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2020-2021 Corona Virus

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Lovely pair of consecutive headlines in a list:


Carnival, Princess, Holland America, Norwegian announce plans to resume cruising this summer
Norwegian, Princess , Holland America and Carnival announced plans to resume cruising this summer, including some voyages to Alaska.

Thailand sees first local cases of Indian COVID-19 variant

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I wonder if they will be resuming the cruises from the US.  

I have family in Thailand. :(

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Countries reporting the most new infections each day averaging the last seven days
INDIA             283,597

BRAZIL            64,489

USA                 29,980

ARGENTINA    29,277

COLOMBIA      15,619

Countries reporting the most deaths each day averaging the last seven days
INDIA               4,145

BRAZIL            1,954

USA                   591

COLOMBIA       496



Of every 100 infections last reported worldwide, more than 56 were reported from Asia and the Middle East. The region is reporting a million new infections about every two days.  The situation as reported is getting worse most notably in Bahrain, Sri Lanka, Maldives, Malaysia, Taiwan, Vietnam, Thailand, Timor-Leste and Afghanistan.

In Europe, it's only getting substantially worse in Denmark and Russia (as reported).  UK and Portugal have up-ticks that seem under control.  The average number of new infections reported in the Netherlands has fallen for 12 days straight.

Latin America shows the situation getting worse in Argentina, Bolivia, Cuba, Suriname, Trinidad and Tobago, Paraguay, Guyana, Colombia, Honduras, Brazil, and Uruguay

In Africa, the situation is getting worse in Botswana, Angola, Egypt, Burundi, Namibia, Eritrea, and Rwanda, as best we know.

In Oceania, Papua New Guinea is again getting worse.


All the above are up to date.  Now for last week's numbers:


In the US, deaths for the week ending May 16 totaled 4,165, the lowest weekly death toll since March 2020.  Roughly 37% of the population was fully vaccinated, and 47% had at least one dose. 

Only four states reported higher infection rates than the week prior, and one of those was Alabama.  The thing with Alabama was that they processed a backlog that added 9000 positive cases, so basically the week should be ignored except in a yearlong tally.  The same thing happened in Alabama in late March, with nearly 8000 cases.  Either they focus on clearing out backlogs every couple of months, or something political is going on.  The other rising totals were Mississippi (1544 new cases), Vermont (397 new cases), Washington DC (365 new cases) and Nevada (2559).


Where cases increased in the last week

For the week ending Sunday, May 16, 2021

State Total cases Per 100K New cases Per 100K 1-wk chg.
Alabama 540,083
11,015 9,095 185.5
Mississippi 314,710
10,574 1,544 51.9
Washington, D.C. 48,545
6,879 365 51.7
Vermont 23,883
3,828 397 63.6
Nevada 320,539
10,407 2,559 83.1


In a nutshell, this shows Mississippi in trouble.  The per capita infection rate is higher in Vermont; however, the per capita income in Vermont is more than double the per capita income in Mississippi, and money makes a difference in medical care.  At 33.2%, Mississippi has the lowest vaccination rate in the country.  Medicaid spends over 7000 a person there, nearly half of it being for "managed care," meaning the practice of paying private health plans with Medicaid funds to cover enrollees (something the deep red state government does very little to publicize), and three quarters of that is eligible for federal matching funds.  And still people go to Alabama for hospital care, miles and miles from home.  There is talk now in some quarters of including vaccination status in the triage criteria, should there be need.  In a state like Mississippi, there is always some de facto triage going on--whether people admit it or not--but given the hospitalization chart below, I do not think the kind of triage they are talking about is going to hit Mississippi anytime soon, unless a spike like this hits again and surrounding states suddenly stop taking the overflow. 

You notice I haven't mentioned Nevada.  I only know two people there, and they are on Medicaid.  One has been trying for two years to get glasses, and trying for several years to get reconstructive surgery on his thumb that would allow him to return to work.  The per capita income there is a little higher than Mississippi, much lower than Vermont.  The air is dry, which Covid loves.  Las Vegas, with the casinos reopened, could be ground zero if Covid does develop a new, ground-sweeping mutation for the US.  Watch for that.


The chart for the hospitalized is overall very good:


For the week ending Sunday, May 16, 2021

State Avg. this week Per 100K 1-wk chg.
United States 30,346
Connecticut 230
Alaska 36
Vermont 11
New Hampshire 61
Delaware 90
South Dakota 69
New Jersey 992
Puerto Rico 259
New York State 1,837
Michigan 2,158
Maryland 720
Rhode Island 96
Idaho 85
Minnesota 468
Massachusetts 392
Pennsylvania 1,715
Iowa 153
New Mexico 120
Ohio 925
Kansas 165
Virginia 723
North Dakota 36
Tennessee 703
Indiana 857
Florida 2,628
Illinois 1,813
Georgia 1,288
Texas 2,337
Colorado 655
Hawaii 51
Arizona 587
Maine 122
South Carolina 349
California 1,785
Nevada 325
Nebraska 123
Wisconsin 327
Arkansas 169
Louisiana 319
Kentucky 406
Oklahoma 170
Alabama 351
Washington 654
Montana 65
North Carolina 1,037
Missouri 756
Oregon 356
Utah 155
Mississippi 219
Washington, D.C. 100
West Virginia 257
Wyoming 31


Edited by Ambergris
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Benjamin Mueller
Tue, May 25, 2021, 4:42 AM
LONDON — A new and potentially more contagious variant of the coronavirus has begun to outpace other versions of the virus in Britain, putting pressure on the government to shorten people’s wait for second doses of vaccines and illustrating the risks of a faltering global immunization drive.  The new variant, which has become dominant in India since first being detected there in December, may be responsible in part for a grievous wave of infections across Southeast Asia, including Nepal, where people have been dying in hospital corridors and courtyards. But efforts to understand the variant picked up once it began spreading in Britain, one of at least 49 countries where it is present. Scientists there are sequencing half of all coronavirus cases amid a push to complete the reopening of its economy.  The preliminary results out of Britain, drawn from only a few thousand cases of the variant, contained both good and bad news, scientists said.

The variant, known by evolutionary biologists as B.1.617.2, is “highly likely” to be more transmissible than the variant behind Britain’s devastating wintertime surge, government scientists have said. That earlier variant, known as B.1.1.7, was itself considerably more contagious than the one that first emerged last year in Wuhan, China.

A Public Health England report published this past weekend provided signs that government scientists said were consistent with a more transmissible virus: The variant first seen in India was roughly 50% more likely than B.1.1.7 to be transmitted to the close contacts of an infected person. Government scientists said last week that it could be anywhere from a few percentage points to 50% more contagious than B.1.1.7.

Helpfully for Britain and other wealthy nations, the latest worrisome variant has emerged at a less dire moment of the pandemic. More than 4 out of every 5 people in England above the age of 65 — among the groups most vulnerable to the virus — have been given both doses of a coronavirus vaccine, driving down hospitalizations and deaths. 

