Daily Archives: November 11, 2021

As Americas pandemic for now seems to be moving into a new phase with national rates in decline from the September peak and vaccines rolling out to children, a new worry has appeared on the horizon: wildlife passing on the virus.

A new study shows that deer can catch the coronavirus from people and give it to other deer in overwhelming numbers, the first evidence of animals transmitting the virus in the wild. Similar spillover and transmission could be occurring in certain animal populations around the world, with troubling implications for eradicating the virus and potentially even for the emergence of new variants.

One-third of Iowa deer sampled over nine months had active infections, with a peak of 80% testing positive between November and January, according to a preprint study that has not yet been peer-reviewed or published.

It builds on previous findings that one-third of deer in other US states were exposed to the virus and developed antibodies, but it differs in showing high rates of active infections, which last for a much narrower window of time.

The virus very likely spilled over from humans to deer through several different interactions, and then it probably spread to other deer, according to the analysis.

Nearly everything about their study shocked the scientists. They knew deer could be infected with the coronavirus. But they were stunned by the numbers four out of five deer tested positive at the highest peak as well as high viral loads that were truly gobsmacking, Suresh Kuchipudi, clinical professor of virology at Penn State and coauthor of the study, told the Guardian. They were also surprised by the fairly clear links in the genetic analysis connecting human transmission to the animals and then the rapid transmission to other deer.

If there is spillover into free-living deer, it will rip through like wildfire, said Vivek Kapur, professor of microbiology at Penn State and coauthor of the study. This analysis was limited to Iowa, but the researchers believe widespread infection is just as likely among deer in other states.

Deer, which are abundant in North America and a popular target for hunters, are highly susceptible to SARS-CoV-2, and they may contract it by grazing on discarded food, drinking contaminated wastewater, or nosing through undergrowth where a person has spit or relieved themselves.

If they come in contact with the virus from any means of source, they are going to be infected, Kuchipudi said. It is highly likely that the animal will pick up the infection even though face-to-face interaction never happened.

These results have implications for other wildlife as well. It is possible certain other animals are also contracting and spreading the coronavirus around the world, which would make it difficult to eradicate the virus and to prevent mutations that could lead to new variants.

Around the world, SARS-CoV-2 has been reported in cats, dogs, ferrets, minks, lions, tigers, pumas and gorillas. Hyenas at the Denver zoo recently tested positive, the first confirmed cases in those animals.

In August 2020, an outbreak at a mink farm in Utah led investigators to sample wild mink nearby and they found antibodies and active infections in some of the wild animals.

In November 2020, Denmark killed 17 million mink after the virus jumped from people to farmed mink and back to people again the only documented case of animals passing the coronavirus back to people. The virus mutated, but none of the changes were dangerous.

Even before the Covid-19 pandemic, coronaviruses were well known for infecting animals, and vaccinations against common coronaviruses were standard for pets in the US.

Another coronavirus, which now causes mild cold symptoms, may have driven the 1889 pandemic that claimed 1 million lives and it probably spilled over from cattle. Notably, cattle have also passed coronaviruses to deer, prompting concerns that SARS-CoV-2 could similarly move between deer, cattle and people to possibly catastrophic effect.

A virus that can circulate among animals as well as people is much harder to eradicate.

Its much harder to get rid of a virus if it has a reservoir, Stanley Perlman, professor of microbiology and immunology at the University of Iowa, said. As people build immunity to viruses, fatalities begin to drop, but the viruses dont go anywhere the flu virus behind the 1918 pandemic still circulates today.

Its always gonna be with us. What form its in, I dont know hopefully, itll be an attenuated, weakened form, Perlman said.

This cross-species contagion can result in mutations and its hard to know whether these variations will be milder or more severe. So far, theres just been no evidence of spillback into humans from animals, Perlman said.

But the more any virus circulates and moves around, the more opportunity it has to mutate, Ellen Carlin, assistant research professor at Georgetown Universitys Center for Global Health Science and Security, told the Guardian.

Just because a virus mutates, that doesnt mean its a problematic mutation for human or animal health. But it could be, so we need to watch for that, Carlin said. Anything is possible at this point.

