Debra Schrishuhn for PDA National Staff

*Source: WHO

**Reporting delay.

***Source: NPR

****Now 43 countries report more than one million cases of COVID-19, with the remainder being, Spain, Italy, Colombia, Indonesia, Mexico, Poland (surpassing Ukraine), Ukraine, South Africa, Netherlands (surpassing Philippines), Philippines, Malaysia, Czechia (surpassing Peru), Peru, Thailand, Iraq, Belgium, Canada, Romania, Chile, Japan, Bangladesh, , Vietnam (surpassing Israel), Israel, Pakistan, Slovakia (surpassing Serbia), Serbia, Sweden, Austria, Portugal, Hungary, Switzerland (surpassing Kazakhstan), Kazakhstan. and newcomer Jordan. 

Top Ten states with COVID-19 cases:

• California 5,157,293

• Texas 4,381,540

• Florida 3,713,214

• New York 2,836,160

• Illinois 1,890,044

• Pennsylvania 1,829,351

• Ohio 1,776,439

• Georgia 1,644,864

• N Carolina 1,566,617

• Michigan+ 1,564,627

Top Ten states with COVID-19 deaths:

• California 75,468

• Texas74,895

• Florida 62,026

• New York 57,622

• Pennsylvania 34,571

• Illinois ++ 29,842

• Georgia 29,700

• New Jersey 28,568

• Ohio 27,371

• Michigan+++ 26,880

+Now 15 states post more than 1M cases, the remainder being Arizona (surpassing Tennessee),Tennessee, New Jersey, Indiana, and newcomer Wisconsin.

++ Illinois surpasses Georgia in COVID-19 deaths.

+++Still 25 states with more than 10K COVID-19 deaths, the remainder being Arizona, Massachusetts, North Carolina, Indiana, Tennessee, Alabama, Missouri, Virginia (surpassing Louisiana), Louisiana, South Carolina, Kentucky (surpassing Maryland), Oklahoma (surpassing Maryland), Maryland, Wisconsin (surpassing Mississippi), and Mississippi.

Axios, 12/11: Data flooding in from South Africa and Europe is clear: The Omicron variant is spreading extremely quickly, including among vaccinated people. 

Why it matters: If this trend holds up, that means a lot of people — around the world and in the U.S. — are about to get sick, even if only mildly so. 

Driving the news: An early estimate published yesterday by the UK found that two doses of the Pfizer vaccine are only about 30% effective against symptomatic infection with Omicron, and the AstraZeneca vaccine isn’t effective at all. 

• A booster shot of the Pfizer vaccine, however, increases effectiveness to 70-75%.
• Experts expect the vaccines to retain higher levels of effectiveness against severe disease, although this hasn’t yet been measured. 
• Compared to the Delta variant, the risk of reinfection with Omicron is three to eight times higher. This level of immune escape is part of why the variant’s transmission has also spiked.

Between the lines: Researchers are estimating that it’s taking only between two and three days for the number of Omicron cases to double — meaning it’s spreading incredibly fast.

• The UK report estimates that “if Omicron continues to grow at the present rate, Omicron case numbers are projected to reach parity with Delta cases in mid-December.”
• The U.S. isn’t likely to be too far behind the UK.

Yes, but: In the UK, there are no hospitalizations or deaths associated with Omicron so far. 

• Among 43 U.S. cases, only one resulted in hospitalization, the CDC said yesterday.
• That could be because people getting breakthrough infections have milder symptoms, or because the virus overall causes less severe disease, but it’s too soon to draw any firm conclusions. 

What they’re saying: “Omicron would have to be very much milder than Delta, in order to avoid an increase in hospitalisations and deaths,” tweeted Meaghan Kall, one of the authors of the UK report.

• “Remember, a small percentage of a big number is still a bigger number than we would like to see.”

What we’re watching: Only about 26% of vaccinated Americans have received a booster shot, and only 61% of the overall U.S. population is vaccinated, per the CDC.

• If Omicron keeps spreading like it has been, that means U.S. case numbers are also about to skyrocket, save massive behavioral changes. 
• The best thing you can do to prepare is get vaccinated or get a booster shot.