And a new study by Public Health England offered reassuring signs that fully vaccinated people were about as well protected from the variant first detected in India as they were from other forms of the coronavirus.  The Pfizer-BioNTech vaccine offered 88% protection against the variant first sampled in India, only a slight drop from the 93% protection given against the variant from Britain, Public Health England said. The AstraZeneca-Oxford vaccine was 60% effective against the variant from India, compared with 66% effective against the one first seen in Britain.  Because Britons started receiving AstraZeneca’s vaccine later than Pfizer’s, they have been followed for a shorter period, meaning that the effectiveness figures for that vaccine may underestimate the true numbers, scientists said. Other studies in England have shown little to no difference between the effectiveness of the Pfizer and AstraZeneca vaccines.

For now, a rise in cases of the variant from India has not caused an overall surge in the virus in Britain. And not all scientists are convinced that the variant is as contagious as feared. The true test will be whether it surges in other countries, especially those — unlike Britain — that are grappling with high case counts of other variants, Andrew Rambaut, a professor of molecular evolution at the University of Edinburgh in Scotland, wrote on Twitter.

In Britain, part of its rapid growth may have to do with the particular places it was first introduced. Bolton, in northwest England, where the new variant is most advanced, is a highly deprived area with tightly packed housing that could be hastening its spread, scientists said.  “We do not know if the increase in transmissibility is the result of specific mixing patterns, or superspreading events,” a group of researchers led by Robert Challen of the University of Exeter reported on May 11, in a study that was among those presented to an influential government advisory group.  That government advisory body said several days later that it had “high confidence” that the variant first seen in India was indeed more contagious, warning that a “substantial resurgence of hospitalizations” was possible. It said that the variant was gaining a foothold in diverse parts of Britain where “contact patterns or behaviors” alone could not explain its spread.

It is not clear if the variant from India is any deadlier than B.1.1.7. 

With cases of B.1.1.7 falling, the variant first seen in India now accounts for roughly half of the sequenced coronavirus cases being monitored by Public Health England. The agency’s scientists have said it was likely to replace B.1.1.7 as England’s dominant virus within a month, a startling turnabout so soon after B.1.1.7 swept much of the world.

“For countries that are starting to struggle with B.1.1.7, they now know they have an even faster one close by,” said Devi Sridhar, a professor of global public health at the University of Edinburgh in Scotland.  In the United States, which has detected more than 800 cases of the variant from India, a glut of vaccines has given health officials a ready supply of tools for fighting the fast-evolving virus.

But even other wealthy nations, like Britain, are in more difficult positions. To stretch its supply of vaccines, the country extended the gap between the first and second doses of AstraZeneca, Pfizer and Moderna vaccines to up to 12 weeks, longer than the periods studied in clinical trials.  Health officials argued that giving more people the partial protection of a single dose would help the country escape a deadly surge of cases. And the AstraZeneca vaccine appeared to be more potent when its two doses were given at a longer interval.  The gambit appeared to work: Public Health England estimated last week that the immunization campaign had forestalled more than 10,000 deaths and 35,000 hospitalizations in older people.  And yet the latest studies about the variant from India have suggested that those gains came at a price. While fully vaccinated people are amply protected against the new variant, people with only a single dose remain vulnerable, Public Health England said.

A first dose of either the Pfizer or AstraZeneca vaccines provided only about 34% protection against the variant first seen in India, a relatively steep drop from the roughly 51% protection a single dose of either of those vaccines offer against the earlier variant from Britain.  (There was considerable statistical uncertainty about the 34% effectiveness figure, and some scientists offered reasons that it may end up being higher.)  Many Britons are only partially vaccinated. Of the 38 million people given a first vaccine dose in Britain, more than 15 million were still waiting for their second doses, including many in their 40s, 50s and early 60s.

“It may come back to bite us,” Simon Clarke, an associate professor in cellular microbiology at the University of Reading, said of Britain’s delayed dosing strategy. “There’s clear evidence now that one dose isn’t as good as two doses, at least with the Indian variant, and I suspect with others as well.”  In response, the government has sought to tighten the space between two doses for some people, and — belatedly, in the view of many scientists — begun experimenting with ways to encourage sick people to isolate.

Some scientists have urged the government to go further by dramatically closing the gap between doses of the Pfizer or Moderna vaccine, for instance, and rerouting those shots to cities hardest hit by the variant from India. Because the AstraZeneca vaccine appears most protective with a 12-week dosing interval, those scientists said, using it meant leaving people only partially vaccinated for a period of time.

At the very least, Sridhar said, people needed to be reminded to remain cautious until they were fully vaccinated.  Prime Minister Boris Johnson’s plan to scrap almost all remaining lockdown restrictions on June 21 rests in large part, scientists said, on how many second doses Britain can administer in the coming weeks.

For many poorer nations, starved for vaccines, there is little choice but to leave long delays between first and second doses. Some of them are uncertain about when shipments of second doses will arrive. Large portions of those countries remain unprotected.

If the variant from India spreads as quickly in other countries as it has in Britain, the burden on unvaccinated nations may grow.  “It’s a warning,” Sridhar said. “What we’re seeing in India is being repeated in Nepal, it’s being repeated in other countries. You need to get ahead of it.”

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Countries reporting the most new infections each day  
INDIA               245,697

BRAZIL                66,195

ARGENTINA       32,310

USA                    25,246

COLOMBIA         16,860

Countries reporting the most deaths each day *
INDIA                 4,073

BRAZIL               1,903

USA                      568

ARGENTINA         493

COLOMBIA           485


In trouble:

Europe: Belarus, possibly Greece

Asia and Middle East (...most in trouble): India, Bahrain, Sri Lanka, Malaysia, Maldives, Timor-Leste, Nepal, maybe Taiwan and Vietnam

Latin America and Caribbean: Bolivia, Cuba, Paraguay, Suriname, Trinidad and Tobago, Argentina (high population country), Colombia (high population country), Uruguay, Guyana, Venezuela (population half that of Colombia), Brazil (very high population country, 4x Colombia), and some tiny countries: French Guiana, Honduras, Costa Rica, Guatemala, Chile, Sint Maarten, Dominican Republic, Ecuador, Peru, Bahamas, El Salvador, Guadeloupe, Haiti

Africa: Angola, Egypt, maybe Cape Verde and Botswana


In the US, reported new cases have fallen for six weeks in a row and hit their lowest level since the week ended June 14, 2020.  Nine out of 50 states logged week-over-week increases in new cases, including Hawaii and Delaware, both of which processed backlogs.  Excluding those, Michigan led the nation in new cases per capita, although its new infections have fallen for five weeks in a row. The next highest per capita rate was in Wyoming, where cases rose by 27% from the prior week.  The lowest rates of infection based on population were in California, Oklahoma and Nebraska.  Overall, the average number of COVID-19 patients in hospitals fell 14%, to the lowest week since April 2020.