The emerging evidence on animal reservoirs increasingly points to the need for several long-term efforts to stem the viruss spread, Carlin said. Vaccines for humans, for instance, can only go so far in preventing cases when a virus is circulating among animals.

We need to do a better job detecting these viruses in animals before they reach people, and we need to be doing a better job preventing spillover before it happens. And that requires addressing really tough challenges, like land use change and deforestation and climate change and urbanization, Carlin said. It also requires investing in health care and monitoring systems, experts say.

The study in deer is a really hard reminder that we need to do a much better job funding wildlife research, not just for SARS-CoV-2 but for other infectious diseases, Carlin said. We have scientists who are more than capable of going out there and figuring out whats going on with SARS-CoV-2, but theres no real system in place to do that on a national level.

More research would also reveal whether or how animals spread the virus across species, including to people.

If research like this hadnt been conducted, Kuchipudi said, the outbreaks among Iowa deer would have gone undetected. There was a silent epidemic, if you will, happening in the deer, he said. We would have never known unless we tested the samples.

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As Covid recedes in US a new worry emerges: wildlife passing on the virus - The Guardian

A child and a dog run along a beach in Haiti, from where health workers appear to have contracted a new coronavirus. Around the world, in Malaysia, a similar coronavirus has been found apparently being passed to humans from dogs. Hector Retamal/AFP via Getty Images hide caption

A child and a dog run along a beach in Haiti, from where health workers appear to have contracted a new coronavirus. Around the world, in Malaysia, a similar coronavirus has been found apparently being passed to humans from dogs.

Early in 2017, a team of medical personnel, including doctors, nurses and volunteers, returned home to Florida after volunteering at a clinic in Haiti. Soon after their return, 20 members of the team began to feel a bit under the weather.

"They had a slight fever and didn't feel 100% right," says virologist John Lednicky at the University of Florida. "But they weren't very sick."

At the time, Zika virus was circulating in Haiti, and health officials were worried the travelers might have been infected, potentially importing the mosquito-borne illness to Florida. So officials took urine samples from each traveler and asked Lednicky to test for Zika.

Lednicky ran the standard PCR tests for the virus, and they all came back negative. But he wasn't satisfied. He had a hunch that the urine samples did contain a virus not Zika but something else.

So he took a little bit of the urine from six of the travelers and added it to a special solution of monkey cells. The goal was deceptively simple: to see if any viruses in the urine would infect the monkey cells, start replicating and grow to detectable levels. Then Lednicky could collect the virus's genes and identify it.

"This is what we do in our lab," Lednicky says. "We cast a wide net. We try to isolate viruses. And oftentimes, when we do that, the unexpected happens."

Indeed, the unexpected occurred.

"We found a coronavirus," he says. And not just any coronavirus, but one that many scientists believe may be a new human pathogen likely the eighth coronavirus known to cause disease in people. Turns out, this coronavirus in the Haiti travelers has cropped up previously, on the other side of the globe.

Back in May, scientists at Duke University reported they had detected a nearly identical virus coronavirus in children at a Malaysian hospital.

The researchers found the virus in the upper respiratory tract of 3% of the 301 patients they tested in 2017 and 2018.

The genetic sequence of the Malaysian virus suggested it likely originated in dogs and then jumped into people. "The majority of the genome was canine coronavirus," virologist Anastasia Vlasova told NPR in May.

Although the findings sounded alarming, the researchers had no evidence that the virus could spread among people or that it was widespread around the world.

"These human infections with ... canine coronaviruses appear to be isolated incidents which did not lead to extensive human transmission," virologist Vincent Racaniello wrote on the Virology Blog.

Now Lednicky and his colleagues have found an almost identical virus infecting people 11,000 miles away at the same time. The genetic sequence of the virus in Haiti is 99.4% identical to the one in Malaysia. Lednicky and his colleagues reported this past Sunday in the journal Clinical Infectious Diseases.

And the big question is: How does a dog virus in Malaysia wind up in doctors and nurses in Haiti?

