Ambergris

The red line above is the one to pay attention to. It's the deaths of lung and heart/lung collapse. It's where any fudge-factor would work from. The red triangles are flu.

I'm off work today to handle appointments and errands, and couldn't sleep last night, so I've been online a while.

Countries reporting the most new infections each day, based on the latest 7-day average reported INDIA 357,040 BRAZIL 60,386 USA 51,546 TURKEY 41,045 FRANCE 26,255 the most deaths INDIA 3,059 (more likely, the number is between ten thousand and twenty-one thousand per day) BRAZIL 2,526 USA 695 COLOMBIA 458 IRAN 426 USA data: Vaccine doses given on 7-day avg: 2,630,407 (maybe about 43% of the population has had at least one dose, ~29% fully vaccinated) New cases 7-day avg: 51,546 New deaths 7-day avg: 695 Currently hospitalized 7-day avg: 39,196 New cases fell 16% last week to about 409,000, the biggest drop since February. Deaths fell below 5,000 per week for the first time since October. Michigan has the most infections per capita, but new infections fell 29% last week. New cases also fell by 20% or more in New Jersey and Pennsylvania, the states with the next thickest rates of infection. Rising rates of infections show in 12 states, but only look worrisome in Tennessee, Oregon and Arizona.

Four people with the Indian variant have been identified in Vietnam. Forty-one people with the Indian variant have been identified in Israel, four of whom had been vaccinated, five of whom were too young to vaccinate, one of whom had already had Covid. 132 cases in the UK as of April 22, so probably much higher now Some references to cases in Greece, Singapore and New Zealand, Japan, a passing note about Switzerland and about a total of 20 countries having been infected--all without numbers-- and since we know Covid loves dry, we can expect there's transmission to Egypt by now even if it hasn't hit the news. India to Egypt is direct and quick. Euphrasyne knows what I mean. From Egypt there's a dry wind across all of North Africa and Southwest Asia.

So, to illustrate the numbers being much higher than reported in India, we have this article from India: GASPING FOR BREATH As Covid-19 reaches rural India, “people are dropping dead like flies” By Arunabh Saikia & Utpal Pathak April 29, 2021 On the evening of April 23, Dhanraj Singh, a 40-year blind man, arrived at the Sikanderpur community health centre in eastern Uttar Pradesh’s Ballia district, complaining of breathlessness. Singh, a resident of the nearby Bansi Bazar village, was running a temperature too. According to the doctor who attended to him, Singh collapsed within “hardly five-seven minutes”. The body was handed over to the family. In any case, the doctor said he would not have been able to help–the centre has no oxygen supplies, not even for emergencies. Singh looked like a “suspected Covid case”, but the doctor said he had no way to be sure. The centre has inexplicably stopped testing for a month. “What can we say, we want to test but we can’t, it is an administrative decision,” said the doctor, who did not want to be identified. “We send people to the block primary health centre where testing is still happening, that is around 5 km-6 km away. It is a tragedy that we are such a big centre and yet we do not test in these times. The Sikanderpur community health centre caters to almost 200 villages in the area. Despite the lack of testing, it seems fairly clear that Covid-19 is sweeping through the towns and villages of Ballia, a district bordering Bihar. Even Ballia’s chief medical officer Rajendra Prasad admitted as much. “The spread is a little too much this time,” he said. “The rural areas are not spared.” Uttar Pradesh started experiencing a surge in the first week of April with the number of cases exploding beginning the second week. On April 8, the state reported 8,490 new cases, crossing the previous peak of 7,016 cases registered in September 2020. However, half of these 8,490 confirmed cases were limited to the four districts of Lucknow, Prayagraj, Kanpur and Varanasi. But things have grown worse from there. On April 25, the state reported nearly 38,000 cases. As of April 27 morning, the state has over 300,00 active cases. Experts say the true numbers are likely to be much higher given the state’s lackadaisical testing. More ominously, the virus is no longer restricted to urban centres. The beleaguered health infrastructure of rural Uttar Pradesh, which recently saw migrants return home from city hotspots to vote in the panchayat elections, is already overwhelmed, conversations with people, doctors and administrators in multiple districts suggest. “Gasping for breath” “People are dropping dead like flies,” said Imran Ahmed. A local activist from Ballia’s Sikanderpur, he has been helping people get access to oxygen, but rarely with any success. “All their family members have the same story to share: they develop a fever and then all of a sudden they are gasping for breath, but there is no oxygen anywhere.” The doctor at the Sikanderpur community health centre confirmed as much. “Our daily patient load is 200-250 patients per day and 90% of the cases come with problems of cough, fever and breathlessness,” he said. “The more severe cases who need oxygen, there are eight-ten everyday, we refer to the district hospital.” But there is no guarantee of oxygen in Uttar Pradesh’s district hospitals either, as Shivakant Pal of Sitapur’s Babupurwa village found out on April 24. Pal’s mother Ramdevi Pal, 42, had been running a fever since April 20, but that morning she was struggling to breathe. The family hired an autorickshaw and took her to a nearby private hospital where the doctor asked them to rush to the district hospital located some 30 km away. Ramdevi Pal’s oxygen saturation level had dropped to 35%, the ideal level being above 95%. There, Shivakant Pal counted 72 beds–and one oxygen cylinder. His mother did not get any oxygen from it. She died gasping for breath at around 6.30 pm. “During the time we were there, at least five people died apart from my mother in the hospital, all of whom had come looking for oxygen. I saw with my own eyes,” said 20-year-old Pal. Officially, Sitapur did not report a single Covid-19 death that day. That’s because, like Dhanraj Singh of Balia, Ramdevi Pal had never been tested for Covid-19. Sitapur’s chief medical officer was not available for comment. A person in her office said she was in a meeting and there was “no problem” as such in the district. [photo] Ramdevi Pal died gasping for breath in the Sitapur district hospital. She was never tested for Covid-19. Desperate for oxygen Uttar Pradesh’s chief minister Adityanath has repeatedly claimed that there was no shortage of oxygen in the state and even threatened to seize the property of those spreading “rumours” and trying to “spoil the atmosphere.” Yet, accounts from across the state suggest it is facing a severe oxygen crisis. For instance, when Sanjay Kushwaha, a resident of a village near the Indo-Nepal border, took his 35-year-old breathless elder brother Manoj Kushwaha to the Kushinagar district hospital on April 18, the doctors administered an injection, but no oxygen. Nor was a Covid-19 test done, Sanjay Kushwaha said, as it was a Sunday. “His condition was not improving so we moved him to a private hospital,” he added. His brother was immediately put on oxygen at the private hospital, but a Covid-test was not done there either, according to Sanjay Kushwaha. Manoj Kushwaha stayed on oxygen support for four days at the private hospital—but after that it too ran out of oxygen. “We were told to arrange our own cylinder because the hospital’s stocks had run out,” said Sanjay Kushwaha. On April 24, the private hospital asked the family to transfer Manoj Kushwaha to the tertiary-care BRD Medical College in Gorakhpur, which according to Sanjay Khushawa refused to admit him. “They told us they are not taking in patients from private [hospitals],” he said. Manoj Kushwaha was brought back to the Kushinagar district hospital, where died on April 25, bereft of any oxygen support. Kushinagar’s chief medical officer did not respond to repeated calls seeking comment. [photo] Sanjay Kushwaha, struggling to breathe, died without oxygen support at the Kushanagar district hospital. ‘Arrange your own cylinder’ It is the same story across districts: hospitals are asking relatives to get their own oxygen cylinders. In Bahraich, when Akshay Srivastava’s mother’s oxygen levels dropped, the family managed to get a cylinder, but under tragic circumstances. An acquaintance, whom the cylinder was meant for, died the previous night. “Well, I don’t know whether there is an oxygen shortage or not, but I can tell you that we entered the district hospital with our own cylinder,” said Srivastava. On Sunday evening, the family was struggling to get a refill–the district hospital authorities had told them they could not help since all the oxygen was earmarked for the Covid ward and Srivastava’s mother’s Covid test was still pending. Srivastava’s mother has since been shifted to a Covid ward where family members said the hospital was administering her oxygen. Bahracih’s chief medical officer Rajesh Mohan Srivastava said there were ample critical care beds in the district. “Our positivity rate is 1.5%,” he said. “People are getting whatever they want.” But few other officials and doctors in the state seem to share that optimism. A senior official in the state’s health department based in one of the eastern districts, currently down with Covid-19 along with the rest of his family, said he was thanking his stars no one in the family needed oxygen yet. “It is all about chance, in all probability I could not have managed too,” he said. Deaths in the villages Professor Gopal Nath heads the Virus Research and Diagnostic Lab at the Institute of Medical Sciences, Banaras Hindu University, expressed a grim view of the situation. “The community spread is so bad in the villages that people don’t know what to do or where to go,” he said. “Also, testing such huge numbers is difficult because where is the health staff to collect so many samples. To meet the current demand, we need ten times more staff.” Nath who hails from a village on the Jaunpur-Varanasi border said he shuddered at the prospect of going there anytime soon. “We have done massive blunders,” he said. “The gram panchayat elections should have been postponed because not only did it see big gatherings, the elections have so much prestige attached to them that people from cities came home to vote carrying the virus with them.” A four-phase panchayat election that began on April 15 is currently underway in Uttar Pradesh. The Allahabad high court refused to postpone it, despite an unprecedented Covid-19 surge in the state. Nath’s fears about a surge in the wake of the elections seem to be well-founded. Situated on the outskirts of Varanasi town, Ramna was of late seeing four-five deaths each day, of people showing Covid-like symptoms, said Amit Patel whose wife is the elected head of the village “Last night three people died in my village,” Patel told Scroll.in on Monday. “None of them were tested.” The primary health centre at Ramna is neither testing people for the virus nor treating people with symptoms. Currently, it is only administering Covid-19 vaccines. Varanasi’s chief medical officer was not available for comment. A representative from his office said he was attending the funeral of his father who died late Monday evening. The representative, however, did say that the “situation was extremely bad in the district.” “Probably the worst in the whole of Uttar Pradesh,” he said. In adjoining Chandauli, the District Combined Hospital at Chakia, which serves a largely rural population, is predictably getting overwhelmed. The hospital has 50 critical care beds reserved for Covid patients. “Last year, at any point of time, a maximum of 13-14 beds were occupied,” said Usha Yadav who till recently headed the facility. “Now my staff tells me there are 100 patients with makeshift beds everywhere. So you can imagine what the situation is.” The burst of cases in the mofussil districts has meant additional pressure on already overburdened health facilities in urban centres like Lucknow. “It is not like we are dealing with patients just from Lucknow–people from the villages are now flooding our hospital,” said Madhulika Singh, who owns a private hospital and a medical college in the city “From Faizabad, Gonda, Raebareli, Basti, Ambedkar Nagar, everyone is coming to Lucknow. There just aren’t enough hospitals there.”

