April 13, 2023: Johns Hopkins COVID 19 Situation Report

COVID-19 Situation Report

Weekly updates on COVID-19 epidemiology, science, policy, and other news you can use.

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Announcements

NEW JOURNAL ISSUE The March/April 2023 issue of the Johns Hopkins Center for Health Security journal Health Security is now online. You can find it here:https://www.liebertpub.com/toc/hs/21/2

In this issue

> White House launches US$5 billion program to accelerate COVID-19 vaccine, treatment development in partnership with private sector

> US President Biden signs resolution ending COVID-19 national emergency; public health emergency set to expire on May 11

> US FDA expected to authorize additional bivalent booster dose for older adults, people with compromised immune systems

> Adults self-reporting post-COVID condition more likely to experience trouble accessing healthcare than people without condition

> Study highlights correlation between obesity, COVID-related mortality; more US Army troops developed obesity during pandemic

> Multiple recent studies examine maternal, newborn morbidity, mortality in relation to COVID-19

> What we're reading

> Epi update

White House launches US$5 billion program to accelerate COVID-19 vaccine, treatment development in partnership with private sector

The Biden administration on April 10 announced it is launching a US$5 billion-plus program to accelerate the development of new COVID-19 vaccines and treatments, with a focus on 3 goals: creating long-lasting monoclonal antibodies; speeding the development of vaccines that provide mucosal immunity, such as those administered nasally; and bolstering efforts to develop pancoronavirus vaccines that could protect against current and future SARS-CoV-2 variants as well as other known and emerging coronaviruses. The initiative, dubbed “Project NextGen,” will operate in a similar way to the successful “Operation Warp Speed” program—an US$18 billion initiative that supported the rapid development and distribution of COVID-19 vaccines—by using a cross-cutting government approach and partnering with private sector companies to achieve its goals.

According to administration officials, funding for the initiative, which will be based at the Department of Health and Human Services (HHS), is coming from money saved from contracts costing less than originally estimated. HHS shifted funds intended for COVID-19 testing and other priorities, possibly raising questions from Republicans about why those funds were available, after several funding requests for the program and other COVID-related efforts were refused by the US Congress.

Some of the lab work to develop new therapies and vaccines is already underway; for example, researchers posted a preprint to bioRxiv this week identifying 2 human monoclonal antibodies that neutralize all current SARS-CoV-2 variants of concern (VOCs) by conformational locking. The federal government is working to identify potential private sector partners for Project NextGen, and there is no timetable for when any of the products might come to market. Though some experts feel the program’s goals are unattainable, others say that the unprecedented pace of advancements of vaccine development and testing during the pandemic could usher in a golden era of vaccines, setting the stage for further breakthroughs on everything from other respiratory diseases to cancer.

US President Biden signs resolution ending COVID-19 national emergency; public health emergency set to expire on May 11

US President Joe Biden signed a resolution on Monday that immediately ended the COVID-19 national emergency. The national emergency was first declared in March 2020 under the Trump administration and was set to expire in May. The US House Republicans passed the measure in February, and the US Senate passed it last month with a bipartisan 68-23 vote. The national emergency allowed the federal government to take control over pandemic response and support the country’s health and welfare systems; many measures have already been phased out. Some healthcare policies will be changing with the end of the national emergency, but a separate and more consequential public health emergency regarding COVID-19 will remain in effect until May 11.

Repercussions of ending the national emergency may not be strongly felt across the country; however, once the public health emergency ends in May, many uninsured Americans will lose medical- and social-program support permitted under the emergency and face out-of-pocket costs for COVID-19 treatments, vaccines, and at-home tests. Recent polling reflects the complex feelings Americans have toward ending the emergency and returning to normal life, or a new normal, post-COVID.

US FDA expected to authorize additional bivalent booster dose for older adults, people with compromised immune systems

In the coming weeks, the US FDA is expected to authorize second bivalent COVID-19 vaccine booster doses for people who are at least 65 years old or have weakened immune systems in an effort to protect those who are at higher risk of severe disease. Eligible individuals could receive the additional dose at least 4 months after their first shot of the bivalent booster, which targets the SARS-CoV-2 Omicron subvariants BA.4 and BA.5 as well as the original, wild-type coronavirus. The policy change likely will be “permissive,” meaning individuals will be expected to consult with their healthcare providers about whether to get another dose. The US CDC is expected to quickly endorse the shots, according to officials speaking to media on the condition of anonymity.

Last month, the CDC upheld its recommendations that only one bivalent dose is needed for now. Only 16.7% of the US population has received a first dose of the updated booster. Experts are divided over whether or how often healthy adults should get boosters, but more consensus exists that older adults and people with compromised immune systems should get them more often, as protection wanes over time. And although the bivalent booster formulation available now targets Omicron BA.4 and BA.5, the shots are associated with a lower risk of infection or severe infection with the BQ.1–BQ.1.1 and XBB–XBB.1.5 subvariants, the latter of which currently account for most infections in the US.