"The virus probably circulates widely, but no one has paid attention to it," Lednicky says. He suspects it's all over the world. And if you've been around dogs frequently, you might have been infected with this virus or developed an immunity to it by exposure to similar virus. "We'll know when scientists start looking for antibodies inside older blood samples taken from patients with respiratory disease. How many of them were misdiagnosed all along?"

Some scientists also think doctors and researchers should start actively looking for this virus in patients. "I think that's important for several reasons," says virologist Linda Saif at Ohio State University, who has studied coronaviruses for about 40 years.

"No. 1, this virus has been associated with a number of pneumonia cases in children, and No. 2, we really don't know if it can transmit from human to human," she adds.

The fact that scientists detected the almost-identical viruses in both Haiti and Malaysia, at the same time, suggests the virus does spread among people, Saif says.

"There's a temporal sequence here. These two viruses which are very, very similar have been detected in a similar time frame but in widely separated regions of the world," she explains. That could happen if a nearly-identical virus was circulating in dogs in both Haiti and Malaysia and then jumped over to people in both countries during the same year.

"I would be very surprised if that happened," Saif says.

The second hypothesis is that the virus is circulating in people, at low levels, in many parts of the world, under the radar. "That hypothesis is more likely," Saif says.

If that hypothesis turns out to be true, this canine coronavirus will be the eighth coronavirus known to spread among humans.

On the surface, these new findings sound like horrible news. The last thing the world needs right now is another coronavirus one that may trigger pneumonia in children. But Jonna Mazet says it's actually good news because it means scientists have caught this virus before it has caused a big problem.

"The very exciting part is that people are starting to do virus discovery and characterization, even when large groups of people aren't dying and or getting severely ill, which is how most virus discovery has happened in the past," says Mazet, who's an epidemiologist at the University of California, Davis and the founding executive director of the One Health Institute there.

By finding this virus early, scientists now have time to study it, create tools to diagnose it and understand what it might take to stop it. Although it's not a cause for deep concern at this time, there's always the risk the virus could evolve and become a bigger problem, Mazet says, as was likely the case with SARS-CoV-2, which causes COVID-19.

"Almost certainly, SARS-CoV-2 was circulating for quite some time and making people either a tiny bit sick or not sick enough to be noticed," she says. If scientists had detected it at this stage, perhaps the world would have had time to develop a test for it, some promising treatments and even a preliminary vaccine. Perhaps the pandemic would have taken a much different perhaps less deadly course.

"We need to find these novel viruses well before they fully adapt to humans and become a pandemic problem," writes epidemiologist Gregory Gray, from the University of Texas Medical Branch, in an email to NPR. "Fortunately, today we have the tools to both detect and evaluate the risk of such novel viruses. We just need the political will and financial support to do so."

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New coronavirus, likely from dogs, could be 8th coronavirus to spread in humans : Goats and Soda - NPR

The contagious delta variant is driving up COVID-19 hospitalizations in the Mountain West and fueling disruptive outbreaks in the North, a worrisome sign of what could be ahead this winter in the U.S.

While trends are improving in Florida, Texas and other Southern states that bore the worst of the summer surge, its clear that delta isnt done with the United States. COVID-19 is moving north and west for the winter as people head indoors, close their windows and breathe stagnant air.

Were going to see a lot of outbreaks in unvaccinated people that will result in serious illness, and it will be tragic, said Dr. Donald Milton of the University of Maryland School of Public Health.

In recent days, a Vermont college suspended social gatherings after a spike in cases tied to Halloween parties. Boston officials shut down an elementary school to control an outbreak. Hospitals in New Mexico and Colorado are overwhelmed.

In Michigan, the three-county metro Detroit area is again becoming a hot spot for transmissions, with nearly 400 COVID-19 patients in hospitals. Mask-wearing in Michigan has declined to about 25% of people, according to a combination of surveys tracked by an influential modeling group at the University of Washington.

Concern over COVID in general is pretty much gone, which is unfortunate, said Dr. Jennifer Morse, medical director at health departments in 20 central and northern Michigan counties. I feel strange going into a store masked. Im a minority. Its very different. Its just a really unusual atmosphere right now.

