Category: Corona Virus

This is the year that the COVID-19 pandemic was declared to be no longer a global health emergency.

But even though case counts are down in 2023, it's not as if everything is back to normal. There is, for example, a new omicron variant that was first detected in late summer and has spread significantly in recent weeks. It's called JN.1, and health officials have now classified it as a variant of interest. And a frequently asked question is:

Health officials are not sounding the alarm. The World Health Organization says the overall risk is low.

Based on the limited evidence, JN.1 seems comparable to other circulating omicron variants and doesn't appear to cause more severe disease.

COVID vaccines, including the updated booster, continue to provide protection against severe illness and death. In the U.S., hospital admissions for COVID-19 have been climbing since early November.

There have been other pressing COVID questions in 2023. Here are some of the topics we tackled, starting with a quandary about this new phase of the pandemic:

'Emergency' over! Do we unmask and grin? Or adjust our worries?

Is it OK to get a COVID shot and a flu shot and even an RSV shot at the same time?

How do I avoid catching COVID while flying in 2023?

Why do some people get a COVID infection yet show no symptoms?

A few posts from years past drew a lot of readers in 2023 as well:

Can you test positive for COVID from getting a vaccine/booster?

Does a faint line on a self-test mean I'm barely contagious?

Is paxlovid the best treatment?

More here:

COVID FAQs in 2023: New variant info, flying tips, flu shot/booster combos : Goats and Soda - NPR

The World Health Organization (WHO) has said that the number of new COVID cases increased by 52 per cent during the past four-odd weeks, with over 850,000 new cases reported during the period.

The number of new deaths decreased by 8 per cent as compared to the previous 28-day period, with over 3,000 new fatalities reported, the World Health Organization (WHO) said in its latest press release.

As per WHO, as of December 17, over 772 million confirmed cases and nearly seven million deaths have been reported globally since the onset of COVID-19.

Further, the WHO said over 118,000 new COVID-19 hospitalisations and over 1600 new intensive care unit (ICU) admissions have been recorded, with an overall increase of 23 per cent and 51 per cent, respectively, globally.

As of December 18, 2023, JN.1, a sub-lineage of BA.2.86 Omicron variant has been designated a separate variant of interest (VOI) apart from its parent lineage BA.2.86 due to its rapid increase in prevalence in recent weeks. Globally, EG.5 remains the most reported variant of interest.

Due to its rapidly increasing spread, WHO is classifying the variant JN.1 as a separate variant of interest (VOI) from the parent lineage BA.2.86. It was previously classified as VOI as part of BA.2.86 sublineages.

Based on the available evidence, the additional global public health risk posed by JN.1 is currently evaluated as low. Despite this, with the onset of winter in the Northern Hemisphere, JN.1 could increase the burden of respiratory infections in many countries.

The WHO had earlier said it was continuously monitoring the evidence and would update the JN.1 risk evaluation as needed.

Current vaccines continue to protect against severe disease and death from JN.1 and other circulating variants of SARS-CoV-2, the virus that causes COVID-19, it noted.

COVID-19 is not the only respiratory disease circulating. Influenza, RSV, and common childhood pneumonia are also on the rise.

The WHO advises people to take measures to prevent infections and severe disease using all available tools. These include wearing a mask when in crowded, enclosed, or poorly ventilated areas, keeping a safe distance from others, practicing respiratory etiquette (covering coughs and sneezes), cleaning hands regularly, and getting tested if one has any symptoms or if you might have been exposed to someone with COVID-19 or influenza.

(With inputs from ANI)

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Published: 23 Dec 2023, 12:36 PM IST

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Covid update: WHO warns of global rise in cases, says - Mint

India saw a single-day rise of 752 coronavirus infections, the highest since May 21, 2023, while the active cases have increased to 3,420, according to Union health ministry data updated on Saturday.

The death toll was recorded at 5,33,332 with four new deaths -- two from Kerala, one each in Rajasthan and Karnataka -- reported in 24 hours, the data updated at 8 am stated.

The country's Covid case tally stood at 4.50 crore (4,50,07,964).

The number of people recuperated from the disease has increased to 4,44,71,212, and the national recovery rate stands at 98.81%, according to the health ministry's website. The fatality rate stands at 1.19%

The ministry's website stated that 220.67 crore doses of the Covid vaccine have been administered in the country so far.

(Edited by : Sudarsanan Mani)

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India reports 752 new Covid cases, 4 deaths in 24 hours - CNBCTV18

On Saturday, India reported 752 new infections, marking the highest daily count since May 21. Four deaths were also recorded, bringing the nationwide death toll to 5,33,333.

