Tag Archives: Omicron variant

How to navigate renewed COVID threat in the Bay Area

Roger Straw

[Note from BenIndy Contributor Roger Straw: Well, it finally ALMOST happened. My wife and I have been ultra careful, and so far are among the increasingly rare few who have not contracted the coronavirus. Mary Susan is immune compromised, so we still wear masks in the grocery and other crowded indoors places. But we were seriously exposed when close family members tested positive a day or two after celebrating a birthday in our own home. They got on Paxlovid right away, and are fine, but only after a really miserable 2 weeks. We isolated and tested negative every other day for 10 days – and whew, still have not got the bug. Thank goodness we celebrated with windows wide open and seated widely spaced at the long dinner table. Please know that COVID is back, it’s around you, and it is no fun when you get it! And… it can be really serious, even long-lasting. Read on….]

How to navigate renewed COVID threat in the Bay Area

San Francisco Chronicle, by Aidin Vaziri, Aug. 22, 2023

Fans wait for Ethel Cain at the Sutro stage during the first day of the Outside Lands Music Festival on Aug. 11. As the Bay Area’s summer COVID-19 swell gains ground, outdoor venues remain a relatively safe environment, even without masks. | Jessica Christian/The Chronicle

UPDATERising COVID cases prompt Bay Area hospital to reinstate mask mandate

A local theater troupe cancels a weekend of performances because cast members have COVID. A Sunday luncheon is postponed because the hostess has fallen ill. A colleague catches the coronavirus on a trip back from Italy. The nearby Walgreens is sold out of home test kits.

There’s no mistaking that the SARS-CoV-2 virus is staging an unwanted comeback in the Bay Area. The uptick in COVID cases evokes memories of summers since 2020. Official figures, though early, back up the anecdotes: The state’s test positivity rate has climbed to 11.8%, its highest level since the beginning of the year, and hospitalizations are up more than 63% in the last month, from a seven-day average of 163 admissions per day in mid-July to 266 per day last week.

Nationally, there were 12,613 new COVID-19 hospitalizations for the week ending Aug. 12, according to data released Monday by the Centers for Disease Control and Prevention. This figure reflects a 21.6% rise compared to the preceding week. Deaths due to COVID-19, a lagging indicator, are also starting to pick up nationwide, with an 8.3% increase over the same period.

While many cases result in mild symptoms, especially for those who’ve been vaccinated or previously battled the virus, COVID’s disruption to work and life is still undeniable. Plus, some evidence suggests that each subsequent bout of the virus may raise the risk of experiencing a persistent state of exhaustion, brain fog, or other symptoms known as long COVID.

Despite the resurgence, a sense of “pandemic fatigue” pervades the population, prompting many people to resume normal activities and overlook the threat, especially if their risk of severe illness is low. Restaurants, movie theaters, concert venues and airplanes are now packed with crowds of almost entirely unmasked people who roll the dice and hope for the best.

But what if you’re not among those willing to wager on chance, either due to underlying health conditions or general concern about adverse outcomes? As the summer swell gains momentum, here is a refresher on the latest expert advice to navigate uncertain times.

When to consider vaccinations and boosters

Throughout 2023, the dominant strains of the coronavirus nationwide and in the Bay Area have been descendants of the omicron family of SARS-CoV-2. The currently available vaccines and boosters were tailored to combat both the original 2020 coronavirus strain and a 2022 omicron derivative, so they offer somewhat diminished protection against the current variants. Yet they still afford greater protection than no vaccination at all. Updated vaccines geared toward more recent variants are set to roll out in late September or early October.

When to consider a booster:

  • Higher-risk individuals: People at higher risk of severe illness, including those with health conditions such as obesity or diabetes, individuals age 65 and above, or those with compromised immune systems due to underlying immunological problems or cancer treatments, should get a booster shot every six months. Some vulnerable people might consider a shot now if it’s been more than four months since their last.
  • General population: If you are in good health, under 65, and have received a vaccine or battled COVID within the past six months, the best option is likely to wait until the fall for the updated booster. Even if it has been more than six months, you might want to hold out for the new booster because it’s better tuned to fighting off current variants.