The Telegraph Doctors Threatened By Government Samaan Lateef Thu, April 29, 2021, 4:55 AM A surge of Covid-19 in a bastion of support for the Indian prime minister has been met with cover-ups and intimidation as his party workers scramble to limit political damage from the crisis during local elections, doctors allege. Doctors claim test results are being fudged, medical staff gagged and death tolls deliberately under-counted as the coronavirus begins to tear through Uttar Pradesh, a state ruled by the man predicted to be prime minister Narendra Modi's successor. Yogi Adityanath, chief minister of Uttar Pradesh, is accused of using authoritarian tactics to suppress reporting of the scale of medical shortages as the pandemic takes hold among the state's 240m inhabitants. Uttar Pradesh, which is home to over 200 million people, also has strong symbolic importance to the ruling Bharatiya Janata Party as it contains some of the holiest sites in Hinduism, including Varanasi and Ayodhya. An estimated 30 million people voted to elect local village leaders from 520,000 candidates in Uttar Pradesh on Thursday, with fears crowding at polling booths would worsen what has become India's fastest-growing state epidemic. Uttar Pradesh is also predicted to overtake Maharashtra, the state home to Mumbai, for new daily cases by the end of April, according to an Indian government think tank. Uttar Pradesh, along with Bihar and Rajasthan, has seen the highest weekly growth in new cases. One doctor, who works in the state's capital, Lucknow, estimated only one in every 20 Covid deaths were being officially recorded in the state. “Definitely, deaths are being undercounted,” the doctor told the Telegraph. “It is huge. It is deliberate so as to show less number of deaths so that image of the government is protected. "You go anywhere, any locality, people are cremating or burying their dead. Covid deaths happening at home are not counted at all.” Testing labs had also been told to sit on positive results to keep official figures down, he alleged. “Obviously, there is a fear among the doctors,” he said. “The government will terminate doctors if they talk about the crisis. And Yogi is just trying to downplay the havoc that is there in Uttar Pradesh.” Mr Adityanath earlier this week triggered panic after saying police could arrest individuals and hospitals reporting a shortage of medical oxygen or beds. Police in the state also this week prosecuted a man who had used Twitter to plead for oxygen for an elderly relative. Shashank Yadav was accused of making misleading statements, even though his appeal simply read: “Need oxygen cylinder, ASAP.” Mr Adityanath has insisted there is no shortage of oxygen or beds in the state, but the state will enter a full lockdown from Friday. Another doctor in the state said the government was trying to hide the truth. “If the chief minister visits hospitals, he shall regret his comments that there is no shortage of oxygen,” said an officer in a private hospital in Lucknow, who wished to remain anonymous. “He wants hospitals [to] hide the truth. He is least bothered about the people dying in hospitals and at homes.” Reports of crematoriums overwhelmed by bodies have become increasingly at odds with official death tolls in the state. On Tuesday this week the local government reported 39 deaths in Lucknow, despite a single crematorium in the city's Bhainsakund district reporting 60 Covid-19 cremations. Bodies are allegedly lying for days in overwhelmed hospitals and there are long queues outside crematoriums in the state's major cities of Varanasi, Allahabad, and Kanpur. In Agra, in the same state, the authorities were forced to deny accusations they had taken an oxygen cylinder from an 85-year-old woman, who later died, to give to a well-connected patient. Cities including Delhi and Mumbai have so far borne the brunt of the pandemic in India, but the spread into more rural Uttar Pradesh would make it more difficult to count deaths, said Bhramar Mukherjee, professor of public health and epidemiology at the University of Michigan. “It is spreading now in rural areas and that is where India has the weakest infrastructure of reporting of deaths. In big metropolitan areas, people die in hospitals, but in rural areas they die outside of hospitals and the number of those deaths is much higher in somewhere like Uttar Pradesh." The state is hugely important to the ruling BJP in the local elections. “It is one of the most demographically and politically heavyweight states, which has a huge parliamentary representation. Whoever gains political weight in Uttar Pradesh has a lot of say in the central government and that is why it is so important for the BJP and other political parties," said Avinash Paliwal, Senior Lecturer in International Relations at SOAS University of London. Nationwide, India reported nearly 380,000 new infections on Thursday, and some 3,645 new deaths. As pressure on Mr Modi mounted, Arundhati Roy, the Man-Booker winning author, said his government had failed. “Perhaps 'failed' is an inaccurate word, because what we are witnessing is not criminal negligence, but an outright crime against humanity," she wrote in the Guardian.

