Written by Steven Hansen

The U.S. new cases 7-day rolling average are 62.0 % HIGHER than the 7-day rolling average one week ago and U.S. deaths due to coronavirus are now 0.7 % LOWER than the rolling average one week ago. Today’s posts include:

• U.S. Coronavirus New Cases are 81,732
• U.S. Coronavirus deaths are at 486
• Yellen to Congress: Raise the debt ceiling or risk ‘irreparable harm’
• Global Supply Chains Buckle as Virus Variant and Disasters Strike
• European agency is 1st to approve Moderna jab for children
• Poll shows majority of unvaccinated Americans don’t plan on getting full protection
• Why do some people get severe COVID-19? The nose may know
• The COVID-Flu ‘Twindemic’ That Wasn’t
• Statins Again Linked to Lower COVID-19 Mortality
• A spritz instead of a jab? Future COVID-19 vaccines may go up your nose
• Advancing T-cell testing can help parents can make informed decisions on COVID vaccinations
• White House declines to release number of breakthrough COVID-19 cases among vaccinated staff

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Hospitalizations Are The Only Accurate Gauge

Hospitalizations historically appear to be little affected by weekends or holidays. The hospitalization growth rate trend continues to improve.

source: https://gis.cdc.gov/grasp/covidnet/COVID19_3.html

Historically, hospitalization growth follows new case growth by one to two weeks.

As an analyst, I use the rate of growth to determine the trend. But, the size of the pandemic is growing in terms of real numbers – and if the rate of growth does not become negative – the pandemic will overwhelm all resources.

The graph below shows the rate of growth relative to the growth a week earlier updated through today [note that negative numbers mean the rolling averages are LOWER than the rolling averages one week ago]. As one can see, the rate of growth for new cases peaked in early December 2020 for Thanksgiving, and early January 2021 for end-of-year holidays – and it now shows that the coronavirus effect is improving.

In the scheme of things, new cases decline first, followed by hospitalizations, and then deaths. The potential fourth wave did not materialize likely due to immunizations.

Coronavirus and Recovery News You May Have Missed

Poll shows majority of unvaccinated Americans don’t plan on getting full protection – USA Today

he majority of unvaccinated Americans say they do not plan to get vaccinated against COVID-19, according to a new poll.

Centers for Disease Control and Prevention data shows 56.5% of Americans have gotten at least one dose, and 43.5% have not received one. Of those people, a poll by The Associated Press and the NORC Center for Public Affairs Research found that 35% say they probably will not get the vaccine, and 45% say they definitely will not.

Unvaccinated people don’t have confidence in the effectiveness of the vaccine, the survey found, with 64% saying they have little to no confidence in it, even against the highly spreadable delta variant that now accounts for a vast majority of cases in the U.S.

The findings come as governors in states with high infection rates are asking those who remain unvaccinated to get the shot. The study was conducted before a number of Republican governors and lawmakers made their appeals this week.

Yellen to Congress: Raise the debt ceiling or risk ‘irreparable harm’ – The Hill

Treasury Secretary Janet Yellen urged congressional leaders Friday to raise the federal debt limit as soon as possible or risk “irreparable harm to the U.S. economy and the livelihoods of all Americans.”

In a Friday letter, Yellen warned that the Treasury Department is unable to project how long it could stave off a potentially catastrophic default on the national debt if Congress does not either raise or suspend the debt ceiling before Aug. 1.

“In recent years Congress has addressed the debt limit through regular order, with broad bipartisan support,” Yellen wrote. “I respectfully urge Congress to protect the full faith and credit of the United States by acting as soon as possible.”

The debt ceiling does not increase or reduce government spending, but sets a cap on how much debt the government can take on while paying for obligations already approved by Congress and the president. A two-year deal to suspend the debt limit expires on July 31, and Congress is unlikely to reach another agreement to lift it before then.

Senate Republican leaders said this week there will not be enough Republicans to support a debt ceiling increase or suspension if it is not tied to debt reduction measures. Democrats have refused those requests, arguing that the GOP is holding the economy hostage to partisan demands.