San Francisco Chronicle, 12/11: The president of California’s medical board said she was “followed and confronted” by members of a group under investigation by a U.S. House of Representatives panel for promoting dubious Covid-19 treatments, saying they flew a drone over her family’s home and “ambushed” her outside her office.

Washington Post, 12/11: “European leaders and scientists warned Friday that the omicron variant could become dominant in some countries startlingly soon, overtaking the delta variant, which has remained the most common version of the virus globally for months.”

New York Times, 12/11: “Masks will be required as of Monday in all indoor public spaces in New York State that do not require vaccination for entry, Gov. Kathy Hochul announced on Friday, as the state grapples with a spike in coronavirus cases and hospitalizations. The new requirement means that shops, restaurants and venues will require patrons to be masked unless their employees check that those entering the premises are fully vaccinated.”

The Guardian, 12/11: Where did Omicron come from? By all accounts it is a weird variant. Though highly mutated, it descended not from one of the other variants of concern, such as Alpha, Beta or Delta, but from coronavirus that was circulating maybe 18 months ago. So where has it been all this time? And why is it only wreaking havoc now?

Researchers are exploring a number of hunches. One is that Omicron arose in a remote region of southern Africa but failed to spread until now. Another is that it evolved in infected animals, such as rats, and then crossed back into humans. But a third explanation is gaining ground as more data come to light, that Omicron arose in a person with a weakened immune system: someone having cancer treatment perhaps, an organ transplant patient or someone with uncontrolled HIV.

The latter possibility has sparked global concern. Sub-Saharan Africa is home to two-thirds of the global population living with HIV. For a whole series of reasons, ranging from lack of access to clinics to fear of stigmatisation and disrupted healthcare, 8 million people in the region are not on effective HIV therapy. Beyond the direct problems this causes with disease progression and vulnerability to Covid – people with advanced or uncontrolled HIV are far more likely to die from coronavirus – is the risk that uncontrolled HIV is driving the emergence of Covid variants.

“For me there are two key things,” says Dr Richard Lessells, an infectious diseases physician at the University of KwaZulu-Natal in Durban, who was part of the team that first reported Omicron. “First there is the science that needs to go on to get a better understanding of this. But more importantly, on a public health level, we don’t need to wait for the science. It is a reminder that while addressing the immediate challenge of Covid-19, we also need to intensify efforts to end HIV as a public health problem.”

The suspicion that variants of concern can evolve in patients with weakened immune systems is not new. The Alpha and Beta variants, first spotted last year in the UK and South Africa respectively, are widely thought to have emerged after long-term infections in patients. The mechanism was laid out by Charles Darwin more than 150 years ago: evolution through natural selection. If a person is infected with Covid but mounts a weak immune response, the infection can persist for months. In that time, antibodies neutralise some of the virus, but not the versions they bind to less well. These surviving viruses proliferate, mutate and undergo further selection – potentially leading to variants that evade immune defences.

A preliminary study posted online this week reveals the process in action. Scientists in South Africa, Lessells among them, traced a particular sample of coronavirus to a 36-year-old woman who was not receiving effective antiviral therapy. Tests revealed that she had harboured the Covid virus for 216 days, in which time it accumulated 32 mutations, making it similar to the vaccine-evading Beta variant. If weakening of the immune system by HIV drives Covid evolution, the researchers say, then antiretroviral therapy must be ramped up to prevent it.

Writing in the journal Nature, Lessells and his colleagues make the case more strongly. They warn that the failure to tackle the Covid pandemic “with sufficient urgency” in countries with high rates of uncontrolled HIV “could lead to the emergence of variants of the coronavirus Sars-CoV-2 that spread more easily between people or render the vaccines less effective”. With Omicron, one possibility is that the virus lingered in an immunocompromised patient for months – explaining why it descends from such an old version – before it acquired the right mutations to break out and spread like wildfire.

The effort needed, then, is huge. Covid has caused massive disruption to healthcare services, with HIV patients among those badly hit. More than 1,300 healthcare workers have died of Covid in South Africa alone. Thousands more may leave the profession because of the unsustainable strain. The UK’s hefty cuts to international aid, including slashing funds for the UN agency focused on fighting HIV/Aids from £15m to £2.5m, will hardly help the situation.

