October 27, 2022: Johns Hopkins COVID 19 Situation Report

COVID-19 Situation Report

Editor: Alyson Browett, MPH

Contributors: Erin Fink, MS; Clint Haines, MS; Noelle Huhn, MSPH; Amanda Kobokovich, MPH; Aishwarya Nagar, MPH; Christina Potter, MSPH; Matthew Shearer, MPH; and Rachel A. Vahey, MHS

CALL FOR APPLICATIONS Applications are now open for the Johns Hopkins Center for Health Security’s Emerging Leaders in Biosecurity (ELBI) Fellowship Class of 2023. ELBI inspires and connects the next generation of biosecurity leaders and innovators. This highly competitive, part-time program is an opportunity for talented career professionals to deepen their expertise, expand their network, and build their leadership skills through a series of sponsored events. Applications can be submitted through 11:59PM (EST) November 11, 2022. Learn more about eligibility requirements and application materials here: https://www.centerforhealthsecurity.org/our-work/emergingbioleaders/apply.html

EPI UPDATE The WHO COVID-19 Dashboard reports 625.7 million cumulative cases and 6.56 million deaths worldwide as of October 26. Global weekly incidence dropped to 2.8 million new cases after remaining steady for 6 weeks, decreasing 12.5% compared to the previous week. Weekly incidence in all regions remained relatively steady or fell over the previous week. Global weekly mortality continued to decrease for the tenth consecutive week, down 11.6% from the previous week.*

*The WHO dashboard notes that data from the Africa Region are incomplete.

UNITED STATES

The US CDC is reporting 97.1 million cumulative cases of COVID-19 and 1.07 million deaths. Incidence for the week ending October 19 remained steady over the previous week, at 260,808 reported cases. Weekly mortality also remained steady for the week ending October 19, at 2,566 reported deaths.**

**Beginning October 20, the US CDC began reporting and publishing aggregate case and death data, and line level data where applicable, from jurisdictional and state partners on a weekly basis rather than daily. As a result, COVID-19 data on cases and deaths are updated every week on Thursdays by 8pm ET.

New hospital admissions remained steady last week, increasing 1.1%, while current hospitalizations continued to exhibit a downward trend, decreasing 2.9% over the past week. Both trends peaked around the end of July and both now appear to be leveling.

The BA.5 sublineage continues to be the dominant strain in the US, accounting for 62.2% of sequenced specimens; however, its estimated prevalence has decreased for 9 consecutive weeks. The second most prevalent sublineage, BA.4.6, appears to be losing its growth advantage to others, decreasing to 11.3% as of October 22. Several other Omicron sublineages continue to exhibit increasing trends, including BQ.1 (9.4%), BQ.1.1 (k7.2%), and BF.7 (6.7%). BA.2.75 (1.6%) and BA.2.75.2 (1.3%) and also show relative growth advantage over BA.5.

GLOBAL PANDEMIC PROJECTIONS The number of new daily global COVID-19 cases is projected to rise slowly over the coming months, increasing from about 17 million now to about 18.7 million by the end of January 2023, the University of Washington Institute for Health Metrics and Evaluation predicts in an analysis published this week. The increase will be impacted by the emergence of various Omicron lineage subvariants, seasonal behavioral changes, and COVID-19 policies in China, where many of the world’s most susceptible population resides. The model’s reference scenario also estimates 245,000 additional reported deaths due to COVID-19 will occur through February 1. The analysis also includes estimates using an 80% mask use scenario and an antiviral access scenario.

‘TRIPLEDEMIC’ Experts in the US are warning the nation could see a convergence of three respiratory diseases—COVID-19, influenza (flu), and respiratory syncytial virus (RSV)—this fall and winter, in what some are calling a “tripledemic.” There are signs that cases of all three infections are rising in parts of the country, likely driven by people feeling confident enough to stop wearing masks and gather more indoors. Newly emerging sublineages of the Omicron variant of concern (VOC) have mutations that potentially make them resistant to existing therapeutics and preventive treatments and possibly immune evasive enough to bypass protections provided by previous infections or vaccination. That is leading the US government to step up efforts to get more people vaccinated and boosted with newer bivalent shots that target the Omicron BA.5 and BA.4 lineages.

Cases of RSV are surging earlier than usual, especially among young children. While many kids contract the virus by age 2 through mingling with other children, there is a potential that nonpharmaceutical interventions—such as lockdowns, social distancing, masking, and increased hygiene—helped to limit the spread of other respiratory diseases, essentially creating an “immunity gap.” Therefore, some toddlers and infants have never been exposed to RSV, leaving them more susceptible to infections. Notably, there is no vaccine and no effective treatment for RSV. Most people recover within a week or two, but RSV can be serious for young children and older adults who have weaker immune systems or underlying health conditions. Already, about three-quarters of pediatric hospital beds nationwide are full and emergency rooms are experiencing long waits.

Additionally, some parts of the country, especially Southern states, are experiencing an early flu season. Flu rates are highest among young children aged 0-4, but the number of cases is increasing in every age group. The past two years saw lower-than-average numbers of cases, and though there is a flu vaccine, protection rates range from 20%-60%. And, unfortunately, flu vaccine uptake dropped during the pandemic. The Southern Hemisphere saw an early flu season with higher case numbers and higher hospitalizations, and many feel nations in the Northern Hemisphere will follow that trend as the weather cools. With hundreds of circulating SARS-CoV-2 variants and increases of other respiratory viruses, taking steps to prevent disease transmission—including getting vaccinated and/or boosted, staying home if sick, wearing masks, and washing hands—remains vital this season to help prevent further strain on the healthcare system, severe disease, and more deaths.

US BOOSTER CAMPAIGN As the US heads into its third winter of the COVID-19 pandemic, US health officials this week announced additional efforts to encourage individuals, particularly those who are older or immunocompromised, to get vaccinated or boosted against COVID-19 at no cost. US President Joe Biden publicly received his fifth shot, coinciding with the release of an updated COVID-19 plan that includes enlisting Walgreens, DoorDash, and Uber to provide free delivery of antiviral prescriptions, calling on educational institutions to hold vaccination clinics for their communities, encouraging employers to provide paid time off for employees to get vaccinated, and urging building operators to improve indoor air quality.