Where reported cases increased or decreased for the week ending Sunday, May 23, 2021

State Total cases Per 100K New cases Per 100K 1-wk chg.
United States 33,280,204
10,024 179,663 54.1
Hawaii 35,867
2,533 2,106 148.7
Delaware 108,365
11,129 1,366 140.3
Wyoming 59,660
10,308 581 100.4
New Jersey 1,014,088
11,417 3,329 37.5
Kansas 312,997
10,744 1,292 44.3
Rhode Island 151,258
14,278 873 82.4
Arkansas 340,137
11,271 1,355 44.9
Idaho 191,068
10,692 1,160 64.9
Mississippi 316,272
10,627 1,562 52.5
Louisiana 467,815
10,063 2,982 64.1
New Mexico 201,868
9,627 1,218 58.1
Kentucky 455,790
10,202 3,253 72.8
Arizona 876,732
12,045 3,754 51.6
Ohio 1,097,300
9,387 6,406 54.8
Utah 404,477
12,616 1,910 59.6
Texas 2,938,521
10,134 12,346 42.6
Florida 2,310,335
10,757 18,331 85.3
Indiana 740,606
11,001 4,727 70.2
Oklahoma 451,830
11,419 983 24.8
Illinois 1,377,886
10,874 9,262 73.1
Virginia 673,029
7,885 2,845 33.3
North Dakota 109,603
14,382 499 65.5
Maryland 458,483
7,584 2,287 37.8
California 3,778,099
9,562 8,164 20.7
Wisconsin 672,422
11,549 2,754 47.3
Georgia 1,122,710
10,574 4,407 41.5
Iowa 400,864
12,705 1,373 43.5
Pennsylvania 1,200,202
9,375 9,625 75.2
Alaska 69,902
9,555 438 59.9
Maine 66,979
4,983 1,264 94.0
North Carolina 995,754
9,494 6,416 61.2
New York State 2,083,501
10,710 9,274 47.7
Tennessee 860,084
12,594 3,029 44.4
Puerto Rico 263,496
8,251 2,930 91.7
Nevada 322,352
10,465 1,813 58.9
Oregon 198,689
4,711 3,005 71.2
Michigan 986,435
9,877 10,096 101.1
Montana 111,203
10,405 518 48.5
Colorado 537,401
9,332 5,701 99.0
Massachusetts 705,142
10,231 3,103 45.0
Minnesota 598,766
10,617 4,339 76.9
South Dakota 123,911
14,007 267 30.2
West Virginia 159,735
8,913 1,267 70.7
Nebraska 222,884
11,522 549 28.4
Connecticut 346,325
9,714 1,348 37.8
New Hampshire 98,303
7,230 627 46.1
South Carolina 590,981
11,478 2,388 46.4
Vermont 24,106
3,863 223 35.7
Washington, D.C. 48,748
6,907 203 28.8
Washington 427,494
5,614 4,829 63.4
Missouri 614,805
10,017 3,143 51.2
Alabama 542,124
11,057 2,041 41.6


deaths in the last week

For the week ending Sunday, May 23, 2021

State Total deaths Per 100K New deaths Per 100K 1-wk chg.
United States 590,240
178 3,969 1.2
Alaska 369
50 16 2.2
Missouri 9,360
153 146 2.4
Maine 820
61 18 1.3
Ohio 19,709
169 181 1.5
Arizona 17,555
241 89 1.2
Iowa 6,035
191 29 0.9
Idaho 2,080
116 11 0.6
Colorado 6,632
115 70 1.2
Alabama 11,112
227 74 1.5
Washington 5,702
75 76 1.0
New Mexico 4,131
197 18 0.9
Tennessee 12,380
181 68 1.0
Indiana 13,553
201 73 1.1
North Carolina 12,958
124 96 0.9
Florida 37,207
173 409 1.9
Minnesota 7,370
131 74 1.3
Georgia 20,661
195 155 1.5
Connecticut 8,212
230 39 1.1
Vermont 255
41 3 0.5
Maryland 9,007
149 78 1.3
Massachusetts 17,823
259 70 1.0
Louisiana 10,522
226 44 0.9
Mississippi 7,279
245 25 0.8
Illinois 25,001
197 206 1.6
Texas 51,428
177 280 1.0
Utah 2,290
71 32 1.0
South Dakota 2,001
226 10 1.1
Oklahoma 6,918
175 40 1.0
Kansas 5,057
174 19 0.7
Kentucky 6,716
150 60 1.3
Michigan 20,140
202 350 3.5
Montana 1,603
150 5 0.5
New Jersey 26,091
294 130 1.5
Pennsylvania 27,090
212 220 1.7
Virginia 11,106
130 88 1.0
California 62,602
158 268 0.7
New Hampshire 1,344
99 12 0.9
Washington, D.C. 1,127
160 7 1.0
Nevada 5,552
180 22 0.7
Arkansas 5,817
193 23 0.8
New York State 52,831
272 177 0.9
Oregon 2,622
62 35 0.8
Wisconsin 7,748
133 36 0.6
North Dakota 1,507
198 3 0.4
Puerto Rico 2,474
78 36 1.1
Delaware 1,659
170 8 0.8
South Carolina 9,684
188 31 0.6
Wyoming 713
123 1 0.2
Hawaii 494
35 2 0.1
West Virginia 2,772
155 11 0.6
Rhode Island 2,704
255 4 0.4
Nebraska 2,248
116 -9 0.0


You got something to tell us, Nebraska?

the number of people in hospitals 

For the week ending Sunday, May 23, 2021

State Avg. this week Per 100K 1-wk chg.
United States 26,096
Wyoming 40
New Mexico 146
Arkansas 191
Idaho 95
Utah 159
Oklahoma 170
Wisconsin 326
Arizona 580
Louisiana 312
Kansas 161
Washington 621
Indiana 811
Montana 60
Mississippi 201
California 1,624
Maine 111
Kentucky 368
North Dakota 33
Texas 2,114
South Carolina 314
Georgia 1,152
Missouri 673
Iowa 135
Nevada 287
South Dakota 61
Minnesota 412
West Virginia 225
Ohio 810
Colorado 573
Alabama 303
Pennsylvania 1,473
Oregon 306
Florida 2,243
Tennessee 591
Hawaii 43
Vermont 9
Virginia 599
New Hampshire 51
Illinois 1,490
Delaware 73
New York State 1,474
Washington, D.C. 80
Massachusetts 309
New Jersey 768
Puerto Rico 199
Michigan 1,649
North Carolina 791
Maryland 545
Rhode Island 72
Nebraska 84
Connecticut 150
Alaska 21


Edited by Ambergris
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I don’t know how accurately the numbers are being reported but it’s great to see them going down.  We are still seeing people coming down with it near us but overall numbers are lower.  

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I haven't kept up with the numbers in a while. But know it is coming down here in VA. Our church is going to reopen on June 6th.  We have had church in our cars for over a year. though I just started going back about 2 months after DH pasted. It's been hard but getting better with time. I just have to keep busy to keep my mind off things. Though the nights are the worst but that to will get better with time. 

All the grocery stores have taken down their you must wear a mask sign as it is no longer required unless the store owner still wants it. I just keep a mask with me just in case. Doctor says no on the vaccine because of me having auto immune disease. So I cannot get it. I will still continue to use hand sanitizer and keeping my hands washed as well as taken my Vitamins D, C and zinc. So I will still be taken precautions. 