India reported 656 new Covid-19 cases in the past 24 hours, raising concerns amidst the looming threat of the JN.1 subvariant. While the number of new cases remains relatively low compared to previous peaks, the slight increase in the active caseload, which now stands at 3,742 from 3,420, has put authorities on alert.

In the last 24 hours, one new death was reported in Kerala, bringing the total death toll in the country to 5,33,333, according to the data updated at 8 am. The case fatality rate remains at 1.18 per cent.

Kerala, the state where the Covid sub-variant JN.1 was initially identified, witnessed the highest surge in active cases, recording 126 new cases in a single day, as per the Ministry of Health and Family Welfare. Other states experiencing an increase in daily active cases include Karnataka (96), Maharashtra (35), Delhi (16), Telangana (11), and Gujarat (10).

In the last 24 hours, 333 people have recovered from Covid-19, bringing the total number of recoveries to 4,44,71,545. The national recovery rate remains at an impressive 98.81 per cent, as reported by the Health Ministry.

The total number of Covid-19 cases in the country has reached 4.50 crore (4,50,08,620). On Saturday, India reported 752 new infections, marking the highest daily count since May 21. Four deaths were also recorded, bringing the nationwide death toll to 5,33,333.

The active cases have crossed the 3,000-mark, reaching 3,420. The Health Ministry reported that on Friday, India recorded 640 fresh Covid-19 infections and one death, with the active caseload increasing from 2,669 to 2,997. The total number of Covid vaccine doses administered in the country stands at 220.67 crore.

The recent uptick in Covid-19 cases, particularly associated with the JN.1 sub-variant of Omicron, has prompted the central government to advise caution, especially for individuals with comorbidities, urging them to wear face masks as a precautionary measure. Although the government has reassured the public that the current spike is not a cause for concern, it remains vigilant against emerging strains of the virus.

As of December 21, a total of 22 cases of the JN.1 sub-variant have been reported across the country. The majority of these cases, 19 in total, were identified in Goa, with one case each reported in Kerala and Maharashtra.

The JN.1 variant, classified as a 'variant of interest' by the World Health Organisation, has gained attention for its rapid spread in recent weeks. Despite the rise in cases, health officials have emphasised that no clustering of cases related to the JN.1 variant has been observed in India, and the reported cases have been mild, with patients recovering without complications.

According to officials, there has been no clustering of cases in India attributable to the JN.1 variant. They stated that all of the cases were found to be minor, and the patients healed without any consequences.

Also Read:'Sanjay Singh is not my relative': Brij Bhushan Sharan Singh's first reaction after Centre suspends newly-elected WFI

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India records 656 new Covid-19 cases amid fears of JN.1 strain, active count stands at 3,742 - Business Today

"What Covid taught us is never to take anything for granted," says Dr Ashok Seth, Chairman, Fortis Escort Hospital, while talking to The Times of India. India on Thursday recorded 594 fresh Covid-19 infections while the number of active cases increased to 2,669 from 2,311 the previous day, according to Union health ministry data. The country's Covid-19 tally stands at 4.50 crore (4,50,06,572). The death toll climbed to 5,33,327 with six more people -- three from Kerala, two from Karnataka and one from Punjab -- succumbing to the viral disease.

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Five facts to know about Covid-19 sub-variant JN.1: Leading doctor explains how to stay safe - Times of India

Current evidence, including randomized controlled trial and observational data, suggests that SARS-CoV-2 rebound occurs initially as a mild illness 37 days after resolution of the initial acute illness, occurs in both treated and untreated patients, and is not associated specifically with receiving nirmatrelvir/ritonavir. Moreover, rebound occurs when there is variable, host-mounted immune response to infection during the course of illness. Finally, no hospitalizations or deaths were reported among outpatients who experienced rebound.

Some observational studies demonstrated a higher frequency of rebound among treated persons (10%14%) (11,14,22) than reported by the randomized controlled trial, EPIC-HR (8,10) (Supplementary Table, https://stacks.cdc.gov/view/cdc/137156). Viral rebound might occur in persons on antiviral treatment because they are at high risk for severe disease and might have host factors, such as immunosuppression, that contribute to the natural variability in viral dynamics (21). Risk factors for rebound appear to be similar to risk for severe disease, but further studies are needed to understand whether persons with certain characteristics or underlying medical conditions are predisposed to experiencing rebound. Another important consideration is that persons receiving antiviral treatment might be at higher risk for experiencing rebound given the viral suppression related to use of treatment early in the disease course and resumption of viral replication after completion of treatment because of delayed viral clearance. This elevated risk could be due to early discontinuation of antiviral treatment or the need for longer courses of treatment among certain persons, such as those who are immunocompromised (14). Two ongoing clinical trials of nirmatrelvir/ritonavir will further characterize the frequency of rebound after different durations of nirmatrelvir/ritonavir treatment among immunocompromised subjects and the potential benefit of nirmatrelvir/ritonavir retreatment among subjects with posttreatment rebound.***

