Covid-19 is coming out of the left field: warnings and warnings for European and UK public health officials and ill preparedness during the cold weather

A new Covid-19 wave appears to be brewing in Europe as cooler weather arrives, with public health experts warning that vaccine fatigue and confusion over types of shots available will likely limit booster uptake.

Their changes aren’t on the scale of what happened when the original Omicron arrived on the scene in November 2021. Researchers and public health officials are scrambling to figure out how a strain of the virus came out of the left field.

WHO data released late on Wednesday showed that cases in the European Union reached 1.5 million last week, up 8% from the prior week, despite a dramatic fall in testing. Case numbers around the globe continue to decline.

The hospitalization rates for the H1N1 swine flu vaccine have been high at this point in the season. The latest CDC update tracks data through October 29.

We encourage people to get this updated vaccine, it is called the BA.5 bivalent vaccine. It will have a decent amount of cross-protection against the others, but it will be disappointing how few people take these vaccines, as we are in October.

European and British officials have endorsed the latest boosters only for a select groups of people, including the elderly and those with compromised immune systems. Complicating matters further is the “choice” of vaccine as a booster, which will likely add to confusion, public health experts said.

The lack of a major public health campaign and the fact that it is all over is likely to cause people to lose interest in risk reduction. “So on balance I fear that uptake will be quite a bit lower.”

Penny Ward, visiting professor in pharmaceutical medicine at King’s College London, said: “Another confounder is that quite a high proportion of the population might have also had a Covid episode in recent months.”

The European Centre for Disease Prevention and Control reports that since the roll-out of new vaccines began in the European Union, 40 million vaccine doses have been delivered to member states.

Adam Finn said that the life seems to have been back to normal with regards to Covid, at least with regards to financial and war-related worries.

Italy’s Gimbe science foundation said the government, soon to be replaced after an election, was ill prepared for the autumn-winter season, and highlighted that a publication on the government’s management of the pandemic had been blocked.

Meanwhile, British officials last week warned that renewed circulation of flu and a resurgence in Covid-19 could pile pressure on the already stretched National Health Service.

Some researchers say that the US is seeing early signs of that. In parts of the Northeast such as Pennsylvania and Connecticut, the levels of virus being detected in wastewater is up. It could be an early-warning sign that something is going to happen.

What’s happening in Europe gives the first hint of what is to come. Several European countries including the U.K., France and Italy, have experienced a rise in infections.

The director of the Centers for infectious disease research and policy at the University of Minnesota says that the recent events in Europe have been a glimpse into the future. The bottom line for us in this country is that we have to be prepared for what they’re seeing in Europe.

We must be prepared for this. Countries need to be in a position to conduct surveillance, to deal with increases in cases and perhaps deal with increases and hospitalizations. We do not know if there is a change in severity. We have to remain vigilant, as our vaccines remain effective.

However, it’s not certain the U.S. experience will echo Europe’s, says Justin Lessler, an epidemiologist at the University of North Carolina who helps run the COVID-19 Scenario Modeling Hub.

That’s because it’s not clear whether Europe’s rising cases are related to people’s greater susceptibility to new subvariants they’ve not yet been exposed to. In addition, different countries have different levels of immunity.

Lessler believes that if both behavioral changes and climate are accounted for we might be able to avoid similar spikes. If it’s immune escape across various versions of convergent evolution, the outlook for the U.S. may be more concerning.

“It’s not too early to say that something is happening, but it’s something we’re keeping an eye on,” says Amy Kirby, lead of the Centers for Disease Control and Prevention.

Rubin says there is evidence of increasing transmission in the northern part of the country. “The winter resurgence is beginning.”

It appears highly unlikely this year’s surge will get the same severity as the last two years in terms of disease and deaths.

“We have a lot more immunity in the population than we did last winter,” says Jennifer Nuzzo, who runs the Pandemic Center at the Brown University School of Public Health.

“Not only have people gotten vaccinated, but a lot of people have now gotten this virus. In fact, some people have gotten it multiple times. And that does build up [immunity] in the population and reduce overall over risk of severe illness,” Nuzzo says.

The poor uptake of the new boosters, combined with the immune evasiveness of the new variants and the waning of population immunity, is almost surely a recipe for rising cases and hospitalizations in the weeks ahead.

More than 12 million people got an updated bivalent Booster six weeks ago, according to the newest data from the CDC. That is less than 10% of the population that is eligible to get one.

And the demand for the newest boosters is pretty lethargic so far. Almost 8 million people have not received one of the new boosters, even though more than 200 million are eligible.

It’s critical that people are up to date on their vaccines, says Nuzzo. The most important thing we can do is to take off the table that the virus can cause severe illness and death.

