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'Very nice spring, very nice summer': Omicron will bring us closer to normal, experts say – National Post

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‘We need to lay out a strategy and a plan towards moving back toward something that is nearer normality’

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Anna Bershteyn says there are absolutely no guarantees, of course, but if asked to read the tea leaves, she sees “a very nice spring, a very nice summer, where people can let loose,” see others and not worry so much about COVID-19 .

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It’s just a hope, “but if I had to make a guess, I would say that what Omicron will probably give us is a period of respite,” said Bershteyn, an assistant professor in the department of population health at New York University Grossman School of Medicine. Immunity gained through vaccination, infection or a combination of the two, could move populations closer to controllable levels of COVID, she and other scientists said. The hope is that the virus “sort of vaccinates itself” — that a milder strain gives us immunity to a later, potentially more severe one.

While hospital and ICU numbers are rising nationally, Omicron infections may have peaked and the country could be on a downward slope, federal health officials said Friday.

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COVID is here to stay. SARS-CoV-2 will continue to live in the human population, Dr. Theresa Tam, Canada’s chief public health officer said. While we must prepare for more potential unusual variants, “we do need to lay out a strategy and a plan towards moving back toward something that is nearer normality,” Tam said . In England, mandatory masking in public spaces and vaccine passports will be dropped beginning next week, while Spain is moving toward treating SARS-CoV-2 much like seasonal flu.

Many questions linger: It’s not clear how long immunity to Omicron will last, whether we could see a second wave, or whether infection with a milder stain will indeed provide immunity against whichever Greek letter-named version of SARS-CoV-2 comes next. The virus has already proven whip smart — scientists didn’t see heavily mutated Omicron coming — and it’s still evolving.

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“The big game changer is indeed the moment when nearly everybody will have had some sort of immunity,” Dr. Peter Juni, of Ontario’s COVID-19 science table  recently told a COVID research consortium . “I can’t guarantee endemicity relatively soon, but I can guarantee we can move much closer to endemicity after the Omicron wave.”

Here’s what we know about where we are now and where we need to go.

Rapid rise, rapid descent?

“Our modelling suggests that we are at the peak around now, with some provinces (Ontario and Quebec, which experienced Omicron earliest) just past the peak and others just behind it,” said Caroline Colijn, an associate professor of mathematics at Simon Fraser University and COVID-19 modeller.

In Ontario, the rate of hospitalizations and intensive care admissions is slowing. Restaurants and gyms will reopen starting Jan. 31, with all remaining restrictions to go by mid-March, Premier Doug Ford announced Wednesday. British Columbia is seeing a slowing in transmission rate. “That’s partly the end of the holidays, but I think it partly is  a lot  of people have COVID right now,” said Colijn and that’s having a dampening effect. More people are isolating “or cancelling things if they hear five of their friends have COVID.” That, combined with a shorter course of infections, can drive a speedy decline, she said.

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Our modelling suggests that we are at the peak around now

But Canada might also have a more rounded peak, or double peaks, because of the timing with schools and universities reopening and the lifting of restrictions, Colijn said. “We may not see the very rapid decline that has been seen in South Africa, for example.”

Official case counts are almost irrelevant, with testing systems so overwhelmed. “But it’s important if the number of actual infections happening starts to go down quickly, because that’s going to decrease the burden on everybody — fewer people sick, fewer people in hospital, fewer workplace closures, fewer schools affected,” Colijn said.

Why not just get infected and get it over with?

Famed cardiologist and author Dr. Eric Topol isn’t thrilled with the “Omicron will ultimately find just about everybody,” messaging. “Let’s not invite an unpredictable virus that can cause long COVID,” or secondary attacks, where people who may not be particularly at risk of a bad infection themselves unwittingly pass the virus to someone who can wind up very sick,” Topol said, during a recent University of California, San Francisco Department of Medicine Grand Rounds Q&A. 

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In Australia, “COVID chasers” are hoping to time infections when it’s less inconvenient to isolate. Their thinking runs the lines of, “It’s going to happen anyway, I want to live my life, I’m sick of trying to avoid COVID and it’s likely to be mild in someone like me.”