Rebound does not likely represent reinfection or resistance to treatment (12); however, further studies are needed to confirm this finding. The FDA analysis identified potential treatment-associated mutations that were not clinically relevant among two treated patients because rebound symptoms resolved without hospitalization (8). It is important to ensure that use of antivirals does not accelerate viral evolution and result in resistant mutations, such as through counseling patients to complete antiviral treatment and monitoring for resistance using molecular analyses. Two studies demonstrated shedding of infectious virus during rebound (8,11). Comparisons of genomic strains present in both acute and rebound episodes and viral culture to determine infectiousness are important to understanding the clinical implications of rebound. In addition, a large assessment of innate and adaptive immunity and monitoring biomarkers of inflammation and cytokine storm would contribute to understanding of the underlying pathophysiology of recurrence.

The findings in this report are subject to at least five limitations. First, standardized definitions for symptom, viral, and clinical rebound were not used across studies. Using standard definitions to accurately reflect outcomes could improve interpretability and comparisons of data across studies and settings. Most studies examined symptom or viral rebound. A definition that requires reemergence of virus after complete resolution of illness, which takes 710 days for a healthy adult, and a negative viral test result after resolution of initial symptoms would allow for examination of clinical implications of rebound or recrudescence, such as a dysregulated immune response (23). Second, publications about recurrences and viral kinetics might have been missed given the narrow search. Third, a major limitation of observational studies is the difficulty in verifying whether antiviral treatment courses were completed and whether vaccination status and previous infection were documented accurately. Fourth, few studies correlated symptoms with viral load, which makes the significance of recurrence of mild symptoms difficult to understand because symptoms are subjective and might not represent viral reactivation. Finally, ascertainment bias is also possible given that persons receiving antiviral treatment are closely followed, and more likely to report recurrent symptoms, which would explain the early case reports being associated with nirmatrelvir/ritonavir, the most commonly used oral antiviral in the United States.

Viral rebound can occur in persons who do and do not receive antiviral treatment and might reflect viral fluctuation that is part of the natural disease process early in the course of illness. Risk for experiencing rebound could be related to many factors, such as immunosuppression, delayed viral clearance, and overall immune response. The current literature review, along with a recently published randomized trial (8), suggests the substantial benefit of antiviral treatment among persons at risk for severe disease outweighs the risk for rebound, because rebound resolves quickly and is not associated with an increase in severity of recurring signs and symptoms. Increased education and awareness among practitioners and patients about rebound not increasing risk for hospitalization or death might increase use of COVID-19 treatment. According to NIH COVID-19 Treatment Guidelines, rebound should not deter providers from prescribing life-saving antiviral treatments when indicated to prevent morbidity and mortality from COVID-19 (1).

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SARS-CoV-2 Rebound With and Without Use of COVID-19 Oral - CDC

The active caseload has also climbed, pushing past the 3,000 mark to reach 3,420.

India's Covid-19 situation has sparked concern as the country recorded its highest number of daily cases in seven months, with 752 new infections reported in the past 24 hours. This surge comes amidst rising anxieties about the JN.1 sub-variant, a more transmissible Omicron offshoot.

The active caseload has also climbed, pushing past the 3,000 mark to reach 3,420. While the death toll remains relatively low, with four fatalities reported in Kerala, Karnataka, and Rajasthan, the sudden spike in cases has revived vigilance measures across the country.

In the last 24 hours, India reported four new deaths due to COVID-19, with two fatalities in Kerala, and one each in Rajasthan and Karnataka. The total death toll now stands at 5,33,332, and the case fatality rate is recorded at 1.18 percent.

The country's cumulative COVID-19 case count is 4.50 crore (4,50,07,964). The morning update from the health ministry revealed an increase in active cases in 17 states, with Kerala (266), Karnataka (70), Maharashtra (15), Tamil Nadu (13), and Gujarat (12) being among the affected regions.

In the last 24 hours, 325 people have recovered from COVID-19, bringing the total number of recoveries to 4,44,71,212. The national recovery rate is now at 98.81 percent.

On Friday, India reported 640 new COVID-19 infections and one death, increasing the active caseload to 2,997 from the previous day's 2,669, according to the Health Ministry.

