The Most Common Places COVID Is Spreading Right Now (And Where It's Not)

By Catherine Pearson

10/19/2021 05:45am EDT 

Curious what activities may be associated with higher COVID-19 transmission? Here's what data suggests.

The types of places that carry the biggest risk for COVID-19 transmission have changed over time ― partly because experts have learned more about how the virus works and partly because the virus itself has changed. The delta variant is more than two times as contagious as previous strains, which has obvious implications for transmission.

Also, nearly 60% of the population in the United States is now fully vaccinated, which impacts the virus’s spread. Fully vaccinated people are not only less likely to become hospitalized or die, they’re also far less likely to spread the virus (despite some confusing public health messaging around this second point).

So here’s what we know about the places where transmission is the highest right now, and places where the spread isn’t as bad as people might think:

Where COVID Is Spreading The Most Right Now

Inside restaurants and bars

Throughout the pandemic, it’s been pretty clear that restaurants and bars are sources of COVID-19 transmission, and recent evidence suggests that continues to be the case.

“You have decreases in cases and deaths when you wear masks, and you have increases in cases and deaths when you have in-person restaurant dining,” Rochelle Walensky, director of the Centers for Disease Control and Prevention, said in March in response to CDC data showing a link between indoor dining and increased COVID-19 cases. During the delta summer surge, there were clusters linked to restaurants that occurred in various parts of the country, including some among restaurant staff (though it’s not easy for health officials to pinpoint where exactly COVID-19 is spreading when there is a lot of it in the community).

And of course the risk of contracting COVID-19 when you’re enjoying a meal indoors depends a lot on local transmission and vaccination rates. Some places, like New York City, require proof of vaccination, if you’re eligible, before you can dine indoors. (Younger children are exempt.) If you’re going to eat inside, pay attention to both of those factors, as well as where you’re sitting. Avoid crowded areas (like the bar) and sit by an open window or door if possible.

Small, informal get-togethers

Experts have long warned that small get-togethers seem to be driving transmission, and research suggests that continues to be the case. One 2020 study found that in areas with high transmission, households that had recently held a birthday party had a 30% higher risk of COVID-19 infection than those that did not host a get-together. (The researchers didn’t have information on where the parties were hosted, attendees, etc.) It’s not easy to study spread from informal gatherings, because they’re hard to track, but health experts definitely believe that delta has made getting together with others riskier.

That is why the CDC still recommends that small gatherings be held outdoors if possible, and that people living in areas with substantial or high transmission mask up if they’re spending time indoors together. Even though new COVID-19 cases have declined dramatically over the past month, most of the country still falls into that substantial or high transmission category.

“Most people are getting COVID in their free time,” Alexa Mieses Malchuk, a North Carolina-based family physician, told HuffPost, by which she means that people are getting sick when they’re together socially rather than in schools or office buildings.

Very crowded outdoor settings

Outdoor settings are less risky than indoor settings, but “it’s not like being outdoors is a magic wand,” said Mieses Malchuk. If you’re outdoors with a small group of people maintaining physical distance, that’s very different than if you’re at a crowded outdoor event spending a lot of time in close quarters with others.

“The more people we add, the more variables come into play. Naturally as crowds grow, it is harder and harder to keep that physical distance,” she said. “What’s more, you don’t know the vaccination status of everyone around you.”

That’s why there have been coronavirus clusters linked to outdoor music festivals, for example. Experts are also looking into COVID-19 spread associated with youth sports leagues, though they’ve said cases linked to outdoor sports probably have more to do with kids spending time together off the field than with games and practices.

Where COVID Does Not Appear To Be Spreading

Schools with mask mandates

Throughout the pandemic, research has shown that schools were not major sources of COVID-19 transmission — but there were concerns that might change as schools across the U.S. reopened this fall amid the delta surge.

Early evidence suggests that schools with mask mandates appear to be faring well, while schools without them have seen more cases. “Nationwide, counties without masking requirements saw the number of pediatric COVID-19 cases increase nearly twice as quickly during this same period,” according to a recent CDC study.