New Mexico is running out of intensive care beds despite the states above-average vaccination rate. Waning immunity may be playing a role. People who were vaccinated early and have not yet received booster shots may be driving up infection numbers, even if they still have some protection from the most dire consequences of the virus.

Delta and waning immunity the combination of these two have set us back, said Ali Mokdad, a professor of health metrics sciences at the University of Washington. This virus is going to stick with us for a long, long time.

The delta variant dominates infections across the U.S., accounting for more than 99% of the samples analyzed.

No state has achieved a high enough vaccination rate, even when combined with infection-induced immunity, to avoid the type of outbreaks happening now, Mokdad said.

In a deviation from national recommendations, Colorado Gov. Jared Polis signed an executive order Thursday that allows any resident 18 or older access to a COVID-19 booster shot, another step to prevent hospitals and health care workers from being overwhelmed by the states surge in delta infections.

Progress on vaccination continues, yet nearly 60 million Americans age 12 and older remain unvaccinated. Thats an improvement since July, when 100 million were unvaccinated, said White House COVID-19 coordinator Jeff Zients.

First shots are averaging about 300,000 per day, and the effort to vaccinate children ages 5 to 11 is off to a strong start, Zients said at a briefing Wednesday.

Virginia Techs Linsey Marr, a leading researcher on the airborne spread of the coronavirus, predicted the northward spread of the virus in a Twitter post Sept. 15. The virus spreads in the air and can build up in enclosed rooms with poor ventilation. Colder weather means more people are indoors breathing the same air, Marr said.

Imagine that everyone you spend time with is a smoker and you want to breathe as little of their smoke as possible, she said.

The closer you are to a smoker the more exposure you have to that smoke, Marr said. And if youre in a poorly ventilated room, the smoke builds up over time.

Marr said she and her vaccinated family will use rapid tests before gathering for Christmas to check for infection.

Its hard to know whats coming next with this virus, Marr said. We thought we knew, but delta really surprised us. We thought the vaccine would help end this, but things are still dragging on. Its hard to know whats going to happen next.

___

Associated Press Writer Ed White in Detroit contributed to this report.

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COVID-19 hot spots offer sign of what could be ahead for US - Associated Press

BERLIN The University Hospital of Giessen, one of Germanys foremost clinics for pulmonary disease, is at capacity. The number of Covid-19 patients has tripled in recent weeks. Nearly half of them are on ventilators.

And every single one is unvaccinated.

I ask every patient: Why didnt you get vaccinated? said Dr. Susanne Herold, head of infectious diseases, after her daily round on the ward on Thursday. Its a mix of people who distrust the vaccine, distrust the state and are often difficult to reach by public information campaigns.

Patients like hers are the main drivers of a fourth wave of Covid-19 cases in Germany that has produced tens of thousands of new daily infections more than the country has had at any point in the pandemic.

For Germany it is a startling turnabout. At the onset of the pandemic, Germany had set an example for how to manage the virus and keep the death toll low. It was quick to put in place widespread testing and treatment, expand the number of intensive care beds and had a trusted leader in Chancellor Angela Merkel, a trained scientist, whose governments social distancing guidelines were widely observed.

But today, a combination of factors has propelled a new surge, among them wintry temperatures, a slow rollout of booster vaccines, and an even more pronounced spike in infections in neighboring eastern European nations like the Czech Republic. The fact that Germany is in a kind of political limbo as it transitions between governments has not helped.

But virologists and pandemic experts say there is little doubt that it is the unvaccinated who are contributing most to the wave of infections burdening in hospitals across the country.

Its our low rate of vaccination we havent done what was necessary, said Dr. Herold in Giessen. She was part of a team of scientists who modeled the impact of a fourth wave and warned in early summer that with the hyper contagious Delta variant at least 85 percent of the whole population would need to be vaccinated to avert a crisis in the health care system.

We are still below 70 percent, she said. I dont know how we can win this race against time with the fourth wave. I fear weve already lost.

