1. EPI UPDATE The WHO COVID-19 Dashboard reports 643 million cumulative cases and 6.62 million deaths worldwide as of December 8. Global weekly incidence remained relatively stable last week, decreasing 1.3% compared to an increase of 16.8% the previous week. A total of 3.04 million cases were confirmed the week of November 28. Weekly incidence fell over the previous week in Africa (-64%)*, South-East Asia (-27%), Western Pacific (-10%), and the Eastern Mediterranean (-4%). The Americas (+14%) and Europe (+4.5%) regions experienced increasing weekly incidence. Global weekly mortality decreased from the previous week, down 17%.

*The WHO dashboard notes that data from the Africa region are incomplete.


The US CDC is reporting 98.8 million cumulative cases of COVID-19 and 1.08 million deaths. Incidence for the week ending November 30 remained relatively stable over the previous week, falling to 303,101 cases from 306,856 cases for the week ending November 23. Weekly mortality fell significantly for the week ending November 30, with 1,780 reported deaths compared to 2,634 deaths the week ending November 23. The decline could be a result of delayed reporting due to the US Thanksgiving holiday.

2. MASK USE The US CDC is once again encouraging people to wear masks to help reduce the spread of respiratory illnesses, as hospitalizations rise due to the so-called “tripledemic” of COVID-19, RSV, and flu. The nation appears to be at the start of another COVID-19 wave, with hospitalizations reaching a 3-month high last week. Hospitals are already feeling strain from earlier-than-normal increases in RSV and flu cases and hospitalizations. The US is experiencing the highest levels of hospitalization from flu that it has seen in a decade this early in the season. Experts warn that holiday gatherings present a prime opportunity for respiratory viruses to spread and urge people to take precautions, including mask use, physical distancing, testing, and increased air ventilation. While it is unlikely that widespread mask mandates will return, masking in crowded areas can lower the risk of infection and help decrease the burden on overwhelmed hospitals. 

One more reason to don a mask during the colder months could be to help keep your nose warm. A study published this week in the Journal of Allergy and Clinical Immunology suggests that exposure to cold temperatures hinder immune responses in the upper respiratory tract by killing nearly half of the virus and bacteria-fighting cells in the nostrils, allowing viruses or bacteria to evade this initial immune response. 

3. Authorities are urging indoor masking in major cities as the ‘tripledemic’ rages (NPR) Public health officials are revisiting the topic of indoor masking, as three highly contagious respiratory viruses take hold during the holiday season. Over the past few weeks, a surge in cases of COVID, the flu and respiratory syncytial virus — known as RSV — has been sickening millions of Americans, overwhelming emergency rooms and even causing a cold medicine shortage. The triple threat has been called a “tripledemic” by some health experts. Rochelle Walensky, director of the Centers for Disease Control and Prevention, noted this past week that the simultaneous combination of viruses has been straining healthcare systems across the country.

4. Wrangling Over the International Pandemic Pact Has Begun (Think Global Health) Health officials met this week in Geneva to discuss a rough draft of a pandemic treaty, an international plan to avoid another disaster on the scale of COVID-19. This is the first of many drafts to come, in a process that began with a decision made in December 2021 by the World Health Organization’s (WHO) 194 member states to develop something like a treaty—perhaps an accord, agreement, or other ‘instrument’—to govern the global pandemic response. The project is spearheaded by the WHO and is slated for completion in May 2024.


Nirmatrelvir Plus Ritonavir for Early COVID-19 in a Large U.S. Health System

”…In the EPIC-HR (Evaluation of Protease Inhibition for Covid-19 in High-Risk Patients) trial, nirmatrelvir plus ritonavir led to an 89% reduction in hospitalization or death among unvaccinated outpatients with early COVID-19. The clinical impact of nirmatrelvir plus ritonavir among vaccinated populations is uncertain….The overall risk for hospitalization or death was already low (1%) after an outpatient diagnosis of COVID-19, but nirmatrelvir plus ritonavir reduced this risk further.

”(During the study period, 12 541 (28.1%) patients were prescribed nirmatrelvir plus ritonavir, and 32 010 (71.9%) were not. Patients prescribed nirmatrelvir plus ritonavir were more likely to be older, have more comorbidities, and be vaccinated. The composite outcome of hospitalization or death occurred in 69 (0.55%) patients who were prescribed nirmatrelvir plus ritonavir and 310 (0.97%) who were not (adjusted risk ratio, 0.56 [95% CI, 0.42 to 0.75]). Recipients of nirmatrelvir plus ritonavir had lower risk for hospitalization (adjusted risk ratio, 0.60 [CI, 0.44 to 0.81]) and death (adjusted risk ratio, 0.29 [CI, 0.12 to 0.71]).”


1. Variants: Based on projections for the week ending Dec. 10, the CDC estimates that BQ.1.1 accounts for 36.8 percent of cases and BQ.1 accounts for 31.1 percent of cases nationally. All other lineages are decreasing in proportion this week compared to last week.

2. As of Dec. 7, a total of 1,080,472 COVID-19 deaths have been reported in the United States.

 3. About 64 percent of sites across the country are reporting moderate to high virus levels in wastewater. Of these sites, 38 percent are reporting some of the highest levels for those sites since Dec. 1, 2021.

4. About 27 percent of sites are seeing a decrease in virus levels and about 65 percent are reporting an increase.


Newsletter: You’re done with masks? That’s too bad, because COVID isn’t done with us


Will trust in science survive the pandemic?


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