Tag: COVID19

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Are we overcounting COVID-19 deaths?

In slightly more than 2 years, authorities have recorded 5.75 million COVID-19 deaths worldwide. Some people believe that this is an overestimate of the actual mortality from the disease. Others think COVID-19 has caused many more deaths than the official figures show. Medical News Today has looked at the evidence and spoken with experts to uncover the truth behind the numbers.

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What do the COVID-19 death counts mean? Image credit: Daniele Frediani/Archivio Daniele Frediani/Mondadori Portfolio via Getty Images.

As the COVID-19 pandemic enters its third year, there are reasons for optimism.

Firstly, vaccines are reducing the number of deaths, at least in those countries where vaccination is widely available.

Secondly, evidence is growing that the latest variant, Omicron, causes less severe disease than previous variants. One study in California has shown a significantly lower risk of death with Omicron than with Delta, although the paper has yet to undergo peer review.

However, the global death toll has been enormous, with official figures placing it at more than 5.75 million. Of these deaths, more than 900,000 have occurred in the United States.

Some people dispute these numbers, claiming that COVID-19 did not actually cause many of the deaths for which the authorities held it responsible. So how are these deaths being counted?

Most countries record every death and its cause, providing a permanent legal record. In the United Kingdom, the guidelines on how to complete the medical certificate of cause of death run to several pages.

The doctor who records the death must note the primary cause of death and any contributing factors on the death certificate. And therein lies the problem.

COVID-19 can lead to multiple problems — pneumonia, respiratory failure, blood clots, stroke, and heart attack — any of which might cause death. And most of those who die after contracting COVID-19 have one or more comorbidities.

So, how many people have died of COVID-19, and how many have died with COVID-19?

Consider the example of an 86-year-old man in a care home with late stage dementia and coronary artery disease (CAD). He contracts COVID-19 but has few symptoms. Then, he dies. What was the primary cause of death?

One doctor might record dementia as the primary cause, with CAD and COVID-19 as contributing factors. Another might decide that COVID-19 was the primary cause as, without contracting the SARS-CoV-2 virus, the man might have lived for a few more weeks with the other two conditions.

Dr. William Schaffner, professor of infectious diseases at the Vanderbilt University Medical Center in Nashville, TN, agreed that the actual cause of death can be hard to determine. “Deaths are, to a degree, imprecise,” he said to MNT. “A physician must make a judgment of cause of death.”

Whether the man died of COVID-19 or with COVID-19 is open to interpretation. And this is why some dispute the official figures.

The World Health Organization (WHO) defines a death from COVID-19 as “a death resulting from a clinically compatible illness in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID-19 disease, e.g., trauma.”

The U.S. attributes death to COVID-19 where this disease, or the coronavirus that causes it, appears as a cause or contributing cause of death on the death certificate.

The U.K. records any death that occurs within 28 days of a positive PCR test for SARS-CoV-2 as a COVID-19 death. The official U.K. COVID-19 death toll is now about 159,000.

However, a video that people have widely shared on social media has stated that the true number of COVID-19 deaths in the U.K. is 17,000 — just over one-tenth of the official number. This is the number of people for whom COVID-19 was the only recorded cause of death. Some people believe that this is the number that the government should publicize.

Similarly, in the U.S., CDC data showed that COVID-19 was the sole cause of only about 5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of listed COVID-19 deaths. These data led to the former U.S. president, Donald Trump, claiming on social media that the published figures were greatly exaggerating the severity of COVID-19.

When doctors determine that COVID-19 is not the sole cause of death, they record other causes on the death certificate. In the U.S., at least 90{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of such recorded deaths had COVID-19 as the underlying cause of death rather than a contributing cause.

So although we could say that all of these people died with COVID-19 and not of COVID-19, the disease almost certainly played a role in their deaths.

One way of avoiding this issue is to record excess deaths during the pandemic and attribute these to COVID-19, rather than looking at how many people had COVID-19 on their death certificate. However, this approach has its own problems.

Experts calculate the excess death rate by comparing figures for a given period with the average for that same period over several previous years. So, a person looking for excess deaths in January 2022 might compare the deaths in that month with the January average for, say, the past 10 years.

The problem with counting excess deaths, though, is that it does not take into account changes in populations. In many countries, populations are getting older.

In 2000, over-65s accounted for approximately 1 in 8 people in both Europe and the U.S. By 2020, more than one-fifth of Europeans were over the age of 65 years, and people in this age bracket made up one-seventh of the U.S. population. And these numbers are increasing rapidly.

As populations get older, more people die. So, comparing the death rates in 2021 with those from previous years might give a skewed perspective. Some of those excess deaths would have occurred without the pandemic.

In addition, deaths from some causes, such as infectious diseases, have decreased during the COVID-19 pandemic due to lockdowns and physical distancing. This will affect the excess deaths figure.

Despite misgivings from some quarters, most experts believe that COVID-19 deaths are not being overcounted. Indeed, many think that undercounting is more likely, particularly in the early months of the pandemic.

“Early on, there was not widespread testing, so we underestimated the deaths. Now, the death data are more reliable. There may be some plus or minus, but death data are pretty accurate.”

– Dr. William Schaffner

Dr. Arturo Casadevall, a distinguished professor and chair of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health in Baltimore, echoed this view.

“My view is that the current number of COVID-19 deaths is an undercounting simply because those deaths reflect the ones we know about, and not every death caused by this disease was recorded or diagnosed as such,” he told MNT.

Higher income countries record all deaths, noting the causes on the death certificate. This is not the case worldwide.

The problem of unrecorded deaths is particularly acute in low and middle income countries. When a death is unrecorded, only those who witness the death may know its cause.

In India, the WHO has recorded more than 500,000 deaths due to COVID-19, but household surveys and statistical models suggest that the number could be as much as 10 times higher. Without good data on deaths and births, the COVID-19 death toll can never be certain.

The true death toll of COVID-19 may not be known for many years. Many experts also believe that the final numbers should also include those who died not with COVID-19 but because of it.

“The number of deaths attributed to COVID-19 does not include other deaths associated with the pandemic, such as those caused by the absence of proper care for other conditions because the healthcare system was focused on COVID-19, and much routine care such as cancer screening was slowed or postponed.”

– Dr. Arturo Casadevall

While the pandemic continues, it will be difficult to get a true figure for global deaths. “Death data are a lagging indicator. They are pretty reliable, but it takes longer for people to die and the data to be collected,” Dr. Schaffner cautioned.

However long it takes for the true figures to emerge, the COVID-19 pandemic has inflicted, and continues to inflict, an appalling global death toll. And it is becoming clear that the figures are almost certainly underreported, as Dr. Casadevall explained:

“I think that in coming years, we will see revisions to this number with higher estimates of total deaths as we come to better understand the toll of this calamity.”

For live updates on the latest developments regarding COVID-19, click here.

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COVID-19 news for Toronto, Ontario on Feb. 10

The latest coronavirus news from Canada and around the world Thursday. This file will be updated throughout the day. Web links to longer stories if available.

7:05 p.m. British Columbia health officials are reporting five new deaths due to COVID-19 bringing the total fatalities in the province to 2,730, reports The Canadian Press.

A news release Thursday says the province reported 1,318 new cases of the virus, although officials have said this number is likely much higher, because B.C. has reached its testing capacity, according to CP.

Officials say they will no longer provide the number of active cases or those who are out of isolation.

They say the number of people in hospital with COVID-19 is 867, a drop from 985 last Thursday, while 138 people are in intensive care.

They say 90.4 per cent of those eligible aged 12 and older have had two shots of a vaccine, while 51.1 per cent of those have also had a booster dose.

Provincial health officer, Dr. Bonnie Henry, has said all regulated health workers including dentists, pharmacists, doctors and chiropractors will be required to have their first shot of a COVID-19 vaccine by March 24 and the second dose within 35 days.

5:45 p.m. The Ontario government says it has successfully petitioned a court to freeze access to millions of dollars donated through online fundraising platform GiveSendGo to the truckers convoy protesting COVID-19 restrictions in Ottawa and at several border crossings, reports The Canadian Press.

A spokeswoman for Premier Doug Ford says Ontario’s attorney general brought the application to the Superior Court of Justice seeking an order that would prohibit anyone from distributing donations made through the website’s “Freedom Convoy 2022” and “Adopt-a-Trucker” campaign pages, according to CP.

Spokeswoman Ivana Yelich says an order binding “any and all parties with possession or control over these donations” was issued today.

Hundreds of semi-trucks rolled into downtown Ottawa two weeks ago to protest COVID-19 vaccine mandates and health restrictions and now trucks are also blockading border crossings in Alberta, Manitoba and Ontario.

