Changing Times – January 13, 2022

from  Time Magazine

Inside the Nation’s Largest Guaranteed Income Experiment

Editor’s note:  Ten years ago I would have thought this is a really dumb ideal.  Today I am not so sure.  Robotics is why I have changed my mind.  For example, within 10 year autonomous drive trucks will be in common use. Experts say as many as 800,000 truck drivers could be impacted.  The country could be running out of jobs.  

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One evening in early June, Leo and his family were able to enjoy a treat they hadn’t experienced in months: a sit-down meal at a restaurant.

At a fried chicken chain in a Compton, California strip mall, they splurged on a few plates of fried rice, each costing under $13.99. The money Leo, 39, makes as a mechanic never seems to satisfy the deluge of bills that pile up on his kitchen counter each month, so the modest meal felt like a luxury. “It made me very happy,” Leo says in Spanish through an interpreter.

The family was only able to afford the meal because Leo is part of a groundbreaking guaranteed income experiment in his city called the Compton Pledge. In regular installments between late 2020 and the end of 2022, Leo and 799 other individuals are receiving up to $7,200 annually to spend however they like. Leo, an undocumented immigrant from Guatemala who TIME has agreed to refer to by a pseudonym to protect his identity, receives quarterly payments of $900.

The organization running Compton Pledge, called the Fund for Guaranteed Income, is building the technological infrastructure necessary to distribute cash payments on a broad scale and has partnered with an independent research group to study the extent to which a minimum income floor can lift families like Leo’s out of poverty. The pilot, which distributes money derived from private donors, is not just about giving people the ability to buy small indulgences. It’s testing whether giving poor families a financial cushion can have a demonstrable impact on their physical and psychological health, job prospects and communities. And perhaps the biggest question of all: Can these cash infusions transcend their status as a small research project in progressive Los Angeles and someday work as a nationwide program funded by taxpayers?

The theory is gaining momentum in the U.S. Six years ago, there were no programs distributing and studying the effects of providing swaths of Americans no-strings-attached cash, according to Stanford’s Basic Income Lab, an academic hub tracking such programs. But now, pilot programs are taking place in roughly 20 cities around the country, from St. Paul, Minnesota to Paterson, New Jersey, with Compton’s exercise serving as the nation’s largest city-based experiment in terms of number of people served. Most of the programs are philanthropically funded—including Compton’s—and distribute different amounts of money to targeted populations, from Black pregnant women to former foster children to single parents. These laboratories for wealth redistribution all have one thing in common: they give some of society’s poorest and most marginalized people cold-hard cash, and then let them spend it however they want.

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS –1/5/2022

Our Area “G” and area doctors are seeing lots of Omicron but the hospitals are not yet filled. 

From the Texas Tribune today:

”COVID-19 trends: With the omicron surge in full swing in the state, here’s the latest on what we know about COVID-19 trends.

Texas is reporting that 1 in 3 COVID-19 tests are coming back positive, a record high. The share of positive cases reported is called the positivity rate. A rate over 10% puts states in the “red zone,” according to federal guidelines. We are far past that threshold: Texas is at 34.4%.

Hospitalizations have more than doubled compared to two weeks ago. Keep in mind that hospitalizations are still far below the pandemic peak of 14,218 on Jan. 11, 2021.

Five of the state’s 22 hospital regions are reporting that more than 15% of local hospital beds are occupied by COVID-19 patients. Earlier in the pandemic, a threshold of 15% was one factor Texas Gov. Greg Abbott used to define a region as a “danger zone” that led to business closures. Abbott has taken a largely hands-off approach to the omicron variant.

At least 45 Texas hospitals reported that their ICU beds were filled to capacity last week. That is a rising number — but one that is still far below earlier pandemic peaks.

Meanwhile, many Texas K-12 schools are pushing through with plans for in-person classes despite a surge in COVID-19 cases as officials try to reassure parents and students they are prepared to open safely this week.”