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Our mask mandate is supposed to end June 2nd. Just trying to get us through Memorial Day I guess. Some stores say you can be unmasked now if you have been fully vaccinated. Some stores say you must wear a mask until June 2nd.


Our curfew ended on Feb.11th. but I didn't notice it until tonight when I looked it up. Shopping places still close between 10:00 - 11:00 though. So I guess I've got no where to go and all night to get there. 



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50% of adults are fully vaccinated in the US.  On May 24, the seven-day average of new cases was the lowest it has been since June 2020. But among unvaccinated people, the infection rate and death rate are estimated to be as high as in late January 2021.

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3 hours ago, Ambergris said:

50% of adults are fully vaccinated in the US.  On May 24, the seven-day average of new cases was the lowest it has been since June 2020. But among unvaccinated people, the infection rate and death rate are estimated to be as high as in late January 2021.

Do you have a source for that one?  I haven't heard anything about the rates still being that high.

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I don't remember where I got that one, but it sounds like something from either the New York Times or Reuters.  It's not graph-y enough to be from my usual CDC charts, but I might have grabbed it from a footnote.  file:///C:/Users/flami/Downloads/Community_Profile_Report_20210525_Public.pdf

sorry, try https://covid.cdc.gov/covid-data-tracker/#community-profile-report

Edited by Ambergris
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The Washington Post has different numbers: The reported infection rate among the unvaccinated is 69% higher than the standard national rates, the death rate  is about the same as it was two months ago, and the hospitalization rate is as high as it was three months ago.

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One day last week, India reported 4,529 deaths in one 24-hour period.  At times the graph says one case in three in the world is in India, but usually it says one case in two in the world is in India.  Basically, the story is India. I suspect there are as many per capita cases in Brazil or Egypt, at least in the hot spots, but Brazil at least doesn't speak English and isn't talking as readily, so the world media focuses on India.  Yet the official status in India is "There is continuous decline in daily cases after reporting the highest number of cases (4,14,188) on 7th May.  Cases per million is 19,235."  The Ministry of Health India insists that the infection rate is less than half what it was in January, never mind that its official death toll is many times higher than it was then, and that bodies found floating in the river are neither tested nor counted in that official death toll.  The WHO thinks the actual death toll is at least three times what MOH India reports and could be a million and a half.




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Tue, May 25, 2021, 3:05 AM
KUALA LUMPUR, Malaysia (AP) — A worsening coronavirus outbreak in Malaysia has sparked alarm and is spilling over into neighboring Thailand, which recently discovered a more infectious variant in its south believed to have come from Malaysia.  Malaysia has experienced a rapid climb in new cases since April that has strained its hospitals and prompted the government to impose a near lockdown until June 7.  But infections have not abated, with a record 7,289 new cases reported Tuesday, pushing the country's tally to 525,889 — a five-fold increase since the start of the year. Deaths have spiked to more than 2,300. It is the third worst-hit country in Southeast Asia after Indonesia and the Philippines.

Health director-general Noor Hisham Abdullah warned Tuesday that the country has to “prepare for the worst” amid signs that new cases could spike further.

Senior Minister Ismail Sabri Yaakob expressed concern Tuesday that the number of infected children has grown eight-fold to 64,046 so far this year, from just over 8,000 at the end of last year. Two-thirds are under 12, including 6,290 babies under 18 months old, he said.  The government has shut all schools, prohibited dining in restaurants and banned social activities and inter-state travel, but has resisted calls for a full lockdown because of fears it would cause an economic catastrophe.  Instead, restrictions were tightened Tuesday with more people made to work from home, business operating hours shortened and consumers allowed to shop at malls for only two hours. The capacity and frequency of public transport have also been cut by half, causing longer lines and bigger crowds at bus and train stations.

Malaysia aims to vaccine 80% of its population by next year and has ramped up its inoculation program, with nearly 2.5 million of its 33 million people having received at least one dose of vaccine. Still, officials are worried about the rapid spread of the virus, especially clusters involving new variants originating in South Africa and India.

The outbreak has spilled into Thailand, which has locked down several southern villages along the Malaysian border after identifying infections involving the South African variant that is thought to be more contagious. It was believed to have been spread by an infected person who crossed the border from Malaysia.

Thailand has also seen a recent surge, with confirmed cases rising to 135,439, including 832 deaths. It will begin its national vaccination campaign on June 7 and hopes to vaccinate 70% of the estimated 70 million people living in the country by the end of the year. It has administered 2.91 million doses so far, using vaccines from AstraZeneca and China’s Sinovac.  Health officials have called on the government to quickly diversify its vaccine procurement. Only four vaccines have so far been authorized for use in Thailand and only two have been administered: AstraZeneca and Sinovac. The AstraZeneca vaccine is to be locally manufactured and play a key role in the inoculation effort.  Critics of Thailand’s handling of the crisis say local business interests played a role in delaying and limiting vaccination efforts.  Food and Drugs Administration Secretary-General Paisarn Dankum said the government will consider later this week whether to approve a vaccine made by China's Sinopharm.


Bold is mine.

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The Wall Street Journal:

Covid-19 Is Killing Hundreds of Pregnant Women and Babies in Brazil.
By Luciana Magalhaes and Samantha Pearson | Photographs by Tommaso Protti for The Wall Street Journal
May 27, 2021 7:00 am ET
VITÓRIA, Brazil—Taíssa Souza, an advertising manager, wasn’t due to give birth until April. But in February she fell so ill with Covid-19 that she struggled to breathe, forcing doctors to deliver her baby son who was pressing up against her disease-ridden lungs.  It was too late. Ms. Souza, an otherwise healthy 30-year-old, died three weeks after the caesarean section. She didn’t get to hold her newborn, who was whisked away for fear she would infect him, or say goodbye to her 4-year-old son.  “She was so young, I can’t make sense of it,” said her husband, Victor Silva, a military police officer from this hard-hit coastal city. “Our sons will have to grow up without the affection and protection of a mother.”
More than a hundred pregnant women are dying from Covid-19 every month in Brazil, more than twice the rate last year, according to government figures—a tragedy researchers largely blame on the P.1 variant of the virus that first emerged in the Amazon and overwhelmed hospitals. In total, more than 800 expectant and postpartum mothers in Brazil have died from the disease since the pandemic began.  At least 1,000 pregnant women have died from complications related to Covid-19 in the Americas, according to an estimate from the Pan American Health Organization (PAHO) Tuesday, based on data from 24 countries. Pregnant women in Brazil face the highest risk of dying from the disease in the region, it said.

