Frequently Asked Questions about COVID-19 — December 15, 2021

  “Shared expectations lead to predictability.”

426. Hospitalization metrics are checked daily but planning has increased safety.

         QHow close are we to having hospital care stressed to the limit?

         A:  There has been attention given to the concerns about hospital capacity to manage increasing numbers of Covid-19 patients in Connecticut.  One of the metrics being monitored daily is the Covid Act Now hospitalization which is the percentage of the ICU beds that are filled.  Statewide, this metric has been relatively stable peaking recently at 62%.  Nearly a year ago, on January 13, 2020, the highest prevalence of Covid-19 in Connecticut was reported – 84.6 cases per 100,000 population.  Since the start of the pandemic, ICU bed availability has not been a problem in this state.   It never exceeded 68%.  Federal funds in 2002 were used by the Connecticut Hospital Association to build a system that identified each day the open beds in all 28 Connecticut Hospitals.  This information was centralized so that available beds statewide could be shared – no hospital alone would suffer from being overwhelmed.  This organized system of sharing hospital beds has continued to date making it less likely any hospital would reach the point of critical standards of care being needed.  The Federal Emergency Management Agency (FEMA) has a long-standing program of sending Disaster Medical Assistance Teams (DMAT) that have been requested by many states to provide medical personnel to supplement diminished hospital staff when this is the problem    In spite of these protective strategies, the Covid Act Now advisory metric on hospitalization is checked daily.

427. Vaccine hesitancy is worldwide and is correlated with political populism.

         Q: Why do so many people fight against getting the vaccine?

         A:  A Morning Consult poll of 15 countries in November examined the cultural causes of vaccine hesitance.   Nearly 25% of Russians, 18% of Americans, and about 10% of Germans, Canadians, and French are “unwilling” to get vaccinated, according to a November Morning Consult poll of 15 countries.  About a third of South Africans have been vaccinated, a higher percentage than most other African countries, but 22% of South Africans weren’t willing to accept a COVID-19 vaccine, according to a study from this past spring, compared with just 4% of people in Ethiopia and 38% of people in the Democratic Republic of the Congo. Malawi and South Sudan recently destroyed thousands of vaccine doses because the countries weren’t going to be able to administer them before they expired.

Vaccine hesitancy is an urgent problem and a global one. New variants can emerge wherever populations remain unvaccinated.  “If we had had everybody immunized in the world who is over the age of 18 with at least one dose of COVID vaccine, Omicron might not have happened,” Noni MacDonald, a vaccinologist at Dalhousie University in Nova Scotia, stated.  There is a need to better understand why people reject vaccines. Some feel that it is a lack of trust – of medical and governmental authorities.  Getting people to overcome their hesitancy will require restoring their trust in science and their leaders.  Populism, a political expression of this mistrust, is correlated with vaccine hesitancy.  In a study in 2019, Jonathan Kennedy, a sociologist at Queen Mary University of London, found a significant association between the percentage of people who voted for populist parties within a country and those who believe vaccines are not important or effective. Past research has similarly found that populists around the world are more likely to believe in conspiracy theories about issues such as vaccination and global warming. “Vaccine hesitancy and political populism are driven by similar dynamics: a profound distrust in elites and experts,” Kennedy writes. In politics, populism and vaccine hesitancy are manifested by supporting parties and figures outside the mainstream, like Donald Trump.

428. Booster shots appear to protect from the Omicron variant infections.

         Q. I’m fully vaccinated. Will this protect me from Omicron infection?

         A. The short answer is “Yes – if you get the booster shot.” The New York Times has just published a report that indicates the Pfizer booster shot “offers significant protection against the fast-spreading Omicron variant.” Laboratory blood samples taken from people one month after they had received a booster shot showed neutralizing antibodies against Omicron offering protection. Those antibody levels were comparable to those against the Delta variant after two doses, the company said. These results come one day after a preliminary report on laboratory experiments in South Africa also found Omicron seemed to bypass the power of just two doses of the Pfizer vaccine.

Paul Offit, MD, a vaccine expert with Children’s Hospital of Philadelphia and a member of the Food and Drug Administrations’s vaccine advisory committee, said he also wanted “to sound a note of reassurance.” “The virus has mutated to the point that it has become less neutralizable by antibodies,” he said. But he said there is no evidence that the vaccines have become less effective at preventing severe disease. “In all likelihood, two doses of an mRNA vaccine will protect you against serious illness,” he said. Still, the results seemed to underscore the importance of booster shots.