Public transportation

Studies conducted in 2020 found that public transportation in places like New York City does not seem to be a big driver of COVID-19 transmission, and research also suggests that extends to other types of group transport, like school buses. That probably has a lot to do with the fact that the CDC has required the use of face masks on public transportation and indoor transportation hubs.

All of this really depends on where you live

While it’s helpful to have a big-picture view of the types of activities that have been linked to greater COVID-19 transmission — and to stay on top of national trends — Mieses Malchuk said it’s probably much more useful for anyone making decisions about their own risk during certain activities to continue checking out their local health department data. You can do this by searching online for your city and the phrase “COVID cases.” The CDC also tracks community spread by county, and updates it daily.

Also, know what your local regulations are regarding mask mandates and other preventive measures. Your risk of getting COVID-19 is very different if you’re dining indoors in an area with no mask mandates and high transmission than if you’re dining indoors in an area with relatively low transmission and where you’re required to wear a mask indoors — or maybe even be vaccinated to eat indoors.

Ultimately, those two factors — your local transmission rates and regulations — probably tell you more than any one study can about where you’re at a higher risk of contracting the coronavirus. Studies take time, and the virus is so widespread at this point it’s difficult to pinpoint where exactly people are getting it. Also, while national health organizations like the CDC and American Academy of Pediatrics are tracking COVID-19 transmission, a lot of the tracking is done at the local level — and different states, counties and even institutions (like schools) have different ways of collecting and disseminating that information.

“We don’t just have one centralized place in which all schools or community organizations report,” Mieses Malchuk said.

So do your best to stay on top of what’s happening around you, follow local and national recommendations, and talk to your doctor if you have specific unanswered questions about your own risk.

Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.

Source: https://www.huffpost.com/entry/most-common-places-covid-spreading_l_6169b113e4b00cb3cbd29a91

What are the Delta, Gamma, Beta and Alpha Covid variants?

By Michelle Roberts

Health editor, BBC News online

19 October 2021

Officials are keeping a close watch on a new descendent of the Delta variant of Covid, which is causing a growing number of infections in the UK.

AY.4.2 - which some are calling "Delta plus"- has changes or mutations that might potentially help the virus survive more effectively.

Other current variants of concern include:

• Alpha (B.1.1.7), first identified in the UK but which spread to more than 50 countries

• Beta (B.1.351), first identified in South Africa but which has been detected in at least 20 other countries, including the UK

• Gamma (P.1), first identified in Brazil but which has spread to more than 10 other countries, including the UK

Viruses mutate all the time and most changes are inconsequential. Some even harm the virus. But others can make the disease more infectious or threatening - and these mutations tend to dominate.

Source: https://www.bbc.com/news/health-55659820

Covid-19: New mutation of Delta variant under close watch in UK

By Michelle Roberts

Health editor, BBC News online

19 October 2021

Officials are keeping a close watch on a new descendant of the Delta variant of Covid that is causing a growing number of infections.

Delta is the UK's dominant variant, but latest official data suggests 6% of Covid cases that have been genetically sequenced are of a new type.

AY.4.2, which some are calling "Delta Plus", contains mutations that might give the virus survival advantages.

Tests are under way to understand how much of a threat it may pose.

Experts say it is unlikely to take off in a big way or escape current vaccines.

It is not yet considered a variant of concern, or a variant under investigation - the categories assigned to variants and the level of risk associated with them.

What is AY.4.2?

There are thousands of different types - or variants - of Covid circulating across the world. Viruses mutate all the time, so it is not surprising to see new versions emerge.

Original Delta was classified as a variant of concern in the UK in May 2021 after overtaking the Alpha variant to become the dominant type of Covid in circulation.

But in July 2021 experts identified AY.4.2.

This offshoot or sublineage of Delta has been increasing slowly since then. It includes some new mutations affecting the spike protein, which the virus uses to penetrate our cells.