A preliminary study posted online this week reveals the process in action. Scientists in South Africa, Lessells among them, traced a particular sample of coronavirus to a 36-year-old woman who was not receiving effective antiviral therapy. Tests revealed that she had harboured the Covid virus for 216 days, in which time it accumulated 32 mutations, making it similar to the vaccine-evading Beta variant. If weakening of the immune system by HIV drives Covid evolution, the researchers say, then antiretroviral therapy must be ramped up to prevent it.

New York Times, 12/11: “Chief Justice John Roberts rejected an emergency request to block the federal mask mandate for air travel while challenges to it moved forward. The chief justice did not ask for a response to the application for emergency relief or refer the application to the full Supreme Court, and he gave no reasons for his ruling. Those were all signs that he viewed the legal question in the case as insubstantial.”

CNBC, 12/10: A new CNBC poll finds President Biden’s overall approval rating stabilized at a low level of 41%, about the same level as former President Donald Trump’s, compared to 50% who disapprove. But Biden’s approval rating on handling the economy and dealing with the coronavirus both declined.

New York Times, 12/9: “William Hartmann, one of two Republican election officials from Michigan who initially refused to certify the results of the 2020 presidential election in Wayne County, where Joe Biden had trounced Donald Trump, died on Nov. 30 at a hospital near Detroit. About two weeks before Mr. Hartmann’s death, which was confirmed by the Michigan Republican Party, his sister, Elizabeth Hartmann, wrote on Facebook that he was ‘in ICU with Covid pneumonia and currently on a ventilator.’ Mr. Hartmann had been outspoken in his opposition to Covid vaccines.”

New York Times, 12/9: “With cases of the Omicron variant doubling every three days and the government doing an about-face on restrictions it had long resisted, Britain is bracing for a new coronavirus surge, unsure if it will be a relatively minor event or a return to the dark days of earlier pandemic waves. Early evidence in Britain backs up tentative findings elsewhere, notably in South Africa, where the heavily mutated new variant is already widespread: It appears to be the most contagious form of the virus yet, a previous case of Covid-19 provides little immunity to it, and vaccines seem less effective against it. But it also seems to cause less severe illness than earlier variants.”

Washington Post, 12/9: Sen. Ron Johnson (R-WI) recommended mouthwash as a treatment for the coronavirus during a town hall meeting Wednesday, the Washington Post reports. Said Johnson: “Standard gargle, mouthwash, has been proven to kill the coronavirus. If you get it, you may reduce viral replication. Why not try all these things?” Johnson later shared on Twitter a study on a public website that says backs up his point.

Bloomberg, 12/9: “The omicron variant of Covid-19 is 4.2 times more transmissible in its early stage than delta, according to a study by a Japanese scientist who advises the country’s health ministry, a finding likely to confirm fears about the new strain’s contagiousness.”

New York Times, 12/9: “More than 200 million Americans — over 60 percent of the population — have been fully vaccinated against the coronavirus. The United States remains far behind not only developed countries like Singapore and Portugal, which will soon have vaccinated 90 percent of their populations, but developing nations like Cambodia (over 80 percent).”

Electoral-vote.com, 12/9: The debt ceiling deal was not the only news to come out of the Senate yesterday. The upper chamber also voted 52-48 to rescind President Joe Biden’s mandate that businesses with 100+ employees require their staffs to be vaccinated. The matter was brought to a vote, over the objections of Senate Majority Leader Chuck Schumer (D-NY), utilizing a provision of the Congressional Review Act. The “yea” votes included the 50 Republicans, plus two ruby-red-state Democrats, Jon Tester (MT) and Joe Manchin (WV).

There is zero chance that the bill will become law, of course. House Republicans are going to try to bring it to the floor in their chamber using parliamentary trickery, but it’s not clear it will work. They would also need a few Democratic votes, but it’s not clear they can get them. And even if House Minority Leader Kevin McCarthy (R-CA) overcomes these two rather sizable issues, the administration has already promised to veto the bill. And 52 votes in the Senate is just a tiny bit short of the number needed to override a presidential veto.

In the end, the courts will be where the fate of Joe Biden’s mandate is decided. Actually, his mandates, as the mandate for federal contractors is currently on the docket of a federal judge in Georgia, the mandate for healthcare workers is before a judge in Louisiana, and the large-employer mandate is on the to-do list of the United States Court of Appeals for the Sixth Circuit (headquartered in Ohio). And, of course, the Supreme Court is sure to get involved in at least one or two of these cases, particularly the large-employer mandate.

