time.

Most of the new cases are almost certainly Omicron which is probably less lethal than Delta. In the next six months, we will have several new drugs to treat Covid as well as enhanced and available testing capabilities.

New vaccines will be developed for any and all of the Variants when and if they appear.  The situation is improving. It remains prudent to be vaccinated and boosted.

J. Harris: The “77” for the 13th comes from Judge Sims and the MNM. I can’t find that data yet,  but they were correct a couple of days ago with a “35.”This would raise our “Cases Per 100,000” value considerably. Obviously, I am very concerned. I started wearing my mask again two days ago. We live in an unvaccinated county. This is probably still Delta. We should know soon. “Merry Christmas.”

My computer ate my homework and I inadvertently deleted some good stuff. Sorry. Today’s not a total loss, however. 

SARS-CoV-2 Vaccine Antibody Response and Breakthrough Infection in Patients Receiving Dialysis

”…In our cohort, we were able to implement an unbiased monthly serologic testing strategy to study postvaccination response in a geographically diverse population with sizeable proportions of racial and ethnic minority groups and patients with chronic illnesses (such as heart failure or diabetes). Using these real-world data from a time when the Delta variant of SARS-CoV-2 was also circulating widely in the United States, we found a clinically meaningful indication that antibody values measured using an accessible assay and at time points remote from vaccination are strongly associated with risk for breakthrough infection. This brings us closer to defining a “persisting antibody” threshold (34) for immunity. The relative importance of such a threshold may be greater for high-risk or immunocompromised groups compared with otherwise healthy persons because many components of their immune response may be impaired (35). This is evident in our data, as 40% of patients with breakthrough infection were hospitalized.

”…Several studies have reported a stronger initial antibody response with mRNA-1273 [Moderna] than with BNT162b2 [Pfizer] putatively due to the higher mRNA dose in the mRNA-1273 formulation (35, 38). Our longitudinal analyses confirmed that persons vaccinated with mRNA-1273 maintained slightly higher index values than those receiving BNT162b2 throughout the 6-month follow-up. A single dose of Ad26.COV2.S [J&J] did not yield a detectable antibody response in more than half of patients. The manufacturers of Ad26.COV2.S recently submitted data showing improved efficacy of this vaccine with 2 doses given 2 months apart (39). Finally, although healthy persons with SARS-CoV-2 infection before vaccination seem to mount peak antibody responses that are more than 2-fold higher than among those who were not infected (40), we found that antibodies among patients receiving dialysis wane over time regardless of prior SARS-CoV-2 infection and are equivalently low 6 months after vaccination. Patients with prior SARS-CoV-2 infection also experienced breakthrough infection in our cohort.”

From THE LANCET:

Serial antigen rapid testing in staff of a large acute hospital

(J. Harris: A short, readable description of Covid detection and containment in a large Singapore hospital.  An expensive and sophisticated serial testing program is described — the results must have pleased a staff that seemed  healthy and reasonable and intelligent to start with.)

Emerging SARS-CoV-2 variants: shooting the messenger

J. Harris: This is a short discussion of travel bands in countries who report variants. 

HOW ABOUT A GOOD JOKE?

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J. Harris: Just a  quick word and some new information from the British.The new Covid numbers are up our area, but the hospital admissions are not increased. We are likely testing more, finally,  as well. These new cases may be Omicron as well as Delta. I would avoid crowds and wear your masks, wash hands, keep distance and the like. Vaccination with 3 jabs helps considerably, but not completely. The state numbers are somewhat confusing, so I’m going with the NYT who seem to be doing better stats at this time (and are probably getting them from Hopkins) It appears Omicron may be less lethal than Delta, but should be avoided. Don’t try to catch it. The Omicron symptoms may only seem like a bad cold, but STAY AWAY from GRANDMA if you get sick. 

Omicron is speeding through Britain, and boosters help provide protection, U.K. scientists say.

”…the study, published by British government scientists on Friday, also indicated that third vaccine doses provided considerable defense against Omicron…Four months after people received a second dose of the Pfizer-BioNTech vaccine, the shots were roughly 35 percent effective in preventing symptomatic infections caused by Omicron, a significant drop-off from their performance against the Delta variant, the scientists found.A third dose of the Pfizer-BioNTech vaccine, though, lifted the figure to roughly 75 percent… Omicron is managing to spread [easily]. Someone infected with the Omicron variant, for example, is roughly three times as likely as a person infected by the Delta variant to pass the virus to other members of his or her household…a close contact of an Omicron case is roughly twice as likely as a close contact of someone infected with Delta to catch the virus…Even if Omicron causes [less] severe illness [for example] at only half the rate of the Delta variant… computer modeling suggested that 5,000 people could be admitted to hospitals daily in Britain at the [anticipated] peak of its Omicron wave — a figure [that would be] higher than any seen [previously] at any other point in the pandemic…”

The C.D.C. found 43 Omicron cases, almost all of them mild, in the first week of December.

”Forty-three infections with the Omicron variant were identified in 22 states during the first eight days of December, the Centers for Disease Control and Prevention reported on Friday, offering a first glimpse of the variant’s course in the United States.

One individual, who was vaccinated, required a brief hospital stay, and there were no deaths. The most common symptoms were cough, fatigue and congestion or a runny nose. The first cases appeared to be mild, but the report warned that “as with all variants, a lag exists between infection and more severe outcomes.”

Omicron, which has been deemed a variant of concern, is believed to be even more transmissible than the Delta variant, which continues to account for virtually all coronavirus infections in the United States.

The actual number of Omicron cases is almost certainly higher, but to what extent is uncertain. The country initiated enhanced genomic surveillance on Nov. 28 in order to increase the detection of Omicron, and an average of 50,000 to 60,000 coronavirus-positive specimens are now being sequenced every week.

The new variant contains mutations that may make it somewhat resistant to available treatments and to the body’s immune defenses, experts say.

Young adults under the age of 40 accounted for most of the Omicron cases. The majority — 34 individuals, representing 79 percent of the total — were fully vaccinated when they had their first symptoms or tested positive.

Fourteen of these people had received a booster dose before their diagnoses, and six had previously been infected with the coronavirus.

About one-third of those infected with Omicron had traveled internationally in the two weeks prior to testing positive or developing symptoms, indicating that the variant is spreading locally in communities, the report said.

The Omicron cases were found all over the country, including Hawaii, Washington State, California, Texas and Minnesota, as well as in more than a half-dozen states on the East Coast, including Florida, New York, Pennsylvania and Massachusetts.

The C.D.C. report predicted additional Omicron infections, transmitted in November, will be discovered in the coming days.

“Even if most infections are mild, a highly transmissible variant could result in enough cases to overwhelm health systems,” the authors warned. “The clinical severity of infection with the Omicron variant will become better understood as additional cases are identified and investigated.”

Experts are urging Americans to get vaccinated and to continue to practice precautions: wearing masks, improving ventilation in closed spaces, getting tested and going into quarantine, or isolation, if needed to slow transmission.

—by Roni Caryn Rabin

THANK YOU NY TIMES 

LASTLY:

I’m so old that there was no television when I was a child.

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75688