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Health

‘Dealing With A Different Beast’: Why Delta Has Doctors Worried

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Catherine O’Neal, MD, an infectious disease physician, took to the podium of the Louisiana governor’s press conference on July 16 and did not mince words.

“The delta variant is not last year’s virus, and it’s become incredibly apparent to healthcare workers that we are dealing with a different beast,” she said.

Louisiana has one of the least vaccinated states in the country. In the United States as a whole, 48.6% of the population is fully vaccinated. In Louisiana, it’s just 36%, and delta is bearing down.

O’Neal spoke about the pressure rising COVID cases were already putting on her hospital, Our Lady of the Lake Regional Health System, in Baton Rouge. She talked about watching her peers, 30 and 40-year-olds become severely ill with the latest iteration of the new coronavirus—the delta variant—which is sweeping through the US with astonishing speed, causing new cases, hospitalizations, and deaths to rise again. 

O’Neal talked about parents who might not be alive to see their children go off to college in a few weeks.  She talked about increasing hospital admissions for infected kids and pregnant women on ventilators.

“I want to be clear after seeing what we’ve seen the last two weeks. We only have two choices: We are either going to get vaccinated and end the pandemic, or we’re going to accept death and a lot of it,” O’Neal said, her voice choked by emotion.

Where Delta Goes, Death Follows

Delta was first identified in India, where it caused a devastating surge in the spring, In a population that was largely unvaccinated, researchers think it may have caused as many as 3 million deaths. In just a few months’ time, it has sped across the globe.

Research from the UK shows that delta is highly contagious. It’s about 60% more easily passed from person-to-person than the alpha version (or B.1.1.7, which was first identified in the UK). 

Where a single infected person might have spread older versions of the virus to 2 or 3 others, mathematician and epidemiologist Adam Kucharski, PhD, an associate professor at the London School of Hygiene and Tropical Medicine, thinks that number—called the basic reproduction number– might be around 6 for delta, meaning that on average, each infected person spreads the virus to 6 others.

“The delta variant is the most able and fastest and fittest of those viruses,” said  Mike Ryan, MD, MPH, executive director of the World Health Organization’s health emergencies program, in a recent press briefing. Early evidence suggests it may also cause more severe disease in people who are not vaccinated. 

“There’s clearly increased risk of ICU admission, hospitalization, and death,” said Ashleigh Tuite, PhD, an infectious disease epidemiologist at the University of Toronto in Ontario.

In a study published ahead of peer review, Tuite and her co-author, David Fisman, PhD, reviewed the health outcomes for more than 200,000 people who tested positive for SARS-CoV2 in Ontario between February and June of 2021. Starting in February, Ontario began screening all positive COVID tests for mutations in the N501Y region for signs of mutation.

Compared to versions of the coronavirus that circulated in 2020, having an alpha, beta, or gamma variant, modestly increased the odds that an infected person would become sicker.  The delta variant raised the risk even higher, more than doubling the odds that an infected person would need to be hospitalized or could die from their infection.

Emerging evidence from England and Scotland, analyzed by Public Health England, also show an increased risk for hospitalization with delta. The increases are in line with the Canadian data.  Experts caution that the picture may change over time as more evidence is gathered.

“What is causing that? We don’t know,” Tuite said.

Enhanced Virus

The delta variants (there’s actually more than one in the same viral family), have about 15 different mutations compared to the original virus. Two of these, L452R and E484Q, are mutations to the spike protein that were first flagged as problematic in other variants because they appear to help the virus escape the antibodies we make to fight it.

It has another mutation away from its binding site that’s also getting researchers’ attention – P681R.

This mutation appears to enhance the “springiness” of the parts of the virus that dock onto our cells, said Alexander Greninger, MD, PhD, assistant director of the UW Medicine Clinical Virology Laboratory at the University of Washington in Seattle.  So it’s more likely to be in the right position to infect your cells if you come into contact with it.

Another theory is that P681R may also enhance the virus’s ability to fuse cells together into clumps that have several different nuclei. These balls of fused cells are called syncytia.

“So it turns into a big factory for making viruses,” said Kamron Kadkhoda, PhD, medical director of immunopathology at the Cleveland Clinic, in Ohio.

This capability is not unique to delta or even to the new coronavirus.  Earlier versions and other viruses can do the same thing, but according to a recent paper in Nature, the syncytia that delta creates are larger than the ones created by previous variants.

Scientists aren’t sure what these supersized syncytia mean, exactly, but they have some theories. They may help the virus to copy itself more quickly, so a person’s viral load builds up quickly. That may enhance the ability of the virus to transmit from person to person.

And at least one recent study from China supports this idea. That study, which was posted ahead of peer review on the website Virological.org, tracked 167 people infected with delta back to a single index case. 

China has used extensive contact tracing to identify people that may have been exposed to the virus and sequester them quickly to tamp down its spread. Once a person is isolated or quarantined, they are tested daily with gold-standard PCR testing to determine whether or not they were infected. 

Researchers compared delta cases to the characteristics of people infected in 2020 with previous versions of the virus.

This study found that people infected by delta tested positive more quickly than their predecessors did. In 2020, it took an average of 6 days for someone to test positive after an exposure. With delta, it took an average of about 4 days. 

When people tested positive, they had more than 1000 times more virus in their bodies, suggesting the delta variant has a higher growth rate in the body.

This gives delta a big advantage. According to Angie Rassumussen, PhD, a virologist at the Vaccine and Infectious Disease Center at the University of Saskatchewan, in Canada, who posted a thread about the study on Twitter, if people are shedding 1000 times more virus, it’s much more likely that close contacts will be exposed to enough of itto become infected themselves.