[The Washington Post] Opinion | Omicron is bad. But we don’t need to resort to lockdowns. (recommended by the NYT)

”…where we are: The risk to individuals is low, while the risk to society is high. Policy solutions that demand substantial individual sacrifice will not work; instead, we need to acknowledge the public’s very real weariness and come up with practical strategies that keep society functioning…..

”Research is increasingly pointing to omicron causing less severe disease compared with previous variants. In addition, vaccination — especially with a booster — appears highly protective against hospitalization and death. The tsunami of viral transmission means that many vaccinated people will have breakthrough infections, but the vast majority will have symptoms somewhere between a mild cold and the flu….The United States has three options for dealing with this surge. First, we could reimpose lockdowns. While some European and Asian countries have chosen this path, I believe it’s a nonstarter here. Even if lockdowns could more quickly bring omicron under control, there is no political appetite or public backing for this level of collective sacrifice.

”Second, we could let omicron run its course. There’s a school of thought that omicron is so contagious it will infect nearly everyone anyway, and it’s better to get this variant and develop additional immunity. Instead of trying to stop it, we could treat omicron as we do a common cold: We don’t isolate people with colds, and getting rid of isolation and quarantine would alleviate staffing shortages and keep the economy going. However, this path of uncontrolled spread would almost assuredly push many hospitals over the edge, and patients could die because they can’t access timely care.

”There is a third path that aims to save our hospitals while also minimizing disruption. We don’t need to ask people to stay home, but we should require that they wear high-quality masks in all indoor public spaces. We don’t need to cancel gatherings, but we should mandate proof of vaccination — and boosters — for all indoor dining, gyms, movie theaters, and sporting events….The United States has three options for dealing with this surge. First, we could reimpose lockdowns. While some European and Asian countries have chosen this path, I believe it’s a nonstarter here. Even if lockdowns could more quickly bring omicron under control, there is no political appetite or public backing for this level of collective sacrifice.

There is a third path that aims to save our hospitals while also minimizing disruption. We don’t need to ask people to stay home, but we should require that they wear high-quality masks in all indoor public spaces. We don’t need to cancel gatherings, but we should mandate proof of vaccination — and boosters — for all indoor dining, gyms, movie theaters, and sporting events…

Initial results of a 4th-dose study in Israel show an expected rise in antibodies.

”…Israel is facing a surge in coronavirus cases, driven by the Omicron variant. In an effort to protect the most vulnerable parts of the population, Israel has already begun offering fourth vaccine doses to people 60 and over, to people with weakened immune systems, and to medical and nursing home workers…”

Coronavirus Disease 2019 (COVID-19)

What’s the difference between quarantine and isolation?

1. If you might have been exposed to COVID-19, you should stay home. This is called quarantine.
2. Quarantine keeps someone who might have been exposed to the virus away from others.
3. You should isolate if you have COVID-19, whether or not you have symptoms.
4. Isolation separates people who are infected with viruse from others, even in their home. 

WHAT TO DO IF YOU THINK YOU HAVE COVID?

1. Talk to your doctor if you have one.

2. Carefully Study this Texas website:

The Texas Department of State Health Services (DSHS)

(J. Harris: In my opinion, our Texas website is now GREAT.  If you take your time and check out the subcategories in which you have an interest, you will know t what to do if you are exposed, or get sick, want a vaccination, or want to go to the opera. The answers to most all questions will be on this site. In addition, our local Health Dept. can be reached at 903 938-8338.)

Quarantine and Isolation (In detail)

FROM  THE ATLANTIC: Several articles on testing.

1. The Atlantic Daily: What Rapid Tests Miss

2. Don’t Be Surprised When You Get Omicron

3. Stop Wasting COVID Tests, People

”We don’t want our limited testing supply “tied up by people who just want to know so they can visit their friends or go to the opera…But other types of COVID screening—before and after family gatherings, for instance, or while visiting nearby vacation destinations—are optional. It might seem reckless to suggest that people undergo less surveillance; indeed, the standard expert’s take has been the opposite, that we all should screen ourselves as often as possible in order to help reduce community spread. But even with increased testing, we stand little chance of controlling Omicron this winter at the population level. And testing is, for now, a zero-sum game. Each unnecessary swab that you consume means one fewer is available for more important purposes—such as diagnosing asymptomatic infection….We should also try to allocate tests based on underlying risks. The unvaccinated are, overall, most in danger of being hospitalized and dying from the virus, so they are also, overall, the people who benefit the most from having those around them screened for infection. Social bubbles being what they are, I suspect that many people with arsenals of at-home tests spend much of their personal time around other vaccinated and relatively low-risk individuals, making the public-health benefits of their personal screening programs marginal at best.”