Germanys vaccination rate is far better than that of many central and eastern European countries, where the death toll from coronavirus is soaring. In Romania, for example, only about four in 10 people have had two shots, and coronavirus deaths have hit record levels.

Still, with about one in three Germans not yet fully vaccinated, the German vaccination rate is among the lowest in Western Europe. In Belgium, Denmark and Italy three in four people are fully vaccinated. In Spain and Iceland, only about two in 10 have yet to get the second shot. Portugal has a vaccination rate of close to 90 percent.

The German rate lags because of pockets of vaccine resistance that are not limited to, but especially deep, in the former Communist east, where the far-right Alternative for Germany party is strong. Tino Chrupalla and Alice Weidel, leaders of the AfDs parliamentary group, are both proudly unvaccinated and both tested positive for the virus in recent weeks.

What we are experiencing is above all a pandemic of the unvaccinated, the minister of health, Jens Spahn, said earlier this month.

Infections have also spiked in parts of Bavaria and Baden-Wrttemberg, two wealthy southern states that are home to a noisy protest movement against measures to combat the virus, known as the Querdenker, or contrarians.

We have two viruses in the country, Markus Sder, the Bavarian governor, said in a television debate recently. We have coronavirus and we have this poison, which is being spread on a massive scale, he said referring to misinformation about vaccines.

Nov. 11, 2021, 4:16 p.m. ET

Klaus-Peter Hanke knows about that poisonous propaganda firsthand.

He is the mayor of Pirna, a town of less than 40,000 in the eastern state of Saxony, which experienced a wave of violent protests from anti-vaxxers in the final days of the lockdown last spring.

One in three voters in the voting district that includes Pirna cast their ballots for the AfD in Septembers national election. And just under half of inhabitants refuse to get vaccinated. They have helped to make Saxony the state with the lowest vaccination rate in Germany and with the highest per capita number of new infections.

The readiness to get vaccinated is low here, Mr. Hanke said in an interview. We tried to counter that with dialogue. But there is a point where you hit a wall, and you just cant get any further and one result is that it has escalated.

The Covid ward at the hospital is running out of beds. There, too, almost all patients are unvaccinated, Mr. Hanke said: Nine out 10.

And still, several restaurants in town have signs in the window, inviting everyone not just those vaccinated or recovered from an infection as per state rules to come inside.

There are now 10 control teams of three people each a police officer a health official and someone from the department of public order who roam the citys restaurants, bars and hairdressers and fine those disregarding the rules on the spot: Owners have to pay 500 euros, about $572, patrons 150 euros, $170.

Its pretty drastic, said Mr. Hanke, who has vaccine resisters in his own circle of friends. But we see no other way to get people to change their behavior.

Anecdotally at least, the tough approach might be paying off. Waiting times at mobile vaccination units increased to two hours this week, Mr. Hanke reported, suggesting that the threat of exclusion from much of indoor public life might be nudging more people to get a shot.

Several other German states are now working on similar regulations, introducing stricter mask mandates and instead of a negative test, making proof of vaccination or past infection mandatory for entry to many venues.

That may no longer be enough, said Sandra Ciesek, director of the Institute of Medical Virology at the University Hospital of Frankfurt and cosignatory of a paper by seven prominent scientists published last week, in which they urge politicians to speed up booster shots and consider a range of measures, including partial lockdowns for the unvaccinated or even a short-term national lockdown.

The absence of political leadership at the national level at a time when the number of new daily infections is soaring beyond 50,000 has added to the muddled approach to containing the virus.

Since her conservative party lost the national election in September, Ms. Merkel remains only as the head of a caretaker government while her likely successor, Olaf Scholz, has been absorbed by difficult coalition talks with two other parties.

Where is Angela Merkel? Der Spiegel asked in an article this week, before asking a few paragraphs lower: Where is Scholz?

It is a question many virologists across the country are asking, too, concerned that a lack of political leadership is wasting valuable time and potentially costing lives.

There is no real center of power and responsibility: The country is missing leadership, said Michael Meyer-Hermann, head of the department of Systems Immunology at the Helmholtz Centre for Infection Research and a member of the council of experts that has advised Ms. Merkel throughout the pandemic.

