Overheard

• 78% of Americans have had COVID-19
• We know Long COVID is a thing
• If we lose Obamacare, 78% of Americans could be denied healthcare insurance due to a pre-existing condition

BTW:

The Problem

An underlying problem driving a lot of our political difficulties is a standard tactic of The Daddy State to manufacture a general distrust of expertise. And it's been going on for a very long time.

At least 30 years ago, my brother-in-law - a decent, smart, and funny guy who was eventually afflicted with the kind of aggressive brain rot that's come to characterize MAGA - started to love shit-talkin' people who knew stuff.

"Y'know what an expert is, dontcha, Mike? The word is a combination of Ex and Spurt - a has-been drip under pressure."

Propagating suspicion about intellectuals is a hallmark of authoritarianism, because the guys who know stuff will contradict a lot of what the authoritarian needs us to believe. In order to manipulate a political culture, the autocrat has to exert some control over what and how we think.

Trump totally fucked up the pandemic response, and needed ways not only to deflect criticism, but to turn the whole thing to his advantage. So:

• Fauci's a tool of Big Pharma
• Fauci's lying so he can duck his responsibility for COVID
• The eggheads at CDC are power-mad bureaucrats in cahoots with radical socialistic unions out to destroy the schools, the economy, and America's way of life
• Masks are a distraction - unnecessary - bad for you and your kids
• Vaccines cause autism - they're a way to put ID tags and tracking devices in your arms - they modify your DNA to make you obedient - it's a population control scheme and when the time is right, the 5G network will activate a neurotoxin that kills millions and blah blah blah
• Buy more ivermectin

And of course, there's a slew of others:

• Climate Change is a hoax; big government controls the weather
• Wildfires are started by space-based lasers directed by a global cabal of Jewish bankers
• The Rapture
• China is about to launch a massive EMP attack
• Don't go to a doctor for your cancer - he'll keep you sick so he can sell you more chemotherapy - just stay home and eat lots of blue-green algae
• and on and on and on

It's all pointed at getting us to cede our personal agency to the authoritarians, and giving us a nice ego massage so we can feel better about our C-minus GPA, and the fact that we really don't know jack shit about nuthin', and that's how it should be anyway because why would I listen to a buncha radical lefties who just wanna keep me ignorant?

And that ain't the half of it, but here endeth the rant.

Opinion

The Checkup With Dr. Wen: In defense of the 6-foot social distancing rule

Anthony Fauci didn’t deserve the abuse he received about the COVID pandemic guideline.

Pandemic-era social distancing guidelines have taken a beating this week. Critics have argued passionately that the Centers for Disease Control and Prevention’s recommendation to remain six feet apart was arbitrary, wrong and should never have been implemented.

I disagree. The guidance, like other public health recommendations, wasn’t perfect. But it did help to reduce transmission and was an important point of reference at a time when people needed simple, easy-to-follow guidelines.

Anthony S. Fauci, who during the pandemic was the nation’s top infectious-diseases expert, endured the brunt of the criticism during a bruising congressional hearing on Monday. Questions zeroed in on testimony he gave during a closed-door session in January that the six-foot rule “sort of just appeared” and “wasn’t based on data.” At times, the exchange devolved into personal attacks, with Rep. Marjorie Taylor Greene (R-Ga.) repeatedly refusing to address Fauci as “Dr. Fauci,” saying his medical license “should be revoked” and that he belongs in prison.

Recall that, at the start of the pandemic, SARS-CoV-2 was a novel coronavirus. Health officials knew little about it and assumed it behaved like other common respiratory viruses. Influenza and respiratory syncytial virus (RSV) are among the viruses that are transmitted predominantly via small droplets expelled when someone coughs, sneezes and breathes. These particles can land on someone’s nose, mouth or eyes, or they can be inhaled by those in proximity. They can also land on surfaces and infect people who touch them.

Over time, scientists learned that the COVID-19 virus — and especially new variants of the pathogen — was highly contagious. Studies demonstrated that it not only spread via droplets, but also by much smaller aerosol particles. Whereas droplets are heavier and quickly fall to the ground, aerosols can linger and be carried over longer distances.

Public health guidance eventually pivoted toward improving ventilation as an infection control measure, as aerosol experts had long advocated. Today, the science is pretty well settled that COVID-19 can be transmitted via both droplets and aerosols.

Critics of the six-foot rule are right in some ways. With aerosol transmission, someone could become infected even if they are further than six feet away. And, as Fauci suggested in his testimony, there have been no randomized-controlled trials looking at six feet of distancing vs., for instance, the World Health Organization’s more lenient recommendation of one meter, which is just over three feet.

But here’s what the six-foot rule got right: Droplet transmission remains one of two dominant routes of spread. A rule that reduces droplet transmission won’t curb all spread, but it can help protect people from the virus.

Moreover, I think Americans understood there wasn’t something magical about the exact distance. Did anyone really believe that being five feet away from others was dangerous while seven feet was safe? Rather, this guidance was based on a common-sense understanding that being in close contact with an infected person is risky.

This understanding is still correct. A large contact-tracing study published last year in Nature found that household contacts accounted for 6 percent of exposures to the COVID-19, but 40 percent of transmissions. Most positive cases occurred after at least an hour of exposure, suggesting that prolonged close contact is of highest risk.

Another interesting study examined a cluster of COVID cases on a 10-hour commercial flight with 217 passengers and crew. Of the 16 people who ended up testing positive, 12 were seated near the infected person. Seating proximity increased infection risk more than sevenfold.

As readers of the Checkup newsletter know, I often discussed the six-foot rule alongside two other ways to reduce transmission: being outdoors and masking. If the goal is to avoid COVID, someone in an indoor crowded area should wear a high-quality mask, but it’s not necessary if they are outdoors or well-spaced from others. The six-foot rule provided a helpful starting point to help people decide what precautions they needed to take.

Don’t get me wrong: I think it’s crucial for lawmakers to discuss whether workplaces and schools needed to impose six-foot separation rules And I would love to have more research on how much mitigation measures such as social distancing and masking reduced transmission. We also need data on their very real harms. Such information is necessary to guide policy decisions moving forward.

