Category Archives: Corona Virus

By Maggie Brown, WRAL multiplatform producer

The U.S. Centers for Disease Control and Prevention on Thursday updated a map of COVID-19 in the community to show that 61 of North Carolina's 100 counties are at high risk. The majority of counties in eastern and southern North Carolina are at high risk.

The CDC recommends that North Carolina residents who are at high risk for severe illness consider wearing a mask in public and take additional precautions, like get a booster shot, avoid poorly ventilated spaces or crowds and test frequently.

Wake and Johnston counties are not currently seeing as much coronavirus in the community as other surrounding counties, according to the CDC's analysis of coronavirus data.

This week, Wake County saw on average around 308 coronavirus cases for each 100,000 residents. Health leaders say that number is likely not the full the picture because of many people who are testing positive for the virus at home and not reporting the data to the state.

Around 8 people per 100,000 in Wake County are currently being admitted to the hospital with COVID-19, which keeps Wake County in the "medium" risk category as defined by the CDC.

Wake County's positivity rate, however, has been on a steady incline since May. As of Thursday, North Carolina's positivity rate was at 19%, which means more than 1 in 6 coronavirus tests that are taken in North Carolina come back positive. That number doesn't include at-home tests.

Around 95% of the population in Wake County has received some sort of vaccination against coronavirus. Not everyone is fully vaccinated, and even fewer people have received booster shots.

The counties with the lowest percent of the population vaccinated are Rutherford, Robeson, Montgomery, Hoke, Tyrrell, Polk and Harnett.

Harnett County around 40 miles away from Wake County has a high vaccination rate among those 65 an older, but a relatively lower vaccination rate among those who are below the age of 65.

Only 43% of Harnett County's population is fully vaccinated against coronavirus, compared to Wake's 95%. According to the CDC, fully-vaccinated is defined as completing two doses of either a Moderna or Pfizer two-dose vaccine or a single shot of the Johnson & Johnson vaccine. For people who are severely immunocompromised, that definition changes, the CDC says.

The curves below, showing a 7-day rolling average of reported new cases in each county, use data collected from state health officials by Johns Hopkins University's Coronavirus Resource Center. The counties are sorted by the largest total of lab-confirmed COVID-19 cases, and the top-20 counties are shown by default. Vertical axes are scaled by default based on the largest number of new cases. Select the variable axis setting to scale each county's cases individually to see their respective spikes. Enter a county below to highlight it for comparison. NOTE: Starting on Sept. 25, the Johns Hopkins data began including cases identified through antigen testing reported by DHHS. The addition of these cases appears as a sharp spike in some counties.

Source: Johns Hopkins CSSE Graphic: Tyler Dukes, WRAL // Get the data

For every 100,000 people in Harnett County, the CDC estimates that nearly 300 people are testing positive with coronavirus this week. The county's test positivity rate is higher than the state's more than 26% of people who get tested in the county are testing positive for coronavirus, according to CDC data.

On the other hand, Rutherford County has the lowest vaccination rate but is not in the CDC's high risk category. The county is one of the 36 under medium risk for community spread. According to CDC data, it falls into this category because new coronavirus-related hospital admissions are falling below 10 per 100,000 people.

However, around the same number of people per capita are testing positive for COVID-19 in Rutherford County as in Harnett County.

The U.S. announced Thursday that coronavirus vaccines specific to the latest omicron variants -- BA.4 and BA.5 -- will be available to the public starting in September.

Everyone has been eligible for a booster shot, however, many people have not taken advantage of the opportunity. A second booster shot is recommended for Americans over 50 and those over 12 with certain immune deficiencies.

But there's little hope in the data that people are interested in getting another booster shot. Only 28% of North Carolinians 18 and older have been fully vaccinated and also received a first booster shot, CDC data shows.

Experts worry about another fall surge in cases as new highly-contagious variants of omicron are emerging.

The number of North Carolinians testing positive for COVID-19 and going to the hospital has increased by 17% this week compared to last week, according to data released by the state on Wednesday.

North Carolina is seeing levels of coronavirus cases and hospitalizations not seen since the end of omicron's peak in February, the data shows.

A total of 1,290 people were admitted to the hospital with COVID-19 in the week ending July 24, which is the most North Carolina has seen since the week ending on February 19.

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More than 60 NC counties at 'high' risk for COVID in the community, CDC says - WRAL News

CLEVELANDFive Northeast Ohio counties have high COVID-19 transmission spread, according to information the Centers of Disease Control and Prevention released on Thursday.

The following counties are under high transmission rates:

There are a total of 2,817 cases in Cuyahoga County, which is a 19.92% increase over the last seven days. Out of those total cases, 228 of them are new.

Over 65% of the population in the county are fully vaccinated, with 75% with at least one dose.

The CDCs community-level classifications are now based on a mixture of new case numbers, new hospital admissions and the percentage of hospital beds devoted to COVID-19 patients.

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See complete coverage on our Coronavirus Continuing Coverage page.

Vaccinating Ohio - Find the latest news on the COVID-19 vaccines, Ohio's phased vaccination process, a map of vaccination clinics around the state, and links to sign up for a vaccination appointment through Ohio's online portal.

See data visualizations showing the impact of coronavirus in Ohio, including county-by-county maps, charts showing the spread of the disease, and more.

View a map of COVID-19 testing locations here.

Visit Ohio's Coronavirus website for the latest updates from the Ohio Department of Health.

View a global coronavirus tracker with data from Johns Hopkins University.

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COVID-19 levels 'high' in 5 Northeast Ohio counties - News 5 Cleveland WEWS

The COVID-19 pandemic has changed everything. What should we know about how you approach the world now? How has the pandemic changed your social life, your work life, your interactions with your neighbors? Get in touch here.

It may be time to delete another app on your phone.

Pennsylvania has discontinued its COVID-19 exposure app, and Delaware plans to discontinue its COVID exposure alerts in the coming months.

The Pennsylvania, Delaware, and New Jersey health departments launched their respective apps in 2020 as part of an effort to prevent the spread of the virus.

The apps use bluetooth technology to track whether one user has been in close proximity to another who reports a positive COVID-19 test to the app. Unlike traditional contact tracing, even strangers can be alerted about a possible exposure.

So, Im in the grocery store, Im positive. Youre in the grocery store, and you come in contact with me. We dont know each other. Theres nothing that can replace that, said Dr. Tracey Johnson, Delawares Director of Contact Tracing.

Unlike its neighboring states, New Jersey plans to continue operating its app, for now. However, Pennsylvanias and Delawares health departments say the app is no longer critical.

Every case in Delaware comes through our lab, and we are able to send them a text notification. We are able to do that, and say, Hey, youre positive, and we can give them the guidance right there, Johnson said. So, were actually taking on some of that role that we didnt have before, when we needed that app, and now we can do [ourselves].

She said the app will likely be discontinued in about two months.

The Pennsylvania Department of Health did not agree to an interview with WHYY News, but spokesperson Maggi Barton said in an email that the app is no longer necessary because more people are educated about COVID-19.

Now, more than ever, residents are familiar on what COVID-19 symptoms are, where to find a test (whether a PCR test or a test they take in the comfort of their home), and what those next steps are after testing positive like isolating and quarantining, she said. People using at-home tests are encouraged to notify the people they have come in contact with to notify them of potential exposure.

She said that contact tracing efforts continue without any further assistance from the app, and that the department has continued to adapt and build long-term supports and resources during the pandemic.

Originally posted here:

A 'lost opportunity': Pa. and Del. are discontinuing their COVID-19 exposure apps - WHYY

COVID-19 can have many impacts, both physical and psychological. One question that keeps coming up in the media and recent literature is whether there is a link between COVID-19 and erectile dysfunction.

In this article, we look at numerous studies on the associations between COVID-19 and erectile dysfunction (ED).

We also explore whether ED can increase the risk of COVID-19, potential complications of COVID-19, treatments for ED, and when to contact a doctor.

Several studies explore COVID-19s effects on ED.

Researchers involved in a 2021 pilot study examined the penile tissues of four people, two with a history of COVID-19 infection and two without. Results suggests the two that had COVID-19 showed a presence of the virus function in their biopsies. The scientists conclude that the bodys cell dysfunction from COVID-19 infection can contribute to ED.