And if they’re shedding earlier in the course of their infections, the virus has more opportunity to spread.

This may help explain why delta is so much more contagious.

Beyond transmission, delta’s ability to form syncytia may have two other important consequences.  It may help the virus hide from our immune system, and it may make the virus more damaging to the body.

Commonly, when a virus infects a cell, it will corrupt the cell’s protein making machinery to crank out more copies of itself. When the cell dies, these new copies are released into the plasma outside the cell where they can float over and infect new cells. It’s in this extracellular space where a virus can also be attacked by the antibodies our immune system makes to fight it off.

“Antibodies don’t penetrate inside the cell. If these viruses are going from one cell to another by just fusing to each other, antibodies become less useful,” Kadkhoda said.

Escape Artist

Recent studies show that delta is also able to escape antibodies made in response to vaccination more effectively than the Alpha, or B.1.1.7 strain.  The effect was more pronounced in older adults, who tend to have weaker responses to vaccines in general.

This evasion of the immune system is particularly problematic for people who are only partially vaccinated.  Data from the UK show that a single dose of vaccine is only about 31% effective at preventing illness with delta, and 75% effective at preventing hospitalization. 

After two doses, the vaccines are still highly effective—even against delta—reaching 80% protection for illness, and 94% for hospitalization, which is why US officials are begging people to get both doses of their shots, and do it as quickly as possible.

Finally, the virus’s ability form syncytia may leave greater damage behind in the body’s tissues and organs.

“Especially in the lungs,” Kadkhoda said.  The lungs are very fragile tissues. Their tiny air sacs—the aveoli–are only a single cell thick.  They have to be very thin to exchange oxygen in the blood.

“Any damage like that can severely affect any oxygen exchange and the normal housekeeping activities of that tissue,” he said. “In those vital organs, it may be very problematic.”

The research is still early, but studies in animals and cell lines are backing up what doctors say they are seeing in hospitalized patients.

 A recent preprint study from researchers in Japan, found that hamsters infected with delta lost more weight—a proxy for how sick they were—compared to hamsters infected with an older version of the virus.  The researchers attribute this to the viruses’ ability to fuse cells together to form syncytia.

Another investigation, from researchers in India, infected two groups of hamsters—one with the original “wild type” strain of the virus, the other with the delta variant of the new coronavirus. 

As in the Japanese study, the hamsters infected with delta lost more weight.  When the researchers performed necropsies on the animals, they found more lung damage and bleeding in hamsters infected with delta. This study was also posted as a preprint ahead of peer review.

German researchers working with pseudotyped versions of the new coronavirus—viruses that have been genetically changed to make them safer to work with—watched what happened after they used these pseudoviruses to infect lung, colon, and kidney cells in the lab.

They, too, found cells infected with the delta variant formed more and larger syncytia compared to cells infected with the wild type strain of the virus. The authors write that their findings suggest delta could “cause more tissue damage, and thus be more pathogenic, than previous variants”.”

Researchers say it’s important to remember that while interesting, this research isn’t conclusive. Hamsters and cells aren’t humans.  More studies are needed to prove these theories.

Scientists say what we already know about delta makes vaccination more important than ever.

 “The net effect is really that, you know, this is worrisome in people who are unvaccinated and then people who have breakthrough infections, but it’s not …’ a reason to panic or to throw up our hands and say you know, this pandemic is never going to end,” Tuite said, “Because what we do see is that the vaccines continue to be highly protective.”

Follow me on Twitter: @ReporterGoodman

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This post originally posted here Medscape Medical News

Health

Half of Unvaccinated in US Unconcerned About Delta Variant: Poll

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Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

About half of unvaccinated or partially vaccinated Americans aren’t concerned about the contagious Delta variant, according to a new CBS/YouGov poll.

Among unvaccinated or partially vaccinated people, 48% said they were “personally concerned” about the Delta variant, as compared with 72% of fully vaccinated people who said they were concerned.

Public health officials have voiced warnings in recent weeks about the rapid spread of the Delta variant, especially in locations with low vaccination rates.

“I am worried about what is to come because we are seeing increasing cases among the unvaccinated in particular,” Vivek Murthy, MD, the U.S. surgeon general, said Sunday on CNN’s “State of the Union.”

“And while, if you are vaccinated, you are very well protected against hospitalization and death, unfortunately, that is not true if you are not vaccinated,” he added.

About 68% of U.S. adults have received at least one vaccine dose, according to the latest CDC tally updated on Sunday. About 59% are considered fully vaccinated.

The CBS/YouGov poll found that 53% of unvaccinated Americans said they wouldn’t get a shot due to potential side effects. About 50% said they don’t trust the U.S. government, and 45% said they don’t trust the science behind the COVID-19 vaccines.

In addition, 74% of the unvaccinated group said they’d still reject a COVID-19 vaccine, even if their own doctor recommended it. Conducted between July 14-17, the poll included more than 2,200 U.S. adults.

More than 186 million Americans have received at least one vaccine dose, and 161 million are fully vaccinated. A remaining 90 million eligible people have yet to receive a shot, according to Newsweek.

About 99.5% of current COVID-19 hospitalizations and deaths are occurring in unvaccinated patients, Murthy said Sunday.

“That’s why it is so important that we take every measure possible to make sure people have the information they need about the vaccine, to make sure they have access to the vaccine and to help them get vaccinated as quickly as possible,” he said. “It is our fastest, most effective way out of this pandemic.”

