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

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

2022 Timeline

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

December          100,751,994            1,092,674                            11,829,499                98,637

2023 Timeline

January              104,196,861            1,132,935                            11,964,001                99,944

February             105,345,992            1,146,142                            12,084,297              100,816

March                106,102,029             1,153,730                           12,155,825               101,798

April                    106,630,327            1,159,839                            12,221,606              102,390 

May                    107,085,763            1,164,967                             12,263,722             102,769         

The JHU stopped collecting data as of 10 March 2023.   In the U.S., only New York, Arkansas and Puerto Rico still publish case and death counts daily.  

UPDATED WEEKLY – Worldometer, Last updated on 28 May 2023

POPULATION - is 336,705,309 of 28 May 2023, 1:29 pm PST, based on Census U.S. and World Population Clock.

      * updated information

    ** no updated information at this reporting

Cases Worldwide

                              Worldometer       

• TOTAL CASES      -    689,402,313

Recovered       -    661,822,894

• TOTAL DEATHS    -        6,883,596

Cases in the U.S.

• TOTAL CASES       -   107,085,763

Recovered        -   105,158,714

• TOTAL DEATHS     -       1,164,967
  • Employment increased by 253,000 jobs in April
  • Unemployment dropped slightly to 3.4 % in April

Cases in California

• TOTAL CASES       -     12,263,722

Recovered        -    12,107,042

• TOTAL DEATHS     -         102,769

• Primary series     -  29,588,939      75     %
• Bivalent Booster -    7,463,290      25.7 %**

                     *  USA Facts as of 10 May, 2023

                     ** No updated information

05/21/2023 (WHO)           Cases                 Deaths      Recovered    Fully Vaccinated, % (USA Facts)**

• Texas                    -    8,600,393        94,424        8,491,612         18,406,327         64 %
• Florida                  -   7,577,402         88,288        7,484,604         14,971,549         70 %
• New York             -    7,023,538        77,640        6,940,879         15,763,340         81 %
• Illinois **                -   4,136,659         42,005       4,081,662           9,054,864         72 %       
• Pennsylvania       -   3,560,821         51,048       3,507,147           9,444,480         74 %
• N. Carolina**       -   3,501,404         29,059            N/A              7,018,862          67 %
• Ohio                     -  3,449,990          42,299       3,395,262          7,089,473           61 %
• Georgia               -  3,088,493          42,766       3,039,954          6,103,647           57 %  
• Tennessee**        -  2,540,984          29,534       2,510,364          3,852,924           56 %
• Arizona                -  2,478,214          33,502       2,435,296          4,821,350           66 %
• Alabama**         -  1,659,936           21,138       1,623,935          2,611,593          53 %
• Louisiana***        -  1,603,492          18,998       1,578,981           2,561,641          55 %
• W. Virginia          -     651,307            8,136           N/A                1,071,540           60 %          

 *   USA Facts as of 10 May, 2023

**  no updated information at this reporting

             ***  correction

United States progress **                                      11 May 2023, 1:17 pm PST

• Doses Distributed                                                  984,444,295
• Doses Administered                                             676,728,782
• 1st dose administered                                         270,227,181           81.4 %                    
• Primary series administered                                230,637,348           69.5  %
• Bivalent Booster**                                                  56,478,510           17      %          
• Total population                                                  336,705,309

   *Updated information

               ** No updated information at this reporting

• https://usafacts.org/visualizations/covid-vaccine-tracker-states/
• https://www.worldometers.info/coronavirus/country/us/
• https://covid.cdc.gov/covid-data-tracker/ - fullyVaccinatedhttps://covid.cdc.gov/covid-data-tracker/#vaccinations

COVID   UPDATE

VARIANT UPDATE

THEY’VE DONE IT AGAIN.  ANOTHER TRANSFORMER – “ARCTURUS!”  I’M WORE OUT!!

Everyone is kind of tired and has given up’ on COVID. But this new variant is ‘one to watch,’ the WHO says.  March 31, 2023·.  The World Health Organization has its eye on a new COVID variant driving a new surge of cases in India, a time when reported cases are down in much of the rest of the world.

XBB.1.16, dubbed “Arcturus,” is very similar to U.S. dominant “Kraken” XBB.1.5,  the most transmissible COVID variant yet, according to Maria Van Kerkhove, COVID-19 technical lead for the WHO. 

Additional mutations in the virus’s spike protein, which attaches to and infects human cells, has the potential to make the variant more infectious and cause more severe disease.  