But none of this means people were misguided in keeping their distance from potentially infected people. It also does not mean that we should disregard social distancing as a mitigation measure against other contagious diseases. If, for example, the avian flu outbreak progresses to human-to-human transmission, we might need to bring back distancing to reduce droplet exposure.

And it definitely does not mean that Fauci somehow misled the public. Those viewing Monday’s congressional testimony should ignore the partisan noise and focus on the calm responses from the physician-scientist who guided the country through a once-in-a-generation health crisis and continues to serve as the very model of a dedicated public servant.

Still Ain't Over

2 new COVID variants called ‘FLiRT’ are spreading in the U.S. What are the symptoms?

The new "FLiRT" COVID-19 variants, including the now dominant KP.2 strain, are circulating in the US. Experts discuss symptoms, transmission and vaccines.

Respiratory virus season may be ending in the United States, but a new group of COVID-19 variants are circulating, sparking concerns about a potential summer wave.

The family of variants, nicknamed "FLiRT," after their mutations, include KP.2, which is now the dominant variant in the United States. In recent weeks, KP.2 quickly overtook JN.1, the omicron subvariant that drove a surge in COVID cases this past winter.

Currently, KP.2 accounts for one in four infections nationwide, according to the latest data from the U.S. Centers for Disease Control and Prevention.

During a two-week period ending April 27, KP.2 made up nearly 25% of cases in the U.S., up from about 10% during the previous two-week period ending on April 13. After KP.2, the next most common variant is JN,1, which accounts for 22% of cases, followed by two JN.1 subvariants, JN.1.7 and JN.1.13.1.

Another FLiRT variant, called KP.1.1, is also circulating in the U.S., but is less widespread than KP.2. It currently accounts for about 7.5% of infections nationwide, per the CDC.

Although cases and hospitalizations are down and the country is in the middle of a COVID-19 lull, the new FLiRT variants are stoking concerns about another wave of infections this summer.

Will there be another COVID-19 surge? What are the symptoms of the FLiRT variants? Are vaccines still effective? We spoke to experts to learn more.

What are the FLIRT variants?

The FLiRT variants — KP.2 and KP.1.1 — are spinoffs of JN.1.11.1, a direct descendant of JN.1, and were initially detected in wastewater samples from across the country.

The new variants have two additional mutations that set them apart from JN.1 and appear to give them an advantage over previous variants, Dr. Albert Ko, infectious disease physician and professor of public health, epidemiology and medicine at Yale School of Public Health, tells TODAY.com.

The nickname 'FLiRT" is based on the technical names for their mutations, according to the Infectious Disease Society of America.

Just like other COVID-19 strains that have gained dominance in the U.S. over the last year — JN.1, HV.1, EG.5 aka Eris, and XBB.1.16 or Arcturus — the FLiRT variants part of the omicron family.

The emergence of KP.2 and other FLiRT variants is the "same old story," Andrew Pekosz, Ph.D., virologist at Johns Hopkins University, tells TODAY.com. The SARS-CoV-2 virus mutates and gives rise to a new, highly contagious variant, which becomes the dominant strain. "The timeline that it happens in, three to six months, is much faster than we see with other viruses like influenza," says Pekosz.

Are the new variants more transmissible?

“It’s still early days, but the initial impression is that this variant (KP.2) is rather transmissible,” Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center, tells TODAY.com.

The proportion of cases caused by KP.2 is increasing while the proportion caused by other variants is decreasing, which suggests KP.2 has features that give it an advantage, the experts note.

KP.2 looks very similar to its parental strain JN.1, says Pekosz, which is highly contagious. "Except it has these two mutations. ... I think these two mutations together are making KP.2 a better virus in that it maintains its ability to transmit, but also now evades some of the pre-existing immunity in the population,” says Pekosz.

Over 97% of people in the U.S. have natural or vaccine-induced antibodies against the SARS-CoV-2 virus, per the CDC, but this immune protection fades over time.

Low vaccination rates and waning immunity create a vulnerable population, which may allow the FLiRT variants to take hold. Only time and more data will tell, the experts note.

Laboratory studies suggest that KP.2 is mutated enough such that current vaccines and immunity from prior infection will only provide partial protection, says Schaffner. "We'll have to see how true that is, but it appears, over time to be becoming a more prominent variant," he adds.

“It’s still really early in the emergence of KP.2, but I don’t think we need to sound the alarm bells as of yet,” says Ko.

Will there be a summer surge?

It's too soon to tell whether the FLiRT variants will cause a summer wave or surge, the experts note. However, it is clear that COVID-19 is still circulating and won't be taking any time off.

"We're seeing these infections year-round, at modulating levels. ... We’re probably not at the stage yet where we’ll see COVID go away completely at any time of the year,” says Pekosz.

Test positivity, which is an early indicator of case levels, is at 3% as of April 20, down 0.4% from the previous week and a sharp decline from around 12% in mid-January, per the CDC. (The CDC no longer tracks the total number of cases in the U.S.)

"We're not seeing a lot of hospitalizations, and we're certainly much lower than we were in the winter, so I'd say right now we're at a low point, which is reassuring," says Ko.

Wastewater data published by the CDC show that the viral activity level for COVID-19 is currently “minimal” — it was considered high or very high for most of January and February.

"It seems like transmission is pretty low right now, and that makes sense because usually the big peaks are in the winter, when people are inside and in more contact," says Ko.

COVID-19 has caused summer waves in the past, the experts note, which are often smaller than the winter surges. “I don’t think that we’ll see any kind of massive surge in cases,” says Pekosz.

Speculating based on current COVID-19 trends, Ko says, “KP.2 may cause a small wave, but not necessarily the large peaks that we saw in the winter — again, it is too early to tell.”

The seasonality of COVID-19 is something scientists are still trying to understand. But one thing is obvious: “This virus is now integrating itself into our population and our way of life,” says Schaffner.

There are several reassuring factors, says Ko. First, KP.2 is not a highly divergent variant — in other words, it doesn't have a very large number of new mutations that differentiate it from other strains. Second, many people have immunity from recently being infected with the FLiRT variant predecessor JN.1. Last, during the summertime, people are spending less time indoors, which allows the virus fewer opportunities to spread.