The CDC recommends boiling for ten minutes to kill botulism too.

Depends on what the group is doing. Mass singing, shouting, (or anything else that involves heavy breathing) or wiping sweat on each other is strongly discouraged.

...Gupta and several other infectious disease experts said this week that a combination of political, biological, behavioral and meteorological factors led to the outbreak. Parts of India, including New Delhi, the nation's capital with nearly 19 million residents, have lower humidity this time of year. The virus is known to spread better when the air is dry, likely contributing to the enormous spread there, said Dr. Ashish Jha, dean of the Brown University School of Public Health in Providence, Rhode Island. Holiday crowds also helped spread the virus. Authorities postponed the annual pilgrimage of Kumbh Mela by a month until mid-February, but more than 700,000 already had arrived on the banks of the Ganges River by mid-January, and millions more were expected through the end of this month. "It's a huge gathering, and it's a very efficient way of spreading the virus to a large group of people," Jha said. "And then those people dispersed all across India and spread the virus all over the country." Prime Minister Narendra Modi didn't want to jeopardize his popularity by banning the gathering, said Chunhuei Chi, professor of international health at Oregon State University and director of its Center for Global Health. "Even before the celebration cases were already rising, but since the holiday, cases have been rising exponentially," he said. India also tried to ban criticism of government policies in social media, he said. Then there are the variants. The B1.1.7 variant first seen in the U.K. is far more contagious than the original strain of the virus and may be helping to infect more people, Jha said. Lack of surveillance has been a problem in India, he said, making it impossible to understand which variants are there and how far they've spread. Though more surveillance would have been helpful to understanding the outbreak, that alone would not have prevented the tsunami of cases, Jha said. There was enough data without genetic surveillance by early to mid-March to indicate the outbreak was getting worse. "There was plenty of information for action, and that didn't happen, so I don't know to what extent adding genomic surveillance data … would have moved the policy," he said. In February, there were about 350,000 coronavirus cases in India and 2,670 deaths. So far this month, there have been more than 3 million cases, a ninefold increase, and 17,000 deaths, according to data Subramanian tracks at Harvard. Models suggest India's caseload will not peak until mid-May, and it could be even longer if Indians fail totake measures now to reduce infections, Gupta said. Roughly 10% of Indians have been vaccinated so far, she said, with large-scale production and distribution underway in a country well versed in running mass vaccination campaigns. On May 1, every adult will be eligible for a vaccine, she said. But even at the current delivery rate of about 2 million shots a day, the population is so large it will take time to vaccinate enough people to help infection rates fall. Some communities have imposed curfews, and others are considering movement restrictions. No one is expecting a national lockdown, but "in states that are facing unbelievable numbers, numbers you could not even imagine would occur, there has to be more thought to the lockdowns," Gupta said. In the meantime, she said, more testing and high-quality masks are needed, along with spaces for sick people to isolate from healthy family members. Many people don't bother with masks, and even those who do often wear ones made of thin cloth that are not tight-fitting and are "not really an optimal barrier," she said.

The New York Times 'This Is a Catastrophe.' In India, Illness Is Everywhere. Jeffrey Gettleman Tue, April 27, 2021, 2:32 PM NEW DELHI — Crematories are so full of bodies, it’s as if a war just happened. Fires burn around the clock. Many places are holding mass cremations, dozens at a time, and at night, in certain areas of New Delhi, the sky glows. Sickness and death are everywhere. Dozens of houses in my neighborhood have sick people. One of my colleagues is sick. One of my son’s teachers is sick. The neighbor two doors down, to the right of us: sick. Two doors to the left: sick. “I have no idea how I got it,” said a good friend who is now in the hospital. “You catch just a whiff of this…..” and then his voice trailed off, too sick to finish. He barely got a bed. And the medicine his doctors say he needs is nowhere to be found in India. I’m sitting in my apartment waiting to catch the disease. That’s what it feels like right now in New Delhi with the world’s worst coronavirus crisis advancing around us. It is out there, I am in here, and I feel like it’s only a matter of time before I, too, get sick. India is now recording more infections per day — as many as 350,000 — than any other country has since the pandemic began, and that’s just the official number, which most experts think is a vast underestimation. New Delhi, India’s sprawling capital of 20 million, is suffering a calamitous surge. A few days ago, the positivity rate hit a staggering 36% — meaning more than one out of three people tested were infected. A month ago, it was less than 3%. The infections have spread so fast that hospitals have been completely swamped. People are turned away by the thousands. Medicine is running out. So is lifesaving oxygen. The sick have been left stranded in interminable lines at hospital gates or at home, literally gasping for air. Although New Delhi is locked down, the disease is still rampaging. Doctors across this city and some of Delhi’s top politicians are issuing desperate SOS calls to India’s prime minister, Narendra Modi, on social media and on TV, begging for oxygen, medicine, help. Experts had always warned that COVID-19 could wreak real havoc in India. This country is enormous — 1.4 billion people. And densely populated. And in many places, very poor. What we’re witnessing is so different from last year, during India’s first wave. Then, it was the fear of the unknown. Now we know. We know the totality of the disease, the scale, the speed. We know the terrifying force of this second wave, hitting everyone at the same time. What we had been fearing during last year’s first wave, and which never really materialized, is now happening in front of our eyes: a breakdown, a collapse, a realization that so many people will die. As a foreign correspondent for nearly 20 years, I’ve covered combat zones, been kidnapped in Iraq and been thrown in jail in more than a few places. This is unsettling in a different way. There’s no way of knowing if my two kids, wife or I will be among those who get a mild case and then bounce back to good health, or if we will get really sick. And if we do get really sick, where will we go? ICUs are full. Gates to many hospitals have been closed. A new variant known here as “the double mutant” may be doing a lot of the damage. The science is still early but from what we know, this variant contains one mutation that may make the virus more contagious and another that may make it partially resistant to vaccines. Doctors are pretty scared. Some we have spoken to said they had been vaccinated twice and still got seriously ill, a very bad sign. So what can you do? I try to stay positive, believing that is one of the best immunity boosters, but I find myself drifting in a daze through the rooms of our apartment, listlessly opening cans of food and making meals for my kids, feeling like my mind and body are turning to mush. I’m afraid to check my phone and get another message about a friend who has deteriorated. Or worse. I’m sure millions of people have felt this way, but I’ve started imagining symptoms: Is my throat sore? What about that background headache? Is it worse today? My part of town, South Delhi, is now hushed. Like many other places, we had a strict lockdown last year. But now doctors here are warning us that the virus is more contagious, and the chances of getting help are so much worse than they were during the first wave. So many of us are scared to step outside, like there’s some toxic gas we’re all afraid to breathe. India is a story of scale, and it cuts both ways. It has a lot of people, a lot of needs and a lot of suffering. But it also has lot of technology, industrial capacity and resources, both human and material. I almost teared up the other night when the news showed an Indian Air Force jet load up with oxygen tanks from Singapore to bring to needy parts of the country. The government was essentially airlifting air. However difficult and dangerous it feels in Delhi for all of us, it’s probably going to get worse. Epidemiologists say the numbers will keep climbing, to 500,000 reported cases a day nationwide and as many as 1 million Indians dead from COVID-19 by August. It didn’t have to be like this. India was doing well up until a few weeks ago, at least on the surface. It locked down, absorbed the first wave, then opened up. It maintained a low death rate (at least by official statistics). By winter, life in many respects had returned to something near normal. I was out reporting in January and February, driving through towns in central India. No one — and I mean no one, including police officers — was wearing a mask. It was like the country had said to itself, while the second wave was looming: Don’t worry, we got this. Few people feel that way now. Modi remains popular among his base, but more people are blaming him for failing to prepare India for this surge and for holding packed political rallies in recent weeks where few precautions were enforced — possible superspreader events. “Social distancing norms have gone for a complete toss,” one Delhi newscaster said the other day, during a broadcast of one of Modi’s rallies. In India, as elsewhere, the wealthy can pad the blow of many crises. But this time it’s different. A well-connected friend activated his entire network to help someone close to him, a young man with a bad case of COVID. My friend’s friend died. No amount of pull could get him into a hospital. There were just too many other sick people. “I tried everything in my power to get this guy a bed, and we couldn’t,” my friend said. “It’s chaos.” His feelings were raw. “This is a catastrophe. This is murder.” I take few risks except to get food for my family that can’t be delivered. I wear two masks and cut wide berths around as many people as I can. But most days pass with the four of us marooned inside. We try to play games, we try not to talk about who just got sick or who’s racing around this besieged city looking for help they probably won’t find. Sometimes we just sit quietly in the living room, looking out at the ficus and palm trees. Through the open window, on long, still, hot afternoons, we can hear two things: Ambulances. And birdsong.