Sources:

CBS News: “Biden nets positive marks for handling pandemic, but vaccine resistance, Delta concern remains — CBS News poll.”

CNN: “State of the Union, July 18, 2021.”

CDC: “COVID-19 Vaccinations in the United States.”

Newsweek: “Over Half of Unvaccinated Americans Say They’re Not Concerned About Delta Variant: Poll.”

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This post originally posted here Medscape Medical News

US

With vaccination rates not at the levels needed to stop the spread of Covid, the Delta variant is so contagious, the unprotected will likely get it, an expert says

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“And for most people who get this Delta variant, it’s going to be the most serious virus that they get in their lifetime in terms of the risk of putting them in the hospital,” Dr. Scott Gottlieb, commissioner of the US Food and Drug Administration during the Trump administration, told CBS’ “Face the Nation” Sunday.
Delta is the most transmissible Covid-19 variant yet, US Surgeon General Dr. Vivek Murthy told CNN. And experts say it is exacerbating the rise in cases among unvaccinated Americans.
In Los Angeles County, the rate of new Covid-19 cases has increased 300% since July 4, the county health department said. Covid-19 hospitalizations have more than doubled from the previous month.
And 48 states are now seeing new case numbers surge at least 10% higher than the previous week, according to data from Johns Hopkins University.
That is concerning, Murthy said, because often a rise in cases and hospitalizations is followed by a rise in Covid-19 deaths. Experts are particularly worried about the unvaccinated populations, as 99.5% of the deaths from Covid-19 occur among people who have not been vaccinated, Murthy said.
The only way to stem the rise in cases is vaccination, Murthy told CNN’s Dana Bash Sunday.
The fight to increase vaccinations is transitioning to the hands of local leaders, Murthy said. Springfield, Missouri, Mayor Ken McClure told “Face the Nation” he hopes community leaders will convince people to get vaccinated before it is too late.
“So it gets down to the community leaders, the community institutions that people trust saying you have to get vaccination. That’s the only way that we are going to emerge from this,” McClure said.
Face mask signage is displayed outside the Trunks bar after midnight early Sunday morning in West Hollywood, California, alerting patrons masks are again required by the county indoors.

Delta variant sends younger people to the hospital

The Delta variant might spread faster than other strains of coronavirus because it makes more copies of itself inside our bodies at a faster pace, researchers found.
In research posted online, scientists examining 62 cases of the Delta variant found viral loads about 1,260 times higher than those found in 63 cases from the early epidemic wave in 2020.
The Delta variant is also sending younger and previously healthy people to hospitals — the vast majority of which have not been vaccinated, say doctors in several states suffering surges.
“This year’s virus is not last year’s virus,” said Dr. Catherine O’Neal, an infectious disease specialist at Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana.
“It’s attacking our 40-year-olds. It’s attacking our parents and young grandparents. And it’s getting our kids,” O’Neal said. She said her Covid-19 unit now has more patients in their 20s than previously during the pandemic.
In the face of rampant misinformation about the virus and the vaccine, McClure urged people to use trusted sources and to “make sure people have good information.”
Misinformation “takes away our freedom,” Murthy said, adding that the inaccurate information inhibits people’s power to make educated decisions about the health of themselves and their families.
And with the virus’ disproportionately higher impact among people who aren’t vaccinated, the consequences can be severe.
“All this misinformation that’s floating around is having a real cost that can be measured in lives lost, and that is tragic,” Murthy said.

Children under 12 likely won’t get vaccinations soon

One important reason adults should get vaccinated, experts have said, is to protect children who are not yet eligible for the vaccine.
Currently, Covid-19 vaccines are only authorized for children 12 and older, but studies are underway to test the safety and efficacy of vaccinating younger children.
On Saturday, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, shed light on the timeline for approving Covid-19 vaccines for children younger than 12.
Right now, he told CNN’s Jim Acosta, scientists are conducting studies in de-escalating age groups, looking at children from 12 to 9-years-old, then 9 to 6, 6 to 2 and then 2-years to 6-months old.
“Thus far, things look good, but the final decision is going to be up to the FDA. And I would imagine that likely will not happen until we get well into the winter, towards the end of this year,” Fauci said.

11 people show up to three-hour vaccination event

In Alabama, which has one of the lowest vaccination rates in the US, a three-and-a-half-hour vaccination clinic at a church outside of Birmingham Sunday yielded little progress as only 11 people showed up.
MedsPlus, the health care provider on site, has been holding clinics at churches, business and community centers, in hopes of partnering with local leaders that people trust. But according to Alabama Public Health Department’s dashboard, the number of vaccines administered in the state has dropped off in a steep decline since the peak in March and April.
According to data from the CDC, just 33.7% of Alabama’s residents were fully vaccinated as of Sunday.
Since April 1, 529 people have died in Alabama from Covid-19. According to the Alabama Public Health department, about 96% of them were unvaccinated.
Shuntasia Williams, 15, said she got her first dose of vaccine at the event because she wants to be protected when school starts next month. She told CNN she’s proud of her friend group for being vaccinated, but she has also seen rumors online that her peers are falling for.
“I seen somebody that said their arm got so swollen, it had to get amputated off,” Williams said. “That is the most crazy thing. One thing about vaccines is they start spreading rumors about it, but you have to get out and see it for yourself.”
Williams said these are not first-hand accounts by people, but rather misleading posts and articles that continue to be shared.
“Take it from me. I’m 15 years old. Go get the vaccine. It’s not shocking. My arm is not swollen. I’m not getting my arm amputated. I’m actually feeling great,” she said.