“I’m not expecting a large surge in the summer, but again, we have to be cautious and we have to follow the data,” says Ko. “We always have to be humble because SARS-CoV-2 has taught us a lot of new things.”

What are the symptoms of the newest COVID variants?
It is still too early to tell whether the symptoms of KP.2 and other FLiRT variants are different from previous strains.

“The FLiRT variants are probably not going to create very distinctive symptoms. It looks at the moment to follow the other subvariants,” says Schaffner.

The symptoms of the FLiRT variants are similar to those caused by JN.1, which include:

• Sore throat
• Cough
• Fatigue
• Congestion
• Runny nose
• Headache
• Muscle aches
• Fever or chills
• New loss of sense of taste or smell
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

According to the CDC, the type and severity of symptoms a person experiences usually depend more on a person’s underlying health and immunity rather than the variant that caused the infection.

Similar to JN.1 and other omicron subvariants, the FLiRT variants seem to be causing milder infections, says Schaffer.

“There’s no evidence now that makes us think KP.2 is more virulent or more able to cause severe disease than the prior variants,” says Ko.

Do vaccines protect against newer variants?

"Early laboratory studies indicate that the vaccines will continue to provide protection against KP.2 — a little less protection, but not zero by any means," says Schaffner.

As the virus mutates, it is becoming progressively different from the omicron strain targeted in the latest updated booster released in the fall of 2023. "We would expect that to happen, and we anticipate the plan is to have an updated vaccine in the fall available to everyone," says Schaffner.

Even if vaccines do not prevent infection, they can still offer some protection by preventing severe disease, hospitalization, and COVID-19 complications, TODAY.com previously reported.

“It’s still clear that the more severe cases that come into the emergency room predominate in people who either are not up to date on their vaccines or haven’t gotten a vaccine in a really long period of time,” says Pekosz.

Vaccination is especially important for the elderly, says Pekosz, which is why the CDC recently recommended adults ages 65 and older get an additional dose of the 2023-2024 updated COVID-19 vaccine.

Unfortunately, vaccination uptake is still poor, the experts note. "The vaccines are still showing signatures of effectiveness, but they're not being utilized anywhere close to the level that they should be," says Pekosz.

All current PCR and at-home tests are recognizing KP.2 and other FLiRT variants, the experts note. (Though if you have symptoms of COVID and test negative, it's a good idea to stay home to avoid potentially exposing other people, TODAY.com previously reported.

If you are using an at-home antigen test, always remember to check the expiration date and whether it’s been extended by the U.S. Food and Drug Administration.

“Antivirals (such as Paxlovid) are also working well. ... There’s not any major signals of antiviral resistance in the population, which is a positive sign,” says Pekosz.

How to protect against new FLiRT variants

While it's too early to tell how the FLiRT variants will pan out this summer, people can always take steps to protect themselves and others against COVID-19.

The CDC recommends the following prevention strategies:

• Stay up to date with COVID-19 vaccines.
• Test for COVID-19 if you have symptoms or an exposure.
• Stay home when you are sick.
• Return to normal activities only after you have been fever-free and symptoms have been improving for at least 24 hours.
• Practice good hand hygiene.
• Improve ventilation.
• Wear a mask in crowded, indoor spaces.
• Practice social distancing.

Reminder

Healthcare analysts have looked at every county in the US and found a direct correlation between Support For Trump and COVID Deaths.

The more they supported Trump, the more they believed the bullshit, and the more they died from COVID.

- snip -

In the spring of 2020, the areas recording the greatest numbers of deaths were much more likely to vote Democratic than Republican. But by the third wave of the pandemic, which began in fall 2020, the pattern had reversed: Counties that voted for Donald Trump over Joe Biden were suffering substantially more deaths from the coronavirus pandemic than those that voted for Biden over Trump. This reversal is likely a result of several factors including differences in mitigation efforts and vaccine uptake, demographic differences, and other differences that are correlated with partisanship at the county level.

Chart shows in early phase of pandemic, far more COVID-19 deaths in counties that Biden would go on to win; since then, there have been many more deaths in pro-Trump counties
During this third wave – which continued into early 2021 – the coronavirus death rate among the 20% of Americans living in counties that supported Trump by the highest margins in 2020 was about 170% of the death rate among the one-in-five Americans living in counties that supported Biden by the largest margins.

As vaccines became more widely available, this discrepancy between “blue” and “red” counties became even larger as the virulent delta strain of the pandemic spread across the country during the summer and fall of 2021, even as the total number of deaths fell somewhat from its third wave peak.

During the fourth wave of the pandemic, death rates in the most pro-Trump counties were about four times what they were in the most pro-Biden counties. When the highly transmissible omicron variant began to spread in the U.S. in late 2021, these differences narrowed substantially. However, death rates in the most pro-Trump counties were still about 180% of what they were in the most pro-Biden counties throughout late 2021 and early 2022.

The cumulative impact of these divergent death rates is a wide difference in total deaths from COVID-19 between the most pro-Trump and most pro-Biden parts of the country. Since the pandemic began, counties representing the 20% of the population where Trump ran up his highest margins in 2020 have experienced nearly 70,000 more deaths from COVID-19 than have the counties representing the 20% of population where Biden performed best. Overall, the COVID-19 death rate in all counties Trump won in 2020 is substantially higher than it is in counties Biden won (as of the end of February 2022, 326 per 100,000 in Trump counties and 258 per 100,000 in Biden counties).

Partisan divide in COVID-19 deaths widened as more vaccines became available

Partisan differences in COVID-19 death rates expanded dramatically after the availability of vaccines increased. Unvaccinated people are at far higher risk of death and hospitalization from COVID-19, according to the Centers for Disease Control and Prevention, and vaccination decisions are strongly associated with partisanship. Among the large majority of counties for which reliable vaccination data exists, counties that supported Trump at higher margins have substantially lower vaccination rates than those that supported Biden at higher margins.

Today's Eternal Sadness

I found a picture of my late husband & me from the late 80’s. He died of Covid on May 25th, 2020. He served in the 82nd Airborne during Vietnam & died because the president was “playing it down”. I was not allowed to see him. He died alone surrounded by people in hazmat suits. pic.twitter.com/pWZa45Ee4A

— Karmacat (@TallisHolly) March 5, 2024

Confirming COVID-19

Research shows that even mild COVID-19 can lead to the equivalent of seven years of brain aging.