Donors initially raised more than $10 million through GoFundMe, which announced last Friday it was pulling the plug on the campaign and that the money would be refunded.

Convoy organizers quickly set up a new campaign on Christian fundraising site GiveSendGo, which had raised US$8.2 million by today.

4:44 p.m. Quebec’s opposition parties are accusing the government of taking too long to give up COVID-19 emergency powers and they say the delay is helping Premier François Legault and his ministers avoid scrutiny, reports The Canadian Press.

Earlier this week, the government renewed the state of emergency. Legault told reporters the emergency order would only be lifted once a bill is passed allowing the government to keep some powers, such as the ability to impose the vaccine passport system and mask mandates, according to CP.

Opposition parties, however, say the government should end the state of emergency and have a debate in the legislature about what measures should remain.

Liberal health critic Monsef Derraji said the government uses ministerial decrees too often.

“It’s the wrong way to govern,” Derraji said in an interview Thursday.

Health Minister Christian Dubé has said he would introduce a bill in March to lift the state of emergency, but he has also said it would be up to the opposition as to whether the legislation passes before June.

Derraji said he’s concerned the state of emergency won’t be lifted in time to ensure the government is held to account on its pandemic spending before Quebecers head to the polls.

Quebec reported 35 more deaths linked to COVID-19 on Thursday and 36 fewer hospitalizations.

The Health Department said there were 2,312 COVID-19 hospitalizations, after 193 people were admitted to hospital in the past 24 hours and 229 people were discharged. It said 173 people were in intensive care, an increase of two from the day before.

4:34 p.m. The Ontario government says it has successfully petitioned a court to freeze access to millions of dollars in donations to the truckers convoy that were raised through online platform GiveSendGo, reports The Canadian Press.

A spokeswoman for Premier Doug Ford says Ontario’s attorney general brought the application to the Superior Court of Justice and an order binding “any and all parties with possession or control over these donations” was issued today, according to CP.

4 p.m. An Ontario Superior Court justice has delayed hearing an application for an injunction that would stop protesters blocking Canada-bound traffic at the Ambassador Bridge border crossing in Windsor.

Chief Justice Geoffrey Morawetz says he understands that the matter is urgent, but the application is “serious in nature” and the defendants should be given the chance to make their case.

He also granted the City of Windsor intervener status in the injunction application, which was brought by the Automotive Parts Manufacturers’ Association.

Morawetz says he will hear submissions tomorrow at noon.

The mayor of Windsor, Ont., says the situation at the Ambassador Bridge is an occupation and it must end.

Dilkens also says anyone who may wish to join the protest is not welcome in his city.

3:55 p.m. Ontario’s top doctor says he’s reviewing timelines for Ontario’s reopening plan and all other COVID-19 measures now that a massive wave of Omicron variant cases is receding, reports The Canadian Press.

Dr. Kieran Moore says the Omicron wave has peaked and it’s time to focus on resuming other activities in the health system and society at large, according to CP.

Now that hospitalizations, intensive care admissions and other virus indicators are improving, the province is lifting a directive that paused all surgeries deemed non-urgent and is allowing them to resume gradually.

Moore says dates for further lifting restrictions on businesses and social gatherings, set to happen in stages on Feb. 21 and March. 14, could be reviewed next week.

He says he’s reviewing the timelines for ending all public health measures including mask rules and proof-of-vaccination requirements and says he will make recommendations to government as early as next week.

His comments came a day after the Ontario’s health minister said the province wasn’t considering lifting mask rules or its vaccine passport system affecting businesses, as some other Canadian provinces have begun to do.

3:15 p.m. Health officials in New Brunswick are reporting another three deaths from COVID-19 in the province today, and this increases the toll to 278 since the start of the pandemic, reports The Canadian Press.

The latest deaths involve two people in the Saint John region, one in their 40s and the other over 90, and a person over 90 in the Fredericton area, according to CP.

There are 140 people hospitalized as a result of COVID-19, up one from Wednesday.

That includes one person in intensive care and eight people on ventilators.

There are 321 healthcare workers who are isolating after testing positive for COVID-19.

Provincial data shows 85.7 per cent of eligible New Brunswickers five and older have received two doses of COVID-19 vaccine and 47 per cent have had booster shots.

2:47 p.m. Health officials in Newfoundland and Labrador say there are now 25 people in hospital due to COVID-19, which matches the previous high in the province, reports The Canadian Press.

It’s the second time the province has seen this many pandemic-related hospitalizations; the first was less than two weeks ago on Feb. 1, according to CP.

A government news release today says eight of the hospitalized patients are in intensive care.

Officials are reporting 243 new cases of COVID-19, with 18 per cent of tests completed in the previous 24 hours yielding a positive result.

There are 1,588 active reported cases in the province, although the figure does not include those who may have contracted the disease, but did not qualify for a test to confirm their infection.

Federal data shows Newfoundland and Labrador continues to have the highest COVID-19 vaccination rate in the country, as 95 per cent of eligible residents have had at least one shot as of Jan. 30.

2:19 p.m. Health officials in Prince Edward Island are reporting seven people in hospital due to COVID-19. This is unchanged from Wednesday, reports The Canadian Press.

Chief public health officer, Dr. Heather Morrison, says that number includes one person in intensive care, according to CP.

She says there are five others in hospital who were admitted for non-COVID-19 reasons and have tested positive for the disease.

Morrison is reporting 210 new cases of COVID-19 today, along with 220 recoveries.

There are 1,982 active reported COVID-19 infections in the province.

Six long-term care facilities have outbreaks, and 21 early learning and child-care centres have reported cases or outbreaks.

1:54 p.m. Crowdfunding site GoFundMe will speak to members of Parliament about what measures it has in place to prevent the funding of extremism.

NDP MP Alistair MacGregor announced today representatives from the site have accepted a request to appear before the House of Commons standing committee on public safety and national security.

MacGregor brought forward the motion and says they will appear March 3.

It comes as a protest against vaccine mandates and COVID-19 health restrictions drags on well into its second week on Parliament Hill, clogging up surrounding streets.

Read the full story here on the Star.

1:20 p.m. A high school in southeast Manitoba is in “hold and secure” mode due to a protest against COVID-19 restrictions outside.

Steinbach Regional Secondary School says students will remain in classes with their teachers, while exterior doors are locked except for students and staff.

The local school division says RCMP are on scene at the school.

1:15 p.m. Ottawa’s public school board says it has reached out to local police about the potential for protesters to drive past schools today.

Protesters mused online about driving past schools after snarling traffic around the national capital’s airport earlier today.

The Ottawa-Carleton District School Board is calling the idea unacceptable, adding that the safety of students and staff shouldn’t be threatened.

So far, the board says there are no reports of concerning activity.

The board’s statement on Twitter says staff will make safety a top priority.

It adds that students and staff will shelter in place if there is reason for concern about school safety.

1:03 p.m. The Bank of Montreal is projecting that the Ambassador Bridge shutdown could start to cut into Canada’s first quarter GDP growth if the protests continue.

Each day they blockade the Ambassador Bridge, protesters are choking off a $400-million lifeline for the North American economy. They may already, experts say, have caused Canada “incalculable” long-term economic damage.

Everything from car parts and appliances to fruits and vegetables was sitting in long lines of tractor trailers on both sides of the Windsor-Detroit crossing Tuesday, snarled up behind protesters who say they’re against COVID-19 vaccine mandates.

Read here for more on the Ambassador Bridge blockade from the Star’s Jacob Lorinc.

12 p.m. RioCan Real Estate Investment Trust is “pruning” its tenant mix to ensure malls and other retail spaces it owns are filled with resilient businesses that are best positioned to weather any further COVID-19 upheaval.

Chief executive Jonathan Gitlin said Thursday that the Toronto-based commercial landlord’s close look at who is renting its spaces will result in the company shedding some assets in enclosed malls, “which are harder to evolve into today’s current demands from our tenants.”

“Within the properties that we are keeping, there is a tenant mix that in order to stay relevant and in order to stay on top of consumer trends, needs to continuously evolve and change,” he said on a call with analysts.

“We are switching over to more necessity-based purveyors and in some cases, it might not be tenants with amazing covenants, but they just have some great uses that will add to…the flavour of the shopping centre.”

11:45 a.m. Michigan’s governor is calling on Canadian authorities to end the protests at two busy border crossings

Gov. Gretchen Whitmer says the blockade at the Ambassador Bridge connecting Windsor and Detroit, and the Blue Water Bridge in Sarnia, Ont. is threatening her state’s economy.

She says local, provincial and federal governments in Canada must de-escalate what she calls an economic blockade.