The US appears to be in a better position heading into this winter, with treatments and vaccine doses more widely available, but Biden administration officials are concerned another surge in cases, as well as rising cases of other respiratory diseases, could overwhelm healthcare systems and lead to more deaths. Some experts are concerned a crisis-fatigued public and mixed pandemic messaging are making booster campaign efforts more challenging; only about 19.4 million US residents have gotten the updated shot, accounting for less than 10% of those who are eligible, according to US CDC data. The Omicron subvariants BQ.1 and BQ.1.1 are gaining ground in the US, and for those already vaccinated, receiving an updated booster dose is the best protection from severe disease or death. While some might not look forward to vaccination side effects, a study published October 21 in JAMA Network Open suggests those who experience fever, chills, or muscle pain tended to have more robust antibody responses following the shots. But don’t worry: even among those who experience little to no side effects, vaccines elicit a strong immune response.

BIVALENT BOOSTER IMMUNE RESPONSE Early data on the immunogenicity of the new bivalent booster targeting the Omicron BA.4 and BA.5 Omicron sublineages show the shots appear to work about as well as earlier monovalent booster doses. The two preprint studies—one from researchers from Harvard University and the other from Columbia University—show that neutralizing antibody responses to the bivalent vaccine formulation were about the same as those to the monovalent vaccine formulation when examined 3-5 weeks post-vaccination. Researchers emphasized, however, that the boosters still offer robust and prolonged protection against severe disease or death from COVID-19, and public health officials continue to encourage people to get boosted as soon as possible. Some experts suggested that the studies were not run for a long enough time and included too small of a population to provide a full picture of bivalent vaccine booster immunogenicity.

US COVID DEATH RATES A data brief published October 25 by the National Center for Health Statistics (NCHS) analyzed COVID-19 mortality rates in 2020, illuminating demographic trends early on in the outbreak according to urbanicity, age, and sex. The report’s findings noted that overall age-adjusted COVID-19 death rates ranked highest to lowest were found in large central metropolitan urban counties, noncore rural counties, micropolitan rural counties, large fringe metropolitan urban counties, small metropolitan urban counties, and medium metropolitan urban counties. When broken down by sex, geographic trends remained largely similar, although the highest death rates for women were found in noncore rural counties and the second highest death rates found in large central metropolitan urban counties. Notably, death rates were at least 50% higher for men than women across all counties, with the greatest difference found in large central metropolitan urban counties, where rates were 78% higher for men.

Another data brief by NCHS found that this trend was further exacerbated in adults aged 65 and older, with males experiencing death rates 1.5 times higher than females. Sex differences in COVID-19 death rates in adults aged 65 and over held across all races. Death rates in older men were highest among Hispanic men, followed by non-Hispanic Black men and non-Hispanic American Indian or Alaska Native men. Death rates among older women were highest among non-Hispanic American Indian or Alaska Native women, followed by non-Hispanic Black women and Hispanic women. As has been well-established in other studies, overall COVID-19 death rates increased by age group in adults aged 65 and older. The majority (66.2%) of deaths due to COVID-19 among these older adults occurred in a healthcare setting, compared with 24.3% in a nursing home or long-term care facility, and 4.7% at home.

US WORKFORCE The COVID-19 pandemic has significantly impacted the US workforce, particularly due to the burden of post-acute sequelae of SARS-CoV-2 (PASC), more commonly known as long COVID. Some estimates posit that the economic costs of long COVIDcould be trillions of dollars. With an estimated 16 million people of working age suffering with long COVID, and as many as 4 million out of work because of their symptoms, many recognize COVID-19 as a mass disabling event. A recentstudy from the Federal Reserve Bank of New York notes there has been an increase of about 1.7 million people with disabilities since the pandemic began and close to 1 million workers with new disabilities, likely due to an increase in Americans living with long COVID.

Many people with long COVID have reduced the number of hours they work or dropped out of the labor force, but an increase in the number of workers with disabilities suggests that more people with long COVID and disabilities are continuing to work. Some experts believe that the surge of workers with disabilities could also be attributed toa tight labor market and a rise in remote work, which allows people with disabilities to enter and remain in the workplace. As more people with long COVID and disabilities enter and remain in the workplace, experts encourage employers tomake reasonable workplace accommodations to retain them. Advocates encourage employers toset a positive example by supporting their employees’ needs regardless of their status under the Americans with Disabilities Act, under which employers are expected to make “reasonable accommodations” for people with disabilities.

Similar to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)— which also often follows viral infection—symptoms of long COVID can include fatigue, brain fog, and muscle/joint pain. The accommodations employers have provided to workers with ME/CFS, such as telework and flexible scheduling, could be extended to workers with long COVID as well, along with other changes that allow workers to control their environment, limit physical exertion and commuting, take breaks as needed, manage symptoms, and access comprehensive health benefits. Although making workplace accommodations requires upfront costs, advocates encourage employers to consider the long-term benefits of creating flexible and inclusive policies.

Relatedly, a recent study from theNational Bureau of Economic Research illustrated the phenomenon of “long social distancing” and documented that anxiety around getting COVID-19 has kept close to 3 million people out of the workforce, consequently reducing potential economic output by nearly 1%, or US$250 billion, in the first half of 2022. Long social distancing has ramifications beyond the workforce and economy; many people who continue to protect themselves through social distancinghave reported waning social support and increased isolation. Although many in the US seem to be moving on from the pandemic, the long-term economic and social impacts of COVID-19continue to affect people who struggle to make a complete recovery.

PANDEMIC POLITICIZATION Polling and analysis in the US show Republicans are more likely than Democrats to have lower rates of vaccine uptake and areas with more Republican voters have experienced more COVID-19-related deaths. But viewing the pandemic through a political lens is not useful, Dr. Ashish Jha, the White House COVID-19 Response Coordinator, said last week, urging people to instead view COVID-19 strictly through a public health and medical lens. Nevertheless, partisan messaging surrounding the pandemic is ramping up as US political candidates campaign ahead of mid-term elections. This week, US President Joe Biden publicly received an updated COVID-19 vaccine booster vaccine and called on the country to put politics aside to focus on personal health and the health of friends and family. His public vaccination likely was an effort by the White House to increase awareness that a new booster shot is available—a recent KFF poll found that around half of adults say they have heard “a little” or “nothing at all” about the bivalent boosters—but also a political move to highlight the Biden administration’s COVID-19 efforts, which typically score higher approval ratings than other issues.

