Worse than Covid: The effects of past disease outbreaks still being felt

Mervyn Dykes06:00, Oct 11 2021

Palmerston North writer Mervyn Dykes in 2018 with his just realised book Polio and Me.
DAVID UNWIN/STUFFPalmerston North writer Mervyn Dykes in 2018 with his just realised book Polio and Me.

OPINION: If you think we are hard done by with all the Covid restrictions, have a chat with your parents and grandparents, if you are lucky enough to have them still around.

In terms of case numbers and deaths, Covid is just a beginner.

Of course much can be made of the brilliant efforts to produce effective vaccines in a startlingly short time, but the figures from earlier disease outbreaks make us realise just how fortunate we are.

No, we are not talking of the Black Death here – as horrifying as it was. We are talking of two recent pandemics – the “Spanish” flu and Poliomyelitis, or polio for short.

To date we have had 28 Covid-19 deaths in New Zealand, though no doubt others are on the way. The Spanish Flu in 1918-19 killed 9000 New Zealanders in only two months – about half the total casualties from World War I over four years.

READ MORE:
Kiwis need to get stuck into the Covid-19 vaccine
Covid-19: Allergic reactions to vaccines rare, short-lived
Coronavirus: New Zealand’s experience with measles, flu helped country tackle Covid-19 effectively, WHO boss says

ADVERTISEMENTAdvertise with Stuff

Polio killed 173 people in one year alone and returned at approximately 10-year intervals to kill another 30 to 50 in each outbreak.

On a world-wide basis, the Spanish Flu killed 50 million people and infected about 500 million. Polio was given the earlier name of infantile paralysis because young children seemed particularly susceptible. However, adults could contract it too and with them the consequences were likely to be more severe.

The name “Spanish Flu” was particularly unfair to Spain. It first broke out among servicemen in France at the end of the war and for propaganda purposes was given that name when the Spanish king became ill.

In November and December of 1918, thousands of New Zealanders became infected. The flu outbreaks began in Auckland and spread south to the Waikato and then Taranaki – just the way Covid is doing today.

Also, as with Covid, Māori proved particularly susceptible with about 2500 of them among the dead. There was no handy vaccine, so the disease was fought with basic tactics that are still being used against Covid today – isolation, quarantine, disinfectants and personal hygiene.

Many cities were organised in blocks, each with its own commander, and workers went door-to-door to locate the unwell.

Large gatherings were banned, businesses were closed and medical staff were stretched to their limits. The same techniques were used later to combat polio.

New Zealand ships visiting the Pacific Islands took the flu with them to cause havoc and many deaths there.

Suddenly, the flu was gone, although researchers worked for many years to detect its source – believed to be avian in nature, which was echoed in the “bird flu” of more recent years.

Polio is a disease that has been forgotten about, says Dykes, and along with that so have the sufferers.
DAVID UNWIN/STUFFPolio is a disease that has been forgotten about, says Dykes, and along with that so have the sufferers.

Polio is a different case and is believed to have been around for thousands of years. There is even an ancient Egyptian depiction of a man with a withered leg using a staff to help him walk.

https://www.stuff.co.nz/manawatu-standard/opinion/300426642/worse-than-covid-the-effects-of-past-disease-outbreaks-still-being-felt

Many people believe a cure was found in the 1950s and ‘60s, but this is not true. The vaccinesdeveloped prevent a person contracting polio, but do not cure it. As recently as the 1940s and ‘50s, the cause of polio was unknown and almost mediaeval tactics were used to combat it.

Patients were trussed and strapped up to prevent them from moving about. For some, the only way for them to breathe was to be placed in a mechanical device known as an “iron lung” which helped them breathe.

Today polio still exists in Afghanistan, Nigeria and Pakistan, and in recent years a small outbreak occurred in New Guinea. The last “wild” case in New Zealand was in 1977, but it is estimated that there could still be as many as 10,000 New Zealanders dealing with the late effects of polio.

These might not manifest themselves until decades after the initial attack and cause various symptoms including muscular weakness, loss of concentration, fatigue, pain and depression.

In many instances the people suffering from LeoP or PPS (Post Polio Syndrome) have no obvious physical handicaps. What is particularly frustrating for them is that many “modern” medical people have received little training in polio and believe that it has been cured. The post-polio effects are often attributed to “old age”.

Spare a thought for the surviving polio patients amid the Covid furore and raise a glass to them on October 24, World Polio Day.

Yeah, they were tough, our parents and grandparents.

COVID has killed about as many Americans as the 1918-19 flu

By CARLA K. JOHNSON43 minutes ago

https://apnews.com/article/science-health-pandemics-united-states-coronavirus-pandemic-c15d5c6dd7ece88d0832993f11279fbb

FILE - This photo made available by the Library of Congress shows a demonstration at the Red Cross Emergency Ambulance Station in Washington during the influenza pandemic of 1918. Historians think the pandemic started in Kansas in early 1918, and by winter 1919 the virus had infected a third of the global population and killed at least 50 million people, including 675,000 Americans. Some estimates put the toll as high as 100 million. (Library of Congress via AP, File)

1 of 10FILE – This photo made available by the Library of Congress shows a demonstration at the Red Cross Emergency Ambulance Station in Washington during the influenza pandemic of 1918. Historians think the pandemic started in Kansas in early 1918, and by winter 1919 the virus had infected a third of the global population and killed at least 50 million people, including 675,000 Americans. Some estimates put the toll as high as 100 million. (Library of Congress via AP, File)

COVID-19 has now killed about as many Americans as the 1918-19 Spanish flu pandemic did — approximately 675,000.

The U.S. population a century ago was just one-third of what it is today, meaning the flu cut a much bigger, more lethal swath through the country. But the COVID-19 crisis is by any measure a colossal tragedy in its own right, especially given the incredible advances in scientific knowledge since then and the failure to take maximum advantage of the vaccines available this time.

“Big pockets of American society — and, worse, their leaders — have thrown this away,” medical historian Dr. Howard Markel of the University of Michigan said of the opportunity to vaccinate everyone eligible by now.

Like the Spanish flu, the coronavirus may never entirely disappear from our midst. Instead, scientists hope it becomes a mild seasonal bug as human immunity strengthens through vaccination and repeated infection. That could take time.

“We hope it will be like getting a cold, but there’s no guarantee,” said Emory University biologist Rustom Antia, who suggests an optimistic scenario in which this could happen over a few years.ADVERTISEMENT

For now, the pandemic still has the United States and other parts of the world firmly in its jaws.

While the delta-fueled surge in new infections may have peaked, U.S. deaths still are running at over 1,900 a day on average, the highest level since early March, and the country’s overall toll stood at just over 674,000 as of midday Monday, according to data collected by Johns Hopkins University, though the real number is believed to be higher.

Winter may bring a new surge, with the University of Washington’s influential model projecting an additional 100,000 or so Americans will die of COVID-19 by Jan. 1, which would bring the overall U.S. toll to 776,000.

The 1918-19 influenza pandemic killed 50 million victims globally at a time when the world had one-quarter the population it does now. Global deaths from COVID-19 now stand at more than 4.6 million.

The Spanish flu’s U.S. death toll is a rough guess, given the incomplete records of the era and the poor scientific understanding of what caused the illness. The 675,000 figure comes from the U.S. Centers for Disease Control and Prevention.