Masking calculus

Few topics have sparked more debate than masking, with arguments ranging from its efficacy to ideological objections to mandates. Yet the evidence remains clear: Consistent masking has been shown to be an accessible and effective means to reduce transmission, whether you’re at risk of unknowingly spreading the virus or of contracting it.

For those looking for more protection in the current environment, situations where a tight-fitting quality N95 or KN95 mask can be beneficial include:

  • Public transportation.
  • Airport waiting lounges and during aircraft boarding and taxiing.
  • Crowded indoor spaces where people are singing or shouting.
  • Bustling restaurants before and after meals.

Scenarios that may not warrant the same level of precaution include:

  • Walking or hiking outdoors.
  • Open-air concerts or sporting events.
  • Alfresco dining or social interactions.

Navigating social situations and testing

Although there are no definitive rules for safe or unsafe behavior in more intimate social settings, a combination of thoughtfulness and common courtesy can guide most interactions.

  • Home test kits, while still able to detect the latest coronavirus strains, are not as reliable as they were in the past. A positive home test remains a clear indication of COVID, and there’s no need to confirm the diagnosis with an official lab test unless it’s required for work absences or other reasons.
  • A greater concern is the potential for “false negatives” from home tests during the early stages of infection. If you suspect you may be ill and are worried about meeting other people, multiple tests over successive days should clear up any doubt.
  • If you need to have more certainty for some reason, many pharmacies and health providers still provide a polymerase chain reaction, or PCR, laboratory test, which is considered the gold standard. Payment is dependent on insurance carriers, and out-of-pocket testing can cost upward of $100.
  • When visiting at-risk friends or family members, wearing a mask requires minimal effort and can safeguard your loved ones. If you have any reason to suspect you may be sick or have been exposed to the virus, taking a home COVID test before meeting affords a quick — if imperfect — screen.
  • For hospital or nursing home visits, an over-the-counter test ahead of time and masking can help protect vulnerable populations, as well as yourself.

What should you do if you are exposed or infected?

  • In case of exposure: The Centers for Disease Control and Prevention offers a practical risk calculator for determining post-exposure actions following contact with someone who has COVID-19. The first step: Put on a mask to protect others for 10 days, watch for symptoms such as fever, and test yourself on Day 6. If you’re negative, keep masking until Day 10, and then you can stop.
  • If you are infected: In the event of a positive test or development of symptoms, the CDC advises immediate isolation. Wear a high-quality mask if you must be around others. The most infectious period usually spans the first five days after testing positive.
  • When to seek emergency treatment: If you have trouble breathing, persistent pain or pressure in the chest, feel disoriented, unable to wake or stay awake, or experience a change in skin tone, call 911 or your local emergency department.
  • When to end isolation: Those who show no symptoms can end isolation after five days, the CDC says. But if you do have symptoms, you should continue to isolate until you are fever-free for 24 hours without the use of fever-reducing medication.If you had moderate (difficulty breathing) or severe (requiring hospitalization) symptoms, you should isolate through Day 10. Wear a mask until you have two sequential negative test results 48 hours apart.
  • Treatments and medications: For those experiencing mild illness, the CDC advises home recovery, with over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) to help manage symptoms.A Food and Drug Administration-approved antiviral drug, Paxlovid, can effectively treat mild to moderate COVID-19 in individuals who are at greater risk, but treatment must be started within days of symptom onset. Preliminary research also suggests Paxlovid can reduce the risk of developing long COVID.

More COVID on the Benicia Independent…


What to know about the new COVID variant before you go out this weekend

[Note from BenIndy Contributor Nathalie Christian: Between the Benicia Peddler’s Fair this weekend the start of school next week, we’re entering a period of high risk for COVID exposure. Please take a moment to read about the new, highly transmissible “Eris” variant below and make choices that match not just your risk level, but the risk level of those closest to you – especially the elderly and the immunocompromised. If you’re in a high-risk group, don’t hesitate to reach out to your healthcare provider if you are experiencing symptoms. Not only is Paxlovid plentiful, it is also very effective; in its initial trial involving unvaccinated, high-risk patients, Paxlovid reduced hospitalization or death by 86 percent. Stay vigilant, stay safe.]