So sorry to hear of this.

the week ending Sunday, April 25, 2021 DEATHS TO DATE ONE-WEEK TOTAL State Total deaths Per 100K New deaths Per 100K 1-wk chg. United States 572,510 172 4,972 1.5 –3.9% Michigan 18,409 184 475 4.8 +28.0% California 61,100 155 437 1.1 –25.7% Florida 35,534 165 425 2.0 +0.2% New York State 51,695 266 402 2.1 –14.3% Texas 50,155 173 357 1.2 –5.1% Pennsylvania 26,038 203 294 2.3 +3.2% New Jersey 25,380 286 237 2.7 –13.2% Georgia 19,975 188 217 2.0 –19.6% Illinois 24,139 191 184 1.5 +13.6% North Carolina 12,523 119 136 1.3 –2.2% Ohio 19,122 164 131 1.1 –20.1% Arizona 17,268 237 115 1.6 +71.6% Kentucky 6,449 144 111 2.5 +26.1% Virginia 10,691 125 110 1.3 +0.9% Maryland 8,661 143 99 1.6 –7.5% South Carolina 9,430 183 94 1.8 +56.7% Tennessee 12,142 178 93 1.4 +93.8% Massachusetts 17,550 255 88 1.3 +17.3% Alabama 10,851 221 61 1.2 –21.8% Minnesota 7,079 126 59 1.0 –6.3% Puerto Rico 2,265 71 58 1.8 +11.5% Nevada 5,422 176 57 1.9 +72.7% Missouri 9,030 147 55 0.9 –59.3% Louisiana 10,336 222 54 1.2 –18.2% Colorado 6,384 111 54 0.9 +58.8% Washington 5,434 71 54 0.7 –6.9% Wisconsin 7,473 128 53 0.9 +32.5% Connecticut 8,047 226 52 1.5 +2.0% Indiana 13,274 197 50 0.7 –34.2% Iowa 5,927 188 46 1.5 +91.7% West Virginia 2,821 157 36 2.0 –10.0% Nebraska 2,242 116 29 1.5 –514.3% Oregon 2,485 59 25 0.6 +25.0% Arkansas 5,718 190 24 0.8 –27.3% New Mexico 4,024 192 23 1.1 –8.0% Mississippi 7,175 241 22 0.7 –61.4% Oklahoma 6,716 170 19 0.5 –32.1% Utah 2,182 68 18 0.6 +260.0% Montana 1,563 146 17 1.6 –26.1% Kansas 4,968 171 15 0.5 +0% Delaware 1,616 166 14 1.4 –41.7% New Hampshire 1,284 94 14 1.0 +7.7% Idaho 2,031 114 14 0.8 –41.7% Rhode Island 2,660 251 13 1.2 +44.4% North Dakota 1,486 195 7 0.9 –12.5% Maine 772 57 7 0.5 –53.3% South Dakota 1,958 221 5 0.6 –28.6% Hawaii 478 34 4 0.3 +33.3% Washington, D.C. 1,099 156 3 0.4 –80.0% Wyoming 705 122 2 0.3 +0% Vermont 244 39 2 0.3 –81.8% Alaska 334 46 0 0.0 –100.0%

India leads the world in the daily average number of "new infections reported," accounting for one in every 3 infections reported worldwide each day Average number of new infections reported each day in Bulgaria falls by more than 1,800 over the last 3 weeks, 52% of its previous peak Greece crosses 10,000 "reported coronavirus-related deaths." Countries reporting the most new infections each day (7-day average) INDIA 321,606 USA 58,447 BRAZIL 56,817 TURKEY 51,646 FRANCE 29,788 Countries reporting the most deaths each day (7-day average) BRAZIL 2,495 INDIA 2,336 USA 710 POLAND 483 COLOMBIA 432 I am looking at the numbers for the flu season this year. What flu season? Was I the only person who got it? There was ONE pediatric death reported. Or maybe one in the state of New York. I need to chew the numbers more before I feel like I can taste a pattern.

Good morning. Many people in India thought the country had escaped the worst of Covid-19. What happened? April 26, 2021 By David Leonhardt There is a new Covid-19 mystery in India, and it is far grimmer than the first one. For most of the past year, Covid deaths across much of Asia and Africa have been strikingly low, as I described last month. And they remain low in nearly all of Africa and East Asia — but not India, which is suffering a terrible outbreak. Hospitals are running out of oxygen to treat patients, and confirmed Covid deaths have climbed to 2,000 per day, up from fewer than 100 in February. The true death toll is even higher. The sharp increase has surprised many people, both inside and outside India. “India’s massive Covid surge puzzles scientists,” as Smriti Mallapaty wrote in Nature. “I was expecting fresh waves of infection,” Shahid Jameel, a virologist at Ashoka University, said, “but I would not have dreamt that it would be this strong.” The price of hubris To make some sense of what’s happening, it helps to go back to last year, when Indian doctors and officials were preparing for waves of serious Covid illnesses. But those waves never quite arrived. Instead, millions of people contracted only mild cases. The most plausible explanations — the amount of time people spend outdoors in India, the low levels of obesity, the population’s relative youth and the possibility that previous viruses had created some natural immunity — all seemed to suggest that India was not simply on a delayed Covid timetable. The country, like many of its neighbors, seemed to be escaping the worst of the pandemic. Scientific research suggesting that about half of adults in major cities had already been infected was consistent with this notion. “It led to the assumption that India had been cheaply, naturally vaccinated,” Dr. Prabhat Jha, an epidemiologist at the University of Toronto, told me. Government officials acted particularly confident. As Ramanan Laxminarayan, a Princeton University epidemiologist based in New Delhi, told Nature, “There was a public narrative that India had conquered Covid-19.” Some scientists who thought that a new Covid wave remained possible were afraid to contradict the message coming from Prime Minister Narendra Modi’s government. Modi has a record of stifling dissent, and Freedom House, the democracy watchdog group, recently said India had become only a “partly free” country that was moving “toward authoritarianism.” Confident they had beaten Covid, government officials relaxed restrictions on virtually all activities, including weddings, political rallies and religious gatherings. The northern town of Haridwar held one of the world’s biggest gatherings this month, with millions of people celebrating the Hindu festival Kumbh Mela. By mid-March, though, the virus was beginning to reassert itself. A major factor appears to be that many people who previously had mild or asymptomatic cases of Covid remained vulnerable to it. (A recent academic study, done in China, suggests that mild cases confer only limited immunity.) The emergence of contagious new variants is playing a role, too. This combination — less immunity than many people thought, new variants and a resumption of activities — seems to have led to multiple superspreader events, Dr. Jennifer Lighter of New York University told me. The situation is so dire that some Indian crematories are overwhelmed. Suresh Bhai, who works in one in the western state of Gujarat, told The Times that he had never seen such a never-ending assembly line of death. What now? The available solutions are no secret. The same two strategies have worked around the world: restricting the activities that spread the virus, and accelerating the pace of vaccinations. Over the past two weeks, some local governments, including in Delhi and Mumbai, have announced restrictions on travel, weddings, shopping and other activities. Speeding up vaccinations will be more complicated. About 10 percent of India’s population has received at least one shot, leaving more than a billion people to vaccinate fully. To do so, India — a major vaccine manufacturer — has recently cut back on exporting doses. Indian officials have also criticized the Biden administration for not exporting more vaccine supplies to India, given the large U.S. supply. (The U.S. said yesterday that it would do so.) Amid all the suffering, there is one glimmer of potential good news, Jha said. Caseloads in India’s second-most populous state — Maharashtra, home to Mumbai — have often been a leading indicator of national trends, and cases there have leveled off over the past week. It’s too early to know whether that’s just a blip, but it would be a big deal if the situation in Maharashtra stabilized. The latest: In another anti-democratic move, India’s government ordered Facebook, Instagram and Twitter to take down posts critical of its handling of the pandemic.

