Category: Corona Virus

Some European countries, such as Spain, are making plans for the time they might be able to treat SARS-CoV-2 as an endemic disease one that's always around but fairly predictable. But the World Health Organization cautions that the pandemic is not over. Above: Masked pedestrians in Barcelona, Spain, in July 2021. Joan Mateu/AP hide caption

Some European countries, such as Spain, are making plans for the time they might be able to treat SARS-CoV-2 as an endemic disease one that's always around but fairly predictable. But the World Health Organization cautions that the pandemic is not over. Above: Masked pedestrians in Barcelona, Spain, in July 2021.

Each week, we answer frequently asked questions about life during the coronavirus crisis. If you have a question you'd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: "Weekly Coronavirus Questions." See an archive of our FAQs here.

We all know what the word pandemic means now, but remind me what endemic means again and are we there yet?

It's been two years since the World Health Organization, on March 11, 2020, officially declared a global pandemic.

Since then, we're all become too familiar with the word pandemic and sister terms such as epidemic and outbreak.

(If you're fuzzy on the definitions, check out this glossary.)

"But now we're starting to hear the word 'endemic,' " says epidemiology professor Charlotte Baker at Virginia Tech in reference to a new stage for SARS-CoV-2.

So should we be looking forward to that?

First, let's explain the term.

The word "endemic" comes from the Greek word endmos, which means "in the population."

In epidemiology, it means that the disease is always present at a baseline level. So it's not down to zero. There are observable cases. But unlike a pandemic or epidemic, in which a disease's behavior is often surprising or unexpected, an illness that has become endemic has become more predictable.

A candy analogy might help.

If you think of a disease as a regular-size KitKat bar, Baker says, and you open the package one day and there are six pieces instead of four, that candy bar is acting more like an epidemic (that is, a sudden spike of a disease that could lead to a pandemic if it spreads globally).

"An epidemic means more cases than we expect," she explains. And if you unwrapped a KitKat bar to reveal six pieces, you'd know something was wrong "it throws you off, you know something's happening," she says, just as you know that you can't count on things staying the same when there's an epidemic.

As much as none of us want to be joined at the hip with COVID-19 forever that's the nature of an endemic situation this stage does have some advantages.

First of all, you know what you're getting: "Endemic means that the disease or infection reached a steady state where it doesn't cause large outbreaks but it still circulates, causing individual cases," explains epidemiologist Dr. Isaac Weisfuse, an adjunct professor in Cornell University's master's of public health program. "There's always a "background rate of infection causing cases or maybe more cases in enclaves of people who haven't been vaccinated," he adds.

Most strains of influenza are endemic, for example, and you can roughly predict when flu season will begin and end. (Every once in awhile, there are new variants that throw things off, like H1N1 in 2009, which caused a pandemic.) Other endemic diseases in the U.S. include pneumonia and chickenpox. With minimal precautions, such as vaccination, boosters and optional masking, life for most people proceeds as normal.

So are we there yet, endemically speaking?

"We're all in a rush to get to the endemic stage I would love it," Baker says. "But when it will happen is a really good question."

There are a few potential roadblocks in the way namely, variants.

"The problem hanging over all of us is what happens if a new variant should occur," Weisfuse says.

In other words, we're far from being able to predict what will happen next with COVID-19. If the disease were a candy bar, we still don't know what to expect when we unwrap it.

Also, Baker notes, the pandemic won't officially be over until the World Health Organization says it's over.

Once that's decided at a special meeting, some countries could still be stuck in epidemic status while others may skip right into endemic.

And, our experts noted, an endemic disease doesn't change the fact that people still need to protect themselves by getting vaccinated.

"The virus might find you if you're unvaccinated or if you have underlying risk factors," Weisfuse says. A small number of those people will still need to be hospitalized, he notes.

I've also heard the terms eliminated and eradicated. Is it too optimistic to hope for that?

Unfortunately, yes.

If a disease is "eliminated" from a country, that means no more transmission among its population (although cases might still be introduced from outsiders). That's the categorization for measles, for example, in the U.S. and a number of European countries.

Other diseases such as smallpox have been eradicated, which means there is zero transmission. (The last naturally occurring case of smallpox was in 1977.)

In both cases, vaccines were to thank for the decline of the diseases.

COVID-19, however, is unlikely to ever be eradicated and doesn't appear to be on track to be eliminated, either, since the virus has been found in animals such as mink, hamsters and deer.

"Once you have a disease with an animal reservoir, it's very hard to eradicate," Weisfuse says. That's because once it's in animals, it can find its way back to humans like the three people in Hong Kong who reportedly caught COVID-19 from pet-store hamsters.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases," echoed that sentiment in January, when he pointed out that COVID-19 is not on a path to eradication.

"If you look at the history of infectious diseases, we've only eradicated one infectious disease in man, and that's smallpox. That's not going to happen with this virus. But hopefully it will be at such a low level that it doesn't disrupt our normal social, economic and other interactions," he said at the World Economic Forum's Davos Agenda.

And some places are already planning for the endemic stage: Spanish Prime Minister Pedro Sanchez has asked European officials to discuss when COVID-19 should be considered endemic, and California has adopted the first endemic policy for COVID in the U.S. According to The Associated Press, the California plan "emphasizes prevention and quick reaction to outbreaks over mandated masking and business shutdowns."

But it's also important to remember that endemic is not synonymous with harmless. Malaria, for example, is considered endemic in a number of countries. In 2020, the World Health Organization tallied 627,000 deaths from this mosquito-borne disease.

Sheila Mulrooney Eldred is a freelance health journalist in Minneapolis. She has written about COVID-19 for many publications, including The New York Times, Kaiser Health News, Medscape and The Washington Post. More at sheilaeldred.pressfolios.com. On Twitter: @milepostmedia.