Covid-19 Vaccines for the Prevalence of Infections: The Good News About BA.5 and Its Conversion to a New Variant, BA.2

This newsletter is the last before I leave for a book leave. I’ll be back in late January. Until then, other Times journalists will be writing The Morning, and I look forward to reading their work along with all of you.

If these antibodies stop working against the virus, the United States will still have Covid-19 antiviral drugs like Paxlovid, molnupiravir and remedsivir to help those at risk of severe complications.

The warning is similar to others who believe there will be a rise in cases in the coming months and that the infections will decline in the future.

The three subvariants we’re tracking all seem to give a lot of immune escape. Now, the good news about them is while they seem to do a better job of escaping immunity, they are derived from BA.5 or BA.2, its closely related cousin, and the new vaccines we have, which protect you against BA.5 should really continue to work really quite well against these new variants. So we don’t know all the details. Obviously we’re looking at that. There is one more reason for people to get this vaccine.

An Explanation of the Effects of COVID on the Immune System in the Prevalence of Childhood Asthmophobia and Related Diseases

My friends, family and I have always said that they should get it before Halloween. I mean, go get it now. You are going to have high degree of protection as you get into Thanksgiving and the holidays if you get it before Halloween. You know, you can’t time these things too tightly. So in general, my recommendation is go get it, go get it soon. And certainly get it before Halloween.

I would say I’m aware of the fatigue. You know, we’re now at a point where COVID doesn’t have to rule our lives. We don’t have to take extraordinary precautions the way we did two years ago or even a year ago. This is a once a year shot for majority of Americans. I have gotten a flu shot for 20 years. It is not a big deal. I go get my flu shot every fall It helps protect me during the fall and winter. The vaccine is a once-a- year shot for a majority of Americans.

For some high-risk people, they may need a shot more than once a year. They might need one again in the spring. But for a majority of people, we’re at a point where it’s a once-a-year shot, it’s not that inconvenient, not that big a deal, and it’s a great way to protect yourself.

Identifying Covid-19 variants in the United States and Europe as convergent evolution of Scrabble variants, according to a Yale School of Public Health Associate Professor

In the United States, these are BQ.1, BQ.1.1, BF.7, BA.4.6, BA.2.75 and BA.2.75.2. In other countries, the recombinant variant XBB has been rising quickly and appears to be fueling a new wave of cases in Singapore. There are rising cases in Europe and the UK.

Dr. Peter Hotez, who co-directs the Center for Vaccine Development at Texas Children’s Hospital, says he thinks of them collectively as the Scrabble variants because they use letters that get high scores in the board game like Q, X and B.

Lumped together, the variants accounted for almost 1 in 3 new Covid-19 infections nationwide last week, according to the latest estimates from the US Centers for Disease Control and Prevention.

Though they each descend from slightly different branches of the Omicron family tree, these new offshoots have evolved to share many of the same mutations, a phenomenon known as convergent evolution.

A new phase of the evolution of the viruses is thought to have been entered with the convergence, because it will see circulation of several variants at the same time.

According to a Yale School of Public Health associate professor, there is a chance that several co-circulating, semi-dominate lineages will occur this winter.

“That’s because with convergent evolution, perhaps several different lineages can independently obtain similar transmissibility levels versus a single new variant taking over.

“This is what predominantly happens for most pathogens, such as the flu and RSV,” Grubaugh wrote in an email. Most of the circulating virus has high fitness because it has adapted well to human transmission.

Maria Van Kerkhove, the Covid-19 response technical lead for the World Health Organization, said Wednesday that the large mix of new variants was becoming more difficult for WHO to assess because countries were dialing back on their surveillance.

Do we expect BA.5 to be the dominant variant of the coronavirus? “It’s not going to be THAT big,” says Fauci

Fauci told CNN that most people feel somewhere in the middle of November that they will become a significant proportion and have bumped BA.5 off as the dominant variant.

These variants are different from BA.4 and BA.5, but they’re descended from those viruses, the result of genetic drift. So they share many parts of their genomes with that virus.

“It isn’t that different from BA.5 that it would completely escape the protection that you would get from vaccine” – if people would just get the shot, Fauci said.

The original strain of the coronavirus can be protected against with the bivalent booster vaccine.

“It’s probably going to be significantly bigger than the BA.5 wave, at least that’s what I expect,” said Mark Zeller, a project scientist who monitors variants at the Scripps Research Institute. He doesn’t think this winter’s surge will reach the heights of January’s Omicron wave.

The genetic changes these variants share appear to help them escape the immunity created by vaccines and past infections – a recipe for reinfections and breakthrough infections, particularly for people who haven’t had an updated booster.

