SARS-CoV-2 is having a mixed impact across the globe. The WHO is tracking more than 100 subvariants of Omicron, and each country has a different makeup of “subvariant soup,” but two are winning the race: XBB and BQ.1.1. Couple this with changing behaviors and different immune histories (which wave hit and when; booster uptake), and country-to-country comparisons are getting harder than ever.
"(Keep in mind that reported cases remain flat; these no longer accurately reflect transmission due to at home antigen testing.) The City University of New York system is 24 colleges. across the 5 boroughs and the students and employees live not only in NYC but also outside of it in NJ, Long Island etc. They do randomized testing of faculty, staff and students (all who have at least had the initial vaccine) weekly.
It's a good way to track infection rates. During Omicron, the positivity rate was over 20%. It has stayed at 1.5% for the past two weeks. It is probably one of the best ways to consistently track transmission since people are picked at random.
I asked my GP here in Germany about getting a booster in December since my fiancé and I both had Covid in June. He is strictly following guidance of the Standing Commission for Immunization, which currently only recommends boosters for people over the age of sixty with at least 6 months since an infection or last immunization. Same applies to at risk persons with certain chronic diseases (which my coronary artery disease apparently is not). You’d think with the information in this report they would be thankful for every person looking to get boostered.
What is the current state of affairs on the All Variant vaccine that the Army and others were working on? I read that we won't be out of the playing catch-up mode until we develop a pan-sarbecovirus immunization.
How long after having been infected with COVID would you recommend waiting to get your fall booster? I suspect a lot of people haven't gotten the fall booster because they were infected during this summer's wave and the CDC is recommending waiting 90 days after infection to get boosted.
First of all, I enjoyed listening to your podcast with Andy Slavitt!
I understand social networks as a concept with monkeypox, but these new variants (which sound like Star Wars droid names) seem to spread quite easily beyond networks.
The possible correlation between low booster rates, Oktoberfest, and German health system collapsing does not bode very well for us here in the US. (Low boosters, holidays, health care workers down 20%). I continue to think that experts like Paul Offit here in Philly need to up their game.
The “our world in data” graph showing “number of COVID-19 patients in ICU per million people” is a total nightmare for people like me with color blindness. I can’t even try to comprehend that! Not your fault but we 8% of males get no ADA love.
Riding the wave. Working overtime to persuade patients. Ever masking in office, stores. Thanks again for the great update 👌
Oh how I hate to hear this and thank you for making sense of all the various variants! When will we know if we are getting more severe symptoms again? It scares me to think of variant like Delta with zero masks being worn!
Thanks for this update! I've heard the term "variant swarm" to describe the plethora of Omicron variants now out in the world, but "subvariant soup" seems more apt to me, especially since not all subvariants will proliferate in any given country or region. I'm doubly glad I received my fall bivalent booster last month. I'm continuing to mask up in public indoor spaces with a high quality N95 or KN95 mask. To echo Dr. Jetelina, definitely get the fall booster if you haven't already.
Thanks ! Timely update of crucial stuff, an example of an excellent epidemiological post that features accuracy plus concision. Sinclair Lewis' mythical George Babbitt would have been tickled greatly and probably would have boomed, "This update has punch, pow, and zip".