Whitmer is calling on Canadian authorities to “take all necessary and appropriate steps” to immediately reopen all lanes of traffic.

11:37 a.m. After racking up debt through years of ultralow interest rates, Canadians are being urged to modify their spending as they face the prospect of rising borrowing costs coupled with soaring inflation.

“Recalibrate your spending completely, recalibrate how you’re living your life,” advises Laurie Campbell, director, client financial wellness at debt relief specialist Bromwich and Smith.

Like going on a diet, she says managing money while under stress requires lifestyle changes to avoid going back to old habits.

Campbell suggests people closely examine their whole financial situation and make a serious effort to reduce debt as much as possible even though the lifting of lockdowns will likely spur a desire to go out and spend.

11:25 a.m. Interim Conservative leader Candice Bergen is calling on protesters to take down the blockades of border crossings.

Speaking in the House of Commons, Bergen says the time has come for them to stop the disruptive action that is causing economic harm.

She says farmers, manufacturers, small businesses and families are suffering because of the border blockades.

Bergen adds that she doesn’t believe that is what the protesters want to do.

Bergen also says the protesters’ anti-vaccine-mandate message has been heard and is pledging her party’s support to that end.

Bergen made the comments today at the start of debate on a Conservative motion calling on the government for a plan for ending COVID-19 restrictions.

11 a.m. Manitoba RCMP say a protest has shut down the province’s main border crossing with the United States.

Mounties say a large number of vehicles and farm equipment is blocking the Emerson port of entry, located about 100 km south of Winnipeg.

They say no traffic is getting through in either direction and people should avoid the area.

A protest over COVID-19 public health measures also continues outside the Manitoba legislature in Winnipeg.

10:53 a.m. General Motors’ assembly plants in Ontario and Michigan have curbed production due to the Ambassador Bridge blockades. GM Oshawa cut workers’ hours yesterday, as did the Lansing Delta plant.

10:32 a.m. Ottawa police say nearly two dozen trucks have left the city. Police say a dozen trucks left a parking lot outside the city’s core after negotiations with protesters who have used the area as a staging and logistics ground.

Police say 10 more trucks have also left downtown, and another vehicle was towed for obstructing traffic.

They are also repeating their request that remaining protesters leave the city after almost two weeks of being encamped in the national capital.

Read the full story here on the Star.

10:16 a.m. Ontario reporting 1,897 people are hospitalized with COVID-19, 445 people are in ICU.

56 per cent were admitted to the hospital for COVID-19 and 44 per cent were admitted for other reasons but have tested positive for COVID-19; 76 per cent of patients admitted to the ICU were admitted for COVID-19 and 24 per cent were admitted for other reasons but have tested positive for COVID-19, according to Health Minister Christine Elliott.

In Ontario, 31,153,087 vaccine doses have been administered. 92.1 per cent of Ontarians 12+ have one dose and 89.6 per cent have two doses.

10:10 a.m. Ontario’s expert science advisers say rapid antigen tests don’t detect COVID-19 infections with the Omicron variant as reliably as they did with the Delta strain, but changing the way the tests are performed can boost their sensitivity.

The science advisory table says in a brief today that the rapid tests, which involve nasal swabs, are less sensitive for Omicron, especially in the first one or two days after infection.

But, they say the tests are better at detecting Omicron if people swab both cheeks, followed by the back of the tongue or throat, then both nostrils.

9:58 a.m. A new poll suggests almost 30 per cent of Canadians believe it’s time to lift pandemic restrictions and “learn to live” with the COVID-19 virus, while more than 40 per cent want measures to ease carefully.

Forty-three per cent of Canadians surveyed by Leger identified their feelings about the current state of the pandemic as “prudent” — the most popular answer of four options — saying they did not want to lift restrictions too quickly.

But 29 per cent said they were ready to move on, selecting the answer that said they were “adequately vaccinated” and viewed the Omicron variant as “less serious.”

9:45 a.m. Inflation soared over the past year at its highest rate in four decades, hammering America’s consumers, wiping out pay raises and reinforcing the Federal Reserve’s decision to begin raising borrowing rates across the economy.

The Labor Department said Thursday that consumer prices jumped 7.5 per cent last month compared with 12 months earlier, the steepest year-over-year increase since February 1982. The acceleration of prices ranged across the economy, from food and energy to apartment rents and electricity.

When measured from December to January, inflation was 0.6 per cent, the same as the previous month and more than economists had expected. Prices had risen 0.7 per cent from October to November and 0.9 per cent from September to October.

9:30 a.m. Spaniards removed their facemasks or stuffed them into their pockets for the first time in nearly two months after the country’s outdoor mask mandate was lifted Thursday. Italians face a similar treat Friday.

Both countries have high vaccination rates, declining infection numbers and lower hospitalization figures than during previous surges of the coronavirus. Sara de la Rubia, a 45-year-old nurse in Madrid, said dropping the masks will be a moment to test the effectiveness of vaccines.

“There has to be a moment in which we have to normalize things, start to (have) a normal life, to test how things work,” she said.

After peaking in January, Spain’s contagion rate has been dropping for two weeks, alleviating pressure on hospitals and encouraging authorities to relax some of the measures adopted in mid-December against the fast-spreading omicron variant of the coronavirus.

9:16 a.m. A protest against COVID-19 measures is preventing Canada-bound traffic from crossing the Ambassador Bridge for yet another day.

Police say those using the border bridge to cross into the U.S. can expect significant delays and are telling all motorists to avoid both access points to the span due to the ongoing demonstration.

The protest on the Canadian side of the bridge has prevented Canada-bound traffic from crossing since the demonstration began Monday.

8:57 a.m. Africa is moving to the “control phase” of the COVID-19 pandemic and increased vaccination rates will be crucial in helping the continent live with the disease, the World Health Organization’s Africa director Matshidiso Moeti said Thursday.

“Although COVID-19 will be with us for the long term, there is light at the end of the tunnel,” Moeti said. “This year we can end the disruption and destruction the virus has left in its path, and gain back control over our lives.”

Africa is heading toward “what might become a kind of endemic, living with the virus … I believe that we are transitioning from the pandemic phase and we will now need to manage the presence of this virus,” she said, addressing reporters at a virtual media briefing.

8:33 a.m. French President Emmanuel Macron said last month he wanted to “p- off” the unvaccinated. He appears to have succeeded.

Protesters against the country’s vaccine mandates aim to use their vehicles to block roads in Paris beginning Friday to show their anger over the restrictions.

The Paris police issued an order banning the demonstration from Friday to Monday, citing the risk of “disturbing the public order.” The protesters, some of whom say they were inspired by the “freedom convoys” in Canada, plan to continue on to Brussels on Monday. Rudi Vervoort, head of the Brussels Capital regional government, said in a statement that the district was also banning the convoy.

8:15 a.m. Toyota’s three Ontario auto plants will stop production for the rest of the week due to the Ambassador Bridge blockade. That’s at least six auto plants shut down or reducing production over the protests.

8:05 a.m. As provinces begin lifting COVID-19 pandemic restrictions, psychology experts expect stress and anxiety to run high among those who remain wary of letting their guards down.

It will take time for many to adjust, they say, but the quick approach some provinces are taking could make the transition more jarring.

Alberta ended its vaccine certificate system on Wednesday, days before its mask requirements for students is set to drop, while Saskatchewan plans to do away with its vaccine mandate on Monday. Other provinces, including Ontario, have taken a more gradual approach to dismantling COVID-19 measures.

Steve Joordens, a psychology professor at the University of Toronto, said it’s natural for people to feel conflicted as restrictions ease.

Though many are tired of the mandates aimed at slowing the spread of the virus, there’s still some underlying fear.

“In the back of our mind there’s this niggling anxiety of: are we doing this too soon?” Joordens said. “Are we going to end up getting our butts kicked again (by a new variant)? And given all the division we’re seeing right now, could this make things worse?”

7:50 a.m. Britain’s Prince Charles has tested positive for COVID-19 and is self-isolating, his office said Thursday.

A message on the royal’s official Twitter page said Charles tested positive on Thursday morning and was “deeply disappointed” not to be able to attend a scheduled visit in Winchester, England.

No other details were immediately available.

Charles, 73, met dozens of people during a Wednesday evening reception at the British Museum.

7:30 a.m. Pope Francis’ first foreign trip of the year is to the Mediterranean island nation of Malta, the Vatican said Tuesday in announcing an April 2-3 trip that had originally been scheduled for 2020 but was postponed because of the pandemic.

Francis, 85, will visit the main island cities of Valletta, Rabat and Floriana as well as the island of Gozo. Further details were to be released later.

