21 Comments
Jan 24, 2022Liked by Katelyn Jetelina

Wonderful summary, as always. Many at Yale follow your posts and rely on your clear explanations!

Sharing this feedback on today's post from Nate Grubaugh from Yale School of Public Health, who is tracking variants super closely, sequencing many samples and reports out here: https://covidtrackerct.com/variant-surveillance/ and on twitter @NathanGrubaugh. Evolving situation, for sure.

"As I mentioned during our meeting, while BA.2 is quite divergent from BA.1, it has a very similar receptor binding domain (RBD).

Two minor points.

I wouldn't call this "stealth Omicron" as we can use the lack of SGTF to identify it as Delta gets pushed out, but I understand their point.

I also disagree with the hypothesis that BA.1 or BA.2 are the result of evolution in animal reservoirs and additional spillover into humans. Omicron, as more of an upper airway infection, appears to be highly adapted for human-to-human respiratory transmission. In non-human animals, SARS-CoV-2 is probably not a primary respiratory pathogen, more likely fecal-oral. Based on other coronavirus evolution in animal reservoirs/intermediate hosts, what emerges is more of a lower respiratory tract infection, not upper.

Best,

Nate

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author

fantastic! thanks for this feedback

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I’m skeptical that Canada is “plumetting”. We may be going down or plateauing but no one knows the real numbers since some provinces have stopped testing people as they are running out of resources. So in my province only specific people (health workers, seniors homes, public institutions) can get tested and consequently are reported. There is no telling how many infected people are unaccounted for. So the only numbers we have are hospitalizations and deaths, the former of which is only now slowly going down. Just wanted to clarify that. And I do have a question, in instances like ours where majority of population are not being tested, is the positivity rate still a good metric to look at? I’ve been wondering as that is slowly decreasing as well.

Thanks so much for all you do!!!!

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Thank you so much for continuing to publish these ❤️ I seriously marvel at how you manage to get these completed and published so often despite working and having two tiny kiddos. From one parent to another, thank you!

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Jan 24, 2022·edited Jan 24, 2022

Dr. Jetelina, could a future piece of YLE address the policies and actions you would like the US to take in order to control the pandemic? Hypothetically, let's say you're the new CDC Director or pandemic board chief and POTUS defers to your advice. What would you want done?

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yes i’ve been trying to put my thoughts together. and it’s really difficult, but a post should be coming out soon

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That's great to hear! I look forward to reading your work. If it helps, I think Justin Feldman wrote a great piece about missed opportunities during the first year of the Biden admin. Here is a link: https://jmfeldman.medium.com/a-year-in-how-has-biden-done-on-pandemic-response-88452c696f2

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Dr. Jetelina, do you think cases have truly plateaued, or that testing has decreased (especially with the lack of reporting positives from home kits)? Thank you for all you do!

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i think cases have truly peaked because test positivity rate is also decreasing. i don’t true the raw county but i do trust the pattern. if TPR was still increasing, i wouldn’t trust case pattern

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Thank you for the incredible work you do. This blog is my only sane source of information on the pandemic. I just wanted to call attention to a miniscule typo - "We are loosing more Americans each day to COVID19 than we did during 9/11". Loosing should be losing with one o.

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thank you!!

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I so appreciate your newsletters with facts and science, not politics and opinions.

Will you talk about school masking? Does it work? Should we continue and when should we stop? I live and teach in one of the nation’s largest school districts that is going toe to toe with our new governor who said masks in schools should be a family’s choice. Teaching is hard enough, being mask cops isn’t our job but I want the staff and students to be safe.

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Thank you again for nice detailed information. Please try to help us with Acronyms that we might not be familiar with. I had to google orf1ab, S1, and RBD to find out they were various gene sections in the COVID virus, which made the chart with those TLAs on top of the box more understandable.

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Thank you for all the information you have been providing us with. Its been nice to have access to a reliable source of information.

How do you think things would look by the end of March? I have been trying to read on projections. I understand that this is difficult to predict due to the variants and human behavior. My family has been planning a trip to Disney World for Spring (we bought tickets before omicron and after the kids got vaccinated)… but I am wondering if we should cancel or pospone.

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Jan 24, 2022·edited Jan 24, 2022

Thanks again for your hard work. Question, why are you saying that Omicron may be milder compared to Delta? My understanding is that we did not know this definitively.

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founding

Would you be willing to translate this MMWR early release study into lay terms? It provides some much needed insight on the protection provided by previous infections, both with and without vaccines, but I've already seen it used to makes claims that may not accuately reflect the data. I know enough about statistics to know that I don't yet know enough to hold an informed conversation with friends or patients about this study. Converting hazard ratios into more familiar numbers, such as percent risk or odds would be very helpful. I did try the math, but I trust an epidemiologist's intepretation much more. Thank you for your continued work and helping us navigate these past few years.

Report link: https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm?s_cid=mm7104e1_e&ACSTrackingID=USCDC_921-DM73434&ACSTrackingLabel=MMWR%20Early%20Release%20-%20Vol.%2071%2C%20January%2019%2C%202022&deliveryName=USCDC_921-DM73434

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I will echo the posts of appreciation. You're doing really good, important work with these posts. One idea for a future post is to discuss the factors that might lead to long COVID. The NYT article has me intrigued what else we know about long COVID and what we still need to figure out. https://www.nytimes.com/2022/01/25/health/long-covid-risk-factors.html

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Thank you so much for the valuable, understandable information you share.

I understand that a virus can mutate. I don't understand how it does it on a broad scale. If I had Delta, how do I pass on Omicron?

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Dr. Jetelina or anyone reading, could you please cite a source for this part? "It is also very likely that there will be cross-reactivity: BA.1 infection will protect against BA.2 infection."

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On the graph that shows the cases per million, I noticed that India was almost flat on its cases, is it because of under reporting, a younger population or something else? Thank you for the great newsletter.

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I so appreciate your perspective -- cautionary but not alarmist!

Unlike some others I follow who are beginning to say that we should prepare ourselves for more "normal" behaviors as omicron passes. That feels like jumping the gun to me.

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