Adults self-reporting post-COVID condition more likely to experience trouble accessing healthcare than people without condition

According to an April 10 study published in JAMA Network Open, 22.5% of adults self-reported experiencing post-COVID condition (PCC)—commonly known as long COVID and defined for this study as experiencing symptoms more than 4 weeks after first having COVID-19 that were not explained by another condition or factor—and were more likely to have difficulty getting and paying for healthcare compared to adults without PCC or those never diagnosed with COVID-19. They attributed their unmet needs to healthcare being too costly (27%), inability to get a timely appointment (22%), difficulty getting health plan care authorizations (16.6%), and difficulty finding doctors who accept new patients (16.4%). Moreover, nearly 14% of adults found it challenging to communicate with payers about the cost of care, their network, or the services that their health plans covered. These unmet health needs and lack of access to healthcare may reflect a few obstacles: PCC treatments are still vaguely defined; insurers struggle to identify how to authorize and reimburse PCC treatments; knowledge about how to manage PCC is limited; and social determinants of health may widen preexisting health disparities among survey participants. This ambiguity around defining and characterizing long COVID and PCC makes it difficult for people to seek much-needed treatment.

Though it is difficult to identify why some people who are infected with SARS-CoV-2 experience long COVID while others do not, a growing body of evidence indicates that a persistent, active viral infection with SARS-CoV-2 may drive PCC by lingering long after an initial infection. Fresh concerns have emerged around the long-term prognosis for children and teenagers experiencing long COVID, some of whom suffer from severe symptoms. Some clinicians question whether the condition is real, revealing a need to raise awareness that between 4% and 25% of kids who get COVID-19 develop long COVID, and that it is a real condition. Regardless of patient symptoms and characteristics, experts recommend using patient-centered communication and empathy as a starting point when identifying treatments for people with PCC.

Study highlights correlation between obesity, COVID-related mortality; more US Army troops developed obesity during pandemic

A study published in Scientific Reports this week analyzed data from 142 countries and found a statistically significant positive association between COVID-19 mortality and the proportion of obese individuals in the adult population, regardless of income group or demographic factors such as median age, proportion of elderly, and/or proportion of females. The estimated elasticity of COVID-19 mortality with respect to the proportion of obese individuals was highest in high-income countries; on average, every 1% point increase in the proportion of obese individuals contributed to an additional 1.5% points increase in COVID-19 mortality in high-income countries. The positive association between obesity and COVID-19 mortality remained robust even when considering age, gender, and income.

In related news, a retrospective cohort study of active duty US Army soldiers showed that nearly 10,000 of the nearly 192,000 soldiers included in the study developed obesity between February 2019 and June 2021, pushing the rate to nearly a quarter of the troops studied. Higher rates of obesity could result in decreased health of the US Armed Forces, as overweight and obese troops are more likely to be injured, less likely to endure the physical demands of their jobs, and at risk of missing more work days.

Multiple recent studies examine maternal, newborn morbidity, mortality in relation to COVID-19

The US has the highest maternal mortality rate of developed countries, and the rate rose during the COVID-19 pandemic, disproportionately impacting racial and ethnic minorities and those in rural areas and small cities. Several recent studies examined COVID-19’s effects on maternal and newborn morbidity and mortality.

• The mortality risk of pregnant patients with COVID-19 at delivery between March 2020 and December 2020 was 14 times higher than those who were not infected with SARS-CoV-2, according to a new analysis published in JAMA Network Open by researchers from the University of Southern California. Existing risk factors for severe COVID-19, such as high blood pressure, cholesterol, and diabetes, also made pregnancy higher risk, with social determinants of health and discrimination also playing a role in the disparity.

• A booster (third) dose of the Pfizer-BioNTech mRNA COVID-19 vaccine administered during pregnancy was associated with a 53% reduction in the risk of infant hospitalization due to COVID-19 during the first 120 days of life, compared to infants whose mothers received 2 doses, according to a study published in Nature Medicine. The study—conducted in Israel and including infants born between August 24, 2021, and March 15, 2022—also found that shorter durations between COVID-19 vaccinations and infant delivery were associated with greater immune protection. The study’s results highlight the importance of maternal vaccination for newborn health and may support women’s decisions to be vaccinated and, thereby, improve vaccination uptake rates among pregnant women, the researchers note.

• Infants born to women who had asymptomatic or mild COVID-19 disease during pregnancy did not show any neurodevelopmental delays compared to infants with no exposure to SARS-CoV-2, according to a study conducted by researchers from Columbia University and published in JAMA Network Open. The study included 407 infants aged 5 to 11 months old from New York City, Salt Lake City, and Birmingham, Alabama, and involved telehealth assessments of the infants in their home environments that took place between March 2021 and June 2022. Almost one-third (112) of the infants were exposed to SARS-CoV-2 in utero, with 25% exposed to asymptomatic maternal infection and 74.5% exposed to symptomatic maternal infection, and the researchers found no significant differences in infants exposed to the virus in utero and those with no exposure. The authors concluded that these findings offer helpful information for pregnant individuals who might contract COVID-19 during pregnancy, but further studies with longer-term follow-up are still needed.

• Notably, however, researchers from UHealth–University of Miami Health System and the University of Miami Miller School of Medicine recently published a case study in Pediatrics showing that SARS-CoV-2 breached the placenta and caused brain damage in 2 newborns. The infants initially tested negative for the virus at birth but had significantly elevated SARS-CoV-2 antibodies detectable in blood, indicating that either antibodies crossed the placenta, or passage of the virus occurred and the immune response was the infant's. Both infants experienced seizures, small head sizes, and developmental delays, and one died at 13 months of age. This is the first study to confirm cross-placental SARS-Cov-2 transmission leading to brain injury in newborns. The researchers recommend pre-pregnancy or pregnancy maternal COVID-19 vaccination as an important defense against infection in newborns.