Migration is expected to be a theme of Francis’ visit, given Malta has been a flashpoint in Europe’s longstanding migration debate.

6:55 a.m. All extracurricular activities can return to Ontario schools starting immediately — meaning high-contact sports such as hockey and basketball that have been sidelined will be given the go-ahead, as will choirs and wind instruments for music, the Star has learned.

As Ontario continues to slowly ease COVID-19 restrictions while the Omicron surge slows, the province’s chief medical officer of health will announce the new measures for schools at his Thursday news conference.

The move will allow elementary and secondary school athletes to play without masks, but wear them when they are back at the bench, sources told the Star.

Read the full story from the Star’s Kristin Rushowy

6:30 a.m. After two years of living with kids in periodic virtual learning and a partner who is an essential worker, Annette Power was “in desperate need of a vacation.”

She was ready to spend March break visiting her mother in Barbados with her two children, but the trip was cancelled.

The family came down with Omicron during the winter break, delaying the vaccination appointment dates for her kids.

Read the full story from the Star’s Clarrie Feinstein

6:14 a.m. The Toronto Zoo is reopening Thursday, 10 days after most restrictions eased in the province.

Zoo management said, in a statement posted on Facebook, the delay is “to work on some exciting new elements” being added to the facility.

Patrons will have to show their vaccine certificates with QR codes, along with a piece of ID, to enter the zoo, the statement added.

Read the full story from the Star’s Akrit Michael

5:40 a.m. Coronavirus cases continue to rise rapidly in Tonga, and tests have confirmed that the particularly contagious omicron variant is behind the isolated Pacific island nation’s first community outbreak since the start of the pandemic, officials said Thursday.

Health Minister Saia Piukala told reporters that 31 more people had tested positive for the virus, nearly doubling Tonga’s active cases for the second day in a row to a total of 64, the online Matangi Tonga news portal and other media reported.

While the number may seem small, the nation of 105,000 had managed to escape thus far without any infections aside from a single case brought in from a missionary returning to Tonga from Africa last October, which was successfully isolated.

5:37 a.m. Casting the spreading “Freedom Convoy” protests as a grave threat to Canada, the federal government is settling into a back-seat role in the crisis, offering to send police reinforcements to the local officials leading the responses.

Federal ministers outlined the seriousness of the blockades that have now spread across the country, with blockades against COVID-19 health measures choking off key border crossings and threatening jobs, public safety and millions of dollars in trade.

At the same time, police in Ottawa sent their toughest warning yet to protesters occupying the streets of the capital: clear out or face the prospect of arrest.

Read the full story from the Star’s Raisa Patel

5:36 a.m. As countries in Europe and other provinces in Canada begin lifting COVID restrictions, some Ontarians may be wondering why they still have to live with them.

Unlike in Alberta, Saskatchewan and some U.S. states and European countries, there are no immediate plans to do away with mask or vaccine mandates in Ontario, Health Minister Christine Elliott said at a press conference Wednesday.

This is despite Ontario’s COVID situation looking bright, according to Dr. Peter Jüni, scientific director of Ontario’s COVID-19 science table. Though it’s hard to gauge the true presence of COVID in the province, as the speed with which Omicron spread became too much for our testing infrastructure, techniques like wastewater surveillance seem to show Ontario is on the other side of Omicron’s peak.

Read the full story from the Star’s Ben Cohen

5:27 a.m. A teachers’ strike has paralyzed learning at many Zimbabwean schools, which opened this week after a prolonged closure due to the COVID-19 pandemic.

In Harare, some schools managed to open Thursday while at others a few teachers reported for work but did not teach, according to unions. The government denounced the strike as “unwarranted conduct” that is depriving children of their right to education.

Many teachers decided to stay at home to protest salaries of about $100 a month. They are demanding that their pay be increased to about $500 per month.

In 2018, teachers earned the equivalent of about $540 a month but that amount has been eroded by years of inflation, currently estimated at 60{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, and the devaluation of Zimbabwe’s currency.

4 a.m. Dr. Kieran Moore’s weekly COVID-19 news conference comes a day after the province’s health minister said Ontario will keep its mask mandate and vaccine certificate system in place.

Christine Elliott said Ontario won’t follow the lead of other provinces that have already begun lifting proof-of-vaccination rules and intend to end masking rules soon. She didn’t say when those policies would end, but said the province expects mask rules will remain in place for “some time.”

Moore’s news conference also comes after the province began making rapid test kits available for free at grocery stores, pharmacies and other sites. Elliott said expanding access to the tests is part of Ontario’s plan to roll back COVID-19 restrictions in stages.

Thursday 4 a.m. The NDP is calling on the U.S. ambassador to testify before the House of Commons foreign affairs committee, saying American funding of the nearly two-week-long anti-vaccine mandate protest in Ottawa is an attack on Canada’s democracy.

A significant amount of the more than $10 million in donations to the demonstration came from U.S. donors.

The Commons committee meets today and would need unanimous consent of all parties to issue an invitation to Ambassador David Cohen.

Protesters have been warned by police that if they continue blocking streets they could be charged with mischief to property, have their vehicles and other property seized and possibly forfeited, and that charges or convictions may lead to them being barred from travelling to the United States.

The declaration from police comes after municipal officials in Ottawa spoke with the federal government to find solutions to end the protest that has sparked solidarity rallies, some of which have blocked traffic at border crossings in Coutts, Alta., and the busy Windsor-Detroit Ambassador Bridge crossing.

Emergency Preparedness Minister Bill Blair says Ottawa residents have been subjected to “acts of thuggery and disrespect” by demonstrators, and the government is working to ensure Ottawa police have the “resources that they need to enforce the law to restore public order and to bring this unlawful protest to an end.’’

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Press Briefing by White House COVID-19 Response Team and Public Health Officials

Via Teleconference

11:06 A.M. EST

MR. ZIENTS:  Good morning, and thanks for joining us.  Today, we’ll start with an update from Dr. Walensky on the state of the pandemic and CDC’s COVID-19 surveillance efforts.

Dr. Walensky.

DR. WALENSKY:  Good morning.  Thanks, Jeff.  I’d like to start by walking you through today’s data. 

The current seven-day daily average of cases is about 247,300 cases per day, a decrease of about 44 percent over the previous week. 

The seven-day average of hospital admissions is about 13,000 per day, a decrease of about 25 percent over the previous period.

And the seven-day average of daily deaths are at about 2,400 a day, which is an increase of about 3 percent over the prior week. 

This week, we reached a tragic new mark of 900,000 deaths in this country from COVID-19. 

Each week, I share with you the burden of disease in the United States, including case counts, hospital admissions, and the number of deaths.  Much of the data I readily share is because we have made huge strides in our ability to effectively monitor this virus, and new tools allow us to prepare and react to an evolving virus and inform response measures in near real time. 

Today, I’d like to walk you through just a few of the layers of surveillance we have in place, some that we have been expanding and developing over the past two years and others that are bedrocks of our public health work. 

Let’s start at the local community level where our biggest question is: Can we quickly identify spikes in cases?  As people with COVID-19 shed the virus, testing in wastewater or our sewage systems can help us monitor COVID-19 in communities and provide an early warning of increased COVID-19 cases to help communities prepare. 

Last week, CDC publicly released national wastewater surveillance data, tracking more than 400 testing sites across the country in 212 communities, which we will double to more than 800 testing sites in the next four weeks. 

On this map, you can see the testing sites that we monitor and trends in the levels of the virus.  Communities in blue have decreasing levels of virus, while communities in red and orange have increasing levels. 

This is a powerful tool that, when paired with traditional public health surveillance, can help us identify where the disease is spreading and how best to distribute resources. 

We’ve also made significant progress in syndromic surveillance, defined by the ability to identify symptoms and cases that are suggestive of COVID-19 disease.  Through syndromic surveillance, we can answer questions about disease severity and patient populations with the highest burdens of disease — crucial information to inform guidance and prevention measures. 

More than 6,000 healthcare facilities across the country, representing over 70 percent of emergency departments, contribute data to our syndromic surveillance and help us understand where and how the virus is having an impact. 

In addition to monitoring where the virus is and how disease presents in the community, our genomic surveillance can quickly identify variants so that we can understand their impact.  Each week, CDC analyzes genomic sequences from all 50 states and uses these sequences to understand the spread of variants across the country. 

On this slide, you can see the projections of variant proportions for the last 14 weeks.  Omicron, shown in pink and purple, now represents nearly 100 percent of viruses circulating in the United States. 

Our cohort studies and state-level surveillance data provide detailed and regular reports of how our vaccines are working in the real world among diverse populations, giving us faster and better data to know that our vaccines are working against new and emerging variants. 