“Pregnancy and newborn care have been disrupted in nearly half of the countries in the Americas, leaving expectant and new mothers at risk,” said PAHO Director Carissa F. Etienne at a news briefing, warning the pandemic could erase more than two decades of progress in tackling maternal deaths in the region.
At least 579 babies under the age of 1 have died from Covid-19 in Brazil since the start of the pandemic. Hundreds of babies are being delivered prematurely to save their sick mothers. Others perish in the womb, starved of oxygen as their mothers gasp for air, or contract the disease and die in the first months of life.  Comparative data from other countries is scarce, but Brazil’s maternal and infant mortality rates from the disease appear to be far higher than in many other countries such as the U.S., researchers said.  Research from around the world has shown that pregnant women are at greater risk from Covid-19. A large study by the Centers for Disease Control and Prevention late last year found pregnant women were 70% more likely to die than women of the same age who weren’t pregnant.  As a baby grows, it pushes up against the mother’s diaphragm, putting a strain on her lungs. Parts of her immune system are also suppressed so the body doesn’t reject the growing fetus.  New variants like the P.1 strain that emerged in the Amazon may make the disease even more risky for pregnant women in Brazil, researchers say. Studies have shown the strain to be up to 2.2 times more contagious than previous versions and possibly more deadly—a hypothesis researchers are still investigating.
“What’s happening in Brazil is so concerning,” said Neel Shah, an obstetrician and assistant professor at Harvard Medical School. “I can only imagine the degree of fear when the government comes out and says there is a new strain and it seems to be impacting pregnant people differently.”    In India, where new strains have also led to a devastating recent wave of infections and deaths, there are also worries that pregnant women are increasingly affected. There are no nationwide public data yet on the total maternal and neonatal deaths due to Covid-19. But Dr. Alpesh Gandhi, president of the Federation of Obstetric and Gynaecological Societies of India, said his organization is aware that relatively more pregnant women are getting infected with Covid-19 and are having more severity and complications during this second wave.  Based on interactions with gynecologists in different parts of India, he said about 30% to 40% of pregnant women with Covid-19 are symptomatic in the latest surge compared with about 15% in the previous year’s surge. Among those with symptoms, “more of them are needing oxygen support because they are having less immunity and their lungs are getting more affected,” he said.  Brazil is still reporting about 66,000 new Covid-19 cases a day—more than the whole of Europe—and about 80% more than India on a per capita basis. About 450,000 Brazilians have died from the disease so far.
Scant testing means the reality for Brazil’s mothers and their newborns may be even worse than official figures suggest. Considering that deaths from unidentified respiratory diseases could also have been caused by Covid-19, the virus may have killed as many as 1,600 babies, as well as 1,300 pregnant and postnatal mothers in Brazil, said Fatima Marinho, an epidemiologist in Brazil for the public-health organization Vital Strategies.  In the U.S., which has a larger population, 74 babies under the age of 1 have died from Covid-19, according to the Centers for Disease Control and Prevention. The CDC said it is still investigating “whether there were any maternal deaths related to Covid.”

“It’s all so very painful,” said Francisca Rosângela, whose grandson died from Covid-19 in São Paulo state when he was just 17 days old after catching the disease from his mother.  “We don’t know how it happened, how they were infected,” she said in a message on Facebook. “We had been doing everything to protect her and the baby.”

For doctors, dealing with pregnant Covid-19 patients often means making heartbreaking decisions.

“If you remove the baby too early you risk them dying outside the womb, you remove them too late and they die inside the womb from a lack of oxygen,” said Rosangela Maldonado, coordinator of the high-risk maternity ward of the Dr. Jayme Santos Neves Hospital in Vitória.  “Our job is to deal with new life, so every death is devastating,” she said.
Bárbara Cesar, a fisherman’s wife, was pregnant with twins when she contracted Covid-19 and began coughing so hard it would make her vomit. Doctors at the hospital knew they had to intubate her to save her life, but doing so while she was pregnant could kill her baby daughters due to oscillations in their oxygen levels. Alternatively, delivering her babies prematurely could leave them with health issues for the rest of their lives, from impaired vision to behavioral problems.  Doctors opted for an emergency C-section.  “The nurse asked me if I was praying, and told me to pray some more,” said the 26-year-old, who only met her new daughters for the first time when she came off a ventilator three weeks after their birth.

In Brazil, where 2,000 people are dying a day from Covid-19, only 10% of the population has been fully vaccinated. Brazil’s health ministry has urged couples to put off having children until the worst of the pandemic is over.
An aggressive Covid-19 variant called P.1 has spread from the Amazon to other parts of Brazil and has now been identified in U.S. cases. WSJ’s Paulo Trevisani reports from Porto Alegre’s overwhelmed hospitals, where doctors say young people are getting ill. Photo: Tommaso Protti for The Wall Street Journal  Another factor driving the deaths of women in pregnancy is that the country’s overwhelmed health system has meant less prenatal care for babies and mothers, say doctors.

“Preventative care ceased to exist in Brazil,” said Marcelo Otsuka, an infectious-disease specialist at the Pediatrics Society of São Paulo. Infections such as syphilis in pregnant women, which can lead babies to die shortly after birth, have often gone untreated during the pandemic, said Mr. Otsuka. Pregnant women from Brazil’s poorest families have also struggled to feed themselves during the pandemic. 

Glenda Barbosa, a 23-year-old cashier for a bakery in Minas Gerais state, said her baby son was only a week old when he had to be intubated after catching Covid-19 from his 3-year-old brother. “I was in agony, desperate,” she said, describing how his tiny hands had turned purple as he gasped for air.  After almost three weeks on a ventilator, he managed to breathe for himself again and is now home. “He was just a little newborn baby, battling to survive,” said Ms. Barbosa.
—Krishna Pokharel contributed to this article.


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Why are so many babies dying of Covid-19 in Brazil?
By Nathalia Passarinho and Luis Barrucho  BBC Brazil

Published15 April
More than a year into the pandemic, deaths in Brazil are now at their peak. But despite the overwhelming evidence that Covid-19 rarely kills young children, in Brazil 1,300 babies have died from the virus. One doctor refused to test Jessika Ricarte's one-year-old son for Covid, saying his symptoms did not fit the profile of the virus. Two months later he died of complications from the disease.  After two years of trying, and failed fertility treatments, teacher Jessika Ricarte had all but given up on having a family. Then she fell pregnant with Lucas.

"His name comes from luminous. And he was a light in our life. He showed that happiness was much more than we imagined," she says.  She first suspected something was wrong when Lucas, always a good eater, lost his appetite.  At first Jessika wondered if he was teething. Lucas's godmother, a nurse, suggested that he might just have a sore throat. But after he developed a fever, then fatigue and slightly laboured breathing, Jessika took him to hospital, and asked for him to be tested for Covid.

"The doctor put on the oximeter. Lucas's levels were 86%. Now I know that is not normal," says Jessika. 

But he was not feverish, so the doctor said: "My dear, don't worry. There's no need for a Covid test. It's probably just a minor sore throat."  He told Jessika that Covid-19 was rare in children, gave her some antibiotics and sent her home. Despite her misgivings, there was no option to have Lucas tested privately at the time.