A 2022 statistical study involving global data of over 66 million people excluding those that already had ED before January 2020 indicates there is a higher chance of getting ED after COVID-19 infection. However, this study relies on statistical data from a global database instead of a blind clinical study, which is an important limitation.

Another 2022 study among 348 participants attempts to determine if COVID-19 can cause testicular damage. Comparing testosterone levels before and after COVID-19 in a 1-year span, this study suggests those positive for COVID-19 had a greater decrease in testosterone levels than those who did not get the infection.

A 2022 report looking at 693 publications in the realm of COVID-19 and ED points to compelling evidence that the virus may harm males health and sexual function. This includes a nearly 6-fold higher risk of getting ED.

One 2022 study among 156 males at the beginning of COVID-19 infection and in the month after getting COVID-19 found they had more depression and anxiety and a lower erectile function score. This could indicate that COVID-19 may result in more anxiety, which in turn increases the chance of ED.

A 2020 report explores how experiencing an infection with severe acute respiratory syndrome in 2002 affected peoples mental health. It suggests that the infection was capable of having a long-term negative impact on mental health and that COVID-19 may be similar.

According to a 2022 report by the National Institutes of Health (NIH), people with chronic long-term depression or persistent feelings of loneliness were 81% more likely to experience hospitalization after a COVID-19 diagnosis. This suggests that COVID-19 may be a psychological risk factor for mental health.

A 2020 report states that sexual performance anxiety contributes to premature ejaculation and ED. Therefore, it seems reasonable that general anxiety may also have an effect. In fact, a 2021 study involving adult males suggests that those with anxiety disorders have a high risk of developing ED.

The above studies show an association between COVID-19, anxiety or depression, overall health, and ED.

However, people can have underlying health conditions that affect the results. Most of the studies state that more research is necessary to truly explore the link between COVID-19 and ED.

Very few studies have explored the risk of getting COVID-19 in people with ED.

One 2021 study looked at 100 participants, 25 of which were positive for a COVID-19 infection. It found that people with ED were more likely to have COVID-19 than those without ED.

This study points out that its results are preliminary and more research is necessary. It is also important to note that correlation does not equal causation.

However, there is also another viewpoint.

An older 2013 study found that males with ED have a higher chance of developing cardiovascular disease (CVD). According to a 2022 study, while scientists need to do larger studies, evidence suggests that CVD increases COVID-19 severity. This means there is an indirect association that ED may increase the risk of COVID-19.

The CDC recommend a number of ways to decrease the chance of getting COVID-19.

These include:

The CDC also states that people with a weakened immune system should take extra precautions.

According to the National Institue of Diabetes and Digestive and Kidney Diseases, treatments for ED include:

According to a 2020 article, other emerging treatments include low intensity shockwave therapy, stem cells, and nitrate oxide donors. However, scientists need to do long-term studies to determine their efficacy, safety, downsides, and overall results.

People with COVID-19 who have concerns about its long-term effects on their particular health condition should consult a doctor to see if there are any precautions or tests they can take. Many online health services can help people access a doctor, even if they cannot leave their house.

Similarly, those with CVD or any underlying medical condition that increases their chance of getting COVID-19 should also talk with a doctor to increase preventive measures. The CDC lists a number of conditions that pose a high risk of getting severe illness with COVID-19.

Some people may feel anxious or uncomfortable at the prospect of speaking with a doctor about ED. However, the condition is nothing to be embarrassed about, and a doctor or urologist can most likely help resolve or treat the symptoms.

Both COVID-19 and ED affect many people. Numerous studies suggest links between the two, including direct and indirect associations.

In particular, it seems that people with COVID-19 may have a higher chance of getting ED or worsening their current ED. The opposite could also be true. However, more research is necessary to determine the long-term impact.

One way to prevent ED may be to increase protection against COVID-19. There are numerous ways to do this, including wearing masks. People with a weakened immune system or ED and those experiencing complications from COVID-19 may find it helpful to speak with a doctor about their concerns.

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COVID-19 and erectile dysfunction: Link, risks, and more - Medical News Today

The coronavirus disease 2019 (COVID-19) pandemic prompted schools worldwide to cancel in-person learning for weeks and months, but a new study argues schools canand shouldsafely operate with a mix of vaccination and regular testing of unvaccinated students.

The study, published in The Lancet Infectious Diseases, is based on a model of school transmission developed based on contact data and pilot screenings from 683 French schools.

Corresponding author Vittoria Colizza, PhD, of Sorbonne University, said the experience of the pandemic has made 2 things clear: having schools open leads to an increase in community transmission and yet keeping schools open should be a primary objective to safeguard the educational, emotional, and social needs of children.

Assessing vaccination and protocols in schools is therefore key to maintaining schools open in light of a continuously evolving pandemic, Colizza and colleagues said.

Using data from 2 periods in 2021, the authors created a model that could be used to see how various interventions might affect transmission and risk in a school setting. The authors calculated school-specific reproductive numbers for COVID-19 for both the Alpha and Delta variants.

For the Alpha variant, the reproductive number was 1.40 (95% confidence interval [CI] 1.35-1.45) in the primary school and 1.46 (95% CI 1.41-1.51) in secondary schools. They noted that that rate was higher than the rate estimated via community surveillance.

For the Delta variant, they found something of a divergence, with a significantly higher reproductive number in primary schools, 1.66 (95% CI 1.60-1.71), and a lower reproductive number in secondary schools, 1.10 (95% CI 1.06-1.14).

Using those rates, the investigators calculated that if the schools tested 75% of unvaccinated students on a weekly basis and tested any student with symptoms, they could reduce cases by 34% in primary schools and 36% in secondary schools.

Moreover, such a regime would translate into fewer lost days of instruction. In fact, the authors said such a strategy could reduce lost days by 80% compared to simply testing symptomatic children and then closing their classes.

Our analysis indicates that regularly screening the school population is efficient in preventing infections while reducing absence from school, especially in settings where the school population is not yet vaccinated, coverage is low to moderate, or vaccine protection has largely waned, Colizza and colleagues wrote.

The investigators said even with masks and other precautions, transmission is likely at schools. They said their model affirms that a regular testing protocol is a critical component of viral mitigation at school.

It also provides a cost-benefit analysis considering successive variants, comparing multiple protocols, and evaluating the key role of adherence in the context of partly vaccinated school populations, they wrote.

Notably, while the authors said their goal was to limit both community spread and missed days of school, they said it is not clear that reactive classroom closures are even particularly effective, given that the virus can spread silently, and some people do not have obvious symptoms. They said proactive screening allows school officials to detect more cases, enabling them to take a more targeted approach when deciding which students need to isolate.

Colizza and colleagues emphasized that vaccinating students is essential. While vaccination of teachers is beneficial, the authors said it does not significantly limit spread, even if a schools entire teaching staff is vaccinated.

This results from the small number of teachers and the observed lower rate of interaction they have with students, and it is confirmed even when community incidence in adults is much higher than in the student-age classes, they wrote.

The authors concluded that COVID-19 is likely to continue to be a factor affecting public health and education for the foreseeable future.

Regular testing remains a key strategy to epidemic control in school settings with moderate vaccination coverage or following waned vaccine protection, all the while minimizing days lost, they concluded.

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Regular COVID-19 Screening in Schools Can Control Infections, Limit Closures - Contagionlive.com

A transmission-electron micrograph of SARS-CoV-2 Omicron virus particles (pink) replicating within the cytoplasm of an infected CCL-81 cell (teal). Photo: NIAID Integrated Research Facility/NIAD

Were still in the midst of one of the largest COVID waves of the pandemic, and its fueled by the Omicron BA.5 subvariant, the most contagious and most immune-evasive coronavirus strain yet. Scrippss Dr. Eric Topol, who has been one of the loudest voices sounding the alarm over BA.5, has repeatedly described the strain as the worst COVID variant on account of it having more fitness, growth advantage, and immune evasion than any of its predecessors. According to the latest CDC estimate, BA.5 now accounts for nearly 82 percent of all new infections in the U.S., where it has prompted a surge in reported cases, test-positivity rates, COVID wastewater levels, and, thanks to its immune evasion, reinfections. Last week, it even infected President Biden with his first-ever COVID case; this week, an outbreak hit the Senate.