You’ve heard me discuss many of these platforms before, like our hospital surveillance through CDC’s COVID-NET and IVY; our collaboration with seven integrated healthcare and public health research centers through VISION; surveillance of infection is essential in frontline workers in HEROES-RECOVER; and our nationwide surveillance of vaccine effectiveness in children and young adults in overcoming COVID-19. 

Taken together, these studies provide us an in-depth and comprehensive understanding of how vaccines are working with participations in sites nationwide. 

And importantly, COVID-19 vaccines are being administered under the most intensive vaccine safety monitoring effort in the United States’ history. 

Our nationwide vaccine safety networks — such as V-safe, which provides personalized and confidential health check-ins via text message — and other systems — such as VAERS, the Clinical Immunization Safety project, and the Vaccine Safety Datalink — empower us with the data of any rare side effects or reactions after vaccination or boosting.

This is a huge amount of data.  CDC — along with our partners across government; state and local jurisdictions; academia; and healthcare — has cast a wide and comprehensive net over the country to follow the virus and its impacts in real time. 

And we will continue these data as our guiding — using these data as our guiding source as we look to what comes next.

I know there will come a time when we move from a phase of crisis to a point where COVID-19 is not disrupting our daily lives.  And as we all look forward to this next step, I want to instill in everyone that moving forward from this pandemic will be a process that’s led by our surveillance and our data. 

I’m confident that CDC and our public health partners are well positioned to lead the way. 

Thank you.  And now, with that, I will turn things back over to you, Jeff. 

MR. ZIENTS:  Thanks, Dr. Walensky. 

Now, let’s move to booster shots.  We know that there are a number of different ways to view progress on boosters, depending on which data set you’re looking at.

For example, some people assess boosters as a proportion of all adults who are fully vaccinated, while others look at the total U.S. adult population, even though not every adult is eligible for a booster shot yet.

So, before I turn to Dr. Fauci on the effectiveness of booster shots, I want to review how we assess the available data and use the best available data to measure the progress we’re making on getting people booster shots.

CDC data aggregated from state health departments shows that more than 90 million booster shots have been administered.  We know that that is likely undercounted as some people reported their booster as a first shot and others forgot their vaccination card altogether.

States have been matching data and have encountered some challenges across different channels, which has led to delayed reporting for booster shots in many states.

CDC is working with states to address these issues to improve the data.

At the same time, CDC conducts a weekly survey, which is a nationally representative survey of over 16,000 adults.  Looking at the CDC survey results, you get a more up-to-date picture of the progress we are making on boosters.

Based on the latest CDC survey, we estimate over two thirds  of all eligible adults and over 80 percent of all eligible seniors — those most at risk  and most vulnerable — have received a booster shot.

CDC’s survey results are consistent with the Kaiser Family Foundation survey which shows 70 percent of eligible adults report they’ve gotten a booster.

So, we have a strong foundation to build on, with most eligible adults boosted.

In fact, we estimate at least two out of three adult — eligible adults in the U.S. are now boosted — two out of three eligible adult Americans with a booster shot.

And across the last two months, we’ve made important strides on equity, with the majority of booster shots going to people of color, in a very improvement from the prior two months.

The significant progress we made on boosters is one of the reasons why we were able to confront Omicron with fewer disruptions to schools and businesses than in prior surges.  And we clearly need to keep driving this progress.

So , our message is clear: All eligible individuals should get their booster shot right away.  Booster shots are free.  They’re available at 90,000 convenient locations across the country and, as Dr. Fauci will discuss, critical to getting people the highest level of protection.

With that, over to you, Dr. Fauci.

DR. FAUCI:  Thank you very much, Jeff.  What I’m going to do now over the next couple of minutes is to just build on what Jeff said and talk to you, based on real data, why it is so critically important to get booster shots.

I’m going to talk about laboratory data, clinical trial data, and real-world data.

Next slide.

So there are multiple — and I can’t show them all — in vitro studies that show that COVID-19 vaccine booster doses markedly increase the neutralization of variants, including what we’re dealing with currently, namely Omicron.

Next slide.

This is the slide that shows the genomic mean titer of antibody, namely the proteins that neutralize the virus.  If you look at the far left-hand side of the slide, seven months after people receive a second dose and before the booster, look how low the response is to Omicron, which is the bar that has the red circles.  It’s 23.

One month after the booster, it goes way up into the highly protective zone of 850.  And even six months after the booster, it is still at a high level of 136 — way above what it was seven months after the second dose.  So, that’s representative laboratory data.

Next slide.

Now, a randomized controlled clinical trial showed the dramatic impact of the booster dose in preventing symptomatic disease.  And the data are really striking.  I’ll show you one clip of that on the next slide.

As you can see in red are individuals who’ve gotten two doses — it says placebo, but it’s two doses — without the booster.  And this is a  Pfizer study, but it really holds true with other products like Moderna.

If you look at the result in blue of the cumulative incidence of COVID-19 following a booster shot, the difference is dramatic.

Next slide.

Now we’ll move to real-world effectiveness studies showing that booster doses reconstitute the waning protection, especially against severe disease, hospitalization, and deaths.

So, next slide.

So, here, we look at individuals less than six months after the second dose.  And on the  far left, you see when you’re dealing with Delta, it’s 90; when you’re dealing with Omicron, it’s 81.  But more than six months after the second dose, it wanes with Omicron to 57, holding up a bit better with Delta.

But after the third dose, you get protection at 90 percent with Omicron, which  is even better than after six months after the second dose.  Again, another example of the critical importance of boosting.

Next slide.

Here is another way of looking at it.  When you look at symptomatic disease and hospitalizations, again, when you’re dealing with Omicron, on the far left, the protection against symptomatic disease is quite low at week 25, following two doses.  If you look at the boost, it goes up substantially to 40 percent. 

But the critical data are on the right-hand part of the slide.  If you look at hospitalizations and look at two doses of the Pfizer BioNTech either at 2 to 4 weeks or 10 to 14 weeks, it’s still way up there at 75 percent.

Next slide. 

And again, if you look at CDC data, which shows a dramatic reduction in the risk of hospitalization and death for people who’ve received a booster dose, we can see that on the next slide. 

And this is a summary of data: If you compare a fully vaccinated person with one who has received a booster shot, and look at the monthly rate of COVID-19 associated hospitalizations during a timeframe of December 2021, there was a 45-fold higher likelihood of an unvaccinated person in the age range of 50 to 64, and a 51-fold higher likelihood of an unvaccinated age 65 and older of being hospitalized when you compare it to an individual with a boost.

Next slide.

When you look at death rate, again, the data are really rather striking.  If you look at unvaccinated in red and look at the death rate per 100,000 compared to a fully vaccinated person who’s not been boosted — showing you why vaccinations even without boosts are important.  But look what the booster does: It brings back the death rate per 100,000 to a remarkably low level. 

So, we can only come to one conclusion on the last slide: that  COVID-19 vaccines, booster shots can keep you out of the hospital and certainly can save your life.

Back to you, Jeff.

MR. ZIENTS:  Thanks, Dr. Fauci. 

Before we open for questions, I want to highlight how far we’ve come in our fight against COVID.

Last week, we learned the U.S. economy created 6.6 million new jobs in the President’s first year in office.  That’s the best 12 months of job creation in our nation’s history. 

Notably, this includes 467,000 jobs created in January and 510,000 in December.  Those were the two months when we were at the height of the Omicron surge.

The first time we faced a similar threat from COVID back in April of 2020, we lost around 20 million jobs in one month.  Even as we face the extremely transmissible Omicron variant and saw a record number of cases, businesses stayed open and our economy kept growing stronger.  That’s because we’re in such a different position today in terms of our ability to manage this virus. 

We have over 210 million people fully vaccinated and vaccines freely available.  And we have more tools like boosters, treatments, masks, and tests that give us additional layers of protection. 

Today, fully vaccinated and boosted Americans are able to keep living their lives safely, even when this virus throws us a curveball.  And we’re able to keep our kids in school and keep our businesses open.

As the President said on Friday, January was a tough month for this country, but we got through it together.  Over the past three weeks, daily cases are down over 65 percent; hospital admissions are down 40 percent.

The President’s COVID plan is working.  We’re moving toward a time when COVID won’t disrupt our daily lives, a time when COVID won’t be a constant crisis but rather will be something we can protect against and treat. 

With that, let’s open it up for a few questions.  Over to you, Kevin.

MODERATOR:  Thanks, Jeff.  We’ve got a lot of questions today.  So, let’s actually try to keep it to one question. 

First, let’s go to Zeke Miller at the AP. 