• A recent survey conducted by the Annenberg Public Policy Center at the University of Pennsylvania reveals that many women of childbearing age in the US have doubts about the safety and effectiveness of flu and COVID-19 vaccines during pregnancy. According to the results, 53% of women aged 18 to 49 years believe the flu vaccine is safe for pregnant women and their fetuses, while 17% disagree. For the COVID-19 vaccine, 42% of women of childbearing age believe it is safe and effective during pregnancy, while 31% do not. Vaccination status also influenced the results, with vaccinated women expressing more confidence in the vaccines. The survey emphasizes the need to dispel misconceptions and prioritize public health messaging on the importance of vaccination for pregnant women and their infants. The US CDC recommends that pregnant women receive both vaccines.

What we’re reading

COVID ORPHANS Approximately 245,000 children in the US have lost one or both parents to COVID-19, and an estimated 10.5 million children globally have been orphaned by the pandemic, according to the Global Reference Group on Children Affected by COVID-19 and the journal BMJ. Such children, their families, and communities face complex needs—including grief counseling, mental health support, school transitions, and legal guardianship arrangements—but despite the significant implications, those needs have largely been overlooked in policy responses, The Guardian reports. Half of the nearly quarter-million US children who have lost one or both parents live in only 5 states—California, Texas, Florida, New York, and Georgia—according to “Hidden Pain,” a report from the COVID Collaborative. Notably, Black children in the US are twice as likely as White children to have lost a parent or caregiver to COVID-19. Nevertheless, there is no comprehensive national policy to provide assistance to COVID orphans, though some US states, such as California, have developed statewide programs, and independent organizations are working to fill gaps to provide support and programming for children grieving the loss of a parent. Other countries also are grappling with the issue, with some countries using lessons from the HIV/AIDS pandemic to locate orphans and provide social service support, and others—including Mexico, Peru, Colombia, and South Africa—developing programs to give COVID orphans grants or monthly stipends, according to BMJ.

COVID LITIGATION The COVID-19 pandemic’s battlelines appear to be moving from hospitals to the courtroom, Politico Magazine reports, with cases challenging mask and testing mandates, vaccine requirements, quarantine measures, and medical malpractice making up a growing area of US civil law. Public health law experts are concerned such cases will further erode public health authority, making the nation even less prepared for the next pandemic, while lawyers filing the suits worry that when another disease emergency hits, the federal government will attempt to bring back COVID-era restrictions and mandates.

COVID-19 AID TO US HOSPITALS The Republican-led US House Oversight and Accountability Committee is investigating how COVID-19 relief funds, known as the Provider Relief Fund, were distributed to hospitals following a Wall Street Journal report last year showing that much of the aid went to profitable facilities. The committee has requested documents from the US Department of Health and Human Services (HHS) regarding the funds’ distribution, expressing concerns that aid went to profitable hospitals in wealthy areas while rural hospitals struggled financially. The WSJ investigation found that more than 1,200 profitable hospitals received federal pandemic aid even though they likely did not need the funds, while some financially struggling hospitals continued to post losses even after receiving aid. House Republicans have been focusing on pandemic aid waste and fraud in recent investigative efforts.

FLORIDA VACCINE ANALYSIS In October 2022, Florida Surgeon General Dr. Joseph Ladapo—who has drawn criticism for his resistance to COVID-19 mandates and health policies endorsed by the federal government—advised men aged 18 to 39 not to receive mRNA COVID-19 vaccines, counter to recommendations from the US CDC. He based his guidance on a controversial state analysis showing the risk of cardiac-related deaths increased significantly for some age groups after receiving a vaccine; however, that report omitted information showing that SARS-CoV-2 infection could increase the risk of cardiac-related death much more than getting vaccinated, according to drafts of the analysis obtained by the Tampa Bay Times. At least 4 early drafts of the analysis provided a counterpoint to Dr. Ladapo’s assertions, but that information was missing from the final version released by the Florida Department of Health. Several epidemiological experts highlighted concerns and flaws with the state’s final analysis, called on the nonbinding recommendation to be rescinded, and criticized Dr. Ladapo's statements on social media as promoting vaccine hesitancy.

TRADITIONAL VALUES A study by researchers from the University of California-Los Angeles published this week in Scientific Reports found that while people with more traditional or socially conservative values in other countries were more likely to adhere to COVID-19 recommendations, in the United States, people with those values were more likely to dismiss pandemic-related guidance. The researchers—who surveyed nearly 8,000 people in 27 countries across North America, South America, Europe, Asia, and Africa—found that in a majority of countries, individuals’ endorsement of tradition positively correlated with their adherence to costly COVID-19-avoidance behaviors, but the effect was most weakly correlated in the US, Canada, Poland, Austria, and Indonesia. They suggest that US individuals with traditional values perceived threats to the economy and personal liberty more strongly than the threat posed by COVID-19, and that the polarization of discourse around science and trust in the US may have contributed to higher COVID-19 deaths per capita compared with any other highly developed nation. The study emphasizes the need to understand how different cultural values influence responses to health threats such as pandemics and climate change.

ACCESS TO TREATMENTS The WHO, in collaboration with Unitaid and Medicines Law & Policy, this week published a briefing document aimed at supporting countries in accessing affordable COVID-19 treatments. The document provides factual explanations of legal instruments that WHO Member States can use to promote public health and access to COVID-19 therapeutics, while complying with multilateral trade obligations and national legislation. The document also highlights the need for expanding the geographic scope of voluntary licenses to ensure broader access to affordable treatments.