Jessika says that some of his symptoms dissipated at the end of his 10-day antibiotics course, but the tiredness remained - as did her concerns about coronavirus.  "I sent several videos to his godmother, my parents, my mother-in-law, and everyone said that I was exaggerating, that I should stop watching the news, that it was making me paranoid. But I knew that my son was not himself, that he was not breathing normally."  Lucas was not himself
This was May 2020, and the coronavirus epidemic was growing. Two people had already died in her town, Tamboril in Ceará, north-east Brazil. "Everyone knows each other here. The town was in shock."  Jessika's husband Israel was worried that another hospital visit would increase the risk that she and Lucas would become infected with the virus.

But the weeks went by, and Lucas became sleepier and sleepier. Finally on 3 June, Lucas vomited over and over again after eating lunch, and Jessika knew she had to act.  They returned to their local hospital, where the doctor tested Lucas for Covid, to rule it out.

Lucas's godmother, who worked there, broke the news to the couple that his test result was positive.

"At the time, the hospital did not even have a resuscitator," says Jessika. 

Lucas was transferred to a paediatric intensive care unit in Sobral, over two hours away, where he was diagnosed with a condition called multi-system inflammatory syndrome (MIS).  The journey from Tamboril to the nearest ICU in Sobral took over two hours  This is an extreme immune response to the virus, which can cause inflammation of vital organs.  Experts say the syndrome, which affects children up to six weeks after they are infected with coronavirus, is rare, but leading epidemiologist Dr Fatima Marinho from the University of São Paolo, says that, during the pandemic, she is seeing more cases of MIS than ever before. Although it doesn't account for all deaths.

When Lucas was intubated, Jessika wasn't allowed to stay in the same room. She rang her sister-in-law to try and distract herself.

"We could still hear the sound of the machine, the beep, until the machine stopped and there was that constant beep. And we know that happens when the person dies. After a few minutes, the machine started working again and I started to cry."

The doctor told her Lucas had suffered a cardiac arrest but they had managed to revive him.  Dr Manuela Monte, the paediatric doctor who treated Lucas for over a month in the ICU in Sobral, said she was surprised that Lucas's condition was so serious, because he did not have any risk factors.

Most children affected by Covid have comorbidities - existing conditions such as diabetes or cardiovascular disease - or are overweight, according to Lohanna Tavares, a paediatric infectologist at Albert Sabin Children's Hospital in Fortaleza, the state capital.  But that wasn't the case with Lucas.
During the 33 days Lucas was in the ICU, Jessika was only allowed to see him three times. Lucas needed immunoglobulin - a very expensive medication - to deflate his heart, but luckily an adult patient who had bought his own had donated one leftover ampoule to the hospital. Lucas was so ill that he went on to receive a second dose of immunoglobulin. He developed a rash on his body and was running a persistent fever. He needed support to breathe.  Then Lucas began to improve and the doctors decided to take out his oxygen tube. They video-called Jessika and Israel so that he wouldn't feel alone as he regained consciousness.

"When he heard our voices he started to cry," says Jessika.  It was the last time they were to see their boy react. During the next video call "he had a paralysed look". The hospital requested a CT scan and discovered Lucas had had a stroke.

Still, the couple were told Lucas would make a good recovery with the right care and would soon be moved out of ICU and into a general ward.  When Jessika and Israel went to visit him, the doctor was just as hopeful as they were, she says.  "That night, I put my cell phone on silent. I dreamed Lucas came up to me and kissed my nose. And the dream was a great feeling of love, gratitude and I woke up very happy. Then I saw my cell phone and saw the 10 calls that the doctor had made."

The doctor told Jessika that Lucas's heart rate and oxygen levels had dropped suddenly, and he had died early that morning.

She feels sure that if Lucas had been given a Covid test when she had requested it back in early May he would have survived.  "It is important that doctors, even if they believe it is not Covid, do the test to eliminate the possibility," she says.  "A baby does not say what he is feeling, so we depend on tests."
Jessika believes that the delay in proper treatment made his condition more serious. "Lucas had several inflammations, 70% of the lung was compromised, the heart increased by 40%. It was a situation that could have been avoided."

Dr Monte, who treated Lucas, agrees. She says that although MIS cannot be prevented, treatment is much more successful if the condition is diagnosed and treated early. "The earlier he would have received specialised care, the better," she says. "He arrived at the hospital already critically ill. I believe he could have had a different outcome if we could have treated him earlier."

Jessika now wants to share Lucas's story to help others who may miss critical symptoms.  "Every child I know was saved by some warning and the mother says: 'I saw your posts, I took my son to the hospital and he is now at home.' It's as if it were a little bit of Lucas," she says.  "I have been doing for these people what I wish they had done for me. If I had had information, I would have been even more cautious."

There is a misconception that children are at zero risk for Covid, says Dr Fatima Marinho, who is also a senior adviser to the international health NGO Vital Strategies. Marinho's research has found that a shockingly high number of children and babies have been affected by the virus.  Between February 2020 and 15 March 2021, Covid-19 killed at least 852 of Brazil's children up to the age of nine, including 518 babies under one year old, according to figures from the Brazilian Ministry of Health. But Dr Marinho estimates that more than twice this number of children died of Covid. A serious problem of underreporting due to lack of Covid testing is bringing the numbers down, she says.  Dr Marinho calculated the excess of deaths by unspecified acute respiratory syndrome during the pandemic, and found that there were 10 times more deaths by unexplained respiratory syndrome than in previous years. By adding these numbers, she estimates that the virus in fact killed 2,060 children under nine years old, including 1,302 babies.
Why is this happening?
Experts say the sheer number of Covid cases in the country - the second-highest number in the world - have increased the likelihood that Brazil's babies and young children are affected.  "Of course, the more cases we have and, as a result, the more hospitalisations, the greater the number of deaths in all age groups, including children. But if the pandemic were controlled, this scenario could evidently be minimised," says Renato Kfouri, president of the Scientific Department of Immunisations of the Brazilian Society of Pediatrics.

Such a high infection rate has overwhelmed Brazil's entire health care system. Across the country, oxygen supplies are dwindling, there is a shortage of basic medicines and in many ICUs across the country there are simply no more beds.
Brazilian President Jair Bolsonaro continues to oppose lockdowns and the infection rate is being driven by a variant called P.1 which emerged in Manaus, in northern Brazil, last year, and is thought to be much more contagious. Twice the number of people died last month than in any other month of the pandemic, and the upward trend is continuing.
Another problem driving the high rates in children is a lack of testing.  Marinho says that for children often the Covid diagnosis comes too late, when they are already seriously ill. "We have a serious problem detecting cases. We don't have enough tests for the general population, even fewer for children. Because there is a delay in the diagnosis, there is a delay in care for the child," she says.

This is not just because there is little testing capacity, but also because it is easier to miss, or misdiagnose, the symptoms of children suffering from Covid-19, as the disease tends to present differently in younger people.  "A child has a lot more diarrhoea, a lot more abdominal pain, and chest pain, than the classic Covid picture. Because there is a delay in diagnosis, when the child arrives at the hospital they are in a serious condition and can end up complicating - and dying," she says.

But it's also about poverty and access to health care.  An observational study of 5,857 Covid-19 patients under the age of 20, carried out by Brazilian paediatricians led by Braian Sousa from the São Paolo school of medicine, identified both comorbidities and socioeconomic vulnerabilities as risk factors for the worst outcome of Covid-19 in children.

