China on Saturday finished building a 1,500-room hospital for COVID-19 patients to fight a surge in infections the government said are harder to contain and that it blamed on infected people or goods from abroad. The hospital is one of six with a total of 6,500 rooms being built in Nangong, south of Beijing in Hebei province, the official Xinhua News Agency said.

China had largely contained the coronavirus that first was detected in the central city of Wuhan in late 2019 but has suffered a surge of cases since December. A total of 645 people are being treated in Nangong and the Hebei provincial capital, Shijiazhuang, Xinhua said. A 3,000-room hospital is under construction in Shijiazhuang.

Virus clusters also have been found in Beijing and the provinces of Heilongjiang and Liaoning in the northeast and Sichuan in the southwest. The latest infections spread unusually fast, the National Health Commission said. “It is harder to handle,” a Commission statement said. “Community transmission already has happened when the epidemic is found, so it is difficult to prevent.” The Commission blamed the latest cases on people or goods arriving from abroad. It blamed “abnormal management” and “inadequate protection of workers” involved in imports but gave no details.

“They are all imported from abroad. It was caused by entry personnel or contaminated cold chain imported goods,” said the statement. The Chinese government has suggested the disease might have originated abroad and publicized what it says is the discovery of the virus on imported food, mostly frozen fish, though foreign scientists are skeptical. Also Saturday, the city government of Beijing said travelers arriving in the Chinese capital from abroad would be required to undergo an additional week of “medical monitoring” after a 14-day quarantine but gave no details.

Nationwide, the Health Commission reported 130 new confirmed cases in the 24 hours through midnight Friday. It said 90 of those were in Hebei. On Saturday, the Hebei government reported 32 additional cases since midnight, the Shanghai news outlet The Paper reported. In Shijiazhuang, authorities have finished construction of 1,000 rooms of the planned hospital, state TV said Saturday. Xinhua said all the facilities are due to be completed within a week. A similar program of rapid hospital construction was launched by the ruling Communist Party at the start of the outbreak last year in Wuhan.

More than 10 million people in Shijiazhuang underwent virus tests by late Friday, Xinhua said, citing a deputy mayor, Meng Xianghong. It said 247 locally transmitted cases were found. Meanwhile, researchers sent by the World Health Organization were in Wuhan preparing to investigate the origins of the virus. The team, which arrived Thursday, was under a two-week quarantine but was due to talk with Chinese experts by video link. The team's arrival was held up for months by diplomatic wrangling that prompted a rare public complaint by the head of the WHO.

That delay, and the secretive ruling party’s orders to scientists not to talk publicly about the disease, have raised questions about whether Beijing might try to block discoveries that would hurt its self-proclaimed status as a leader in the anti-virus battle.

As the total number of coronavirus infections in California approaches 3 million, health officials said Sunday that a new strain — different from a highly contagious variant first identified in the United Kingdom — is popping up more frequently across the state.

Researchers have identified the strain in a dozen counties and have linked it to several large outbreaks in Santa Clara County. The California Department of Public Health said it’s not yet clear whether the variant is highly contagious or is just being identified frequently as lab work becomes more sophisticated. Santa Clara County laboratories studying changes in the virus’ genome sequence found the strain in samples from community testing sites and from outbreaks where “very high numbers of people exposed contracted the virus,” officials said. “This virus continues to mutate and adapt, and we cannot let down our guard,” said Dr. Sara Cody, Santa Clara County health officer and director of the Public Health Department, in a prepared statement.

The variant carries three mutations in the spike protein, which the virus uses to attach to and enter cells, said Dr. Charles Chiu, a virologist at UC San Francisco. The two COVID-19 vaccines on the market in the U.S., produced by Pfizer-BioNTech and Moderna, train the body’s immune system to target the spike protein. This means that, in theory, the virus mutations could alter the spike protein to a degree that the vaccines become less effective.

Chiu said researchers are prioritizing the study of the variant and are working to determine whether the virus is “more infectious or affects vaccine performance.”The variant is not the same as the highly contagious strain first identified last month in the United Kingdom. The Centers for Disease Control and Prevention warned Friday that the U.K. variant, known as B117, could become the dominant coronavirus strain in the U.S. by March because it spreads so quickly.

The new variant has also been reported in Los Angeles, Orange, Riverside, San Francisco, San Bernardino, San Diego, Humboldt, Lake, Mono, Monterey and San Luis Obispo counties. Scientists say they don’t know how prevalent the strain is, because viral genomic sequencing isn’t performed everywhere across the state or the country.

