What comes after emergency?

As someone who participated in a COVID vaccine clinical trial, who has other vulnerable people in my life, and who tries to be a diligent and responsible community member, I’ve been following the science, public health information, and news about the pandemic over these last, long 3.5 years. I’ve done so many blog posts about it, I’ve lost count.

As you may know, the World Health Organization and the United States are winding down their public health emergency declarations.

This does not mean, though, that the pandemic itself has ended. COVID-19 is still widespread across the world and hundreds die every day as a result. There is still the potential for new variants and COVID is not yet seasonal, like influenza. Eventually, COVID will become endemic, as the flu is, but we aren’t there yet.

While some US programs, such as tracking hospitalization rates and wastewater testing, will continue, others will end. I will miss the COVID maps and risk ratings that the CDC has been providing. Besides the overall community risk assessment, the transmission rate maps were important to me in deciding how much public masking I needed to do or whether large, indoor gatherings were advisable at all. It’s true that, with so many COVID cases discovered through home testing and never officially recorded, the statistics are not as comprehensive as they were during the months of testing centers, but, for example, it’s helpful for me to know that my county has a moderate transmission rate but the county to our east is currently at the highest transmission rate level, two notches higher than here. Having that information could inform a decision between using a drive-through or dining in on my way through the county, as well as alerting me that the higher infection levels could spread in my direction. After Thursday, that information will not be readily available to me.

I’ll still follow the science and public health advice as best I can and will get my next booster when recommended. I’ll test at home if I have symptoms and avoid being in public when I’m sick with anything, COVID or not. I’ll keep a supply of KF94 masks in my size nearby for high-risk situations that may arise. I’ll try to do all the things we should be doing all the time, like eating well, getting enough rest, and practicing good hygiene.

I still, though, don’t want to get COVID if I can help it. To the best of my knowledge, I’ve never been infected, although I could have had an asymptomatic case at some point. I know very few people who are in that category these days.

Will the end of the emergency declarations and the resulting decline in data be a factor in my eventually contracting COVID?

Impossible to predict, but fingers crossed.

XBB.1.5

A new COVID subvariant has emerged here in the United States. It is designated XBB.1.5 and is considered the most transmissible Omicron variant to date by the World Health Organization. It is also considered to be highly immune evasive, which means it is more likely to cause infection among those who have COVID antibodies, whether from vaccines or prior infection. However, the vaccines should still be effective in reducing hospitalization and death rates from infection.

XBB.1.5 is especially prevalent in the northeastern region of the US. It is powering the rise in regional cases accounting for 72.7% of cases in the past week. It is also likely the driver behind Broome County, New York, where I live, again moving into the CDC’s high community risk level classification. (That will mean mandatory masking at our concerts this weekend.)

The XBB.1.5 subvariant orignated in the US, but has spread to some other countries. Meanwhile, China is suffering through a huge infection wave, although there is no reliable official data on its extent.

In many places, especially in the Northern Hemisphere winter, there are also high rates of flu and RSV.

As always, I’ll repeat my advice. Vaccinate, if you are eligible and vaccines are available to you. In particular, if you are eligible for the bivalent COVID booster, get it as soon as possible because it is much more protective against all Omicron strains than the original formulation. If you are sick, get tested. If you contract COVID or flu, immediately contact a medical provider to see if you can take antiviral medication to cut down on symptom severity. When there is risk in your area, use a high-quality mask in indoor public spaces and avoid crowds. Increase ventilation and/or air filtration indoors. Wash hands frequently and avoid touching your face (more for flu/RSV prevention than for COVID). Try to eat and sleep well. Look out for one another.

We need to work together for this pandemic to end. We are all tired of COVID but we need to fight effectively and continuously. Ignoring the risk and letting the virus spread just gives it even more opportunity to mutate and develop more virulent strains. We are now in our fourth year of the COVID pandemic. Let’s work together to make it the last.
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Join us for Linda’s Just Jot It January! Find out more here: https://lindaghill.com/2023/01/06/the-friday-reminder-for-socs-jusjojan-2023-daily-prompt-jan-7th/

two years into COVID vaccines

After yet another period of high community risk level for COVID here in Broome County, New York, we have just today returned to medium level. After a post-Thanksgiving spike in infections, we experienced a hospitalization spike which had increased our community risk level. With the US health system also dealing with an early, hard-hitting flu season and RSV, the dreaded triple-demic, in some areas hospitals are reaching capacity and sending patients to other locations. Additionally, infection rates are predicted to rise as family and friends gather for Hanukkah, Christmas, and New Year celebrations in the coming weeks.

This comes at a time when only 14.1% of people five and over in the US have received the new bivalent COVID booster, which was designed to better combat the Omicron BA.4/5 variants and is proving effective against the current dominant strains, BQ1 and BQ1.1, which are part of the BA.5 lineage.

Furthermore, a recent study indicates that the US vaccination program likely saved 3.2 million lives and prevented 18.5 million COVID-related hospitalizations. The vaccines are estimated to have averted nearly 120 million infections. Another recent study shows that in the two years of COVID vaccine availability in the US, the excess death rate among Republicans is significantly higher than among Democrats, mirroring the difference in vaccination rates, a sad reflection of the politicization and misinformation around vaccines by many prominent Republicans.

It’s horrifying.

The mistrust sown over the COVID vaccine among Republicans seems to be spreading to other vaccines as well. A newly published survey finds that over 40% of Republican or Republican-leaning respondents oppose requirements for the MMR (measles, mumps, rubella) for school children.

This does not bode well for public health measures. It’s frightening how many people will believe politicians or media figures rather than doctors and public health experts on these important issues. People have been infected because they weren’t up to date on vaccinations. People have been hospitalized, developed long COVID, experienced complications, or died at higher rates because they refused vaccines or boosters. The data show this.