Countries reporting the most new infections each day (averaged over 7 days) INDIA 281,683 USA 64,173 BRAZIL 60,185 TURKEY 59,204 FRANCE 31,532 Countries reporting the most deaths each day (averaged over 7 days) BRAZIL 2,580 INDIA 1,802 USA 714 POLAND 508 MEXICO 412 Note that Canada's infection rate (reported infection numbers) is not huge but is about as high as it has ever been, with last week's number being higher, and that next week's death rate for them might be their highest death week since this began.

India's COVID tsunami is the worst in the world. Why that should concern Americans. Andrew Romano·West Coast Correspondent Thu, April 22, 2021, 10:02 AM In America, it’s easy to believe — and likely correct, given the country’s rapid pace of vaccination and high level of prior infection — that the worst of the COVID-19 pandemic is over. But in India right now, every day is worse than the last. “In the last 24 hours alone, [India has] had 300,000 cases, and that’s most certainly an undercount,” said Dr. Kavita Patel. “In some parts of India, like Mumbai and New Delhi, as high as 1 in 3 or 1 in 4 people are testing positive, [and that’s] actually, again, an underestimate. As a result, India’s hospitals are completely full. There is now rationing of everything, including doctors, nurses, oxygen, beds, supplies.” More than one year into the pandemic, the deepening disparities between two of the world’s largest countries should remind optimistic Americans that the light at the end of their own tunnel remains a long way off for most of the planet’s population — and that it’s probably time for the U.S. to start thinking about how it can help end the pandemic elsewhere too. At its peak this winter, the U.S. was recording an average of 260,000 new COVID-19 cases each day. Yet after skyrocketing 122 percent over the last 14 days, India’s daily case counts have already crossed that threshold twice this week. The curve is so steep, it’s almost vertical. If the virus continues to spread at the same clip, according to Bhramar Mukherjee, a biostatistician at the University of Michigan, India could be averaging half a million new daily cases within the next month — a figure that no other country has ever come close to. Deaths are likely to follow: Over the past two weeks alone, they have soared 128 percent. At this point, India accounts for about 1 in every 3 new cases globally. Its rate of spread is the fastest in the world. And the tsunami shows no sign of subsiding anytime soon. But the bigger problem is that these terrible numbers tell only part of the story. For one thing, India is currently testing at a much lower rate (about 1 test per 1,000 residents per day) than the recent high-water marks in Western countries such as the U.S. (5.5), France (8) or the U.K. (21). Meanwhile, in Delhi, one of India’s hardest-hit areas, test positivity reached 30 percent this week, prompting a six-day lockdown. The combination of inadequate testing and high positivity suggests that hundreds of thousands of infections are going undetected each day. Many — perhaps most — COVID-19 deaths are being missed as well. India is currently averaging more than 1,100 daily deaths, the second-highest level in the world after Brazil. But as Ramanan Laxminarayan, an economist and epidemiologist who is the founder and director of the Center for Disease Dynamics, Economics & Policy, explained in a recent interview with the New Yorker, “We don’t know the cause of death for four out of five people in normal times” in India because “only one in five deaths is medically recorded” — and “that has continued during COVID.” At the same time, Laxminarayan continued, “the levels of testing are so low that the people who didn’t get tested and then died of a stroke or a heart attack that was likely COVID-related would not be reported as a COVID death.” The undercount, in other words, is probably huge. Reports from the frontlines of India’s spiraling surge support this theory. According to a Reuters investigation published Monday, “Several major cities are reporting far larger numbers of cremations and burials under coronavirus protocols than official COVID-19 death tolls, according to crematorium and cemetery workers, media and a review of government data.” In Surat, for instance, Reuters reported that over the last week, two facilities have cremated more than 100 bodies a day under COVID protocols — far in excess of the city’s official daily COVID death toll of around 25. At one of them, gas and firewood furnaces have been running so long without a break that “metal parts have begun to melt.” In Lucknow, data from the largest COVID-only crematorium shows that the number of bodies that arrived on six different days in April was twice as high as the official number of deaths recorded across the entire city. Elsewhere, India Today reported that two Bhopal facilities alone cremated 187 bodies on days when the city’s official death toll stood at five, and in Ahmedabad last week, 63 bodies left a single COVID-only hospital for cremation on a day when the entire city recorded just 20 coronavirus deaths. Hospitals, likewise, are on the brink of collapse. “There are two patients per bed in the big hospitals in New Delhi, and that’s if you can get into the hospital in the first place. There are literally lines of ambulances that are fifty or a hundred long,” Laxminarayan said. The result is a vicious cycle: the more patients have to compete for limited beds, oxygen and medicine, the more care suffers — and the more people die who could have been saved. “The huge pressure on hospitals and the health system right now will mean that a good number who would have recovered had they been able to access hospital services may die,” Gautam Menon, a professor at Ashoka University, told Reuters. The point is not just that the situation is bad in India, and likely to deteriorate even further. The point is that India is not all that unique. Like many poorer countries across the developing world, it seemed to dodge a bullet during earlier stages of the pandemic, leaving most of its population untouched — and lacking any immunity. Like many of those same countries, India was lulled into a false sense of security after a seemingly successful lockdown and a recent ebb in infections; less than two months ago, the country’s health minister announced that it had entered “the endgame” of the pandemic, and mass gatherings — cricket matches, large weddings, election rallies — promptly resumed. And as in nearly all other developing countries, barely anyone in India — just 8 percent of its vast population — has received at least one vaccine dose. To put that in perspective, 40 percent of Americans, 50 percent of Britons and 60 percent of Israelis have received at least one vaccine dose. Yet globally, the U.S., the U.K. and Israel are outliers. So far, just 33 countries have administered one vaccine dose to at least 20 percent of their residents. The other 160 or so haven’t — and more than 100 of them are lagging even further behind than India. Epidemiologists tend to tell Americans they should care about these inequities because they pose a direct risk to America’s progress against the pandemic in the form of variants, or mutant versions of the virus that can potentially dodge immunity, evade vaccines and/or transmit more efficiently from person to person. Why? Because dangerous variants are most likely to evolve in places where spread is high and lots of people are sick for long periods of time. And it’s true, for what it’s worth, that India is now battling a concerning variant of its own. Called B.1.617, it is a “double mutant,” with a pair of protein-spike changes that may increase its transmissibility and help it partly resist immunity. Scientists are still trying to figure out what role, if any, B.1.617 is playing in India’s surge. To be safe, the U.K. on Monday banned travel from India, and Prime Minister Boris Johnson canceled his own trip there. The bottom line, however, is that India — with its relative lack of prior immunity, its slow rate of vaccination, its mass gatherings and its close quarters — was vulnerable to a massive COVID-19 surge even without a new variant making matters worse. And so are most other countries around the world. By the same token, a country like the U.S. — home to just 4.3 percent of the world’s population but a full 23.9 percent of its vaccinations — is increasingly invulnerable. Even the risk of variants is likely overhyped in America: The existing vaccines still protect against them, and extra-effective booster shots are already in development. So as U.S. supply starts to exceed demand — and as even the nation with the world’s largest vaccine maker struggles to vaccinate its own people — the question then becomes: What is America, with a population of 328 million, ultimately going to do with the rest of the 1.2 billion vaccine doses it has already secured? “Now that we have experienced our own supply and it is sufficient for our entire population, [the United States] should shift gears to thinking about allocating any excess vaccines, as well as our own domestic manufacturing ability, to help other countries,” said Patel. “That is something that we’re going to have to contend with as we are getting closer and closer to our own herd immunity … but other countries are significantly behind.”