Several Republican candidates are arguing that scientific and public health institutions have gained too much power during the pandemic. A new poll from the Pew Research Center suggests that while a majority of respondents agree that government investments in scientific research are worthwhile for society, many expressed a shared concern that the US is failing to gain ground in science globally. Notably, a partisan divide became apparent when respondents were asked about their views on the role of scientists in the policy arena, with Democrats more likely than Republicans to support scientists in active policy roles. Additionally, respondents’ confidence in scientists is lower than the high point seen early in the pandemic but has remained steady over the past year, according to the poll. While other issues appear to be dominating this year’s elections and both parties’ overall spending on COVID-19 messaging has dropped since the 2020 election, the pandemic remains an important issue for voters and elected officials.

Ohio Voter Suppression Case

The New York Times

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Right-Wing Operatives Plead Guilty in Voter-Suppression Scheme

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Two right-wing political operatives have pleaded guilty in Ohio to a telecommunications fraud charge for arranging thousands of robocalls that falsely claimed that the information voters included with mail ballots could be used by law enforcement and debt collectors, prosecutors said.

Jack Burkman, center, and Jacob Wohl, left, in 2018. Prosecutors said they used robocalls to intimidate residents in minority neighborhoods to refrain from voting by mail in 2020.© Joshua Roberts/Reuters

The operatives, Jacob Wohl, 24, of Los Angeles, and Jack Burkman, 56, of Arlington, Va., entered their pleas on Monday in Cuyahoga County Common Pleas Court in Cleveland, prosecutors said.

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The men were indicted in 2020 after they were accused of using the robocalls to intimidate residents in minority neighborhoods to refrain from voting by mail at a time when many voters were reluctant to cast ballots in person because of the coronavirus pandemic. The calls also claimed that the government could use mail-in voting information to track people for mandatory vaccination programs, prosecutors said.

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“These individuals infringed upon the right to vote, which is one of the most fundamental components of our democracy,” the Cuyahoga County prosecutor, Michael C. O’Malley, said in a statement announcing the guilty pleas on Monday.

According to the indictment, Mr. Wohl and Mr. Burkman were each charged with multiple counts of bribery and telecommunications fraud. Those charges were merged into one count each of telecommunications fraud under the plea deal in Ohio, James Gutierrez, an assistant Cuyahoga County prosecutor, said in an interview on Tuesday.

“We made convicted felons out of them,” Mr. Gutierrez said. “Our goal was to make them accountable, and we did.”

Mr. Gutierrez said that the count that the two men pleaded guilty to covered the calls that were made to voters in Cuyahoga County, which includes Cleveland. They face up to a year in prison and a fine of $2,500 when they are sentenced on Nov. 29, he said.

Brian Joslyn, a lawyer for Mr. Burkman, did not respond to a call to his office requesting comment. Mark Wieczorek, a lawyer representing Mr. Wohl, declined to comment when asked about the plea deal.

When announcing the indictments in 2020, prosecutors in Ohio said Mr. Burkman and Mr. Wohl used a voice broadcasting service provider to place more than 67,000 calls across several Midwestern states. More than 8,100 of them went to telephone numbers in Cleveland and East Cleveland, and about 3,400 were answered by a person or went to voice mail.

The recorded messages “falsely warned people that if they voted by mail that their information could be used by law enforcement, collection agencies” and the Centers for Disease Control and Prevention “for the purposes of pursuing old warrants, collecting outstanding debts, and tracking people for mandatory vaccines,” Mr. O’Malley’s office said.

The Ohio attorney general, Dave Yost, whose office investigated the calls, said in a statement on Monday that Mr. Wohl and Mr. Burkman had been trying to suppress voting in minority neighborhoods.

“Voter intimidation won’t be tolerated in Ohio,” Mr. Yost said.

The allegations against the two operatives came at a time when Donald J. Trump, as president, was seeking to discredit mail-in voting, saying without offering evidence that it was rife with fraud. At the time, millions of voters were expected to vote by mail because of the pandemic.

Mr. Wohl and Mr. Burkman face similar charges in Michigan, where they were charged in 2020 with intimidating voters, conspiracy to intimidate voters, using a computer to intimidate voters and conspiracy to use a computer to intimidate voters, according to a criminal complaint.

Michigan’s attorney general, Dana Nessel, said the calls were part of a broad effort to intimidate nonwhite voters from casting mail-in ballots. The case is pending in the Michigan Supreme Court, a spokeswoman said on Tuesday.

The Federal Communications Commission last year proposed a fine of just over $5 million for Mr. Wohl, Mr. Burkman and his company, J.M. Burkman & Associates, for apparently making 1,141 unlawful robocalls to wireless phones without consent. An F.C.C. spokesman said on Tuesday that the proposed fine was still pending.

In 2020, a federal judge in New York ordered the two men to call 85,000 voters who had received robocalls and inform them that the original call “contained false information.”

Above is from:  Right-Wing Operatives Plead Guilty in Voter-Suppression Scheme (msn.com)

October 20, 2022: Johns Hopkins COVID 19 Situation Report

COVID-19 Situation Report

Editor: Alyson Browett, MPH

Contributors: Clint Haines, MS; Noelle Huhn, MSPH; Amanda Kobokovich, MPH; Aishwarya Nagar, MPH; Christina Potter, MSPH; Matthew Shearer, MPH; and Rachel A. Vahey, MHS

PhD APPLICATIONS OPEN In a world of rapid innovation in the biological sciences, the emergence of new diseases, and changing environmental pressures, health security risks to the global community are a rising concern. The field of health security has a growing need for trained experts who can provide science-based solutions and inform global policies to shape preparedness and response efforts. Selected students, with interest in pandemics and global catastrophic biological risks (GCBRs), will receive full funding to complete their PhDs in the Health Security track within the Johns Hopkins Bloomberg School of Public Health’s Department of Environmental Health and Engineering. More information and application details can be found https://www.centerforhealthsecurity.org/our-work/education/#phd. The application deadline is December 1, 2022.