So far, there is no indication that it is considerably more transmissible as a result of these changes, but it is something experts are studying.

The mutations - Y145H and A222V - have been found in various other coronavirus lineages since the beginning of the pandemic.

Scientists are constantly checking for new genetic changes that Covid is undergoing.

Some emerging variants are worrying, but many are inconsequential. The difficult job is spotting, tracking and managing the ones that could matter.

The UK is a front-runner in carrying out these vital lab analyses, having completed more than a million tests so far.

The first step is to pick up new mutants worth watching, such as this new offshoot - AY.4.2.

Next, if there is a strong suggestion that the genetic changes might make the virus more contagious, it is classified as a variant under investigation and more checks are done.

If it becomes clearer that it could be more transmissible and escape some of the built up immunity from past infections or vaccines, or potentially cause more serious disease, it is moved into the variant of concern category. That's the one Delta belongs to.

At this stage, experts don't think AY.4.2 is likely to take hold - so in time it could well burn out and drop off the watch list.

Prof Francois Balloux, director of University College London's Genetics Institute, said: "It is potentially a marginally more infectious strain.

"It's nothing compared with what we saw with Alpha and Delta, which were something like 50 to 60 percent more transmissible. So we are talking about something quite subtle here and that is currently under investigation.

"It is likely to be up to 10 percent more transmissible.

"It's good that we are aware. It's excellent that we have the facilities and infrastructure in place to see anything that might be a bit suspicious.

"At this stage I would say wait and see, don't panic. It might be slightly, subtly more transmissible but it is not something absolutely disastrous like we saw previously."

The Prime Minister's official spokesman said: "It's something we're keeping a very close eye on.

"As you would expect we're monitoring it closely and won't hesitate to take action if necessary."

A few cases have also been identified in US. There had been some in Denmark but new infections with AY.4.2 have since gone down.

The UK is already offering booster doses of Covid vaccine to higher risk people ahead of winter to make sure they have the fullest protection against coronavirus.

There is no suggestion that a new update of the vaccine will be needed to protect against any of the existing variants of the pandemic virus.

Source: https://www.bbc.com/news/health-58965650

Merck pill seen as 'huge advance,' raises hope of preventing COVID-19 deaths

By Deena Beasley and Carl O'donnell

October 1, 2021

7:27 PM AST

Last Updated 3 days ago

https://www.youtube.com/watch?v=qVW2QqHUJUw&t=1s

Summary

• Merck will seek U.S. approval for pill as soon as possible
• If approved, would be 1st oral antiviral COVID-19 drug
• Merck shares rally, some vaccine makers fall
• U.S. government to buy 1.7 mln courses at $700 each

Oct 1 (Reuters) - An experimental antiviral pill developed by Merck & Co (MRK.N) could halve the chances of dying or being hospitalized for those most at risk of contracting severe COVID-19, according to data that experts hailed as a potential breakthrough in how the virus is treated.

If it gets authorization, molnupiravir, which is designed to introduce errors into the genetic code of the virus, would be the first oral antiviral medication for COVID-19.

Merck and partner Ridgeback Biotherapeutics said they plan to seek U.S. emergency use authorization for the pill as soon as possible and to make regulatory applications worldwide.

"An oral antiviral that can impact hospitalization risk to such a degree would be game-changing," said Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security.

Current treatment options include Gilead Sciences Inc's (GILD.O) infused antiviral remdesivir and generic steroid dexamethasone, both of which are generally only given once a patient has already been hospitalized.

"This is going to change the dialogue around how to manage COVID-19," Merck Chief Executive Robert Davis told Reuters.

Existing treatments are "cumbersome and logistically challenging to administer. A simple oral pill would be the opposite of that," Adalja added.

The results from the Phase III trial, which sent Merck shares up more than 9%, were so strong that the study is being stopped early at the recommendation of outside monitors.

Shares of Atea Pharmaceuticals Inc (AVIR.O), which is developing a similar COVID-19 treatment, were up more than 21% on the news.