Mounting research shows that COVID-19 leaves its mark on the brain, including with significant drops in IQ scores

From the very early days of the pandemic, brain fog emerged as a significant health condition that many experience after COVID-19.

Brain fog is a colloquial term that describes a state of mental sluggishness or lack of clarity and haziness that makes it difficult to concentrate, remember things and think clearly.

Fast-forward four years and there is now abundant evidence that being infected with SARS-CoV-2 – the virus that causes COVID-19 – can affect brain health in many ways.

In addition to brain fog, COVID-19 can lead to an array of problems, including headaches, seizure disorders, strokes, sleep problems, and tingling and paralysis of the nerves, as well as several mental health disorders.

A large and growing body of evidence amassed throughout the pandemic details the many ways that COVID-19 leaves an indelible mark on the brain. But the specific pathways by which the virus does so are still being elucidated, and curative treatments are nonexistent.

Now, two new studies published in the New England Journal of Medicine shed further light on the profound toll of COVID-19 on cognitive health.

I am a physician scientist, and I have been devoted to studying long COVID since early patient reports about this condition – even before the term “long COVID” was coined. I have testified before the U.S. Senate as an expert witness on long COVID and have published extensively on this topic.

How COVID-19 leaves its mark on the brain

Here are some of the most important studies to date documenting how COVID-19 affects brain health:

• Large epidemiological analyses showed that people who had COVID-19 were at an increased risk of cognitive deficits, such as memory problems.
• Imaging studies done in people before and after their COVID-19 infections show shrinkage of brain volume and altered brain structure after infection.
• A study of people with mild to moderate COVID-19 showed significant prolonged inflammation of the brain and changes that are commensurate with seven years of brain aging.
• Severe COVID-19 that requires hospitalization or intensive care may result in cognitive deficits and other brain damage that are equivalent to 20 years of aging.
• Laboratory experiments in human and mouse brain organoids designed to emulate changes in the human brain showed that SARS-CoV-2 infection triggers the fusion of brain cells. This effectively short-circuits brain electrical activity and compromises function.
• Autopsy studies of people who had severe COVID-19 but died months later from other causes showed that the virus was still present in brain tissue. This provides evidence that contrary to its name, SARS-CoV-2 is not only a respiratory virus, but it can also enter the brain in some individuals. But whether the persistence of the virus in brain tissue is driving some of the brain problems seen in people who have had COVID-19 is not yet clear.
• Studies show that even when the virus is mild and exclusively confined to the lungs, it can still provoke inflammation in the brain and impair brain cells’ ability to regenerate.
• COVID-19 can also disrupt the blood brain barrier, the shield that protects the nervous system – which is the control and command center of our bodies – making it “leaky.” Studies using imaging to assess the brains of people hospitalized with COVID-19 showed disrupted or leaky blood brain barriers in those who experienced brain fog.
• A large preliminary analysis pooling together data from 11 studies encompassing almost 1 million people with COVID-19 and more than 6 million uninfected individuals showed that COVID-19 increased the risk of development of new-onset dementia in people older than 60 years of age.

Drops in IQ

Most recently, a new study published in the New England Journal of Medicine assessed cognitive abilities such as memory, planning and spatial reasoning in nearly 113,000 people who had previously had COVID-19. The researchers found that those who had been infected had significant deficits in memory and executive task performance.

This decline was evident among those infected in the early phase of the pandemic and those infected when the delta and omicron variants were dominant. These findings show that the risk of cognitive decline did not abate as the pandemic virus evolved from the ancestral strain to omicron.

In the same study, those who had mild and resolved COVID-19 showed cognitive decline equivalent to a three-point loss of IQ. In comparison, those with unresolved persistent symptoms, such as people with persistent shortness of breath or fatigue, had a six-point loss in IQ. Those who had been admitted to the intensive care unit for COVID-19 had a nine-point loss in IQ. Reinfection with the virus contributed an additional two-point loss in IQ, as compared with no reinfection.

Generally the average IQ is about 100. An IQ above 130 indicates a highly gifted individual, while an IQ below 70 generally indicates a level of intellectual disability that may require significant societal support.

To put the finding of the New England Journal of Medicine study into perspective, I estimate that a three-point downward shift in IQ would increase the number of U.S. adults with an IQ less than 70 from 4.7 million to 7.5 million – an increase of 2.8 million adults with a level of cognitive impairment that requires significant societal support.

Another study in the same issue of the New England Journal of Medicine involved more than 100,000 Norwegians between March 2020 and April 2023. It documented worse memory function at several time points up to 36 months following a positive SARS-CoV-2 test.

Parsing the implications

Taken together, these studies show that COVID-19 poses a serious risk to brain health, even in mild cases, and the effects are now being revealed at the population level.

A recent analysis of the U.S. Current Population Survey showed that after the start of the COVID-19 pandemic, an additional 1 million working-age Americans reported having “serious difficulty” remembering, concentrating or making decisions than at any time in the preceding 15 years. Most disconcertingly, this was mostly driven by younger adults between the ages of 18 to 44.

Data from the European Union shows a similar trend – in 2022, 15% of people in the EU reported memory and concentration issues.

Looking ahead, it will be critical to identify who is most at risk. A better understanding is also needed of how these trends might affect the educational attainment of children and young adults and the economic productivity of working-age adults. And the extent to which these shifts will influence the epidemiology of dementia and Alzheimer’s disease is also not clear.

The growing body of research now confirms that COVID-19 should be considered a virus with a significant impact on the brain. The implications are far-reaching, from individuals experiencing cognitive struggles to the potential impact on populations and the economy.

Lifting the fog on the true causes behind these cognitive impairments, including brain fog, will require years if not decades of concerted efforts by researchers across the globe. And unfortunately, nearly everyone is a test case in this unprecedented global undertaking.

COVID-19 Update (Kinda)

Today's Today

Four years ago, we had no idea what shit was coming our way.