CALL FOR PAPERS Together with the 2022 Preparedness Summit Planning Committee, the Johns Hopkins Center for Health Security journal, Health Security, will publish a new supplement in 2023. The aim of this supplement is to extend conversations begun at the 2022 Preparedness Summit to contribute to a growing body of knowledge about the COVID-19 pandemic and its impact on public health preparedness. Potential authors are encouraged to submit manuscripts that consider how the COVID-19 pandemic is transforming public health preparedness policy and practice and discuss the future of the field. The deadline for submissions is January 17, 2023. More information is available here: https://www.centerforhealthsecurity.org/our-work/journal/call-for-papers/index.html

EPI UPDATE The WHO COVID-19 Dashboard reports 623 million cumulative cases and 6.55 million deaths worldwide as of October 19. Global weekly incidence again remained steady at slightly more than 3 million cases for the sixth consecutive week, decreasing only 0.87% compared to the previous week. Weekly incidence in Europe remained relatively steady over the previous week, falling 3% after steady increases for the previous 4 weeks. Weekly incidence increased 11% in the Western Pacific, while all other regions reported decreasing trends. Global weekly mortality continued to decrease for the ninth consecutive week, down 15% from the previous week.

UNITED STATES

The US CDC is reporting 96.8 million cumulative cases of COVID-19 and 1.06 million deaths. Daily incidence continues to decline, down to 37,052 new cases per day, the lowest average since mid-April. Average daily mortality also continues to decline, down to 323 deaths per day on October 18.**

**Changes in state-level reporting may affect the accuracy of recently reported data, particularly over weekends. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent dates.

Both new hospital admissions and current hospitalizations continue to exhibit downward trends, with decreases of 1.8% and 3.3%, respectively, over the past week. Both trends peaked around the end of July, although the decreasing trend appears to be leveling.

The BA.5 sublineage continues to be the dominant strain in the US, accounting for 67.9% of sequenced specimens; however, its estimated prevalence has decreased for 8 consecutive weeks. Notably, the BA.4.6 sublineage (12.2%) appears to be losing its growth advantage to others, including BQ.1 (5.7%), BQ.1.1 (5.7%), and BF.7 (5.3%). BA.2.75.2 (1.4%) and BA.2.75 (1.3%) also show relative growth advantage over BA.5.

IMMUNE EVASIVE OMICRON SUBVARIANTS ​​While past surges in COVID-19 cases have been driven largely by single SARS-CoV-2 variants, experts are eyeing a collection of Omicron subvariants that could drive an anticipated wave of infections this fall and winter. In the US, BA.4.6 appeared to be gaining momentum, although BF.7, BQ.1, and BQ.1.1 are showing recent potential growth advantage. The same sublineages are also showing evidence of growth advantage over BA.5 in the United Kingdom. Additional variants, including the recombinant variant XBB, are fueling increases in cases in Southeast Asia and Europe. The US has yet to see a large surge due to these subvariants, with the number of new cases continuing to drop. But public health experts warn data on new cases is unreliable—many are turning to wastewater surveillance to help predict where and when surges may occur—and most expect the downward trend to reverse over the next few weeks. The collection of variants, sometimes referred to as “scrabble variants” or “subvariant soup,” accounts for nearly 1 in 3 new infections reported in the US last week. Globally, detecting these variants and developing accurate assessments of the risk they pose to public health is challenging, as many countries have rolled back their surveillance efforts.

While available vaccines remain effective in preventing severe illness and death from COVID-19, there are concerns the emerging subvariants will be more immune evasive than previous variants, particularly due to mutations in the receptor binding domain that would prevent antibodies from docking and attacking the virus. AstraZeneca’s EvuSheld, the only monoclonal antibody authorized to prevent SARS-CoV-2 infection, is ineffective against BA.4.6. Other monoclonal antibodies in development already demonstrate vulnerabilities to newly emerging Omicron subvariants. With this new information, the Biden administration is searching for other potential candidates for use among immunocompromised persons.

US RESPONSE With public vigilance waning and the hopes of new pandemic funding from the US Congress fading, the COVID-19 response in the US is entering a new and uncertain phase. Omicron subvariants remain the predominant circulating lineages, many with high levels of transmissibility and immune evasion. Most places have completely dropped public health measures meant to mitigate transmission, and fewer and fewer Americans are wearing masks indoors or in crowded public spaces. With lower vaccine demand and less federal funding, vaccine manufacturers must soon decide whether and how high to price vaccines and boosters moving forward. While people with health insurance likely will continue to be able to access free or low-cost COVID-19 vaccines and therapies, those who are uninsured or underinsured potentially could lose no-cost access, a factor that would exacerbate underlying inequities. One factor influencing when COVID-19 tools will be commercialized is when the public health emergency declaration ends; however, the Biden administration last week extended the public health emergency for another 90 days, into January 2023, ahead of an expected potential winter surge. This decision aligns with a recent statement from the WHO reinforcing that COVID-19 very much remains a global emergency and calling for nations to sustain efforts to fight against its spread. Still, the US likely will end its public health emergency in 2023, when it will significantly cut back on certain components of its COVID-19 response.

Notably, efforts are underway to prevent such a situation from happening again in the future. On October 18, US President Joe Biden signed a National Security Memorandum to launch the administration’s “National Biodefense Strategy and Implementation Plan for Countering Biological Threats, Enhancing Pandemic Preparedness, and Achieving Global Health Security.” The strategy calls for US$88 billion in funding over the next 5 years to strengthen key areas of pandemic preparedness and biodefense. The strategy will also bring together key government sectors to support its implementation, including the White House, the Intelligence Community, the US Department of State, and the US HHS.

