U.S.                                                                  California

                                    CASES               DEATHS                                  CASES                DEATHS       

December 2020    19,111,443              341,149                              2,120,610               24,241

2021   Timeline

January                  26,185,362              441,319                              3,310,949               40,702

February                 28,602,101              513,137                              3,563,578               51,953

March                     30,459,874              552,072                              3,668,277               59,240

April                        32,225,012               574,280                             3,742, 115               62,078

May                        33,261,284               594,468                             3,789,227                63,247

June                       33,624,871               603,966                             3,814,890                63,569

July                         34,434,136               610,859                             3,903,052                64,231 

August                   39,057,368               638,700                              4,326,204               65,757 

September            43,471,906               698,149                             4,720,860                69,130

October                45,979,056               746,021                             4,915,796                71,950

November            48,214,360               776,586                             5,060,666                74,152

December            54,859,966               825,816                             5,515,250                76,520

2022 Timeline

January                74,333,528                884,265                             8,292,735                79,801

February               79,025,644               949,957                             8,961,636                85,043                        

March                   81,780,503            1,007,320                             9,102,677               89,052

UPDATED WEEKLY - Last updated on 27 March 2022, 3:28 pm PST, John Hopkins Corona Virus Dashboard and Worldometer

Cases Worldwide

                       John Hopkins                                                    Worldometer

• TOTAL CASES    -   480,605,630                      TOTAL CASES        -     481,852,448

              Recovered     -                                               Recovered         -     416,057,175

• TOTAL DEATHS  -       6,122,514                      TOTAL DEATHS      -         6,147,775

POPULATION - is 334,358,250 as of 27 March 2022, 3:28 pm PST, based on Census U.S. and World Population Clock.

Cases in the U.S.

• TOTAL CASES      -   79,949,733                      TOTAL CASES        -     81,618,888

              Recovered       -                                             Recovered           -     64,271,245

• TOTAL DEATHS    -        976,702                      TOTAL DEATHS      -       1,003,430
  • ​Payroll enrollment rises by 678,000 in February
  • Unemployment rate lowers to 3.8%
  • Average hourly earnings for all employees increase 0.1% January 2022

Cases in California

• TOTAL CASES       -   9,089,859                       TOTAL CASES        -        9,087,361

              Recovered        -                                            Recovered         -             N/A

• TOTAL DEATHS     -        88,597                       TOTAL DEATHS      -            88,718

03/27/2022                   Cases (WHO)                  Deaths (WHO)                Recovered (WHO)

• Texas                 -   6,736,214                            87,618                           6,531,087
• Florida               -   5,885,390                            73,018                               N/A
• New York          -   5,130,627                            68,433                               N/A
• Illinois                 -   3,061,224                            37,589                           2,979,863
• Pennsylvania    -   2,779,049                            44,210                               N/A
• Ohio                  -   2,669,698                            37,793                           2,618,373
• N. Carolina       -   2,624,305                            23,174                           2,579,420
• Georgia            -   2,485,736                            36,771                           1,790,842
• Tennessee         -   2,019,535                           25,519                           1,985,885    
• Arizona              -   1,997,037                           28,883                           1,948,007

*correction

          **reporting information is limited, reduced testing and increased cases

United States progress                                       Updated as of 27 March 2022, 3:28 pm PST

• Doses Distributed*                                               701,257,665
• Doses Administered*                                          559,873,640               
• 1st dose administered                                        255,271,920                   76.9%                   
• 2nd dose administered                                      217,424,576                   65.5%
• Booster administered                                           97,269,485                    44.7%                   
• Total population                                                 334,358,250

   *Updated information

• https://usafacts.org/visualizations/covid-vaccine-tracker-states/
• https://coronavirus.jhu.edu/vaccines/us-states
• https://www.worldometers.info/coronavirus/country/us/
• https://coronavirus.jhu.edu/vaccines/us-states
• https://covid.cdc.gov/covid-data-tracker/#vaccinations
• https://usafacts.org/visualizations/weekly-unemployment-claims/?utm_source=bing&utm_medium=cpc&utm_campaign=ND-Jobs&msclkid=b11efd9b16dc12762fd79d422c12da27
• https://www.edd.ca.gov/newsroom/unemployment-may-2021.htm
• https://www.bls.gov/

MARCH    BLOG

COVID UPDATE

VARIANT UPDATE

A rare hyper-inflammatory syndrome has been reported in teens after COVID vaccination. Why experts aren't worried.  Tue, February 22, 2022, 3:00 PM.  A new report by the Centers for Disease Control and Prevention has identified cases of a potentially dangerous but quite rare hyper-inflammatory condition in vaccinated adolescents. 