California goes from worst to first in virus infections BRIAN MELLEY Thu, April 22, 2021, 8:13 PM LOS ANGELES (AP) — Just a few months ago, California was the epicenter of the coronavirus pandemic in the U.S. Hospitals in Los Angeles were drowning in patients, and ambulances were idling outside with people struggling to breathe, waiting for beds to open. The death count was staggering — so many that morgues filled and refrigerated trucks were brought in to handle the overflow. Now as cases spike in other parts of the country, California has gone from worst to first with the lowest infection rate in the U.S. even as it has moved quickly to reopen more businesses with greater customer counts and allow larger gatherings. A scramble to get COVID-19 vaccinations has given way to an open invite in many places. Where people lined up hours and counties struggled to get doses, there now appears to be a glut of the shots in many locations. “It has been a success story for California to have gone from our, if you will, viral tsunami that happened after the back-to-back holiday season to where we are now,” said Dr. Robert Kim-Farley of the University of California, Los Angeles' public health school. At the peak of California's winter surge that followed the Thanksgiving, Christmas and New Year's holidays, the state was recording 40,000 new cases daily and well above 500 deaths per day. Those numbers have dwindled to 2,300 new cases and 68 deaths daily. The state surpassed Hawaii on Thursday with the lowest average number of cases per capita in the past two weeks, according to data compiled by Johns Hopkins University. One in every 2,416 people in California tested positive in the past week. At the other end of the spectrum, one in every 223 people in Michigan was diagnosed with the virus. Kim-Farley said it's been like turning around a massive tanker ship to reach today's level of improvement. He credited government and public health agencies with providing clear guidelines that businesses, schools and individuals largely followed, including mask mandates and social distancing. Gov. Gavin Newsom has been allowing businesses and schools to reopen by county based on case levels. At different points in the pandemic, he has faced heavy criticism for being too restrictive, and now some worry he is moving too quickly. All counties have improved enough to move out of the strictest of four tiers, and 38 of the 58 counties — accounting for 87% of the state's population — now are in the second least-restrictive tier. Newsom said he plans to lift most remaining coronavirus restrictions by June 15. The pandemic has surged unevenly across the U.S. Cases were low in California a year ago, compared with New York, where hospitals were overwhelmed last spring. When California was in the throes of a second winter spike in mid-January, Michigan cases were tapering to a low point in February before surging to the highest current infection rate in the U.S. Kim-Farley said California's surge had put fear into more people to wear masks, a rule still in place that he said he has helped prevent a resurgence. “Some states in the United States that lifted mask mandates are suffering the consequences of that with increasing numbers of cases while we are continuing to see decreases,” he said. California struggled with its vaccine rollout like other states, limiting doses to health workers and elderly who were more at risk of being hospitalized or dying. Doses have increased as cases have tapered, and the high number of infections over the winter also led to a certain level of natural immunity. Only weeks ago, counties struggled to get doses. The state limited eligibility for the precious vaccine, and stories abounded of cheaters jumping the line to get a shot. The Vaccine Spotter website that helps book appointments showed a state map Thursday awash in green dots, indicating available appointments. Many were available the same day, and some sites were allowing people to show up without appointments. Los Angeles County opened up sites in Palmdale and Lancaster to walk-ups. The largest mass vaccination clinic in Napa County saw demand drop from a flood to a trickle just days after California last week expanded vaccine eligibility to everyone 16 and older. It's also allowing walk-ins. “We definitely have the capacity,” county spokeswoman Janet Upton said. “But now what we’re lacking is, seemingly, public interest.” California has about 40 million residents, and a little more than half the 32 million eligible for vaccines have gotten at least one shot. A combination of concern over reports of rare complications along with misinformation and conspiracy theories and a sense among some that the danger has waned has led to vaccine hesitancy. Los Angeles County Public Health Director Barbara Ferrer tried to persuade more people to set aside worries about the vaccine, noting that the chance of a serious side effect is the same as dying in a 200-mile road trip that most people would not hesitate to take. "The risk of having a serious side effect from COVID vaccine is about one in a million,″ she said. “We take these tiny risks every day as we go about our lives because we know what’s on the other side of it is so worthwhile. Similarly, the return to normal that’s on the other side of vaccination is worthwhile.” With the rollout of the vaccine, mortuaries that had run out of space have returned to normal. “It’s the difference between night and day,” said Todd Beckley, the general manager of Inglewood Cemetery Mortuary. “There was a time where we had nine deaths a day, and they were all COVID. We haven’t had a COVID death in four days.”

In many places, it is illegal to release animals after you have trapped them.

Guinea pigs need Vitamin C supplements if you are going to raise them on rabbit rations. They are squeakier than rabbits, and their backs break very easily. You can up-size them pretty quickly by taking the biggest of each litter as your breeders, but that risks sacrificing other qualities, so watch your other goals (litter size, mothering skill, etc.) too. They taste like pork, with a fattier meat that will keep you from dying of "rabbit starvation."