In response to the ongoing situation, the Bihar government has issued directives for all districts and hospitals in the state to intensify COVID-19 RT-PCR testing, including random testing of arrivals at airports in Patna, Gaya, and Darbhanga.

The central government has reassured the public that the current increase in COVID-19 cases is not a cause for concern and urged people not to panic. Health Minister Mansukh Mandaviya conducted a review of the preparedness of health facilities nationwide and emphasised the importance of remaining vigilant against emerging strains of COVID-19.

While addressing the situation, the government has advised individuals with comorbidities to wear face masks as a precautionary measure. As of December 21, there have been 22 reported cases of the COVID sub-variant JN.1 in the country, with 19 cases identified in Goa and one each in Kerala and Maharashtra. Authorities are yet to disclose details of one case.

JN.1, a variant stemming from the Omicron lineage and designated as a 'variant of interest' by the World Health Organization, has rapidly spread in recent weeks. Authorities have emphasised that no significant clustering of cases linked to the JN.1 variant has been observed in India.

All reported cases have been characterised as mild, with patients recovering without experiencing complications.

Also Read:India vigilant as JN.1 Covid-19 subvariant emerges with 22 confirmed cases

More:

India's Covid cases reach 7-month high with 752 cases in a single day, 4 deaths reported as JN.1 variant causes concerns - Business Today

Dr Raman Gangakhedkar, who leads the new Covid task force that Maharashtra has formed, has emphasised prioritising systems to build a comprehensive database for analysing hospitalisation and death surveillance.

In an interview with The Indian Express, Dr Gangakhedkar, former head of epidemiology at the Indian Council of Medical Research, explained that the aim is not only to detect Covid-like illnesses but also to identify emerging diseases within clusters.

Edited excerpts from the interview:

Q: There is currently a rise in Covid cases across India. Is it due to the new variant, or is it a result of increased testing?

The primary factor is the variant. Despite increased testing, the uptick is not substantial; people are being tested just like they were during the Omicron outbreak, not voluntarily. Initial data analysis is required in our upcoming meeting at the task force. Public information indicates JN.1 is prevalent in a significant proportion of cases. While its not the sole variant, about 31 per cent of cases in the US, where it originated in September, are now attributed to JN1. So a notable portion is gradually becoming prevalent in India too.

Q: Are we anticipating another Covid wave, or do we possess sufficient herd immunity to combat it?

Its challenging to provide a definitive answer at this moment. The available information on this specific variant suggests that it remains relatively mild. Based on current knowledge, hospitalisation and mortality may not increase significantly. However, with the holiday season and large gatherings underway, caution is essential to avoid being caught off guard. The focus is on ensuring rapid response and preparedness to handle any potential surge, minimising the impact on the healthcare system.

Q: What are the foremost steps or priorities currently occupying your thoughts?

Covid is emphasising the need for well-established data on hospitalisation and a death surveillance system. This system will not detect only Covid-like illnesses but, over time, could identify new diseases within clusters.

Then the question arises: should we expand genomic surveillance further? The suggestion is to develop smart genomic surveillance, focusing on clusters where hospitalisations or deaths have increased without a clear cause. Rather than routine genomic surveillance, the emphasis is on investigating specific cases to determine if a new variant is the cause. Despite Covid becoming a recurring presence, especially in winter with new variants, the presumption is hindered by the lack of hospitalisation surveillance. Without such surveillance, attributing trends to specific seasons becomes challenging, as hospitalisations could be due to other respiratory illnesses like influenza or respiratory syncytial virus.

Q: Isnt the health department already scrutinising data through regular Covid updates?

No, Covid data primarily focuses on the number of infections. We need a more in-depth analysis of hospitalised patients and fatalities, considering factors like comorbidities, time of admission and clustering. While not challenging, it requires the development of a network, possibly involving medical colleges, to collect and submit meaningful data for analysis.

Q: How do you intend to streamline the process of gathering hospitalisation data and conducting regular analyses?

That will be discussed in the meeting at the task force, but its crucial to establish systematic surveillance for hospitalisation cases and deaths.

Q: Do you think continuous surveillance throughout the year is necessary?

Its currently challenging to ascertain. The crucial discussion involves organising hospital data for meaningful analysis, emphasising the need for a network to efficiently analyse the data. While AI may not be essential, the focus should be on identifying abnormalities in the data. This underscores the requirement for a long-term systemic change to prevent surprises with new infections. The Covid situation provides an opportunity to establish resilient surveillance systems, fostering continuous learning and awareness.