CNN’s Aya Elamroussi, Holly Yan,Claudia Dominguez, Ben Tinker and Natasha Chen contributed to this report.

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Health

Delta Variant Drives Rising COVID Case Counts in Every State

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Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

The number of COVID-19 cases is going up in every state as the Delta variant continues to spread across the nation.

An analysis by The New York Times of data from state and local health agencies showed a 7-day average of about 28,000 new cases a day on Thursday, a major jump from around 11,000 daily cases on June 20. That’s still better than the last surge in January, when there was a 7-day average of about 255,000 new cases a day.

“This will definitely be a surge,” Michael Osterholm, PhD, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told the Times. “It won’t be as big as what happened in January. But we still have 100 million people in the United States who are susceptible to COVID-19.”

The CDC says the Delta variant is now responsible for about 59% of new COVID-19 infections in the nation.

Hospitalizations are not nearly as high as during the dark days of January, but they’re rising from last month, especially in areas with low vaccination rates.

In Springfield, MO, health officials are seeking state funding to set up a field hospital to handle the overflow of patients, USA Today reported. That was a tactic used in California during the worst days of the pandemic.

“Over the past week, we have seen dramatic increases in COVID-19-related cases,” said Katie Towns, the interim Greene County, MO, Health Department director. “We need help.”

Less than half of the adults in Missouri are fully vaccinated, according to the Times.

The Times said new cases are up 70% in the last 2 weeks in Mississippi, where only 43% of adults are vaccinated. That’s the lowest rate in the nation.

The Mississippi State Department of Public Health is now advising everybody over 12 to get vaccinated, all people to wear masks when indoors in public areas, and everybody over 65 to avoid indoor mass gatherings — whether they’re vaccinated or not.

National health officials keep urging people to get vaccinated, especially because the three vaccines given emergency use authorization have been shown to give strong protection against the Delta variant.

But vaccine hesitancy remains, especially in the Southern and Midwestern states.

The Times said only about 530,000 people in the U.S. are being vaccinated a day, down from 3.3 million a day in April. Less than half the U.S. is fully vaccinated, the CDC says, though 79% of people over 65 — the most vulnerable demographic — are fully vaccinated.

“In March, people flooded to our vaccination sites — all we had to do was open a door,” Ben Weston, MD, the director of medical services for the Milwaukee County Office of Emergency Management in Wisconsin, told the Times. “Now we have to go out and find people.”

About 48% of people in Milwaukee County are fully vaccinated, The Times reported.

L.A. County Makes Indoor Masking Mandatory

Los Angeles County public health officials are once again making face masks in indoor public places mandatory — not just advisable — regardless of a person’s vaccination status. The new masking order takes effect Saturday.

Because of the Delta variant, case counts have soared since the state government reopened the economy on June 15, L.A. County Public Health said in a news release.

The Health Department reported 210 new COVID cases on June 15, compared to 1,537 new cases on Thursday — the highest number since mid-March. Thursday’s test positivity rate was 3.7%, up from .5% on June 15.

The Delta variant accounted for 71% of all sequenced cases from June 27 to July 3, the Health Department said.

“We expect to keep masking requirements in place until we begin to see improvements in our community transmission of COVID-19,” L.A. County Health Officer Muntu Davis, MD, said in the release.

Sacramento and Yolo counties in California are now recommending, but not requiring, that residents wear masks in indoor public places, according to SFGate. California Gov. Gavin Newsom said last week there was no immediate plan for a statewide requirement.

Austin, TX, Brings Back COVID Protocols

Because of a surge in infections, the city of Austin, TX, is returning to Stage 3 protocols, the city government said in a news release.

The city recommends that unvaccinated or partially vaccinated people wear masks at indoor and outdoor gatherings or while dining, shopping, and traveling. People who are unvaccinated or partially vaccinated and considered high-risk should avoid those activities altogether.

Vaccinated people don’t need to wear masks during those activities, the news release said.

“While the Delta variant has likely been circulating in our area for a while, we now have confirmation through sequencing that it is here,” said Desmar Walkes, MD, the health authority for Austin-Travis County.

“Disturbingly, we are now experiencing a rise in COVID hospitalizations that could overwhelm our city’s ICUs. Almost all these hospitalizations involve those who have not been vaccinated. This is a plea for people to become vaccinated, so we do not put our ICU capacity at risk,” Austin Mayor Steve Adler said in the news release.

But the Texas Tribune pointed out that the Stage 3 guidelines don’t carry the weight of law. Last May, Gov. Greg Abbott banned pandemic mandates.

MLB Game Postponed After Six Yankees Test Positive

A Thursday game between the Boston Red Sox and the New York Yankees was postponed when six Yankee players tested positive for COVID-19, Yankees general manager Brian Cashman said, according to CNN.

“We have three positives, and we have three pending that we’ve had rapid tests on,” Cashman said. The rapid tests are being confirmed with other tests, he said.

The three players with confirmed positive tests were all vaccinated, he said. In March, eight “breakthrough” cases were reported with the Yankees.

Sources

The New York Times: “After a Steep Plunge in Virus Cases, Every State Is Seeing an Uptick,” “See How Vaccinations Are Going in Your County and State.”

USA Today: “Health leaders ask for funding to set up ‘alternate care site’ as hospitals strain under new COVID-19 infections.”

Mississippi State Department of Public Health: “Preventing COVID-19: Recommendations and Requirements.”