Epi update

As of April 12, the WHO COVID-19 Dashboard reports:

• 762.8 million cumulative COVID-19 cases
• 6.9 million deaths
• 525,841 million cases reported week of April 3
• 32% decrease in global weekly incidence
• 2,426 deaths reported week of April 3
• 57% decrease in global weekly mortality

Over the previous week, incidence declined in Africa (-22%), Europe (-27%), and the Americas (-72%) but increased in the Western Pacific (+14%), Eastern Mediterranean (+48%), South-East Asia (+73%) regions.

UNITED STATES

The US CDC is reporting*:

• 104.2 million cumulative cases
• 1.13 million deaths
• 120,820 cases reported week of April 5 (down from previous week)
• 1,773 deaths reported week of April 5 (up from previous week)
• 11.1% weekly decrease in new hospital admissions
• 12.0% weekly decrease in current hospitalizations

The Omicron sublineages XBB.1.5 (88.3%), XBB.1.9.1 (5.1%), XBB.1.5.1 (2.4%), and XBB (1.9%) currently account for a majority of all new sequenced specimens, with various other Omicron subvariants accounting for the remainder of cases.

*According to the CDC, as of April 1, 2023, the state of Iowa no longer reports aggregate COVID-19 case data to CDC. As a result, case counts from Iowa will no longer be reported at the national, regional, state, or county-levels on COVID Data Tracker or data.cdc.gov.

New COVID variants on the way

WHO, appears to have a new symptom. Here’s what you need to know

0:15

Erin Prater

Mon, April 10, 2023 at 7:41 PM CDT

In this article:

• 
  

  Coronavirus

A new COVID variant the World Health Organization has its eye on seems to be causing a new symptom in children rarely caused by other Omicron spawn.

XBB.1.16, dubbed “Arcturus” by variant trackers, is fueling a new surge of cases in India, at a time when reported cases are down in much of the rest of the world. The country’s health ministry is holding mock drills to ensure that hospitals are prepared for rising COVID cases, the BBC reported Monday, noting that some states have again made mask-wearing in public mandatory.

Levels of the variant are also rising in the U.S., Singapore, and Australia, among others.

But XBB.1.16 may not be just another run-of-the-mill Omicron. Dr. Vipin Vashishtha—a pediatrician in India and former head of the Indian Academy of Pediatrics Committee on Immunization—tweeted Thursday that pediatric cases of COVID are on the increase for the first time in six months, and that “an infantile phenotype seems emerging.”

The symptoms he’s now seeing among children:

• High fever

• Cough

• “Itchy” conjunctivitis—or pink eye—without pus, but with “sticky eyes”

The latter symptom hasn’t been seen in earlier COVID waves, he noted.

COVID cases in kids under 12 in India are increasing, The Times of India reported Monday. While they’re generally mild, doctors are warning “parents of children with obesity, asthma, and [those] suffering from other immunocompromised conditions not to ignore the symptoms,” and to seek care if necessary, the publication noted.

Experts told The Times they were also seeing a rise in hospitalizations of children due to adenovirus, which has symptoms similar to COVID and can also result in conjunctivitis. Adenovirus and COVID are impossible to distinguish from each other without testing.

There are “lots of anecdotals of pediatric conjunctivitis in India” right now, Raj Rajnarayanan, assistant dean of research and associate professor at the New York Institute of Technology campus in Jonesboro, Ark., and a top COVID variant tracker, tells Fortune.

Richard Reithinger, an infectious disease epidemiologist at the nonprofit research institute RTI International, tells Fortune that he’s also heard such reports, but that it’s “probably too early to tell” if the virus’s symptom set has truly shifted.

Conjunctivitis has previously been reported as a COVID symptom, he notes, though not often.

Researchers at Nebraska Medicine’s Truhlsen Eye Institute previously identified the virus in the eye’s tear film, a thin layer of fluid that covers the eye’s outer surface. The presence of the virus there could lead to conjunctivitis, the institute noted in a November blog post.

According to the Truhlsen Eye Institute, symptoms of conjunctivitis include:

• Tearing, or watery eyes

• Redness

• Swelling

• Pain or irritation

• Itching

• Discharge

XBB.1.16 has 'the oomph to outcompete' other variants

Rajnarayanan expects to see XBB.1.16 and another new Omicron spawn, XBB.1.9, gain steam over the next few weeks, “if nothing else emerges.”

XBB.1.16 and its descendents have “the oomph to outcompete” other circulating COVID variants—“as of now,” he says, noting that new variants evolve quickly.

The XBB.1.16 family of variants “are the next big group” after Kraken variants, he notes.

When it comes to the pandemic, the world is currently in the “age of recombinants”—or existing variants that have combined with each other to potentially wreak more havoc—Ryan Gregory, a biology professor at the University of Guelph in Ontario, Canada, tells Fortune.

XBB.1.16 is a recombinant of two descendants of so-called “stealth Omicron” BA.2. A preprint study updated Sunday from scientists at the University of Tokyo suggests that it spreads about 1.17 to 1.27 times more efficiently than relatives XBB.1 and XBB.1.5, also known as "Kraken," which currently dominates U.S. cases.

XBB.1.16’s increased ability to outpace other variants suggest that it “will spread worldwide in the near future,” researchers wrote, adding that the variant is “robustly resistant” to antibodies from a variety of COVID variants, including “stealth Omicron” BA.2 and BA.5, which surged globally last summer.

That means it could cause cases to rise again, even in areas that have recently seen increased COVID infections—especially if those infections stemmed from either BA.2, BA.5, or their descendants.