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Will SARS-CoV-2 become endemic? And what would that mean? : Goats and Soda - NPR

Raul Andino knows his pathogens. For more than 30 years the University of California, San Francisco researcher has studied RNA viruses, a group that includes the virus that causes COVID-19. And yet he never imagined hed witness a pandemic of this scale in his lifetime.

The magnitude of it and the implications of it are still hard to comprehend, Andino says.

Although experts in his field suspected a pandemic would occur, its hard to know when, he says. Its similar to an earthquakeyou know the earthquake will happen, but normally you dont think about it.

On March 11, 2020exactly two years agothe World Health Organization declared COVID-19 to be a pandemic. The disease has since infected nearly 500 million people in almost 200 countries and killed more than six million people worldwide, and its not over yet.

Along the way, this coronavirus has presented scientists with a bevy of surprises: Many experts are still amazed by how quickly the virus evolves, what it does to the human body, and how it moves in and out of other species.

The original SARS-CoV-2 virus rapidly evolved into a string of variants that have hindered a return to pre-pandemic normalcy. Even with the viruss genetic blueprint in hand and the ability to decode the genomes of new variants within hours, virologists and healthcare professionals struggle to predict how its mutations will alter the viruss transmissibility and severity.

Millions of people are grappling with symptoms that linger for weeks to several months after theyd been diagnosed with an infection. Scientists are racing to understand the biology of this new and perplexing syndrome called long COVID.

Two years in, theres still a lot we dont know about SARS-CoV-2, says David Wohl, an infectious disease specialist at the University of North Carolina. Heres what scientists have uncovered so farand the mysteries that continue to tantalize and frustrate coronavirus experts.

Experts had been warning of some kind of looming pandemic for decades. As humans expand settlements into wild areas, they raise the odds of a new pathogen jumping from an animal to a person, giving rise to a deadly zoonotic disease. A study published in Natureshowed that emerging infectious diseases originating in wildlife had increased significantly between 1940 and 2004.

But most experts were worried about influenza viruses and would not necessarily have expected a coronavirus to cause such havoc.

That changed with the 2002-04 Severe Acute Respiratory Syndrome (SARS) outbreak, which infected more than 8,000 people in 29 countries and left 774 dead. Then the 2012 Middle East Respiratory Syndrome (MERS) outbreak infected more than 2,000 people in 37 countries; that virus has so far killed nearly 900.

Still, people werent paying as much attention to coronaviruses compared to the really bad guys like influenza, HIV, dengue viruses, Andino says.

Then SARS-CoV-2 arrived with a bang. It was spreading faster than previous coronaviruses, and one reason, scientists suspect, is its ability to move efficiently from one cell to the next. SARS-CoV-2 is also harder to contain because it causes so many asymptomatic cases, people who can then unknowingly spread the virus. In a way, SARS-CoV-2 has found a way in which it can [rapidly] spread and also cause disease, Andino says. Its the worst-case scenario playing out.

Adding to the oddities, the SARS-CoV-2 virus acquired genetic mutations much more rapidly than expected.

Coronaviruses usually mutate at lower rates than other RNA viruses, like influenza and HIV. Both SARS-CoV and SARS-CoV-2 accumulate approximately two mutations each month; half to one sixth the rate seen in influenza viruses. Thats because coronaviruses have proofreading proteins that correct errors introduced into the virus genetic material as it replicates.

Thats why we thought [SARS-CoV-2] would not evolve very fast, says Ravindra Gupta, a clinical microbiologist at the University of Cambridge.

But the virus quickly proved Gupta and his colleagues wrong. The emergence of Alphathe first variant of concern identified in the United Kingdom in November 2020stunned scientists. It had 23 mutations that set it apart from the original SARS-CoV-2 strain, eight of which were in the spike protein, which is essential for anchoring to human cells and infecting them.

It became clear that the virus could make these [surprising] evolutionary leaps, says Stephen Goldstein, an evolutionary virologist at the University of Utah. With this set of mutations, Alpha was 50 percent more transmissible than the original virus.

The next version, Beta, was first identified in South Africa and was reported as a variant of concern just a month later. It carried eight mutations on the viral spike, some of which helped the virus escape the bodys immune defenses. And when the Gamma variant emerged in January 2021, it had 21 mutations, 10 of which were in the spike protein. Some of these mutations made Gamma highly transmissible and enabled it to reinfect patients who previously had COVID-19.

Its surprising to see these variants make pretty significant leaps in transmissibility, Goldstein says. I just dont think weve observed a virus do that before, but of course, we have not actually observed any pandemics previously with the amount of genetic sequencing capacity we have now.

Then came Delta, one of the most dangerous and contagious variants. It was first identified in India and designated a variant of concern in May 2021. By late 2021 this variant dominated in almost every country. Its unique constellation of mutations13 overall and seven in the spikemade Delta twice as infectious as the original SARS-CoV-2 strain, led to longer lasting infections, and produced 1,000 times more virus in the bodies of infected people.

"It [SARS-CoV-2]s ability to come up with new solutions and ways to adapt and spread with such easeits incredibly surprising, Andino says.

However, Omicron, which is two to four times more contagious than Delta, rapidly replaced that variant in many parts of the world. First identified in November 2021, it carries an unusually high number of mutationsmore than 50 overall and at least 30 in the spikesome of which help it evade antibodies better than all the earlier virus versions.

These huge jumps [in mutations] make the pandemic far less predictable, says Francois Balloux, a computational biologist at the University College London Genetics Institute in the United Kingdom.

One of the most compelling explanations for the huge leaps in the number of mutations is that that the SARS-CoV-2 virus was able to evolve for long periods of time in the bodies of immunocompromised people.

During the past year, scientists have identified cancer patients and people with advanced HIV disease who were unable to get rid of their COVID-19 infection for months to nearly a year. Their suppressed immune systems enabled the virus to persist, replicate, and mutate for months.