What to know about ‘Eris,’ the new COVID-19 subvariant sweeping the US

Lu Foster receives a COVID-19 booster shot at the Lynne and Roy M. Frank Residences in San Francisco in October 2021. The FDA approved a second bivalent booster dose for older adults and people with compromised immune systems. | Brontë Wittpenn for The Chronicle.

Today, by Caroline Kee, August 10, 2023

The EG.5 “Eris” variant is now the dominant COVID-19 strain in the U.S. Here’s what to know about transmission and symptoms.

A new COVID-19 variant called EG.5 is sweeping across the United States as cases and hospitalizations rise. The fast-spreading new COVID subvariant, also referred to as Eris, is now the dominant strain circulating in the U.S., health officials say.

As of last week, EG.5 accounted for the largest proportion of COVID-19 infections in the country compared to any other variant, according to the latest data from the U.S. Centers for Disease Control and Prevention,

Eris is also on the rise in several other countries around the globe. On Wednesday, Aug. 9, the World Health Organization decided to classify EG.5 as a “variant of interest.”

The new subvariant, which experts nicknamed “Eris” on social media, started circulating in the U.S. earlier this spring. Last month, EG.5 quickly overtook the prevailing omicron XBB subvariants, which had been driving the largest share of cases in the country.

During a two-week period ending on Aug. 5, Eris accounted for an estimated 17.3% of new confirmed COVID-19 cases in the U.S., up from 12% two weeks prior, according to the latest CDC data.

Many are wondering if the EG.5 subvariant is more transmissible or severe, and whether it’s causing different symptoms.

What is EG.5 , aka Eris?

EG.5 is a descendant of the omicron XBB sublineage of the virus (specifically, XBB.1.9.2), but it has an extra mutation in its spike protein, according to a WHO risk evaluation report.

“When we look at its sequence, EG.5 is really similar to the other XBB variants that are circulating right now, with a couple of small changes,” Dr. Andrew Pekosz, a virologist at Johns Hopkins University, tells TODAY.com.

The WHO added EG. 5 to its list of variants under monitoring on July 19, 2023, but the variant was first detected in February 2023. “Scientists have known about this variant, and it’s been present in other countries, as well,” says Pekosz.

So far, EG.5 has been reported in 51 countries and there has been a steady increase in prevalence globally — the majority of sequences are from China, followed by the U.S., South Korea, Japan and Canada, per WHO.

XBB.1.16, also called the “Arcturus” variant, remains the most prevalent strain of COVID-19 worldwide.

WHO considers the public health risk posed by EG.5 to be “low” and similar to that of XBB.1.16 and other variants of interest.

Is EG. 5 more transmissible? 

The EG.5 variant is very similar to other omicron variants, which means it’s highly transmissible, Dr. Albert Ko, an infectious disease physician and professor at Yale School of Public Health, tells TODAY.com.

However, EG.5 is likely more transmissible than other XBB variants, Dr. Sharon Nachman, chief of the division of pediatric infectious diseases at Stony Brook Children’s Hospital, tells TODAY.com.

“If it was equally transmissible, then we wouldn’t see it gaining strength number-wise compared to some of the other variants,” says Nachman, adding that EG.5 quickly pushed out other XBB variants in the U.S., which were dominant over the summer.

Why exactly EG.5 is more transmissible is not yet known, Ko says.

“Whether it’s escaping population immunity or it has some intrinsic factor that makes it better able to transmit from one person to another … it’s hard to separate,” he adds.

According to WHO, EG.5 has increased immune escape properties compared to other variants. “EG.5 may cause a rise in case incidence and become dominant in some countries or even globally,” WHO said in a report.

However, Pekosz notes that the EG.5 variant may not be the sole reason for the U.S. summer uptick. “When you have a new variants, and cases creeping up, there’s always concern about whether that variant could be driving the increase,” says Pekosz.

“Right now, it doesn’t look like that variant alone is driving the case increases (in the U.S.) … there’s still a lot of other variants co-circulating,” he adds.

According to CDC estimates, EG.5 accounted for about 17% of COVID-19 cases in the U.S. during the two-week period ending on Aug. 3. — after EG.5, the next most common variants were XBB.1.16, XBB.2.3, and XBB.1.5, which accounted for 15%, 11% and 10% of cases, respectively.

