Fortnite is a wildly popular video game set in a “post-apocalyptic, zombie-infested world.”
Fortnight is the real-world COVID-19 scenario played out over the last two weeks of 2021 in a pre-apocalyptic, virus-infested world. It isn’t pretty. It can’t be shut down by the click of a computer mouse. And it’s far from over.
Daily case counts in the U.S. spiked to nearly half a million at the end of December, virtually doubling the previous peak reached in January a year ago. The million cases reported Monday by Johns Hopkins likely included some accumulation over the holiday weekend, only slightly diminishing the shock value of that number.
The seven-day moving average of daily new cases posted by the Centers for Disease Control and Prevention was 316,000 on December 29 and 491,652 on Monday, far eclipsing the high of 250,000 last January. Worldwide, a similar drama is unfolding.
The timing couldn’t be worse. Sheer numbers of infections are once again besieging hospitals, nursing homes and healthcare workers already stretched brittle and thin by two years of pandemic casualties and unrelenting stress.
Thousands of flight cancellations erased or disrupted holiday travel plans. Long lines of the anxious at airports had their parallel in long lines of the anxious waiting for COVID-19 tests that were in high demand but short supply.
Some schools and colleges decided to return to remote learning for a while after the holidays. Most vowed to make “back to school” literally back to school, with appropriate health and safety measures in place—alas, not without tumult: The Chicago Teachers Union voted against in-person classes; there’s no school today.
Many businesses advised their employees to ring in the new year by working from home yet again.
That was not coal in our Christmas stocking. It was a big fat lump of Omicron.
OMG it’s OMC
The Omicron variant of the SARS-CoV-2 virus has lived up to its billing as a highly transmissible infection. Experts are telling us to expect a blizzard, tsunami or (insert your own meteorological catastrophe) in the next few weeks. The major challenge for the world in early 2022 is to weather this weather.
COVID-19 transmission is now high in 96% of US counties and substantial in another 2%.
On the brighter side—and there is a brighter side—early evidence hints that Omicron is not as deadly as Delta, which is still inflicting illness and death. The hoped-for mantra is “more contagious, less dangerous,” certainly for the vaccinated and boosted.
While case counts have soared, deaths have remained relatively steady at 1,100 a day nationally. However, an ensemble forecast published by the CDC predicts 20,000 to 30,000 new deaths in the last week of January.
So, really, how are we doing?
Vaccination remains the best defense against the pandemic offense. Nearly 245 million people in the U.S.—78.4% of the vaccine-eligible population five and older—have had at least one shot, and 66% are fully vaccinated (which does not include boosters at this point).
A little more than a third of U.S. adults (37.7%) have had a booster shot; 16- and 17-year-olds became eligible for boosters a month ago and youngsters aged 12 to 15 just got the thumbs (and sleeves) up on Monday.
What now, what next? As the never-ending story of the pandemic stretches into its third calendar year, here are 10 trends compelling our attention.
10. Mandates will have their day in court.
• On Friday, the Supreme Court will hear arguments in the challenges to two federal vaccination mandates. One covers millions of healthcare workers in Medicare- and Medicaid-funded facilities while the other requires vaccination or testing for businesses with 100 or more employees.
• The Centers for Medicare and Medicaid Services is already setting vaccination targets for healthcare employees covered by its mandate, Kimberly Marselas reports in McKnight’s Long-Term Care News. The deadline for health workers to get their first shot is now January 27.
• State and local vaccination mandates have generally survived court battles to date. A vaccination mandate affecting all private businesses in New York City took effect December 27.
• As of Monday, proof of vaccination is required to gain access to indoor public places in Chicago. Similar vaccine passport approaches are coming January 15 in Boston (the program has been dubbed “B Together”) and Washington, D.C.
9. Boosters are getting a boost.
• The spread of Omicron is prompting an urgent call for boosters to provide the extra layer of protection that will likely be needed. On Monday, the FDA approved giving boosters of the Pfizer/BioNTech vaccine five months (rather than six months) after the first two shots. The agency also approved a third primary dose for moderately or severely immunocompromised children ages 5 to 11, including organ transplant recipients. The CDC concurs with both decisions.
• The California Department of Public Health is requiring workers in healthcare facilities to receive boosters by February 1.
• Israel has already approved a fourth dose of vaccine for the most vulnerable, including people over 60 and those with suppressed immune systems.
• The U.K. set a goal of getting all eligible adults boosted by the end of 2021, Luke Haynes reports in GP.
• The World Health Organization, on the other hand, is not in favor of booster campaigns. They believe such efforts will only delay vaccine distribution to areas that haven’t even vaccinated people yet, thus allowing more variants to materialize.
8. We’re trying to learn how to live with the virus.
• The CDC has shortened the recommended period of isolation from 10 days to five for people with COVID who have no symptoms or symptoms that are resolving (no fever for 24 hours). If they test positive after five days, the isolation extends to 10 days. After isolating, they are urged to wear a mask around others for another five days.
• The CDC has also updated the quarantine recommendations for people exposed to COVID-19. Adults who have received their booster and kids 5 to 17 who have completed the primary series of vaccination don’t need to quarantine but should mask up for 10 days after the exposure and get tested five days after the exposure. People who had confirmed COVID-19 infection within the past 90 days also do not need to quarantine.
• For the unvaccinated or adults due for a booster, the recommended quarantine is five days. Get tested—right away if you have symptoms or five days after exposure if not symptomatic.