 (Before CNN went completely in the tank)

A seemingly healthy woman’s sudden death is now the first known US coronavirus-related fatality

By Sarah Moon, CNN
April 24, 2020

A 57-year-old Northern California woman whose February 6 death has become the first known coronavirus-related fatality in the US had been in relatively good health, her brother told CNN.

She was Patricia Dowd, a Bay Area woman who worked as a manager for a semiconductor company and who “exercised routinely, watched her diet and took no medication,” the Los Angeles Times first reported Wednesday.

Rick Cabello, Dowd’s older brother, told CNN she didn’t smoke and was in good health.

“She was an athlete in her high school days, she was always active,” Cabello said Wednesday. Her sudden death was a shock to family members. They all believed it was a heart attack, Cabello said.

California’s Santa Clara County had announced Tuesday that tissue samples confirmed two people who had died in early February tested positive for coronavirus – well before the United States’ previously understood first coronavirus-related death on February 29 in Washington state.

One victim was a 57-year-old woman who died on February 6, and the other was a 69-year-old man who died on February 17, the county said. The county did not name the woman, but Cabello told the Los Angeles Times and CNN that she was Dowd, his sister.

Neither patient had a recent history of travel that would have exposed them to the virus, Santa Clara County Department of Public Health Director Dr. Sara Cody said in a Wednesday news conference, and officials are presuming both cases represent community transmission.

‘She had flu-like symptoms’

Before Dowd was found dead February 6, “she had flu-like symptoms for a few days, then appeared to recover,” the Los Angeles Times reported.

“She wasn’t feeling well, which was very unusual for her,” Cabello said. “I remember her specifically saying ‘I’m not feeling well,’” he added.

She also had canceled plans to go a weekend funeral, the Los Angeles Times reported.

Dowd started working from home as her condition improved and had been in touch with a colleague around 8 a.m. on the day of her death. She was found dead about two hours later, according to the Los Angeles Times.

A traveler and ‘everybody’s rock’

Dowd was a frequent world traveler, her brother said.

She had planned to travel to China later this year and went abroad “multiple times a year to different global locations,” a family member told the Los Angeles Times. Dowd had a history of foreign travel, as did her coworkers at Lam Research, the newspaper also reported.

Dowd was “hardworking, loyal, and caring,” Cabello told the Los Angeles Times.

“She was the energy person in her large network of friends,” her brother said. “She was everybody’s rock.”

In a tribute wall set up for Patricia Dowd by the Cusimano Family Colonial Mortuary, a coworker wrote, “I’ll always remember the kindness and generosity of her spirit. She was genuinely caring and had an amazing energy.”

TIME LINE

• December 31, 2019: China reports mysterious pneumonia cases to the World Health Organization.
• January 7, 2020: China says the cases were caused by a new coronavirus.
• January 17: US starts screening for symptoms at certain airports.
• January 21: First US case confirmed in Washington state.
• January 31: US says it will deny entry to foreign nationals who’ve traveled in China in the last 14 days.
• February 6: A person in California’s Santa Clara County dies of coronavirus; link not confirmed until April 21.
• February 17: A second person in California’s Santa Clara County dies of coronavirus; link not confirmed until April 21.
• February 26: CDC announces what’s then thought to be the first possible US case of community spread, in California.
• February 29: A patient dies of coronavirus in Washington state – then believed to be the country’s first novel coronavirus death.

Neither of the two victims who died in February had been tested for the virus at the time of their deaths because testing capacity was limited, Santa Clara County officials said Tuesday in a news release.

Tests were only available through the US Centers for Disease Control and Prevention and were restricted to people who had a known travel history and showed certain symptoms.

Both of the victims who passed away in February had flu-like symptoms before dying, county officials said.

“Because there was continued suspicion by the medical examiner that these deaths were caused by Covid-19, the medical examiner sent autopsy tissue to the CDC for definitive testing,” the coroner’s office said in a statement.

As the county investigates more deaths, it’s likely that more will be tied to the virus, officials said. And that adds to evidence that suggests the current case and death tallies across the country may be significant undercounts.

COVID-19 Update

Opinion

Covid is back, and the U.S. is unprepared for the next bug. Here’s what to do.

Millions of Americans have the boxes of tissues, missed work days and hospital visits to prove it: Respiratory illnesses, including influenza, covid-19 and RSV, have surged this winter. Meanwhile, health experts warned once again last week that the world needs to prepare for a hypothetical “Disease X” perhaps far deadlier than covid-19. Yet, for all covid’s lessons, health officials, governments and the public have more to do, fighting the diseases circulating now and making the next pandemic less severe.

Extend paid sick leave

The pandemic changed many Americans’ behaviors. Many more people are reaching for face masks without being urged and staying home when feeling ill. Institutions and governments should do all they can to encourage basic hygienic practices that should be common courtesy. National paid sick leave, for example, would encourage more people to stay home — at least among the one-quarter of the workforce who now lacks it.

Get new vaccines into more people’s arms

The SARS-CoV-2 virus is still evolving rapidly. The current variant, JN. 1, appeared only in September. Fortunately, hospital admissions have not skyrocketed; the most recent booster vaccine continues to protect against hospitalization and severe illness. Still, only 21 percent of adults older than 18 years in the United States are vaccinated with the updated booster. More should get it.

During the pandemic, hopes were high that researchers would develop a pan-coronavirus vaccine that could work against all variants and provide longer protection. A road map for the research and development has been created, and research efforts are underway, including the Biden administration’s $5 billion Project NextGen. But experts say the progress is slow and the obstacles complex.

Science has yet to entirely unravel long covid, the tendency of those who are infected to experience fatigue and other debilitating symptoms in the months after. It seems that covid may cause damage throughout the body’s organs — and to the immune system. The best way to avoid long covid is to get vaccinated.

But as The Post’s Lauren Weber documented recently, lawmakers who oppose vaccine requirements are winning elections for state legislatures. Robert M. Califf, commissioner of the Food and Drug Administration, and Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, which oversees vaccines, warn in a Jan. 5 article in JAMA that vaccine hesitancy has reached a tipping point: “The situation has now deteriorated to the point that population immunity against some vaccine-preventable infectious diseases is at risk.”