Marinho agrees this is an important factor. "Most vulnerable are black children, and those from very poor families, as they have the most difficulty accessing help. These are the children most at risk of death." She says this is because crowded housing conditions make it impossible to socially distance when infected, and because poorer communities do not have access to a local ICU.  These children are also at risk of malnutrition, which is "terrible for the immune response", Marinho says. When Covid payments stopped, millions were plunged back into poverty. "We went from 7 million to 21 million people below the poverty line in one year. So people are also going hungry. All of this is impacting mortality."

Sousa says his study identifies certain risk groups among children that should be prioritised for vaccination. Currently, there are no vaccines available for children under 16 years of age.
Visits by relatives to children in ICU have been restricted since the beginning of the pandemic, for fear of infection.  Dr Cinara Carneiro, an ICU doctor at Albert Sabin Children's Hospital, says this has been immensely challenging, not just because parents are a comfort to their children, but because they can also help in a clinical sense - they can tell when their child is in pain or in psychological distress and when they need soothing rather than medicating.
And she says the parents' absence intensifies their own trauma when they hear their child's condition has deteriorated and they haven't been there to witness it.

"It hurts to see a child dying without seeing their parents," says Dr Carneiro. In an attempt to improve the communication between parents and their children, staff at Albert Sabin hospital clubbed together to buy phones and tablets to facilitate video calls.  Dr Carneiro says this has helped immensely. "We have made over 100 video calls between family members and patients. This contact has greatly reduced the stress."

Scientists stress the risk of death in this age group is still "very low" - the current figures suggest only 0.58% of Brazil's 345,287 Covid deaths to date have been of 0-9 year olds - but that is more than 2,000 children.  "The numbers are really scary," says Dr Carneiro.
When to seek help
While coronavirus is infectious to children, it is rarely serious. If your child is unwell it is likely to be a non-coronavirus illness, rather than coronavirus itself.

The Royal College of Paediatrics and Child Health advises parents seek URGENT help (call 111 or go to A&E) if their child is:

  • Becoming pale, mottled and feeling abnormally cold to the touch
  • Has pauses in their breathing (apnoeas), has an irregular breathing pattern or starts grunting
  • Has severe difficulty in breathing, becoming agitated or unresponsive
  • Is going blue round the lips
  • Has a fit/seizure
  • Becomes extremely distressed (crying inconsolably despite distraction), confused, very lethargic (difficult to wake) or unresponsive
  • Develops a rash that does not disappear with pressure (the 'Glass test')
  • Has testicular pain, especially in teenage boys
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May 27, Britain:

As of Wednesday, Public Health England said there had been 6,959 confirmed cases of the B.1.617.2 variant of concern – up 3,535 from 3,424 a week ago.  Health secretary Matt Hancock said at Thursday's Downing Street press conference that up to 75% of all COVID-19 cases in the UK could now involve the variant.  The continued spread of the variant is raising fresh doubts over the government's plans to lift all lockdown restrictions in England on 21 June.

At the same briefing, Dr Jenny Harries, chief executive of the UK Health Security Agency, said the "pure data... looks quite worrying".  However, she explained the rise in cases could also be linked to the increase in testing in "hotspot" areas.  Dr Harries explained: "I think it is really, really just on the cusp at the moment.  If we see cases rise, we’re not clear yet quite whether that is a rise in variant cases taking off, or whether it’s actually a rise because we are actively – quite rightly – detecting them and challenging these chains of transmission."

Hancock had earlier told MPs "it’s too early now to say" whether lockdown will end as planned in three-and-a-half weeks' time."


This is the Indian Variant.  

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Reuters May 28

Antibody drugs and COVID-19 vaccines are less effective against a coronavirus variant that was first detected in India, according to researchers. The variant, known as B.1.617.2, has mutations that make it more transmissible. It is now predominant in some parts of India and has spread to many other countries. A multicenter team of scientists in France studied a B.1.617.2 variant isolated from a traveler returning from India. Compared to the B.1.1.7 variant first identified in Britain, the India variant was more resistant to antibody drugs, although three currently approved drugs still remained effective against it, they found. Antibodies in blood from unvaccinated COVID-19 survivors and from people who received both doses of the Pfizer/BioNTech vaccine were 3-fold to 6-fold less potent against the India variant than against the UK variant and a variant first identified in South Africa, according to a report posted on Thursday on the website bioRxiv ahead of peer review. The two-dose AstraZeneca vaccine, which does not protect against the South Africa variant, is likely to be ineffective against the India variant as well. Antibodies from people who had received their first dose "barely inhibited" this India variant, said study co-author Olivier Schwartz of Institut Pasteur. The study, Schwartz added, shows that the rapid spread of the India variant is associated with its ability to "escape" the effect of neutralizing antibodies. (https://bit.ly/3fQLeJ0)

New antibody drug keeps mild COVID-19 from worsening

An antibody drug from Vir Biotechnology (VIR.O) and GlaxoSmithKline (GSK.L) that protects against progression of COVID-19 in high-risk patients with mild to moderate disease received emergency use authorization by the U.S. Food and Drug Administration on Wednesday. In a large randomized trial, patient risk of progression to more severe illness was reduced by 85% with the drug, sotrovimab, compared to a placebo, according to an interim report from the trial posted on Friday on the medRxiv website in advance of peer review. Everyone in the trial had risk factors for severe COVID-19 such as heart disease, diabetes, obesity and old age. Three of 291 patients (1%) in the sotrovimab group became sick enough to be hospitalized, versus 21 of 292 (7%) in the placebo group, researchers said. All five patients who needed to be admitted to intensive care received placebo, they reported. Serious complications were less common with sotrovimab than with placebo, they added. The antibody treatment will be available for COVID-19 patients in the coming weeks, GSK and Vir said on Wednesday. (https://bit.ly/3i4udO2; https://reut.rs/3wH9xjq)

Joint and muscle disease drugs may limit vaccine response

The COVID-19 vaccines from Pfizer/BioNTech (PFE.N), (22UAy.DE) and Moderna (MRNA.O) may be less effective in patients taking immunosuppressant drugs for rheumatic and musculoskeletal diseases, researchers said. "While additional research is required, patients on immunosuppressants should be aware that they may not be fully protected against COVID even after full vaccination. Therefore, patients should talk to their providers before relaxing precautions," said Dr. Julie Paik of Johns Hopkins University School of Medicine in Baltimore. In an earlier study, her team found that most patients with rheumatic and musculoskeletal diseases do respond appropriately to the vaccines. Looking more closely at 20 people whose immune systems did not respond well - that is, no antibodies were detectable after vaccination - the researchers found that most were receiving multiple immunosuppressive agents. "A unifying factor" among the patients was their use of medications such as rituximab and mycophenolate mofetil that affect immune cells called lymphocytes that produce antibodies and help control immune responses, the researchers reported on Monday in the journal Annals of Internal Medicine. "Our study highlights the need for physicians and patients to be aware that immunosuppressants may prevent an appropriate vaccine response against SARS-CoV-2," Paik said. (https://bit.ly/3fuX7oV)