Originally posted here:

Maharashtra's new Covid task force to focus on systematic surveillance of hospitalisations and deaths, says Dr Raman ... - The Indian Express

As winter arrives in the northern hemisphere, a new version of Omicron is taking off in many countries. While it is too early to know whether the JN.1 variant will trigger a new surge of COVID-19 cases, its rapid spread has prompted the World Health Organization (WHO) to designate it a "variant of interest" one containing genetic changes predicted or known to affect characteristics such as disease severity, transmissibility or antibody evasion. Here's what we know about the JN.1 variant so far.

First detected on 25 August 2023, JN.1 has already become the most prevalent variant in some countries. It is now rapidly increasing across all WHO regions. Wastewater data from multiple countries approaching the winter season also points at a large wave of SARS-CoV-2 infections in the community, WHO said.

In its initial risk assessment for JN.1, published on 19 December 2023, WHO added that as of 16 December 2023, JN.1 had been detected in 41 countries, and represented 27.1% of SARS-CoV-2 uploaded to the international GISAID database in the week ending 3 December. This was a substantial increase compared to the data reported four weeks earlier, when the global prevalence of JN.1 was 3.3%. The countries reporting the largest proportion of cases were France, USA, Singapore, Canada, the UK and Sweden.

When the BA.2.86 (Pirola) variant emerged in July 2023, scientists quickly became alarmed by the large number of mutations it contained, relative to previous forms of Omicron. JN.1 has acquired several further mutations, the most notable being a change in the part of the spike protein that latches onto human cells, known as the L455S mutation. This region is a major target for so-called neutralising antibodies ones that help to block infection.

According to research published online in The Lancet Infectious Diseases, the L455S mutation may slightly reduce the ability of JN.1 to bind to human cells but enhance its ability to evade the immune system. In theory, this could make it less transmissible than BA.2.86, but better able to reinfect people who have previously had COVID-19.

The same study investigated the ability of antibodies from people who had previously received three doses of COVID-19 vaccines and were recovering from a breakthrough infection with the XBB sub-variant of Omicron. As predicted, the researchers found that JN.1 was better able to evade these antibodies than BA.2.86. Other preliminary studies also support the idea that JN.1 may be more immune-evasive, although WHO stressed that such data is limited for now.

Although data is limited at this stage, the available evidence does not suggest that JN.1 is any more dangerous than other currently circulating forms of SARS-CoV-2. "While there is a rapid increase in JN.1 infections, and likely increase in cases, available limited evidence does not suggest that the associated disease severity is higher as compared to other circulating variants," said WHO.

Even if JN.1 is more capable of sidestepping antibodies from previous infections and vaccinations, it is not entirely resistant to them. The more antibodies someone has, the greater their chances of fighting off COVID-19. By refreshing the immune system's memory of SARS-CoV2, COVID-19 vaccines top up people's antibody levels, reducing their risk of infection. And if the virus does break through, other immune defences including T-cells are also primed to reduce the severity of that infection, reducing the risk of hospitalisation and death.

Based on current evidence, the WHO has assessed the public health risk posed by JN.1 to be "low", but warned that the sub-variant may still cause an increase in COVID-19 cases amid a surge of other viral and bacterial infections, including influenza, RSV and common childhood pneumonia.

JN.1 is no different to earlier forms of SARS-CoV-2 in the way that it spreads primarily through coughs, sneezes and exhaled air. Coughing or sneezing into your elbow or a tissue, regularly washing your hands with soap, keeping rooms ventilated and wearing a good quality mask in crowded, enclosed or poorly ventilated areas will all help to reduce transmission as will staying home if you are unwell. WHO has recommended universal masking and improved ventilation in health facilities.

Even though most people now have some degree of immunity against SARS-CoV-2 through vaccination and/or previous infection, COVID-19 is not just a cold, and people are still being hospitalised and dying from it. The threat of Long COVID also looms large. If you have respiratory symptoms and COVID-19 tests are available where you live, you should get tested and take precautions to limit further spread.

Original post:

Seven things you need to know about the JN.1 COVID-19 variant - Gavi, the Vaccine Alliance

COVID-19 hospitalizations on the rise in Maine

by Thomas O'Boyle, WGME

FILE - Health care workers treat patients at Maine Medical Center in Portland. (Maine Medical Center)

Health officials in Maine are now tracking a slight increase in COVID-19 cases but still lower numbers than a year ago. This comes as many are gathering for the holidays.

The state's COVID dashboard shows the number of hospitalizations has reached its highest point since April.

Half of the counties in Maine are at a medium level for hospital admissions.

Experts say the holidays which saw people spending time with others indoors helped COVID-19 to spread.

The US CDC says the positive test rate is at just under 12%.

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COVID-19 hospitalizations on the rise in Maine - WGME