New variants may not always cause “waves” of cases anymore. That’s because a continual parade of new Omicron variants creates a baseline of infections that remains “unsustainably high,” Gregory says.

XBB.1.16 the most transmissible yet

The WHO declared XBB.1.16 a “variant under monitoring” in late March. It’s the most transmissible variant yet, Maria Van Kerkhove, COVID-19 technical lead for the WHO, said at a March 31 press conference.

Additional mutations in the virus’s spike protein, which attaches to and infects human cells, create the potential for it to infect more easily and even cause more severe disease. For this reason, and due to rising cases in the East, XBB.1.16 is considered “one to watch,” Van Kerkhove said at the time.

COVID hospitalizations and deaths have so far not risen in India, though both are referred to as “lagging indicators”—meaning that such developments, if they occur, usually happen several weeks after a rise in cases.

The variant still hasn’t been broken out in the U.S. by the CDC. On Friday, XBB.1.16 cases were still reported under XBB, which comprised just under 2% of U.S. cases. Cases must comprise at least 1% nationally before they’re reported in their own category.

But XBB.1.16 is clearly in the process of infiltrating the U.S. Nearly half of such sequences identified in the U.S. were identified via airport surveillance, Rajnarayanan notes, citing data from GISAID, an international research database that tracks changes in COVID and the flu virus.

This story was originally featured on Fortune.com\

Above is from:  https://news.yahoo.com/finance/news/arcturus-highly-transmissible-covid-variant-004116935.html

Frontier declares bankruptcy

Frontier declares bankruptcy

Story by The Badger Project • Yesterday 11:04 AM

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Following investigation, Frontier agrees to $15 million in internet upgrades in Wisconsin, $90k "payment"© Provided by The Badger Project

Telephone and internet company has 80,000 customer accounts in Wisconsin; “expects to continue providing quality service”

By Peter Cameron, THE BADGER PROJECT

Frontier Communications, the national phone and internet company that serves tens of thousands of people in Wisconsin, filed for Chapter 11 Bankruptcy on April 14.

The company “expects to continue providing quality service,” it said in a press release announcing the bankruptcy.

Frontier has customers in 29 states. In Wisconsin, it serves a territory of about 800,000 people, according to FCC data. Frontier has about 80,000 customer accounts in Wisconsin, company spokesman Javier Mendoza said.

The company has enough cash on hand to meet its ongoing obligations, it said in the press release.

Frontier has approximately $11 billion in unsecured debt, it said. The company hopes to reduce that by $10 billion in the bankruptcy proceedings.

In a Chapter 11 bankruptcy, the debtor usually proposes a plan of reorganization of its debt in order to keep its business going while paying creditors over time, sometimes at a reduced rate.

The U.S. Bankruptcy Court for the Southern District of New York, where Frontier has filed, has authorized the company to continue paying employee wages, healthcare and other benefits, Frontier announced April 16.

April 6, 2023: Johns Hopkins COVID 19 Situation Report

COVID-19 Situation R

Epi update

As of April 6, the WHO COVID-19 Dashboard reports:

• 762 million cumulative COVID-19 cases
• 6.89 million deaths
• 711,352 million cases reported week of March 27
• 12% decrease in global weekly incidence
• 4,745 deaths reported week of March 27
• 25% decrease in global weekly mortality

Over the previous week, incidence declined or remained relatively stable in all WHO regions except the South-East Asia (+90%) region.

UNITED STATES

The US CDC is reporting:

• 104.1 million cumulative cases
• 1.12 million deaths
• 139,991 cases week of March 29 (down from previous week)
• 1,596 deaths week of March 29 (down from previous week)
• 10.2% weekly decrease in new hospital admissions
• 11.4% weekly decrease in current hospitalizations

The Omicron sublineages XBB.1.5 (87.9%), XBB.1.9.1 (4.6%), XBB (2.5%), and XBB.1.5.1 (2.1%) currently account for a majority of all new sequenced specimens, with various other Omicron subvariants accounting for the remainder of cases.

The New York Times this week launched a “build-your-own-dashboard” to track COVID-19 in US locations.

New season, new COVID-19 booster shot

New season, new COVID-19 booster shot

The Food and Drug Administration has decided to allow some people to get a second booster of an updated vaccine to target the omicron variant, NPR reports.
Those eligible include people 65 and older who got their first omicron booster at least four months ago, as well as people with weakened immune systems.
An official announcement is expected within two weeks, NPR reports.
The news comes as the agency is “focusing on planning for an annual COVID booster campaign starting in the fall of 2023 — with vaccines that will have been updated to target whichever variant is expected to be circulating next winter,” NPR reports. [NPR]

Blackhawk Bank acquired by downstate bank

Beloit-Based Blackhawk Bank Acquired By First Mid Bank & Trust

March 21, 2023 at 2:50 pm Kevin Haas

• 
  

Blackhawk Bank, which has 10 locations including this one at 3101 11th St. in Rockford, was acquired by First Mid Bank & Trust on Tuesday, March 21, 2023. (Photo by Kevin Haas/Rock River Current)

By Kevin Haas
Rock River Current
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BELOIT, Wis. — Blackhawk Bank, which has served the region for more than 140 years, has been acquired by Matoon, Illinois-based First Mid Bank & Trust.