The BA.5 wave has also been driving up the number of U.S. hospitalizations, along with a slight rise in the number of COVID deaths, but it hasnt produced severe outcomes anywhere near the scale seen in previous major waves. Indeed, the rapid onset of BA.5 and its subvariant brethren (BA.4, BA.2, and BA.2.12.1) without a corresponding surge in severe COVID has prompted a sense that were finally in a new phase of the pandemic where new strains come and go, COVID continues to spread and surge and unsettle, but our bolstered immune systems hold the line and we avoid the recurring nightmare of mass illness and death.

Scientists are still studying the new variant, and the BA.5 wave has been playing out differently in various countries, likely due to a complicated combination of factors. But while the far less severe impact of the BA.5 wave in the U.S. has, thus far, been a welcome departure from what weve encountered before, some COVID experts, like Topol, remain concerned. Though its been more than two and a half years since COVID arrived, were still not staying ahead of the virus.

Topol and immunologist Akiko Iwasaki just co-wrote a paper calling for an accelerated Operation Warp Speedlike initiative to pursue nasal COVID vaccines, which could provide mucosal immunity that stops the virus in the part of the body where it starts. Topol has also pushed for the development of other potentially variantproof vaccines, like pan-sarbecovirus and pan-coronavirus vaccines. This week, the White House hosted a summit on future COVID vaccines attended by many of the top minds in the field, including Iwasaki, but its far from clear that any of the promising ideas and goals discussed there will get the government funding theyd need to have an impact on the pandemic anytime soon.

I recently had a long conversation with Topol about BA.5, why hes troubled by it, and what the variant and its arrival portend for the future.

On one hand, here in the U.S. weve seen a significant drop in hospitalizations and deaths amid the wave of cases of BA.5 and the other earlier Omicron subvariants. But youve been calling attention to the fact that in some other countries, BA.5 has fueled some alarming spikes in cases, hospitalizations, and even deaths. So, is the U.S. through the worst of this?I agree that, overall, if you look at it globally, hospitalizations and deaths from BA.5 are not going to reach levels anywhere close to Omicron or previous waves, but theyre not trivial elevations. Deaths are going up over the whole world from BA.5. Our wave is still playing out right now. Were poorly vaccinated here in the U.S. poorly boosted, especially in high-risk people like seniors. So I wouldnt want to conclude that were out of the woods. We could be in for more trouble before the BA.5 wave is finished.

Im actually a very optimistic person. When we were coming down from Delta and had not seen Omicron, I thought, Wow, the worst is over. Then Omicron proved to be an onslaught in terms of spread by any metric as well as the toll it took in more serious outcomes. So with that background, the recent CDC report that came out about the vaccines really has me worried.

Whys that?Its not like all of a sudden theres going to be a variant with total immune escape from vaccines. But in the CDC morbidity and mortality report, it said that two-dose vaccine effectiveness against hospitalization for the original BA.1 Omicron strain were not talking about infections because were well past having good vaccine coverage for that but for hospitalization, it dropped to 61 percent for two doses. And for BA.2 and BA.2.12.1, the latter of which is more like BA.5 but not as bad, two doses against hospitalization dropped to 24 percent. That should set off alarms because we dont have a lot of people with a third shot. For three shots the efficacy jumped back up, but only to 52 to 69 percent with BA.2/2.12.1.

Kaiser Southern California has also had two reports on vaccine effectiveness in their big network of patients, and they show the same attrition against hospitalizations as was seen in this much larger new comparison from the CDC.

So how can you feel good about these data? I dont see how. This narrowing benefit of the vaccines, which I think is due to more immune escape, not due to more infections in the unvaccinated, its still a very big gap. To drop down almost 40 points in effectiveness against hospitalizations with only two shots this should be a signal that something is going on with our vaccine protection. But you dont see anybody raising concerns about this. All you hear is happy talk that we have great protection from hospitalizations and deaths. I dont know about that. These data dont support that.

So that suggests that hospitalizations will likely keep going up in the BA.5 wave? Yeah, theyre going to go up. The number of current U.S. hospitalizations is already over 40,000. I wouldnt be surprised if it gets to 50,000 or 60,000. It isnt going to get near 160,000, like it did with BA.1, only because so many people got infected with BA.1 and theres some cross-immunity. But the number of hospitalizations has been going up substantially. It had gotten down to 12,000 and now back up past 40,000. If you look at the curve, it has a new increased slope since BA.5 started to take effect, and its still on the way up. The question is does it get to 50,000? Does it get to 60,000? Thats a lot of sick people in the hospital.

And the other thing I would just say, parenthetically, is with BA.5, Ive never seen so many infections in my personal network, including family, friends, colleagues. Ive never seen infections last as long. After 10 days, still testing positive, after day 12, 13, 14. The behavior of BA.5 is different and the fact that our CDC still adheres to this five-day isolation recommendation, its incredulous. Theyre actually promoting spread by doing that.

Theres no question that this is a different effect from BA.5 in terms of the length of infectiousness, how much its spread, and maybe not more hospitalizations. But remember, thats with Paxlovid, which now has 90 percent efficacy in preventing hospitalizations for high-risk people.

Right, if a variant emerges that Paxlovid isnt as effective against, that could suddenly leave us much more vulnerable to severe COVID again.Yes. And I think most of us whove really zoomed into the mutations on MPro, the main protease of the virus that Paxlovid works on Id say its just a matter of time. Its inevitable. Already these mutations have appeared naturally because of the pressure that the virus is getting from Paxlovid. Its inevitable. Were going to see resistance to this drug, which, after the vaccines, is the second-most-important advance that we have had to take on the virus. But it may be short-lived, it could be that by years end or the beginning of next year, we wont have Paxlovid as a remedy or rescue anymore. Theres no question Paxlovid is helping keep the hospitalization number down.

Updated booster shots that better target the Omicron lineage are on the way. Will those help us stay ahead of the virus?We need variantproof boosters. No more chasing variants because we are not very good at that. Just get the vaccines that would take on all sarbecovirus and betacoronavirus so we can put an end to the whole idea of trying to anticipate the variant that well need a booster for. We know how to do that. We have over 25 incredibly potent broad neutralizing antibodies. We can make vaccines that induce several of those antibodies to never have to worry about a variant in terms of having protection.

But those arent the boosters arriving this fall.No. The booster plan is for BA.5. And saying that will be here for the fall is highly optimistic. It took seven months to get a BA.1 booster. Then the government sent the pharmaceutical companies back to go get us a BA.5 booster. Thinking that could be available in October or November thats highly optimistic. And we certainly dont know what variant is going to be with us at that time. It wont be BA.5 anymore. Therell be something else that will outcompete BA.5. Once that BA.5 booster is available, it may not work against the then circulating virus because it knows how to evolve.

Why arent these better boosters in the pipeline instead?Well, its pretty clear that Congress is unwilling to fund a dollar more for COVID. And thats, of course, the Republicans blocking any COVID bill. But there are even people in the Biden administration who arent sure how much these next-generation vaccines including variantproof, universal, and nasal are going to help us. Thats just, I think, being out of touch with the science. And any COVID bill dedicated to getting ahead of the virus would need to include better drugs, more drugs. Because we have to plan for Paxlovids obsolescence, and we dont have anything to replace it yet but there are many good candidates in the pipeline.

There seems to be at least anecdotal evidence that a small number of people are now getting reinfected within a matter of weeks. What do you make of that?Those added mutations that we first saw with BA.2.12.1 and now in BA.4 and BA.5 that immune evasion is whats responsible for all these early reinfections. Thats where this virus is going. Its got a flashing light: I have found ways to evade your immune system, and I can keep building on that. Reinfection is perhaps the best real-time signature of immune evasion.

Whats your sense of where long COVID is going? Is there any other way to avoid it than just not catching regular COVID in the first place, which is clearly getting harder to do at this point in the pandemic? Is there some other way to handle it?Well, youre right. Avoid the infection, first. Then, if you had a vaccine, that seems to avoid the chance of long COVID to some extent, but we also have to have treatments for it we dont have any yet that are validated. We have a billion dollars from the NIH toward long COVID, but youre not seeing any real contributions that funding has advanced yet. And we know that long COVID is not a homogeneous disorder. There are different components. Some are much more immune-mediated, some are much more autonomic nervous system-mediated. So theres a lot to unpack with that.