It’s not a terribly brilliant idea, Topol, founder and director of Scripps Research Translational Institute, and other scientists said. Omicron can cause severe disease. It’s not uniformly mild. With hospitals grappling with shortages of staff and COVID-19 drugs, people who do end up in hospital risk ending up with less-than-optimal care, Juni said. And while it will take months before it’s known whether Omicron can cause long COVID, the phenomenon typically follows mild infections.

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  1. FILE PHOTO: A respiratory therapist and six nurses prone a coronavirus disease (COVID-19) patient inside the intensive care unit of Humber River Hospital in Toronto, Ontario, Canada April 19, 2021.

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Vaccines are still the best shot at making COVID manageable

The vaccines are still holding their own against severe disease with Omicron, and a third dose boosts immunity even higher. Still, demand for third doses appears to be slowing, and while Pfizer has said it should have a vaccine that targets Omicron specifically by March, Topol and others said what’s needed is a universal, “pan” coronavirus vaccine that would protect against all variants and make it harder for the virus to mutate its way around. Omicron proved that SARS-CoV-2 can take huge leaps in evolution, “and get all these mutations all in one jump,” Bershteyn said. “You really can’t place Omicron on the family tree of variants that we’ve seen before. It sort of came out of nowhere, and as far as I can tell there’s no biological rule that says that it couldn’t do this again  and  be very contagious and very deadly at the same time.”

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“The unvaccinated who do not have a boost to their immunity from vaccine are likely to become susceptible again to whatever variant comes next,” she said, and regulatory discussions should be happening now, including, would manufacturers have to do a full clinical trial of a new vaccine, or a small, short trial, looking at the antibody response? How long to monitor for safety? A vaccine against Omicron is three months away. If a more dangerous variant emerged, “we couldn’t wait three months. You’d have to completely lock down everything. It’s just not feasible.”

What’s the endgame?

“Waning immunity and the emergence of new variants will shape the long-term burden and dynamics of COVID-19,” Colijn and colleagues wrote in a pre-print.

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“If we can get another infection in a couple of months, that’s not a good thing for where this virus settles out,” Colijn said. “But if we’re well protected for a year, that’s pretty good news. And what that means is that (COVID) will decline to hopefully pretty low levels and stay at those levels.”

But endemic doesn’t mean “not a problem,” she said. “It just means that it’s stable — it’s not having this huge wave that goes through the population.”

Waning immunity and the emergence of new variants will shape the long-term burden and dynamics of COVID-19

She doesn’t think there’s pressure on the virus to get more severe. Transmission is where the virus is having “its reproductive opportunities. We have the high transmissibility without it carrying along a really high severity. So, hopefully, we don’t get the big, bad new variant,” Colijn said.

Hospitalizations will never be reduced to zero. “There are always going to be frail vulnerable people who succumb to this virus,” McMaster University infectious diseases specialist Dr. Martha Fulford said in an earlier interview. Once past this hump, and with more protection because of boosters, more immunity from infections and more effective treatments, a broader conversation will be needed about the risks posed by COVID and the risks that exist from locking down “forever and a day,” she said.

National Post

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Quebec health officials confirm 25 monkeypox cases now in province – Global News

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Quebec public health officials are reporting a total of 25 confirmed cases of monkeypox in the province as of Thursday.

Dr. Luc Boileau, interim public health director in the province, described it as a “serious outbreak” of the virus. Officials are investigating several more suspected cases.

“We had about 20 to 30 suspected cases under investigation so far,” Boileau said.

The province will also begin administering the Imvamune vaccine to close contacts of confirmed or suspected cases of monkeypox as soon as Friday. A single dose will be provided within four days of exposure to the virus.

Quebec’s Health Ministry said in a statement that a second dose of the vaccine could be administered, but only if the risk of exposure is “still present 28 days later” and “only following a decision by public health authorities.”

READ MORE: Mass vaccinations for monkeypox not needed, WHO official says

Boileau said the majority of confirmed cases in the province are tied mostly to men who have had sexual relations with other men. There has been one case in a person under 18.

Last week, Quebec recorded the first cases of the virus in the country. The first suspected cases were reported on May 12 in Montreal.