Meanwhile, late Sunday, Dr. Erica S. Pan, state epidemiologist for the Department of Public Health, sent an alert to California medical providers recommending that they temporarily stop administering Moderna COVID-19 vaccine doses from a single lot after “fewer than 10" people had allergic reactions to the shot at a community vaccination clinic, Pan said. More than 330,000 doses from the lot were distributed to 287 providers in California from Jan. 5 to Jan. 12, officials said. Providers should use other available vaccine doses “out of an extreme abundance of caution,” Pan said, until Moderna and state and federal health officials finish their investigation.

So many people have died in Los Angeles County that officials have temporarily suspended air-quality regulations that limit the number of cremations. Health officials and the L.A. County coroner requested the change because the current death rate is “more than double that of pre-pandemic years, leading to hospitals, funeral homes and crematoriums exceeding capacity, without the ability to process the backlog,” the South Coast Air Quality Management District said Sunday.

Epidemiology of post-COVID syndrome following hospitalisation with coronavirus: a retrospective cohort study

Objectives The epidemiology of post-COVID syndrome (PCS) is currently undefined. We quantified rates of organ-specific impairment following recovery from COVID-19 hospitalisation compared with those in a matched control group, and how the rate ratio (RR) varies by age, sex, and ethnicity.

Setting NHS hospitals in England.

Participants 47,780 individuals (mean age 65 years, 55% male) in hospital with COVID-19 and discharged alive by 31 August 2020, matched to controls on demographic and clinical characteristics.

Results Mean follow-up time was 140 days for COVID-19 cases and 153 days for controls. 766 (95% confidence interval: 753 to 779) readmissions and 320 (312 to 328) deaths per 1,000 person-years were observed in COVID-19 cases, 3.5 (3.4 to 3.6) and 7.7 (7.2 to 8.3) times greater, respectively, than in controls. Rates of respiratory, diabetes and cardiovascular events were also significantly elevated in COVID-19 cases, at 770 (758 to 783), 127 (122 to 132) and 126 (121 to 131) events per 1,000 person-years, respectively. RRs were greater for individuals aged <70 than ≥ 70 years, and in ethnic minority groups than the White population, with the biggest differences observed for respiratory disease: 10.5 [9.7 to 11.4] for <70 years versus 4.6 [4.3 to 4.8] for ≥ 70 years, and 11.4 (9.8 to 13.3) for Non-White versus 5.2 (5.0 to 5.5) for White.

Conclusions Individuals discharged from hospital following COVID-19 face elevated rates of multi-organ dysfunction compared with background levels, and the increase in risk is neither confined to the elderly nor uniform across ethnicities. The diagnosis, treatment and prevention of PCS require integrated rather than organ- or disease-specific approaches. Urgent research is required to establish risk factors for PCS.

...

Principal findings
In the largest study to-date to examine PCS in individuals hospitalised with COVID-19, comprising 47,780 COVID-19 cases with matched controls, we describe three major findings. Firstly, COVID-19 hospitalisation was associated with increased risk of readmission and death following discharge, relative to that in individuals of similar demographic and clinical profiles over the same period; nearly a third of people post COVID-19 hospital discharge were re-admitted and more than 1 in 10 died.

In the largest study to-date to examine PCS in individuals hospitalised with COVID-19, comprising 47,780 COVID-19 cases with matched controls, we describe three major findings. Firstly, COVID-19 hospitalisation was associated with increased risk of readmission and death following discharge, relative to that in individuals of similar demographic and clinical profiles over the same period; nearly a third of people post COVID-19 hospital discharge were re-admitted and more than 1 in 10 died.

highdesert wrote: Mon Jan 18, 2021 12:35 pm

In the largest study to-date to examine PCS in individuals hospitalised with COVID-19, comprising 47,780 COVID-19 cases with matched controls, we describe three major findings. Firstly, COVID-19 hospitalisation was associated with increased risk of readmission and death following discharge, relative to that in individuals of similar demographic and clinical profiles over the same period; nearly a third of people post COVID-19 hospital discharge were re-admitted and more than 1 in 10 died.