L.A. County Public Health: “L.A. County Community Transmission of COVID-19 Increases from Moderate to Substantial; Reinstating Masking Indoors for Everyone — 1,537 New Confirmed Cases of COVID-19 in Los Angeles County and 3 Deaths.”

SFGate: “LA County requires masks again, 2 California counties recommend.”

City of Austin: “COVID-19 News Update.”

Texas Tribune: “Austin announces stricter coronavirus protocols for unvaccinated residents as cases increase. But it can’t legally enforce them.”

CNN: “Game postponed after 6 New York Yankees have tested positive for Covid-19, team says.”

https://www.usatoday.com/story/news/local/ozarks/2021/07/14/missouri-delta-variant-surge-springfield-health-leaders-seek-covid-alternate-care-site-hospitals/7969633002/

https://msdh.ms.gov/msdhsite/_static/14,21866,420.html#prevention

http://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm

recommend ithttps://www.sfgate.com/bayarea/article/Yolo-County-face-mask-recommendation-16316894.php

https://www.austintexas.gov/news/austin-public-health-moves-stage-3-risk-based-guidelines

https://www.texastribune.org/2021/07/15/coronavirus-texas-austin-protocols/

https://www.cnn.com/2021/07/16/us/new-york-yankees-covid-tests-spt/index.html

https://www.webmd.com/vaccines/covid-19-vaccine/news/20210514/new-york-yankees-report-8-breakthrough-covid-cases

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This post originally posted here Medscape Medical News

Travel

News: Delta Air Lines returns to profit in second quarter

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Delta Air Lines has reported a $ 652 million profit for the three months to June.

The figure was buoyed by $ 1.5 billion in government benefits related to the first and second payroll support program extensions.

Revenue for the quarter stood at $ 6.3 billion, down 49 per cent from the same period in 2019.

The airline generated $ 1.9 billion of operating cash flow, $ 1.5 billion of free cash flow and $ 195 million of free cash flow in the June quarter.

“With the best employees and operation in the industry and an accelerating demand environment, we achieved significant milestones in the quarter including a solid pre-tax profit in the month of June,” said Ed Bastian, Delta chief executive.

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“Looking forward, we are harnessing the power of our differentiated brand and resilient competitive advantages to drive towards sustainable profitability in the second half of 2021 and enable long-term value creation.”

He added: “Domestic leisure travel is fully recovered to 2019 levels and there are encouraging signs of improvement in business and international travel. 

“With the recovery picking up steam, we are making investments to support our industry-leading operation. 

“We are also opportunistically acquiring aircraft and creating upside flexibility to accelerate our capacity restoration in 2022 and beyond in a capital-disciplined manner.”

Over the next three months, Delta said it expects passenger capacity will be down 28 to 30 per cent and revenue off 30 to 35 per cent, compared with the same period in 2019.

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This post originally posted here Breaking Travel News

Business

Coronavirus latest: J&J says vaccine produces durable immune response against Delta variant

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Ohio University has announced a series of scholarship and prize giveaways for vaccinated students, while the state prepares to revive its multi-million-dollar lottery scheme to boost vaccination coverage.

Fully vaccinated students who sign up for the college’s “vaccination pathway” programme, which exempts them from having to take a weekly asymptomatic Covid-19 test, will be eligible for weekly prize drawings between now and mid-August, Ohio University said in a statement on Wednesday.

Two weekly winners for the next four weeks can choose between $ 500 scholarships or other prizes such as an on-campus autumn photo shoot, a VIP ride in the homecoming parade or “dinner with a soon-to-be-announced Ohio University celebrity.” (The university’s alumni include Nancy Cartwright, the voice of Bart Simpson, MacGyver star Richard Dean Anderson, and businessman Robert Walter, who had a role in the creation of Cardinal Health.)

The grand prize, to be drawn in the fifth week, is a scholarship for the autumn 2021 semester.

The announcement comes a day after Ohio governor Mike DeWine said the state planned to announce a new vaccination incentive programme within the next week.

DeWine provided few details during a press conference on Tuesday afternoon, but hinted the lottery could include smaller amounts of money to give more people a chance at winning, local media reported.

While some states had begun to offer beer or tickets to the baseball, Ohio in May became the first to announce a vaccine lottery offering million-dollar cash prizes and full college scholarships to previously or newly vaccinated residents. California and New Mexico were among those to follow Ohio’s lead. West Virginia did, too, but also pledged guns as prizes.

The Republican governor said on Tuesday he was concerned about the spread of the Delta variant of Covid-19 and parts of Ohio that have low vaccination rates. The highly-transmissible strain of the virus, which was first identified in India, is behind an increase in cases in communities in states like Missouri, Arkansas and Mississippi that have low vaccination coverage.

When DeWine announced the first lottery in mid-May, Ohio had vaccinated about 37 per cent of its population, which compared to the national average of about 35 per cent. Two months later, 45.6 per cent of residents are fully vaccinated, which is 2.6 percentage points below coverage for the US overall and puts Ohio in the bottom half of states.