Invest in preparedness

When the pandemic hit four years ago, the United States was unprepared. In the aftermath, political leaders vowed that pandemic preparedness would be high on the national agenda.But Congress and the Biden administration balked at creating a national commission on the pandemic that could have suggested basic changes. In earlier years, there was bipartisan support for the Pandemic and All-Hazards Preparedness Act, on which the U.S. response effort relied, but now reauthorization faces resistance from House Republicans angry over the way public health agencies handled the pandemic. The law expired last year.

The World Bank last year established a Pandemic Fund to strengthen pandemic preparedness, with a focus on low- and middle-income countries. Experts said it would need $10 billion a year to be effective; so far it has raised $2 billion. In October, the Global Preparedness Monitoring Board warned, “The world’s capacity to deal with a potential new pandemic threat remains inadequate.”

Build early warning systems

The pandemic boosted many countries’ capacity to conduct genomic sequencing, key to tracking covid. But they have yet to stitch together a global early warning system that would catch outbreaks before they spread.

There has been some progress. Wastewater surveillance has proven quite useful for tracking covid, detecting trends and providing early warning. The World Health Organization and the Centers for Disease Control and Prevention have set up new data centers, hoping to avoid the confusion and analytical gaps that hampered the coronavirus response. While Washington dithers, some states have taken concrete action, such as Republican Gov. Eric Holcomb’s creation of a commission in Indiana to help improve its public health system. Also, the White House has launched the new Office of Pandemic Preparedness and Response.

As J. Stephen Morrison and Michaela Simoneau of the Center for Strategic and International Studies have pointed out, a new generation of national leaders is rising in public health agencies: Mandy Cohen, director of the CDC; Monica Bertagnolli, director of the National Institutes of Health; Jeanne Marrazzo, director of the National Institute of Allergy and Infectious Diseases; and Renee Wegrzyn, director of the new Advanced Research Projects Agency for Health.

If the last few years has taught us anything, they will not have a moment’s rest.

Another Bullshit Prediction

50 million Americans have not died of the COVID vaccination.

If this was even close to true, the population of The United States would be down around 285,000,000. We are currently at almost 335,000,000.

This is a very good example of The Grifter Culture of Conservative Inc.

COVID-19 Update

I think I'm over the hump battling whatever this shit is that's making me feel like I'm coughing up the lining of my lungs, and blowing these weird cornflake-looking boogers out of my nose.

I tested yesterday, and came up negative for COVID, but dang this has been quite a fight.

I slept OK last night, and I think I'm on the mend.

That said - and thank you for indulging me on that one - here comes COVID again.

Another covid wave hits U.S. as JN.1 becomes dominant variant

The United States is in the throes of another covid-19 uptick, cementing a pattern of the virus surging around the holidays as doctors and public health officials brace for greater transmission after Americans return to school and work this week.

Coronavirus samples detected in wastewater, the best metric for estimating community viral activity, suggests infections could be as rampant as they were last winter. A smattering of health facilities around the country, including every one in Los Angeles County, are requiring masks again. JN.1, the new dominant variant, appears to be especially adept at infecting those who have been vaccinated or previously infected.

While photos of positive coronavirus tests are once again proliferating across social media, fewer people are going to the hospital than a year ago. The Centers for Disease Control and Prevention reported 29,000 covid hospitalizations in the week before Christmas, the most recent data, compared with 39,000 the previous year. The agency has reported an average of 1,400 weekly deaths since Thanksgiving, less than half of the fatalities at the same point last year.

Even so, covid remains one of the leading causes of death as well as the top driver of respiratory virus hospitalizations — worsening the strain on hospitals also seeing influxes of flu and RSV cases.

“Of the three major viruses, it is still the virus putting people in the hospital most and taking their life,” CDC Director Mandy Cohen said in an interview Wednesday.

Even mild cases can lead to the lasting complications inflicted by long covid.

When you have covid, here's how to know if you're no longer contagious

The CDC still recommends people isolate for five days after testing positive, though many Americans have stopped doing so and free tests are harder to come by, making it easier for the virus to keep spreading if people don’t know their cold is actually covid.

“As with any public health advice, getting people to adhere to policies is always challenging,” said Simbo Ige, commissioner of the Chicago Department of Public Health who is urging residents to follow that guidance. “Appealing to people’s desire to be part of the solution to ending covid or reducing the impact of covid is what we have seen be most effective.”

Michihiko Goto, an infectious-disease specialist who has seen a modest uptick in covid patients at the Department of Veterans Affairs in Iowa City, worries that the return of college students will seed more infection in the coming weeks.

The CDC guidance for isolation makes sense, he said, but the reality is that many people do not have the flexibility at work to do so.

“People without paid sick leave may not be able to [isolate] because they have to feed their families,” he said.

While coronavirus cases have surged every winter since the pandemic began, the CDC says it is not yet considered a seasonal disease like influenza. The coronavirus fluctuates throughout the year, and the typical winter waves could be influenced by other factors such as holiday travel, cold weather pushing people indoors and the evolution of the virus. The JN.1 variant that is now the most common in the United States has significantly more mutations than its predecessors, which could explain why people who had dodged infections during the summer surge are getting sick.

“If you look at the different peaks in cases since the beginning of the pandemic, every one of them coincided with the emergence of a new variant,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “Too many people are attributing this to seasonality.”

Few Americans are staying up to date on their coronavirus vaccines to train their immune systems to keep up with an evolving virus. According to CDC estimates, just 19 percent of Americans have received the latest version of the vaccine that lab experiments show offer better protection against the JN.1 variant than the previous formula.

“That’s not doing enough to suppress the virus from evolving, getting stronger and more evasive,” said Jessica Malaty Rivera, an epidemiologist and senior science communication adviser at the de Beaumont Foundation, a public health organization.

Medical professionals and public health officials say they’re facing growing skepticism of coronavirus vaccines, particularly among conservatives. The latest pushback came Wednesday from Florida’s top health official, who urged people to stop receiving mRNA coronavirus vaccines, citing debunked claims that they could contaminate patients’ DNA.

Mainstream health officials have encouraged vaccination, particularly for people older than 65, to minimize the damage caused by covid waves.