“We’re keeping an eye on (EG.5) because of the uptick in cases, but it doesn’t look like there’s anything particularly concerning about this variant,” says Pekosz.

More data is needed to understand how EG.5’s transmissibility compares to other strains. However, decreased levels of testing and genomic sequencing are making it harder to accurately track new COVID-19 cases and which variants are driving them, Pekosz notes.

“Right now, there’s an awful lot of guesswork,” he says.

Is EG.5 more severe?

The data available do not indicate that EG.5 causes a more severe infection compared to other variants, the experts note.

In its risk assessment of EG.5, WHO said, “There have been no reported changes in disease severity to date.”

Although the U.S. recently saw the first increase in COVID-19 hospitalizations of the year, there isn’t evidence that EG.5 is causing this uptick or that it’s more likely to cause hospitalizations in general, Nachman notes.

“The people that are getting hospitalized often have lots of co-morbidities, and they’re at-risk no matter what COVID strain they get,” says Nachman.

However, it’s possible that hospitalizations could increase even more because of more people getting infected with EG.5, says Ko. “There’s no clear evidence of that at this point, but we have to keep on evaluating,” Ko adds

Population immunity from vaccination and prior infection should protect people from severe illness as EG.5 continues to circulate.

What are the symptoms?

There isn’t enough clinical data about the most common symptoms of EG.5 yet, NBC News previously reported.

“There’s no change in EG.5 symptoms right now,” says Pekosz. So far, the symptoms of EG.5 look very similar to the standard omicron symptoms, says Ko. These include:

    • Cough
    • Sore throat
    • Runny nose
    • Sneezing
    • Fatigue
    • Headache
    • Muscle aches
    • Altered sense of smell

“It may progress to some more significant feelings of difficulty in breathing as the infection spreads into your lungs,” says Pekosz.

Certain groups are at higher risk of developing severe illness or complications, including people over 65 and those who are immunocompromised or have underlying medical conditions.

Can COVID-19 tests detect EG.5? 

All COVID-19 tests — including PCR tests performed by a medical provider and rapid at-home antigen tests sold over-the-counter — should be detecting EG.5, says Pekosz.

The experts emphasize the importance of getting tested as COVID-19 cases increase, and especially during the fall when viruses that cause similar symptoms (such as flu and RSV) are circulating.

“If you’re in one of the high-risk groups for getting severe COVID, you really shouldn’t hesitate to get a test,” says Pekosz, adding that early detection and treatment is key. COVID-19 antivirals such as Paxlovid are effective against EG.5 and other variants, but they work best when taken early, he adds.

Whether your insurance covers COVID-19 testing may have changed since the end of the U.S. federal public health emergency in May, TODAY.com previously reported, so check with your insurer if you have questions about testing costs.

It’s also important to check the expiration date of at-home tests. The shelf life of rapid tests ranges from four to 24 months, according to the U.S. Food and Drug Administration, but the expiration dates of some tests have been extended.

Will I need a COVID-19 booster this fall?

The experts encourage everyone to stay up to date on COVID-19 vaccines, which may include a new booster dose in the coming months. In June 2023, the FDA advised vaccine manufacturers to update their boosters to target omicron XBB.1.5, which was the dominant strain at the time.

These shots haven’t been approved yet, but the FDA could authorize Pfizer’s booster shot by the end of August, NBC News reported.

Although the new boosters will not include the EG.5 strain, they may still provide protection, the experts note. “If I vaccinate you with the vaccine that contains XBB, you will make antibodies that are specific to XBB and pretty close to EG.5,” says Nachman.

“Right now, EG.5 looks like it’s very closely matched to the vaccine that’s going to be available this fall,” says Pekosz.

However, the CDC has not yet released any firm guidance or recommendations around booster doses for the fall.

“The message is to pay attention to the COVID vaccine program that’s going to come out in the fall. … It’s a vaccine that many people (especially high-risk individuals) should consider taking,” says Pekosz.