Gupta identified one such mutation (also seen in the Alpha variant) in a sample from a cancer patient who remained infected for 101 days. In an advanced HIV patient in South Africa who was infected for six months, scientists recorded a multitude of mutations that helped the virus escape the bodys immune defenses.

That the virus is changing its biology this quickly in its evolutionary history is a huge find, Gupta says. Other viruses like influenza and norovirus also undergo mutation in immunocompromised individuals, but it is very rare, Gupta says, and they infect a narrow range of cells.

By contrast, SARS-CoV-2 has proven capable of infecting many different areas of the bodycreating yet more baffling effects for scientists to untangle.

Early in the pandemic medical professionals noticed that the virus wasnt just causing pneumonia-like illness. Some hospitalized patients also presented heart damage, blood clots, neurologic complications, and kidney and liver defects. Mounting studies within the first few months suggested one reason why.

SARS-CoV-2 uses proteins called ACE2 receptors on the surface of human cells to infect them. But because ACE2 is present in many organs and tissues, the virus was infecting more parts of the body than just the respiratory tract. There were also a few reports of the virus, or parts of it, in blood vessel cells, kidney cells, and small quantities in brain cells.

Ive studied a lot of pandemics, and in almost all of them, you look at the brain, youll find the virus there, says Avindra Nath, a neuroimmunologist at the National Institutes of Health. For instance, brain autopsy tissues from 41 hospitalized and dead COVID-19 patients revealed low levels of the virus. But there were also clear signs of damage, including dead neurons and mangled blood vessels.

Thats the biggest surprise, Nath says.

Its likely that the virus triggers the bodys immune system to go into a hyperactive mode called a cytokine storm, which causes inflammation and injury to different organs and tissues. An abnormal immune response can persist even after infection, resulting in lingering symptoms including chronic fatigue, heart palpitations, and brain fog.

But there are virus reservoirs that can cause chronic inflammation, says Sonia Villapol, a neuroscientist at theHouston Methodist Research Institute. A recent study thats not yet been peer-reviewed showed that SARS-CoV-2 genetic material could persist for up to 230 days in the body and brains of COVID-19 patients, even in those who harbored only mild or asymptomatic infections.

Susan Levine is an infectious-disease doctor in New York who specializes in the treatment and diagnosis of chronic fatigue syndrome, which has parallels with long COVID. She now sees 200 patients every week, compared to 60 in pre-pandemic times. Unlike CFS, long COVID hits you like a ton of bricks, Levine says. Its like a tornado inside your body where youre going from working 60 hours a week down to being in the bed all day within a week of getting the infection. The action is so compressed.

Scientists are now concerned about the persistence of SARS-CoV-2 outside human populations and its potential to spread to other animals and jump back into humans, possibly extending the pandemic.

In April 2020 tigers and lions at New Yorks Bronx Zoo tested positive for COVID-19, sparking interest in finding other animals that might be susceptible. Soon after a study identified mammals including certain primates, deer, whales, and dolphins to be among the most vulnerable to COVID-19 given the similarity between their ACE2 receptors and the counterpart in human cells.

Another study used a machine learning approach to assess the abilities of 5,400 mammal species to transmit SARS-CoV-2; it found that several animals most at risk of spreading COVID-19 were those living alongside people, such as livestock and even pets.

So far SARS-CoV-2 has infected pet cats, dogs, and ferrets, ravaged mink farms, and spread to tigers, hyenas, and other animals in zoos. Whats more, SARS-COV-2 has successfully jumped from humans to captive minks and back into mink farmers. And a person in Canada was potentially infected with COVID-19 when the virus jumped from a white-tailed deer.

The concern is if it continues to evolve in deer to a point where deer become more and more immune to it, their preexisting antibodies from their reinfection could also further drive viral evolution, says Samira Mubareka at Canadas Sunnybrook Health Sciences Centre. Also, the virus may be circulating in other animals out there.

Still, the spread of SARS-CoV-2 among humans continues to be a bigger concern for scientists, as they learn more about the virus and its presence and impact in both humans and animals.

We still dont know what the future holds, Wohl says. Well be two years plus of history and track record, and even then with that knowledge, its still hard to predict what will happen.

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Two years into the pandemic, COVID-19 still surprises experts - National Geographic

Friday, March 11 marks two years since the World Health Organization declared COVID-19 a global pandemic.

It was very, very intense and very stressful, but also a lot of team building through adversity, said Dr. Amy Beth Kressel, Medical Director of Infection Prevention and Antimicrobial Stewardship at Eskenazi Health.

We would do one thing and then literally the same day we would have to change something because everything was changing so quickly. The hospital and my colleagues and I really came together.

A lot has changed in Central Indiana since WHOs declaration just about every COVID-19 metric continues to fall.

At Eskenazi Health, Dr. Kressel said frontline workers were caring for two COVID-19 inpatients as of Friday morning. That is compared to somewhere between 130 or 140 COVID-19 inpatients at the height of the Omicron surge.

We were able to take care of our patients through a lot of teamwork and a lot of grace for each other, said Dr. Kressel. So thats the positive.

On the flip side, Dr. Kressel said there is one lesson she hopes is learned: the nations supply chain is broken and needs to be fixed.

Supply chains basically broke, said Dr. Kressel. Personal protective equipment, we have shortages of critical medicines, we were concerned about our ventilators Its not as critical now but the supply chain issues are not completely resolved.

Dr. Kressel said she hopes there will be genuine action to make hospitals and the health care system more resilient to a future pandemic or any sort of future crisis.

I really think resiliency is going to have to be baked in across all the systems, said Dr. Kressel.

Meanwhile in Monroe County, health officials agree the pandemic caught many sectors by surprise.

