Status report on corona

COVID-19 Updates - December 21, COVID-19 Situation Report Editor: Alyson Browett, MPH Contributors: Clint Haines, MS; Natasha Kaushal, MSPH; Amanda Kobokovich, MPH; Christina Potter, MSPH; Matthew Shearer, MPH; Marc Trotochaud, MSPH; and, Rachel A. Vahey, MHS. RISE OF OMICRON The Omicron variant of difficulty (VOC) has end up the predominant variant throughout North America and Europe, while the relaxation of the world braces for the eventual takeover. The WHO introduced on December 18 that 89 nations have now stated Omicron inside their borders, with excessive probability that instances are in many different international locations however have absolutely no longer but been confirmed. While the Delta VOC before overtook different circulating variations to come to be the predominant SARS-CoV-2 variant, Omicron’s upward thrust in these areas came about precipitously, inside 1 month after it was once first mentioned in South Africa on November 24. While preliminary information out of South Africa indicated that contamination with the Omicron variant was once much less possibly to lead to hospitalization, the sheer quantity of instances ensuing from the fantastically transmissible variant show up to be inflicting vast healthcare stress and societal disruption. In the US, Omicron now money owed for 73.2% of the complete wide variety of SARS-CoV-2 infections, in contrast to 1 week in the past when it accounted for solely 12.6% of all infections. As of December 20, forty eight states, Puerto Rico, and Washington, DC, have stated instances of Omicron; South Dakota and Oklahoma have but to record cases. This fast enlarge in Omicron instances has startled public fitness officials. With instances presently doubling each and every 1.5 to three days, healthcare services are bracing for a surge in hospitalizations, with some areas already experiencing these challenges. In the Northeast, the place instances are presently surging, states like Rhode Island and Maine are reporting that their hospitals are being strained to their limits. As neighborhood participants are seeking for scientific care in excessive numbers, healthcare workforce are additionally checking out high quality for SARS-CoV-2, similarly exacerbating the pressure on resources. Some states are activating their National Guards to help bolster medical, testing, and vaccination efforts. With trying out traces wrapping round metropolis blocks and excursion journey shortly approaching, public fitness officers are urging all who are capable to get wholly vaccinated and obtain their booster shots. US President Joe Biden is set to tackle the state tonight and is anticipated to announce plans to furnish free exams and extra useful resource for hospitals. Outside of the US, different international locations are dealing with the equal challenges with the brought difficulties of decrease vaccination prices due to reduced get entry to and supply. While most world leaders appear hesitant to provoke lockdowns akin to the preliminary March 2020 responses, many are imposing restrictions in an effort to gradual the entry of Omicron into their nations. Israel has banned journey to North America and many European countries, whilst Asia Pacific island countries are shifting to shut their borders to global vacationers or at least amplify surveillance and quarantine measures for inbound travelers. In many European nations the place Omicron is already spreading at excessive rates, some leaders are thinking about enforcing stricter measures beforehand of the vacation season. In the UK, Prime Minister Boris Johnson referred to he is thinking about a variety of measures, such as lockdowns, as COVID-related hospitalizations rise. Regardless of strategy, all international locations are making an attempt to speed up their vaccination packages to stop a fall down of their healthcare systems. VACCINE EFFICACY As the Omicron variant of problem (VOC) continues to hastily unfold round the world, preliminary facts all of the vaccines show up to grant safety towards extreme disease, but most of the SARS-CoV-2 vaccines used international can also provide little protection in opposition to contamination from the enormously contagious variant. According to a not-yet-peer-reviewed evaluation from Imperial College London, Omicron can generally keep away from vaccine-induced immunity or immunity from a previous infection, with the threat of reinfection estimated to be 5.4 instances increased than that with the Delta VOC. The researchers estimated that vaccine effectiveness (for AstraZeneca-Oxford and Pfizer-BioNTech vaccines) towards symptomatic Omicron contamination is between 0% and 20% after two doses and between 55% and 80% after a booster dose. Preliminary laboratory effects from Moderna launched this week in a press launch confirmed a 50 μg booster dose—the equal method approved as a booster with the aid of the US FDA—produced a 37-fold make bigger in neutralizing antibodies in contrast with the major 2-dose series, whilst a full a hundred μg dose booster produced an 83-fold enlarge over two doses. The full dose had barely extra facet consequences than the half of dose. Pfizer-BioNTech in the past this month introduced a booster dose of their vaccine additionally helped extend neutralizing antibodies towards Omicron. All of the