Q    Thanks.  In the last week, we’ve seen a number of Democratic-led — -run states move back towards normalcy, removing mask mandates.  New York is expected to follow today.  We saw Connecticut, other states lift mask requirements in schools. 

You’ve talked a lot about leading — the President trying to lead the nation out of the pandemic, but right now, the federal response seems to be following what a lot of states are doing.  Is the White House planning for emerging — bringing the country out of the pandemic?  And what would that plan look like?

MR. ZIENTS:  Well, thanks for the question.  So while cases and hospitalizations, as Dr. Walensky showed, are trending downward, we do remain focused on fighting the Omicron surge.  So, that’s priority number one. 

The President, as I just mentioned, has been clear that we’re moving toward a time when COVID won’t disrupt our daily lives, a time when COVID won’t be a constant crisis so we’re no longer fearing lockdowns and shutdowns, but getting back to safely doing what we all love.  In doing so, we will rely on the powerful set of tools that have been built: the vaccines, the booster shots, treatments, and testing. 

For the last several weeks, we’ve been working closely with Secretary Becerra, our team of doctors.  And the White House COVID Response Team under the President’s leadership is reaching out to governors and outside public health experts and doctors and local public health officials on steps we should be taking to keep the country moving forward. 

We know that in different areas of the country, cases have fallen more significantly, and this will lead to different approaches and different timing.  And we will continue to coordinate closely with state and local leaders. 

Next question.

MODERATOR:  Let’s go to Sabrina Siddiqui at the Wall Street Journal.

Q    Thank you so much.  This is a question for Dr.  Walensky.  I just want to follow up on current guidance around masks, because, you know, the last CDC recommendation was that there should be indoor masking in public settings where transmission is substantial or high.  According to CDC data, that appears to still be the entire country — the case in the entire country where community transmission is high.  So is that still the recommendation?

And furthermore, you’ve also recommended that there be universal masking in schools.  Is that — is that a recommendation you stand by as states are also moving to drop — or to lift mask mandates for teachers and students in schools?

MR. ZIENTS:  Dr. Walensky?

DR. WALENSKY:  Yeah, thank you, Sabrina.  So we certainly understand the need and desire to be flexible, and we want to ensure the public health guidance that we’re providing meets the moment that we’re in.

As we’ve discussed and as you noted, cases and hospitalizations are falling.  This is, of course, encouraging.  And that leads us, of course, to have us look at all of our guidance based on the latest data and the science and what we know about the virus. 

We also look, of course, as Jeff mentioned, to our hospitalizations, looking at the hospitals as a barometer of how they’re doing locally so those decisions can be made at the local level. 

And, of course, we at CDC will keep the public informed about our guidance, and we will clearly communicate those recommendations to the public if and when they are updated.

Thank you.

MR. ZIENTS:  Next question, please.

MODERATOR:  We’ll go to Cheyenne Haslett at ABC News.

Q    Hi, thank you.  Dr. Walensky, you mentioned the specific benchmarks on hospitalization that you’re looking to for when it will be a good time to change some of this guidance for unmasking, both in schools and generally in public for adults.  What exactly will that benchmark be?

DR. WALENSKY:  Right.  So, Cheyenne, we — you know, in part of our review of the surveillance, we look at wastewater, we look at cases, we look at hospitalizations — we’ve been reporting hospitalizations — we look at deaths.  And, of course, those decisions are made at the local level.

But at this time, we continue to recommend masking in areas of high and substantial transmission — that’s much of the country right now — in public indoor settings.  And so we’re, of course, taking a close look at this in real-time, and we’re evaluating rates of transmission as well as rates of severe outcomes as we look at updating and reviewing our guidance.

MR. ZIENTS:  Next question, please.

MODERATOR:  We’ll go to Victoria Knight at Kaiser Health News.

Q    Thanks so much for taking my question.  So, I’ve been talking to people who are immunocompromised, people who are disabled, living with chronic illnesses, and they’re all telling me that they’re feeling like they are being left behind, especially in light of a lot of states lifting their mask mandates, and they’re feeling like their needs are not being considered moving forward after Omicron.  So what is your message to them?  What do you expect them to do?  Do they need to just stay in their houses?  What is your message to people like that?

MR. ZIENTS:  Dr. Walensky?

DR. WALENSKY:  Right.  So this is among the considerations that we take into account as we work on all of our recommendations.  We, of course, have to make recommendations that are, you know, relevant for New York City and rural Montana.  We have to make recommendations that are met — relevant for the public, but also for the public who is immunocompromised and disabled.  And so, that — all of those considerations are taken into account as we work on our guidance. 

MR. ZIENTS:  Next question, please. 

MODERATOR:  Let’s go to Kaitlan Collins at CNN.

Q    Thanks so much.  Dr. Walensky, you just said that you do continue to recommend masking indoors in areas of high transmission, and that you said that that’s most of the country right now.  So are you seeing any data that supports the decisions of these governors to drop mandates?  And when it comes to masking, should people be listening to the CDC or listening to their governors?

DR. WALENSKY:  Kaitlan, we’ve always said that these decisions are going to have to be made at the local level and that policies at the local level will look at local cases, they’ll look at how local hospitals are doing, they’ll look at local vaccination rates.

And they, as I understand it, in many of these decisions are using a phased approach.  Not all of these decisions are being made to stop things tomorrow, but they’re looking at a phased approach.

And so, what I would say is: Again, they have to be done at the local level.  But I’m really encouraged that cases are continuing to drop dramatically, hospitalizations are continuing to drop dramatically as people are making these decisions and as we are working on our guidance.

So I’m encouraged to see those trends.

MR. ZIENTS:  Next question, please.

MODERATOR:  Let’s go to Sheryl Stolberg at the New York Times. 

MR. ZIENTS:  Sheryl?

Q    Can you hear me?

MR. ZIENTS:  Now we can, yes.

Q    Sorry about that.  Thank you for taking this question — it’s for Dr. Walensky.  Dr. Walensky, the states have been asking explicitly, governors have been asking explicitly for guidance from the CDC on mask-wearing and how to relax mitigation numbers. 

Is the CDC prepared to provide guidance to the governors?  And when will it do so?

DR. WALENSKY:  Sheryl, thank you.  And I’ll simply go back to: Yes, we are prepared.  We are working on that guidance.  We are working on, you know, following the trends for the moment. 

What I will say though is, you know, our hospitalizations are still high, our death rates are still high.  So, as we work towards that and as we are encouraged by the current trends, we are not there yet.

MR. ZIENTS:  Next question, please.

MODERATOR:  Let’s go to Kristen Welker at NBC.

Q    Hi, everyone.  Thanks so much for doing this call.  I know that you have spoken in the past about the fact that we could be moving closer to having a vaccine for children under the age of five.  And obviously, when you look at some of the polling, it’s potentially concerning: Just 3 in 10 parents of children under the age of five say that they’ll get their child vaccinated. 

Can you update us on your latest efforts once those vaccines are approved to reach those parents who are still skeptical?  What should they know?  And why should they have confidence in the vaccines once they are approved?  What will your messaging be, and what are your latest outreach efforts?

MR. ZIENTS:  Well, Dr. Fauci, maybe you can do a minute or two on the under-five vaccine status.  And then I’ll talk some about both the operational issues and the — answering questions and building confidence work. 

Dr. Fauci.

DR. FAUCI:  Yeah.  Thank you, Jeff. 

Yes, the data from the trials on children from 6 months to 24 months, as well as those from 21 months to — up to the end of 4 years have been conducted by the pharmaceutical company, in this case, Pfizer. 

The data have been submitted to the FDA, and the FDA VRBPAC, or their advisory committee, will be meeting on February 15th.  I think people need to be assured that any decision that the FDA makes, as is historically always the case with them, will really be based on the scientific data of both safety and efficacy.  And we can assure you that the decision will be based on that. 

And if, in fact, approved, it will be approved on the fact that the data show clear efficacy and safety. 

So, I’ll go back to you, Jeff, for the rest of that question.

MR. ZIENTS:  Thanks, Dr. Fauci.  So, operationally, we will be ready once FDA and CDC make their recommendations.  As we talked about last week, this vaccine is specifically formulated for these young kids.  So, we’re launching a new program specially for kids under five.

The planning process is well underway.  CDC is working with states to help them prepare.  We’ve secured enough vaccine supply for all kids in this age group — all 18 million.  We have enough needles, syringes, and kits.  And these are all specially formulated, are made for this age group to send alongside the vaccine.

And we’re working closely, you know, with pediatricians and family doctors and children’s hospitals and pharmacies to make sure the vaccine is available at thousands of locations across the country — locations that parents know and trust. 

We can start packing and shipping the vaccine once FDA makes its decision.  So, we will be prepared for those parents that are eager to get their kids vaccinated. 