AND LAST BUT NOT LEASED: 

NEW JOKES FROM MAYOR AUDREY KARIEL:

I had my patience tested. I’m negative.

 When one door closes and another door opens, you are probably in prison.

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P.O. Box 721

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75688

CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS –1/4/2022

Notice the “COVID PERCENT OF HOSP CAPACITY ” above. Last year, Gov. Abbot ordered a shut down when it reached “15” %. We remain well below that number (which reached about 26%). Area G admissions are up, but not spectacularly so. Thus, I am reasonably sure that we are mostly seeing the Omicron variant rather than Delta. Last year we had a max of 266 patients in G on ventilators. Currently, we have 39. Additionally, in most areas, unvaccinated people, often younger folks, make up most of the hospitalized patients. For a lot of us “mature” folks, it’s time for a 4th jab. The Harrison Cty Health Clinic has Pfizer vaccine.  903 938-8338. Many locals have recently been exposed to Covid, including me and my family — so we are hiding out at present. 

Global Percentage of Asymptomatic SARS-CoV-2 Infections Among the Tested Population and Individuals With Confirmed COVID-19 Diagnosis (FROM JAMA)

Key Points

Question  What is the percentage of asymptomatic individuals with positive test results for SARS-CoV-2 among tested individuals and those with confirmed COVID-19 diagnosis?

Findings  In this systematic review and meta-analysis of 95 unique studies with 29 776 306 individuals undergoing testing, the pooled percentage of asymptomatic infections was 0.25% among the tested population and 40.50% among the population with confirmed COVID-19.

Meaning  The high percentage of asymptomatic infections from this study highlights the potential transmission risk of asymptomatic infections in communities.

”…In this systematic review and meta-analysis, we found that the pooled percentage of asymptomatic SARS-CoV-2 infections among the tested population was 0.25%. Among the confirmed population, 40.50% of individuals had asymptomatic infections. The high percentage of asymptomatic infections highlights the potential transmission risk of asymptomatic infections in communities. Screening for asymptomatic infection is required, especially for countries and regions that have successfully controlled SARS-CoV-2. Asymptomatic infections should be under management similar to that for confirmed infections, including isolating and contact tracing….”

ALSO FROM CURRENT JAMA:

Analysis of COVID-19 Vaccine Type and Adverse Effects Following Vaccination

Conclusions

In this real-world cohort, serious COVID-19 vaccine adverse effects were rare, and overall adverse effects were similar to industry and government reports. This independent evaluation enabled the comparison of adverse effects between vaccine manufacturers, noting that adverse effects were more common with mRNA-1273 compared with BNT162b2. Large digital cohort studies may provide a mechanism for independent postmarket surveillance of drugs and devices.

(J. Harris: Reassuring  article wih good graphics and readable conclusions.)

FROM BECKER:

1  19 healthcare organizations suspending COVID-19 vaccination mandates

2. Michael Dowling: A call for civility and decency

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COVID Briefing – December 30,2022

from  the New York Times

An informed guide to the pandemic, with the latest developments and expert advice about prevention and treatment.

The year ahead

As we prepare to enter the third year of the pandemic, we have been hoping for more normality and less Covid disruption by now. Case counts are soaring to all-time highs in some parts of the world, and 2022 is shaping up to be just as uncertain as the last 12 months.

That said, we’ve made huge strides against the coronavirus this year. There are now multiple vaccines that offer powerful protection against the worst effects of Covid, as well as remarkably effective treatments for those who become infected.