XBB.1.16 is gaining steam in a country with hefty population immunity from  prior infection and immunity is concerning.  It’s not clear how big a surge the new variant may cause in India or elsewhere.   Large waves aren't the main pattern of COVID cases, it’s the consistently high baseline that won't come down.

Where else has XBB.1.16 been seen?  From reported sequences, the variant has also been spotted in the U.S., in California, New Jersey, Virginia, Texas, Washington, New York, Illinois, Minnesota, Georgia, Florida, Pennsylvania, Ohio, Nevada, Indiana, North Carolina, Louisiana, and Delaware.  A descendant variant, XBB.1.16.1, has also been seen in Nebraska, Missouri, and Michigan.

XBB.1.16 and its descendants have also been identified in Singapore, Australia, the United Kingdom, Japan, Israel, Canada, Malaysia, Denmark, New Zealand, Germany, South Korea, Spain, the Netherlands, Thailand, Sweden, South Africa, Italy, and China.

How many people have infections from this COVID variant?  April 28 projections announced by the CDC estimate that XBB.1.16 has inched up to 11.7% of virus circulating nationwide.  There were more than 88,000 reported cases nationwide over the past week, but CDC officials stated cases are being substantially undercounted because of at-home testing and states no longer regularly reporting data.

How did XBB.1.16 evolve?  The variant XBB.1.16 is a recombinant or combination, of two descendants of “stealth Omicron” BA.2.   XBB, has three additional mutations, according to the WHO and it's picking up additional mutations, Raj Rajnarayanan, assistant dean of research and associate professor at the New York Institute of Technology campus in Jonesboro, Ark., and a top COVID variant tracker. 

So why is XBB.1.16 so concerning?  XBB.1.16 has two new mutations that “makes it fitter than any variant so far,” Rajnarayanan indicated.  Those two mutations don’t exist on relative XBB.1.5.

Particularly concerning is mutation K478R, which may make the variant better at overcoming antibodies from prior infection and vaccination, making people sicker and spreading. 

XBB.1.16 has shown an ability to quickly outpace U.S. dominant XBB.1.5 when it comes to spread, showing a 188% growth advantage in past three months.  XBB.1.16 could be on track to outcompete another variant called XBB.1.9, which makes up 12.7% of circulating virus across the U.S.

Does the "Arcturus" COVID variant cause pink eye?  Here's what scientists and health officials say about the new strain.  APRIL 28, 2023.  Health authorities around the globe, including at the World Health Organization, have downplayed claims that XBB.1.16 is causing new or worse symptoms compared with other Omicron variant strains.  Some have pointed to "pink eye" or conjunctivitis, as a potential new symptom caused by XBB.1.16.  April 18, WHO officials described it as a "known symptom that already is part of COVID." 

Doctors have reported conjunctivitis sometimes showing up as the only symptom of COVID-19 in patients as early as 2020. It can also appear before other more typical symptoms.

VACCINE UPDATE

Nasal vaccines promise to stop the COVID-19 virus before it gets to the lungs – an immunologist explains how they work.  Sat, April 1, 2023 at 7:04 AM PDT.  The Pfizer-BioNTech and Moderna mRNA vaccines have played a large role in preventing deaths and severe infections from COVID-19.  Researchers are still developing alternative approaches to vaccines to improve their effectiveness, including how they’re administered. Immunologist and, Michael W. Russell, microbiologist of the University at Buffalo explains how nasal vaccines work and where they are in the development pipeline.

How does the immune system fight pathogens?  The immune system has two distinct components: mucosal and circulatory.

• The mucosal immune system provides protection at the mucosal surfaces of the body which include:  the mouth, eyes, middle ear, the mammary and other glands, the gastrointestinal, respiratory and urogenital tracts.  Antibodies and a variety of anti-microbial proteins in the secretions that cover these surfaces, as well as immune cells in the lining of the surfaces, directly attack invading pathogens.

• The circulatory part of the immune system generates antibodies and immune cells that are delivered through the bloodstream to the internal tissues and organs. These circulating antibodies do not usually reach the mucosal surfaces in large enough amounts to be effective. The mucosal and circulatory compartments of the immune system are largely separate and independent.

What are the key players in mucosal immunity?  The immune components are proteins known as antibodies or immunoglobulins.  The immune system generates antibodies in response to invading agents that the body identifies as “non-self,” such as viruses and bacteria.  Antibodies bind to specific antigens to allow antibodies to either inactivate them, as with toxins and viruses or kill bacteria with the help of additional immune proteins or cells.