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This post originally posted here International homepage

US

With cases surging, driven by unvaccinated Americans and fueled by the Delta variant, hospitals are again bracing for another round of devastation

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“I remember seeing articles in the news about hospitals in California with empty Covid units and I longed for that experience,” Segarra, the chief medical officer with Baptist Health’s Baptist Hospital, said. “It’s an experience we were working our way towards that unfortunately has taken a rather sad turn.”
In the weeks since, the hospital’s Covid-19 patient numbers have more than tripled, and staff are now treating more than 70 people, an “exponential growth,” he said, that they were not expecting. To accommodate the climbing patient numbers, the hospital recently reopened two units that were previously shut down.
The overwhelming majority of those coming in sick with Covid are unvaccinated, Segarra said. Many are young — people in their 20s and 30s who are getting “extremely, extremely sick” and some of whom are dying.
Roughly 45% of people in Florida are fully vaccinated, according to state data. The low vaccination rates, along with a dangerous coronavirus variant that’s now the dominant strain in the United States and the relaxed Covid-19 guidelines, are what Segarra said he thinks have led to the increase.
“It’s very sad to see as a health care professional, to see that this is generally an avoidable and preventable disease and to see so many people dying from a preventable illness,” he said. “It’s heartbreaking.”
With cases of the virus surging in most of the United States — driven by unvaccinated Americans and fueled by the highly contagious Delta variant — Covid-19 hospitalizations are climbing in other parts of the country, too, and hospitals are again bracing for another round of devastation.
And in Covid hot spots such as Florida and Missouri, where patients are quickly filling Covid units, experts warn a rise in deaths could soon follow.
Emergency personnel wear face masks to help prevent the spread of Covid-19 while leaving an hospital clinic emergency room on March 24, 2021, in Orlando, Florida. Parts of the state are now seeing a surge of patients

Younger, healthier patients are getting treated

In Texas County Memorial Hospital in Houston, Missouri, hospital leaders say half the number of Covid-19 deaths they’ve seen since the start of this year — eight in total — occurred over the past week.
A little more than 23% of the county’s population has received at least one Covid-19 vaccine dose, according to hospital spokesperson Helania Wulff. And the county, now labeled as “very high” risk, saw its positivity test rate jump from 9.5% last week to more than 30% this week, Wulff said.
Lauren Toman, the hospital’s director of respiratory care, said that while during previous surges patients tended to be older and have preexisting conditions, patients now are younger and healthier — but are coming in sicker and getting worse more quickly.
“They rapidly decline, very fast, and then even after intubation we’ll see them rapidly decline and unfortunately we are seeing people passing quicker than before,” Toman told CNN.
All the patients she has worked with in recent weeks have been unvaccinated, Toman said.
An hour and a half away, Erik Frederick, the chief administrative officer at Mercy Hospital Springfield, told CNN they’re seeing patient numbers accelerate “at a pace that’s almost unbelievable.”
The hospital went from 26 Covid-19 patients June 1 to more than 130 on Saturday — higher than ever before, including their winter surge.
“Last year, it took us from September 1 to our peak, on December 28, to go from 24 to 113 (patients),” Frederick said. “We eclipsed that this year in 39 days.”
There’s a “direct line,” he said, between the low vaccination rates the community has seen to the rise in cases and hospitalizations. Roughly 40% of residents in Missouri are fully vaccinated, according to state data, and some of the counties the hospital serves still haven’t hit the 20% mark, Frederick said.
Patients there have also trended younger. Roughly 91% of patients in the intensive care unit are on ventilators, and these include young patients, in their 20s, 30s and 40s, he said.
While Missouri is quickly emerging as a new Covid hot spot, health leaders in other parts of the United States are reporting similar patterns. Dr. Jeffrey Chapman, the chief medical officer at Wyoming’s Cheyenne Regional Medical Center, say the hospital’s increase in Covid-19 patients includes a younger demographic that is overwhelmingly unvaccinated and “deteriorating” faster.”
In Mississippi, where less than 34% of the population is fully vaccinated, the state’s top health officer warned the Delta variant surge has led to seven children being treated for Covid in state ICUs — including two on ventilators.
Virtually of all the cases in the state involved the Delta variant, Mississippi State Health Officer Dr. Thomas Dobbs said on Twitter, adding the “vast majority” of cases, hospitalizations and deaths were among unvaccinated Americans.

An increased risk for vaccinated Americans too

In Kansas, the University of Kansas Health System recorded several days with just two or three Covid-19 patients back in late May. Now, it’s treating more than three dozen patients, according to Dr. Steven Stites, the chief medical officer.
More than 80% of new patients are unvaccinated, though others have been vaccinated, he said.
“When you dig into those patients, what you see is that they’re all severely chronically ill patients,” he said. “Vaccination is not an entirely ‘Get out of Jail Free’ card. It makes things a lot better, but it doesn’t make it go away.”
Experts say that while vaccines are very effective, they’re not perfect — and Americans who have been fully vaccinated should still consider the levels of transmission and the type of environment they’ll be in when deciding whether to wear a mask. And the Centers for Disease Control and Prevention has said immunocompromised people or those who are chronically ill should consult with their physicians before shedding their masks.
“I’m a little nervous about the open society and people thinking everything is normal when it’s not and especially when you’re more chronically ill you still need to keep your mask on,” Stites said.
In Mississippi, Dobbs said on Twitter that 7% of the state’s Covid-19 deaths were in vaccinated people, calling that number “worrisome.”
“We are allowing too much circulating Delta to reach our most vulnerable,” he wrote.