The outgoing government no longer really reacts, and the incoming government is playing everything down, he added.

After the number of daily new coronavirus infections hit a record high on Nov. 3, reaching 33,949, German virologists sounded the alarm. The response from Mr. Scholzs future coalition partners was a statement promising that there would not be another lockdown.

For me it was a key moment, Professor Meyer-Hermann said. They act like the pandemic is over at a time when the numbers are exploding.

Christopher F. Schuetze contributed reporting.

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Germanys Fourth Covid Wave: A Pandemic of the Unvaccinated - The New York Times

There are continued concerns that California could see a resurgence of COVID-19 over the coming weeks and months.

What that might look like, and how severe it may ultimately turn out to be, remains an open question.

Officials and experts largely agree that California is unlikely to see a surge that reaches the grim heights of last winters which overloaded hospitals with COVID-19 patients and killed tens of thousands statewide largely because many residents are already vaccinated.

But a spike in cases during the winter months, when temperatures fall and a packed holiday calendar might tempt residents to travel and mingle without taking appropriate precautions, is still a real possibility.

With cases ticking up in most parts of the state, we cannot let our guard down, and we cannot underestimate this deadly virus, Dr. Toms Aragn, director of the California Department of Public Health and the states public health officer, said in a statement Monday.

Heres a breakdown of where we are.

Health officials have been warning about a potential new rise in COVID-19 cases in California as seniors who got their shots last winter and havent received a booster shot may start to see their immunity wane, leaving them exposed to greater risk for infection and hospitalization, and as people gather indoors more with cooling weather and approaching holidays.

Demand for booster shots has fallen below expectations in California. And each infected Californian is increasingly spreading the coronavirus to more people.

As of Saturday, computer models estimated that every infected Californian was spreading the virus on average to 0.96 other people. If that number rises above 1, that will set the stage for further growth of the pandemic.

Officials are hopeful that strict vaccination requirements in some of Californias most populated areas will help slow the spread of cases in the winter. In Los Angeles, a new city rule generally requiring patrons to show proof of full vaccination to enter venues such as indoor restaurants, gyms, movie theaters, and hair and nail salons went into effect Monday but wont be enforced until after Thanksgiving.

Statewide, infections and COVID-19 hospitalizations have plateaued following months of decline.

But in some areas with lower vaccination rates, hospitalizations for COVID-19 have risen significantly since mid-October: by 35% in San Bernardino County and 27% in Fresno County. Even in Orange County, where vaccination rates are relatively high, COVID-19 hospitalizations are up by 29% over the same time period.

The San Joaquin Valley is reporting the states highest rate of COVID-19 hospitalizations; for every 100,000 residents, the region has 25 people hospitalized with COVID-19, compared with 15 per 100,000 in rural Northern California, 14 in the greater Sacramento area, eight in Southern California and four in the San Francisco Bay Area.

Some experts say a rate of five or greater is concerning.

In Southern California, San Bernardino and Riverside counties are reporting the worst hospitalization rates per 100,000 residents: 15 and 10, respectively. San Diego County is at eight, Orange County seven, L.A. County six and Ventura County four.

On Nov. 8, 2020, California reported a seven-day average of 6,200 new coronavirus cases a day. One month later, the state was reporting 26,000 new cases a day. In early January, the number jumped to more than 45,000. Daily reported caseloads didnt consistently fall back below 10,000 until mid-February.

Current case rates are roughly the same as last year at this time. For the seven-day period that ended Monday, California was reporting 5,720 new coronavirus cases a day, according to data compiled by The Times.

Nearly 62% of Californians are fully vaccinated.

However, there are millions of residents statewide who have less protection against the coronavirus. Given the evidence that vaccine immunity can wane over time, officials stress that its important for everyone eligible particularly those who are at high risk of severe COVID-19 symptoms to get a booster shot.

Unvaccinated Californians continue to be disproportionately affected by the pandemic, state data show. Unvaccinated individuals are roughly seven times more likely to get COVID-19, 10 times more likely to require hospitalization and 17 times more likely to die than those who are vaccinated.