That's a very large sample 47,780 COVID-19 cases and they had controls. If age isn't a factor and clinical profiles are similar then eliminating everything else leaves the virus. Average age 65 and 55% male - over 50 has the higher death rate and most deaths are male. Don't know morbidity rates in the UK. This could go on for a long time.

highdesert wrote: Thu Jan 21, 2021 10:23 am Bloomberg has a vaccine tracker showing COVID-19 vaccines administered per 100 people in the US. CA looks terrible.
https://www.bloomberg.com/graphics/covi ... tribution/

featureless wrote: Thu Jan 21, 2021 10:28 am

highdesert wrote: Thu Jan 21, 2021 10:23 am Bloomberg has a vaccine tracker showing COVID-19 vaccines administered per 100 people in the US. CA looks terrible.
https://www.bloomberg.com/graphics/covi ... tribution/

While I was getting drilled on at the dentist yesterday, he was telling me how difficult and expensive it is to get PPE for his office and what a train wreck the vaccine rollout is. He's signed up for the dental injection crew training and was describing how even that program has missed the basics of locations, storage and syringes.

highdesert wrote: Thu Jan 21, 2021 10:50 am

featureless wrote: Thu Jan 21, 2021 10:28 am

highdesert wrote: Thu Jan 21, 2021 10:23 am Bloomberg has a vaccine tracker showing COVID-19 vaccines administered per 100 people in the US. CA looks terrible.
https://www.bloomberg.com/graphics/covi ... tribution/

While I was getting drilled on at the dentist yesterday, he was telling me how difficult and expensive it is to get PPE for his office and what a train wreck the vaccine rollout is. He's signed up for the dental injection crew training and was describing how even that program has missed the basics of locations, storage and syringes.

Hope you're feeling better featureless, been there - had that - not fun. Especially with a temporary crown until the permanent crown arrives.

Newsom's a disaster as an administrator, he's not making things happen. While they are authorizing dentists to administer vaccines why didn't they include podiatrists who are surgeons and paramedics in CA and even medical assistants who do it already in physician's offices. Or as Mason mentioned former corpsmen/corpswomen. The recall is rolling along.

featureless wrote: Thu Jan 21, 2021 11:03 am

highdesert wrote: Thu Jan 21, 2021 10:50 am

featureless wrote: Thu Jan 21, 2021 10:28 am

highdesert wrote: Thu Jan 21, 2021 10:23 am Bloomberg has a vaccine tracker showing COVID-19 vaccines administered per 100 people in the US. CA looks terrible.
https://www.bloomberg.com/graphics/covi ... tribution/

While I was getting drilled on at the dentist yesterday, he was telling me how difficult and expensive it is to get PPE for his office and what a train wreck the vaccine rollout is. He's signed up for the dental injection crew training and was describing how even that program has missed the basics of locations, storage and syringes.

Hope you're feeling better featureless, been there - had that - not fun. Especially with a temporary crown until the permanent crown arrives.

Newsom's a disaster as an administrator, he's not making things happen. While they are authorizing dentists to administer vaccines why didn't they include podiatrists who are surgeons and paramedics in CA and even medical assistants who do it already in physician's offices. Or as Mason mentioned former corpsmen/corpswomen. The recall is rolling along.

Yep, crowns suck, but I hear they are better than root canals.

Yeah, I don't get Newsom. He really was doing well on the pandemic response early on and then shit just fell apart. I don't envy him the responsibility, but come on. There is no reason we don't have a workable vaccine rollout plan beyond incompetence. Yes, CA is huge and has a lot of people. But we also have so many biotech, medical and tech advantages.

My personal experience working with CA agencies is that there is way to much emphasis on checking boxes (every one of them, and then rechecking that they are all checked) and way too little emphasis on getting shit done and empowering independent agency of state employees. Sure, we need regulation and accountability. But when applications sit for so long in the box checking stage that they are obsolete by the time they get near approval and then need to be redone, well, that's not accountable or productive. It's a fucking waste of everyone's time and money. I suspect the same is occurring with the vaccine programs.

highdesert wrote: Thu Jan 21, 2021 12:12 pm Recall groups have been doing events to get signatures in So Cal, I don't know where they are at. One party government gets lazy and complacent and CA has had one party government for too long.

featureless wrote: Thu Jan 21, 2021 12:23 pm

highdesert wrote: Thu Jan 21, 2021 12:12 pm Recall groups have been doing events to get signatures in So Cal, I don't know where they are at. One party government gets lazy and complacent and CA has had one party government for too long.

That's for sure. If nothing else, we serve as an example that Dems don't have all the answers and can get quite constipated in their haste to address everything while often missing the underlying issues.

Gov. Gavin Newsom urged Californians to “hold me accountable” to a goal of administering 1 million doses of COVID-19 vaccine in 10 days, but nearly two weeks later a series of data collection problems have left state officials unable to offer clear evidence of success or failure.