How to protect yourself from EG.5:

In addition to staying up to date on COVID-19 vaccinations, the experts emphasize taking precautions to protect yourself and curb transmission of COVID-19, including:

    • Washing your hands with soap and water frequently
    • Staying home when sick
    • Avoiding contact with sick people
    • Improving ventilation
    • Wearing a mask in crowded, indoor spaces
    • Covering coughs and sneezes

A recent uptick in COVID numbers proves it is alive and well in California

COVID numbers are ticking up in California. Here’s what to know

Lu Foster receives a COVID-19 booster shot at the Lynne and Roy M. Frank Residences in San Francisco in October 2021. The FDA approved a second bivalent booster dose for older adults and people with compromised immune systems. | Brontë Wittpenn for The Chronicle.

San Francisco Chronicle, by Aidin Vaziri, July 28, 2023

As people crowd movie theaters for “Barbie,” flock to stadiums to see sold-out Taylor Swift concerts and resume their annual trips to Europe, in what largely feels like a summer in the days before the pandemic, highly transmissible variants of the coronavirus have found ideal conditions to reemerge and infect people.

That’s why health officials say a subtle but sustained increase in key COVID-19 indicators is not unexpected. Emergency department visits, test positivity rates and wastewater virus levels in some areas signal a slight rise in infections, according to the latest figures from the California Department of Public Health and the U.S. Centers for Disease Control and Prevention. Meanwhile, hospital admissions across the United States are up by more than 10% from the previous week.

Kathleen Conley, a spokesperson for the CDC, said that the nation is still in a good place despite this increase.

“U.S. COVID-19 rates are still near historic lows after seven months of steady declines,” she said in a statement. “The U.S. has experienced increases in COVID-19 during the past three summers, so it’s not surprising to see an uptick.”

While the 7,109 hospital admissions nationwide reported for the week of July 15 marks the highest level since December, it remains significantly lower than the peak observed during the omicron surge last July, when weekly U.S. hospitalizations reached more than 44,000.

According to the state’s health department, as of Thursday, California reported an average of 858 COVID-related hospitalizations per day over 14 days, up by 7.4% since the beginning of the month, with an average of nine deaths per day over seven days, compared with five on July 1.

To date, nearly 1.14 million people in the United States have died because of COVID-19 since the onset of the pandemic. But the combination of vaccination and immunity from previous infections has driven down community transmission, while treatments such as the antiviral medication Paxlovid have helped significantly reduce the likelihood of severe illness and death due to COVID.

That progress led to the U.S. reaching a pandemic milestone last week as the rate of excess deaths — the number of Americans dying from any cause compared with statistical averages — fell to below 1% after growing to as high as 30% during previous virus surges, according to the CDC.

“The death rates are no longer different from the usual death rates at this time of year,” Dr. Bob Wachter, the chair of medicine at UCSF, said this week in a podcast interview for Medscape. “That is a remarkable achievement and says something about the state of the pandemic and the state of immunity, either from vaccines or from infection or both. And it’s worth celebrating. It’s worth going back to something that feels a little bit closer to normal than we’ve lived for the last three or four years. But you have to do it with your eyes open.”

In California, the coronavirus test positivity rate has jumped to 7.6% this week, compared with 4.1% a month ago. That figure is more indicative of trends than community penetration because so few people now get laboratory tests. Most now rely on home test kits whose results are rarely reported to authorities. Others have discontinued testing altogether.

“In the same way people stop wearing masks and throw caution to the wind, once they’ve run out of their home tests, are they going to go to Walgreens and spend $30 to buy some more?” said Wachter, who himself recently got COVID-19 after avoiding it for more than three years. “I’m guessing they’re not.”

There is no single variant driving the current increase in infections, as XBB.1.15 and XBB.1.16 have declined in circulation over the past two weeks, while newer omicron offshoots like EG.5, XBB.1.16.6 and XBB.2.3 are uniformly gaining traction. No individual variant accounts for more than 15% of the measured proportion.

The upturn is not limited to the U.S. Japan has experienced a rise in COVID-19 hospitalizations and emergency department visits for nine consecutive weeks, indicating the country may be entering its ninth waveof infections. But Europe is reporting flat numbers.

The World Health Organization continues to underscore that COVID-19 “remains a major threat,” as several countries grapple with high disease burdens. In its latest weekly update, the agency urged government leaders not to dismantle their pandemic response infrastructure.

The WHO noted that EG.5, a descendant of the XBB.1.9.2 variant, has an additional mutation that could aid its rapid global spread. However, it said there is “no evidence of rising cases and deaths or a change in disease severity associated with EG.5.”