So what are you most worried about with regard to the future evolution of SARS-CoV-2?The known unknown, which is that this virus still has many more ways to become more resistant to our immune response and we should plan on that. We keep thinking weve reached some kind of limit. But the most important lesson from BA.5, to me, is that its worse. If it had come without BA.1 as a predecessor the only reason BA.5 doesnt look horrific right now is because BA.1 had built up the immunity wall. More than half of Americans have had BA.1 or BA.2. And were now seeing in BA.5 the most innovation, the most growth advantage, the most fitness of the virus yet and were just not dealing with it.

If some people think, Oh, it cant get worse, its going to get better. We dont know that. You have to plan for the worst-case scenario. And the worst-case scenario is that the virus further increases its immune evasion. Its already picking up things that worked in prior versions of the virus: For instance, BA.2.12.1 and BA.5 have the same key L452R mutation that the Delta variant had. Anyone who thinks the virus doesnt have room to evolve further is just not paying attention.

Is that a near-term threat? Can we predict a timetable for any of this evolution? No, but its accelerating. We know that much. The time its taken to get from BA.1 to BA.5 is not a good tempo for a whole new lineage to outcompete the prior one and achieve dominance worldwide.

So it doesnt look good. These new strains are clearly happening more frequently than they used to. In the first 12 months of the pandemic, there was no evolution of the virus. We basically had the original Wuhan strain, and then D614G, which arguably only had minor functional consequences. Alpha was mild compared to anything weve seen subsequently, then there was Delta, which obviously had more infectiousness and virulence. But now, with this whole Omicron family, its moving at a very rapid pace.

We cant predict the new mutations. We cant predict the timing. We can try to extrapolate, but even extrapolating, we had no good semblance of what Omicron would look like with its 57 spike mutations in BA.1. No one accurately predicted we would be looking at that.

And its too fast.Its the known unknown. Yeah.

UCL Genetics Institute director Francois Balloux recently explained that he wasnt as concerned about the emergence of further Omicron subvariants as he was about the reemergence of COVID lineages, like Delta, that have undergone a kind of underground evolution. So a strain circulating in some isolated part of the world; or one within an animal reservoir, i.e. an animal population the virus has spilled into from humans; or one that has evolved via a long-term chronic infection in someone who is immunocompromised which is how many scientists believe Omicron itself evolved. How worried are you about these paths?When an immunocompromised person gets infected, they really cant mount a good immune response. So the virus, instead of what its been doing globally for two and a half years, goes through this accelerated evolution in that person, picking up mutations left and right. It basically has unchecked potential to evolve in that person, and then that evolved virus infects other people. Thats pretty certainly what happened with Omicron.

I agree that the animal reservoirs are also a concern because weve already seen spillover to many different species, including hamsters, mink, cats, and deer. So thats another way that the virus can evolve, in an animal reservoir, and come back to spillover in humans.

We also havent contained the virus around the world, so it can continue to evolve through the millions of infections each day. And there are tens of millions of immunocompromised people in the world. It just takes one person, really, to trigger things. And then you have all these hybrid versions of the virus that were seeing, all these recombinants, which could bring about the worst elements of different parts of the virus. Most of the public focus on the evolution of SARS-CoV-2 has been spike-centric, but there are lots of other parts of the virus that can be troubling, that can make the virus more difficult to deal with. So again, theres lots of room for this virus to go.

There are too many paths. If youre just taking odds, and you have all these different routes and tens of millions of people that are immunocompromised around the world, are you going to bet against the virus evolving into something thats more challenging than what we have today? I dont think so.

Is there anything we can do to defend against COVID strains spilling back over from animal populations?No. No defense at all, unfortunately.

You and some other scientists have suggested that Omicron and particularly BA.5 are so different from any previously dominant COVID strains that in many ways we are now effectively dealing with a new virus. Youve also pointed out that if the original Omicron strain had the characteristics of BA.5,the Omicron wave would have been far worse. I understand thats a way to highlight why people should be concerned about BA.5 and what it means for COVIDs evolution, but is that actually possible? Can a BA.5 evolve on its own without there first having been a BA.1?Its a good question because we dont really know how BA.5 evolved. We just know it did. And could BA.5 have come in from an immunosuppressed person de novo without BA.1? Possibly. We just dont know. Basically new mutations showed up. Four key mutations showed up beyond BA.2 that have caused a lot of trouble, but we dont really know precisely how that occurred.

But we know why it occurred.Yeah. The virus is under pressure from vaccines and prior infections and now Paxlovid. So its finding ways to stand up to find new hosts. All viruses want is to find a new host. So they just keep mutating, and some of them dont work. Most of them fortunately dont work, but a lot of them do, and those are what were seeing.

Meanwhile, globally, were still giving COVID as many opportunities to evolve as we were a year ago if not more because now there are reinfections.Yeah, if not more. Were putting pressure on the virus to find new ways to circumvent our immune response and thats what it continues to do.

And at the same time, weve collectively done virtually nothing to prepare for whatever evolves next.Right. From day one of this pandemic, we have never tried to get ahead of the virus. Labs have come up with all sorts of broad neutralizing antibodies that would be variantproof. Nasal vaccines, to block transmission, to achieve mucosal immunity there are 12 in clinical trials. There are all these drugs in the hopper. Pan-coronavirus vaccines. These are all academic pursuits or largely from small companies. There hasnt been a national or a much larger international initiative to get ahead of the virus.

By initiative, you mean money.Money and an Operation Warp Speed 2, with collaborations and private-public industry partnerships. And not necessarily just the U.S., it should be global. But you dont see that, and its so stupid because look how successful we were. Operation Warp Speed showed how good we could be at this. But we havent done anything. We keep reacting and chasing instead of doing the things we know would get ahead of it.

I look at the data, and it says we can do better than this. I know we can; the science is there. Its just waiting in the hopper to be activated, but were just not taking it seriously enough. And I want to get out of this thing. I thought we were out of it as we came down with Delta in June 2021. Who wouldve thought we would get to now, a year-plus later, and theres still no light ahead of us? Thats why I want to take the aggressive get-ahead stance.

It seems like political will for that stance is nonexistent in the U.S. right now.Its also internationally. You dont see the U.K. which has been a model for science in the pandemic or many places around the world that are capable of it talking about going after pan-coronavirus vaccines. Why arent we making this a global priority?

Im optimistic that we can seize and achieve containment of the virus once and for all. Ive been optimistic like that for many months, but I feel like Im a Lone Ranger not a single voice, but one of a minority.

To be clear, you mean a pharmacological way to contain the virus. Because were never going back to nonpharmaceutical interventions like we saw in the first few years of the pandemic, or at least unless theres an enormous rise in hospitalizations and deaths.Yeah. In January 2021, my colleague Dennis Burton and I wrote in Nature that we need a variantproof vaccine. This virus is ideally suited, as compared to flu or HIV, for a variantproof vaccine. The initial success of Pfizers vaccine was 95 percent against symptomatic COVID. Theres never been a flu vaccine like that. Look at the success of Paxlovid: a 90 percent reduction in hospitalizations and deaths. This virus is vulnerable. Weve proven that. Were just not building on our successes. Its incredible. This is a less challenging, less hypermutating virus than the flu. Our COVID vaccines make flu vaccines look like a joke, or at least they did.

So we already have COVID on the ropes and can finish it off if we try.Thats why Im so optimistic. We can do this. But were not doing it.

This interview has been edited for length and clarity.

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BA.5 Shows COVID Is Evolving Fast. Why Aren't We Fighting Back? - New York Magazine

Last Christmas, as the Omicron variant was ricocheting around the United States, Mary Carrington unknowingly found herself at a superspreader eventan indoor party, packed with more than 20 people, at least one of whom ended up transmitting the virus to most of the gatherings guests.

After two years of avoiding the coronavirus, Carrington felt sure that her time had come: Shed been holding her great-niece, who tested positive soon after, and she was giving me kisses, Carrington told me. But she never caught the bug. And I just thought, Wow, I might really be resistant here. She wasnt thinking about immunity, which she had thanks to multiple doses of a COVID vaccine. Rather, perhaps via some inborn genetic quirk, her cells had found a way to naturally repel the pathogens assaults instead.