According to The Lancet Child & Adolescent Health study, 21 reports of MIS-C were found in those who received at least one dose of the Pfizer-BioNTech vaccine.  Six showed no evidence of prior coronavirus infection.  According to the report, 11 developed MIS-C after the first dose, while 10 after the second dose.  The time from dose to hospitalization was eight days for those receiving one vaccine dose and five days for those receiving two doses.  Under CDC guidelines, people are considered fully vaccinated two weeks after receiving their second dose.

“That tells me that these children were infected before they were vaccinated and they just didn’t have sufficient time to develop immunity with the vaccine prior to developing MIS-C,” according to Dr. Jim Versalovic, pathologist-in-chief and COVID-19 command center co-leader at Texas Children’s Hospital.

The data highlights the importance of vaccinating children and teens, as most of the cases were those not considered fully vaccinated.  The study also showed the unvaccinated are more likely to develop MIS-C compared to those who are vaccinated.  CDC researchers determined developing MIS-C after vaccination is extremely rare, only one case occurs per million vaccinated people in this age group.  Only 57% of 12- to 17-year-olds are fully vaccinated, according to CDC data. 

Why do some people get Covid when others don’t?  Here’s what we know so far.  UPDATED SAT, FEB 5 202210:20 PM EST.   One of the great mysteries that has emerged from the Covid-19 pandemic — and one that’s still being investigated by infectious disease specialists — is why some people catch Covid and others don’t, even when they’re equally exposed to the virus.

• There has been an increasing amount of research being devoted to the reasons why some people never seem to get Covid — a so-called never Covid cohort.
• There are multiple anecdotes of Covid cases discovered among couples, families or groups of colleagues who have mixed closely, but not everyone has become infected.
• This could be due to several factors, such as prior infection with a similar virus to genetics.

New research was published by Imperial College London suggesting that people with higher levels of T-cells, a cell in the immune system, from common cold coronaviruses were less likely to become infected with SARS-CoV-2, the virus that causes Covid-19.

Dr. Rhia Kundu, first author of the study from Imperial’s National Heart and Lung Institute, indicated “being exposed to the SARS-CoV-2 virus doesn’t always result in infection.  We found that high levels of pre-existing T-cells, created by the body when infected with other human coronaviruses like the common cold, can protect against Covid-19 infection,” she said.

Dr. Kundu cautioned, “This is an important discovery, but only one form of protection and no one should rely on this alone.  The best way to protect yourself against Covid-19 is to be fully vaccinated, including the booster dose.”

Early data suggests “never covid’” individuals have naturally acquired immunity from previous infections with common cold coronaviruses.  20% of common cold infections are due to common cold coronaviruses, but why some individuals maintain levels of cross-reactive immunity remains unknown.”

The genetic factor.  Another question that has arisen during the pandemic, why two people with Covid may respond so differently to the infection, one could have heavy symptoms and the other could be asymptomatic.  The answer might lie in our genes.

Research to be published regarding immunogenetics, the relationship between genetics and the immune system and Covid-19 infection, have found variations between people’s immune systems “makes a difference whether you get symptomatic disease.”

How strong is your immunity against Omicron?  Mon, February 14, 2022, 7:13 AM.  Scientists, public health officials, politicians and the general public have debated whether prior SARS-CoV-2 infection, or “natural immunity,” offers protection comparable to vaccines against COVID-19. 

The answer is complicated!  Studies show protecting yourself against the Omicron variant is to get vaccinated and boosted.  Any infection on top of that, while not desirable, offers more protection.

A 2021 CDC study analyzed COVID-19 cases in California and New York.   Data was collected from May 30 to Nov. 20, 2021, a period before and during the Delta wave, showed that prior to the Delta variant, case rates were lowest for people who were vaccinated and not previously infected with COVID-19.  By early October, when Delta was dominant, case rates were substantially lower among both unvaccinated and vaccinated people with previous infections, suggesting that natural immunity during this period was superior to vaccines.

It must be noted, the CDC research was conducted when vaccine-induced immunity was waning for many people, prior to the emergence of the highly transmissible Omicron variant and when most U.S. adults were not yet eligible to receive booster shots.   With natural infections, if you have mild symptoms, you may not mount the strong cellular immune response needed to fight the infection in the future, while vaccines are subject to rigorous trials and elicit a high immune response.  Experts agree vaccines are more quantifiable, predictable and reliable in protection. 

Based on available epidemiological data, those likely to be the most protected against both infection and hospitalization are people who have had a breakthrough infection. Data shows people make really broad neutralizing antibodies.  The antibodies recognize every possible variant and even distant viral species, but they also make really high levels of those antibodies.  This category of people, with both infection and vaccination, are known as “hybrid” or “super” immunity.   The CDC has indicated that a third dose of the Pfizer or Moderna vaccine was 90 percent effective at preventing hospitalization and 82 percent effective at preventing emergency department and urgent care visits.