I think the second part of your question is — there are parents that are — that do have questions, and we need to answer those questions.  And we’ve learned through our efforts across the last year that the best messengers are local messengers — local community groups and leaders, doctors, and other health practitioners. 

So, we are working closely with HHS to line up that group and make sure that they have the materials that they need, the training they need to be able to answer the questions that parents have about getting their kids vaccinated. 

Next question, please.

MODERATOR:  Last question.  Let’s go to Josh Wingrove of Bloomberg.

Q    Hi there.  Thank you very much.  Dr. Fauci, can you talk a little bit more about what you think the data show now of the need for a shot beyond the third dose, beyond a booster?

As you know, boosters are being given as early as five months — we are approaching five months now — some of the — first folks who got it.

What do we know about how often or if further shots will be needed going forward, and in particular, whether we might need specific types of shots for any variant?  Thank you.

DR. FAUCI:  Yeah.  Yeah, thank you for that question.  That’s obviously an issue that have been followed very closely.  Because as I’ve said in answer to questions on previous press conferences — similar questions — is that you follow individuals for a period of time after the third dose and you measure a number of phenomenon.  You measure laboratory phenomenon, but you measure the real-world data on the efficacy in preventing, for example, hospital visits, as well as hospitalizations.

And I believe that you’re going to be hearing data about that as they — data become available.  And that should not be within a very long period of time. 

I think you should be appreciative of the fact that when you’re talking about any decisions that will be made — and I’m not anticipating any of that now — but that has to be put into the context of whom you’re talking about.

For example, there may be the need for yet again another boost — in this case, a fourth-dose boost for an individual receiving the mRNA — that could be based on age, as well as underlying conditions. 

So, I don’t think you’re going to be hearing, if you do, any kind of recommendations that would be across the board for everyone.  It very likely will take into account what subset of people have a diminished, or not, protection against the important parameters such as hospitalization.

MR. ZIENTS:  Thank you, everybody.  We look forward to the next briefing. 

11:37 A.M. EST

To view the COVID Press Briefing slides, visit: https://www.whitehouse.gov/wp-content/uploads/2022/02/COVID-Press-Briefing-2.9.22-clean.pdf

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Toyota braces for still more production cuts amid COVID-19 outbreak in Japan

TOKYO – Toyota Motor Corp., reeling from COVID-19 outbreaks in Japan, has prolonged production suspensions in the home current market, lopping off 65,000 units from its January output.

The country’s major automaker introduced the most recent slowdowns on Monday, just times immediately after asserting common interruptions due to the fact of the pandemic and world wide microchip lack.

On the additionally aspect, the widening COVID-similar slowdowns in January will preserve factors that can be applied in February. That will empower Toyota to keep a lot more strains open in February and support it offset generation cutbacks it had previously predicted for following month.

It remains unclear to what extent the most up-to-date wave of infections has impacted output at other companies’ vegetation in Japan.

Toyota’s latest January suspensions hit 19 traces at 11 vegetation in Japan, out of a overall of 28 traces in 14 vegetation. Impacted automobiles incorporate the Toyota Yaris, Corolla, Prius, Camry, C-HR and Land Cruiser, as properly as the Lexus LC, LS IS, RC, NX and LX. A variety of domestic-industry vans are also impacted.

Toyota said the stoppages strengthen the blow to 65,000 cars dropped from Japanese output in January, which include prior suspensions for January introduced previous month and previous 7 days.

The setback will make it complicated to attain Toyota’s earlier mentioned global output purpose of 800,000 units in January, Toyota spokeswoman Shiori Hashimoto mentioned.

Of the 65,000 units missing in Japan in January, about 45,000 units will be dropped because of to COVID-19 interruptions, she said. The rest are similar to the continuing semiconductor scarcity.

Just very last week, Toyota warned it would skip its worldwide generation concentrate on for the fiscal yr as the carmaker capitulates to the double whammy of sections shortages and the pandemic.

Toyota explained final 7 days it expects worldwide production to occur in below the 9 million-vehicle goal for the fiscal 12 months ending March 31. It was the next time this fiscal year that Toyota dialed down its companywide creation determine.

The warning arrived as Toyota claimed the international semiconductor shortage would force the carmaker to slash worldwide output by 150,000 units in February to about 700,000 autos.

Toyota blamed for the February downturn firmly on the ongoing microchip disaster.

Toyota started off the present-day fiscal year concentrating on 9.3 million autos in the 12 months ending March 31. And the company mostly confounded the industry by boosting output and notching record gains inspite of the pandemic-microchip broadside. But above past summer season, Toyota at last succumbed to the international slowdown and joined rivals in pulling again generation.

Last fall, it sounded an optimistic observe indicating that in December all 14 plants and 28 creation lines in Japan would be “operating normally” for the very first time considering that May perhaps.

But very last 7 days, Toyota stated February suspensions would hit 11 traces at 8 crops in the house market. Now, nevertheless, because parts will now be freed up by the January COVID-19 suspensions, Toyota says it will want to suspend functions next thirty day period at only seven strains in 6 vegetation.

That will deliver output again on-line for these nameplates as the Toyota Corolla, Prius and Camry, in addition to the Lexus LS, IS, RC and specified NX types.

Toyota had previously stated world wide output would get to 800,000 models in December and 800,000 in January. But it hasn’t announced formal generation final results for people months nevertheless.

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How does COVID-19 affect the brain?

Healthcare workers in PPE having a discussionShare on Pinterest
A recent article in the journal Science outlines what we know about the neurological consequences of SARS-CoV-2 infection. NICOLAS TUCAT/AFP via Getty Images
  • Neurologic complications from COVID-19 are common and can range from decreased mental clarity to stroke.
  • A recent perspective article outlines what we know about these complications so far.
  • The authors explain how prior assumptions that the virus directly affected brain cells have been disproven.
  • Instead, nervous system injury is likely a result of severe inflammation and neurovascular injury.
  • Neurologic insults from SARS-CoV-2 infection could increase the incidence and severity of neurodegenerative diseases, such as Alzheimer’s and Parkinson’s disease, in future generations.

Early in the pandemic, researchers observed that people recovering from COVID-19 were not returning to their pre-illness state of health — this is now commonly known as “Long COVID.”

Among the myriad persistent symptoms, many people experience headaches, memory issues, and cognitive deterioration.

Researchers from Northwestern University in Chicago, IL, were the first to report that even non-hospitalized people with COVID-19 demonstrated significant cognitive dysfunction that persisted well beyond 6 weeks from the acute infection.

In the journal Science, Dr. Serena Spudich and Dr. Avindra Nath review our current understanding of the neurologic consequences of COVID-19.

Building on clinical observations, autopsy, and laboratory findings, the authors propose theories of causality about how COVID-19 may result in long-term neurologic symptoms.

Neurologic complications of COVID-19 include:

  • loss of smell (anosmia)
  • stroke
  • delirium — a mental state characterized by an inability to rest, illusions, and incoherent thought and speech patterns
  • encephalopathy — a temporary or permanent state of altered brain function
  • psychiatric symptoms
  • peripheral neuropathy — a condition where nerve damage alters the communication between the central nervous system and the rest of the body

The authors acknowledge that the mechanisms by which COVID-19 can wreak havoc on the human nervous system are not well understood.

Cerebrovascular complications, such as a stroke, can occur early in the infection — even before the respiratory effects of the disease. Central inflammatory conditions and peripheral nerve symptoms occur later, typically 2 weeks after the acute infection.

These disparate timelines suggest that the cause of these neurologic symptoms may differ. Studying the cerebrospinal fluid (CSF) offers clues as to underlying mechanisms for neurologic damage in people with COVID-19.

CSF is a fluid that surrounds the spinal cord and brain.

Scientists have observed increases in certain immune-related compounds in the CSF, including:

  • Interleukin-1 (IL-1) and IL-2 proteins, which are inflammatory cytokines produced by the body.
  • Expression of genes controlled by interferon, an infection-fighting protein present during viral infections.
  • Activated T-cells and natural killer cells, which combat viral antigens.
  • Markers that indicate the presence of monocytes — large white cells that fight infection.
  • Breakdown proteins suggesting nerve damage.

Conversely, researchers have not found evidence that the SARS-CoV-2 virus directly impacts the nervous system. For instance, research has shown that the following factors are reduced or absent in people with a SARS-CoV-2 infection:

  • Cells that cause inflammation are not found clustered around the brain, which normally occurs in cases of viral encephalitis — a swelling of the brain.
  • The CNS does not contain viral RNA.
  • Limited presence of SARS-CoV-2 nucleic acid or viral protein in the brain cells of people who died from COVID-19.

