COVID in California: Wachter says he will mask ‘likely forever’ in some situations – San Francisco Chronicle

The warnings were stark and the early evidence looked worrisome, as Bay Area COVID cases took off after Thanksgiving. But whether due to “hybrid immunity” or individual precautions, the winter surge has proved tamer than feared and metrics are clearly improving. One key metric: nationwide hospitalizations are falling, a reassuring sign of a weakening pandemic. That doesn’t mean we’re entirely out of the woods, though: variant proportions reported by the CDC continue to show gains for the immune evasive XBB strains, though they still trail the BQ family in the western U.S.

UCSF’s Wachter says he will mask “likely forever” in some situations

In his most recent COVID-19 risk analysis for his social media followers, UCSF’s Chair of Medicine Dr. Bob Wachter said he is once again ready to let down his guard. “I’m changing my behavior. In the Bay Area, I’m now OK with indoor dining & removing my mask for small group gatherings,” he said in a long Twitter thread posted on Thursday. “I haven’t changed, the risk has.” He said with infection rates falling below 10 cases per 100,000 people in the region and hospitalization levels relatively low in San Francisco, the “trend line certainly supports the premise that there’s less virus around than last month.”

For the 65-year-old, vaccinated and boosted Wachter, who believes he has never had COVID, that means he can engage in what he considers riskier behavior, such as playing poker indoors with a group of vaccinated friends, dining indoors, or attending small gatherings. He said he would likely wear a mask for his weekly grocery trip to Safeway but not to pop into a corner store. And for more high-risk settings like public transit, theaters, and other large gatherings, Wachter reasoned that he would “plan to wear a mask (always a KN95; why not wear a good mask if you’re going to mask?), likely forever. I’m comfortable taking it off briefly to eat on a long flight, but will try to keep it on when I can.”

He emphasized that these were decisions he was making based on his individual risk assessment and that everybody should weigh their own comfort levels against the threat of infection, long COVID, and other complications the disease could bring. “Just because we’re all tired of this doesn’t change the risks & thus doesn’t change the way I think about managing them,” Wachter said.

Feds tell pharmacies to give unused N95s to health care providers

The U.S. Department of Health & Human Services is asking pharmacies across the nation that received N95 masks meant to be distributed for free to local communities now to give their unused inventory to health care providers in their region. “You may recall that HHS previously distributed free N95 masks from the Strategic National Stockpile to communities across the U.S. With the increase in COVID-19 cases this winter, HHS is encouraging pharmacy partners to share their remaining inventory of N95 respirators with health care providers and other community agencies and organizations,” the agency said in a bulletin sent on Thursday. However, the HHS acknowledged that there might not be much spare inventory to go around. “Please note that, as this initiative began a year ago, some pharmacy partners may have limited or no remaining N95s for donation,” the note said.

Opinion: Five things we can do to adapt to endemic COVID

In a Chronicle op-ed, UCSF infectious diseases doctor and professor of medicine Monica Gandhi argues that COVID-19 is past the pandemic stage but says combating it forever will take ongoing hard work. She touches on a range of controversial subjects — from mistrust of the medical establishment, to over-attribution of COVID hospitalizations and deaths, to whether public health guidelines have been weakened too much — and offers five sweeping suggestions for how to respond to the continuing threat of COVID. Read more on her provocative suggestions, which range from eliminating quarantines and mask mandates to aiming booster shots primarily at vulnerable populations.

No evidence vaccine increases stroke risk, WHO says

The World Health Organization said there is no evidence that the updated bivalent COVID-19 vaccine increases the risk of strokes in older people, despite widespread media reports following a recent joint announcement from the FDA and CDC that they had spotted some warning flags in their data.

According to a report by Voice of America, WHO officials said the concerns, which are related to one U.S. data system that monitors safety, presented misinformation about deaths related to COVID-19 infection. “At this point in time, the best evidence is that there is no true association between the booster doses of Pfizer in the older adults and strokes,” said Kate O’Brien, WHO director of immunization, vaccines, and biologicals.

“There is an ongoing, unending system to continuously monitor safety, not only for COVID vaccine and dose-by-dose but also for all other vaccines,” O’Brien said. She added that because the WHO currently lacks direct evidence on the relative performance of the monovalent and bivalent vaccines against the XBB.1.5 strain of the coronavirus, the WHO recommends both for booster doses.

Japan to classify coronavirus as seasonal flu

Japanese Prime Minister Fumio Kishida on Friday announced plans to downgrade the legal status of COVID-19 this spring to the equivalent of seasonal influenza, a move that would further relax mask-wearing and other preventive measures as the country seeks to return to normality. Kishida said he has instructed experts and government officials to discuss the details of lowering COVID-19’s status, the Associated Press reports. A change would also remove self-isolation rules and other anti-virus requirements and allow COVID-19 patients to seek treatment at any hospital instead of only specialized facilities.