GAIN-OF-FUNCTION STUDY A laboratory at Boston University has come under criticism for its recent gain-of-function experiments on the SARS-CoV-2 virus. Gain-of-function (GOF) refers to laboratory experiments that strategically and specifically enhance the function of one or more genes to study the outcome. They can range from something as simple as overactivating an important enzyme to enhancing the pathogenicity of a virus. In the Boston University (BU) experiments, performed at the BSL-3 level, the original strain of SARS-CoV-2 was modified to contain Omicron variant spike proteins with the aim of studying why some strains of SARS-CoV-2 are more pathogenic and transmissible than others. This work was reviewed internally by the BU institutional review board (IRB) and externally by the Boston Public Health Commission but not by the US NIH or NIAID, which were partial funders. NIH is currently launching a probe to evaluate whether this experiment should have been subject to federal oversight and review before moving forward. BU maintains that the research was not directly funded by the NIH and therefore there was no wrongdoing in not alerting them before beginning the experiment. The federal government takes GOF research very seriously, especially for those manipulating pathogens with potential pandemic potential, as SARS-CoV-2 certainly is. Even before the lab-leak hypothesis of SARS-CoV-2 origins, there was a large amount of controversy surrounding how and when to allow GOF research to move forward.

However, BU refutes that this experiment even should be considered as gain-of-function and maintain that they actually made a less dangerous version of the virus. The school criticized the initial media reports of the experiment, saying they were highly sensationalized; several outlets stressed the study’s finding that the altered strain caused 80% mortality in mice with severe disease, but that proportion is in line with experiments using unaltered SARS-CoV-2. Still, the finding that the resulting strain was less pathogenic does not alter the fact that the methods used fall within the definition of GOF research. Many biosecurity experts have come forward to disagree with BU’s characterization of their research and reiterate that this was in fact GOF research. The NIH inquiry and the renewed conversation among the scientific community will hopefully spur greater understanding and consensus around the risks and benefits of GOF research, in addition to institutionalizing the use of greater safeguards when conducting research with pathogens of pandemic potential.

LIFE EXPECTANCY & PREGNANCY-RELATED MORTALITY The COVID-19 pandemic interrupted decades worth of gains in global life expectancy. According to a study published October 17 in Nature Human Behaviour examining life expectancy losses during the pandemic, those countries that had higher proportions of their populations vaccinated by October 2021 experienced smaller life expectancy deficits in winter 2021. Of the 29 countries included in the analysis, most countries in Western Europe bounced back relatively well from life expectancy losses while most countries in Eastern Europe, the United States, and Chile experienced continuing declines in their pre-pandemic life expectancy. All nations had lower life expectancy than would be expected if pre-pandemic trends had continued. According to data from the US CDC, US life expectancy fell by a total of 2.6 years between 2019 and 2021 to 76.1 years, the lowest level since 1996.

In the US, COVID-19 contributed to about 25% of the more than 2,000 maternal deaths in 2020 and 2021, according to a report published by the US Government Accountability Office. Pregnant people are more vulnerable to severe COVID-19 outcomes, the US CDC has warned. Since 2018, maternal deaths have increased nearly 80%, with COVID-19 associated with 401 of the 1,178 pregnancy-related deaths last year. Additionally, racial and ethnic disparities widened; pregnancy-related deaths among Black people climbed from 44 per 100,000 in 2019 to 68.9 per 100,000 in 2021, rose from 12.6 per 100,000 in 2019 to 27.5 last year for Hispanic individuals, and increased from 17.9 in 2019 to 26.1 in 2021 for White people. Many factors contributed to the increase in maternal deaths, including the emergence of the Delta variant, mental health, lack of access to medical care, and low vaccination rates among pregnant people, among others. Experts note that many of these deaths were preventable, highlighting the urgent need to find solutions.

US CDC VACCINES FOR CHILDREN PROGRAM The US CDC Advisory Committee on Immunization Practices (ACIP) on October 19 recommended that vaccines against COVID-19 be included in the CDC Vaccines for Children program, which provides no-cost vaccines for a variety of diseases to children and adolescents aged 18 and younger whose families cannot afford them. Children are eligible for the program if they qualify for Medicaid, or are uninsured, underinsured, or Native American. The panel of independent advisors voted unanimously to include COVID-19 vaccines in the program to ensure these children can receive the shots for free after the federal government shifts the vaccination program to the commercial market. When the Biden administration decides to end the COVID-19 public health emergency—which it extended again last week—more than 5 million children are expected to lose health insurance under federal programs.

During the meeting, the panel emphasized they were not voting on adding COVID-19 vaccines to the CDC annual vaccination schedule, although a meeting to consider doing is taking place today. While the CDC decides a recommended vaccination schedule for children based on age, US states decide which vaccines are mandatory for entry into schools. Nonetheless, the CDC had to push back on a Fox News contributor who amplified a false claim that the CDC was set to mandate COVID-19 vaccines for schoolchildren. Public health experts agree there is legitimate debate over whether school-aged children should be required to receive the vaccines but warned the erroneous claim represents another example of how quickly misinformation can spread and potentially harm children, erode trust in federal health institutions, or endanger health officials. Experts also agree more states and localities will require children be vaccinated to attend the upcoming 2023 school year.

NOVAVAX BOOSTER On October 19, the US FDA authorized Novavax’s monovalent, protein-based COVID-19 vaccine as a booster for adults. The Novavax booster targets only the original coronavirus strain, although the company is concurrently studying an Omicron-targeting vaccine, in addition to a bivalent booster. The US CDC recommended the monovalent product for use among adults aged 18 years and older who have not yet received any COVID-19 booster but who have completed a primary series vaccination with any authorized or approved vaccine at least 6 months prior. The authorization offers another option for individuals who cannot or are reluctant to receive one of the bivalent mRNA vaccine boosters, or for those who would otherwise not receive a booster.