Eli Lilly makes bebtelovimab, which is one of the lab-made therapies that are impervious to severe Covid-19 infections.

The immune function of people with age, drugs or disease is likely to be affected by the use of antibody therapies. These are the same people whose bodies don’t respond robustly to vaccines.

The White House Covid-19 response is responsible for encouraging the development and sale of new therapies after they are made.

It would take us a long time to get a monoclonal into the market, because we do not have the money right now.

Antibodies are a losing proposition for companies because it takes millions of dollars of investment to make them and because the virus is evolving so fast, they might be effective for only a few months.

What can we learn about RSV when we see it, and what we need to do to make sure we have more funding to help us improve our lives?

He says current realities require that the government continue to incentivize the production of new therapies, and he expects that the Biden administration will again try to ask Congress to pass more funding to do that.

When Sizemore and her family left for out of state to celebrate Sizemore’s birthday, she was hoping Raegan would try swimming. The 15-month-old was not herself on Saturday.

Older adults and infants are more at risk for serious illness from Respiratory syncytial virus (RSV), a common respiratory infections that causes mild, cold-like symptoms and can cause serious illness.

The staff at UH Rainbow Babies & Children’s Hospital in Cleveland knew that Raegan would need to be admitted when they saw her vitals. She needed oxygen.

For some kids, though, it can be a much more serious disease. RSV can be especially dangerous for preemies, newborns, children with weakened immune systems or neuromuscular disorders, and those under age 2 with chronic lung and heart conditions, the CDC says.

The unusually high number of RSV infections so early in the year are already pushing hospitals to capacity. For the second time in two years, experts have seen a surge in the number of children with respiratory syncytial virus being sent to the hospital during the summer months.

Those conditions have led to what some doctors are calling an unprecedented number of infants and children in emergency rooms and pediatric intensive care units across the country.

UH Rainbow Babies was unable to take emergency admissions due to the surge of patients, so it went on diversion for a couple of days. It’s taking patients again now, but it’s still slammed with RSV cases.

Connecticut Children’s Hospital is considering whether or not to draw on the National Guard to help care for young patients in the wake of a dramatic increase in cases.

How did Lindy and Zoey Green get accustomed to the ice packs? Why is the Spread of Influenza and Respiratory Syncytial Virus Surging?

“I don’t know how but she slept with those ice packs on top of her,” Zoey Green said, holding an exhausted Lindy at the hospital. She said they’re trying to keep her hydrated so she doesn’t have to go back on an IV.

She said that their census numbers are very high and that they are trying to figure out how to accommodate all of the sick in the community.

Restrictions to curb the spread of COVID-19 markedly blunted the spread of other respiratory illnesses. Influenza and respiratory syncytial virus (RSV) can cause cold-like symptoms for young children and elderly people, but it is not as dangerous as it once was. Now, in the Northern Hemisphere, RSV is surging, and the hospitalization rate for flu in the United States is higher for this time of year than it has been since 2010. Why exactly are these surges happening now? And what will happen in winters in the future?

At UH Rainbow Babies staff are hoping things don’t get much worse. “If we’re not peaking, then holy hell, because I hope we’re peaking right now,” said Dr. Amy Edwards, associate medical director for children’s infectious diseases.

How concerned should parents be? What is happening during the 2019-2020 RSV pandemic, and what is going on at the children’s hospital?

When the people stayed home to prevent the spread of the coronavirus in 2020 and 2021, it affected the usualRSV season. There was an immunity gap because case counts were low.

Most adults don’t realize they have a mild illness, or that it’s nothing more than a Cold or allergy, and end up interacting with others.

It is not the same as flu or Covid, so you feel fine, Edwards said. “And then what happens is, your neighbor has that beautiful baby, and you bring over a casserole, and you kiss that little baby because you feel fine. You don’t feel sick. Sometimes they end up in the hospital, because you pass it on to them.

It is possible for a baby to be dehydrated, have a high temperature, bluish skin or become unresponsive if they are taken to the ER. Most will go home after a few days, according to the CDC.

Davis told the children’s hospital in Grand Rapids that hand hygiene is the most important thing to do to keep ourselves and others safe. She tells people to never touch their faces unless they recently washed their hands.

She said when a child or adult is sick they need to stay home and not spread any respiratory illness.

She wants other parents to know that if their child has a cough, they should take it seriously. “This could have been a much worse situation if we didn’t get Raegan help.”

But just how concerned should parents be? Here are answers to some of the most common questions about the RSV infection, who is most at risk and what might be causing this year’s outbreak.

There’s something else going on, she added. Very young children born just before or during the pandemic did not benefit from regular or early exposure to common viruses, including RSV, which would have helped build up an immunity.