The ebbing of COVID-19 could happen if the virus progressively weakens as it mutates and more and more humans’ immune systems learn to attack it. Vaccination and surviving infection are the main ways the immune system improves. Breast-fed infants also gain some immunity from their mothers.

Under that optimistic scenario, schoolchildren would get mild illness that trains their immune systems. As they grow up, the children would carry the immune response memory, so that when they are old and vulnerable, the coronavirus would be no more dangerous than cold viruses.

The same goes for today’s vaccinated teens: Their immune systems would get stronger through the shots and mild infections.ADVERTISEMENT

“We will all get infected,” Antia predicted. “What’s important is whether the infections are severe.”

Something similar happened with the H1N1 flu virus, the culprit in the 1918-19 pandemic. It encountered too many people who were immune, and it also eventually weakened through mutation. H1N1 still circulates today, but immunity acquired through infection and vaccination has triumphed.

Getting an annual flu shot now protects against H1N1 and several other strains of flu. To be sure, flu kills between 12,000 and 61,000 Americans each year, but on average, it is a seasonal problem and a manageable one.

Before COVID-19, the 1918-19 flu was universally considered the worst pandemic disease in human history. Whether the current scourge ultimately proves deadlier is unclear.

In many ways, the 1918-19 flu — which was wrongly named Spanish flu because it first received widespread news coverage in Spain — was worse.

Spread by the mobility of World War I, it killed young, healthy adults in vast numbers. No vaccine existed to slow it, and there were no antibiotics to treat secondary bacterial infections. And, of course, the world was much smaller.

Yet jet travel and mass migrations threaten to increase the toll of the current pandemic. Much of the world is unvaccinated. And the coronavirus has been full of surprises.

Markel said he is continually astounded by the magnitude of the disruption the pandemic has brought to the planet.

“I was gobsmacked by the size of the quarantines” the Chinese government undertook initially, Markel said, “and I’ve since been gob-gob-gob-smacked to the nth degree.” The lagging pace of U.S. vaccinations is the latest source of his astonishment.

Just under 64% of the U.S. population has received as least one dose of the vaccine, with state rates ranging from a high of approximately 77% in Vermont and Massachusetts to lows around 46% to 49% in Idaho, Wyoming, West Virginia and Mississippi.

Globally, about 43% of the population has received at least one dose, according to Our World in Data, with some African countries just beginning to give their first shots.

“We know that all pandemics come to an end,” said Dr. Jeremy Brown, director of emergency care research at the National Institutes of Health, who wrote a book on influenza. “They can do terrible things while they’re raging.”

COVID-19 could have been far less lethal in the U.S. if more people had gotten vaccinated faster, “and we still have an opportunity to turn it around,” Brown said. “We often lose sight of how lucky we are to take these things for granted.”

The current vaccines work extremely well in preventing severe disease and death from the variants of the virus that have emerged so far.

It will be crucial for scientists to make sure the ever-mutating virus hasn’t changed enough to evade vaccines or to cause severe illness in unvaccinated children, Antia said.

If the virus changes significantly, a new vaccine using the technology behind the Pfizer and Moderna shots could be produced in 110 days, a Pfizer executive said Wednesday. The company is studying whether annual shots with the current vaccine will be required to keep immunity high.

One plus: The coronavirus mutates at a slower pace than flu viruses, making it a more stable target for vaccination, said Ann Marie Kimball, a retired University of Washington professor of epidemiology.

So, will the current pandemic unseat the 1918-19 flu pandemic as the worst in human history?

“You’d like to say no. We have a lot more infection control, a lot more ability to support people who are sick. We have modern medicine,” Kimball said. “But we have a lot more people and a lot more mobility. … The fear is eventually a new strain gets around a particular vaccine target.”

To those unvaccinated individuals who are counting on infection rather than vaccination for immune protection, Kimball said, “The trouble is, you have to survive infection to acquire the immunity.” It’s easier, she said, to go to the drugstore and get a shot.

___

AP Health Writer Tom Murphy in Indianapolis contributed to this report.

Why The World Should Be More Than A Bit Worried About India’s Nipah Virus Outbreak

  • Facebook
  • Twitter
  • Flipboard
  • Email

September 12, 20218:56 AM ET

https://www.npr.org/sections/goatsandsoda/2021/09/12/1035571714/why-the-world-should-be-more-than-a-bit-worried-about-indias-nipah-virus-outbrea

KAMALA THIAGARAJAN

A road blockade set up during the Nipah virus outbreak in India this month.C. K Thanseer/DeFodi Images via Getty Images

In 2018, we reported how the South Indian state of Kerala beat back the deadly Nipah virus. Local filmmakers and musicians even made a celebratory music video about it. Three years later, the state is faced with yet a new case of Nipah — its third outbreak since 2018 — and it couldn’t have come at a worse time. Kerala, known for its palm-lined beaches on the Arabian Sea, is still reeling after a caseload of 4 million COVID infections since the pandemic began.

The Nipah virus is making news again after tragic reports that a 12-year-old boy died of the disease on Sept. 5, in Kerala’s Kozhikode district. He had been admitted to a private hospital after running a high fever and showing symptoms of encephalitis — swelling of the brain.

GOATS AND SODA

India Beat One Of The World’s Deadliest Viruses — And Made A Music Video About It

About This Series

Over the next week, we’ll be looking back at some of our favorite Goats and Soda stories to see “whatever happened to …”

While figuring out how to prevent and treat the Nipah virus is very much a work in progress, there have been advances.

Nonetheless, Nipah remains a concern, not just in India but for the entire planet. The World Health Organization classifies it as a “virus of concern” for future epidemics because “each year it spills over from its animal reservoir into humans,” says Dr. Stephen Luby, professor of infectious disease at Stanford University. And when humans are infected it can be transmitted from person-to-person.Article continues after sponsor message

But the virus is not as transmissible as some other viruses. “There are occasional Nipah superspreaders who infect a lot of people,” says Luby. “But the average transmission rate is less than one person per infection.

“However, each time a person is infected, the virus is in an environment that selects for human adaptation and transmissibility. The risk is that a new strain that is more efficiently transmitted person-to-person could generate a devastating outbreak. Indeed, since 70% of people who are infected with Nipah virus die, such a strain could represent the worst pandemic humanity has ever faced.”

That’s why, he says, it’s important to “continue to invest in strategies to reduce the risk of spillover and to develop countermeasures across a range of high-risk pathogens.”

Still a mysterious virus

Following the boy’s death, public health authorities swung into action, contact tracing friends, family and health workers. They identified and isolated 251 people, including 30 close family members. Eleven samples from those in close contact with the boy were sent for testing, and on Aug. 8; they were negative. But how this child contracted Nipah is still unclear.

ASIA

The Death Of A 12-Year-Old Boy Sparks Worries Of A Nipah Virus Outbreak In India

“It’s really difficult to establish the cause of the boy’s illness,” says Dr. Thekkumkara Surendran Anish, associate professor of community medicine at the Government Medical College in Thiruvananthapuram. “The infected patient was just too sick to tell us anything about what he ate or did. That’s why it’s all speculation.”