It's everywhere - the pandemic fatigue that is. So many of my neighbors are tired of sitting at home, wearing masks and going for that nth booster. I suspect that many have the mindset that natural immunity is the way to go because none of their immediate friends, family or relatives died - the Barrington Declaration mindset. Well, I don't accept that. I've read the science. My wife and I are vulnerable and we have had our 5th shots without significant incidents. But, then again we are not that significant cohort that gave up being cautious after the 1st shot and decided to play roulette. There are lots of folks at risk and will need treatment. Believe it or not not everyone has access to that EUA product Paxlovid. Germany may be the next big reservoir to spur the latest variant across the Pond. Let's hope not. After the debacles with the HCQ and Ivermectin there hasn't been a whole lot about repurposed drugs. I/we believe others are untapped nuggets that hasn't had a fair shake. Only those 2 highly politicized candidates made the ClinicalTrials. Both found to be inefficacious. On the CURE ID website one can review the efforts of the NIH, FDA, CDC, NCATS, and C-path to promote other repurposed drugs for treating COVID19. Many on the list are familiar but a number are not. Some are even more difficult to obtain than the Paxlovid and they surely are not EUA (= subsidized/free). On the CURE ID COVID-19 list of drugs being actively promoted the top drug - HCQ is a no-show. Trials showed no benefit. The 2nd drug on the list is a newcomer, but not new to our total pharmacopoeia. Our local experience with hydroxyurea (HU) spans over 2 years and counting. It's has a tried and true safety profile and multi-thousands of Sicklers benefit from using it DAILY over a period of years, yet it's under-utilized for this genetic disorders according to many Hematologists. The drug also carries a LOT of baggage as an antimetabolite. But it also has anti-viral activities and was well studied during the heyday of the HIV research. It's not new at all. HU has been shown to be safe and beneficial for more than one disease. HU enhances tissue oxygenation, reduces thromboembolisms, it increases HgbF. Lots of these pharmacodynamics beneficial in early and advanced COVID19. It's really unreasonable that this drug is labeled as a one drug one disease product, more so in the oncology and hematology areas and not immunomodulatory or infectious disease areas. Remember thalidomide? One drug, one disease but MAJOR fetal abnormalities resulting from its intended use as a soporific for some pregnant German women decades ago. It was shelved it for years and years. It's reincarnation as levalidomide for myeloma was a boon for those patients in need of therapy. Certain drugs can be useful for many disorders because there are common organ and cellular dysfunctions that have a common theme. COVID19 and Sickle Cell Disease have those commas themes for example. Check the case reporting under COVID19 in the CURE ID website: <https://cure.ncats.io>. People should not die or suffer the progression of the disease. Too often family, friends and physicians are standing by a COVID19 victim's bedside wringing their hands and cursing the virus and how futile is our current treatment approach. Think outside the box. Apply sound physiological principles. We have seen successes numbering nearly 2,000 prescriptions and counting. 5 days of HU at standard doses with 2mg folic acid x5 days is consistently efficacious in aborting the symptoms. As few as 2 days of HU has eliminated the need for hospitalization for progressive hypoxia or treatment of the cytokine response associated with many other organ dysfunctions. The T 1/2 for the drug is only 2-4 hrs. Toxicity and ADRs are unheard of by the recipients in our region. There have been NO reports of rebound/relapses. It appears to be efficacious for all the COVID19 lineages thus far. If you are a prescriber, please consider it. This is not misinformation. It's inexpensive, readily available, brief and SAFE. It's been used for only 3 days with inpatient advanced COVID19 cases followed by anticholinesterase inhibitor pyridostigmine titrations with tremendous success in restoring cognition from a comatose state, restoring swallowing, mobility, etc. All the typical myaesthenic deficits seen with MG are addressed with the immunomodulatory effects of HU and subsequent AChEI sequence of therapy. The other option is to watch the victim slowly succumb when other options have been exhausted. Do nothing? Comfort care is all that is left to do? Not so. Think outside the box. Be a patient advocate and not a demigod.
I have three friends who have recently come down with colds. They have done at home and PCR tests. Their results are negative for Covid. They all live in different cities.
I suppose it’s possible they all truly do have colds, or even the flu. Yet isn’t it also possible that as new variants emerge, the tests become less effective at detecting Covid?
Is there any kind of easy-to-read "family tree" site for the various lineages of SARS-CoV-2, possibly one that's searchable? I somehow missed the rise of BQ.11 and would like to figure out how it's connected back into things that I've at least heard of...