The Role of Acidosis in the Pathogenesis of Severe Forms of COVID-19.  

Part of the body’s mechanism for adaptation and survival is the maintenance of the acid-base balance.  In metabolic processes, excess acid is formed, but is removed from the body by the lungs or the removal of carbon dioxide through respiration.  With the kidneys, it is through the release of protons into the urine.  Changes in blood pH are smoothed out by several buffer systems: hemoglobin, bicarbonate, phosphate, and plasma proteins.  

Acidosis or the decrease in blood pH, can occur for a variety of reasons. There are two variants of metabolic acidosis - lactic acidosis and ketoacidosis.  Several studies have provided evidence that acidosis is often associated with a severe form of COVID-19.  Blood lactate levels were significantly higher in hospitalized COVID-19 patients than ambulatory patients.  Among hospitalized patients, lactate levels were the highest in non-survivors. 

Patients 65 and over are more vulnerable to metabolic acidosis during COVID-19.   The risk of developing severe pneumonia increases when diagnosed with cardiovascular diseases, obesity, cancer, chronic obstructive pulmonary disease (COPD), chronic kidney disease and pregnancy.  Metabolic acidosis in COVID-19 usually does not develop immediately, but only after a significant time due to the gradual depletion of the body’s resources.

Acidosis can not only be diagnosed in intensive care units but also in publicly available clinical diagnostic laboratories (CDL).  The positive role of diet changes (restriction of carbohydrates, fats, spices) and adherence to diet therapy in the prevention of the severe course of COVID-19.   Another way to prevent acidosis is early oxygen intervention and maintenance of blood oxygen saturation in patients.  It helps to avoid the metabolic switch to anaerobic glycolysis.

A particular way of preventing acidosis is the intake of alkaline drinks, which is used by athletes, runners, and cyclists.  Usually, sodium and potassium citrate are taken.  The same method is used to dissolve types of kidney stones.

Pneumonia that develops with COVID-19 leads to disruption of gas exchange in the lungs, provoking the development of hypoxia. The hypoxic disorder is one of the main defining features of COVID-19.  Severe Acute Respiratory Syndrome or SARS is included in the name of the SARS-CoV-2 virus.

Severe pneumonia in COVID-19 is accompanied by a drop in blood oxygen saturation.  The first stage of saturation reduction proceeds relatively smoothly, developing over several days.  The subsequent drop in saturation and the occurrence of oxygen deficiency are already occurring rapidly and require hospitalization, oxygen support and intensive care.  

• The lytic phase of the virus leads to the death of type 2 alveolocytes, which disrupts the structure of the alveoli by a decrease in the production of surfactant in alveolocytes, which leads to a change in surface tension.  As a result, the changes in air pressure in the lungs do not lead to compression and expansion of the alveolar vesicles, the dead volume of lungs increases and gas exchange decreases.
• COVID-19 is frequently manifested by thrombosis in pulmonary capillaries, which prevents the transfer of oxygen. 
• Production of the extracellular matrix (ECM), rich in hyaluronic acid, is designed to “seal” areas of extensive lung damage to prevent general lung collapse. As a side effect of this process, a part of functional alveoli is filled with ECM and switched off from gas exchange.
• Another mechanism limiting gas exchange in COVID-19 patients is a change in the properties of the erythroid precursor cells.  This leads to greater production of immature red blood cells, followed by their massive release into the bloodstream and a corresponding drop in hemoglobin levels. 

Inflammation and Acidosis.  Any intensive inflammation contributes to the increase of acidosis, especially local inflammation.   This is due to three factors.

• First, gas exchange takes place mainly in small vessels.  The increased metabolic activity    resulting from inflammation requires oxygen, which is limited.  When small vessels are damaged, hypoxia and increased metabolic activity of infiltrating leukocytes shifts metabolism toward lactic acid production, leading to the accumulation of lactate. 
• Second, in the process of oxidative burst that accompanies inflammation, there is a massive production of protons by neutrophils. 
• Third, in case of concomitant bacterial infection, short-chain fatty acids accumulate.  

Prolonged hypoxia leads to acidosis, which promotes chronic inflammation both locally and in a generalized manner.  Hypoxia is likely to be an important factor contributing to the development of hyper-inflammation seen in severe COVID-19.   Acidosis influences the functioning of immune cells and further stimulates the development of inflammation.

A slight deviation of blood acidity from the physiological norm can significantly change the ability of hemoglobin to bind oxygen.