Albert Bourla, MD, the chairman and chief executive officer of Pfizer, said the company began developing a version of its vaccine specifically targeting Omicron right after Thanksgiving and could produce it in mass quantities within 95 days. Moderna is on a similar path. But Dr. Bourla noted that Pfizer had developed two other prototypes in response to new variants and that neither had proved necessary because the original vaccine worked against the virus’s mutations.

429. The development of antiviral medicines faces many barriers.

         Q:  Why aren’t there more drugs available to treat Covid-19?

         A:  Priyanka Runwal is a science journalist who writes for National Geographic.  In a recent article, she explores the difficulty in creating antiviral medicines to control the COVID-19 pandemic.  Years before the rise of the COVID-19 pandemic, virologists started a quest to find drugs that can protect people against emerging coronaviruses. The journey has been slow and failures have been frequent.  Unlike vaccines that can prevent infection, antiviral medicines act as a second line of defense, slowing down and eventually arresting the progression of disease when infections occur. They are also important when effective vaccines aren’t available against viral diseases, as is the case for HIV, hepatitis C, and herpes.  But developing antivirals is an expensive and difficult endeavor. That’s especially true for acute respiratory diseases, for which the window for treatment is short – before the patient experienced shortness of breath.  In the case of COVID-19, researchers have resorted to repurposing old drugs or compounds that were being tested against other diseases.  “That’s typical,” says Katherine Seley-Radtke, a medicinal chemist at the University of Maryland. “Every time a new virus emerges or an old one re-emerges; you pull out what’s there in the cupboard to see what works.”  So far Remdesivir, originally developed by biopharmaceutical company Gilead Sciences for hepatitis C and Ebola infections, is the only antiviral drug approved by the U.S. Food and Drug Administration to treat COVID-19. It must be administered via injection while a patient is in the hospital.  Experts think oral antivirals like Merck’s are set to be the most promising tools to work alongside vaccines at combating the pandemic. Provided they are affordable, antivirals could be especially important among people who remain unvaccinated either out of choice or due to limited access and economic constraints.  In June 2021 President Joe Biden announced an investment of more than a billion dollars to advance the development of antivirals for COVID-19. As part of the same plan, he also promised an additional $1.2 billion in funding toward discovering new compounds.

Unlike bacteria, viruses can’t reproduce on their own. They rely on their host cell’s machinery to replicate. That means a virus must insert itself into a living cell and hijack its machinery to make thousands of copies of itself. These “offspring” then escape and go on to infect nearby host cells, spreading the disease inside the body and ultimately to new carriers.  Antiviral drugs often work by preventing the virus from attaching to or entering the host cell, or by obstructing its replication once it’s in there.  One challenge is the increasing diversity of viruses causing severe disease in humans, and thus the need for antivirals that work against a variety of these pathogens.

430. Great Britain is taking action to control Omicron finding it very infectious.

         Q:  Is any country experiencing the Omicron variant found it to be spreading?

         A:  In a recent article, it was reported that cases of Omicron were doubling in Great Britain.  So far, officials are unsure if it will be a relatively minor event or a return to the dark days of earlier pandemic waves.  Britain has one of the world’s most robust systems for sequencing viral genomes, so it can identify and track new variants earlier and more thoroughly than other countries. The country’s Health Security Agency released new data last week Wednesday. The data “suggests that Omicron is displaying a significant growth advantage over Delta.” The agency warned that if the recent growth rate continues, the country expects “to see at least 50 percent of COVID-19 cases to be caused by the Omicron variant in the next two to four weeks.”

In response to Omicron, Britain reversed course on some restrictions this week, urging people to work from home when possible, introducing new mask rules, and requiring people to show vaccine passports at some venues.  This is an early answer to one of the three inquiries currently underway.  Its transmissibility is greater than other variants.  Not enough data is yet known to objectively identify to what extent.  Its virulence so far has been characterized by its recent cases being characterized as a “mild disease.”

The data to date tentatively indicates that the Omicron variant compared to the Delta variant is

  • more transmissible,
  • less virulent causing fewer hospitalizations and deaths, and

does not evade vaccinations in persons who are fully vaccinated and are eligible for and taken their booster shots