"(Keep in mind that reported cases remain flat; these no longer accurately reflect transmission due to at home antigen testing.) The City University of New York system is 24 colleges. across the 5 boroughs and the students and employees live not only in NYC but also outside of it in NJ, Long Island etc. They do randomized testing of faculty, staff and students (all who have at least had the initial vaccine) weekly.
It's a good way to track infection rates. During Omicron, the positivity rate was over 20%. It has stayed at 1.5% for the past two weeks. It is probably one of the best ways to consistently track transmission since people are picked at random.
https://www.cuny.edu/coronavirus/safety-tracker/
I asked my GP here in Germany about getting a booster in December since my fiancé and I both had Covid in June. He is strictly following guidance of the Standing Commission for Immunization, which currently only recommends boosters for people over the age of sixty with at least 6 months since an infection or last immunization. Same applies to at risk persons with certain chronic diseases (which my coronary artery disease apparently is not). You’d think with the information in this report they would be thankful for every person looking to get boostered.
What is the current state of affairs on the All Variant vaccine that the Army and others were working on? I read that we won't be out of the playing catch-up mode until we develop a pan-sarbecovirus immunization.
My profound thanks -- once more -- for trying to make sense of an increasingly complex situation.
How long after having been infected with COVID would you recommend waiting to get your fall booster? I suspect a lot of people haven't gotten the fall booster because they were infected during this summer's wave and the CDC is recommending waiting 90 days after infection to get boosted.
First of all, I enjoyed listening to your podcast with Andy Slavitt!
I understand social networks as a concept with monkeypox, but these new variants (which sound like Star Wars droid names) seem to spread quite easily beyond networks.
The possible correlation between low booster rates, Oktoberfest, and German health system collapsing does not bode very well for us here in the US. (Low boosters, holidays, health care workers down 20%). I continue to think that experts like Paul Offit here in Philly need to up their game.
The “our world in data” graph showing “number of COVID-19 patients in ICU per million people” is a total nightmare for people like me with color blindness. I can’t even try to comprehend that! Not your fault but we 8% of males get no ADA love.
Riding the wave. Working overtime to persuade patients. Ever masking in office, stores. Thanks again for the great update 👌
Oh how I hate to hear this and thank you for making sense of all the various variants! When will we know if we are getting more severe symptoms again? It scares me to think of variant like Delta with zero masks being worn!
Thanks for this update! I've heard the term "variant swarm" to describe the plethora of Omicron variants now out in the world, but "subvariant soup" seems more apt to me, especially since not all subvariants will proliferate in any given country or region. I'm doubly glad I received my fall bivalent booster last month. I'm continuing to mask up in public indoor spaces with a high quality N95 or KN95 mask. To echo Dr. Jetelina, definitely get the fall booster if you haven't already.
Thanks ! Timely update of crucial stuff, an example of an excellent epidemiological post that features accuracy plus concision. Sinclair Lewis' mythical George Babbitt would have been tickled greatly and probably would have boomed, "This update has punch, pow, and zip".