Carrington, of all people, understood what that would mean. An expert in immunogenetics at the National Cancer Institute, she was one of several scientists who, beginning in the 1990s, helped uncover a mutation that makes it impossible for most strains of HIV to enter human cells, rendering certain people essentially impervious to the pathogens effects. Maybe something analogous could be safeguarding some rare individuals from SARS-CoV-2 as well.

Read: America is running out of COVID virgins

The idea of coronaviral resistance is beguiling enough that scientists around the world are now scouring peoples genomes for any hint that it exists. If it does, they could use that knowledge to understand whom the virus most affects, or leverage it to develop better COVID-taming drugs. For individuals who have yet to catch the contagiona fast-dwindling proportion of the populationresistance dangles like a superpower that people cant help but think they must have, says Paula Cannon, a geneticist and virologist at the University of Southern California.

As with any superpower, though, bona fide resistance to SARS-CoV-2 infection would likely be very rare, says Helen Su, an immunologist at the National Institutes of Allergy and Infectious Disease. Carringtons original hunch, for one, eventually proved wrong: She recently returned from a trip to Switzerland and found herself entwined with the virus at last. Like most people who remained unscathed until recently, Carrington had done so for two and a half years through a probable combination of vaccination, cautious behavior, socioeconomic privilege, and luck. Its entirely possible that inborn coronavirus resistance may not even existor that it may come with such enormous costs that its not worth the protection it theoretically affords.

Of the 1,400 or so viruses, bacteria, parasites, and fungi known to cause disease in humans, Jean-Laurent Casanova, a geneticist and an immunologist at Rockefeller University, is certain of only three that can be shut out by bodies with one-off genetic tweaks: HIV, norovirus, and a malaria parasite.

The HIV-blocking mutation is maybe the most famous. About three decades ago, researchers, Carrington among them, began looking into a small number of people who we felt almost certainly had been exposed to the virus multiple times, and almost certainly should have been infected, and yet had not, she told me. Their superpower was simple: They lacked functional copies of a gene called CCR5, which builds a cell-surface protein that HIV needs in order to hack its way into T cells, the viruss preferred human prey. Just 1 percent of people of European descent harbor this mutation, called CCR5-32, in two copies; in other populations, the trait is rarer still. Even so, researchers have leveraged its discovery to cook up a powerful class of antiretroviral drugs, and purged the virus from two people with the help of 32-based bone-marrow transplantsthe closest that medicine has come to developing a functional HIV cure.

The stories with those two other pathogens are similar. Genetic errors in a gene called FUT2, which pastes sugars onto the outsides of gut cells, can render people resistant to norovirus; a genomic tweak erases a protein called Duffy from the walls of red blood cells, stopping Plasmodium vivax, one of several parasites that causes malaria, from wresting its way inside. The Duffy mutation, which affects a gene called DARC/ACKR1, is so common in parts of sub-Saharan Africa that those regions have driven rates of P. vivax infection way down.

In recent years, as genetic technologies have advanced, researchers have begun to investigate a handful of other infection-resistance mutations against other pathogens, among them hepatitis B virus and rotavirus. But the links are tough to definitively nail down, thanks to the number of people these sorts of studies must enroll, and to the thorniness of defining and detecting infection at all; the case with SARS-CoV-2 will likely be the same. For months, Casanova and a global team of collaborators have been in contact with thousands of people from around the world who believe they harbor resistance to the coronavirus in their genes. The best candidates have had intense exposures to the virussay, via a symptomatic person in their homeand continuously tested negative for both the pathogen and immune responses to it. But respiratory transmission is often muddied by pure chance; the coronavirus can infiltrate people silently, and doesnt always leave antibodies behind. (The team will be testing for less fickle T-cell responses as well.) People without clear-cut symptoms may not test at all, or may not test properly. And all on its own, the immune system can guard people against infection, especially in the period shortly after vaccination or illness. With HIV, a virus that causes chronic infections, lacks a vaccine, and spreads through clear-cut routes in concentrated social networks, it was easier to identify those individuals whom the virus had visited but not put down permanent roots within, says Ravindra Gupta, a virologist at the University of Cambridge. SARS-CoV-2 wont afford science the same ease of study.

Read: Is BA.5 the reinfection wave?

A full analogue to the HIV, malaria, and norovirus stories may not be possible. Genuine resistance can manifest in only so many ways, and tends to be born out of mutations that block a pathogens ability to force its way into a cell, or xerox itself once its inside. CCR5, Duffy, and the sugars dropped by FUT2, for instance, all act as microbial landing pads; mutations rob the bugs of those perches. If an equivalent mutation exists to counteract SARS-CoV-2, it might logically be found in, say, ACE2, the receptor that the coronavirus needs in order to break into cells, or TMPRSS2, a scissors-like protein that, for at least some variants, speeds the invasive process along. Already, researchers have found that certain genetic variations can dial down ACE2s presence on cells, or pump out junkier versions of TMPRSS2hints that there could be tweaks that further strip away the molecules. But ACE2 is very important to blood-pressure regulation and the maintenance of lung-tissue health, said Su, of NIAID, whos one of many scientists collaborating with Casanova to find SARS-CoV-2 resistance genes. A mutation that keeps the coronavirus out might very well muck around with other aspects of a persons physiology. That could make the genetic tweak vanishingly rare, debilitating, or even, as Gupta put it, not compatible with life. People with the CCR5-32 mutation, which halts HIV, are basically completely normal, Cannon told me, which means HIV kind of messed up in choosing CCR5. The coronavirus, by contrast, has figured out how to exploit something vital to its hostan ingenious invasive move.

The superpowers of genetic resistance can have other forms of kryptonite. A few strains of HIV have figured out a way to skirt around CCR5, and glom on to another molecule, called CXCR4; against this version of the virus, even people with the 32 mutation are not safe. A similar situation has arisen with Plasmodium vivax, which we do see in some Duffy-negative individuals, suggesting that the parasite has found a back door, says Dyann Wirth, a malaria researcher at Harvards School of Public Health. Evolution is a powerful strategyand with SARS-CoV-2 spewing out variants at such a blistering clip, I wouldnt necessarily expect resistance to be a checkmate move, Cannon told me. BA.1, for instance, conjured mutations that made it less dependent on TMPRSS2 than Delta was.

Read: The BA.5 wave is what COVID normal looks like

Still, protection doesnt have to be all or nothing to be a perk. Partial genetic resistance, too, can reshape someones course of disease. With HIV, researchers have pinpointed changes in groups of so-called HLA genes that, through their impact on assassin-like T cells, can ratchet down peoples risk of progressing to AIDS. And a whole menagerie of mutations that affect red-blood-cell function can mostly keep malaria-causing parasites at baythough many of these changes come with a huge human cost, Wirth told me, saddling people with serious clotting disorders that can sometimes turn lethal themselves.

With COVID-19, too, researchers have started to home in on some trends. Casanova, at Rockefeller, is one of several scientists who has led efforts unveiling the importance of an alarm-like immune molecule called interferon in early control of infection. People who rapidly pump out gobs of the protein in the hours after infection often fare just fine against the virus. But those whose interferon responses are weak or laggy are more prone to getting seriously sick; the same goes for people whose bodies manufacture maladaptive antibodies that attack interferon as it passes messages between cells. Other factors could toggle the risk of severe disease up or down as well: cells ability to sense the virus early on; the amount of coordination between different branches of defense; the brakes the immune system puts on itself, so it does not put the hosts own tissues at risk. Casanova and his colleagues are also on the hunt for mutations that might alter peoples risk of developing long COVID and other coronaviral consequences. None of these searches will be easy. But they should be at least simpler than the one for resistance to infection, Casanova told me, because the outcomes theyre measuringserious and chronic forms of diseaseare that much more straightforward to detect.

If resistance doesnt pan out, that doesnt have to be a letdown. People dont need total blockades to triumph over microbesjust a defense thats good enough. And the protection were born with isnt all the leverage weve got. Unlike genetics, immunity can be easily built, modified, and strengthened over time, particularly with the aid of vaccines. Those DIY defenses are probably what kept Carringtons case of COVID down to a mild course, she told me. Immune protection is also a far surer bet than putting a wager on what we may or may not inherit at birth. Better to count on the protections we know we can cook up ourselves, now that the coronavirus is clearly with us for good.