The biggest concentration of coronavirus cases has expanded from Montana, North Dakota and Wyoming and is spreading farther south, through Colorado, Utah, New Mexico and Arizona.

States with low vaccination rates, such as Wyoming, where only 44.5% of residents are fully vaccinated, are seeing among the nations highest case rates, as are several states with vaccination rates similar to Californias 61.9%, such as Colorado at 62.1%, New Mexico at 62.6% and Minnesota at 61.6%, said Dr. George Rutherford, a UC San Francisco epidemiologist and infectious diseases expert.

Even in highly vaccinated places like New Hampshire and Vermont, you can see how these northernmost tiers of counties are starting to develop outbreaks and more transmission, as is Alaska, Rutherford said recently at a UC San Francisco forum.

Thats why Colorado, New Mexico and Minnesota could be warning signs of Californias future, Rutherford said. Those three states have weekly coronavirus case rates that are triple what California is reporting now. Wyomings is more than 3 times worse than Californias.

Rutherford said that relatively speaking, L.A., Orange and Ventura counties are doing well. But he warned that San Diego, Riverside and San Bernardino counties have a fairly high level of cases.

These factors all suggest that unvaccinated people should get their shots, including children ages 5 to 11 who just became eligible last week, Rutherford said.

People who have recovered from COVID-19 still need to get immunized, too. A study published by the U.S. Centers for Disease Control and Prevention said COVID-19 survivors who remained unvaccinated were five times more likely to get a new coronavirus infection compared with fully vaccinated people who had never been infected.

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Should California worry about another winter COVID-19 surge? - Los Angeles Times

Twenty months into the pandemic, and the COVID ward at the Royal Preston Hospital is getting busy again.

Admissions have almost doubled over the past month.

So who are the patients ending up on Ward 23 - dubbed the COVID ward?

They are young and unvaccinated, but they are also beginning to be those who have not had their booster jabs.

We met Michael Croft, 73, who welled up as he described the terror of being told he needed to go to ICU.

He has had both jabs but had not booked a booster as the letter arrived the day he was admitted to hospital.

"It's frightening," Mr Croft told us. "To be really honest, I didn't realise how serious it was on ground level because until you've been in here, you don't know."

In the next bed, we met Adam McBride, 37, who was admitted three weeks ago after his breathing rapidly deteriorated.

Mr McBride, who is unvaccinated, said he had meant to book a jab but had not got around to it. He spent his 37th birthday in intensive care.

"I don't know if I was on my deathbed but I certainly felt like it," he said, before adding that if the vaccine reduces the chance of going through "what I've been through" then it needs to be taken.

Dr Mohammed Munavvar, who has been running the COVID ward at the Royal Preston since the start of the pandemic, said he knows what the virus can do - but he also knows what the vaccines can do.

He explained: "In the group of patients who deteriorate and require critical care admission, the vast majority still are unvaccinated or have received only a single dose of the vaccine."

Dr Munavvar also said he is seeing more patients who have been fully vaccinated but whose condition is much less severe and their stays shorter. That's why he says the boosters are vital.

Another problem became apparent during our visit: COVID is having a huge impact on patients with other serious respiratory illnesses, such as pneumonia or lung cancer, who need hospital treatment.

We saw a bay with six beds lying almost empty because someone had unexpectedly tested positive which meant no non-COVID patients could be allowed in.

You could hear the frustration in Dr Munavvar's voice as he said: "We're helpless. We can't do anything. Our hands are tied and we can't bring them in."

What's more, waiting times for outpatient appointments are much longer because there are over three thousand discharged COVID patients needing check-ups.

Meanwhile, the pandemic is taking a significant toll on staff.

Ward manager Rebecca Tuson told us: "You know, we've had staff who've suffered with PTSD in the trust who still aren't back at work as a result of that. They've seen some horrific, horrific deaths."

Elsewhere in the hospital there is another plea - this time from the maternity and neonatal teams, who are worried vaccination rates among pregnant women are low.

We met nurse Emma Fenwick who miscarried at the start of the pandemic but said she did not think twice when getting the vaccine. She is now 37 weeks pregnant and is due any day.