When asked about the lack of virus in the CSF and brain cells, Dr. Santosh Kensari, chair, and professor of translational neurosciences and neurotherapeutics at St. Johns’ Cancer Institute in Santa Monica, CA, commented:

“If the virus isn’t there, it’s not directly [causing] the problem — that would be encephalitis — but the viruses can cause systemic problems, like the inflammation that [can] affect every organ system, including the brain — its an indirect effect.”

Adding and subtracting the positive and negative findings helped the authors of the perspective article to formulate a theory regarding the cause of nervous system consequences of SARS-CoV-2 infection.

They do not rule out that the virus may transiently infect the brain very early in infection. However, the authors ultimately conclude that inflammation and widespread vascular dysfunction may be the vector of neurologic damage in people with COVID-19.

Compared with people with influenza, individuals with COVID-19 exhibit an increased risk of stroke. When scientists studied the blood of people who experienced a stroke, they found elevated blood markers of vascular inflammation, tissue death, and thrombosis, which are clots that obstruct blood flow.

Radiologic testing also provides evidence of injury in people who experienced COVID-19. MRIs confirm microvascular damage and brain atrophy, or shrinkage. Positron emission tomography confirms decreased metabolic activity in the brains of people diagnosed with Long COVID.

This evidence, coupled with the system-wide vascular dysfunction seen in people with severe COVID-19, points to vascular injury as a potential cause of stroke, brain, and nerve injury.

The authors conclude that SARS-CoV-2 is absent and markers of inflammation and vascular dysfunction are increased in the brains of people with COVID-19. So, the effects of COVID-19 are likely the result of an intersection of disease-causing mechanisms:

  • Generalized neuroinflammation supported by the presence of immune cells, cytokines, antibodies, and activated microglia, which are specialized neuron damage-fighting cells.
  • Damage to the cells lining the brain’s blood vessels (endothelium).
  • Elevated levels of blood-clotting proteins.
  • Individual susceptibility, including genetics, preexisting health conditions, and immune strength.

For MNT, Dr. Santosh Kensari addressed why some people might be more susceptible to neuropsychiatric complications from COVID-19 infection.

“I don’t think we know fully, but I suspect it is a variety of factors,” he explained. He believes these probably include the severity of COVID-19 and other cardiovascular risk factors, such as type 2 diabetes.

“My philosophy in medicine has completely changed. For example, inflammation is probably 90{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of aging. Cancer, dementia, all are due to immune function. COVID-19 is making all these things worse because it is driving inflammation.”

– Dr. Santosh Kensari

While laboratory and radiologic evidence support their theories, there is only conjecture on the exact mechanisms at this time.

The authors note that people living with Long COVID may have long lasting immune activation, persistent autoimmune disturbance, or ongoing damage to the endothelium.

Medical experts around the world are worried about the long-term prognosis for people recovering from COVID-19.

From a neurologic standpoint, Dr. Spudich and Dr. Nath are concerned that the neuroinflammation and neuronal injury caused by acute SARS-CoV-2 infection may “accelerate or trigger future development of neurodegenerative diseases, such as Alzheimer’s or Parkinson’s disease.”

And they feel that the neurodevelopmental influences of SARS-CoV-2 infection on children remain unknown.

For MNT, Dr. Santosh Kensari added:

“Chronic inflammation has many causes, including diabetes, obesity, and nutrition. These are a predisposition to autoimmune disorders, and they cause and accelerate the risk of brain-related disorders.”

Given the number of individuals who have experienced COVID-19, the researchers note that the neurologic consequences of COVID-19 represent a global public health problem.

In response to this challenge, the National Institute of Health has established a COVID-19 NeuroDataBank and NeuroBioBank to allow doctors to report and quantify neurologic events from COVID-19.

Drs. Spudich and Nath recommend that rigorous study and interventional trials are needed to dissect why some patients have an acute neurologic illness and others develop chronic disease late in their illness. They propose that understanding the immune dysregulation in individuals with Long COVID holds promise for treatment and long-term management.

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COVID-19 human challenge trial: First results are in

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The results of a United Kingdom-based human challenge trial offer new insights into COVID-19. Dominika Zarzycka/NurPhoto via Getty Images
  • In just-published results, a COVID-19 human challenge trial conducted in the United Kingdom has given unique insights into the progress of SARS-CoV-2 infection.
  • The mean time between exposure to SARS-CoV-2 and development of first COVID-19 symptoms is much shorter than previously thought.
  • Viral load peaked at 5 days after exposure, but active virus was still detectable in some people after 12 days.
  • Peak levels were highest in the nose, reinforcing the importance of wearing a face covering over both nose and mouth.

Imperial College London (ICL) has announced the results of the first COVID-19 human challenge trial. A human challenge trial is a carefully controlled study in which researchers deliberately infect participants with a pathogen to study the effects of that infection.

Prof. Christopher Chiu of ICL led this trial, which researchers carried out in a unit at the Royal Free Hospital in London. The results have not yet undergone peer review and appear on the preprint server Research Square.

Participants in the trial were young, healthy people who had not received a COVID-19 vaccination or had a previous SARS-CoV-2 infection. All those included were 18–30 years old.

Researchers gave all 36 participants a low dose of the original variant of SARS-CoV-2 as a droplet into the nose. They then monitored them for 14 days.

Half of the participants developed a SARS-CoV-2 infection. Two of these participants were asymptomatic. The remaining 16 developed mild symptoms, including a runny nose, sneezing, and sore throat. Some also reported tiredness, headache, slight fever, and muscle aches.

Half of those in the trial did not develop COVID-19 following exposure to SARS-CoV-2. No participants developed serious symptoms.

None of those who acquired an infection developed lung changes, but 12 people experienced anosmia — a loss of sense of smell. All but three people fully regained their sense of smell within 3 months. Researchers continued monitoring participants for 12 months.

This SARS-CoV-2 human challenge trial has revealed new information about the course of the infection.

People develop COVID-19 soon after exposure to SARS-CoV-2. On average, participants who got COVID-19 tested positive for the active virus after only 42 hours. This is contrary to the previous belief that people develop symptoms 5–6 days after exposure. CDC advice has been to test 5 days after suspected contact with SARS-CoV-2.

Viral load increased rapidly following infection, peaking at 5 days after exposure. Those who got the infection still had high levels of active virus 10 days, and some had active virus 12 days following inoculation.

During the course of infection, the virus moved. At around 40 hours after exposure, people had the highest amount of active virus in their throats. The viral load then became higher in the nose.

An important finding of the trial was that lateral flow tests (LFTs) were a good indicator of whether a person has viable virus, even in those without symptoms of COVID-19.

The trial’s insights into the course of SARS-CoV-2 infections could help with the management of COVID-19.

“Our study reveals some very interesting clinical insights, particularly around the short incubation period of the virus, extremely high viral shedding from the nose, as well as the utility of lateral flow tests, with potential implications for public health.”

– Prof. Christopher Chiu, chief investigator on the trial

LFTs can detect even asymptomatic infection with SARS-CoV-2. However, they are less effective at detecting low levels of the virus in only the nose.

People should therefore swab the throat as well as the nose if performing an LFT soon after suspected exposure.

“[O]verall, lateral flow tests correlate very well with the presence of infectious virus,” says Prof. Chiu. “Even though in the first day or two they may be less sensitive, if you use them correctly and repeatedly, and act on them if they read positive, this will have a major impact on interrupting viral spread.”

The researchers found the highest levels of virus in the nose, so they advise that there is a greater risk of viral shedding from the nose. They stress the importance of wearing face coverings correctly to cover the nose and the mouth.

People should also isolate if they contract the infection, as most still have active virus 9 days after exposure to SARS-CoV-2.

“This innovative, careful and ethical human challenge study provides new insights into the brief incubation period of COVID-19 virus infections, helping to explain how the virus is so extraordinarily contagious. The utility of rapid tests in diagnosing infection was confirmed, as well as the importance of mask-wearing as a means of curtailing transmission.”

– Dr. William Schaffner, professor of infectious diseases at the Vanderbilt University Medical Center, Nashville, TN, speaking to MNT

Researchers performed this trial using an early variant of the virus from before the Alpha variant was detected. Investigators are keen to continue human challenge trials using later variants, including Delta.

Dr. Schaffner would like to see further trials. “The study used an early COVID-19 virus strain, and we look forward to results of further studies of the Omicron variant, which [is now] the dominant virus strain worldwide,” he said.

In this trial, only 50{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of those exposed to SARS-CoV-2 contracted the infection. The researchers now plan to investigate why some people appear to be resistant to SARS-CoV-2 infection.

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