In the two strains of Nipah encountered so far — originating in Malaysia in 1999 and later in Bangladesh — pigs and fruit bats are believed to be the intermediary hosts. “One plausible theory is that those who’ve been infected [in Kerala] ate food or fruit contaminated with bat saliva or excreta,” says Anish.

When reports emerged that the boy could have possibly contracted Nipah from eating the rambutan — a tropical fruit with thick red spines resembling lychee that grew around his home — sales of the fruit plunged in Kerala. But the fear that the fruit is the cause of the disease is pure speculation and without evidence, experts say.

By contrast, information about the route of virus’ spread has been established in prior outbreaks. In strains of Nipah originating in Malaysia in 1999 and later in Bangladesh, pigs and fruit bats are believed to be the intermediary hosts, says Anish.

GOATS AND SODA

A Taste For Pork Helped A Deadly Virus Jump To Humans

“We have a very clear understanding of how Nipah virus moves from fruit bats into people,” says Luby. “Bats are attracted to raw date palm sap that is harvested during the wintertime. When people drink raw date palm sap that has been contaminated by bats, they are at risk of contracting Nipah.” The World Health Organization calls the drink a “likely source” of outbreaks in humans in India and Bangladesh.

Survival rates are low

While it is possible to recover, the virus has a high fatality rate.

In 2018, when Nipah emerged for the first time in Kerala, only two of the 19 infected people survived. When it was detected again in 2019, a 23-year-old man was infected, but swift isolation ensured the virus did not spread to others in his community. The patient survived.

“[With] COVID, you are most infectious before the symptoms set in,” says Anish. “Once they do, your ability to infect other people wanes. But that’s not the case with Nipah. When the symptoms set in, you start spreading the virus.” In areas more prone to Nipah infections (Bangladesh, Malaysia, India, and Singapore) being aware of this can help, he says.

After the current case was identified, COVID precautions have helped control the spread of Nipah in Kerala, says Dr. K Puthiyaveettil Aravindan, a former professor of pathology at the Government Kozhikode Medical College. “Hospital workers were already kitted out in full protective equipment. People were masked.” Since the virus is spread from human-to-human through bodily fluids, physical distancing and masking helped.

The virus is not, however, as transmissible as some other viruses. “There are occasional Nipah superspreaders who infect a lot of people,” says Luby. “But the average transmission rate is less than one person per infection.”

Hopes for treatment and a vaccine

With all the concerns about Nipah, efforts to develop a vaccine are ongoing. “There are several promising Nipah virus [vaccine] candidates that have demonstrated high efficacy in animals,” says Luby. In addition, CEPI, the Coalition for Epidemic Preparedness Innovations, is supporting human trials of multiple vaccine candidates.

One study on vaccines, a pre-print, focused on the effectiveness of ChAdOx1 — a multipurpose vaccine vector which can be customized to carry DNA from a wide variety of pathogens. In a trial on African green monkeys, it proved effective when tailored against the Nipah virus.

While the vaccine is still in clinical trials, there’s also a non-patented drug called M 102.4 developed by Christopher C. Broder, a professor of immunology and microbiology at Uniformed Services University of the Health Sciences. It’s a monoclonal antibody that can attach to proteins in a virus and render it ineffective.

“Suppose you get a massive dose of a virus in your body. It’s a matter of time before the pathological process begins and it damages your cells,” says Anish. “You don’t have time to depend on the immune reaction generated by a vaccine at that point. In this narrow window [before you develop symptoms], you can use an agent that can neutralize the virus.”

During Kerala’s 2018 outbreak, M 102.4 was flown in from Queensland, Australia for use on an emergency basis. At the time, it had not been tested on humans. Since then, initial tests in humans have been successful. In a study published by The Lancet, Phase I clinical trials in humans have shown the drug can neutralize Nipah.

In case of any major outbreak, health authorities in Kerala and elsewhere now can use the antibody to get it under control, says Aravindan.

A virus on the move

It’s likely that other Indian states may be affected, too. “Kerala can’t be the only hot spot” says Aravindan. “It’s possible that the health system in other states may not be catching these infections at all.”

He also has concerns about future spread. Genetic changes in the virus are likely, making hosts out of new species of bats and making the virus more transmissible among humans, he says. He adds that Nipah could emerge as a global problem similar to COVID due to international trade, global travel and climate change that causes bats to seek new habitats.

For those reasons, he says, it’s imperative “to analyze which species [of bats] could be infected, the places they’re located” and whether there might be additional intermediary host animals.

For now, the Nipah virus scare in Kerala seems to be under control. But “as long as there’s a lot we don’t know, the possibility of an epidemic can’t be ruled out,” Anish says.

Coronavirus FAQs: A Vaccinated Person’s Guide To COVID Exposure And Elevator Etiquette

September 10, 20215:41 PM ET

MARC SILVER

In a fleeting elevator contact, an individual with a good mask — an N95 or KN95, for example — would be unlikely to become either infected or spread the coronavirus, an expert on COVID-19 says.

Malaka Gharib/NPR

Each week, we answer frequently asked questions about life during the coronavirus crisis. If you have a question you’d like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: “Weekly Coronavirus Questions.” See an archive of our FAQs here.

We’ve been answering coronavirus questions from our audience for over a year, but this past week, I had some questions of my own. While on vacation with my family, I encountered four tricky COVID-19 situations. I really wanted an expert’s advice.

So I interviewed three COVID-19 specialists: Charlotte Baker, an assistant professor of epidemiology at Virginia Tech; Abraar Karan, an infectious disease doctor at Stanford University; and Jill Weatherhead, an assistant professor of adult and pediatric infectious diseases at Baylor College of Medicine. Here’s what they had to say about my concerns.

What if you’re exposed to someone who has COVID-19 — directly or one step removed?

While we were on vacation, an unvaccinated child who’d tested negative for the coronavirus a few days earlier came to an outdoor gathering. He wasn’t feeling so great. That night, he became ill and tested positive for the coronavirus.Article continues after sponsor message

My two adult children, who attended the gathering, were directly exposed, albeit briefly. My wife and I did not attend the event but hung out with our kids in a hotel room for a couple of hours immediately after the gathering. None of us were wearing masks.

We are all fully vaccinated. But we had so many questions! Should our kids quarantine and then get tested? And what about us? We figured we should avoid seeing our kids until their status is known … but were we at any risk of coming down with COVID-19?

All three experts said our children were at low risk of contracting COVID-19 because of their vaccine status and because the event was outdoors, where airflow does a good job dispersing pathogens. And they were only in close proximity with the little boy for a maximum of 10 minutes or so.

Yet the risk is not zero.

The experts’ recommendations: My kids should mask up when they are in public settings, indoors and outdoors, for three to five days in case they were infected and contagious. They should monitor for any potential COVID-19 symptoms such as fever, chills or sniffles. After that time period, they should get a coronavirus test. By that time, there’d be enough viral load for a test to pick up any possible infection.

GOATS AND SODA

Immunity To COVID-19 Could Last Longer Than You’d Think

The experts say it’s best to go to a health provider for a PCR test, which detects genetic material of the virus and thus provides more accurate results than the at-home antigen tests, which assess viral load.

One of my children was planning to fly home on Monday, two days after the exposure. The experts said that was OK given a) they were vaccinated and b) they’d wear a mask.

And what about my wife and me?