• There’s now separate CDC guidance that applies to healthcare workers. Those who have COVID but no symptoms can return to work after seven days (previously 10 days) with a negative test. Isolation time can be cut further if staff shortages are critical.
• Healthcare workers who have received all recommended doses do not need to quarantine at home following high-risk exposures. The guidance makes it easier for nursing home workers who have been boosted to get back on the job sooner, Danielle Brown and Alicia Lasek explain in McKnight’s Long-Term Care News.
7. The COVID prevention and treatment toolbox is growing.
• The FDA has authorized the first oral antivirals for treating COVID-19, Pfizer’s Paxlovid (nirmatrelvir and ritonavir) and Merck/Ridgeback’s molnupiravir. The pills treat mild-to-moderate COVID-19 in people at risk for progression to severe disease; they are not, the FDA emphasizes, a substitute for vaccination. Molnupiravir is for adults only; Paxlovid can be used in adults and in adolescents 12 to 17. Both are believed to be effective against Omicron.
• The GlaxoSmithKline/Vir monoclonal antibody sotrovimab appears to be effective in treating infections caused by Omicron. The other monoclonals, not so much.
• Novavax has submitted its final data package to the FDA and will seek emergency use authorization for its COVID-19 vaccine within the next month.
6. Global vaccine equity is a New Year’s Resolution.
• More than 90 of the 194 member nations of the World Health Organization failed to reach the goal of vaccinating 40% of their populations by the end of 2021. They now pivot to a new goal in the new year of vaccinating 70% by the beginning of July.
5. Aftershocks of 2020 and 2021 will continue to ripple.
• Mental health issues—stress, anxiety and depression—accounted for more than half of work-related illness in the U.K. in 2021, Jessica Brown reports in People Management.
• New Jersey will pay $53 million to families of 119 residents of state-run veterans’ homes who died, mostly of COVID-19.
• Unruly airline passengers have made the skies so unfriendly that the Federal Aviation Administration now has a toolkit explaining its zero tolerance policy for dangerous and disorderly behavior. The FAA reported 5,773 disruptive incidents in 2021—more than 4,000 of them involving face masks—and launched more than 1,000 investigations. That’s five to ten times the annual average.
• Loss of civility is another pandemic. As a grocery store worker told the Los Angeles Times, “I just got called a ‘Nazi pedophile’ for telling someone to put on a mask.”
• The director of health in Franklin County Missouri resigned, citing repeated threats of violence against her. It’s an unfortunate nationwide trend.
4. COVID fatigue is palpable.
• 60% of Americans feel worn out by the impact the pandemic has had on their lives over the past two years, a Monmouth poll reports. And 45% are angry about it. More than a third (36%) are both worn out and angry; they’re sick and tired of being sick and tired.
3. Testing remains essential.
• Systematic testing will help schools, businesses and the world at large achieve a degree of control over the spread of infection. We await further details on the 500 million test kits promised by the federal government.
• The CDC, reporting on programs in Illinois and California, says that a test-to-stay strategy offers an effective alternative to sending schoolkids home on quarantine. Among other measures, the strategy allows students who have been exposed to COVID-19 at school to stay in school if they remain asymptomatic, wear a mask and are tested for the virus at least twice a week throughout the quarantine period.
2. Kids are crucial to the vax push.
• 2022 will likely be the year when the vaccine becomes available to the one group not yet eligible: children under 5 years of age.
• Right now, however, pediatric cases and hospitalizations are surging at a time when vaccination rates of kids 5 to 11 and adolescents 12 to 17 are not. By the end of December, just 23% of children ages 5 to 11 had received at least one dose of vaccine, with rates swinging wildly from state to state (6% to 56% is pretty wild). Among adolescents 12 to 17, 62% have received one dose and 53% are fully vaccinated.
• The American Academy of Pediatrics and Children’s Hospital Association reported 325,000 pediatric cases of COVID-19 in the week ending December 30, nearly doubling the levels occurring just two weeks earlier.
1. Tens of millions remain unvaccinated.
• At least one influential voice out there is urging us not to give up on the vaccine-hesitant—or, in her parlance, the “vaccine-inquisitive.” Dr. Kizzmekia Corbett, who helped develop the Moderna vaccine when she was with the National Institutes of Health, is now a professor at Harvard’s T.H. Chan School of Public Health.
• “I am convinced that many of them can be persuaded,” Dr. Corbett wrote in an op-ed for USA Today. “I have seen time and again that many people who seem implacably opposed are just anxious. They have questions that have not been answered. They have concerns that have not been addressed. And if you sit down with them one—if you treat them with respect, meet them where they are and take the time to listen and explain—you can reach them.”
Coming to us high above the rolling fields of Schneverdingen, Germany, an aerial photograph shows 700 sheep and goats forming the outlines of a giant (330-foot) syringe. It is the masterwork of shepherd Wiebke Schmidt-Kochan, who lured the flocks into place with strategically placed bits of bread, and Hanspeter Etzold, an expert in team-building exercises. “Sheep are such likeable animals,” Etzold told the Associated Press. “Maybe they can get the message over better.”
Good thing they didn’t try this with cats.
…and some songs
Welcome to a new year, and thank you for hanging in there with us. As Benjamin Franklin said, “We must indeed all hang together or most assuredly we will all hang separately.” Remember: Franklin lost his four-year-old son Franky to smallpox and afterward became an “eloquent advocate” of smallpox inoculation.