So, the Senate vote was just political showmanship as Republicans prepare for the 2022 elections, in which they are going to hammer the Democrats hard for being vaccine fascists. The extent to which that works is going to depend on how bad the pandemic is in summer and fall of next year, and also what the courts decide. The worst-case scenario for the blue team is that Biden gets his mandates, they don’t help because of refusal to comply/new variants of the disease, and the Democrats are left with the double whammy of being attacked as “Big Brother” and yet still not getting the pandemic under control. They will be in much better shape, obviously, if the pandemic recedes.

Failing that, if the courts rule against Biden, that at least gives the president and his party the ability to say, “We did everything we could, but the courts, stocked with Republican-appointed judges, got involved.” For what it’s worth, the judges in Georgia and Louisiana are Republican appointees, the Sixth Circuit is majority-Republican-appointee, and so too is the U.S. Supreme Court. (Z)

The Hill, 12/8: “The Senate on Wednesday voted to nix President Biden’s vaccine mandate for larger businesses, handing Republicans a symbolic win. Senators voted 52-48 on the resolution, which needed a simple majority to be approved. Democratic Sens. Jon Tester and Joe Manchin voted with Republicans, giving it enough support to be sent to the House. The resolution faces an uphill path in the House, where Republicans aren’t able to use a similar fast-track process to force a vote over the objections of Democratic leadership.”

Greenville Daily News, 12/8: Michigan Gov. Gretchen Whitmer (D) said that President Biden’s vaccine mandate is “a problem” for her and state government, the Greenville Daily News reports. Said Whitmer: “We’re an employer too, the state of Michigan is. I know if that mandate happens, we’re going to lose state employees. That’s why I haven’t proposed a mandate at the state level. Some states have. We have not, we’re waiting to see what happens in court.”

Political Wire, 12/8: A new Monmouth poll finds 29% of Americans see inflation and everyday bills as the biggest concern facing their family right now. This far outpaces Covid — which was named by 18% or respondents — or any other single issue as the top kitchen table worry in the country.

Bloomberg, 12/8: “The new lineage [of Omicron] has about half the gene variations of the original and can’t be detected with typical screening… It was found in a traveler who had arrived from South Africa and tested positive for the coronavirus on Saturday.”

Washington Post, 12/8: “Nearly two years into a coronavirus pandemic that has killed more than 5 million people, every country, including the United States, remains dangerously unprepared to respond to future epidemic and pandemic threats, according to a report released Wednesday assessing the efforts of 195 countries.”

AP, 12/7: “A federal judge on Tuesday blocked President Joe Biden’s administration from enforcing a Covid-19 vaccine mandate for employees of federal contractors, the latest in a string of victories for Republican-led states pushing back against Biden’s pandemic policies. The order came in response to a lawsuit from several contractors and seven states — Alabama, Georgia, Idaho, Kansas, South Carolina, Utah and West Virginia. It applies across the U.S. because one of those challenging the order is the trade group Associated Builders and Contractors Inc., whose members do business nationwide.”

CDC, 12/7: The CDC reported that 60% of the U.S. population is fully vaccinated against COVID-19. Approximately 71% of the U.S. population has received at least one vaccine dose, and around 23% have had a booster shot.

AFP, 12/7: Dr. Anthony Fauci: “While it would take weeks to judge the severity of the new Covid-19 variant Omicron, early indications suggested it was not worse than prior strains, and possibly milder.” Said Fauci: “It almost certainly is not more severe than Delta. There is some suggestion that it might even be less severe, because when you look at some of the cohorts that are being followed in South Africa, the ratio between the number of infections and the number of hospitalizations seems to be less than with Delta.”