The Treasury Department has taken extraordinary measures to avert defaults during prior debt ceiling showdowns. But Yellen warned Friday that the department is unable to predict when those efforts would run out because of difficulties created by the coronavirus pandemic.

Federal court lifts CDC pandemic restrictions for Florida-based cruise ships – WESH

Pandemic restrictions on Florida-based cruise ships are no longer in place under the latest ruling by a federal appeals court, while the U.S. Centers for Disease Control and Prevention try to fight a Florida lawsuit challenging the regulations.

A three-judge panel of the 11th U.S. Circuit Court of Appeals had temporarily blocked a previous ruling last Saturday that sided with Florida officials, but the court reversed that decision on Friday, explaining that the CDC failed to demonstrate an entitlement to a stay pending appeal.

Last weekend’s temporary stay had kept the CDC regulations regarding Florida-based cruise ships in place while the CDC appeals the Tampa judge’s June decision.

“I’m glad to see the 11th Circuit Court of Appeals reverse its prior decision and free the cruise lines from unlawful CDC mandates, which effectively mothballed the industry for more than a year,” said Governor Ron DeSantis. “The importance of this case extends beyond the cruise industry. From here on out a federal bureau will be on thin legal and constitutional ice if and when it attempts to exercise such sweeping authority that is not explicitly delineated by law.”

The COVID-Flu ‘Twindemic’ That Wasn’t – MedPage

Influenza and several other respiratory viruses declined in circulation during the pandemic in 2020, but increased during the spring of 2021, researchers found.

Flu activity declined in March of 2020, remaining low until May 2021, with less than 0.4% of respiratory samples testing positive for influenza per week of flu season, reported Sonja J. Olsen, PhD, of the CDC, and colleagues.

Similar patterns were observed for most other respiratory pathogens, including parainfluenza viruses, respiratory syncytial virus (RSV) and common human coronaviruses, the authors wrote in Morbidity and Mortality Weekly Report.

However, all respiratory pathogens followed this pattern. Both human metapneumovirus and respiratory adenovirus circulated at low levels from 2020 to 2021, while rhinovirus and enterovirus remained low until May 2020 before increasing to near “pre-pandemic levels,” the authors noted.

Experts previously warned of a COVID and flu “twindemic” in fall 2020 and emphasized the importance of flu vaccination to combat it.

But from October 2020 to May 2021, circulating influenza experienced the lowest activity reported since 1997. Interventions, such as masks used to mitigate the transmission of COVID-19, likely caused the circulation of common respiratory viruses to decline, the authors said.

A spritz instead of a jab? Future COVID-19 vaccines may go up your nose. – National Geographic

The current batch of COVID-19 vaccines effectively prevents severe disease and death and offers substantial protection against the variants. But the authorized vaccines are not 100 percent effective at blocking all infections. To address this deficit, scientists are exploring new ways of delivering vaccines that yield stronger and more durable immunity against SARS-CoV-2. One promising approach might be to trade a jab in the arm for a spritz up the nose.

Over the past several months, as some manufacturers are preparing booster shots to deliver a third dose, a handful of promising studies have revealed the effectiveness of intranasal vaccines in mice, ferrets, hamsters, and non-human primates. Further along are six candidate COVID-19 vaccines, administered as nasal sprays, that are currently in phase 1 clinical trials. And, just this week, at the meeting of the American Society for Virology, Meissa Vaccines announced that a single dose of their intranasal COVID-19 vaccine candidate showed promising results in non-human primates. If these vaccines come to market, immunologists say that might offer better protection because they more closely resemble the way the virus naturally infects us—through the mucous membranes of the nose and upper airways. And immunologists say this makes a difference in the immune response.