The companies announced the agreement to merge on Tuesday, saying First Mid will acquire the Beloit-based bank with a 100% stock transaction. First Mid will pay $90.3 million, which is based on the per-share price of $27.13 at market close on Monday, for the acquisition. Blackhawk shareholders will receive 1.15 shares of FMBH common stock for each share of BHWB.

Blackhawk, which was established in 1881 in Beloit and expanded into northern Illinois in 1996, has 10 locations in southern Wisconsin and Illinois.

“Blackhawk has a long history of providing excellent service with a community-minded focus that aligns very well with First Mid’s philosophy,” Joe Dively, chairman and CEO of First Mid, said in a news release.

More business: Rockford brothers’ company Phateez breaks the mold for sunglasses

Blackhawk has the fifth largest share among banks in the Rockford market, capturing about 9% of the market, according to Federal Deposit Insurance Corporation data. It has approximately $1.32 billion in total assets, $782 million in loans and $1.19 billion in deposits.

Dively said that recent volatility for banks, which came to a head with the collapse of Silicon Valley Bank earlier this month, didn’t play a role in the merger. Discussions between First Mid and Blackhawk have been ongoing for years.

“We have partnered with Blackhawk on many projects over the last several years and could not be more confident in the cultural and strategic alignment,” Dively said. “The combined company will be an approximately $8.1 billion financial institution with significant wealth management and insurance services. We look forward to welcoming Blackhawk’s shareholders, employees and customers to the First Mid team.”

More business: Camera Craft, Rockford’s last locally owned camera store, will close in April

The merger has been unanimously approved by each company’s board of directors and is expected to close in the second half of 2023, subject to regulatory approvals, the green light from Blackhawk’s stockholders and other closing considerations.

“This has been a very long process culminating in today’s announcement, which has reinforced our belief in the strength of these two organizations and the opportunities it will provide once combined,” Todd James, chairman, president and CEO of Blackhawk, said in a news release.

James said customers, employees and shareholders will benefit from access to First Mid’s larger banking organization. He said it will offer larger loan limits and a broader array of services, including wealth management, trust, insurance and agricultural services.

“We are excited to join forces with First Mid, a like-minded partner that shares our commitment to supporting the communities we serve and building strong long-term relationships with customers,” James said.

---

This article is by Kevin Haas. Email him at khaas@rockrivercurrent.com or follow him on Twitter at @KevinMHaas .

Above is from:  Beloit-based Blackhawk Bank acquired by First Mid Bank & Trust | Rock River Current

March 23, 2022: Johns Hopkins COVID 19 Situation Report

COVID-19 Situation Report

Weekly updates on COVID-19 epidemiology, science, policy, and other news you can use.

Click to Subscribe

Announcements

CALL FOR PAPERS Early detection of biological threats, whether naturally occurring or manmade, is critical. Threat agnostic approaches, which do not rely on determining the identity of the agent or pathogen, show early promise. In 2023, the Johns Hopkins Center for Health Security journal, Health Security, will issue a special feature that considers threat agnostic approaches to biodefense and public health. We encourage submissions of original research articles, case studies, and commentaries that explore policy gaps, data and data analysis, and implementation, among potential topics. The deadline is March 31, 2023. For more information, visit: https://www.centerforhealthsecurity.org/our-work/journal/call-for-papers/call-for-papers.html

In this issue

> New analysis appears to link SARS-CoV-2 origin to raccoon dogs in Wuhan market, raises questions about completeness of data shared by China; US law requires declassification of intelligence information

> End of US public health emergency to impact various healthcare programs, rules; US House Republicans eye canceling unspent COVID-19 aid to help rein in federal spending

> US Senate HELP Committee hears testimony from Moderna CEO about expected commercial market price increase for vaccine

> US FDA expected to soon decide on authorization of additional bivalent booster dose; Canada, UK move forward with shots for some individuals

> What we're reading

> Epi update

New analysis appears to link SARS-CoV-2 origin to raccoon dogs in Wuhan market, raises questions about completeness of data shared by China; US law requires declassification of intelligence information

More than 3 years into the COVID-19 pandemic, the origin of the SARS-CoV-2 virus remains a hotly contested topic. In the absence of a “smoking gun,” it is unclear exactly how the virus first infected humans, and it may never be definitively determined whether the virus evolved naturally among animals or escaped a laboratory setting. Investigations into the emergence of SARS-CoV-2 have been hindered by insufficient access to facilities, personnel, specimens, and data in China, and intense political divisions—in the US and elsewhere—have made public debate over the available evidence difficult.

Recent revelations regarding early genetic data from specimens collected at the Huanan Seafood Wholesale Market in Wuhan, China, in early 2020 provide additional support for theories that the pandemic emerged as a result of natural zoonotic transmission. Dr. Florence Débarre, a researcher from France, recently identified a previously undisclosed trove of genetic data published on the GISAID platform. Among the viral genetic data, she identified DNA from multiple mammal species, including raccoon dogs, which are known to be susceptible to coronaviruses. The presence of raccoon dog DNA among the viral sequences indicates that these animals were present at the market and may have been infected with the SARS-CoV-2 virus. Notably, the Chinese government previously asserted that these types of animals were not present at the market. Reportedly, after Dr. Débarre reached out to Dr. George Gao, former Director of the China CDC, to collaborate on further research, the data were removed from GISAID “at the request of the submitter.” Following a briefing by Dr. Débarre’s team last week, WHO Director-General Dr. Tedros Adhanom Ghebreyesus chastised China for withholding the data and called on the Chinese government to share all of the available data immediately. The researchers published their findings (preprint) on March 20. While the new data still do not provide definitive proof, they demonstrate that the Chinese government has more data available than what it has shared.