MODERNA OMICRON BOOSTERS Moderna’s bivalent Omicron-containing booster (mRNA-1273.214), administered as a fourth vaccine dose, produced a stronger immune response to Omicron BA.1 compared to its original booster dose at 90 days, according to the company. Additionally, the updated booster elicited a significantly higher neutralizing antibody response against Omicron BA.4/BA.5 compared to the original version at 28 days, suggesting the booster can produce broad cross-neutralization against Omicron subvariants. Moderna’s BA.1 bivalent booster is central to fall and winter vaccination campaigns in the UK. The company expects to announce interim immunogenicity results of its Omicron BA.4/BA.5-targeting bivalent vaccine (mRNA-1273.222), which is authorized for use in the United States, later this year. It is unclear how well either booster will work against newly emerging Omicron sublineages—including BQ.1.1, XBB, BF.7, and BA.2.75.2—which are expected to be more immune evasive than their older relatives and expected to cause COVID-19 surges in several nations through the end of this year and into the next.

Moderna also announced this week it will work with Gavi, the Vaccine Alliance, to supply more than 100 million doses of its Omicron-adapted bivalent vaccines for purchase at its lowest-tier pricing in 2023 to the COVAX Advance Market Commitment (AMC). Under the new framework, pending orders for Moderna’s original SARS-CoV-2 vaccine will be canceled, and COVAX will instead offer the newer vaccines to low- and middle-income countries (LMICs), which can use them as they see fit. COVAX has delivered nearly 1.8 billion doses of vaccines for COVID-19 to 146 countries, overcoming a rough start to obtain vaccine doses due to hoarding by wealthier nations. Dr. Mike Ryan, executive director of the WHO Health Emergencies Programme, this week at the World Health Summit harshly criticized wealthy nations and pharmaceutical companies for failing to adequately share vaccine doses through COVAX.

Glenn Kirschner: A jury will convict Trump

Salon

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"They are going to convict very quickly": Glenn Kirschner on the trial of Donald J. Trump

Chauncey DeVega - 14h ago

Donald Trump© Provided by Salon

Former President Donald Trump stands at a ‘Save America’ rally on July 22, 2022 in Prescott Valley, Arizona. Mario Tama/Getty Images

Over the course of nine public hearings the House Jan. 6 committee has conclusively shown that Donald Trump tried to end American democracy by nullifying the results of the 2020 election. In an exclamation mark to that conclusion, the House committee has now subpoenaed Trump. It's unlikely, of course, that Trump will supply the evidence the committee demands or appear to testify.

Trump's coup plot was complex and multifaceted. Its tentacles included numerous Republican officials, right-wing paramilitaries, media propagandists, private funders, interest groups, think tanks, and other agents. As was confirmed during last Thursday's committee hearing (presumably its last), the FBI, the Department of Homeland Security, the Secret Service and other law enforcement and national security agencies were aware that some of Trump's followers were armed and were coming to Washington with violent intentions on Jan. 6. Even worse, the evidence suggests that some individuals at the highest levels of the federal government either actively aided Trump's coup attempt or did nothing to prevent it.

Jan. 6 was not the climax of Trump and the Republican fascists' campaign to subvert the Constitution, demolish the rule of law and overthrow democracy. That day was just one more chapter in Trump's lawlessness and contempt for democracy. Trump's presidency was itself an extension of a much larger pattern: Throughout his decades of public life, he has behaved like a crime boss with no respect for anything or anyone beyond his own narrow self-interest and his bottomless hunger for power and wealth.

Ultimately, the Jan. 6 insurrection was just the beginning. Donald Trump and the Republicans' assault on democracy is only escalating as the midterms approach and the future of the country hangs on the precipice. What happens next? What are Attorney General Merrick Garland and the Department of Justice waiting for? What does justice look like? Will Donald Trump and the other coup plotters ever be prosecuted and punished?

Glenn Kirschner is a legal analyst for NBC News and MSNBC who teaches criminal law at George Washington University. For most of his 30-year career in law enforcement, Kirschner was an assistant U.S. attorney in Washington, D.C., often prosecuting serious crimes in federal court, and before that was a prosecutor and appellate attorney in the U.S. Army.

In this conversation, Kirschner describes Donald Trump as a "ruling-class criminal" who serves as living proof of how the rich and the powerful often evade justice in America. Trump's contempt for the rule of law is understandable, since he has never been held properly accountable for his lawbreaking. This time, Kirschner says, Trump may finally gone too far. 

The House Jan. 6 committee hearings, Kirschner suggests, have provided a roadmap for prosecuting Donald Trump for such serious crimes as seditious conspiracy and attempting to defraud the United States. Kirschner believes the evidence is overwhelming and clear, and that it will not be difficult to convince a jury to convict Donald Trump. That does not mean, Kirschner cautions, that Trump is likely to serve time in prison.

The Department of Justice may approach Trump's prosecution, Kirschner says, as a series of overlapping conspiracies rather than as the kind of comprehensive RICO case used against organized crime and other complex criminal organizations.

Toward the end of this conversation, Kirschner warns that it's likely Trump's followers will follow through on his commands to commit acts of violence if he is prosecuted or convicted — but says that most of Trump's MAGA followers are cowards and that any potential violence will be limited in scope.

How are you feeling? As a human being, how are you managing this democracy crisis and the troubled state of our country?

I feel schizophrenic, because one moment I am extremely frustrated and then the next moment I find some reason for hope and optimism. But as a whole I have been trying to balance the need for patience in any large-scale criminal investigation with the frustration that I feel.

Part of my daily work when I was a prosecutor involved assessing whether there was probable cause to support the application for an arrest warrant or an indictment. We had many long-term investigations that started out covert, they were proactive. By comparison, a reactive investigation is when an arrest is made, and we begin presenting evidence and information and seek an indictment. That is the stock in trade of state, local and county prosecutors as opposed to federal prosecutors.

Federal prosecutors mostly do proactive investigations where there is adequate predication and then we start in a very leisurely way. We want the case to be perfect. That's always the goal of the federal prosecutor. When federal prosecutors decide to return an indictment, they have likely already negotiated a pre-indictment plea, so it's already wrapped up in a pretty little bow and dropped on the court docket such that the Department of Justice is never operating under deadlines. We didn't have a sense of urgency. I often found that problematic. Every day, particularly when I was chief of homicide, we were investigating murders, conspiracies and obstruction cases.