“In order to return to our ordinary daily life in Japan while pursuing measures to adapt to living with the coronavirus, we will study concrete measures to gradually move on to a next step,” Kishida said. The move comes as Japan faces widespread infections and record levels of deaths in what is considered its eighth wave of the outbreak since the pandemic began three years ago. According to the Health Ministry, daily deaths totaled a record high of 503 last Saturday, with the country currently reporting known daily cases of between 100,000 and 200,000.

U.S. sees relief as cases, hospitalizations, deaths fall

The seven-day average of weekly new COVID-19 cases in the U.S. decreased by 23.9% compared with the previous week’s average, falling to 47,459 from 62,397, according to updated figures released Friday by the Centers for Disease Control and Prevention. The average number of daily hospitalizations also decreased by 16.4% to 5,014 from the prior week’s average of 5,997. After tallying the highest number of COVID-19 fatalities since late August last week, confirmed COVID-19 deaths also show signs of slowing with the current daily average of 565 marking a 6.1% improvement over the previous average of 601. Better yet, the health agency’s weekly report shows the prevalence of the fall’s three most prominent viruses — the flu, respiratory syncytial virus and COVID — all trending down at a rapid rate, with emergency room visits following suit.

First U.S. case detected 3 years ago today

The first confirmed case of COVID-19 in the U.S. was detected three years ago Friday, according to a federal report released in 2020. The first reported coronavirus cases in the U.S. showed up in several states in late January of that year, among travelers who had recently returned from China, then the epicenter of the pandemic. The nation’s first cases of community transmission — the virus spreading undetected among local residents — were identified in the Bay Area at the end of February. The report suggests that a man in Washington state — at the time the first coronavirus patient identified in the U.S., on Jan. 20 — may have been the source of the initial spread of the disease. He fell ill four days after returning from Wuhan, China and the CDC report said it’s possible that the man infected others before he developed symptoms, and that those people were asymptomatic and were never identified even as they went on to infect others and seed the community. In the Bay Area, the first known case was in a Santa Clara County woman, who fell ill on Jan. 31 and died on Feb. 6, becoming the first person in the U.S. known to have died from COVID-19.

Only 6% of U.S. counties have “high” virus levels

Only 5.8% of Americans live in counties with “high” COVID-19 community levels, according to federal data published Friday. That marks a significant improvement over the 22% reported two weeks ago for the category in which the US Centers for Disease Control and Prevention recommends masking and other virus mitigation measures. Over half of the U.S. population — 50.9% — lives in counties that have “low” COVID-19 community levels, according to hospitalization and case metrics. About 43.3% of the nation has “medium” virus levels.

Cases fall globally but deaths are up 20%, WHO reports

There were nearly 2.8 million new COVID-19 cases and more than 13,000 virus deaths globally last week, according to the latest epidemiological update from the World Health Organization. But the U.N. health agency warned those figures are likely an undercount as it awaits additional data from China. Over the past 28 days, there were nearly 13 million cases and almost 53 000 new deaths — a decrease of 7% and an increase of 20%, respectively, compared to the previous 28-day period. The WHO added that the outbreak in China may be showing signs of easing. “As per the analysis released by China, the number of patients reported to be in emergency wards and the proportion of patients positive for SARS-CoV-2 is also declining after reaching a nationwide peak of over 1.5 million on 2 January 2023,” the report said.

XBB.1.5 now makes up half of U.S. cases

The Centers for Disease Control and Prevention estimates that the immune evasive XBB.1.5 omicron subvariant drove nearly half of all coronavirus infections in the U.S. last week. On Friday, the agency estimated that the latest virus strain was detected in 49.1% of COVID-19 cases sequenced in the week ending Jan. 21, up from 37.2% of cases for the week ending Jan. 14. XBB.1.5 has officially overtaken BQ.1.1., which made up 26.9% of circulating variants last week, and BQ.1, which made up 13.3%. Its parent XBB variant was detected in 3.3% of cases. XBB.1.5’s prevalence varies by region. The strain, which public health experts call the most transmissible COVID-19 subvariant so far, was detected in about 85% of infections in the Northeast but just 24% of cases on the West Coast.

Lack of awareness is top reason for low booster uptake, CDC finds

Seeking to find out why a majority of Americans are not taking advantage of the updated bivalent COVID-19 vaccine boosters that have been available since September, the U.S. Centers for Disease Control and Prevention conducted an online opt-in survey of 1,200 previously vaccinated U.S. residents. The results found that the most common reasons for not getting a bivalent booster dose were lack of awareness about eligibility or availability and overconfidence in immunity. The reasons varied by age group.

“The most common reasons cited for not receiving the bivalent booster dose were lack of awareness of eligibility for vaccination (23.2%) or of vaccine availability (19.3%), and perceived immunity against infection (18.9%),” a report on the survey said. “After viewing information about eligibility and availability, 67.8% of participants who had not received the bivalent booster dose indicated that they planned to do so; in a follow-up survey 1 month later, 28.6% of these participants reported having received the dose.”