Please, get a bivalent COVID booster if you are eligible. Begin or continue the primary vaccination series if you haven’t completed it. If you get symptoms, test immediately and contact a health professional if you test positive to see if antiviral medication is right for you. Don’t go out and expose others if you sick with COVID, flu, or anything else. Mask indoors when infection levels for COVID, flu, RSV, etc. are high in your area. Avoid crowds. Increase ventilation. Wash hands and avoid touching your face – more for flu/cold prevention than COVID. Try to eat and sleep as well as possible.

If you are someone who has been getting health information from pundits, please turn to your personal health care provider, public health department, or national health organizations, such as the CDC. Look for data and advice from public health experts, not anecdotes.

For readers outside the US, turn to your public health experts to see what measures are available and appropriate for you.

Reminder to all: COVID 19 is still a global pandemic. Act accordingly for your health, your household’s and community’s health, and global health.

COVID update

Remember the COVID-19 pandemic?

It’s still going on, even though most people here in the US are ignoring it. We crossed the one million death threshold in mid-May, although it is likely that the true number is higher as not all deaths caused by COVID are listed as such.

The good news in the US is that both the Moderna and Pfizer/BioNTech vaccines have been approved for children beginning at six months. It remains to be seen how many parents/caregivers decide to vaccinate their babies/toddlers/preschoolers. If it were me, I’d be first in line, but I expect we won’t see very high numbers. Only about 30% of 5-11-year-olds are fully vaccinated, despite availability since November, 2021. This boggles my mind, given that these same parents have vaccinated their children against a host of other serious diseases, yet have chosen to leave them unprotected against a disease that has sickened and killed so many here and around the world. It’s true that the vaccines are not a guarantee against infection but they prevent some infections and usually keep those that do occur from causing hospitalizations or deaths. From a public health standpoint, the more people who are vaccinated, the more likely it is that the pandemic will end and COVID-19 becomes endemic.

We are still far from that point, especially as new variants and subvariants are better at evading immunity, whether from vaccination or infection. The US right now is still dealing with Omicron subvariants. BA.2.12.1 is still responsible for the majority of cases here at about 56% but BA.4 and BA.5 are up to 35% of cases which is a large increase and a sign that they may out-compete the already wildly contagious BA.2.12.1.

Our county, which has been struggling with high infection rates for months, mostly due to BA.2 sub-variants that originated in central New York before causing misery more widely, is finally back in the “medium” risk category according to the CDC. It’s a bit discouraging in that Broome and our neighbor Tioga are the only two counties in all of upstate New York that haven’t dropped down into the “low” category. Maybe soon. Meanwhile, I’m continuing to avoid crowds and mask in public places like stores and church.

As you may recall, spouse B and I left the Pfizer/BioNTech COVID vaccine trial this spring in order to receive a fourth shot to boost our immunity before we travelled, but daughter T is still participating. Next month will be the one-year anniversary of her third dose, so she will be having an in-person visit for blood tests and such.

Pfizer and Moderna have both developed newer forms of their vaccines to better battle Omicron. The Food and Drug Administration scientists are meeting today to begin consideration of a new round of booster shots this fall to try to increase protection. It would be great if we can do so. I will definitely get another booster if it is offered, as I am still trying to keep from getting infected because I don’t want to be sick, especially with long COVID.

In the UK, where our daughter E and her family live, BA.4 and 5 are causing another spike in cases. Last week, it is estimated that 1 in 40 people in England and 1 in 20 in Scotland were currently infected. While the UK was initially slow to immunize children, earlier this year they began routine availability for COVID vaccination at age five. ABC’s recent fifth birthday came with the opportunity for her first Pfizer dose, for which we are grateful in the midst of the current wave. While it remains true that children have much lower rates of severe illness than adults, by not immunizing them you are allowing a large pool of little people to congregate, pass around germs, and spread them to their homes and communities. It’s one thing when we are talking about colds or even flu, but COVID-19 is a much more serious public health threat.

As usual, I renew my plea. Vaccinate if you are eligible and have access. Pay attention to infection rates in your area. Mask in indoor public places unless transmission rates are low. Avoid large crowds. Increase ventilation. Stay home if you are sick. Test and talk to your health care provider if you have symptoms. The SARS-CoV-2 virus has already caused immense suffering. Do everything you can to keep it from affecting you, your loved ones, and your community.

SoCS: again with the complications

My life is beyond my control.

The latest wrinkle is that, just as we had worked through the latest set of medical complications with Paco and thought we could arrange another visit with the UK branch of the family before they return to London next week, there were not one but two breakthrough COVID cases discovered in the nursing home staff and the unit is closed to visitors, probably for two weeks.

Because Paco is considered a compassionate care case, we still have limited visitation, but visits need PPE, including N95 masks, and are restricted to no more than two people for about an hour per visit.

Not conducive to visits with a one-year-old and a four-year-old.

We were blessed with an outdoor visit last week and have some pictures to prove it.

That will have to do because I have no control over the situation.

Just hoping that Paco will be able to stay medically stable while we get through this period. He is fully vaccinated, of course, and everyone will be tested multiple times during the lockdown. Fortunately, he was not in close contact with the staff members who tested positive and who were doing the right thing by being fully vaccinated but the delta variant is even more formidable than the original form of the virus.

So, we’ll just keep on doing everything we can.

Even when it’s not ever enough.

I guess “enough” is not a valid concept here.

Even when the best we can do is not close to the best we had hoped for.
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Linda’s prompt for Stream of Consciousness Saturday this week is to begin a post with My. Join us! Find out more here: https://lindaghill.com/2021/08/27/the-friday-reminder-and-prompt-for-socs-aug-28-2021/