A more scientific version of what Homesteader was saying: Vaccines Adapted for Variants Will Not Need Lengthy Testing, F.D.A. Says By Noah Weiland, Katie Thomas and Carl Zimmer Feb. 22, 2021 The Food and Drug Administration said on Monday that vaccine developers would not need to conduct lengthy randomized controlled trials for vaccines that have been adapted to protect against concerning coronavirus variants. The recommendations, which call for small trials more like those required for annual flu vaccines, would greatly accelerate the review process at a time when scientists are increasingly anxious about how the variants might slow or reverse progress made against the virus. The guidance was part of a slate of new documents the agency released on Monday, including others addressing how antibody treatments and diagnostic tests might need to be retooled to respond to the virus variants. Together, they amounted to the federal government’s most detailed acknowledgment of the threat the variants pose to existing vaccines, treatments and tests for the coronavirus, and came weeks after the F.D.A.’s acting commissioner, Dr. Janet Woodcock, said the agency was developing a plan. “The emergence of the virus variants raises new concerns about the performance of these products,” Dr. Woodcock said in a statement Monday. “We want the American public to know that we are using every tool in our toolbox to fight this pandemic, including pivoting as the virus adapts.” Most of the vaccine manufacturers with authorized vaccines or candidates in late-stage trials have already announced plans to adjust their products to address the vaccine variants. The Moderna and Pfizer-BioNTech vaccines use mRNA technology that the companies have said can be used to alter the existing vaccines within six weeks, although testing and manufacturing would take longer. Moderna has already begun developing a new version of its vaccine that could be used as a booster shot against a virus variant that originated in South Africa, known as B.1.351, which seems to dampen the effectiveness of the existing vaccines. A fast-spreading coronavirus variant first observed in Britain has also gained a worrisome mutation that could make it harder to control with vaccines. That variant with the mutation was found in the United States last week. Still, the guidance did not appear to be written with the assumption that new vaccines were imminent, or would be needed at all. Despite the recent indications that some variants — and particularly B.1.351 — make the currently authorized vaccines less effective, the shots still offer protection and appear to greatly reduce the severity of the disease, preventing hospitalizations and death. Asked at a news briefing on Monday afternoon how much the variants would need to spread before updated vaccines were necessary, Dr. Woodcock did not give any specific criteria. “We need to anticipate this and work on it so that we have something in our back pocket before the threshold is upon us,” she said. An updated Covid-19 vaccine can skip the months-long process of a randomized clinical trial that would compare it with a placebo, the agency said. But a tweaked vaccine will still need to go undergo some testing. In trials proposed by the F.D.A., researchers will draw blood from a relatively small group of volunteers who have been given the adapted vaccine. Scientists will then observe what percentage of volunteers’ samples produce an immune response to the variants in the lab, and how large that response is. The vaccines will be judged acceptable if they produce an immune response that is relatively close to the one prompted by the original vaccines. Dr. Peter Marks, the top vaccine regulator at the F.D.A., said at the news briefing that studies would include a “few hundred” people and last several months. Volunteers will also be monitored carefully for side effects. The agency said the testing could be done in a single age group and then extrapolated to other age groups. The guidance also encouraged the use of animal studies to support the case for modified vaccines, in case immune response studies come up with ambiguous conclusions. The F.D.A. acknowledged that many questions remained unanswered, such as what type of data would trigger the need for an adapted vaccine and who would make that decision. The agency also noted that scientists had not yet determined the minimum level of antibodies in a vaccinated person’s blood that would protect someone from the virus. Some other vaccines are regularly updated in a similar way. Because the influenza virus evolves rapidly from one year to the next, vaccine developers have to come up with new recipes annually. The newly tweaked Covid-19 vaccines would be authorized under an amendment to the emergency authorization granted to the original vaccine, regulators said. BOLD MINE ++++ The article above had a paragraph I cut out about "what you need to know" about the Johnson & Johnson "pause" in vaccine distribution. It was far from what you need to know. Did y'all notice for example that the Johnson & Johnson blood clots (at least the ones they're telling us about now) showed up only in women of childbearing age? These are the people who never get into the test groups when they're testing drugs -- for very good reason.

COVID-19 Vaccine Booster Doses May Soon Be a Reality. Here’s What Experts Know So Far. Pfizer, Moderna, and Johnson & Johnson are trying to stay ahead of highly infectious coronavirus variants. By Korin Miller Apr 16, 2021 In an attempt to ensure the effectiveness of their COVID-19 vaccines against new variants of the novel coronavirus, both Pfizer and Moderna are testing a third booster shot of their respective two-dose vaccines. On February 25, Pfizer announced that it is studying a third booster dose in some people who received their first dose of the vaccine more than six months ago. The company specifically stated that emerging and future variants of SARS-CoV-2, the coronavirus that causes COVID-19, were the reason for the study. Pfizer also said that it is exploring the possibility of a new, “variant-specific vaccine” that would target B.1.351 (the highly infectious South African variant). Moderna also announced that it has finished making a variant-specific vaccine to target B.1.351, and the company has begun a Phase 1 clinical trial of the vaccine. Moderna says that it will explore the use of the new vaccine as a “booster dose” for people who are already fully vaccinated, to see if it can “boost immunity against the variants of concern.” Pfizer’s CEO Albert Bourla, Ph.D., has said that people can anticipate the need for a booster. He made the comments in an interview with CNBC, explaining that it’s “likely” people who have received the full two-dose regimen of the Pfizer-BioNTech vaccine will need to have another dose “somewhere between six and 12 months and then from there, there will be an annual revaccination, but all of that needs to be confirmed.” Moderna’s CEO Stephane Bancel confirmed to CNBC that the company will likely have a booster dose for its vaccine ready by the fall, so that additional protection is ready ahead of peak flu season. Both the Pfizer and Moderna vaccines use messenger RNA (mRNA) technology. The vaccines, which do not contain live virus, encode a part of the spike protein—the piece of the virus that latches onto human cells—found on the surface of SARS-CoV-2, according to the Centers for Disease Control and Prevention (CDC). This gives your cells instructions to develop a piece of that protein that is unique to SARS-CoV-2. Your immune system recognizes these new pieces of protein as foreign invaders and mounts an immune response to fight off what it interprets as an infection (even though there is no threat). This causes you to develop antibodies specific to SARs-CoV-2, which will help you fight off future infections. Your body eventually eliminates both the mRNA and the proteins, but the antibodies stick around. Just how long they last, though, is still being studied—the CDC specifically says that more data from both vaccines is needed, but current studies suggest at least six months for the mRNA vaccines. Both vaccines were found to be highly effective during Phase 3 clinical trials. Research from Pfizer’s Phase 3 clinical trial showed that its vaccine is 52% effective after the first dose, and about 95% effective after the second dose in adults ages 16 and up. Results of Moderna’s Phase 3 clinical trial, which were published in The New England Journal of Medicine, found that the company’s vaccine is about 94.1% effective against COVID-19 in people ages 18 and older. But—and this is a big but—the trials were conducted before variants like B.1.1.7, which was first detected in the U.K., and B.1.351 began spreading rapidly, says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. In other words, there is a possibility that the effectiveness of the vaccines today may be lower than what the data from months ago indicates. With the new research being conducted, both Pfizer and Moderna are “trying to preemptively address whether the variants could impact the immunity generated by their vaccines,” says Reynold Panettieri, M.D., director of the Institute for Translational Medicine and Science at Rutgers University. The Johnson & Johnson vaccine works differently than its mRNA competitors. It modifies an existing cold virus with the spike protein. The resulting adenovirus doesn’t have the ability to reproduce in your body, so it can’t cause COVID-19 or other illnesses. The modified virus is pulled inside your cells after the single dose, where it travels to the nucleus, home to its DNA. The adenovirus then puts its DNA into the nucleus, the spike protein gene is read by the cell, and it’s copied into mRNA. This prompts an immune response, causing your body to produce antibodies to the perceived threat. The vaccine is 85% effective at preventing a severe or critical form of COVID-19 that can lead to hospitalization or death at least 28 days after vaccination, according to data released by the company, which has been confirmed in a Food and Drug Administration (FDA) analysis. In a February interview with CNBC, Johnson & Johnson’s CEO Alex Gorsky said that people may need to get the single-dose vaccine each year for several years, similar to the annual flu shot. “Unfortunately, as [the virus] spreads, it can also mutate,” he said. “Every time it mutates, it’s almost like another click of the dial, so to speak, where we can see another variant, another mutation that can have an impact on its ability to fend off antibodies.” That said, the future of the Johnson & Johnson vaccine is currently unclear after the FDA and CDC temporarily paused its use in the U.S. while investigating reports of extremely rare blood clots believed to be linked to the vaccine. All six reported cases out of 6.8 million doses administered, as of April 12, occurred in women between the ages of 18 and 48, with symptoms emerging six to 13 days after vaccination. The agencies stress that the clots “appear to be extremely rare” and the step is out of an “abundance of caution” until a thorough investigation is completed. It’s hard to say at this point, given that not enough time has passed to collect data on this, says infectious disease expert Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security. (Remember: The first COVID-19 vaccines were distributed in the U.S. in December 2020.) Pfizer, Moderna, and Johnson & Johnson have all suggested that they are concerned about the South African variant’s potential impact on the effectiveness of their vaccines, as well as the possibility that future variants may make their vaccines less effective. “It’s still early days in the science,” Dr. Schaffner says. “It may well be that we could use the standard vaccine as a booster to protect against variants—if we need it. We still don’t know how long the standard two-dose vaccine will protect us.” There are different strategies to deal with variants, adds Dr. Adalja. “One is to reformulate the vaccine, and the other is to add another booster with the same formulation,” he explains. Creating a booster could increase antibodies and T cells (a type of white blood cell that’s an essential part of your immune system) enough to help tackle variants of the original, dominant SARS-CoV-2 strain. It’s also possible that a booster shot may make an already effective vaccine even more effective. “They may be trying to see if they can get the efficacy up closer to 100%,” Dr. Panettieri says. Until medical experts know more, Dr. Adalja emphasizes that receiving two doses of the Pfizer or Moderna vaccine will still offer worthy protection. “The priority still should be getting people vaccinated with the original vaccine, which does have an impact on all of the variants when it comes to what matters—serious illness, hospitalization, and death,” he says. Plus, people across the country are still waiting to get their first dose of the vaccine. “[A third dose] would be logistically difficult in the short term,” Dr. Adalja says. But, he adds, distribution should get easier with time as more vaccination systems and supplies become available.