COVID declines in the Bay Area as winter surge loses momentum

The Bay Area appears to have avoided another devastating winter COVID-19 surge, at least for now. The pace of new infections has substantially slowed across California after peaking in late November, despite the holidays and recent storms that kept people indoors. At the same time, concentrations of SARS-CoV-2, the coronavirus that causes COVID-19, have fallen off sharply in most Bay Area wastewater samples during recent weeks. The good news is moderated by the looming threat of a new coronavirus subvariant — the highly contagious XBB.1.5 omicron offshoot, which has reversed positive COVID trends on the East Coast. XBB.1.5 has accounted for a far lower percentage of cases in the West so far, but its share is rising and public health experts can’t predict how it may affect the population here. Read more about declining cases and hospitalizations in California and whether the Bay Area managed to dodge an anticipated winter surge.

Pace of hospital admissions shows signs of slowing nationally

The pace of new COVID-19 hospital admissions is slowing across the U.S. after peaking in early January, according to preliminary figures published Thursday by the U.S. Centers for Disease Control and Prevention. The current seven-day average of new hospitalizations is 5,014, down from 5,997 in the prior week, marking a 16.4% decline. The rate of admissions is 76.7% lower than it was at the same time last year during the winter omicron surge. The agency does not know if the positive trend will continue. In this week’s forecast ensemble, the CDC “predicts that the number of new daily confirmed COVID-19 hospital admissions will remain stable or have an uncertain trend,” with 1,400 to 10,800 new confirmed COVID-19 hospital admissions likely reported on February 10.

State testing sites begin to close this month

California is set to close dozens of state-run COVID-19 testing and treatment sites ahead of the planned end of the the pandemic state of emergency in February. CalMatters reported Thursday that sites operating under 50% capacity are scheduled to close before the end of January. Forty-four OptumServe sites will be shuttered this week, and 48 mobile “mini-buses” will begin closing in two weeks, according to the California Department of Public Health. “A final plan for demobilizing the remaining sites is being prepared, but we have not set a completion date,” the department said in a statement.

Last week, Gov. Gavin Newsom released his January budget proposal, which moves $614 million in unspent COVID-19 response funds to the state’s general fund and drastically reduces the amount of pandemic money for the upcoming year. Most counties will be forced to absorb the responsibility of maintaining public sites. That includes Santa Clara County, where state-run sites are slated for closure in the coming weeks, according to emergency operations spokesperson Roger Ross. The county will continue to run three mass vaccination sites and has already begun folding the COVID-19 response into the health department’s normal operations. “Unfortunately, it appears we will be dealing with COVID for the long haul,” Ross said.

Another study finds vaccine cuts the risk of long COVID

Unvaccinated people have a higher risk of reporting COVID-19 symptoms lasting 28 days or more, indicative of the condition known as long COVID, according to a study by the Uniformed Services University of the Health Sciences Infectious Diseases Clinical Research Program. In a cohort study of nearly 2,000 individuals, researchers found that COVID-19 is associated with increased health care encounters through 6 months after infection, and vaccination was associated with a lower risk of long-term symptoms. The results were published Wednesday in JAMA Network Open. “Participants with COVID-19 were more likely to seek medical care for diabetes, pulmonary, neurological, and mental health-related illness for at least 6 months after onset compared with their pre-COVID baseline health care use patterns,” the authors wrote. “In addition, unvaccinated participants were at higher risk of 28 or more days of symptoms and of medical encounters associated with pulmonary and neurological diagnoses.”

At least 65 million people worldwide have symptoms associated with long COVID, according to a review article published last week in Nature Reviews Microbiology, based on the estimated global rate of 10% of infected people and the more than 651 million documented cases. The researchers of the report suggested that the number is likely an undercount. “There is a broad misconception that everyone makes and retains SARS-CoV-2 antibodies, and many clinicians and researchers are unaware of the limited utility of antibody tests to determine prior infection,” they wrote. “Between 22% and 36% of people infected with SARS-CoV-2 do not seroconvert, and many others lose their antibodies over the first few months.”

Utah surgeon gave kids saline shots instead of vaccine, prosecutors say

A plastic surgeon in Utah and three of his associates were indicted on conspiracy charges last week after prosecutors say they dumped nearly 2,000 doses of the COVID-19 vaccine down a drain, distributed fake vaccination cards — and, at the request of some parents, injected children with saline to convince the young patients that they had been vaccinated, reports The Salt Lake Tribune. Court documents show that Dr. Michael Kirk Moore Jr. and his neighbor Kristen Andersen identified as members of an unnamed private organization “seeking to ‘liberate’ the medical profession from government and industry conflicts of interest.” All four defendants and the Plastic Surgery Institute of Utah were indicted on three counts: conspiracy to defraud the United States; conspiracy to convert, sell, convey, and dispose of government property; and the conversion, sale, conveyance, and disposal of government property and aiding and abetting. They will make their initial appearance in court on Jan. 26.

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