Read this article:

Could Genetics Be the Key to Never Getting the Coronavirus? - The Atlantic

Good evening. Im Karen Kaplan, and its Tuesday, July 26. Heres the latest on whats happening with the coronavirus in California and beyond.

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Were still in a pandemic. The number of coronavirus infections is high and rising. But something fundamental about COVID-19 has changed: It isnt as scary anymore.

Over the last week, the U.S. has averaged a whopping 120,000 new cases per day. (And those are just the ones reported to authorities; the true number is even higher.)

Contrast that to the early weeks of the outbreak, when society all but shut down in an effort to steer clear of the virus and bend the curve. All it took to get our attention back then was fewer than 30,000 cases per day.

They say familiarity breeds contempt, but in this case its having the opposite effect. The more time we spend with the coronavirus, the less we seem to worry about it.

Indeed, infections are now so commonplace that the fear of the unknown is fading, said Dr. Peter Chin-Hong, an infectious diseases expert at UC San Francisco.

You get it yourself and know tons of people who got it, and you fear it less, he said.

That explains why face masks were few and far between among the shoppers packed into the air-conditioned Westfield Valencia Town Center in Santa Clarita on a recent hot summer day, my colleagues Rebecca Schneid, Heidi Prez-Moreno and Hailey Brandon-Potts report.

People are just exasperated and over it, said Hailey Jimenez, 21, who was mask-free during a recent shift tending a jewelry kiosk there. I know Im over it.

Nicki Spravka knows the feeling. The 20-year-old moved from store to store without a mask or much angst.

I go to school in Colorado, and basically for the past year people have been acting like it doesnt exist anymore, she said of the virus. I mean, I guess I care. But it feels like what we do isnt really going to affect it because infections are still going to happen.

People, with and without masks, shop in L.A.'s Santee Alley in mid-July.

(Irfan Khan / Los Angeles Times)

This attitude is not unique to California or the West. The Pew Research Centers most recent survey about Americans attitudes about the pandemic found that only 41% considered the coronavirus a major threat to public health. Thats the lowest figure Pew has ever recorded. (An additional 45% considered the virus a minor threat and 13% called it not a threat.)

Likewise, only 34% of respondents were either somewhat or very concerned that the virus would land them in the hospital, and 50% were somewhat or very concerned that theyd spread an infection to someone else. Those figures also represent all-time lows for the pandemic.

Nationwide, daily COVID-19 deaths have averaged around 365 over the last week. The count hasnt been that low for a year, since the lull before the Delta surge. The only other time it has been lower was the initial weeks of the outbreak. So perhaps there is less reason to fear the coronavirus.

If your metric is infections, it looks hopeless, Chin-Hong said. But if your metric is people getting seriously ill and dying wow, thats a huge victory.

For the most part, the public is focused on the latter metric. But the health establishment is mostly focused on the former, especially the speed with which new variants are emerging and the possibility that one of them will be impervious to our vaccines and treatments, effectively sending us back to square one.

That helps explain why Los Angeles County is probably on the verge of reinstating an indoor mask mandate. Unless conditions substantially improve in the next couple of days, the county is likely to learn Thursday that it is entering its third consecutive week with a high COVID-19 community level because it has more 200 new infections and more than 10 new COVID-19 hospital admissions per 100,000 people over the last seven days. (As of last Thursday, there were 481 new infections and 11.4 new hospital admissions per 100,000 people per week.)

Bringing those numbers down is necessary to protect the vulnerable among us, such as the elderly and people who are immunocompromised, said Dr. Robert Kim-Farley, an epidemiologist and infectious diseases expert at UCLA.

What we need to do is have a mindset, or social norm, that we are going to expect somewhat of a roller-coaster ride as new variants arise and sweep through the population, he said. We can go back to more business as usual, but when rates are high, we should all do our part in reducing transmission.

Julisa Carrillo hopes people hear that message. She was hospitalized because of COVID-19 twice before the vaccines became available. Both of those hospitalizations included time on a ventilator.

More than a year and a half later, her lungs still dont feel the same. In her view, wearing a mask feels like a reasonable trade-off to help people avoid that same fate.

This is a virus that is hurting so many people, she said as she waited for a bus in Huntington Park. I myself dont feel safe.

California cases and deaths as of 6:30 p.m. Tuesday:

Track Californias coronavirus spread and vaccination efforts including the latest numbers and how they break down with our graphics.

The coronavirus can come for anyone, even the leader of the free world. Then-President Trumps illness in 2020 may have seemed like a bit of bad luck though if were being honest, his White House wasnt being particularly careful but current President Bidens diagnosis confirms that even those who take abundant precautions are vulnerable.

But its not all bad news for Biden. Catching the coronavirus in the summer of 2022 is not at all like catching it in the fall of 2020, my colleague Melissa Healy reports. Unlike Trump, Biden is benefiting from a full 2 years of scientific and medical advances against the once-novel virus. Plus, the virus itself has changed in ways that make it harder to evade but easier to survive.

Biden said Monday that hes feeling better every day. His schedule is lighter than it would have been while hes isolating at the White House, but Im meeting all my requirements that have come before me, he said.

Heres a look at the many advantages for Biden and the roughly 850,000 other Americans who caught the virus in the last week that werent available to Trump:

VACCINES: When Trump was diagnosed in early October 2020, the first COVID-19 vaccine from Pfizer and BioNTech was more than two months away from being authorized for emergency use by the Food and Drug Administration.

By the time Biden was diagnosed, he had received two primary doses of the companies Comirnaty vaccine, plus two booster doses. His most recent shot was on March 30. A letter from Dr. Kevin C. OConnor, the White House physician, described him as maximally protected.

Im doing well, getting a lot of work done, he said in a video. (Hes following Dr. Anthony Faucis lead and trying to power through instead of taking the time to rest and recover.)

Biden himself credited his four shots for his mild illness. His symptoms included a runny nose, cough, sore throat and some body aches.

Data from the Centers for Disease Control and Prevention back him up. Among Americans 65 and older, those who are unvaccinated are 3.8 times more likely to wind up hospitalized with COVID-19 than those who have been vaccinated and boosted at least once.

Whats more, people in Bidens age group 65 to 79 who are unvaccinated are nearly 9 times more likely to die of COVID-19 than their counterparts who are vaccinated and boosted. The second booster is important: The risk of death for Americans 50 and older who received it was four times lower than for their peers who stopped at one booster.

President Biden receives his first booster dose of Pfizer and BioNTechs COVID-19 vaccine on Sept. 27, 2021.

(Anna Moneymaker / Getty Images)

TREATMENTS: By the time Bidens illness was announced, he had already begun a course of Paxlovid. In clinical trials, patients at high risk of becoming severely ill were 88% less likely to be hospitalized or die if they took the antiviral (which is administered in pill form over five days). Biden falls into the high risk category because of his age (hell turn 80 in November).

Paxlovid received emergency use authorization in December, more than a year after Trumps bout with COVID-19. After initial shortages, it is now available at test to treat sites around the country, and as of this month, pharmacists have clearance to prescribe it to patients.

Should Biden take a turn for the worse and develop symptoms such as low oxygen levels, blood clots or problems with his heart or kidney function, there are plenty of other tools available to his doctors.

Remdesivir, which was given to Trump, would be available as a backstop, said Dr. Roy M. Gulick, who co-chaired the National Institutes of Healths panel on COVID-19 treatment guidelines. Today, physicians could also turn to one or more of the specialized drugs that calm an overactive immune system; although these were developed to treat other diseases, theyve been found to help those with COVID-19 as well.

Doctors have refined a variety of treatments while tending to Americas 90-million-plus patients over the course of the pandemic, Gulick said. For instance, theyre quicker to prescribe blood thinners for hospitalized patients to reduce the risk of blood clots. Theyve streamlined their use of steroids. Theyre more cautious about putting patients with breathing difficulties on ventilators, since they have the potential to do more harm than good. Theyve also figured out how to position patients with obesity to help keep their airways clear.

So much has changed since Trump got COVID, Gulick said. We have made substantive progress in treating people with severe COVID who are admitted to hospital, and fewer are dying as a result.