Shares of COVID-19 vaccine makers Moderna Inc (MRNA.O) were off more than 10%, while Pfizer (PFE.N) was down less than 1%.

Jefferies analyst Michael Yee said investors believe "people will be less afraid of COVID and less inclined to get vaccines if there is a simple pill that can treat COVID."

Pfizer and Swiss drugmaker Roche Holding AG (ROG.S) are also racing to develop an easy-to-administer antiviral pill for COVID-19. For now, only antibody cocktails that have to be given intravenously are approved for non-hospitalized patients.

White House COVID-19 response coordinator Jeff Zients said on Friday that molnupiravir is "a potential additional tool... to protect people from the worst outcomes of COVID," but added that vaccination "remains far and away, our best tool against COVID-19."

A planned interim analysis of 775 patients in Merck's study looked at hospitalizations or deaths among people at risk for severe disease. It found that 7.3% of those given molnupiravir twice a day for five days were hospitalized and none had died by 29 days after treatment. That compared with a hospitalization rate of 14.1% for placebo patients. There were also eight deaths in the placebo group.

"Antiviral treatments that can be taken at home to keep people with COVID-19 out of the hospital are critically needed,” Wendy Holman, Ridgeback's CEO, said in a statement.

'A HUGE ADVANCE'

Scientists welcomed the potential new treatment to help prevent serious illness from the virus, which has killed almost 5 million people around the world, 700,000 of them in the United States.

“A safe, affordable, and effective oral antiviral would be a huge advance in the fight against COVID," said Peter Horby, a professor of emerging infectious diseases at the University of Oxford.

The study enrolled patients with laboratory-confirmed mild-to-moderate COVID-19, who had symptoms for no more than five days. All patients had at least one risk factor associated with poor disease outcome, such as obesity or older age.

Drugs in the same class as molnupiravir have been linked to birth defects in animal studies. Merck has said similar studies of molnupiravir – for longer and at higher doses than used in humans – indicate that the drug does not affect mammalian DNA.

Merck said viral sequencing done so far shows molnupiravir is effective against all variants of the coronavirus including the highly transmissible Delta, which has driven the recent worldwide surge in hospitalizations and deaths.

It said rates of adverse events were similar for both molnupiravir and placebo patients, but did not give details.

Merck has said data shows molnupiravir is not capable of inducing genetic changes in human cells, but men enrolled in its trials had to abstain from heterosexual intercourse or agree to use contraception. Women of child-bearing age in the study could be pregnant and also had to use birth control.

The U.S. drugmaker said it expects to produce 10 million courses of the treatment by the end of 2021.

The company has a U.S. government contract to supply 1.7 million courses of molnupiravir at a price of $700 per course.

Davis said Merck has similar agreements with other governments, and is in talks with more. Merck said it plans a tiered pricing approach based on country income criteria.

The U.S. government has the option to purchase up to an additional 3.5 million treatment courses if needed, a U.S. health official told Reuters. The official asked to remain anonymous because they were not authorized to comment publicly on the contract.

Merck has also agreed to license the drug to several India-based generic drugmakers, which would be able to supply the treatment to low- and middle-income countries.

Molnupiravir is also being studied in a Phase III trial for preventing infection in people exposed to the coronavirus.

Merck officials said it is unclear how long the FDA review will take, although Dean Li, head of Merck's research labs, said, "they are going to try to work with alacrity on this."

Reporting by Deena Beasley and Carl O'Donnell; Additional reporting by Josephine Mason, and Ahmed Aboulenein; Editing by Lincoln Feast, Kirsten Donovan, Alexander Smith, Bill Berkrot and Sonya Hepinstall

Source: https://www.reuters.com/business/healthcare-pharmaceuticals/mercks-covid-19-pill-cuts-risk-death-hospitalization-by-50-study-2021-10-01/

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Natural versus vaccine immunity

https://www.youtube.com/watch?v=9bamaEMftg4