Once we had probable cause to make an arrest, to indict somebody, I had to assess whether the right thing to do was to continue to investigate proactively, meaning covertly, without making an arrest, or to move forward to an arrest, a takedown and an indictment. The biggest factor in that decision was public safety.

The fact that Donald Trump is not being held accountable doesn't make sense. But it can be explained by the phenomenon of the ruling-class criminal. America has never been willing to hold them accountable.

How does that translate to the investigation of a former president? They're very different investigations in very different circumstances, of course. But I maintain that public safety writ large — for example, the viability of our democracy — should be an enormous factor in when the Department of Justice chooses to move toward an indictment of Donald Trump. Public safety is at risk. Our democracy hangs in the balance.

We are prosecuting Donald Trump's foot soldiers who he unleashed upon the Capitol on Jan. 6 to stop the certification. They are going to trial; they're going to prison. The man who gave the criminal order to attack is playing golf, holding rallies and attending dinner parties. That is a deep injustice at play in America every minute of every day, until Donald Trump is held accountable.

As a working-class black man in America, I know that if I did one-millionth of what Trump is alleged to have done, never mind what is obvious, I would be in prison long ago. The fact that Trump is not in jail facilitates and nurtures this democracy crisis, and feeds the anger that there is one set of rules for the rich and powerful and another one for everybody else. What are Merrick Garland and the Department of Justice and the others investigating Trump waiting for?

Don't ask me to explain the inexplicable, because I can't. Every single jury I spoke with, I warned them that they should not try to make sense of murder or other crimes. Because if you're waiting for it to make sense, or you require it to make sense in order to vote guilty, nobody would ever be convicted. The fact that Donald Trump is not being held accountable doesn't make sense. But it can be explained by the phenomenon of the ruling-class criminal. America has never been willing to hold the ruling-class criminals accountable, whether they are in politics, business, entertainment, the tech business or what have you.

Donald Trump is publicly admitting, for all intents and purposes, that he violated the Espionage Act and committed other high crimes. He is trying to extort the DOJ and Garland with threats of violence. He brags about financially supporting his followers who attacked the Capitol. He shows no fear of being prosecuted or being punished in any way for his obvious crimes. Does he want to go to jail? Or does he simply believe that he is above the law?

Donald Trump believes that he is above the law. And he holds that belief for good reason. It appears that Trump has lived a life of crime and has never been held accountable. That is a dramatic failing of our criminal justice system, our law enforcement agencies and most certainly our nation's prosecutors. Trump, in my opinion, has also come to believe, with good reason, that if he admits his crimes out loud people will take a step back and scratch their heads and say, "Geez, I thought it was criminal what he did, but he is saying he did it. So I'm uncomfortable, because that's not the way we go about investigating and prosecuting crimes in America. Something is wrong here. I don't know what it is, but we have to figure it out." In reality, what we as a society need to do is to focus on why Trump and other such people are not being prosecuted.

I would take that 14-page statement that he issued last week in response to the House Jan. 6 committee subpoena and slap a government exhibit sticker on it. I would then hand it to the jury as sharply self-incriminating evidence of Donald Trump's admission of guilt. This is what has me so unbelievably frustrated and angry. The prosecutors, on both the state and federal level, have all been reluctant, hesitant and maybe even afraid to be the first to charge Donald Trump with committing crimes. No prosecutor wants to be the first to charge a former president who committed crimes. However, everybody will want to be the second to do so. Once that barrier is broken, and the white-hot glare of world media attention is focused on the first prosecutor and his or her office, then everybody's going to want to get into the prosecuting Donald Trump business.

I believe I've seen proof beyond a reasonable doubt in the public reporting, assuming it to be accurate. Moreover, I am 100% confident that the evidence of criminal conduct that we've seen publicly reported or shared with us in the Jan. 6 committee public hearings is about one-tenth of what the Department of Justice has by way of incriminating information.

Certainly, I see a conspiracy to commit offenses against or to defraud the United States. Judge David Carter in California ruled that there was a preponderance of evidence to conclude that Donald Trump committed that crime in a conspiracy with John Eastman. He also concluded that Donald Trump committed a second federal felony, obstructing an official proceeding.

No prosecutor wants to be the first to charge a former president who committed crimes. However, once that barrier is broken, everybody will want to be the second to do so.

I also see evidence of inciting an insurrection or rebellion. Trump gathered together his angry supporters, he promised them a wild time and told them that their vote had been stolen. In total, that is compelling evidence of Donald Trump's criminal intent. Now, what sealed the deal for me was when we learned that Donald Trump told his own DOJ officials that he didn't care if there was no voting fraud and that they should just say that there was and then "leave the rest up to me and the Republican members of Congress."

To my eyes that is conclusive evidence of criminal intent, corrupt intent, guilty mens rea [knowledge of wrongdoing]. We can prove that in our sleep, in my estimation. Trump lied to people with the goal of inspiring them to anger. Then you tell them, "If you don't fight like hell, you're not going to have a country anymore. Go to the Capitol and stop the steal." That is more evidence of Trump's corrupt intent, because he continued to lie to them right up to the moment before they marched on the Capitol. Trump told them directly to go down there and stop the lawful functions of government — and Trump's followers did it. That is inciting an insurrection or rebellion. If we can ever get a prosecutor to plant his or her feet in the well of a court and present this to 12 jurors, they are going to convict Trump very quickly. This is a stronger case than the vast majority of cases I tried in 30 years.

Trump's response to the subpoena, which was a 14-page missive, was really a non-response. He didn't mention the subpoena. He didn't acknowledge it. Trump did not say he would or would not comply, or that he would defy it and file suit. He said nothing about it. Trump began by saying that the election was fraudulent and stolen. That's an admission of guilt. Why? Because his own DOJ officials, his own DHS officials, his own attorney general, all said there was no fraud undermining the election result. In fact, they said it was the safest, most secure election ever. His own staff said that too.

Trump continues to lie. That is evidence of an ongoing 371 conspiracy to defraud the United States. Of course, Trump will defy the subpoena. He will probably file suit and try to run out the clock and he will probably succeed, given how little time the select committee has left. In the end, the subpoena will get stuck in the courts and it will die.