A spokesperson for the California Department of Public Health said Wednesday that it’s likely Newsom reached the 1 million mark over 12 days, not 10 days as promised, but noted that coding errors and data lags have hampered the state’s efforts to accurately count and publicly report how many doses are administered each day.

Newsom’s self-prescribed litmus test was announced as pressures mounted for him to address the state’s slow vaccination rollout, which has left hundreds of thousands of doses sitting on shelves despite the public’s desperate need for the lifesaving drug.

In the last week, the state identified a yet-to-be-resolved coding error with data from a major provider of COVID-19 vaccines, and the extent of the underreporting from that source was still unclear as of Wednesday, according to the public health department. The state also found reporting delays with data from other providers of up to 96 hours between when a dose was given and when it showed up in the California immunization system, Ghaly said.

Data reporting issues prompted groups representing counties and county health officials to warn Newsom in a letter Monday of “significant data lags and reporting challenges that result in an underreporting of California’s progress” on how many doses have been administered. The delay is partially the result of problems with the state’s immunization registry, which has required some jurisdictions to reenter data multiple times because the “system is kicking them out,” according to a letter sent by the groups.

“Here’s your next thing to hold me accountable to: 1 million doses within the next — not 10 days, it was 10 days yesterday when I announced it to the team — nine days,” Newsom said.

However, when the 10 days were up, it became clear that measuring Newsom’s progress — using the data his administration tallies and releases — would be as complicated as the goal itself.

Bisbee wrote: Thu Jan 21, 2021 1:12 pm Los Angeles county revealed a website sign up for the Pfizer vaccine Monday with little fanfare. It opened up the vaccine for anyone over 65 and had slots through the rest of the week until Sunday evening in various venues throughout Los Angeles. I learned about it Monday afternoon through a friend who works for the county and immediately started the sign up process for my parents. I got my Mom a slot at the Pomona Fairplex for Sunday afternoon. By the time I tried for my Dad (who was hesitant anyway) all the slots were filled. It was Monday 4:00pm when the Fairplex location stopped accepting reservations. At around 5:00 my friend mentioned the county website had slowed to a crawl and subsequently crashed. The county still called the effort a success in an email explaining that several thousands of Angelinos made reservations for the vaccine before all the slots filled and the website crashed due to overwhelming response. My friend didn’t even get to make reservations for her parents because she was busy with work when the website was announced in a work email.

Bisbee wrote: Thu Jan 21, 2021 1:12 pm Los Angeles county revealed a website sign up for the Pfizer vaccine Monday with little fanfare. It opened up the vaccine for anyone over 65 and had slots through the rest of the week until Sunday evening in various venues throughout Los Angeles. I learned about it Monday afternoon through a friend who works for the county and immediately started the sign up process for my parents. I got my Mom a slot at the Pomona Fairplex for Sunday afternoon. By the time I tried for my Dad (who was hesitant anyway) all the slots were filled. It was Monday 4:00pm when the Fairplex location stopped accepting reservations. At around 5:00 my friend mentioned the county website had slowed to a crawl and subsequently crashed. The county still called the effort a success in an email explaining that several thousands of Angelinos made reservations for the vaccine before all the slots filled and the website crashed due to overwhelming response. My friend didn’t even get to make reservations for her parents because she was busy with work when the website was announced in a work email.

Bisbee wrote: Thu Jan 21, 2021 2:31 pm http://www.publichealth.lacounty.gov/me ... /index.htm

A link from there to a parallel vaccination website shows reservations available at Dodger Stadium and other fire stations around Los Angeles:

http://www.publichealth.lacounty.gov/me ... /index.htm

featureless wrote: Thu Jan 21, 2021 4:14 pm Based on last night's press conference (whoa! remember those?), I have some hope we'll be getting better communication from the federal level on vaccine status.

To investigate the evolution of SARS-CoV-2 in the immune population, we co-incubated authentic virus with a highly neutralizing plasma from a COVID-19 convalescent patient. The plasma fully neutralized the virus for 7 passages, but after 45 days, the deletion of F140 in the spike N-terminal domain (NTD) N3 loop led to partial breakthrough. At day 73, an E484K substitution in the receptor-binding domain (RBD) occurred, followed at day 80 by an insertion in the NTD N5 loop containing a new glycan sequon, which generated a variant completely resistant to plasma neutralization. Computational modeling predicts that the deletion and insertion in loops N3 and N5 prevent binding of neutralizing antibodies. The recent emergence in the United Kingdom and South Africa of natural variants with similar changes suggests that SARS-CoV-2 has the potential to escape an effective immune response and that vaccines and antibodies able to control emerging variants should be developed.

featureless wrote: Fri Jan 22, 2021 10:35 am It's looking more and more like vaccination will be an annual thing for some time.