Karan, the doctor at Stanford, says that even if our children were infected at the gathering, the virus takes a couple of days to incubate before it can be transmitted. So we were basically in the clear. But out of an abundance of caution, we masked up in all public settings (which we do anyway because of our concern about breakthrough infections).

Our children waited three days and got tested. The results: negative! That gave my wife and me additional reassurance that we had no worries from the incident, so we could resume contact.

But what if our children were not vaccinated? Then it would have been a different story. The Centers for Disease Control and Prevention recommends an unvaccinated person — whose chances of getting infected and thus being contagious are greater than those who are vaccinated — should quarantine at home for 14 days after an exposure.

What should you say if you’re in an elevator and two maskless people enter at the next stop?

There were other moments of concern during our stay that had nothing to do with the little boy who had COVID-19. We were staying at a hotel. My wife and I got on an elevator, which had a sign on the door stating: “Guests should wear face coverings in the elevator.”

We had on masks. Two women without masks got on and eyed my mask.

“Should I put on a mask?” one asked.

“Well, if you want to, you can,” her friend replied.

Neither of them wanted to do so.

I didn’t say anything. And got off at the next elevator stop.

I wondered: Should I have spoken up?

GOATS AND SODA

New Studies Find Evidence Of ‘Superhuman’ Immunity To COVID-19 In Some Individuals

Karan notes that in a fleeting elevator contact, an individual with a good mask (an N95 or KN95, for example, and not a thin cloth mask) would be unlikely to become either infected or spread the coronavirus.

You also have to ask yourself, he says: “Do I think saying something is going to get them to put a mask on?”

But there are other perspectives. Baker, the epidemiologist at Virginia Tech, has a medical condition that puts her at higher risk of getting infected and of severe disease. She says she would have either put in a polite request — “Please ma’am, could you put your mask on?” — or left the elevator at the next stop.

If you’re uncomfortable in an elevator for any reason – unmasked people, too crowded — “you could always get off and take the stairs,” adds Weatherhead, the assistant professor at Baylor College of Medicine.

There’s another issue to consider besides a personal concern about the odds of catching COVID-19. “This is a community-based virus,” Weatherhead says. “Unless everybody has buy-in [regarding protective measures], really nobody’s going to be safe. Everybody has to do their part.”

Which brings me to my next situation. …

If all the staff in a hotel are masked, should I mask up, too?

As I walked down the hallways of the hotel, I was struck by a noticeable mask fact. The housekeepers and other employees walking the halls were all masked. The guests by and large were not.

Now it is true that these hotel employees are in contact with a greater number of individuals in the course of their day than guests walking to their rooms.

And maybe these unmasked guests are all vaccinated.

But maybe some of the employees are not yet vaccinated. “There’s a lot of privilege in being able to get vaccinated,” Karan notes. For one thing, “you have to be able to take time off.”

And this hotel is in a state where the virus is currently surging and the vaccination rate is below 50%.

So what’s the advice? “The idea of masks is they are providing some protection for the [people who are wearing them] and protection for the guests in that hotel or restaurant,” Weatherhead says. And if you’re in an area with high rates of COVID-19, “Having everybody masking is really important — and not just for service staff.”

What do I say to someone who asks me why I’m wearing my mask?

My wife and I were dining at a restaurant with outdoor seating. At a table about 12 feet away sat two gentlemen. One of them noted that my wife and I were both wearing green.

We smiled. True!

Then he asked, “Do you really think you need to wear that mask outdoors?”

I didn’t get to answer — a restaurant staffer escorted the two men to a different part of the outdoor dining area because they were smoking in a nonsmoking zone.

So what might I have said?

Karan says first of all, it would be fine for my wife and me to be unmasked at the outdoor restaurant with no nearby diners. We’d have to take off our masks anyway once our food and drinks arrived.

But there’s also an argument for masks. He suggests I could have answered: “When you have high rates of transmission of disease with high levels of spread, it makes sense to wear a mask. It can reduce the chance you’ll get exposed to the virus or transmit it to others like kids or unvaccinated people.”

Baker notes, “If you’re going to partake in public activities – [going to] shops, restaurants, bars – you have to do a good job of being a good steward, which is being vaccinated, putting on your mask. That shows you’re a willing participant in society to help other people.”

And make sure it’s a good quality mask, she says: “I see a people with bedazzled masks and I’m like, ‘You’re putting holes in it!’ “

Then again, perhaps a case of COVID-19 is in everyone’s future. “The reality is you will be exposed to the virus,” Karan says. “Nobody is going to avoid exposure forever.” That is problematic for those at high risk of severe disease – and he says he is seeing an increase in breakthrough cases among older people and the immunocompromised that require hospitalization. But if you’re vaccinated, “you’ll never know — or may have mild symptoms so you think you just had a cold.”

‘Surprised and disappointed.’ Doctors in Covid-19 hotspots last year are dealing with new record hospitalizations

https://www.cnn.com/2021/09/05/health/us-coronavirus-sunday/index.html

LIVE TVEdition

By Travis Caldwell, CNN

Updated 4:26 AM ET, Mon September 6, 2021

Florida teen speaks out after Covid-19 sent her to the ICU

Florida teen speaks out after Covid-19 sent her to the ICU 03:22

(CNN)With the more contagious Delta variant of Covid-19 sweeping across the country this summer, health care workers and officials are finding themselves returning to a crisis experienced last year when hospitals struggled to handle an influx of patients.In the Southeast, Georgia is now seeing its highest number of hospitalizations since the start of the pandemic, matching peaks experienced in January, according to US Health and Human Services Department (HHS) data.Dr. James Black, director of emergency services at Phoebe Putney Memorial Hospital in Albany, Georgia, told CNN’s Amara Walker Saturday that his hospital nearly doubled its ICU capacity yet is still faced with an overflow of patients.

“The emergency department is full and the hospital is full,” Black said. “Anytime a patient is discharged, we have patients waiting on those beds.”

Florida teen who was hospitalized with Covid-19 wants to get vaccinated and says others should get the shot too

Florida teen who was hospitalized with Covid-19 wants to get vaccinated and says others should get the shot tooThe city of Albany, located in the southwestern part of the state, had one of the worst outbreaks of Covid-19 in the country at the start of the pandemic. Now hospitalizations are eclipsing those earlier numbers, Black said, calling it “disheartening” to be faced with its return as health care workers once again are on the front lines facing daily risk of infection.

“We were frustrated, a little bit bewildered, especially given what we’ve been through at the onset of the pandemic,” Black said, also noting that Georgia trails the national average in vaccination rates.Enter your email to subscribe to the Results Are In Newsletter with Dr. Sanjay Gupta.close dialog

The Results Are In with Dr. Sanjay Gupta

Sign up for the Results Are In NewsletterGet the latest expert advice to live
a healthier and happier life
Sign Me UpNo, ThanksBy subscribing you agree to ourPrivacy PolicyGeorgia has fully vaccinated 42.1% of its population, according to data from the US Centers for Disease Control and Prevention, while nationally, 53% of the population is fully vaccinated.

“We were a little bit kind of surprised and disappointed at the lack of turnout. So, you know, we’ve had to redouble our efforts and pick each other up and certainly, we had hoped to not be having the same discussion 18 months into it. But here we are, seemingly in worse shape overall than we were initially.”