Washington Post, Michael Gerson, 12/7: “Under the intellectual and moral leadership of Rep. Marjorie Taylor Greene (R-GA), Republicans in the House have done their best to set a standard of deadly misinformation, poisonous bigotry and mental vacuity. But Republicans in the Senate — possessing greater intellectual kilowattage and fewer excuses for cowardice — have recently taken center stage in the GOP festival of small-mindedness. During last week’s budget negotiations, and as America prepared for the full-scale arrival of the omicron coronavirus variant, every present Senate Republican voted to ‘defund’ the federal vaccine mandate on businesses, the military and the federal workforce…”

“This is the strangest political cause of my lifetime. In the midst of a public health emergency that has taken more than 1 of every 500 American lives and which has reduced average life expectancy by 1.67 years (reversing about 14 years of life expectancy gains), Republican officials are actively discouraging citizens from taking routine medical precautions for their own welfare. This is not just a disagreement about policy. It is a political movement organized around increasing the risk of death to your neighbors, particularly your ill and elderly ones. And while it is certainly selfish, is not ultimately self-interested. Fatalities have increased especially in Republican-leaning portions of the country. A death cult has adopted a death wish.”

Indianapolis Star, 12/7: Republican legislative leaders in Indiana “announced they are canceling their one-day legislative session originally planned for Monday after fierce backlash to their proposal to severely limit private companies’ abilities to mandate vaccines.”

Bloomberg, 12/7: “The share of global wealth held by billionaires surged to a record during the Covid-19 crisis… About 2,750 billionaires control 3.5% of the world’s wealth.”

Axios, 12/7: “The top 0.01% of individuals now hold about 11% of the world’s wealth, compared to just over 10% in 2020.”

Baton Rouge Advocate, 12/6: “Louisiana Gov. John Bel Edwards’ (D) plan to add the COVID-19 vaccine to the required immunization schedule for students at K-12 schools has energized a wave of opposition from mostly Republican state lawmakers, who are gathering in Baton Rouge Monday for an oversight hearing where they’ll attempt to thwart the proposal.”

Electoral-vote.com, 12/6: According to a study from the Kaiser Family Foundation, an unvaccinated person is three times as likely to identify as a Republican than as a Democrat. In fact, partisanship is now the best predictor of whether someone is vaccinated or not. It wasn’t always this way, however. Earlier in the pandemic, Black folks and young people resisted vaccination, but now most of them have gotten their shots. At this point, 91% of Democrats are vaccinated vs. 59% of Republicans.

This has consequences. Lethal consequences. The vast majority of the 150,000 deaths since May have been among the unvaccinated—that is, among Republicans. If one examines the pool of unvaccinated people since April, initially the pool had roughly equal numbers of Democrats and Republicans. But now 60% of the unvaccinated are Republicans and only 17% are Democrats.

Misinformation seems to be the major factor in the gap. The pollsters read people four false statements about COVID-19. A full 94% of Republicans believed at least one of them and 46% believed all four. Only 14% of the Democrats believed all four. The most widely believed false statement is: “The government is exaggerating the number of COVID-19 deaths.” Currently the actual number of COVID-19 deaths in the U.S. is at least 808,000. Worldwide it is 5.3 million. Will the differential death rates affect the 2022 elections? Probably not, because most of the deaths are occurring in very Trumpy counties that will still go Republican, even with slightly smaller numbers of Republican voters. (V)

Political Wire, 12/6: Mark Meadows, in his book The Chief’s Chief, writes that Donald Trump was much sicker than reported at the time and had “dangerously low” oxygen levels when he was admitted to the hospital for Covid-19.

New York Times, 12/6: “Confirmed cases of the Omicron variant surged in Britain and Denmark on Sunday, backing up scientists’ fears that it has already spread more widely despite travel bans and adding to worries of new lockdowns before the holidays. The coronavirus variant has been found in at least 45 nations worldwide, with the United States and much of Europe reporting a number of new cases in recent days.”

CNN, 12/6: “Overhyping Covid? It’s already killed 780,000 Americans and over 5 million people worldwide. So I don’t have any clue of what he’s talking about.”— Dr. Anthony Fauci, responding to Sen. Ron Johnson (R-WI) who accused him of “overhyping” Covid-19.

New York Times, 12/6: New York City Mayor Bill de Blasio (D) announced a sweeping Covid vaccine mandate for all private employers in New York City on Monday morning to combat the spread of the Omicron variant

Political Wire, 12/6: A new AP-NORC poll finds that among Americans in Gen Z — the survey included ages 13 to 24 — 46% said the pandemic has made it harder to pursue their education or career goals, compared with 36% of Millennials and 31% in Generation X. There was a similar gap when it came to dating and romantic relationships, with 40% of Gen Z saying it became harder.

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