Updated COVID-19 vaccines targeting the XBB.1.5 variant, which has been dominant in the United States throughout 2023, are expected to be available in late September, alongside this year’s flu shot.

“This is the new normal, and COVID will now be baked into the list of day-to-day risks that we all have,” Wachter said. “And all of us have to come to some sense of clarity of how we are going to live our lives in a way that’s fulfilling and maximizes joy.”

FDA authorizes 2nd COVID booster for older adults

UPDATE: Second COVID bivalent booster shots set to roll out. Here’s what you need to know

Lu Foster receives a COVID-19 booster shot at the Lynne and Roy M. Frank Residences in San Francisco in October 2021. The FDA approved a second bivalent booster dose for older adults and people with compromised immune systems. Brontë Wittpenn/The Chronicle 2021

San Francisco Chronicle, by Aidin Vaziri, April 18, 2023 [See also, this article updated: April 19, 2023]

On Tuesday, the U.S. Food and Drug Administration authorized a second COVID-19 booster dose for older Americans and individuals with weakened immune systems to enhance their protection this spring.

Coronavirus map: How many COVID cases are in Bay Area and California

The move comes amid concerns over newer variants of the virus causing the number of COVID-19 cases and deaths to tick back up in the United States, particularly among vulnerable populations.

Individuals age 65 or older may opt for a second shot of the bivalent vaccine targeting the omicron strains of the coronavirus at least four months after their initial dose. For those who are immunocompromised, a second booster shot may be received at least two months later, with additional doses at the discretion of their physician.

The FDA also announced that the original versions of the Pfizer and Moderna vaccines are outdated and will no longer be used. Instead, individuals receiving these shots will be administered the newer omicron-targeted version. For those receiving their first-ever vaccine, a single combo dose will suffice.

A Jackson, Miss., resident receives a Pfizer booster shot from a nurse at a vaccination site. The FDA approved a second bivalent booster dose for older adults and people with compromised immune systems. Rogelio V. Solis/Associated Press 2022

According to Dr. Peter Marks, the FDA vaccine chief, “At this stage of the pandemic, data support simplifying the use of Pfizer and Moderna vaccines. The agency believes this approach will help encourage future vaccination.”

Although Britain and Canada have already recommended an additional spring booster for vulnerable populations, high-risk Americans who last received a dose in the fall have been eagerly anticipating another dose.

Booster doses continue to stave off severe disease and death, even as more contagious variants have emerged, while protection against mild infections is short-lived.

At least 250 people in the U.S. still die from COVID-19 each day, many of them older and at higher risk for the worst outcomes of the disease.

Yvonne Maldonado, an infectious disease expert at Stanford, said, “If you look at who’s dying or getting sick now, it’s people who are unvaccinated or unboosted.”

The Centers for Disease Control and Prevention must approve the latest round of boosters, and its advisers are scheduled to meet on Wednesday.

The Pfizer and Moderna boosters contain protection against both the original coronavirus strain and omicron variants known as BA.4 and BA.5. Recent studies show that the bivalent shots are still effective, even as newer omicron cousins circulate.

The FDA’s simplification also means changes for unvaccinated children. Children under 5 may receive two doses of the bivalent Moderna vaccine or three doses of the Pfizer-BioNTech bivalent vaccine.

People 5 and older may get a single bivalent Pfizer shot or two Moderna doses. Children already fully or partially vaccinated with the original Pfizer or Moderna shots may get a bivalent vaccine, but the number of doses will depend on their vaccination history, the FDA said.

While over 95% of the U.S. population aged 65 and older received at least one vaccine dose, only 42.1% of those eligible have received the latest boosters, which were authorized in August, according to the CDC.

The offering of a second bivalent booster will not interfere with the Biden administration’s previously stated plan of moving the nation toward an annual COVID vaccine similar to the flu shot.

But for eligible high-risk groups, a second booster in the spring is a reasonable choice, said Dr. Matthew Laurens of the University of Maryland School of Medicine.

“We do have vaccines that are available to protect against these severe consequences, so why not use them?” he said. “They don’t do any good just sitting on a shelf. So let’s give them to individuals who are at the highest risk and who can benefit the most.”

The Associated Press contributed to this report.