We didnt have resources in place and infrastructure in place for a lot of things that we have now, said Penny Caudill, Health Administrator for the Monroe County Health Department. It can be an eye opening experience Why didnt we have those things? Well, we didnt have the infrastructure. We didnt pay for the infrastructure. But we can do that going forward and certainly more money is being put into public health. I guess that thats a good thing to come from this.

Caudill said another positive to come out of the pandemic is more open lines of communication and better relationships.

Weve had good relationships with our community partners, with the hospital and the university, but certainly the pandemic has forged new ones, said Caudill.

Friday also marked the last weekly scheduled COVID-19 press conference for the city of Bloomington. Caudill said the county now has the tools and ability to quickly orchestrate another meeting if necessary.

My staff has been incredible the past couple years. Incredible, said Stephenie Mellinger, Administrator for the Madison County Health Department. They may not interact on a daily basis, but they did during this pandemic and so it was really great to see how the whole department came together.

Mellinger said she has done a lot of reflection in this past week leading up to the two-year milestone. While she does remember this day in history, she said she remembers another day more vividly.

I remember more clearly the first case we had in our county, which would have been two years next week, said Mellinger. It was March 17th and I remember not being surprised by it. It was just a matter of time. I mean, we were watching all of this unfold.

Now, eyes are set on the future of public health in Madison County. Mellinger said the pandemic led to the county getting its first-ever mobile unit.

That was a goal of mine and it happened sooner as a result, said Mellinger. I want it to be a health clinic on wheels.

For a little less than a year, the mobile unit has been making its way across Madison County providing a variety of services outside of COVID-19. It now operates four days a week.

We have plans bigger, better, greater plans for that mobile unit and I want to run the wheels off of it, said Mellinger. Definitely, there have been some good things that have come out of [the pandemic].

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Two years with COVID-19: Central Indiana health officials, doctors reflect on highs and lows - FOX 59 Indianapolis

Hidalgo County on Friday reported four coronavirus-related deaths and 183 cases of COVID-19.

Of the four individuals who died due to the virus, two were not vaccinated, according to the report from the Hidalgo County Health and Human Services Department. The youngest person who died was a woman in her 40s from Pharr.

The people who tested positive are in the following age groups:

The county also reported 91 people are currently hospitalized with COVID-19, including 81 adults and 10 children.

Of the 91 people hospitalized with COVID-19, 31 patients are in intensive care units, all of them are adults.

On Friday, schools across Hidalgo County reported 12 students tested positive for the virus.

A total of 4,825 staff members and 16,584 students have tested positive for the virus since the county started reporting school-related infections on Aug. 18, 2021.

Since the pandemic began, 194,132 people have tested positive for the virus, and 3,846 people have died due to the virus in the county.

There are currently 1,072 reported active cases of COVID-19 in the county.

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Hidalgo County reports four coronavirus-related deaths and 183 cases of COVID-19 - KRGV

Three more Mainers have died and another 282coronavirus cases reported across the state, Maine health officials said Saturday.

Fridays report brings the total number of coronavirus cases in Maine to 232,293,according to the Maine Center for Disease Control and Prevention. Thats up from 232,011 on Friday.

Of those, 168,193have been confirmed positive, while 64,100were classified as probable cases, the Maine CDC reported.

One man and two women from York County have succumbed to the virus, bringing the statewide death toll now to 2,145.

The number of coronavirus cases diagnosed in the past 14 days statewide is 6,173. This is an estimation of the current number of active cases in the state, as the Maine CDC is no longer tracking recoveries for all patients. Thats down from 6,758 on Friday.

The new case rate statewide Saturday was 2.11 cases per 10,000 residents, and the total case rate statewide was 1,735.60.

The most cases have been detected in Mainers younger than 20, while Mainers over 80 years old account for the largest portion of deaths. More cases have been recorded in women and more deaths in men.

So far, 4,440Mainers have been hospitalized at some point with COVID-19, the illness caused by the new coronavirus.

Of those, 122 are currently hospitalized, with 23 in critical care and six on a ventilator. Overall, 83 out of 354 critical care beds and 266 out of 328 ventilators are available.

The total statewide hospitalization rate on Saturday was 33.17 patients per 10,000 residents.

Cases have been reported in Androscoggin (22,250), Aroostook (12,311), Cumberland (47,630), Franklin (5,602), Hancock (7,155), Kennebec (22,368), Knox (5,775), Lincoln (5,080), Oxford (11,006), Penobscot (26,879), Piscataquis (2,928), Sagadahoc (4,914), Somerset (9,430), Waldo (5,909), Washington (4,184) and York (38,862) counties. Information about where an additional 10 cases were reported wasnt immediately available.

An additional 525 vaccine doses were administered in the previous 24 hours. As of Saturday, 990,933 Mainers are fully vaccinated, or about 77.4 percent of eligible Mainers, according to the Maine CDC.

As of Saturday morning, the coronavirus had sickened 79,507,030people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 967,126deaths, according to the Johns Hopkins University of Medicine.

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3 more Mainers have died and another 282 coronavirus cases reported across the state - Bangor Daily News

At City Hall on May 8, 2020, Dr. Allison Arwady, left, Commissioner of the Chicago Department of Public Health, listens as Chicago Mayor Lori Lightfoot holds a press conference to announce plans to re-open the city weeks after restrictions were imposed to curb the spread of the coronavirus that causes COVID-19 disease. (Terrence Antonio James / Chicago Tribune)

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Two years of the COVID pandemic in Chicago: Take a look back - Chicago Tribune

A note to our readers

Two years ago today, the World Health Organization declared the Covid-19 outbreak a global pandemic. A week before that, this newsletter was born. Since then, weve been on a journey together braving waves of infections, experiencing sickness and loss, mastering the art of protecting ourselves, and continuously learning about a wily virus that seemed to surprise experts at every turn.

As the Omicron wave fades in the U.S. and as the W.H.O. begins exploring how and when to call an end to the global pandemic were making changes to this newsletter too.