Wastewater tracking by the firm Biobot Analytics shows that the most recent coronavirus levels were slightly lower than the same point last year, except in the Midwest. The difference could be driven by changes in vaccines and variants affecting how much virus people shed, said Marisa Donnelly, a Biobot epidemiologist.

Donnelly said wastewater data is best used as a warning sign when levels rise.

“Right now as I’m seeing really high rates of covid-19 in wastewater, I start to worry about people who are immunocompromised or have risk factors that put them at greater risk of developing severe covid,” Donnelly said.

While the CDC had flagged New York and New Jersey in mid-December as among the first states with the highest share of infections caused by the new variant and high respiratory virus levels, hospitals in those states say those trends did not translate to crises in their wards.

“It’s not uncontrollable, and it’s nothing like it was last year,” said Cathy Bennett, president and CEO of the New Jersey Hospital Association.

Hospital leaders now talk about the coronavirus in the context of the broader respiratory virus season. RSV, most often seen in infants and toddlers in pediatric wards, has already peaked nationally. The flu season started later than normal and is now accelerating, with 136,000 emergency department visits for influenza last week compared with 79,000 for covid.

Northwell Health, New York’s largest health-care system, has seen a surge in people coming to the emergency room and outpatient facilities testing positive for the coronavirus, which was expected after Thanksgiving. Those patients are typically discharged quickly and rarely end up severely ill.

“If you are looking at very sick people in the ICUs, it’s more likely flu than covid,” said Bruce Farber, an infectious disease physician and the system’s chief of public health and epidemiology. “If you are looking at total population in the hospital with people with some respiratory illness, it’s overwhelmingly covid.”

But the addition of covid to the usual winter swirl of respiratory viruses has strained other hospitals — including in Minnesota, where wastewater levels increased tenfold in the week before Christmas.

Covid winters are making long hospital waits the new normal

“Every hospital that does pediatric care is saturated,” said John Hick, an emergency physician at Hennepin Healthcare, in downtown Minneapolis, which has 25 pediatric beds.

For the past month, hospital officials across the state have held coordination calls three times a week to triage which facilities have pediatric beds and whether certain patients can be moved into adult units, Hick said. Last week, the hospital began requiring patients and clinicians to wear masks again when interacting.

On Hick’s last ER shift a few days before Christmas, half the patients had either covid or the flu. He expects to see more covid cases in the coming weeks, given low vaccination rates.

What’s most dismaying, he said, is that many of those cases are preventable.

What Were We Expecting?

US LIFE EXPECTANCY

Pre-Pandemic     2019:    78.8 years

Pandemic   2020-2021:    76.4 years

Post-Pandemic   2022:    77.5 years

New CDC life expectancy data shows painfully slow rebound from covid

Federal death data from the past decade and a half shows an ominous long-term trend in mortality that is not solely due to the coronavirus or other high-profile killers, including drug overdoses and gun homicides. (Melina Mara/The Washington Post)

Newly published data on life expectancy in the United States shows a partial rebound from the worst phase of the coronavirus pandemic, but drug overdoses, homicides and chronic illnesses such as heart disease continue to drive a long-term mortality crisis that has made this country an outlier in longevity among wealthy nations.

Life expectancy in 2022 rose more than a full year, to 77.5 years, in data released Wednesday by the Centers for Disease Control and Prevention. More than four-fifths of this positive jump was attributable to a drop in covid-19 deaths.

But the rebound in 2022, which the CDC had anticipated after studying death rates, regained less than half the years lost to the pandemic, the federal health agency reported.

“The amount of recovery is not as much as we’d like to see,” Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, said after reviewing the report.

He said many peer countries suffered smaller drops in life expectancy and rebounded more quickly from covid-19’s impact.

“It’s disturbing but not surprising to me that we have not experienced the recovery that other countries have,” Woolf said.

In 2019, U.S. life expectancy at birth stood at 78.8 years. That figure cratered to 76.4 in 2021, the lowest since 1996. That was due partly to the extraordinary wave of covid deaths in January and February of that year as the United States had only begun to roll out vaccines. The following winter saw another short but intense wave of deaths as the omicron variant of the virus reached the country, creating the last major surge in pandemic deaths.

“There appears to have been some recovery from covid, but we still have a way to go,” said William Schaffner, an infectious-disease physician at the Vanderbilt University School of Medicine.

“Covid remains with us and continues to put people in the hospital, and have a substantial mortality rate associated with it, particularly among older people and people who are immunocompromised,” Schaffner said.

An epidemic of chronic illness is killing us too soon.

The rise in certain chronic diseases in the United States — and slower progress in combating others — put the nation in a vulnerable position when the novel virus arrived. A scattered and politically polarized response to the pandemic played a role in the dire death toll that followed, as did resistance to vaccination and other public health measures. No other wealthy country experienced so high a rate of death per capita from covid.

The new numbers are clearly positive — compared with 2021. But the same data show the dramatic, and protracted, impact of the pandemic. Between 2019 and 2021, life expectancy dropped 2.4 years, and the 2022 jump restored only 1.1. years of that deficit. (Men lost 2.8 years in those first two years, and women 2.1 years.)

The United States has dug itself into a huge life-expectancy hole, and not just because of the virus that slipped into the country in stealth fashion in 2020. In articles this year, The Washington Post has explored the many reasons this country lags peer nations in life expectancy, and a major finding is that chronic conditions such as heart disease, obesity, diabetes and cancer play an underappreciated role in suppressing life spans.

Fatty liver was a disease of the old. Then kids started getting sick.

The new report affirms that conclusion. Although the coming and going of covid explains much of the shape of the mortality curve during the past several years, the CDC death data from the past decade and a half shows an ominous long-term trend in mortality that is not solely due to the coronavirus or other high-profile killers, including drug overdoses and gun homicides.

Life expectancy rose in a relatively steady fashion for all of the 20th century and the first decade of the 21st. But starting in 2010, the country entered a decade of stagnation in this key metric. Drug overdoses, homicides and suicides played major roles in flattening the life expectancy curve. But the greatest erosion in life spans comes from chronic illnesses, The Post found in its analysis of death data.

Life expectancy peaked at 78.9 in 2014, and then dipped or remained flat through 2019. The new CDC data, despite showing an improvement in 2022, suggests that this period of disappointing life expectancy will continue.