Ms Fenwick told us: "As a mum, you always want to do the right thing to protect your baby. You think, I don't want anything in my body. I don't want anything to hurt my baby.

"But when you read the right information, look at the evidence, you find out it's a lot safer and you're a lot more protected with the vaccine."

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The nurse leader for the neonatal unit, Jo Connolly, said she has seen first-hand the "heartbreaking" impact of COVID on pregnant women.

"Some of the women who get COVID are getting severe symptoms that require hospitalisation and can be at risk of having premature babies," she said.

Those new mums are also unable to be with their baby for the first few days, she added.

The hospital is under pressure and on top of COVID, there is the threat of flu in the coming weeks.

Staff remain stoic but they are worn out and worried about what this winter will bring.

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COVID-19: Patients in this coronavirus ward have almost doubled in a month. Who are the people ending up there? - Sky News

With coronavirus cases nationally plateauing at a relatively high level, experts have warned of the possibility of a winter surge for multiple reasons, including people gathering indoors because of cooler weather, holdouts refusing to get vaccines, and immunity from the shots waning.

Coronavirus outbreaks in Massachusetts have recently made headlines, including one that forced the closure of Bostons Curley K-8 School and one that hit the Essex County jail in Middleton.

The latest numbers are a reminder that its not over till its over, said Dr. Howard Koh, a former assistant US secretary of health and human services and Massachusetts public health commissioner.

These state trends are disconcerting, but not surprising, as national declines in COVID cases have stalled in recent weeks. We need to be extra vigilant and careful as the winter season approaches. We must push the states vaccination rates even higher, resist suggestions to drop mask requirements too early and eliminate disparities, Koh, who is now a professor at the Harvard T.H. Chan School of Public Health, said in an e-mail.

Dr. Sabrina Assoumou, an infectious disease physician at Boston Medical Center and an assistant professor at the Boston University School of Medicine, said, We definitely need to pay attention to the new numbers.

We sort of knew this was going to happen, as colder weather causes people to spend more time indoors which is when COVID tends to be transmitting more efficiently, she said.

We should use it as a warning sign to double down on those measures we know have worked, she said.

The best way we can address this, she said, is vaccinating as many people as possible so we can stop transmission in the community. Vaccination is still our best way out of this pandemic.

She said the recent authorization of COVID-19 vaccines for children 5 to 11, a cohort that numbers 515,000 in Massachusetts, would be a major help in combating the pandemic. We now have a new group of people who are eligible. Lets use that and lets vaccinate them. She said its also important to push up the number of teenagers 12 to 17 who have been vaccinated.

She also said, We need to decide whether this is a time to encourage more masking in indoor public spaces. Its probably time to think about that.

Other key measures to address the pandemic include improving ventilation and the use of rapid at-home testing, she said.

Society has tools to address the pandemic and these numbers are reminding us that we really need to use them as best we can, she said.

Were watching case numbers closely, as most northern states (like ours) are showing an increase. Much of this is due to cases rising rapidly in children, teens, and young adults, who both have lower rates of vaccination and are more likely to engage in activities that facilitate spread of the virus. This is especially true with colder weather bringing people indoors, said Dr. Paul Sax, clinical director of the Division of Infectious Diseases at Brigham and Womens Hospital.

I do think this is a real increase, and we always worry about the vulnerable populations when cases start going up, he said in an e-mail.

Massachusetts is a national leader in vaccinations and experts say that if cases rise here, the number of people who get severely ill and die will likely be lower than in other less-vaccinated places.

We are probably in one of the regions of the country which has the least cause for anxiety, said William Hanage, an epidemiology professor at Harvards Chan School.

But he said people should be sure to get their vaccinations and booster shots. The pandemic is not over. People should behave responsibly, he said.

He also warned, Its really important to note that the Delta variant will find you. Youre not going to be able to dodge Delta. What you want to do is make sure you have the best preparation.

Martin Finucane can be reached at martin.finucane@globe.com.

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The pandemic is not over: In a worrisome trend, COVID-19 cases are rising again in Mass. - The Boston Globe