If a decrease in pH and a drop in blood oxygen saturation has already occurred, then the body’s compensatory capabilities to regulate acidosis have been exhausted.  Apparently, this often happens in case of SARS-CoV-2 infection since a drop in pH and blood oxygen saturation are characteristic features of the severe course of COVID-19.

Hyper-coagulation provokes micro-thrombosis in the pulmonary vessels and lead to systemic thrombosis.  In the lungs, blood clotting disrupts gas exchange and promotes hypoxia throughout the body.   Thrombosis leads directly to hypoxia and decrease in gas exchange and acidosis. The formation of blood clots is also a threshold phenomenon that leads to a sharp deterioration in the patient’s condition.

The pH varies in blood plasma, in the range of 7.2–7.6, in the parts of the lung affected by the virus.  There may be a blood clot, a violation of blood circulation and decreased gas exchange. Arising local acidosis can lead to a lactate concentration in the damaged tissue and result in a significant pH shift in inflammation.

Decreased oxygen levels in the blood are a key problem in COVID-19 patients. The main reason is damage to the lung tissue, leading to impaired ventilation and the formation of micro-thrombi in the vessels of the lungs.  Virus infection of immature red blood cells leads to a corresponding decrease in blood hemoglobin levels that contributes to hypoxia.  Hypoxia and acidosis reinforce each other. 

As COVID-19 progresses, it causes of both metabolic and respiratory acidosis to emerge. Depletion of the buffering capacity of the blood, depletion of the body’s resources necessary to contain the developing acidosis, is critical for reducing saturation.

Acidosis develops when the buffer capacity of the blood is depleted and a striking example of this is the development of acidosis in diarrhea, briefly discussed above.  Another source of acidosis can be hypercapnia, an excess of carbon dioxide in the blood. Disruption of gas exchange in the lungs of patients with COVID-19 creates favorable conditions for the occurrence of hypercapnia and the development of respiratory acidosis.

VACCINE UPDATE

Prior COVID offers less protection vs Omicron; mRNA booster shot efficacy declines within months.  Mon, February 14, 2022, 12:03 PM.  The immune response to COVID-19 helps protect against reinfection, but that protection is weaker against Omicron than it was against earlier variants of the coronavirus, according to new data.   Researchers in a review of national data in Qatar found a previous SARS-CoV-2 infection protects against:

• Omicron reinfection only 56% of the time,
• Having had COVID was 90.2% effective against reinfection with the Alpha variant,
• 85.7% effective against a Beta variant reinfection, and
• 92% effective against Delta reinfection, researchers reported in The New England Journal of Medicine.

"The protection of previous infection against hospitalization or death caused by reinfection with Omicron appeared to be robust," they said.  In cases of reinfection with Omicron, the immune response to previous infection was 87.8% effective at preventing the second infection from progressing to severe or critical illness or death.

mRNA vaccine booster protection declines within months.  Protection provided by booster shots of the mRNA vaccines from Moderna Inc or Pfizer Inc /BioNTech SE starts waning quickly, according to data published in Morbidity and Mortality Weekly Report from the U.S. Centers for Disease Control and Prevention (CDC).

Researchers reported that within two months after the second dose of an mRNA vaccine during the surge in infections caused by the Delta variant, vaccine efficacy was 94% against hospitalization and 92% against emergency department (ED) or urgent care (UC).  Efficacy waned, but climbed to 96% and 97%, respectively, at two months after a booster shot.  Four months later, however, that protection had declined to 76% and 89%.  

Once Omicron became predominant, vaccine efficacy was 71% against hospitalization and 69% against ED/UC visits within two months after the second dose, 91% and 87% at two months after a booster, and 78% and 66% four months later.  The estimates are drawn from analyses of 241,204 COVID-related ED/UC visits and 93,408 hospitalizations between August and January.

"Our findings suggest that additional doses of vaccines may be necessary," said Brian Dixon of the Regenstrief Institute and Indiana University.   "We found that Hispanics or Blacks are half as likely to receive a third vaccine dose than white people, making them more vulnerable to severe COVID."

How to Protect Yourself?  Getting vaccinated is your best bet!

IT’S NOT OVER!

Stay safe.  Mask.  Social distance.  Frequent hand washing.  Avoid crowds

ALWAYS CONSULT YOUR PERSONAL HEALTH CARE PROFESSIONAL

• https://www.cnbc.com/2022/02/03/why-do-some-people-get-covid-while-others-dont.html
• https://news.yahoo.com/how-strong-is-your-immunity-against-omicron-151320307.html
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8469745/
• https://news.yahoo.com/rare-hyper-inflammatory-syndrome-reported-230014504.html