US states that had some of the worst Covid-19 case rates in past week also reported the highest rates of new vaccinations

US states that had some of the worst Covid-19 case rates in past week also reported the highest rates of new vaccinationsTotal hospitalizations in the US nearly tripled in July and doubled again in August, according to HHS data, but weekly national numbers only went up by 2% on Thursday, a potential sign of improvement on the horizon. But this comes as little relief to hospitals in hotspots seeing ICU beds fill up.”We are perilously close…of having, in certain areas of the country getting so close to having full occupancy, that you’re going to be in a situation where you’re going to be in a situation where you’re going to have to make some very tough choice,” Dr. Anthony Fauci told CNN’s Jim Acosta on Sunday.More than 102,000 people nationwide are hospitalized with Covid-19, according to HHS data Saturday, with more than 25,000 in ICUs.”What we really should be doing, and I hope we are doing, is to do everything we can to mitigate the number of people who are getting infected and requiring hospitalization and ICU beds,” said Fauci, the director of the National Institute of Allergy and Infectious Diseases.In Hawaii, the state’s health department reported 13 new deaths from Covid-19 on Wednesday, its highest single-day death figure of the entire pandemic. A number of restrictions on public businesses were reinstated in August, and Gov. David Ige urged out-of-state visitors to not travel to the islands unless they had urgent business.Kentucky Gov. Andy Beshear has called for a special session of the state general assembly to meet Tuesday regarding Covid-19, with the aim to extend the state’s declared state of emergency to January 15 and to review executive, agency and cabinet orders.”The Commonwealth is in a state of emergency. The Delta variant is spreading at a rate never seen before — impacting businesses, shuttering schools and worse, causing severe illness and death,” Beshear said Saturday.Northeast Georgia Medical Center critical care staff work with Covid-19 patients on Monday, August 30, 2021, in Gainesville, Georgia. Many hospitals are experiencing a surge in Covid-19 patients as the state set a new mark for infections.Northeast Georgia Medical Center critical care staff work with Covid-19 patients on Monday, August 30, 2021, in Gainesville, Georgia. Many hospitals are experiencing a surge in Covid-19 patients as the state set a new mark for infections.

Officials concerned about Labor Day weekend

Given the recent surge, public health officials are also worried about Labor Day weekend and whether it could exacerbate an already dire situation.On Tuesday, CDC Director Dr. Rochelle Walensky asked unvaccinated Americans to not travel for the holiday weekend. Those who are fully vaccinated can travel with precautions, but the current transmission rates mean they, too, should take the risk of traveling into consideration.”I know we’re all looking forward to the long weekend,” Mayor Derek Kawakami of Kauai County, Hawaii, said in a news conference Friday. But health care workers will not be able to celebrate, he noted, “because they’re busy taking care of our sick people.””Now what we choose to do over the next 72 to 96 hours is going to determine a lot of within the next two to three months, on whether we start to continue to burn our hospital systems, burn out our health care workers, keep our kids in school, keep our businesses running, and moving on with moving forward and coexisting with Covid-19.””And while we want everybody to have a great time and I hope to see people surfing, enjoying time with their family … we want to remind people, the steps to take are simple,” he said. “Wear your mask indoors, avoid large gatherings, and if you do, do it outside.”

Less-vaccinated parts of California face ICU capacity issues

California’s San Joaquin Valley region has met the threshold to enter “surge protocols,” with less than 10% of staffed ICU beds remaining for three consecutive days, the state Department of Public Health (CDPH) announced Friday.All general acute care hospitals in the San Joaquin Valley region with ICU bed capacity must accept transfer patients when “clinically appropriate” and directed by state health officials or the California Emergency Medical Services Authority, in an effort to find open beds for patients in the area where available.

Already vaccinated against Covid-19? Experts say you're protected, even without a booster shot

Already vaccinated against Covid-19? Experts say you’re protected, even without a booster shotThis is the first region in the state to trigger the public health order, according to CDPH. The region, which includes 12 counties in the central part of the state, had only 9.4% of adult ICU beds available Saturday, far less than the 20% availability in Southern California and the San Francisco Bay Area.The protocol is set to be reevaluated Thursday, according to the department.The surge in patients hospitalized with Covid-19 in the region comes as the vaccination rate in the area lags behind the state’s more urban coastal regions.Less than 50% of eligible residents have been fully vaccinated against Covid-19 across much of the agriculture-rich San Joaquin Valley, CDC data shows, with fewer than one-third of all residents fully inoculated in Kings County.”While the state works to further increase the number of eligible Californians vaccinated, we must take steps to protect the unvaccinated who are more at risk of severe illness, hospitalization and death from Covid-19,” CDPH said in a statement. “This action will ensure the state’s health care delivery system is prepared and can respond appropriately.”https://www.cnn.com/interactive/2020/health/us-coronavirus-dashboard-module/index.html?module=countytogglemap&defaultMetric=casesAvg7Per100K&initialWidth=680&childId=responsive-embed-2021-us-covid-cases-map&parentTitle=How%20doctors%20in%20Covid-19%20hotspots%20last%20year%20are%20%27surprised%20and%20disappointed%27%20at%20new%20record%20hospitalizations%20-%20CNN&parentUrl=https%3A%2F%2Fwww.cnn.com%2F2021%2F09%2F05%2Fhealth%2Fus-coronavirus-sunday%2Findex.html

Vaccinations for those in schools are critical, some states say

More children have needed emergency room visits and hospitalizations in states with lower vaccination rates, according to a recent study from the CDC. And some states are working to get ahead of the latest surge by getting as many eligible people vaccinated as possible.

What to do if your child is exposed to Covid-19 at school

What to do if your child is exposed to Covid-19 at schoolThe state of Washington, which has an October vaccine mandate for teachers and staff going into effect, is seeing “great news” regarding youth vaccination efforts, according to state health secretary Umair Shah on Thursday. At least 41% of children between 12- and 15-years-old are vaccinated and just under half of the state’s 16- to 17-year-olds are fully vaccinated as well.”Washington schools have the structure, protocol and people to have successful in-person education,” Shah said.In Illinois, Gov. JB Pritzker is extending the deadline for teachers, college students and health care workers to receive a Covid-19 vaccination.The state mandate for those individuals to have at least one vaccination dose, originally set to go into effect September 5, is being pushed back to September 19 at the request of representatives of the health care industry and education organizations.

Colorado nurse transforms Covid vaccine vials into a work of art to show appreciation for healthcare workers

Colorado nurse transforms Covid vaccine vials into a work of art to show appreciation for healthcare workers“While hospitals and schools move forward in good faith, this extension ensures they are prepared to meet this requirement to better protect our most vulnerable residents and children who are not yet eligible to get vaccinated,” Pritzker said in a written statement Friday.

Employees will only be required to have one shot by September 19 — with a second shot within 30 days, if necessary — but those who are not fully vaccinated must be tested for Covid-19 at least once a week. Workers must provide proof of the vaccination to their employers.Exemptions are allowed for people with a medical or religious objection to the vaccine, but those employees also must get a weekly Covid-19 test.