Next year will bring more advancements, too, and I’ll be here to keep you updated on the science, and to gather the information and advice you need to live your best life during the pandemic.

Today, in the last Coronavirus newsletter of the year, I’m taking a look ahead. I spoke to Times reporters about some of the big pandemic issues they’ll be tracking in 2022. Here’s what they said.

Living with the virus. This week, Dr. Anthony Fauci was asked whether we had to start to live with the virus and accept some risk of mild infections. His answer was essentially yes.

“We’re never going to stop counting tests,” he said. But we’re going to have to adjust to some controlled spread of the virus, being more sensitive to economic and societal concerns, he said.

My colleague Noah Weiland, a health reporter at The Times, told me that we’d heard comments like this from top officials before, but this time he said it felt particularly notable amid the spread of the Omicron variant. So many people are getting sick, he said, and those who have not may have even resigned themselves to the possibility of an infection sometime in the coming weeks and months.

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P.O. Box 721

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75688

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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J. Harris: To me, the recent data above probably reflects increased Covid infections as well as increased testing. Since the numbers of hospitalized Covid patients remains low, likely the new infections reflect Omicron? It may be a little late for some of us, but masks and crowd avoidance are indicated again, especially for the elderly and frail. 

FROM NYT THIS AM:

1. Middlebury College moves to remote instruction amid an outbreak.

(J. Harris: Vermont has the highest vaccination rates in the US. I’d like to know how many of these students have been vaccinated before becoming ill. Watch.)

2. Protection from mRNA vaccines wanes for some older adults, a C.D.C. study finds.

(J. Harris: So, be sure you have had your 3rd jab. Call Health Dept. at 903 938 8338 to get local vaccination schedule. Boosters available for older teenagers as well.)

Omicron SARS-CoV-2 variant: a new chapter in the COVID-19 pandemic

(J. Harris: Current, brief summary and update of what we know about Omicron.)

”…In terms of diagnostics, the omicron variant is detectable on widely used PCR platforms in South Africa…There is no reason to believe that current COVID-19 treatment protocols and therapeutics would no longer be effective, with the possible exception of monoclonal antibodies, for which data on the omicron variant’s susceptibility are not yet available. Importantly, existing public health prevention measures (mask wearing, physical distancing, avoidance of enclosed spaces, outdoor preference, and hand hygiene) that have remained effective against past variants should be just as effective against the omicron variant.

Extrapolations based on known mutations and preliminary observations, which should be interpreted with caution, indicate that omicron might spread faster and might escape antibodies more readily than previous variants, thereby increasing cases of reinfection and cases of mild breakthrough infections in people who are vaccinated. On the basis of data from previous VoCs, people who are vaccinated are likely to have a much lower risk of severe disease from omicron infection. A combination prevention approach of vaccination and public health measures is expected to remain an effective strategy.

9 Reasons Why I Still Mask Up

(J. Harris: I have no idea who this “civilian” [non medical] writer is, but this short message makes several good points and has a couple of good analogies. My Internist friend in Houston maintains that masks are as important as vaccination — and he treats many Covid patients.)

From Hopkins:

Two Years Into This Pandemic, The World is Dangerously Unprepared for the Next One, Report Says (Washington Post) Nearly two years into a coronavirus pandemic that has killed more than 5 million people, every country, including the United States, remains dangerously unprepared to respond to future epidemic and pandemic threats, according to a report released Wednesday assessing the efforts of 195 countries. Researchers compiling the Global Health Security Index — a project of the Nuclear Threat Initiative, a D.C.-based nonprofit global security group, and the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health — found insufficient capacity in every country, which they said left the world vulnerable to future health emergencies, including some that might be more devastating than COVID-19. The assessment of each country’s ability to prevent, detect and respond to health emergencies in 2021 was based on public information. Researchers also weighed other factors, such as public confidence in government. The average country score for 2021 was 38.9 out of a possible 100 points, essentially unchanged from 2019. No country scored above 75.9.

AND LAST BUT NOT LEASED: WHY I DON’T GET COVID VACCINATED

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