I am concerned that Trump's influence is so great that it will be very difficult to find a fair and impartial jury. Even worse, Trump's followers will try to get on the jury to sabotage the result so that he can escape accountability. If Trump is tried and not convicted, for whatever reason, he may end up becoming even more powerful and dangerous.

Of course those are reasonable concerns. But none of that is a reason not to indict and try somebody for the crimes they committed.

A politician who contemplates offenses against the United States will know that Donald Trump was indicted, he went to trial and it took up two or three years of his life, burning through every penny he might have.

I spent decades trying cases before D.C. juries, and they're not monolithic, but there are certain similarities that I saw. They like their proof beyond a reasonable doubt. But once you give it to them, they're not easily distracted or confused by chaff that may be thrown into the mix by defense attorneys. Also, in my experience D.C. juries tend to take their oath of jury service seriously and decide the case based solely on the evidence, not on politics, ideology, preconceived notions or media accounts that they may have been exposed to before becoming jurors. I have complete confidence, actually, that if you give 12 citizens of the District of Columbia enough evidence to convict, they're going to convict based on the evidence.

Again, I believe the evidence is overwhelming of Donald Trump's guilt. Indicting and trying somebody for serious criminal offenses in and of itself has a powerful deterrent effect, whatever the outcome may be. A politician who is contemplating committing offenses against the United States will know that Donald Trump was indicted, he went to trial and it took up two or three years of his life to burn through every penny he might still have. Even if the jury could not come to a unanimous decision — he's not going to be acquitted, I am almost certain of that — guess what? The benefit of a hung jury is that Donald Trump can be put on trial again. It has to be done. The results are almost secondary. I always told my homicide prosecutors that it is far more important to try cases than to win cases.

I have consistently described Trump as a political crime boss. Would you apply that framework for prosecuting Trump as the leader of a criminal conspiracy under the RICO laws?

First of all, I never want to bring a case that I make more difficult for myself than it has to be. You can bring a conspiracy case. That is a much easier prosecution for what Donald Trump did, in connection with the insurrection, than trying to build a RICO conspiracy. For the latter, you would have to prove there's an organization or an enterprise. You have to prove there's a pattern of racketeering activity. You have to generally show that there were people who fulfill the established roles in the hierarchy of the organization. That having been said, do I see a RICO case in Donald Trump? Yes. I think the Trump Organization was run as a criminal enterprise. That's a RICO organization. One can see Donald Trump's administration as a potential RICO case.

To that point, I see his Cabinet secretaries as having been involved in questionable conduct. Trump's cabinet was literally structured with the kind of hierarchy we would see in a RICO organization. With respect to the insurrection and everything that led up to it and has come after it, I see that much more as a hub-and-spoke conspiracy. Donald Trump is the hub and there are these spokes, the people radiating out from the center. They do not necessarily intersect with each other, but they are all connected to the central person, the mob boss, the kingpin, the one for whose benefit they're committing these crimes — in this example, to try to keep Trump in office unlawfully and unconstitutionally.

There are all these people, every single day on social media and elsewhere, who proclaim, "Donald Trump is going to jail! He will do a perp walk!" To my eyes that borders on the ridiculous. What do you think is going to happen? Is Trump going to jail?

I believe that Donald Trump will be indicted and arrested. It will probably be a negotiated turn in which means that we will not see a perp walk. Trump will go to trial. He is a deeply damaged human being who does not have the capacity to admit guilt. Therefore, Trump goes to trial and gets convicted of his alleged crimes. I believe that the charges will be for a series of different conspiracies. There may be one for the Espionage Act and the document cases involving Mar-a-Lago. There may be another charge for the insurrection. Trump will be convicted. I am almost certain of that outcome.

Will Donald Trump go to prison? My instincts tell me no, because I don't think we have the courage in this country to put a former president in prison. If Trump does not go to prison and is instead sentenced to home confinement, that will be an enormous failing of our government. My position on home confinement has always been that is sentencing somebody to watch movies and TV and order food. That's no kind of punishment. Donald Trump needs to be put in prison, not only to punish him for crimes against the United States, but to deter the next aspiring political criminal or dictator or other killer of our democracy.

Does this all end with a whimper or a bang? Will Donald Trump unleash violence across the country by his followers if he is indicted or convicted?

I don't think we have the courage to put a former president in prison. If Trump does not go to prison and is instead sentenced to home confinement, that will be an enormous failing of our government.

Trump goes out with what he hopes is a bang, but in the end it will be a whimper. His supporters are not strong people. Many of them are not critical thinkers. Many of them only feel strong when they have guns, big automatic weapons, across their bellies and prance around with them. That is not a strong person. That's not the kind of person who's going to take up arms because Donald Trump has been indicted. Instead, that's the kind of person who is going to look for the next false God to worship, such as Ron DeSantis or whoever else it might be.

Trump is going to call for violence, but it will fizzle out because his followers will not rise up. There might be small pockets of violence, but the reality is that we have small pockets of violence across the country in major cities every day. In the end, I don't think there will be any more violence inspired by Donald Trump's arrest than, unfortunately, we suffer in every city and every county in every town across America every damn day.

If you had Merrick Garland's ear right now, what would you tell him?

He is a good, honorable, honest and ethical man. If I could be so bold as to offer him any thoughts, I would say the nation is suffering. The American people are desperate, anxious, depressed, angry and upset. They don't understand why somebody who has committed crimes in the harsh light of day, and then not only admitted to them but bragged about them, is free to play golf every day. That is such a deep injustice. It is doing enormous damage to the legitimacy of the Department of Justice, an institution I respect and love.

On the one hand, you want to say better late than never if you're going to bring charges against Donald Trump. But it's already so late. People have lost so much confidence. You came in as somebody who was determined to rebuild the institution, the prestige and the legitimacy of the Department of Justice. But I think the way this investigation is lingering is doing the exact opposite. I hope he can make decisions quickly that will remedy all of that.

Above is from:  https://www.salon.com/2022/10/17/they-are-going-to-convict-very-quickly-glenn-kirschner-on-the-trial-of-donald-j/