THE VIRUS ITSELF: We may lament the seemingly endless parade of variants and subvariants. But if you had to be infected with the SARS-CoV-2 coronavirus, youd rather have a version of Omicron than the original strain from Wuhan, China.

Trump fell ill before the emergence of the Alpha variant in the U.K., so its a safe bet that he was sickened by a virus that closely resembled the one that left China in late 2019. Virtually all of the SARS-CoV-2 coronaviruses circulating in the U.S. today are some version of Omicron, with the BA.5 subvariant alone accounting for an estimated 82% of specimens, according the CDC, and OConnor said thats probably the strain that got Biden.

For most of the pandemic, the COVID-19 death rate among those infected stood at about 2% of reported cases. But that figure dropped significantly after Omicron arrived, according to Beth Blauer, an associate vice provost at Johns Hopkins University. Now, fewer than 0.5% of reported infections results in death.

Population immunity from vaccines and past infections may help explain that progress, she wrote, but the data trends clearly demonstrate that Omicron is a much less deadly variant.

See the latest on Californias vaccination progress with our tracker.

Through parts of June, Los Angeles County and the San Francisco Bay Area had similar COVID-19 mortality rates. Then July came along, and deaths rose in L.A. but that increase was not matched up north.

As of Monday, the Bay Area had 56 deaths per 10 million residents over the last week. L.A. County, meanwhile, recorded 96 deaths per 10 million residents in the same period, a figure that was 70% higher.

Its not clear why deaths went up here but not there. L.A. has a higher poverty rate and more overcrowded housing. That means if one member of a household is infected, the number of people at risk of exposure is greater. Vaccination rates are also lower here than they are up north. According to The Times tracker, 73.7% of L.A. County residents are fully vaccinated; that percentage is lower than in all but one Bay Area county (Solano).

There are hints that L.A.'s death toll may begin to fall soon. The official count of new infections here has begun to decline, as has the number of infected patients in the countys hospitals. Last Wednesday, that number stood at 1,329; by Friday, it was down to 1,200, before rising somewhat to 1,286 on Monday.

As for coronavirus cases, the county was averaging about 6,100 infections per day over the week that ended Monday. During the previous week, the average number of daily infections was nearly 6,900.

Those improved trend lines are fueling hope that L.A. County Public Health Director Barbara Ferrer might not implement an indoor mask mandate later this week even if the county still has a high COVID-19 community level.

Should we see sustained decreases in cases, or the rate of hospital admissions moves closer to the threshold for medium, we will pause implementation of universal indoor masking as we closely monitor our transmission rates, Ferrer said. No decision will be made until after the CDC updates its community-level assessments on Thursday.

Officials in Beverly Hills would be happy to see the county demur on a mask mandate. The City Council voted unanimously Monday night not to enforce an indoor mask rule, should one materialize.

I support the power of choice, Mayor Lili Bosse said in a statement. This is a united City Council and community that cares about health. We are not where we were in 2020, and now we need to move forward as a community and be part of the solution.

Restaurants and bars, on the other hand, are already bracing for the stink eye they expect to get from customers if they have to go back to enforcing an indoor mask mandate. The job will be even more difficult this time around because the BA.5 subvariant has forced eating and drinking establishments to operate with skeletal staffing.

Im fearful and Im nervous and theres a lot of anxiety behind it, said Robert Fleming, who opened the Capri Club bar in Eagle Rock in June.

Plenty of other employers are dealing with COVID-induced staffing shortages too. Notable among them is the Transportation Security Administration.

The L.A. County health department says at least 233 cases have been confirmed among TSA workers at Los Angeles International Airport since June 9. The federal agency acknowledged an outbreak at LAX but said the figures released by the county overstated the current state of infections.

President Biden wasnt the only politico to catch the coronavirus in the last week. Democratic Sen. Joe Manchin III of West Virginia tweeted Monday that he tested positive for an infection and was experiencing mild COVID-19 symptoms. His Republican colleague Sen. Lisa Murkowski of Alaska tweeted similar news Monday and said she was experiencing flu symptoms.

On the research front, a study from USC has identified some new potential risk factors for developing long COVID. Like previous studies, the analysis found that patients who had obesity prior to their illnesses were more likely to have the lingering symptoms associated with long COVID. The USC team also found that patients who had sore throats, headaches and hair loss after becoming infected with the coronavirus were more likely to have long COVID.

The researchers dont think hair loss itself causes long COVID. Rather, they suspect that hair loss reflects extreme stress, potentially a reaction to a high fever or medications, said Eileen Crimmins, a demographer at USCs Leonard Davis School of Gerontology who worked on the study that appeared in Scientific Reports. So its probably some indication of how severe the illness was.

Separately, a pair of studies by an international team of experts used different analytical approaches to home in on the epicenter of the pandemic that has killed more than 6.4 million people around the world. Both methods point to the same conclusion: The coronavirus probably jumped from animals to humans at the Huanan Wholesale Seafood Market in Wuhan, China. In fact, it probably happened at least twice.

Several researchers who worked on the new papers had been open to the possibility that the virus had escaped from a Wuhan lab. But sleuthing over the last year or so has convinced them that the market is a far more plausible culprit.

In a city covering more than 3,000 square miles, the area with the highest probability of containing the home of someone who had one of the earliest COVID-19 cases in the world was an area of a few city blocks, with the Huanan market smack dab inside it, said one of those researchers, University of Arizona virologist Michael Worobey.

And finally, it looks as though there are no countries left that have more than 100,000 people but are still coronavirus-free. The island nation of Micronesia (population 115,000) appears to have been the last to fall and its outbreak is a doozy. It began last week and has already spread to at least 1,261 people. Eight people have been hospitalized with COVID-19, and one has died.

Turkmenistan is now the only remaining country with a population of at least 100,000 and no official coronavirus cases. Outside experts believe, however, that the virus is there and the countrys autocratic leaders are simply ignoring it.

Todays question comes from readers who want to know: Should I let the county health department know that I got a positive result on a rapid test?

If you live in L.A. County, you dont have to.

That said, there are some calls you should make. If you have a regular healthcare provider, let them know that youve tested positive.

You should also inform your recent close contacts so they can be tested. A close contact is someone whos been within 6 feet of you for a total of 15 minutes over a 24-hour period. Anyone who fits that bill in the two days leading up to your first COVID-19 symptoms or your positive test result (whichever came first) deserves to hear from you.

If you need help tracking down your close contacts, you actually do have a good reason to call the L.A. County Department of Public Health. The department has set up a hotline to assist residents with issues like these. The folks there can also answer questions you may have and can help you get a prescription for an antiviral medication, if warranted. The number for the hotline is (833) 540-0473.

The county health department is keeping track of the positive home test results they hear about. But a spokeswoman told my colleagues Jon Healey and Karen Garcia that department officials dont need you to tell them that youve tested positive and they definitely dont want you to tell them if youve tested negative.

Its not just that health officials are too busy to take your call. Its that they cant gauge the reliability of the home test you (and everyone else) used, or whether you (and everyone else) used it correctly. Thats why they tally only the results of tests performed in a laboratory.

L.A. County is hardly alone in this regard even the CDC takes this approach.

We want to hear from you. Email us your coronavirus questions, and well do our best to answer them. Wondering if your questions already been answered? Check out our archive here.

(Mariah Tauger / Los Angeles Times)

The hands in the photo above belong to chef Genet Agonafer. Shes the proprietor of Meals by Genet, the bistro in L.A.'s Little Ethiopia that helped make the berbere-centered flavors of her native country one of the important pieces of the mosaic that defines Los Angeles cuisine, as my colleague Laurie Ochoa writes.

Ochoa selected Agonafer as The Times 2022 Gold Award honoree. The award is bestowed not just for excellent cooking but also for broadening our culinary horizons.

In light of this praise, you might expect Meals by Genet to have a packed dining room. But when restaurants were able to reopen their dining rooms, Agonafer decided to keep hers closed. (She makes occasional exceptions for weddings and other private parties.) She hadnt missed the stress of full-on restaurant work, but she didnt want to close down altogether. So she opted for a compromise, offering takeout dinners on Thursdays through Sundays.

Although the limited hours mean less money, Agonafer said its a worthy trade-off.