Robust, coordinated immune response marks mild COVID-19

In COVID-19 patients who do not become seriously ill, the immune system reacts to the virus "robustly," with a highly coordinated response, and this coordination may be one key to ensuring a mild illness, according to researchers. Detailed studies of immune system behavior in COVID-19 patients have focused primarily on those with moderate or severe illness and have found "uncoordinated" immune responses. The new study, posted Wednesday on the bioRxiv website ahead of peer review, "used cutting-edge methods to deeply study immune cells" in 18 patients with only mild illness, said study co-author Greg Szeto of the Allen Institute for Immunology in Seattle. In these mildly ill volunteers, the more intense the immune response in early infection, the higher the levels of antibodies in their blood after recovery, the multicenter research team found. And compared to participants who recovered, participants who had lingering troublesome symptoms - so-called Long Covid - had weaker immune responses to the virus in early infection, Szeto added. The differences the study found between mildly ill patients who did and did not develop Long Covid may help researchers devise more personalized ways to monitor immune responses to the virus and better methods for treatment, Szeto's team concluded. (https://bit.ly/3ushEi5)

Open https://tmsnrt.rs/3c7R3Bl in an external browser for a Reuters graphic on vaccines in development.

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NBC May 25, 2021  By Akshay Syal
Of the more than 130 million people in the United States who have been fully vaccinated against Covid-19, there have been reports of at least 10,262 breakthrough infections, according to the Centers for Disease Control and Prevention.  A breakthrough infection occurs when someone tests positive for coronavirus more than 14 days after the second dose of the Pfizer-BioNTech or Moderna vaccines or the single Johnson & Johnson shot.

Roughly a quarter of the breakthrough cases didn’t have symptoms — they were likely detected through routine testing, the CDC found in a report released Tuesday. Of 955 people who were hospitalized, about a third were in the hospital for reasons unrelated to Covid-19, or were asymptomatic. About 160 people, or 2 percent, died. Twenty eight of the deaths were unrelated to Covid-19. The CDC didn’t report whether the people had underlying conditions or comorbidities such as obesity.

The majority of the breakthrough infections were women, 63 percent, and a majority of the patients were 40 to 74 years old.

The report cautions, however, that these cases are likely an underestimate because most people who have been fully vaccinated aren't being regularly tested. Recently, the CDC said that, with some exceptions, people who are fully vaccinated don’t need a coronavirus test, even if they’ve been exposed to the virus, unless they show symptoms.

On May 1, the CDC stopped regularly reporting on mild breakthrough infections so it could focus on investigating only cases severe enough to cause hospitalization or death. However, it's still working with local governments to understand whether variants are linked to infections after vaccination.

Through genomic sequencing, the CDC found that several variants of concern played a role in most of the breakthrough cases. The B.1.1.7 variant first identified in the U.K. was linked to 57 percent of cases, and a quarter were due to the B.1.429, first found in California. A small percentage of sequenced cases were caused by the P.1 from Brazil and the B.1.315 first identified in South Africa.
The proportion of cases due to variants of concern has also been similar to the proportion of these variants circulating throughout the country, the authors wrote.

It’s too soon to know which variants are more likely to result in breakthrough infections, but Dr. Carlos del Rio found the report “reassuring”.  “Breakthrough infections will happen as vaccines are not 100 percent effective,” del Rio, a professor of medicine at the Emory University School of Medicine, said in an email.  Del Rio took away a few things from the report: Many breakthrough infections were asymptomatic, many hospitalized patients were there for reasons unrelated to the virus, and overall there were very few deaths.

In the cases that tested positive after full vaccination, Del Rio added that he would have liked to see information about the cycle threshold of the cases, a value that provides information about the amount of virus that patients were carrying. He suspects many would likely not be infectious due to low viral loads in their systems.

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One of the graphs I don't usually go by has a huge spike in Maryland for this week.  I'm hoping they settled a backlog of cases.  I'll know more in a couple of days.

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And, the moment we've all been waiting for:  Vietnam has found a hybrid between the UK variant and the Indian variant.  It is reportedly faster and stronger and more resistant than either.

The South China Morning Post and the Viet Nam Express reported first, and now western papers are picking up the news.  Fun, fun.

Edited by Ambergris
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As noted above, the count of Indian-variant has doubled in the past week in the England part of the UK, although they're asking whether finding is a factor of people looking harder.  Well, on the one hand--obviously.  And on the other hand--not likely.  They won't find what's not there, and they won't "find" what they don't choose to label.  (Yes, Boris Johnson has been accused of undercounting too.)  One of the towns reporting the most infections of the Indian variant is Bolton, part of Manchester in the north of England.  One hallmark of the Indian variant there is that it's hitting younger people.  But is that unusual?  Here's a chart:The spike in cases in Bolton has been mainly among younger people. (Government data/Yahoo News UK/Flourish)

Edited by Ambergris
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A large part of what's killing people in India is the black fungus, which is eating their sinuses and lungs out.  It starts from the inhalers given to open the lungs, which can cause overgrowth of ordinary tongue/tonsil stuff, and can be boosted by recycled oxygen equipment that hasn't been adequately sanitized.  The black fungus has a rarer subtype called yellow fungus, and there's also a so-called white fungus that is really candida.  We know about candida, right?  This is raging candida that is causing multiple perforations of the intestines, among other things.  The black fungus that goes from the throat to the sinuses can go straight from the sinuses to the brain, and if untreated from the sinuses has about a fifty-percent fatality rate.  Somehow I don't think it would be as much of a problem in the US.


Edited by Ambergris
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Per Scientific American, the black fungus has long been known to be "...particularly ferocious in patients with uncontrolled diabetes."  In India, One adult in eight has diabetes, most of which is poorly controlled.  S. P. Kalantri, a professor of medicine at the Mahatma Gandhi Institute of Medical Sciences and medical superintendent of its hospital, says, "When these patients test COVID-positive, they often are prescribed high-dose steroids, often in the first week. Irrational and unscientific treatment of COVID is extremely common.”

Identifying black fungus early can be difficult.  It doesn't show up on a blood test.  Diagnosis requires a biopsy and follow-up, which can be prohibitively expensive if it is available at all.

Also, antifungal drugs are in short supply in India, according to news reports, and they may be unaffordable for most. There are relatively few categories of antifungals, and while some have been available for decades, newer versions that are less toxic to patients are expensive and scarce. For the preferred drug, “one-day therapy costs 30,000 rupees (about $410), a catastrophic health expenditure for 99 percent of Indians,” Kalantri says. “The therapy often lasts for weeks and requires an intravenous infusion, admission to the hospital and close monitoring of the kidney function.”

It is not possible, at this point, to predict an end to the shadow epidemic of black fungus, though greater awareness of patients’ vulnerability may allow physicians in India to recognize cases earlier. For now, it remains one more way in which the pandemic caught the world by surprise and one more illustration of how its worst effects have fallen hardest on countries that can afford them least.

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