It's everywhere - the pandemic fatigue that is. So many of my neighbors are tired of sitting at home, wearing masks and going for that nth booster. I suspect that many have the mindset that natural immunity is the way to go because none of their immediate friends, family or relatives died - the Barrington Declaration mindset. Well, I don't accept that. I've read the science. My wife and I are vulnerable and we have had our 5th shots without significant incidents. But, then again we are not that significant cohort that gave up being cautious after the 1st shot and decided to play roulette. There are lots of folks at risk and will need treatment. Believe it or not not everyone has access to that EUA product Paxlovid. Germany may be the next big reservoir to spur the latest variant across the Pond. Let's hope not. After the debacles with the HCQ and Ivermectin there hasn't been a whole lot about repurposed drugs. I/we believe others are untapped nuggets that hasn't had a fair shake. Only those 2 highly politicized candidates made the ClinicalTrials. Both found to be inefficacious. On the CURE ID website one can review the efforts of the NIH, FDA, CDC, NCATS, and C-path to promote other repurposed drugs for treating COVID19. Many on the list are familiar but a number are not. Some are even more difficult to obtain than the Paxlovid and they surely are not EUA (= subsidized/free). On the CURE ID COVID-19 list of drugs being actively promoted the top drug - HCQ is a no-show. Trials showed no benefit. The 2nd drug on the list is a newcomer, but not new to our total pharmacopoeia. Our local experience with hydroxyurea (HU) spans over 2 years and counting. It's has a tried and true safety profile and multi-thousands of Sicklers benefit from using it DAILY over a period of years, yet it's under-utilized for this genetic disorders according to many Hematologists. The drug also carries a LOT of baggage as an antimetabolite. But it also has anti-viral activities and was well studied during the heyday of the HIV research. It's not new at all. HU has been shown to be safe and beneficial for more than one disease. HU enhances tissue oxygenation, reduces thromboembolisms, it increases HgbF. Lots of these pharmacodynamics beneficial in early and advanced COVID19. It's really unreasonable that this drug is labeled as a one drug one disease product, more so in the oncology and hematology areas and not immunomodulatory or infectious disease areas. Remember thalidomide? One drug, one disease but MAJOR fetal abnormalities resulting from its intended use as a soporific for some pregnant German women decades ago. It was shelved it for years and years. It's reincarnation as levalidomide for myeloma was a boon for those patients in need of therapy. Certain drugs can be useful for many disorders because there are common organ and cellular dysfunctions that have a common theme. COVID19 and Sickle Cell Disease have those commas themes for example. Check the case reporting under COVID19 in the CURE ID website: <https://cure.ncats.io>. People should not die or suffer the progression of the disease. Too often family, friends and physicians are standing by a COVID19 victim's bedside wringing their hands and cursing the virus and how futile is our current treatment approach. Think outside the box. Apply sound physiological principles. We have seen successes numbering nearly 2,000 prescriptions and counting. 5 days of HU at standard doses with 2mg folic acid x5 days is consistently efficacious in aborting the symptoms. As few as 2 days of HU has eliminated the need for hospitalization for progressive hypoxia or treatment of the cytokine response associated with many other organ dysfunctions. The T 1/2 for the drug is only 2-4 hrs. Toxicity and ADRs are unheard of by the recipients in our region. There have been NO reports of rebound/relapses. It appears to be efficacious for all the COVID19 lineages thus far. If you are a prescriber, please consider it. This is not misinformation. It's inexpensive, readily available, brief and SAFE. It's been used for only 3 days with inpatient advanced COVID19 cases followed by anticholinesterase inhibitor pyridostigmine titrations with tremendous success in restoring cognition from a comatose state, restoring swallowing, mobility, etc. All the typical myaesthenic deficits seen with MG are addressed with the immunomodulatory effects of HU and subsequent AChEI sequence of therapy. The other option is to watch the victim slowly succumb when other options have been exhausted. Do nothing? Comfort care is all that is left to do? Not so. Think outside the box. Be a patient advocate and not a demigod.
Thank you
I have three friends who have recently come down with colds. They have done at home and PCR tests. Their results are negative for Covid. They all live in different cities.
I suppose it’s possible they all truly do have colds, or even the flu. Yet isn’t it also possible that as new variants emerge, the tests become less effective at detecting Covid?
Hubby and I recently got our bivalent boosters. I wish we knew more about how much protection those vaccines will provide against XBB and BQ.1.1.
Are the Omicron variants still detected with at-home antigen tests?
What are we to make of Dr. Paul Offit’s comments? Should he still be an FDA advisor?
https://youtu.be/b5ehD3KLxc4
Is there any kind of easy-to-read "family tree" site for the various lineages of SARS-CoV-2, possibly one that's searchable? I somehow missed the rise of BQ.11 and would like to figure out how it's connected back into things that I've at least heard of...