research are preliminary and do no longer take into account the full spectrum of the human immune response. Still, some specialists are pronouncing that a 3-dose vaccination agenda will be integral and some proof indicates the time between a 2d and 0.33 dose can be shortened from 6 months to three months. Several countries—such as South Korea, UK, Thailand, Belgium, France, Singapore, Taiwan, Italy, and Australia—have diminished the required wait time between doses to between three and 5 months to put together for the arrival of Omicron. Others—including the US, South Africa, and Germany—are sticking to a 6-month schedule. Though there is some subject that shortening the hole may want to compromise immune response to vaccinations, others say a 6-month interval is arbitrary and urge booster doses faster to counter waning antibody levels. Many uncertainties stay about how pre-existing immunity, whether or not from vaccination or preceding infection, will assist at some point of contamination with Omicron, and some proof suggests Omicron-specific vaccine boosters will be necessary. While many higher-income international locations are centered on vaccinating, and boosting, their populations, solely 8% of the populations in low-income nations have acquired at least 1 dose of vaccine. It is vital that the global neighborhood no longer lose focal point on world dreams pertaining to vaccine get right of entry to and administration. OMICRON SEVERITY An preliminary find out about (unpublished) on the severity of the SARS-CoV-2 Omicron variant of issue (VOC) carried out in South Africa suggests that adults are about 30% much less in all likelihood to be hospitalized due to extreme COVID-19 now than all through the Delta surge. Health professionals from the vicinity additionally declare that hospitalized sufferers are much less probable to give up up on ventilators or require intensive care, on average, than for the duration of preceding surges of COVID-19. However, scientists and public fitness officers have been speedy to factor out that the moderate reactions to Omicron in South Africa may additionally no longer be considered in Europe and the US. A giant share of the South African populace is young, via comparison, and many already have some immunity to SARS-CoV-2 due to prior contamination at some point of preceding surges or vaccination. This immunity is believed to be a distinguished issue riding the decreased sickness severity determined in South Africa. In the US, researchers from the Covid-19 Modeling Consortium at the University of Texas at Austin seemed at 18 specific situations for Omicron, warning that underneath the most pessimistic model, “Omicron ought to lead to the biggest healthcare surge to date, until measures are taken to sluggish spread.” The facts have now not but been peer-reviewed. As such, issues over medical institution ability are rising, as many humans are predicted to tour and spend time with household throughout the excursion season, growing the threat of transmission of the fantastically contagious VOC. US states such as New York and New Jersey are already reporting excessive hospitalization charges and an expanded demand for testing. The US Department of Health and Human Services (HHS) reviews that greater than 76% of ICU beds are presently in use, with 21% of these beds being used for COVID-19 patients. Additionally, Regeneron and Eli Lilly are warning that their antibody redress for COVID-19 may be much less amazing in opposition to Omicron. The US pronounced its first Omicron-related loss of life on December 20. The UK presents an unsettling achievable lens into the future for the US. The UK Health Security Agency reviews at least 14 deaths due to Omicron and 129 hospitalizations as of December 20, up from 7 and eighty five on December 18. While it stays too early to inform the injury Omicron will inflict, the developing range of deaths and hospitalizations point out that the variant ought to now not be considered as a barely worse shape of the frequent cold. NOVAVAX VACCINE Following months of manufacturing delays, the 2-dose SARS-CoV-2 vaccine from biotechnology organization Novavax, NVX-CoV2373, acquired conditional advertising authorization by using the European Commission on December 20 and an emergency use record (EUL) from the WHO on December 17. In Europe, the vaccine is regarded as Nuvaxovid and is the fifth vaccine to acquire authorization to forestall COVID-19 in adults aged 18 years and older. Novavax expects to start transport the vaccine to the European Union in the first quarter of 2022. The WHO’s EUL—the ninth for a SARS-CoV-2 vaccine—is for a model of the vaccine manufactured and marketed through the Serum Institute of India (SII), underneath license from Novavax, recognized as Covovax. The WHO checklist approves the COVAX facility to distribute the vaccine with hopes of bolstering world vaccine supply. Covovax—an adjuvanted, recombinant spike protein nanoparticle vaccine—is much less steeply-priced and less difficult to manufacture than some of the different vaccine kinds and simpler to distribute, as it can be saved for 6 months in ordinary refrigeration. The New England Journal of Medicine final week posted outcomes from a section three medical trial checking out the vaccine in almost 30,000 adults in the US and Mexico, displaying