COVID-19: New ‘Mu variant’ from Colombia could be vaccine resistant – WHO

https://www.jpost.com/health-and-wellness/coronavirus/covid-19-new-mu-variant-from-colombia-could-be-vaccine-resistant-who-678428

A number of mutations suggest that the Mu variant could resist immune defenses and possibly even have a faster transmission than other variants.

By AARON REICH   SEPTEMBER 2, 2021 16:29

Email
Twitter
Facebook
fb-messenger

   

This undated transmission electron microscope image shows SARS-CoV-2, also known as novel coronavirus, the virus that causes COVID-19, isolated from a patient in the U.S. Virus particles are shown emerging from the surface of cells cultured in the lab. The spikes on the outer edge of the virus parti (photo credit: NIAID-RML/FILE PHOTO/HANDOUT VIA REUTERS)

This undated transmission electron microscope image shows SARS-CoV-2, also known as novel coronavirus, the virus that causes COVID-19, isolated from a patient in the U.S. Virus particles are shown emerging from the surface of cells cultured in the lab. The spikes on the outer edge of the virus parti(photo credit: NIAID-RML/FILE PHOTO/HANDOUT VIA REUTERS)AdvertisementThe World Health Organization (WHO) is closely monitoring the emergence of a new variant of the novel coronavirus, the Mu variant, which has already been spreading through South America and has shown signs of possible vaccine resistance.First identified in January 2021 in Colombia, the Mu variant has seen sporadic cases emerge throughout South America and Europe. Globally, the variant accounts for less than 0.1% of all cases worldwide. However, the WHO has noted that it has become considerably more prevalent in Colombia and Ecuador, where it accounts for approximately 39% and 13% of respective cases.Further research is needed to accurately verify if this new variant, also known by the designations VUI-21JUL-01 and B.1.621, could be resistant to vaccines. The WHO is still monitoring it as a Variant Of Interest, as there are several mutations, two of which were designated E484K and K417N, suggesting it could resist immune defenses in a similar manner to the Beta variant found in South Africa.Another mutation found, dubbed P681H, has also caused some concern, as this could make the variant more infectious, similar to the Alpha variant found in the UK, according to The Guardian. However, it isn’t clear if this is in fact more contagious than other variants, with an August report by Public Health England noting, “At present, there is no evidence that VUI-21JUL-01 is outcompeting the Delta variant and it appears unlikely that it is more transmissible.”The Mu variant has been detected in some 40 countries so far, including the UK, US, Hong Kong and in Europe, and could spread further.On Thursday, Japan’s Health Ministry confirmed that two Mu variant cases were detected in the country in June and July during airport screenings, the former having been an arrival from the UAE and the latter having arrived from the UK, though both were asymptomatic, the Japan Times reported. According to The Guardian, some 32 people in the UK have been diagnosed with the Mu variant, with the infection patterns indicating that people entering the country had brought it with them. COVID-19 cell (credit: BAR ILAN UNIVERSITY)COVID-19 cell (credit: BAR ILAN UNIVERSITY)But Mu isn’t the only new variant causing concern. Recently, scientists found another variant in South Africa and a number of other countries, designated C.1.2, with concerns that it could be more infectious and evade vaccines, according to a new preprint study by South Africa’s National Institute for Communicable Diseases and the KwaZulu-Natal Research Innovation and Sequencing Platform, which is awaiting peer review.Scientists first detected C.1.2 in May 2021, finding that it was descended from C.1, which scientists found surprising since C.1 had last been detected in January. The new variant has “mutated substantially” compared to C.1 and is more mutations away from the original virus detected in Wuhan than nearly any other variant.Vintage Ads That We Can’t Believe Someone WroteSponsored by GazillionsRecommended byWhile first detected in South Africa, C.1.2 has since been found in England, China, the Democratic Republic of the Congo, Mauritius, New Zealand, Portugal and Switzerland.The South African study comes as a doctor in Turkey reported indications that a new coronavirus variant had been detected in the country, with tests detecting mutations that weren’t found in the current variants named by the WHO.The coronavirus pandemic originated in Wuhan, China, and has since spread worldwide. Over the past two years, the disease has infected hundreds of millions of people. The global death toll is estimated at around 4.5 million.

Florida woman hospitalized with COVID-19 comes home to find husband dead from virus

https://abc7.com/florida-covid-lisa-steadman-coronavirus-winter-haven/10980237/

By Mckenna King, WFTSFriday, August 27, 2021 8:55AMabout:blankEMBED <>MORE VIDEOS 

Have you seen home prices lately in the Antelope Valley? The surging market is fueling a whole host of problems – including pushing more people into homelessness.WINTER HAVEN, Fla. — A Florida woman, who battled and beat COVID-19 in the hospital for eight days, returned home to discover her husband had died in their home due to the virus.

“It was just like walking into a horror scene. It’s just been horrible,” Winter Haven resident Lisa Steadman told WFTS, ABC Action News.

The 58-year-old thought she was through the worst of it.

She and her husband Ron both got diagnosed with COVID-19 in early August.

“I was in the hospital for eight days. Every day I talked to him,” she said.

Ron never ended up in the hospital. Instead, he was home taking care of the dogs, while his wife was gone.

MORE | What we know about the delta variant

EMBED <>MORE VIDEOS 

ABC chief medical correspondent Dr. Jen Ashton explains what we know and don’t know about the threat posed by the Delta variant of COVID-19.

“Sunday, when I talked to him, he told me his phone was acting up, that it wouldn’t hold a charge. I said ‘okay,’ well then Monday came, I couldn’t get ahold of him. So I called the police, Winter Haven Police Department, said could they do a wellness check. They came out, did a wellness check, talked to him, he was out with the dogs, they said, ‘he has a cold,’ but he was okay as far as not fixing to pass away or something.”

But sometime between then and when Steadman left the hospital Wednesday evening, things took a turn for the worst.

“I could hear our little dogs. They were all in the bedroom together, the dogs and him. I rolled to the bedroom door, I opened the door, and he was on the bed passed away,” she said.

Ron died from COVID-related complications.

“He always wore his mask, he always used his hand sanitizer,” she said.

She said that neither of them had received a COVID-19 vaccine – not because they were against it, only because they wanted to wait.

Now, after talking with her doctor and dealing with the virus first hand, her mind has changed.

“I said that when I got better, ’cause I can’t take it ’til the end of September, that I would get the shot,” she said.

Now she shares a message to everyone else.

“Remember you are not promised tomorrow. So you better make sure you tell your loved ones you love them,” she said.

MORE | J&J booster shows promise, but could mixing vaccines be even better?

EMBED <>MORE VIDEOS 

J & J says it’s seeing significant benefits from its COVID vaccine booster shot. But could mixing different vaccine provide even better protection?Report a correction or typo

Parenting Amid Delta Is the Heartbreak That Didn’t Need to Happen

A line of children and their families wait to enter a school building
First Grader Brian Pacheco waits in line along with parents and other students at the entrance to the Lankershim Elementary School campus in Los Angeles, California, on August 17, 2021.