Following unanimous approvals in both houses of the US Congress, President Joe Biden signed a bill requiring US intelligence agencies to declassify all information related to investigations on the origin of SARS-CoV-2 and the Wuhan Institute of Virology in China. To date, various public reports from the US intelligence community indicate that agencies have reached different conclusions regarding the likely origin of the pandemic. Following the release of its report that concluded—albeit with “low confidence”—that a laboratory incident was the most likely origin, the US Department of Energy briefed the Senate Energy and Natural Resources Committee on March 16 about classified information underpinning that analysis.

End of US public health emergency to impact various healthcare programs, rules; US House Republicans eye canceling unspent COVID-19 aid to help rein in federal spending

The WHO said this week that its experts are confident that the public health emergency of international concern (PHEIC) declaration for COVID-19 will be able to be declared over by the end of this year. Similarly, the Biden administration previously announced an end to the US public health emergency for COVID-19 in May, and this week said it will disband its White House COVID-19 Response Team at the same time. The end of the public health emergency will bring with it changes to healthcare access and benefits for many residents nationwide. Millions will lose healthcare coverage with the end of continuous Medicaid enrollment, a change likely to disproportionately impact Black and Hispanic adults, according to a recent Commonwealth Fund report. Additionally, training rules for nursing home staff will become stricter; rollbacks of broader access to certain controlled substances threaten treatment for people recovering from addiction; hospitals and other care facilities will have to comply with stricter capacity and staffing rules; and federal COVID-19 surveillance reporting requirements for states will end.

Additionally, Republicans in the US House are targeting unspent COVID-19 relief money in a plan to cut federal spending. Though a small amount—less than US$80 billion unspent as of January out of the total US$5.2 trillion relief aid allocated—canceling the funds would have huge repercussions for union pension funds, healthcare for veterans, COVID-19 research efforts, and aid for small businesses and transportation systems.

US Senate HELP Committee hears testimony from Moderna CEO about expected commercial market price increase for vaccine

In early 2023, reports emerged publicly that Moderna planned to increase the price of its SARS-CoV-2 vaccine, quadrupling it from between US$15–$26.36 to US$110–$130 per dose, when it shifts its sales to the commercial market later this year. The end of the COVID-19 public health emergency in May will shift the burden of purchasing vaccines to the private sector. Moderna earned about US$40 billion from sales of its COVID-19 vaccines alone over the past 2 years. On March 22, Moderna CEO Stéphane Bancel testified regarding those plans before the US Senate Committee on Health, Education, Labor and Pensions (HELP Committee). Mr. Bancel argued that, while Moderna received considerable funding from the federal government—on the order of US$12 billion for research, development, and procurement—the company will need to implement new production and logistics as the pandemic enters an endemic phase. The combination of new manufacturing processes, storage, wastage, and significantly lower demand necessitates higher costs per dose, he said. Some Senators on the committee argued in favor of Moderna, noting that the success of Moderna’s vaccine illustrates the benefits of capitalism. While the purchase cost of the vaccine is expected to increase, Moderna has committed to ensuring the vaccines remain fully covered by health insurance. Patient assistance programs also will help uninsured or underinsured individuals access the vaccines, but some Senators noted that the paperwork for these programs can be difficult to navigate. Pfizer and BioNTech also plan to increase the cost of their SARS-CoV-2 vaccine to US$110–$130 per dose, but the companies did not use US government funding in developing the shot.

US FDA expected to soon decide on authorization of additional bivalent booster dose; Canada, UK move forward with shots for some individuals

The US FDA is discussing the possibility of authorizing a second round of vaccine boosters targeting the Omicron variant for certain people at high risk of severe COVID-19 illness. The agency is expected to decide within a few weeks, according to people familiar with the deliberations. The bivalent booster is currently recommended for anyone aged 6 months and older after completion of any FDA-approved or FDA-authorized primary series or previously received monovalent booster dose(s), with an exception for the youngest children who received the bivalent vaccine as the last dose in their 3-dose primary series.

While only 16.4% of the total US population has received the updated booster, a small percentage of people are anxiously wondering when they can get another shot. People aged 65 and older are contributing a larger proportion of COVID-19-related deaths over time, particularly those who have underlying health conditions. Additionally, though people who are immunocompromised make up about 3% of the US population, they account for 25% of people hospitalized with COVID-19. For both of these populations, vaccine effectiveness against hospitalization and symptomatic infection begins to drop significantly 2–4 months following their last booster. Canada and the United Kingdom are offering the bivalent booster to older adults, residents of care homes and other senior living settings, and certain people who are immunocompromised. We should know soon whether the US will authorize boosters for similar groups.

What we’re reading

CHILDREN & FAMILIES The COVID-19 pandemic had an unprecedented impact on the lives of children and their families in the United States, and greater focus and investment are needed to address the critical social, emotional, behavioral, educational, mental, physical, and economic health and well-being challenges that the pandemic caused or exacerbated, especially among families identifying as Black, Latino, and Native American, and those with low incomes, that have disproportionately borne the stress of these negative effects, according to a report published March 16 by the National Academies of Sciences, Engineering and Medicine. The report makes several recommendations for federal- and state-level legislatures and agencies to address the short- and long-term effects on children and families and to prepare for the next pandemic. 

