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I Don't Like It Either-- COVID's Back

My friend called the other day sounding like she was running out of patience with me. “Should we buy our tickets to Thailand. Are we going or not?” I’m not ready to get on a plane again. The pandemic is rearing its head again. Thailand is seeing more COVID cases too. The English language Bangkok Post: “An increasing number of Covid-19 patients have been reported in Bangkok and other tourist destinations since the Omicron subvariant BA.2.75 has become dominant in Thailand, according to the Department of Disease Control (DDC). Dr Tares Krassanairawiwong, director-general of the DDC, said there has been a surge in Covid-19 inpatients, patients with critical conditions and fatalities in Bangkok and its five adjacent provinces and tourist provinces in the East and the South. The growing number of patients was preceded by social gatherings among Thai and international tourists across the country, he said.”

In fact, that same friend has a rebound of the COVID that she caught when she flew back from Europe a month ago. I really wanted to go on a trip. But I just don’t see it happening. I was happy yesterday when I went to the supermarket to see almost half the people wearing masks again. I’m guessing that in another week or two everyone will be— at least here in L.A. In other parts of the country… not so much. I noticed Marjorie Traitor Greene bragging on Twitter the other day that she’s never been vaccinated. She’s in my thoughts and prayers.

Yesterday, The Atlantic ran a piece by Yasmin Tayag, It’s Beginning To Look A Lot Like Another COVID Surge. “[A]nother wave seems to be on the horizon in the United States,” she wrote. “In the past two weeks, reported cases have increased by 53 percent, and hospitalizations have risen by 31 percent. Virus levels in wastewater, which can provide an advance warning of spread, are following a similar trajectory. After the past two years, a winter surge 'was always expected,' Nash said. Respiratory illnesses thrive in colder weather, when people tend to spend more time indoors. Thanksgiving travel and gatherings were likewise predicted to drive cases, Anne Rimoin, an epidemiologist at UCLA, told me. If people were infected then, their illnesses will probably start showing up in the data around now. 'We’re going to see a surge [that is] likely going to start really increasing in velocity,' she said."

Winter has ushered in some of the pandemic’s worst moments. Last year, Omicron’s unwanted arrival led to a level of mass infection across the country that we had not previously seen. The good news this year is that the current rise will almost certainly not be as bad as last year’s. But beyond that, experts told me, we don’t know much about what will happen next. We could be in for any type of surge— big or small, long or short, national or regional. The only certain thing is that cases and hospitalizations are rising, and that’s not good.
The pandemic numbers are ticking upward across the country, but so far the recent increases seem especially sharp in the South and West. The daily average of reported cases in Mississippi, Georgia, Texas, South Carolina, and Alabama has doubled in the past two weeks. Hospitalizations have been slower to rise, but over the same time frame, daily hospitalizations in California have jumped 57 percent and are now higher than anywhere else in the United States. Other areas of the country, such as New York City, have also seen troubling increases.

Let’s take a look at the vaccination rates in those states she just mentioned, because the states with the lowest vaccination rates are likely to be the states with the worst death rates. Keep in mind 68% of the country is fully vaccinated.

  • Mississippi- 53% fully vaccinated

  • Georgia- 56% fully vaccinated

  • Texas- 62% fully vaccinated

  • South Carolina- 59% fully vaccinated

  • Alabama- 52% fully vaccinated

  • California- 74% fully vaccinated

Keep in mind that regions within each state vary very widely in terms of vaccination rates. Take Georgia, for example. The suburban counties are Atlanta like Cobb (60% fully vaccinated), DeKalb (58% fully vaccinated), Gwinnett (57% fully vaccinated) are doing badly, but not in comparison to the backward red counties that just voted for Herschel Walker and get their news and beliefs from QAnon. These are the half dozen worst:

  • Long Co.- 22% vaccinated, Herschel +25

  • Charlton Co.- 26% vaccinated, Herschel +53

  • Brantley Co.- 27% vaccinated, Herschel +83

  • Wheeler Co.- 27% vaccinated, Herschel +43

  • Lanier Co.- 28% vaccinated, Herschel +43

  • Heard Co.- 29% vaccinated, Herschel +68

“Whether the nationwide spike constitutes the long-predicted winter wave,” Tayag wrote, “and not just an intermittent rise in cases, depends on whom you ask. ‘I think it will continue,’ Gregory Poland, a professor of medicine at the Mayo Clinic, told me. ‘We will pour more gas on the fire with Christmas travel.’”

[A] confluence of factors has created the ideal conditions for a sustained surge with serious consequences for those who get sick. Fading immunity, frustratingly low booster uptake, and the near-total abandonment of COVID precautions create ideal conditions for the virus to spread. Meanwhile, treatments for those who do get very sick are dwindling. None of the FDA-approved monoclonal antibodies, which are especially useful for the immunocompromised, works against BQ.1 and BQ.1.1., which make up about 68 percent of cases nationwide. Paxlovid is still effective, but it’s underprescribed by providers and, by one medical director’s estimate, refused by 20 to 30 percent of patients.
The upside is that few people who get COVID now will get very sick— fewer than in previous winters. Even if cases continue to surge, most infections will not lead to severe illness because the bulk of the population has some level of immunity from vaccination, previous infection, or both. Still, long COVID can be “devastating,” Poland said, and it can develop after mild or even asymptomatic cases. But any sort of wave would in all likelihood lead to an uptick in deaths, too. So far, the death rate has remained stable, but 90 percent of people dying now are 65 and older, and only a third of them have the latest booster. Such low uptake “just drives home the fact that we have not really done a good job of targeting the right people around the country,” Nash said.
Even if the winter COVID wave is not ultimately a big one, it will likely be bad news for hospitals, which are already filling up with adults with flu and children with respiratory syncytial virus, or RSV. Many health-care facilities are swamped; the situation will only worsen if there is a big wave. If you need help for severe COVID— or any kind of medical issue— more than likely, “you’re not going to get the same level of care that you would have without these surges,” Poland said. Critically ill kids are routinely turned away from overflowing emergency rooms, my colleague Katherine J. Wu recently reported.
We can do little to predict how the ongoing surge might develop other than simply wait. Soon we should have a better sense of whether this is a blip in the pandemic or something more serious, and the trends of winters past can be helpful, Kline said. Last year, the Omicron-fueled surge did not begin in earnest until mid-December. “We haven’t even gotten to January yet, so I really think we’re not going to know [how bad this surge will be] for two months,” Kline said. Until then, “we just have to stay put and watch.”
It is maddening that, this far into the pandemic, “stay put and watch” seems to be the only option when cases start to rise. It is not, of course: Plenty of tools— masking, testing, boosters— are within our power to deploy to great effect. They could flatten the wave, if enough people use them. “We have the tools,” said Nash, whose rapid test came out negative, “but the collective will is not really there to do anything about it.”

According to a new 242-page report from the Senate Homeland Security and Governmental Affairs Committee, more people died and more Americans lost trust in their institutions as a result of the federal government's decisions made in the early days of the COVID-19 pandemic. Trump’s responses to the pandemic made it infinitely worse and this day, avid Trump supporters are the least likely together vaccinated and boosted and more likely to gets seriously ill and die than normal people. Senator Gary Peters (D-MI), chairman of the committee, said that “The suffering that was caused by the pandemic [was] “not inevitable. We could have handled this situation a whole lot differently. Communication from the White House at times contradicted statements from public health officials and statements from public health officials at times contradicted prior statements from other public health officials, without sufficient explanation [leaving the American public grappling with] “inaccurate and contradictory communication.”

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