Respiratory Syncytial Mite: Treatment Options for Infants and Toddlers in a World Without Colds and Flus, says Madhavan

“My hope is that this is not the new normal,” Madhavan said on Friday. “But for this year, it is concerning because it’s still only late October and we don’t know what we’re going to see as we head deeper into fall and especially this winter.”

The problem is that their lungs and muscles aren’t big enough to cough or sneeze out the increased mucus in their airways.

The excess fluid is hard for them to get out and that causes them to have trouble eating and drinking.

Health officials believe hand washing, staying hydrated, keeping hands away from the face, and disinfecting surfaces can help stave off Respiratory syncytial mite or keep it from becoming a serious illness.

She suggested that she should ask others how they are feeling. When people ask that question, the person on the other side doesn’t think to mention it if they’re really sick, and they just think to mention if they’ve had a minor cold. That could turn into a serious case for an infant or toddler, she said.

The best way for children and adults to stay healthy is to get updated COVID booster and flu shots during the remaining fall and winter months.

Anyone over six months old can get the flu vaccine. Madhavan noted that it takes a couple of weeks for the shot’s full protection to take effect. “If a child is under eight years of age, they need two immunizations in one month before they are protected against the flu,” she said.

Source: https://www.npr.org/2022/11/02/1133040571/rsv-questions-answers-treatment-options

Diagnosis and care for infants with severe respiratory virus: the at-home use of palivizumab for high-risk infants

There is, however, a treatment called palivizumab that is available to high-risk infants. Babies born with certain lung or heart conditions who are high risk for severeRSV disease can be injected with this injection. It is administered once a month throughout the RSV season.

“It is not a vaccine in that it does not help the immune system to make longer term immunity, but it gives additional protection during the high-risk periods for those high-risk children”, said Madhavan.

Still, Madhavan stressed, palivizumab is not routinely given to all children. Part of that is due to the possible, more serious side effects associated with the drug, which include swelling of the throat, difficult or rapid breathing, muscle weakness, and unresponsiveness.

Picking up the phone is the best way to tell if you and your child have it, since it could mean exposure to otherviruses that your child doesn’t have and can have risks on.

Health care professionals can help with potential at- home treatment by looking at a list of warning signs.

“Based on that information they can recommend that you start doing nasal saline drops, use a humidifier or shower, or do other things to help loosen up mucus and decrease congestion,” she said. “If it’s a child older than one, they may say try honey to help with a cough or give suggestions on how to bring down a fever.”

It may be time to seek more intensive care for an infant or young child when they are working hard and can’t breathe. The skin between or below the ribs or collarbone pulls in and out, which includes a flaring of the nostrils.

What Have We Learned About Salmonella and Influenza During the First Four Years of COVID-19 Outbreaks? An Immunity Debt

The Mid-Atlantic region has the highest amount of flu activity, followed by parts of the West Coast. The Walgreens data suggests that there are certain areas on the Gulf Coast where there are more prescriptions for the antiviral treatment than any other area.

Seventeen states have less than one in five available beds. Rhode Island and Arizona are two of the five that are more than 90% full.

The restrictions of COVID-19 make us more susceptible to these viruses. What’s behind the current surge in the Northern Hemisphere, and what will the new normal be?

The University of Pennsylvania’s Scott Hensley says that these viruses are coming back with a vengeance. It’s possible that this year is going to be the granddaddy of them all in terms of flu.

In August 2021, researchers in France coined the term ‘immunity debt’ to describe this reduction in population-level immunity. The term has taken off on the micro-blogging site. Matthew Miller is an expert on immunology and he calls the idea that a lack of exposure to infectious diseases has damaged the immune system nonsense.

There is more that researchers don’t know about seasonal viruses. For example, COVID-19 restrictions seemed to have little impact on one type of seasonal virus, rhinoviruses — which are the most common cause of colds — for reasons that aren’t entirely understood. Miller says it may be because of their cold-blooded nature. They’re less prone to desiccation and can persist for longer in the environment.

One question is how the viruses compete and interfere with one another. A strong immune response can be raised when there is a single virus that is not linked to another. Hensley points out that last year’s first wave of influenza declined soon after the Omicron surge began. Perhaps Omicron infection provided some short-lived protection against flu. Or maybe the Omicron surge simply convinced people to mask up and keep their distance.

What is the next unusual winter? A warning from M. B. Pitzer, MD, M. J. S. McCann, D. McKay, and E. C. Fuchs

Pitzer thinks the peaks and valleys of next year will look a little bit like those that occurred before the flu hit. She is not placing bets. But she says: “I do expect that this winter is probably going to be the last unusual winter.”