Hm. I read that wrong, since nobody suggested pulling out plants every year--just every other year. Even that is a really bad idea, though.

India's desperate Covid-19 patients turn to black market for drugs By Vikas Pandey BBC News, Delhi Published13 hours ago Akhilesh Mishra started getting a fever and a cough last Thursday but he initially thought it was just the flu. Akhilesh began to worry the next day, when his father Yogendra developed similar symptoms. The two men decided to get Covid RT-PCR tests done and tried to book a slot online but the next available appointment was three days later. They finally managed to get a slot on Sunday. In the meantime, Yogendra was running a very high fever and his doctor advised him to look for a hospital bed, which turned out to be another daunting task. They were turned away by many private hospitals in the city of Noida and also in the capital, Delhi. The family finally managed to get a bed for him in a private hospital in Delhi and he is now recovering. Akhilesh had thought he would lose his father. "I felt depressed," he said. "I feared that he was going to die without getting treatment. No son should have to go through what I went through. Everybody should have equal access to care." The family's story is not unique. Accounts of family members struggling to find a bed, or life-saving drugs or oxygen cylinders, are being reported all over India. In some cities, there is a long waiting list at the crematoriums. People also have to wait for several hours to get tested for Covid-19 at labs in many cities, including Delhi. And results are coming after 48-72 hours. "I have had symptoms for three days and it's making me anxious that I have to wait for 2-3 days to get a report," a 35-year-old man said outside a lab in Noida. Black-marketing of drugs In recent days in India, social media has been awash with desperate requests for help finding the drugs remdesivir and tocilizumab. The effectiveness of the two drugs is being debated across the world but some countries, including India, have given emergency use authorisation to both. The antiviral drug remdesivir is being prescribed by doctors across the country, and it is in high demand. India has banned exports, but manufacturers are still struggling to meet the demand. India has reported more than 150,000 Covid cases a day for the past three weeks. Hetero Pharma, one of seven firms manufacturing remdesivir in India, said the company was trying to ramp up production. The BBC has found that the shortage in supply is leading to black marketing of the drug in Delhi and several other cities. At least three agents contacted by the BBC in Delhi agreed to supply each 100mg vial of remdesivir for 24,000 rupees ($320; £232) - five times the official price. India's health ministry recommends six doses of 100mg vials for a patient for one course of the drug, but doctors say up to eight doses are needed in some cases. That is a lot of money for a middle-class family. "I had to spend so much money to get the drug, said Atul Garg, whose mother was admitted to a private hospital in Delhi. Finding the drug required "hundreds of calls and many anxious hours", Atul said. Tocilizumab, a drug normally used to treat arthritis, has been proven to save lives in some clinical trials. But it has almost disappeared from the market in India. Rajiv Singhal, general secretary of the All India Chemists and Druggists Association, said his phone was ringing through the day as people asked him to help find the drugs. "The situation is so bad that I can't even get the drugs for my own family members," he said. "We are trying to take action against those who are black marketing, but I admit that there are leakages in the system." Oxygen, X-rays and Covid tests The demand for medical oxygen has also soared in several Indian sates. Several hospitals are turning patients away because they lack supplies. Maharashtra state Chief Minister Uddhav Thackeray asked the federal government to send oxygen by army aircraft, as road transportation was taking too long to replenish the supply in hospitals. The situation is much worse in small cities and towns. When patients are not able to find a hospital bed, doctors advise them to arrange oxygen cylinders at home. Nabeel Ahmed's father was diagnosed with Covid on Friday in a small town in northern India. Five days later, he started having difficulty in breathing. The doctor advised Nabeel to get an oxygen cylinder at home. He had to drive for four hours to another city to pick one up. "It took me eight hours to get a cylinder for my dad while he was struggling to breathe," he said. Another major problem patients are facing in smaller towns is that private labs are refusing to conduct chest X-rays and CT scans. Doctors often ask for these tests to assess the progress of the disease. Yogesh Kumar, who lives in the northern town of Allahabad, said the only way for him to get an X-ray done was to either get admitted to a hospital or to get the test done at a government-run hospital, where the waiting list was too long. A doctor in Allahabad told the BBC: "It's unbelievable that I am unable to get X-rays done for my patients. We have to just rely on blood reports to assess the disease in some cases, which is not ideal." Busy crematoriums Crematoriums in many badly affected cities are running day and night. In some cases, families have to wait for several hours to cremate the deceased. A recent report said that the metal structure of the furnaces inside a crematorium in the western Indian city of Surat had started melting because it had been running day and night without any break. A short video clip went viral recently showing dozens of funeral pyres burning in the northern city of Lucknow in the middle of the night. Many staff members at crematoriums are working without a break. They are getting exhausted. Many around India are asking if these situations were avoidable. "We did not learn lessons from the first wave. We were aware that the second wave was coming but we didn't plan to avoid unfortunate incidences like shortages of drugs, beds and oxygen," said epidemiologist Dr Lalit Kant. "We didn't even learn from other countries which faced similar circumstances," he said. Some names have been changed on request.

My friend X is now living out his life in a VA hospital, and oddly enough is under medication that keeps him from being able to talk coherently.