Beginning next week, we will be switching to a less-frequent schedule, landing in your inbox Monday, Wednesday and Friday. We may pop in more frequently when theres big virus news you need to know about, or even return to a daily schedule if needed. Well also be using this change to cover the most important topics in more depth, bringing you insights from the Times newsroom and beyond.

Before we dive into todays newsletter, I want to say thank you to everyone who has followed along with us these last two years and express special gratitude to those who have written in to share their experiences. Im looking forward to navigating the next phase of the pandemic with you.

Jonathan

Looking back on the last two years may trigger feelings of anguish about missed opportunities, derailed life paths and lost time. But what if there was a way to get some of that time back?

For some perspective on time lost during the pandemic, and what we can do about it, I spoke to Tim Urban, the author of the blog Wait But Why. Our conversation has been condensed and lightly edited.

How should we look at time lost during the pandemic?

People are more resigned to having lost the time to Covid than they should be. People underestimate not only the amount that they can make up, but they can also get into a habit that multiplies the amount of time they have left with people they love and doing the things they love.

How so?

If you actually pick up a calculator and you calculate the amount of quality days or hours you spend with the people you love, it can look like a pretty depressing number.

So for example, I realized that living in a different city than my parents, I probably spend 10 quality days with them a year. Then I thought about the fact that my whole childhood, I was with them almost every day. So it hit me that 95 percent of the days I have with my parents in my life happened in my childhood. If I spend another 10 days a year with them, that adds up to about another year total over many decades.

Theres nothing I can do about human life spans, but the cool thing about that number whether with time spent with friends, family or a relationship is that you can change it, by huge multiples, just by changing the order of your priorities.

How does that work?

So, for example, if you see your parents 10 days a year, you can make it 20, whether its by coming home a few extra weekends or spending an extra week with them during the summer. You could also make 10 into 100 if you want to make a big change and move to the same city.

How should people think about missed opportunities during the pandemic?

When we look back on our life, we often see a branching tree of lives that we could have lived, paths that we could have gone down, things that we missed. And we often wallow in regret about these things. But you can also take that exact same reasoning and apply it to the future. What lies ahead of you is a lush tree of open life paths. They all belong to you at this moment and theres nothing stopping you from going in one of those directions.

So its so easy to look at the pandemic as a bunch of missed opportunities. But the further you go into the future, the less important these two years will become. If you can use the pandemic as a splash of cold water, or a slap in the face, and pick your life path and make better decisions going forward, you can look back and say, because of those two years, my life took a better course.

Whats something you lost over the pandemic and how have you tried to get it back?

My grandmother is 96, but shes still with it. Shes great to talk to and shes got great stories and a lot of wisdom. And during the pandemic, I wasnt really able to see her because she was on lockdown and because of her age, it was too dangerous.

March 12, 2022, 4:26 p.m. ET

But those lost moments actually spurred me to do something Ive wanted to for a long time. I took a recorder to her and recorded a bunch of stories from her. Thats exactly the kind of thing you want to do but just dont. So in some ways, making up for lost time during the pandemic can actually spur you to make really important decisions that maybe you should have made a long time ago.

We asked readers about the opportunities they missed because of the pandemic. Your responses were particularly touching this week. Thank you to all who wrote in.

I ended a relationship right before the pandemic and didnt feel comfortable dating during, given health concerns. Covid effectively wiped two years off my dwindling fertility clock, so Ive now started the process of pursuing single motherhood using donor sperm and artificial insemination. Its not the vision I had for my future, but I cant afford to wait. With supportive family and friends, I will make it work. Sarah, Boston

My father died in October 2019. In February 2020, I made a plan to honor his love of France and my love for him by walking solo from Le Havre hundreds of miles southward to the Mediterranean. I bought the plane ticket in 2020, canceled and rebought it many times. Ive kept my body ready for the journey for two years by running and doing several solo hikes. My French is much better than it was in 2020 as Ive trained while listening to French language podcasts. Now, finally, Im embarking on this journey. A ziplock of my fathers ashes are tucked in my backpack. Ill scatter them on French soil when I arrive at just the right spot, somewhere he might have loved, if he could still share a picnic with me. Cree LeFavour, Provincetown, Mass.

My husband and I had just started an immigration process to Canada when the pandemic began. The process kept on getting longer and longer. Now we have no idea what is going to happen and I even started seeing and feeling Canada farther from us a bit more every day. But Ive been learning new things and preparing myself to have better job opportunities. I just started a software development boot camp a few weeks ago. Ive used the pandemic as a great opportunity to go back to things I love that will also allow me to increase my chances of a better future in any country I finally end up living in. Erndira CB, Mexico City

The pandemic stole memories I could have made with my dad. For two years we skipped our annual visit and ski trip to keep him safe (hes 78). This February we showed up with gloves, hats and masks. We strapped on skis and flew down the mountain together, leaving the years of pandemic worry behind. Susan H., San Jose, Calif.

We were just forming a much needed friendship with another couple who are neighbors . Because of the pandemic, we had no contact for two years except occasional texts and brief greetings as we passed taking out trash or getting mail. We are trying to re-establish contact. I texted how much I had missed our interactions and asked if they were up to socializing yet in our pandemic world. In response, they invited us over for drinksthe first of what I hope will be many new contacts. Elaine Turner, Denver, Colo.