BYWilliam Rivers PittTruthoutPUBLISHEDAugust 24, 2021SHAREShare via FacebookShare via TwitterShare via Email

A white lower-case t on a black background

READING LISTWAR & PEACEThis Afghanistan Vet Became a War Resister and Anti-Racist ActivistPOLITICS & ELECTIONSRegardless of Media Spin, Yesterday’s Budget Vote Was a Progressive VictoryECONOMY & LABORBiden Boosted Food Stamps. Let’s Do the Same to All US Anti-Poverty Programs.RACIAL JUSTICEJohn Lewis Voting Rights Bill Passes House With Zero Republican VotesPOLITICS & ELECTIONSAntifascists Stopped Proud Boys From Entering Portland’s City Center on SundayPOLITICS & ELECTIONSDeSantis’s Poll Numbers Plummet as Florida Deals With Terrifying COVID Numbers

Aday in the life: My back feels like it is made of old winter ice, rotted and black, still hard and so cold. I want to lie on my stomach and have someone take a rolling pin to my spine, up and down, side to side, so I can hear the ice crack and shatter, so I can take in breaths that don’t shudder in the exhale, so my shoulders will come down from beneath my ears, if only for a few minutes, before everything freezes again.

An unbroken night’s sleep is a dim memory of a paradise I failed to fully appreciate when last I was there, a priceless gift taken for granted by a spoiled child. All my dreams are frustration dreams, lost in a maze, lost in a vast building without beginning or end, lost in a strange and menacing cityscape, lost in the dark. I snap awake and sit on the edge of my bed with the blanket wrapped over me like my own personal oxygen tent and try to shake the dream off, but it is always waiting for me beneath my pillow when I return, coiled like an asp sent to do murder in the night. Perhaps you can relate.

I have it easy; at least I had a childhood, replete and complete. My 8-year-old daughter is not so fortunate. Someone will coin a glib nickname for her generation — Generation Rona, or something — that will comprehensively fail to encompass the damage she and her peers are absorbing as we speak. Hemingway said the world breaks everyone, and some grow strong at the broken places. I hope to Christ this is true for my daughter, even as I writhe upon bearing witness to the breaking. So begins another COVID school year.

Get our free emails

  • Email

The pandemic exploded the last four months of my daughter’s first-grade year, routed and ravaged the entire term of her second grade, and now waits like some infinitely patient vampire to suck the life out of her third grade. Indifference to the spread of the virus opened the door for the emergence of variants, one of which is proving to be far more menacing to our children. No vaccine is available for those younger than 12.

It is so rotten, so foul, so unfathomably unfair.

It was better for a while. Late spring and early summer actually hedged toward normal. She was back in the school building, masked and distanced but there, and not trying to navigate at-home education via Zoom. She stopped being alone all the time, and her mother and I could see the strain lines lift from her face like a magic trick after the first day she was back.

The beginning of summer camp at the close of June should have been glory, but was instead another false dawn. Just as my daughter was reuniting with camp friends, running through sprinklers and doing crafts with beads after the long gloom, I found myself required to write this:

The inescapable truth emerging from this ongoing crisis is that very little of it is, in fact, under control. Half the U.S. population remains unvaccinated, including children under 12, and a certain segment of that unvaccinated population disdains even the most unobtrusive protections as an affront to freedom, because Trump. Many areas of the world beyond our borders are struggling to contend with the pandemic, allowing the virus to replicate variants that will continue to test our progress, if not subsume it altogether.

I hate that paragraph. I hated it when I wrote it, and I hate it now, because it did not have to be this way. That “certain segment, because Trump” cohort has directly caused an absolutely horrific infection spike in several of the states Trump carried in 2020, a spike that has spread its shadow over the whole country, just in time for school. Governors like DeSantis in Florida, Abbott in Texas and Lee in Tennessee are pitchforking their constituents into the pandemic’s maw because each seeks Trump’s mantle, full in the knowledge that even attempting to do so is a boon to their fundraising efforts.

I find that I am able to function only if I shove the feral scream of rage in my head into a vault with a heavy lock, and even then, my hands shake. It is one thing to say, “A portion of the country no longer believes in the common good.” It is another to watch that unbelief devour my daughter’s happiness like a glutton at the cafeteria.

More than once over the last few weeks, she has asked me, “Daddy, why are you holding your breath?” I realized I was, exhaled slowly, and told her I was thinking of something to write about. This was not a lie: I was thinking of the people who conflate masks and vaccines with fascism, and my fury rose, and I forgot to breathe, again. I am so worried about my daughter that she has begun to worry about me. My calm, soothing, don’t-worry-be-happy façade — held now for 19 months entirely for her sake — has begun to crack.

I had a run-in some days ago at the playground with a member of the Trump brigades. Our daughters played happily on the monkey bars while she and I chatted about nothing in particular. Like a cloud passing over the sun, a portion of our conversation touched upon something that had been touched by the pandemic, and her entire demeanor changed before my eyes.

“I don’t mean to talk politics, but,” she began, and I immediately prepared myself, because I knew full well that whatever came after “but” was going to boil me if I didn’t lock it all down like a ship confronting a gale. I was not disappointed, which is to say I got exactly what I expected. Everything after “but” was a strangled retinue of fiction, false patriotism, un-science and paranoia. She may as well have had a “Q” seared into the middle of her forehead like a Medieval monk emerged from some crumbling splinter abbey on the bleak side of the river.

When my turn to speak came — it turns out she did need to breathe, and so had to stop the ramble for a tick — I kept it as simple as I could: “My grandmother stole sugar packets from restaurants to her dying day because of what she experienced during the Great Depression. I can’t imagine what she went through. To equate wearing a mask for the common good to tyranny and real hardship makes me want to climb a tree and live with the squirrels.”

Verbatim. You can guess I’d been honing that line for such a confrontation, and it did not let me down. She became very still, eyes wide, looking at me like I was a spider she’d found hiding between the pages of her favorite book. “My daughter needs a bottled water,” she muttered, almost to herself. She collected her daughter — dear God, that poor kid — and was gone, leaving me there on the bench to wonder if I’d done any good at all.This is not the aftermath of a meteor strike or a massive earthquake. Actual people are responsible for this slow slide toward another harrowing COVID winter.

Maybe? Doubtful. The poison has been injected deep, as I suspect will be evidenced by Monday’s FDA approval of the Pfizer vaccine. Many vax-hesitant people claimed they were waiting for that approval before getting the shot, and now that it’s here, I imagine the next verse will be, “But that approval was too fast.” You can lead a horse to water, but you can’t make it give a shit about its community.

Remember that great Staples commercial with the dad exuberantly picking out school supplies in front of his two sullen children to the tune of, “It’s the Most Wonderful Time of the Year”? That was a quarter century ago, and the role reversal now is unsettlingly stark.

Today, most of the kids are champing at the bit to get back to school because it’s normal, Normal, NORMAL! to be in a classroom with children their own age, and not hotboxed at home with doom spilling out of the television like a bilge tide and a tablet standing in for a friend if the kid’s family is able to afford one. The parents, on the other hand, are sullen with worry that the Delta variant will plow through the coming year like a bulldozer with blade down and engine bellowing. Today is the Bizarro World version of that ad.

This is not the aftermath of a meteor strike or a massive earthquake. Actual people are responsible for this slow slide toward another harrowing COVID winter, because they refuse to be responsible for the rest of us, as we have chosen to be responsible for them by masking up, getting the shot and following basic scientific guidance.

Meanwhile, for many parents of young children, autumn threatens to be a season of holding our collective breath. Again.