“The pattern is consistent with the stagnation that we’ve seen since 2010,” said Elizabeth Arias, a demographer with the CDC’s National Center for Health Statistics and lead author of the new report.

“Even without the pandemic, life expectancy was flat or declining,” Arias said. “This is a whole new territory that we’re in, beginning a decade ago.”

Very few countries have yet published life expectancy data for 2022, as reflected in records at the international human mortality database. The few that have, however, all show quicker recovery from the pandemic.

Sweden in 2022 was back to the same life expectancy as before covid, 83.1 years, more than 5½ years longer than in the United States.

In 2022, Belgium, Denmark and Norway had just slightly lower life expectancy than before the pandemic.

Among countries reporting data for 2022, Finland comes closest to the profile of the United States in terms of recovery from the devastation wrought by the pandemic. In Finland, life expectancy was down 0.6 years compared with 2019. But that loss is less than half of the U.S. decrease of 1.3 years since 2019.

Life expectancy at birth is not a prediction for any individual, but a statistical artifact, one that aggregates death rates from many different age cohorts and creates a handy, if potentially confusing, measure of a nation’s overall health.

Schaffner, the Vanderbilt doctor, said the lingering effects of the pandemic and other health challenges provide a reminder that the United States needs to continue its comprehensive childhood vaccination program, which typically requires children to be immunized before attending school.

“And now we have a slow erosion of that, with increasing vaccine skepticism and more and more parents withholding their children from comprehensive vaccination,” Schaffner said. “We don’t want to erode these very successful preventive health initiatives.”

The new CDC report, which is considered “provisional” in advance of a final report due in December, captures the racial and ethnic disparities in life expectancy that were exacerbated by the pandemic.

All race and ethnicity groups in the country have lower life expectancy as of 2022 than before the pandemic. Native Americans suffered the largest overall decline, almost four years, to less than 68 years. Black people suffered the second-largest life-expectancy setback, of two years. Hispanic life expectancy is 1.9 years less than before covid. The overall decline for White people is 1.3 years, and for Asian people 1.1 years.

COVID-19 Update

COVID variant BA.2.86 triples in new CDC estimates, now 8.8% of cases
healthwatch

Nearly 1 in 10 new COVID-19 cases in the U.S. are from the BA.2.86 variant, the Centers for Disease Control and Prevention estimated Monday, nearly triple what the agency estimated the highly mutated variant's prevalence was two weeks ago.

Among the handful of regions with enough specimens reported from testing laboratories, BA.2.86's prevalence is largest in the Northeast: 13.1% of cases in the New York and New Jersey region are blamed on the strain.

Monday's figures mark the first time BA.2.86's prevalence has surged enough to be listed as a standalone variant on the CDC's estimates. Scientists first warned of the highly mutated strain's discovery over the summer.

"In previous Nowcast updates, BA.2.86 was too uncommon to be shown separately and was grouped with other BA.2 strains," the CDC said Monday.

Before this point, officials have said the vast majority of new COVID-19 cases have been blamed on the XBB variant and a crowd of XBB's closely related descendants. Those include the HV.1 and EG.5 variants that are currently predominant nationwide.

The CDC's estimates carry wide margins of error around BA.2.86's prevalence. As little as 4.8% or as much as 15.2% of circulating SARS-CoV-2 could be from BA.2.86, the agency says.

However, this latest estimate – 8.8% through Nov. 25 – is virtually triple what it was on Nov. 11, when 3.0% of new cases were estimated to be BA.2.86. The CDC typically publishes its variant estimates every other Friday, but had delayed last week's release until after the Thanksgiving holiday weekend.

"It is important to note that early projections tend to be less reliable, since they depend on examining growth trends of a smaller number of sequences, especially as laboratory-based testing volume for SARS-CoV-2 has decreased substantially over time," the agency said.

The World Health Organization also recently stepped up its classification of BA.2.86 and its descendants to a "variant of interest" after a rise in cases from the strain.

Early data on BA.2.86 suggests it does not appear to lead to worse or different symptoms than previous strains, the World Health Organization said in its Nov. 21 risk evaluation, but noted a "substantial rise" in recent BA.2.86 reports.

The CDC said it did not disagree with the WHO's assessment that BA.2.86 likely posed a "low" public health risk, adding that for now the strain "BA.2.86 does not appear to be driving increases in infections or hospitalizations in the United States."

It comes as the CDC has begun to track a renewed increase in indicators tracking COVID-19's spread across the U.S. headed into the winter.

After weeks of largely slowing or flat trends, the CDC said this month that figures like emergency department visits had begun to increase nationwide from COVID-19. Virtually all regions of the country are now seeing at least slight increases.

Some of the highest increases are in the Midwestern region covering Illinois, Indiana, Michigan, Minnesota, Ohio and Wisconsin, where trends are nearing levels not seen since early January.

Is the JN.1 variant to blame?

Since August, BA.2.86's broad array of mutations did not appear to be enough for the strain to gain a foothold over XBB and its descendants. Months of the highly mutated variant's spread only resulted in a small share of cases throughout the world.

But scientists in recent weeks have been studying a steep increase in a BA.2.86 descendant called JN.1, which quickly rose to become the fastest-growing subvariant worldwide.

Many cases have been reported in Europe, which has seen increasing cases from BA.2.86 and its descendants.

Authorities in France said on Nov. 13 that JN.1 was largely driving that country's increase in BA.2.86 infections, climbing to 10% of sequences in the country. Early investigations of JN.1 had not turned up any worrying signals so far compared to other BA.2.86 infections, they said, though more in-depth analyses were underway."

Data from recent weeks tallied from the GISAID virus database suggests as much as a third of COVID-19 variants reported from labs in the U.S. have been of JN.1.

It is unclear what proportion JN.1 makes up of the CDC's BA.2.86 estimate.

A spokesperson for the agency did not immediately respond to a request for comment.

Last month, the CDC said it expected COVID-19 tests and treatment would remain effective against JN.1, which is closely related to BA.2.86 aside from a single change to its spike protein that early research suggests is enabling it to spread faster.

This season's vaccines are also expected to work against JN.1 similar to what was estimated for its BA.2.86 parent, the agency said.