“If you want to generate a sustainable, long-lasting immune response, you want to vaccinate locally,” says José Ordovas-Montañes, a Harvard University immunologist who studies immunity in the gut and nasal mucosal tissues. Ordovas-Montañes says that when we get a jab in the arm, we are inducing immunity on a systemic, body-wide scale where our antibodies and T cells will distribute themselves around the blood vessels. While that might sound good, this approach is “sub-optimal” because the immune cells are “distracted” and not focused on the location where the virus enters the body. A shot up the nose, on the other hand, provides a big boost of immunity in the upper respiratory tract and potentially the lungs, eliciting a local antibody response and T cell response. This enables immune cells to apprehend and destroy the pathogen on arrival.

“I think the big benefit is that you generate immunity at the site of infection,” says Donna Farber, an immunologist at Colombia University. “That’s where you need the immunity, where the virus is coming in.”

A shot in the arm is like vaccinating us from the inside out. We generate immunity throughout the body, and some of those antibodies trickle into the airways and nasal passages. But the nasal spray works the other way around, boosting the site of infection first and the rest of the body second. “You basically get a two for one,” says Paul McCray, a pediatric pulmonologist at the University of Iowa.

Global Supply Chains Buckle as Virus Variant and Disasters Strike – gCaptain

A new worldwide wave of COVID-19. Natural disasters in China and Germany. A cyber attack targeting key South African ports.

Events have conspired to drive global supply chains towards breaking point, threatening the fragile flow of raw materials, parts and consumer goods, according to companies, economists and shipping specialists.

German container line Hapag Lloyd described the situation as “extremely challenging.”

“Vessel capacity is very tight, empty containers are scarce and the operational situation at certain ports and terminals is not really improving,” it said. “We expect this to last probably into the fourth quarter – but it is very difficult to predict.”

The Delta variant of the coronavirus has devastated parts of Asia and prompted many nations to cut off land access for sailors. That’s left captains unable to rotate weary crews and about 100,000 seafarers stranded at sea beyond their stints in a flashback to 2020 and the height of lockdowns.

“We’re no longer on the cusp of a second crew change crisis, we’re in one,” Guy Platten, secretary general of the International Chamber of Shipping, told Reuters.

“This is a perilous moment for global supply chains.”

Given ships transport around 90% of the world’s trade, the crew crisis is disrupting the supply of everything from oil and iron ore to food and electronics.

Meanwhile, deadly floods in economic giants China and Germany have further ruptured global supply lines that had yet to recover from the first wave of the pandemic, compromising trillions of dollars of economic activity that rely on them.

European agency is 1st to approve Moderna jab for children – CNBC

• The European Medicines Agency has recommended approving Moderna’s COVID-19 vaccine for children aged 12 to 17.
• It’s the first time the shot has been authorized for people under 18.
• The U.S. Food and Drug Administration is currently considering whether to extend the use of the Moderna vaccine for children.

First dose of Pfizer-BioNTech or Oxford-AstraZeneca vaccines has strong protective effect against COVID-19 in older adults – News-Medical

In an effort to contain the coronavirus disease 2019 (COVID-19) pandemic, the United Kingdom initiated its vaccination campaign on December 8, 2020. To date, more than 77% of the adult population in the U.K. have received at least one dose of the COVID-19 vaccine.

… The researchers found a reduction in the mortality rates due to COVID-19 for people above the age of 80 years. This result reassured the scientists that the reduction in the mortality rate in the older age group was largely due to the availability of vaccines, rather than the result of residual confounding factors.

Additionally, using eligibility as a criterion for being vaccinated, the RDD approach used herein indicated seropositivity in individuals who received a single dose of vaccine. As a result, a decrease in the COVID-19 mortality rate was observed. Notably, a similar trend was not observed in the unvaccinated group.

The researchers estimated vaccine effectiveness to be 70.5% for the vaccinated group who were of or above 80 years and were seropositive. Further, the scientists also found that a single dose of the COVID-19 vaccine provided a robust protective effect against COVID-19 mortality in the older age group.

Why do some people get severe COVID-19? The nose may know – EurekAlert

The body’s first encounter with SARS-CoV-2, the virus behind COVID-19, happens in the nose and throat, or nasopharynx. A new study in the journal Cell suggests that the first responses in this battleground help determine who will develop severe disease and who will get through with mild or no illness.