PAXLOVID A panel of expert advisors to the US FDA voted 16-1 last week to endorse the antiviral Paxlovid (nirmatrelvir-ritonavir) as a treatment for adults with COVID-19 who are at high risk for progression to severe illness. Notably, the committee highlighted potentially harmful drug interactions. Experts later said there is not enough data to determine exactly who would benefit most from the drug and a poor understanding of the treatment among the medical community, hindering its prescription. According to a recently released analysis, Paxlovid use could “lead to 1,500 lives saved and 13,000 hospitalizations averted each week in the United States,” based on COVID-19 data from January 2023. Another study, published March 17 in JAMA Health Forum, modeled population-level impacts of a Paxlovid rollout during a surge like the 2022 winter Omicron wave. The panel’s endorsement likely will lead to full approval of the drug by FDA, although the agency is not required to follow the advice of its advisory committees. A final decision is expected in May. In related news, a study by the Yale School of Medicine is testing whether a 15-day course of Paxlovid can improve the health of people with long COVID.

PANDEMIC-RELATED STATE LAWS, LEGISLATION & REGULATIONS On March 17, KHN published 2 articles examining various state-level legislative actions or laws with pandemic-related roots. One article discusses legislation and proposed regulations in more than a dozen states aimed at controlling healthcare staffing agency wage rates for temporary workers during health emergencies, as well as steps hospitals and health facilities are taking to retain their workers with the acute challenges of the pandemic now in the past. Another article examines how California’s COVID-19 misinformation law, which is meant to discipline doctors who provide false information about COVID-19 patients, is mired in legal limbo after 2 federal judges issued conflicting rulings in recent lawsuits.

CHINA China this week authorized a domestically produced mRNA vaccine against COVID-19, after showing reluctance to use similar vaccines produced in the US and European nations. According to CSPC Pharmaceutical Group Ltd., which makes the vaccine, known as SYS6006, a large clinical trial showed the vaccine is safe and effective against several Omicron subvariants. The WHO urged CSPC to share its full data so the health agency can assess the vaccine for use on the international market. China’s other homegrown vaccines, which use more traditional platforms, proved less effective against newer Omicron variants. According to a report from the Associated Press, China’s sudden scrapping of its strict “zero COVID” policy in late 2022 went against the advice of experts and led to hundreds of thousands of COVID-19-related deaths, some of which could have been avoided with better vaccination coverage and more prepared healthcare facilities.

EQUITABLE VACCINE DISTRIBUTION Equitable worldwide distribution of COVID-19 vaccines would increase global economic benefits by about US$950 billion per year by improving health gains, helping to ease lockdowns, and supporting supply chain recovery, when compared with a scenario focused on vaccinating the entire populations of vaccine-producing countries first then distributing vaccines to other nations, according to an analysis published this week in Nature Communications. The researchers propose a benefit-sharing mechanism that allows all stakeholders to benefit and provides a model to analyze distribution strategies in different infectious and socioeconomic contexts. They note that the need for equitable vaccine distribution is one of the most important lessons to be learned from COVID-19, though global collaboration continues to present a challenge. Notably, wealthy nations already appear to be repeating their COVID-19-era vaccine hoarding tendencies with avian influenza vaccines.

UN CLIMATE REPORT A report released this week by the UN Intergovernmental Panel on Climate Change (IPCC) warned that the world is likely to fail at meeting its most ambitious climate target—limiting warming to 1.5 degree Celsius (2.7 degrees Fahrenheit) above preindustrial temperatures—by the early 2030s. This change could bring about catastrophic damage to the Earth, causing climate disasters and other impacts—such as heat waves, famines, and infectious disease outbreaks—so extreme that humans will have difficulty adapting. The authors said humanity has reached a “critical moment in history” and needs to accelerate actions to achieve its climate goals.

Epi update

As of March 21, the WHO COVID-19 Dashboard reports:

• 761 million cumulative COVID-19 cases
• 6.88 million deaths
• 734,302 million cases reported week of March 13
• 18% decrease in global weekly incidence
• 4,897 deaths reported week of March 13
• 22% decrease in global weekly mortality

Over the previous week, incidence declined or remained relatively stable in all WHO regions except the South-East Asia (+57%) and Eastern Mediterranean (+47%) regions.

UNITED STATES

The US CDC is reporting:

• 103.8 million cumulative cases
• 1.12 million deaths
• 149,955 cases week of March 15 (down from previous week)
• 1,706 deaths week of March 15 (down from previous week)
• This is the lowest weekly mortality since March 2020
• 7.8% weekly decrease in new hospital admissions
• 12.1% weekly decrease in current hospitalizations

The Omicron sublineages XBB.1.5 (90.2%), BQ.1.1 (3.5%), XBB (2.5%), and XBB.1.5.1 (2.2%) currently account for a majority of all new sequenced specimens, with various other Omicron subvariants accounting for the remainder of cases.

USEFUL GRAPHICS

Please note, this is the last week we will include this section; bookmark pages for easy future reference.

The New York Times this week ended its COVID-19 data collection and switched to using official data from the US CDC, which is updated weekly. The dashboard shows information about hospital patients with COVID-19; reported cases and tests; the number of COVID-19 deaths; vaccination coverage and comparisons between vaccinated and unvaccinated populations; and a new interactive county map, including COVID-19 community levels that take into account case and hospitalization data.

Community transmission data, which takes into account case and test positivity data, is available on the US CDC COVID-19 Integrated County View (click on pulldown menu to view COVID-19 Community Transmission, as well as other indicators specific to the US).

Editor: Alyson Browett, MPH

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