Everything is just peaceful and easygoing, she said. There is still that stress when the rush happens or when we have events here, but things are going so incredibly well.

Resources

Need a vaccine? Heres where to go: City of Los Angeles | Los Angeles County | Kern County | Orange County | Riverside County | San Bernardino County | San Diego County | San Luis Obispo County | Santa Barbara County | Ventura County

Practice social distancing using these tips, and wear a mask or two.

Watch for symptoms such as fever, cough, shortness of breath, chills, shaking with chills, muscle pain, headache, sore throat and loss of taste or smell. Heres what to look for and when.

Need to get a test? Testing in California is free, and you can find a site online or call (833) 422-4255.

Americans are hurting in various ways. We have advice for helping kids cope, as well as resources for people experiencing domestic abuse.

Weve answered hundreds of readers questions. Explore them in our archive here.

For our most up-to-date coverage, visit our homepage and our Health section, get our breaking news alerts, and follow us on Twitter and Instagram.

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Coronavirus Today: Out of patience with pandemic precautions - Los Angeles Times

The House passed a bill on Tuesday to allow a government agency to award grants into the cognitive effects of COVID-19.

The legislation, titled the Brycen Gray and Ben Price COVID-19 Cognitive Research Act, passed in a 350-69 vote, with all opposition coming from Republicans. Eight Republicans and four Democrats did not vote.

The measure calls on the director of the National Science Foundation to award grants to eligible entities including higher education institutions or other groups made up of universities and nonprofit organizations to assist them in researching the disruption of regular cognitive processes associated with both short-term and long-term COVID-19 infections.

Research eligible under the bill includes studies on the effects COVID-19 infections have on cog4 nition, emotion, and neural structure and function as well as the influence coronavirus-related psychological and psychosocial factors have on the disruption of cognitive processes.

The grants should be awarded on a competitive, merit-reviewed basis, according to the bill.

In a statement announcing the bill in October, Rep. Anthony Gonzalez (R-Ohio), a co-sponsor of the measure, cited research from The Lancet Psychiatry that says roughly 1 in 3 patients diagnosed with COVID-19 received a neurological or psychiatric diagnosis in the six months after their positive test.

The legislation is named after Brycen Gray, 17, and Ben Price, 48, both of whom died by suicide after experiencing mental health issues following their bouts with COVID-19.

During debate on the House floor Tuesday, Gonzalez spoke about Gray and Price, saying the two tragically passed after battles with cognitive impairments caused by COVID-19.

Despite having no history of mental illness, each of them began to battle symptoms such as anxiety, panic and paranoia. The disease took Brycen and Ben from two of the healthiest, most vibrant people you could find to individuals so debilitated that they could not bear to live another day. While they fought to the bitter end, each chose to end their pain, he added.

The Ohio Republican said the bill would help learn why COVID-19 has an impact on the brain.

If we believe in protecting our families, we need to act now and start finding answers to why COVID-19 can have such a significant impact on the brain. The legislation before us today is another important step in that effort, he said.

Rep. Don Beyer (D-Va.) said researchers are raising alarms about the risk of mental health issues and suicide following COVID-19 diagnoses, adding that improved data collection and additional research is needed to better understand the mental health implications of COVID-19 infection.

Republican no votes included Reps. Rick Allen (Ga.), Jodey Arrington (Texas), Jim Banks (Ind.), Jack Bergman (Mich.), Andy Biggs (Ariz.), Dan Bishop (N.C.), Lauren Boebert (Colo.), Mo Brooks (Ala.), Ken Buck (Colo.), Tim Burchett (Tenn.), Michael Burgess (Texas), Kat Cammack (Fla.), Madison Cawthorn (N.C.), Ben Cline (Va.), Michael Cloud (Texas), Andrew Clyde (Ga.), James Comer (Ky.), Warren Davidson (Ohio), Scott DesJarlais (Tenn.), Byron Donalds (Fla.), Ron Estes (Kan.), Pat Fallon (Texas), Scott Fitzgerald (Wisc.), Virginia Foxx (N.C.), Russ Fulcher (Idaho), Matt Gaetz (Fla.), Louie Gohmert (Texas), Bob Good (Va.), Lance Gooden (Texas), Paul Gosar (Ariz.), Mark Green (Tenn.), Marjorie Taylor Greene (Ga.), Morgan Griffith (Va.), Glenn Grothman (Wisc.), Andy Harris (Md.), Diana Harshbarger (Tenn.), Kevin Hern (Okla.), Yvette Herrell (N.M.), Jody Hice (Ga.), Clay Higgins (La.), Ashley Hinson (Iowa), Darrell Issa (Calif.), Ronny Jackson (Texas), Mike Johnson (La.), Jim Jordan (Ohio), John Joyce (Pa.), Debbie Lesko (Ariz.), Barry Loudermilk (Ga.), Nicole Malliotakis (N.Y.), Tracey Mann (Kan.), Thomas Massie (Ky.), Brian Mast (Fla.), Tom McClintock (Calif.), Dan Meuser (Pa.), Marry Miller (Ill.), Barry Moore (Ala.), Troy Nehls (Texas), Ralph Norman (S.C.), Greg Pence (Ind.), Scott Perry (Pa.), August Pfluger (Texas), Chip Roy (Texas), David Schweikert (Ariz.), Mike Simpson (Idaho), Van Taylor (Texas), Claudia Tenney (N.Y.), Tom Tiffany (Wisc.), Jeff Van Drew (N.J.) and Beth Van Duyne (Texas).

Link:

House passes bill for research on cognitive effects of coronavirus, 69 Republicans vote no - The Hill

The world has experienced a slew of surges caused by an alphabet of variants since the onset of the COVID-19 pandemic in March 2020. Thankfully, none of the variants has led to a significant increase in disease severity.

Becker's spoke to Jonathan Abraham, MD, PhD, an infectious diseases physician at Boston-based Brigham & Women's Hospital, to learn more about why the SARS-CoV-2 virus's evolution hasn't led to significant changes in disease severity from the ancestral strain, and what are the chances that it eventually mutates to cause severe illness.

"It's something that even as a scientific community, we don't understand yet," Dr. Abraham said. He is an assistant professor of microbiology at Harvard Medical School and runs the Abraham Lab, which studies how pathogens interact with the cells of their hosts.

Two questions that remain:

When will immunity significantly wane?

While each new variant appears to be better at infecting vaccinated people than the last, vaccines have still largely protected against severe illness from each of them.

The question of whether the SARS-CoV-2 virus could eventually evolve to cause more severe illness then depends, at least in part, on the level of immunity a population has.

"Overtime, we've seen this virus mutate and mutate, but the question is still when will the immunity we have either from vaccines or from prior exposure [wane,] and by then, will the virus have disappeared or will it have continued to mutate?" said Dr. Abraham.

If the virus continues to mutate over time and the population's immunity wanes significantly, more severe disease is a possibility, "but the question is really hard to separate from one of the infected host, which has some degree of immunity," he said.

In a vaccine-less world where there were no levels of immunity and a mutating virus, variants like omicron would likely cause severe illness. But in a world where most people have been vaccinated or previously infected, that's not the case.

Could the virus evolve to evade T-cell responses?

Even with the virus able to evade antibodies, there is evidence that T-cells a separate arm of the immune system's response play a role in maintaining immunity from COVID-19.

In someone with prior immunity from vaccination, infection or both, "I think most would believe T-cells probably account for why disease severity is not as significant when someone gets infected now," Dr. Abraham said.

"T-cells are really the work horses that may be protecting us from getting sicker," he said, but if the virus mutates in a way that allows it to evade both antibody and T-cell responses, that may be a recipe for more severe disease.

Some research has shown people who have COVID-19 generate T-cells that target at least 15 to 20 different fragments of SARS-CoV-2 virus' protein, according to a Nature report. The targeted protein fragments can vary widely among different people, meaning a population could generate a broad variety of T-cells against the virus.

"That makes it very hard for the virus to escape cell recognition," Dr. Alessandro Sette at the La Jolla Institute for Immunology in California, told the news outlet, adding its "unlike the situation for antibodies."

Read the rest here:

2 questions a Harvard infectious disease expert still has about the coronavirus' evolution - Becker's Hospital Review