Dr. Fauci: ‘Things are going to get worse’ — here’s what that could look like

https://www.cnbc.com/amp/2021/08/05/dr-fauci-things-will-get-worse-amid-covid-delta-surge-unvaccinated.html

Published Thu, Aug 5 2021 3:52 PM EDTCory Stieg@CORYSTIEGShareWASHINGTON, DC - JULY 20: Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, arrives to testify before the Senate Health, Education, Labor, and Pensions Committee at the Dirksen Senate Office Building on July 20, 2021 in Washington, DC. (Photo by Stefani Reynolds-Pool/Getty Images)WASHINGTON, DC – JULY 20: Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, arrives to testify before the Senate Health, Education, Labor, and Pensions Committee at the Dirksen Senate Office Building on July 20, 2021 in Washington, DC. (Photo by Stefani Reynolds-Pool/Getty Images)Pool | Getty Images News | Getty Images

Dr. Anthony Fauci has a sobering prediction: “Things are going to get worse.”

The White House chief medical advisor made those remarks amid rising Covid cases nationwide, due largely to the virus’s newly dominant and more transmissible delta variant, during an interview with ABC’s “This Week” on Sunday. Though it’s tough to imagine a situation more dire than the country’s current surge, “we’re looking to some pain and suffering in the future because we’re seeing the cases go up,” Fauci said.https://25d11482c429ca9bf185a95aef4b5016.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html?n=0

Delta has run rampant through the U.S. in recent weeks, surpassing last summer’s peak of new daily cases and hitting the country’s relatively large population of unvaccinated people — 50% as of Thursday afternoon — particularly hard. Experts suggest the U.S. needs a 90% vaccination rate to reach herd immunity, given delta’s keen ability to spread.

If that doesn’t happen, Fauci told McClatchy D.C. on Wednesday, the virus will keep spreading through the fall and winter — giving it “ample chance” to develop another, worse variant.

So, just how bad is “worse”? Here’s what could transpire in the coming months, and what can be done to stop it:

New (and worse) variants could mean booster shots

So long as a virus can spread, it can mutate and create more dangerous variants. And while the Covid vaccines in use appear to work well against current variants, “there could be a variant that’s lingering out there that can push aside delta,” Fauci told McClatchy.

If a more vaccine-resistant variant emerges, people could need booster shots. Countries like IsraelGermany and France have already started administering third doses of mRNA vaccines as boosters — though the World Health Organization said Wednesday that it’s too soon to move forward with boosters until vaccine inequalities are addressed around the world.https://25d11482c429ca9bf185a95aef4b5016.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html?n=0

“We’re talking about boosters in countries that have access to vaccine,” Keri Althoff, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, told CNBC Make It. “Whereas we still have people all over the world who don’t have any access, at this point, to even the first dose.”

Most of the virus’s current ability to spread across the U.S. — which has plentiful vaccine supply — is due to America’s large population of unvaccinated people. About 30% of the adult population in the U.S. has not received at least one dose, and roughly 33% of eligible children ages 12 -17 have yet to receive a shot.

New data from the CDC has also raised concerns about breakthrough cases, where vaccinated people can occasionally transmit the delta variant to other people. The CDC only tracks breakthrough cases that lead to severe hospitalizations and death, but most breakthrough cases tend to be mild or asymptomatic — leading some experts to say the agency could be missing crucial real-time data on their prevalence and ability to foster new variants.

“The worry has to be that something new is going to evolve, call it epsilon or some other variant, and we need to be monitoring very carefully for that,” Dr. Ezekiel J. Emanuel, vice provost for global initiatives and co-director of the Health Transformation Institute at the University of Pennsylvania, said in a briefing with the Infectious Diseases Society of America on Tuesday.

“Unfortunately, if you’re missing breakthrough infections, you may be missing some evolution here, that would be very important for us to follow,” Emanuel said.

Cases could climb to 100,000 or 200,000 a day

A key indicator that Covid will continue to worsen, according to Fauci: The nation’s seven-day average for new daily cases is currently rising.

“Remember, just a couple of months ago, we were having about 10,000 cases a day,” Fauci told McClatchy. “I think you’re likely going to wind up somewhere between 100,000 and 200,000 cases.” The average is currently higher than the peak last summer, before vaccines were authorized and in use. The seven-day rolling average of daily cases was 84,389 on Aug. 2, according to the CDC’s data. Last year, the CDC reported about 68,700 new cases per day.

There’s evidence that the surge is motivating people to get vaccinated. Louisiana, which has the highest rate of Covid cases per capita, saw the number of people getting vaccinated quadruple in recent weeks.

But even with this vaccination bump, people won’t be considered “fully vaccinated” for a while. The CDC defines “fully vaccinated” as two weeks after the second dose of a two-dose regimen like Moderna or Pfizer, or two weeks after getting the Johnson & Johnson single-shot vaccine. “Even if we vaccinated everyone today, we’re not going to see an effect until the middle to end of September,” Fauci told McClatchy.

Social distancing and restrictions could come back

Last year’s full lockdowns are unlikely to return because the country’s vaccine supply is strong, and experts know more now about how Covid spreads, Fauci told ABC. But as long as vaccines remain unavailable to everyone — like school-aged children, for example — nonpharmaceutical prevention measures like masking and social distancing may come back.

In late July, the CDC walked back its mask guidance for fully vaccinated people, recommending that everyone wear masks in indoor public settings in counties where there is “substantial or high transmission,” as determined by the agency’s data tracker. Masks are also a good idea in areas with high vaccination rates, Althoff said, to help prevent breakthrough cases and dampen further transmission.

“Masking protects yourself and others, and with a variant that is really transmissible, masking indoors is really important right now,” she said.

Restrictions on large indoor and outdoor gatherings could also return — because while canceled parties and six-feet markers in stores are certainly inconvenient, they could help prevent more restrictive measures.

“Nobody wants to go back to what we had before with the lockdowns,” Althoff said.

Sign up now: Get smarter about your money and career with our weekly newsletter

Don’t miss:

China reports first human case

China’s National Health Commission (NHC) announced Tuesday that a 41-year-old man had been confirmed as the first human case of infection with a rare avian flu called H10N3. The case was recorded in the Chinese province of Jiangsu in eastern China. Many different strains of bird flu exist in China, and some infect people sporadically, usually those who work with poultry. There is currently no evidence that H10N3 can be easily transmitted to humans.

The man, a resident of Zhenjiang City, was hospitalized on April 18 and diagnosed with H10N3 on May 28, the health commission said. He did not give any details about the man’s infection. It is now stable and ready to be released. Investigation of his close contacts revealed no other cases, the NHC said. No other cases of human infection with H10N3 have been reported worldwide, the commission said.

A weakly pathogenic virus

H10N3 is low in pathogen, which means it causes relatively less severe disease in poultry and is unlikely to cause widespread epidemic, the NHC added. The strain is “not a very common virus,” said Filip Claes, regional laboratory coordinator for the Food and Agriculture Organization of the United Nations Emergency Center for Cross-Border Animal Diseases at the Regional Office for Asia and the Pacific.

Analysis of the virus’ genetic data will be needed to determine if it looks like older viruses or if it is a new mix of different viruses, Claes said. Since the H7N9 strain killed around 300 people between 2016 and 2017, there have been no significant number of human infections with avian flu.