Building on work published last year identifying SARS-CoV-2-susceptible cells, a team of collaborators at Boston Children’s Hospital, MIT, and the University of Mississippi Medical Center comprehensively mapped SARS-CoV-2 infection in the nasopharynx. They obtained samples from the nasal swabs of 35 adults with COVID-19 from April to September 2020, ranging from mildly symptomatic to critically ill. They also got swabs from 17 control subjects and six patients who were intubated but did not have COVID-19.

“Why some people get more sick than others has been one of the most puzzling aspects of this virus from the beginning,” says José Ordovás-Montañés, PhD, of Boston Children’s, co-senior investigator on the study with Bruce Horwitz, MD, PhD of Boston Children’s, Alex K. Shalek, PhD, of MIT and Sarah Glover, DO, of the University of Mississippi. “Many studies looking for risk predictors have looked for signatures in the blood, but blood may not really be the right place to look.”

COVID-19’s first battlefield: the nasopharynx

To get a detailed picture of what happens in the nasopharynx, the researchers sequenced the RNA in each cell, one cell at a time. (For a sense of all the work this entailed, each patient swab yielded an average of 562 cells.) The RNA data enabled the team to pinpoint which cells were present, which contained RNA originating from the virus — an indication of infection — and which genes the cells were turning on and off in response.

It soon became clear that the epithelial cells lining the nose and throat undergo major changes in the presence of SARS-CoV-2. The cells diversified in type overall. There was an increase in mucus-producing secretory and goblet cells. At the same time, there was a striking loss of mature ciliated cells, which sweep the airways, together with an increase in immature ciliated cells (which were perhaps trying to compensate).

The team found SARS-CoV-2 RNA in a a diverse range of cell types, including immature ciliated cells and specific subtypes of secretory cells, goblet cells, and squamous cells. The infected cells, as compared to the uninfected “bystander” cells, had more genes turned on that are involved in a productive response to infection.

Statins Again Linked to Lower COVID-19 Mortality – Medscape

Among patients hospitalized for COVID-19, those who had been taking statins had a substantially lower risk of death in a new large observational study.

Results showed that use of statins prior to admission was linked to a greater than 40% reduction in mortality and a greater than 25% reduction in risk of developing a severe outcome.

The findings come an analysis of data from the American Heart Association’s COVID-19 Cardiovascular Disease Registry on more than 10,000 patients hospitalized with COVID-19 at 104 hospitals across the United States published in PLoS One.

While several other studies have suggested benefits of statins in COVID-19, this is by far the largest study so far on this topic.

“I would say this is the most reliable study on statins in COVID-19 to date, with the results adjusted for many confounders, including socioeconomic factors and insurance type,” lead author Lori B. Daniels, MD, told this news organization. “However, it still an observational study and therefore falls short of a randomized study. But I would think a randomized study of statins in COVID-19 is probably not feasible, so this study provides excellent data at an observational level.”

Advancing T-cell testing can help parents can make informed decisions on COVID vaccinations – The Hill

There are increasing concerns over COVID-19 vaccines today — some are not based on misinformation but rather a lack of complete information. Parents have been voicing reservations on vaccinating their children due to increasing cases of myocarditis and pericarditis, and potentially other adverse outcomes yet to be identified. Given myocarditis is a life-threatening disease, I empathize with parents and the weight of their decision when considering the limited information we have.

As physicians, we determine a course of treatment for individual patients based on their clinical benefits versus risks. We employ evidence-based guidelines, standards of care, and our clinical experiences to ensure we are advising the best path forward. We know that children and young adults have statistically lower rates of hospitalization and typically experience mild symptoms, but could still spread the disease. While we have several vaccines only available under Emergency Use Authorization, we’re taking very educated guesses based on clues from other coronaviruses and emerging research. Nonetheless, we’re still flying a little blind here.