Monkeypox is a rare disease that comes from the same family of viruses that causes smallpox, which the World Health Organization declared eradicated around the globe in 1980.

The virus spreads through prolonged closed contact. It can cause fever, headache, muscle aches, exhaustion, swollen lymph nodes and lesions.

— with files from Global News’ Dan Spector and the Canadian Press

© 2022 Global News, a division of Corus Entertainment Inc.

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Quebec to start monkeypox vaccination of contacts as officials confirm 25 cases

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MONTREAL — Quebec’s interim public health director says the province could start vaccinating people against monkeypox as soon as Friday.

Dr. Luc Boileau says there are now 25 confirmed cases of the disease in the province and about 30 suspected cases are under investigation.

He says the province has received supplies of smallpox vaccine from the federal government, and it will be administered to people who have been in close contact with confirmed cases of the disease.

Dr. Caroline Quach, the chair of Quebec’s immunization committee, says the vaccine has been shown to prevent monkeypox in animal studies if it is administered within four days of an exposure and can reduce severity if it is administered up to 14 days after an exposure.

She says the disease is transmitted only through prolonged close contact.

Boileau says the majority of cases are in adult men who have been in sexual contact with people who have the disease, and there has been one case in a person under 18.

This report by The Canadian Press was first published May 26, 2022.

 

The Canadian Press

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Monkeypox Warnings Ignored; Dominant COVID Strain Emerges; Better Paxlovid Access – Medpage Today

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Note that some links may require registration or subscription.

Warning signs of the current monkeypox outbreak may have been ignored. (STAT)

The CDC issued a monkeypox travel alert encouraging “enhanced precautions” after cases were reported in North America, Europe, and Australia.

Roche announced it has developed three PCR test kits to detect the monkeypox virus.

The U.S. has a new dominant COVID-19 strain — BA.2.12.1 — a highly contagious sublineage of the BA.2 omicron subvariant that now accounts for 57.9% of all cases, according to CDC estimates.

Washington Gov. Jay Inslee, as well as Lt. Gov.Denny Heck, both tested positive for COVID-19, as did U.S. Rep. Liz Cheney (R-Wyo.). (Seattle Times, The Hill)

As of Thursday at 8:00 a.m. EDT, the unofficial U.S. COVID toll was 83,697,199 cases and 1,004,558 deaths, increases of 218,146 and 913, respectively, compared with this time Wednesday morning.

The Biden Administration, projecting COVID infections will continue to spread during the summer travel season announced additional steps to make nirmatrelvir/ritonavir (Paxlovid) more accessible. (ABC News)

The White House also reported the launch of the first federally-supported test-to-treat COVID site.

U.K. Prime Minister Boris Johnson and other senior leaders of the government are to blame for booze-filled parties that violated the country’s COVID-19 lockdown rules, according to an investigative report. (NPR)

A mouse study suggested that maraviroc (Selzentry), a FDA-approved drug used to treat HIV, may be able to reverse middle-aged memory loss. (Nature)

The University of California system will be paying nearly $700 million to women who said they were sexually abused by a UCLA gynecologist over the course of several decades. (AP)

The parents of a 4-year-old girl spoke out about her mysterious case of pediatric hepatitis that required a liver transplant, one of 180 similar cases under investigation in the U.S. (Today)

Teva Pharmaceuticals has issued a voluntary nationwide recall of one lot of anagrelide capsules, which are used to treat thrombocythemia secondary to myeloproliferative neoplasms, due to dissolution test failure during routine stability testing.

Servier announced the FDA approved ivosidenib (Tibsovo) in combination with azacitidine for certain patients with newly diagnosed IDH1-mutated acute myeloid leukemia.

A report from the American Medical Association shows that payers are not following the prior authorization reforms agreed to in 2018. (Fierce Healthcare)

The mass shooting in Buffalo earlier this month is a reminder that millions of Americans don’t have easy access to grocery stores. (NPR)

COVID-era misinformation is leading a wave of parents to reject ordinary childhood immunizations. (New York Times)

The FDA issued guidance spelling out rules for states that want to import certain prescription drugs from Canada.

  • Mike Bassett is a staff writer focusing on oncology and hematology. He is based in Massachusetts.

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