I missed two years of my late 20s. I dont know that Ill ever quite get them back. Ill never be that age again, that time of life again. So instead of thinking about where I should be, Im focused on what I want to do with the time I have. Now Im teaching English in Japan. Afterwards, I want to motorcycle Vietnam and learn to surf in Bali. Ive decided I cant wait for the pandemic to be over. I cant wait for the world. Im going to live my life while I still have the time. Luke, Okayama, Japan

The love of my life had planned a wonderful trip for the two of us, working around some of his health issues, and then Covid hit. While we waited and waited for travel to be safe, his condition deteriorated and he passed away almost a year ago. We cant get our plans back, but I may try to take our trip by myself when and if life ever becomes normal again. Lynn R., Houston, Texas

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Reclaiming time lost to Covid - The New York Times

If the coronavirus has one singular goalrepeatedly infecting usits only gotten better at realizing it, from Alpha to Delta to Omicron. And it is nowhere near done. Omicron is not the worst thing we could have imagined, says Jemma Geoghegan, an evolutionary virologist at the University of Otago, in New Zealand. Somewhere out there, a Rho, a Tau, or maybe even an Omega is already in the works.

Not all variants, though, are built the same. The next one to trouble us could be like Delta, speedy and a shade more severe yet still trounceable with existing vaccines. It could riff on Omicrons motif, eluding the defenses raised by infections and shots to an extent weve not yet seen. It could merge the worst aspects of both of those predecessors, or find its own successful combo of traits. Each iteration of the virus will require a slightly different set of strategies to wrangle itthe ideal approach will depend on how sick are people getting, and which people are getting sick, Angela Shen, a vaccine-policy expert at Childrens Hospital of Philadelphia, told me.

Our actual response wont just depend on the mix of mutations that the virus lobs our way. It will also hinge on how seriously we take those changes, and what state the virus finds us in when it slams usimmunologically, psychologically. While the next spotlight-hogging variant is still brewing, we can sketch out, in broad and not-at-all-comprehensive strokes, a subset of the cast of characters that could arise, and what it would take to fend off each one.

Lets start with the worst-case scenario, because its also probably the least likely. A new variant checks each of the Big Three boxes: more transmissible, more deadly, and much more evasive of the defenses that vaccines and other SARS-CoV-2 flavors have laid down.

In this version of events, even immunized people could suffer high rates of severe disease; additional boosters might not mount a sufficient blockade. The chasm in protection between the vaccinated and unvaccinated would start to closeperhaps rapidly, if the new variant collides with us when many people arent up-to-date on their shots and population immunity is low.

Such a virus might be so strange-looking that some of our tests and many of our antibody-based treatments could stop working. Viral spread would also outpace what diagnostic tools we have left, obliterating contact-tracing efforts and making the pathogen harder to cordon off. Hundreds of thousands of people in the United States alone could lose their lives in a matter of months, as one recent analysis noted. Countless more would be hospitalized or saddled with the debilitating symptoms of long COVID. This future would feel most like the pasta near-reversion to the first year of the pandemic, Crystal Watson, a senior associate at the Johns Hopkins Center for Health Security, told me. And, accordingly, this future would launch the most dramatic response.

Read: The coronavirus will surprise us again

First, wed have to start cooking up a new vaccine, tailored to fit a sniper-style variants quirks. That alone would take at least three months, by shot-makers current best estimates, not counting the arduous process of rolling out the updated vaccine quickly and equitably. In the interim, if we wanted to avoid the worst impacts, wed have to lean heavily on our old standbys: high-quality masks, potentially mandated into use; restricted travel; capacity limits atpossibly even brief closures ofrestaurants, bars, and gyms. (Hopefully, by this point, good ventilation and air filtration would be more widespread too.) The government might need to fund efforts to develop and distribute new tests and treatments. If the outbreak couldnt be contained, essential spaces such as schools might consider shutting their doors againthough Natalie Quillian, the deputy coordinator of the White Houses COVID-19 response team, told me that, from the standpoint of the administration, we really dont see a scenario where schools need to close.

Thankfully, a variant quite this bad would be hard to come by. Viruses cant rejigger their genomes infinitelynot if they want to keep efficiently infecting their preferred hosts. Vineet Menachery, a virologist at the University of Texas Medical Branch, thinks the virus will probably chance upon ways to dodge immunity to a greater degree than Omicron did. But, he added, the question is, does it have to give up something else to do that?

Even if the virus remakes itself many times, we can expect that its offense will still knock up against some multilayered defenses. Slipping out of the grasp of antibodies isnt that hard, but just statistically speaking, I dont think its possible to escape T-cell immunity, says John Wherry, an immunologist at the University of Pennsylvania, a contributor to a recent report that modeled various scenarios for our future with COVID. The trick, then, would be rousing enough public will to use those backstop tools and duel the virus againnot a sure thing if a doom-esque variant appears anytime soon. The acceptability of policy X, Y, or Z is not going to be the same as it was before, Shen told me.

In a less catastrophic forecast, a variant wouldnt pose an epic triple threat. But it could still pummel a substantial fraction of the population by ratcheting up one trait at a time. That could be any of the Big Three, but consider two examples: a juice-up in immune evasion, or a surge in virulence. All else equal, each could spark waves of serious disease and push the health-care system back to a breaking point.

First, the evasive option. SARS-CoV-2 now faces huge pressure to find an immunological escape hatch. With so many people having been infected, vaccinated, or both, the coronaviruss success has started to lean heavily on its ability to sidestep our shields. This future could be an even more dramatic version of the recent Omicron wave: None of us, no matter how many shots weve gotten, would truly be impervious to infection, or maybe even to serious illness. Through sheer numbers alone, this variant would be poised to land a huge swath of people in the hospital, even if it wasnt, particle for particle, a more deadly threat. Depending on the extent to which the variant eroded vaccine effectiveness, especially against hospitalization and death, we might still need to update our shots and launch a massive revaccination campaign. From the view of the White House, a variant would have to pass a fairly strong threshold to want to do that, Quillian told me. Its a pretty extensive effort to go back and revaccinate the entire population.