‘Only way we’re going to stop this monster’

Hospital leaders say the latest surge in patients comes as staff are already exhausted and traumatized from a battle with the virus that has now lasted more than a year.
In Texas County, Toman said she worries they’re going to see a continued surge, fueled by July 4 festivities and the ongoing summer gatherings, that will “overwhelm every hospital in Missouri.”
“What I fear is, can we survive this again? Can we stay positive, can we all keep our morale up?” she said. “We’re trying hard to be there for each other but we’re tired and we’re scared.”
She said that while she understands the hesitations some community members may have about the vaccine, getting the state’s vaccination numbers higher will be “the only way we’re going to stop this monster.”
Segarra, in Miami, said he agrees.
“We haven’t made the progress that we wish in terms of treating Covid, we don’t have that magic bullet in terms of treating Covid, but boy, we’ve come pretty close to having that magic bullet to avoid it — and to see it not being used is very frustrating,” he said.
The country fell short of meeting President Joe Biden’s goal of at least partially vaccinating 70% of American adults by Independence Day earlier this month. More than a week later, about 67.7% of US adults have had at least one Covid-19 vaccine dose, and nearly 59% are fully vaccinated, according to CDC data.
“We’re dealing with a public health situation that’s beyond our personal needs, so we need to be a little bit more selfless as opposed to selfish,” Segarra said.
“So if you’re on the fence on whether you get vaccinated or not … think of the good that you’ll bring to your society, that you’ll bring to your community, because not only does the vaccine prevent you from getting sick, it prevents you from transmitting it to others.”

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Canada

Eurozone warning: Delta variant and surging cases could spark crisis – stark analysis

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A new survey by Reuters showed nearly nine out of 10 economists polled warned new Covid variants are the biggest risk to the eurozone, which they currently believe will grow by 4.5 percent in 2021. In addition, the latest coronavirus tracker from Reuters has revealed infections, while in most cases remaining below their historic highs, are rising in all but a handful of European countries. Oxford Economics has also collected data that shows the Delta variant now accounts for most new Covid cases in Britain, Portugal and Austria, and over 40 percent of infections in Germany, Spain and Denmark.

The researchers said the impact on the respected economies is hard to predict at the moment.

However, those countries with higher vaccination rates can take some comfort from the muted rise in hospitalisations and death rates in Britain and Israel.

Speaking in Parliament on Monday, the UK’s newly-appointed Health Secretary Sajid Javid confirmed all remaining restrictions in England will be lifted from next Monday, although he and Prime Minister Boris Johnson have urged the population to continue being cautious.

But in a huge warning from a research note from July 12, Oxford Economics said: “Nonetheless if economies reopen and allow cases to surge, the economic gains could prove illusory if Covid-related absences trigger major disruption to businesses and higher cases prompt greater voluntary social distancing.”

Governments throughout Europe are so far refusing a return to full lockdowns over fears of a repeat of the devastating economic impact and the possibility of denting the strong rebound in activity during the last quarter.

But in France, Emmanuel Macron has announced mandatory proof of vaccination or negative tests for some public spaces, coming days after Portugal, the Netherlands and some areas of Spain reintroduced restrictions.

The French President said all health workers in the country must get Covid jabs by September 15, adding vaccination would not be compulsory for the general public for now but stressed that restrictions would focus on those who are not vaccinated.

He said in a televised address to the nation: “We must go towards vaccination of all French people, it is the only way towards a normal life.”

READ MORE: You’re on your own, Emmanuel! Merkel breaks EU ranks with France

Officials in the country are adamant Covid measures should remain in place until more of the country has been vaccinated.

But German Economy Minister Peter Altmaier said a new lockdown would be “absolutely the worst thing and to be avoided at all costs”.

The Netherlands has cited the rising Delta variant as the reason for reintroducing strict measures for nightclubs, festivals and restaurants on Friday.

In Spain, the northern Catalonia region has cut bar opening hours and towns in nearby Valencia have been authorised to bring back curfews.

The whole of Europe is keeping a close eye on developments in England when restrictions are lifted from next Monday, with many officials regarding Boris Johnson’s reopening plan as extremely risky.

Workers will still have to self-isolate when notified by an official app – but that has consistently led to significant labour shortages in hospitality and other sectors.

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US

What the Delta variant’s trajectory in Israel and the UK could mean for the US

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But trends from Israel and the United Kingdom — where the variant became dominant a few weeks sooner than in the US — present hope for a less deadly and severe surge than others that have come before. And experts say that vaccination progress will be the most critical factor in preventing the worst outcomes.
In Israel, average daily cases are twice what they were in mid-April when the first cases of Delta were identified in the country. At that time, there were an average of five deaths each day in Israel. But despite the rise of the Delta variant — which now accounts for more than 90% of new cases in the country — average daily deaths have stayed consistently below that. In fact, Israel has had an average of less than two Covid-19 deaths per day since the last week of May, according to data from Johns Hopkins University.
In the United Kingdom, both cases and deaths are higher than they were when the Delta variant became the dominant strain in the country in mid-May, but cases have climbed exponentially faster than deaths. Average daily deaths in the UK are about twice what they were when the Delta variant became dominant, and cases are about 12 times what they were.
But trends in death due to Covid-19 lag a few weeks behind trends in cases, so the latest data on deaths should be closer in line with data on cases from a few weeks earlier. And even three weeks ago, average daily cases in the UK had multiplied more than the most recent daily deaths.
While both Israel and the UK foreshadow some optimism for Delta’s trajectory in the United States, experts say that Israel’s outcomes have been more overwhelmingly positive because of their substantial vaccination rate.
“In my mind, vaccines are the single most important factor” in the fight against the Delta variant, Becky Dutch, a virologist and chair of the University of Kentucky’s department of molecular and cellular biochemistry, told CNN.
When the first cases of the Delta variant were identified in Israel, about 56% of the population was already fully vaccinated, according to Our World in Data. But in the UK, only 2% of the population was fully vaccinated when the Delta variant was first identified there, only reaching 50% vaccination within the past week.
“There is reason to be moderately hopeful — with the caveat that the reason deaths and hospitalizations have not gone up as much is that there’s pretty high immunity from vaccination and natural infection in individuals most at risk,” Justin Lessler, a professor of epidemiology at the University of North Carolina, told CNN.
In a statement released Monday, the Israeli government said that its analysis has shown the Pfizer/BioNTech vaccine to provide 64% protection against infections caused by the Delta variant but 93% effective in preventing severe disease and hospitalizations, compared to research from May that reported it to be 97% effective.
“If we picked a flu vaccine that is effective as the current mRNA vaccines appear to be against Delta, we would be celebrating. They’re only slightly less good against Delta than the originally circulating strain,” Lessler said.
“The concern is places in the US that have not seen a lot of Covid and vaccination rates among the high-risk population is low.”
Overall, vaccination rates in the US fall somewhere between Israel and the UK. About 16% of the population was fully vaccinated when the first cases of Delta were identified in the US and about 48% are fully vaccinated now that the variant has become dominant.
And vaccination rates vary widely across the country. Less than a third of people in Alabama are fully vaccinated, compared to about two-thirds of people in Vermont, according to the latest data from the US Centers for Disease Control and Prevention.
“The US is a patchwork now,” Dutch said. “It depends on where you live. If you live in a place with high vaccination rates and you’re vaccinated yourself, I’m not overly concerned about you. But if you’re sitting in an area of the country with 35% of the population vaccinated and you’re not vaccinated, I’m much more concerned.”
And while there is some evidence that the virus may evade natural immunity from previous infections and slightly lower the efficacy of the vaccines, experts say these findings are something to pay attention to, they’re not something to panic about.
Instead, Lessler says the rise and spread of the Delta and Alpha variants are a “warning that the virus is going to continue to evolve and continue to — in that evolution — find ways around existing immunity,” but that the hope is that vaccines will “virtually eliminate severe disease” for quite some time.
Business