To investigate the evolution of SARS-CoV-2 in the immune population, we co-incubated authentic virus with a highly neutralizing plasma from a COVID-19 convalescent patient. The plasma fully neutralized the virus for 7 passages, but after 45 days, the deletion of F140 in the spike N-terminal domain (NTD) N3 loop led to partial breakthrough. At day 73, an E484K substitution in the receptor-binding domain (RBD) occurred, followed at day 80 by an insertion in the NTD N5 loop containing a new glycan sequon, which generated a variant completely resistant to plasma neutralization. Computational modeling predicts that the deletion and insertion in loops N3 and N5 prevent binding of neutralizing antibodies. The recent emergence in the United Kingdom and South Africa of natural variants with similar changes suggests that SARS-CoV-2 has the potential to escape an effective immune response and that vaccines and antibodies able to control emerging variants should be developed.

https://www.biorxiv.org/content/10.1101 ... 8.424451v1

Dr Simon Clarke, who is an expert in cell microbiology at the University of Reading, said: "The South African variant has a number of additional mutations including changes to some of the virus' spike protein which are concerning."

The spike protein is what coronavirus uses to gain entry into human cells. It is also the bit that vaccines are designed around, which is why experts are worried about these particular mutations.

"They cause more extensive alteration of the spike protein than the changes in the Kent [UK] variant and may make the virus less susceptible to the immune response triggered by the vaccines," said Dr Clarke.

The latest results from the phase 3 COVID-19 vaccines trials have been very positive. These have shown that vaccinating people with the gene for SARS-CoV-2 spike protein can induce excellent protective immunity.

The spike protein is the focus of most COVID-19 vaccines as it is the part of the virus that enables it to enter our cells. Virus replication only happens inside cells, so blocking entry prevents more virus being made. If a person has antibodies that can recognise the spike protein, this should stop the virus in its tracks.

The three most advanced vaccines (from Oxford/AstraZeneca, Pfizer/BioNTech and Moderna) all work by getting our own cells to make copies of the virus spike protein. The Oxford vaccine achieves this by introducing the spike protein gene via a harmless adenovirus vector. The other two vaccines deliver the spike protein gene directly as mRNA wrapped in a nanoparticle. When our own cells make the spike protein, our immune response will recognise it as foreign and start making antibodies and T cells that specifically target it.

However, the SARS-CoV-2 virus is more complicated than just a spike protein. There are, in fact, four different proteins that form the overall structure of the virus particle: spike, envelope (E), membrane (M) and nucleocapsid (N). In a natural infection, our immune system recognises all of these proteins to varying degrees. So how important are immune responses to these different proteins, and does it matter that the first vaccines will not replicate these?

Following SARS-CoV-2 infection, researchers have discovered that we actually make the most antibodies to the N protein – not the spike protein. This is the same for many different viruses that also have N proteins. But how N protein antibodies protect us from infection has been a long-standing mystery. This is because N protein is only found inside the virus particle, wrapped around the RNA. Therefore, N protein antibodies cannot block virus entry, will not be measured in neutralisation assays that test for this in the lab, and so have largely been overlooked.

Our latest work from the MRC Laboratory of Molecular Biology in Cambridge has revealed a new mechanism for how N protein antibodies can protect against viral disease. We have studied another virus containing an N protein called lymphocytic choriomeningitis virus and shown a surprising role for an unusual antibody receptor called TRIM21.

Whereas antibodies are typically thought to only work outside of cells, TRIM21 is only found inside cells. We have shown that N protein antibodies that get inside cells are recognised by TRIM21, which then shreds the associated N protein. Tiny fragments of N protein are then displayed on the surface of infected cells. T cells recognise these fragments, identify cells as infected, then kill the cell and consequently any virus.

We expect that this newly identified role for N protein antibodies in protecting against virus infection is important for SARS-CoV-2, and work is ongoing to explore this further. This suggests that vaccines that induce N protein antibodies, as well as spike antibodies, could be valuable, as they would stimulate another way by which our immune response can eliminate SARS-CoV-2.

Adding N protein to SARS-CoV-2 vaccines could also be useful because N protein is very similar between different coronaviruses – much more so than the spike protein. This means it's possible that a protective immune response against SARS-CoV-2 N protein could also offer some protection against other related coronaviruses, such as Mers.