In some ways, a more virulent variant that was still susceptible to vaccine-induced defenses could be simpler to deal with. We could expect that people who were up-to-date on their shots would be very well protected, as they were against, say, Delta. The focus would be on shielding the most vulnerable: the unvaccinated, the elderly, the immunocompromised, those with heavy or frequent exposures to the virusall of whom would likely benefit from more vaccine doses, and additional focused measures around masking, distancing, testing, and treatments. And perhaps our responses would remain siloed in these groups. It would probably take a while for us to reimpose restrictions on the general population, Watson, of Johns Hopkins, said.

Read: The COVID strategy America hasnt really tried

Maybe thats not surprising. If much of society remains swaddled in safety, many people wont see a point in reinvesting in vigilance. The suffering of the people who we are already cultured to see as sickly or close to deathor who are concentrated in already marginalized communitiescan be easy to overlook. If its the elderly, the immunocompromised, unfortunately, I think were not viewing them in the same light as we would if it was the whole population, Menachery, the UTMB virologist, said. Which groups ultimately end up shouldering the brunt of the viruss burden will dictate the extent of our response.

Perhaps more of us would be galvanized into camaraderie if a variant pulled a wild card and upped its virulence in an unexpected group. If young adults or children, for instance, suddenly became a prime target, I have to believe the response would be different, says Tom Bollyky, the director of the global-health program at the Council on Foreign Relations, and a contributor to the report on future-COVID scenarios. (Menachery thinks a sudden downshift into kids would be unlikelythats not a typical modus operandi for coronaviruses.)

Theres a third axis on which the virus could shiftsheer transmissibility. Some mutation, or combination of them, could make the virus a bit more efficient at zipping between bodies. But without an accompanying supercharge of virulence, or extreme immune evasion, Im not sure thered be much of a response, to be honest with you, Watson said.

Some people might feel motivated to sign up for a booster. A few localities might push for masking again. Or not. And should a bump in spreadability team up with a drop in virulence, the publics reaction might be more muted still. People might get sick, but with immunity on our side, the proportion of cases that wind up in the hospital would also dwindlea deceptively comforting statistic to see. I have a hard time believing anyones going to care, unless theres more severity, says Adam Lauring, a virologist at the University of Michigan. Perhaps wed see this variants annual hospitalization and death burden on par with or below the flus, a level of suffering that Americans have already implicitly (and perhaps misguidedly) decided is fine.

Read: Were entering the control phase of the pandemic

But souped-up transmissibility is an insidious parlor trick. It helps viruses catch entire populations off guard. Even a somewhat defanged variant can sow chaos if its given the opportunity to spread far and wide enough, and find the vulnerable among us. And wed still be in deep trouble if a fleet-footed variant hit us at a time when wed let our vigilance over vaccination slip, or if efforts to dose up the worlds population equitably were still lagging behind. Plenty of suffering can unfold outside of hospitals as well. Less-severe SARS-CoV-2 infections can still seed long COVID. Hours would still be lost to isolations and illnesses. And though population immunity might be higher than ever right now, protection isnt spread evenly: Too many Americans havent gotten any shots at all, and many of those who have remain vulnerable because of their age or health conditions.

Even if, somehow, the virus were to become completely, truly benign, total complacency could be dangerous. A virus we let spread is a virus that suddenly has more hosts in which to evolve, Geoghegan, the University of Otago virologist, told me. Among them might be immunocompromised individuals, who could harbor the virus long-term. It could tinker with its genome until, by chance, it comes up with the perfect combo of mutations, she said, and then roar back into the population at large. Menachery also worries about SARS-CoV-2s penchant for stewing and shape-shifting in other animal species. Thats what has the potential, he told me, to give us SARS-CoV-3to spark the next coronavirus pandemic.

We cant say when the next threat will appear, or how formidable it will be. But we do have some control over its emergence: The more chances we give the virus to infect us, the more chances we give it to change itself again.

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So ... What Will the Next Variant Look Like? - The Atlantic

There were two additional coronavirus deaths in The Sun Chronicle area since the week ending March 3.

However, Attleboro did not respond to a request for an update so it could be more since Attleboro has the most cases, deaths and the biggest population.

The 10-community Sun Chronicle area includes Attleboro, Foxboro, Mansfield, North Attleboro, Norton, Norfolk, Plainville, Seekonk, Rehoboth and Wrentham.

That being said, the overall number of deaths may actually go down because the state is altering the way it counts coronavirus deaths.

A press release from the states Department of Public Health on Thursday said the definition of a coronavirus death will be tightened.

As a result 3,681 deaths will be trimmed from the list of 22,966 confirmed deaths bringing the total to 19,285.

We are adopting the new definition because we support the need to standardize the way COVID-19 (coronavirus) associated deaths are counted, DPH State Epidemiologist Dr. Catherine Brown said in the press release.

By the numbers

Level of transmission in The Sun Chronicle coverage area Low in Bristol County; Low in Norfolk County

Number of new cases for our 10-community coverage area since March 3, 2022 129.

Percentage positive for the 10-community area 2.17%

Percentage vaccinated with two shots 70.03%

Percentage vaccinated with booster 37.25%

Number of people currently hospitalized at Sturdy Memorial 2

Percentage hospitalized at Sturdy Memorial who are unvaccinated 0%

Number of deaths in The Sun Chronicle area since March 3, 2022 2

Number of total deaths in The Sun Chronicle area 370 (Attleboro did not report so the number is likely bigger)

Massachusetts level of transmission, according to the CDC Low

Percentage of positive cases in state 1.85%

Breakdown by community (first number is new cases, second is vaccination rates)

Attleboro 31, 66.11%

North Attleboro 21, 69.61%

George W. Rhodes can be reached at 508-236-0432.

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Coronavirus cases and vaccination rates for The Sun Chronicle area - The Sun Chronicle

As the Omicron surge of the coronavirus continues to wane, Los Angeles County has been lifting COVID-19 mandates, including indoor masking and vaccine verification in certain settings.