Spread of Delta variant casts shadow over Europe’s economic rebound

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The rapid spread of the Delta coronavirus variant is causing economists to worry that Europe’s brightening economic outlook risks being undermined by rising infection levels and the reintroduction of travel and social restrictions.

The lifting of most lockdown measures across the region in recent months has led to a surge in business activity, retail spending and household confidence, prompting many economists to upgrade their forecasts for European growth.

However, those assumptions are being thrown into doubt now that the highly infectious Delta variant already accounts for the majority of new cases in many European countries and is driving infection rates up to their highest level for months.

“I’m a bit more nervous that it could get derailed by Delta,” said Erik Nielsen, chief economist at UniCredit, which has raised its eurozone growth forecast for this year from 4 to 4.5 per cent. “It has to get quite bad before we get another lockdown, but Google mobility data shows that it is not so much the lockdowns that drive behaviour but voluntary restraint.”

On Friday, Germany and France warned their citizens against travel to Spain, where the coronavirus infection rate has surpassed Portugal to become the highest in mainland Europe, dealing a blow to its tourism sector at the start of the crucial summer season.

Pablo Hernández de Cos, governor of the Bank of Spain, said its forecasts for strong growth were “based on the assumption that the health crisis would be over after the summer” and that Spain’s tourism sector would achieve half its pre-pandemic income this summer, up from a fifth last year. He warned that there was still “uncertainty surrounding the emergence of new Covid-19 variants and the containment measures that these might necessitate”.

The Netherlands said on Friday it would reintroduce restrictions on restaurants, bars, cafés, nightclubs and live events — only two weeks after lifting them — because of a more than tenfold rise in the country’s daily infection rate to almost 7,000 in that period.

Cyprus also reintroduced rules on the number of people allowed at hospitality and entertainment venues last week after its daily coronavirus infection rate hit a high for the year. Meanwhile, Portugal said holidaymakers must be vaccinated, have a negative test or have recovered from the virus to stay in its hotels or eat inside restaurants in many areas.

The European Centre for Disease Prevention and Control said on Friday that the weekly Covid-19 infection rate for the EU and European Economic Area had risen to 51.6 per 100,000 people, up from 38.6 the previous week, while the hospitalisation and death rates were stable. It forecast the infection rate would exceed 90 per 100,000 people in four weeks.

“There are reasons to be concerned, as the risks are there and there seems to be negative momentum,” said Carsten Brzeski, head of macro research at ING. 

Last week, the European Commission raised its forecasts for EU growth in 2021 to 4.8 per cent, after a record contraction of 6.2 per cent last year. Its prediction would be the most rapid expansion seen since 1976 and would mean the EU’s economy regained its pre-pandemic level of output by the end of this year.

Paolo Gentiloni, the EU’s economics commissioner, said the EU’s forecasts did not factor in the prospect of a new wave triggered by the Delta variant, but this was a “downside risk”. He played down the likelihood of fresh lockdowns, saying: “We don’t see a tendency towards new restrictions . . . we see a tendency towards easing restrictions in important countries.”

Some economists take comfort from the fact that most Delta infections have been among younger people who are less likely to fall seriously ill. Hospitalisations and deaths from the virus remain very low, while more than 44 per cent of EU adults are fully vaccinated.

“Thanks to rapid vaccination progress, we still consider it unlikely that countries will again have to impose serious restrictions to economic activity to contain the medical risks,” said Kallum Pickering, economist at Berenberg.

The Spanish government argues that hospitalisation rates remain low — with only 2.6 per cent of beds occupied by Covid patients compared with 2 per cent a week ago — and that the infection rate is less significant than the rising share of fully vaccinated people.

Additional reporting by Daniel Dombey in Madrid and Sam Fleming in Brussels