We need to prioritize vaccine-acquired and infection-acquired immune response research to understand the who, what, when, where, how, and why for future vaccination efforts, including clinical appropriateness. In doing so, federal agencies need to take a deeper dive into T-cells (and B-cells) as they play an essential role in reducing the severity of symptoms and help prevent infection. Here’s why T-cells matter for the long run:

In simplistic terms, when the human body is infected with a virus, it starts producing antibodies in a matter of days. They peak in a matter of weeks. Then, over the next months, as the body works to defeat the virus, the antibodies typically decrease to eventually immeasurable amounts. However, T-cells are designed to be much more resilient and help prevent reinfection in the long term when antibodies are low.

We can glean this from other coronaviruses. Studies show people infected with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) have long-lasting immune responses. In fact, SARS T-cell responses played a role in cross-protection with MERS because they shared similar makeups, and have been found in patients more than a decade later. Our immune response is quite resilient considering people who survived the Spanish flue of 1918 had immune memory almost a century later.

Whether you had an asymptomatic or symptomatic infection from a year ago or longer — while you may not have measurable antibodies now — you most likely have a strong immune response that will protect you from death or significant illness thanks to your T-cells. Wouldn’t that be good to know for many reasons?

White House declines to release number of breakthrough COVID-19 cases among vaccinated staff – USA Today

The White House on Friday refused to release the number of breakthrough COVID-19 cases among vaccinated staff after one aide tested positive for the virus earlier this week.

Press secretary Jen Psaki suggested the public did not need that information, even as the U.S. vaccination effort is flagging and COVID cases are surging due to the more contagious delta variant.

When asked Friday for data on breakthrough cases at the White House, Psaki noted that vaccinated people who have breakthrough infections are much less likely to get severely sick or die.

‘Nothing in this world is 100%’:Those fully vaccinated against COVID-19 can be infected, but serious illness is rare

“As many medical experts have said, inside and outside of the government, those who are vaccinated are protected from serious illness,” Psaki said during the White House briefing. “Most are asymptomatic if they are individuals who are vaccinated.”

Three states are seeing about 40% of the country’s new Covid-19 cases – CNN

While Covid-19 cases in the United States have been rising in almost every state over the past week, a handful have been driving the bulk of the nationwide surge.

White House coronavirus response coordinator Jeff Zients told reporters Thursday the country has “fundamentally changed the course of this pandemic” and the threat of serious disease and death now is to the unvaccinated.

He said counties with the highest case rates have significantly lower vaccination rates than other areas. And a few states have seen many of the new cases.

“This week, just three states Florida, Texas and Missouri, three states with lower vaccination rates accounted for 40 percent of all cases nationwide,” Zients said at a White House news conference. “For the second week in a row, one in five of all cases occurring in Florida alone. And within communities, these cases are primarily among unvaccinated people.”

The following are foreign headlines with hyperlinks to the posts

83% of US Athletes at Tokyo Games Fully Vaccinated

The following additional national and state headlines with hyperlinks to the posts

Search for bodies in Florida condo collapse officially ends.

Face Mask-Related Injuries Rose Dramatically in 2020

Federal Court Rules Gavin Newsom’s School COVID Shutdown Order Violated Parents’ Rights. A recent court order has ruled that California Governor Gavin Newsom violated parent’s rights regarding school closures during COVID-19.

Work flexibility ‘here to stay’ in post-Covid world, says director at three Fortune 500 firms

Delta is dangerous and spreading — but vaccination can stop it

Louisiana Gov. Bel Edwards is calling for mask-wearing to resume indoors for vaccinated and unvaccinated people as more than 1,000 in the state are hospitalized with COVID. The governor said Louisiana has the highest rate of new cases per capita of any state, but did not say he would implement a mask mandate or new restrictions.

Common respiratory viruses are making a comeback, and a particularly severe flu season could be on the horizon, the Centers for Disease Control and Prevention warned Friday.

Today’s Posts On Econintersect Showing Impact Of The Pandemic and Recovery With Hyperlinks

Should Fully Immunized People Wear Masks Indoors? An Infectious Disease Physician Weighs In

Facing Headwinds On New Alzheimer’s Drug, Biogen Launches Controversial Campaign

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