But with those guardrails removed, how will health officials detect signs of potential surges?

The obvious tools of tracking new coronavirus cases and COVID-19 hospitalizations are still in place. But there are seven other indicators that L.A. County plans to monitor as part of an early warning system, according to Public Health Director Barbara Ferrer.

These can alert us early to concerning trends that might lead to higher COVID-19 transmission or increased illness severity, she said.

The county still needs to be prepared for worst-case scenarios that could warrant a return to universal masking such as if COVID-19 vaccines fail to provide robust protection against a new variant of concern, leaving people at higher risk for severe illness.

Then, weve got to look at everything else thats in the toolbox, which is going to be the distancing and the masking, she said.

But while preparedness is always important, based on current trends, Ferrer doesnt anticipate returning to universal masking indoors anytime soon.

I dont actually see that sort of in the near horizon at all, she said.

According to the latest available data, L.A. Countys report card remains in solid shape across all seven of the tracked metrics.

Variants: The percentage of collected coronavirus specimens that are a new variant of concern. The goal is to have fewer than 5%; there are currently no new variants of concern, as defined by the World Health Organization.

Emergency rooms: The percentage of coronavirus-related emergency room visits over a weekly period. The goal is to have fewer than 5%; the latest figure is 4.3%.

Low-income areas: The case rate for L.A. Countys lowest income areas. The goal is to have fewer than 100 cases a week for every 100,000 residents in poor areas; the most recent rate is 51.

L.A. County also will monitor the number of outbreaks in four specific settings of concern:

Nursing homes: The goal is to keep the number of weekly outbreaks at skilled nursing facilities at fewer than 11 a week; there were four in the most recent week.

K-12 school settings: The aim is to keep the number of outbreaks at fewer than four a week; there were four in the most recent week.

Homeless shelters: Officials are seeking to keep the number of outbreaks in settings involving people experiencing homelessness to fewer than 11 a week; there were eight in the most recent week.

Worksites: Authorities want to keep the number of outbreaks at worksites to fewer than 100 a week; there were 30 in the most recent week.

The only rubric that caused health officials moderate concern was the number of new outbreaks in K-12 settings. But that number, too, has been declining. There were four in the most recent week and seven the week before. Between four and nine outbreaks a week represents a moderate level of concern, and 10 or higher a high level of concern, according to the county.

However, just because the relative risks are lower now than earlier in the year doesnt mean caution isnt still warranted. L.A. County continues to strongly recommend masking indoors for staff and students, even after state requirements lift Friday night. L.A. County also is recommending weekly testing of unvaccinated people at school sites.

If there are alerts in two or more areas that reach a moderate or high level of concern, well conduct an in-depth review of contributing factors and consider changes to community-prevention strategies, Ferrer said.

In the meantime, Angelenos have been able to enjoy mask-free outings for nearly a week.

Ferrer said in a recent interview the countys decision to lift the mask mandate was not based on political pressure, though she acknowledged there had been a loud group of people pushing for its end.

Instead, she said the decision was made in light of new guidelines established by the U.S. Centers for Disease Control and Prevention, which found on March 3 that L.A. County no longer was an area where universal mask wearing indoors was recommended.

Ferrer is still strongly recommending universal mask wearing in indoor public settings regardless of vaccination status, a recommendation echoed by California state health officials.

I obviously want everybody to keep a mask on, Ferrer said in the interview. Im very clear about what I think is the safest way to get through the next few weeks, and that is to go ahead and keep a mask on.

While theres been much attention paid to critics of the mask order, Ferrer noted that a lot of people are still wearing their masks. Those who are still wearing them are often quieter, she said, and anticipates they will continue to wear their masks for some time to come and feel very comfortable wearing their masks.

While L.A. Countys coronavirus community level is low essentially meaning the hospital system is not under severe strain transmission rates are still considered substantial, at 89 cases a week for every 100,000 residents. That means theres just a fair amount of virus still circulating, Ferrer said at a briefing Thursday.

To get to a moderate coronavirus transmission level, the rate will need to dip below 50 cases a week for every 100,000 residents; for low transmission level it needs to be below 10.

Once those numbers drop, I think everybody will feel a lot more comfortable easing the strong recommendation to wear masks, Ferrer said, and instead perhaps suggesting only those at higher risk of COVID or those living with people at higher risk keep their masks on in indoor public settings.

Ferrer said Thursday she will be looking closely to see whether case rates rise after the mandatory masking order at schools and child-care sites lifts.

Within a few weeks, well see whether or not we have more transmission at schools, Ferrer said. If we start seeing some significant increases in outbreaks which is transmission that happens at school well have to go back and revisit this guidance. Because the last thing anybody wants is more transmission in schools.

L.A. County also has prepared a five-step plan to respond quickly should signs of a new uptick in infection emerge.

Outbreaks: Workplaces are required to report three or more coronavirus cases detected within a 14-day period, and officials will recommend measures the employers take to keep outbreaks under control.

Testing: Ensure access to free and accessible testing, especially in areas with high case rates.

Therapeutics: Ensure a vast network of providers with anti-COVID drugs. Distribution of some of these drugs remains uneven countywide, and is low in places like South L.A., East L.A., parts of the San Fernando, San Gabriel, Santa Clarita and Antelope valleys, and Malibu. Some wealthier areas are seeing higher levels of drug distribution, including the Hollywood Hills and the Palos Verdes Peninsula.

Vaccinations: Maintain a network of 300 mobile vaccine teams and 1,000 fixed vaccination sites. Officials also want to increase the number of health plans that provide vaccines to people who cant leave home for health reasons.

Surveillance: Analyze 15% to 25% of collected coronavirus samples countywide and sequence them to identify variants, and expand wastewater testing to detect coronavirus infection trends.

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How will L.A. County find warning signs of the next coronavirus surge? - Los Angeles Times