The mucosal immune system generates a specialized antibody called secretory IgA or SIgA, located in mucosal secretions, such as saliva, tears, nasal and intestinal secretion and breast milk, is resistant to digestive enzymes that readily destroy other forms of antibodies.  It is also superior to most other immunoglobulins at neutralizing viruses and toxins and preventing bacteria from attaching to and invading the cells lining the surfaces of organs.

How does the COVID-19 virus enter the body?  Most infectious diseases in people and animals are acquired through mucosal surfaces, such eating or drinking, breathing or sexual contact.  Major exceptions include infections from wounds, or pathogens delivered by insect or tick bites.

COVID-19, SARS-CoV-2, enters the body via droplets or aerosols that get into your nose, mouth or eyes and can cause severe disease if it descends deep into the lungs causing an overactive, inflammatory immune response.

How do nasal vaccines work?  Vaccines can be given through mucosal routes - the mouth or nose. There are several existing mucosal vaccines, most taken by mouth.  Only the flu vaccine is currently delivered nasally.

Antigens in the vaccine induce B cells in mucosal sites to mature into plasma cells that secrete a form of IgA, then transported into mucosal secretions throughout the body, where it becomes SIgA.  If SIgA antibodies in the nose, mouth or throat target SARS-CoV-2, they neutralize the virus before it drops into the lungs and establish an infection.

What advantage do mucosal vaccines have against COVID-19?  Breaking chains of viral transmission is crucial to controlling epidemics. Researchers know that COVID-19 spreads during normal breathing and speech, and exacerbated by sneezing, coughing, shouting, singing and other forms of exertion.  These emissions originate from saliva and nasal secretions, where the predominant antibody is SIgA. 

Existing vaccines do not induce SIgA antibody responses.  Injected vaccines induce circulating IgG antibodies, effective in preventing serious disease in the lungs.  Nasal vaccines induce SIgA antibodies, where the virus is initially acquired in nasal and salivary secretions and can more effectively prevent transmission.

How close are researchers to creating a nasal COVID-19 vaccine?  There have been over 100 oral or nasal COVID-19 vaccines in development around the world.  Most are currently being tested in animal models, however, few have been successfully tested in people.  According to the World Health Organization, 14 nasal COVID-19 vaccines are in clinical trials as of late 2022.

What the research shows about risks of myocarditis from COVID vaccines versus risks of heart damage from COVID – two pediatric cardiologists explain how to parse the data.  March 13, 2023.  ·After the first COVID-19 vaccines appeared in 2021, reports of rare cases of heart inflammation or myocarditis, began to surface.  Most cases, the myocarditis has been mild and responded well to treatment, although four potentially mRNA vaccine-related deaths in adults have been reported worldwide.  No known verified deaths of children have been reported based on available data.  

Studies confirmed that myocarditis risk is significantly higher after an actual COVID-19 infection and the prognosis following myocarditis due to the vaccine is better than from infection.  The specific myocarditis risk varies by age.   

Myocarditis explained.  Myocarditis is a condition that causes heart inflammation.  Pericarditis is inflammation of the outside lining of the heart.  Myocarditis is confirmed by an electrocardiogram, an echocardiogram [ultrasound heart picture] and blood tests.  When available, an MRI [cardiac magnetic resonance imaging] is the most accurate method to diagnose myocarditis. 

.

Myocarditis risk by age and gender.  A survey of all current research reveals the risk of myocarditis after COVID-19 vaccination is highest in young men between ages 18 and 39 and older teen boys between ages 12 to 17.  The highest risk is after the second dose of vaccine.  The cause appears related to how the immune system processes mRNA and sometimes generates an excessive immune response.

Myocarditis risks related to COVID-19 immunizations is lower in children younger than 12 years of age and much lower in adult males older than 50.  The risk of severe disease from COVID-19, in those older than 50 years, has been far higher throughout the pandemic than the risk of myocarditis from COVID-19 vaccination.  The risk of vaccination myocarditis is uniformly lower in girls than in boys.

Infants younger than 6 months can get immunity only from their mother’s antibodies unless they are exposed to COVID-19, as vaccines for this age group are not available.

How to parse the risks.  The risks of myocarditis have been highest in teen boys and young men, but the discussion doesn’t take into account the clot and heart attack risks from COVID-19 itself.  COVID-19 damages blood vessels in all parts of the body.  Organ damage such as kidney failure, blood clots, heart attacks and strokes can occur.

Fewer children than adults die from COVID-19 or it is milder in children.  The primary risk that COVID-19 presents now to children is long COVID, followed by the risk of severe disease. The estimated percentage of children acquiring long COVID is still being debated, but the symptoms from long COVID can be extraordinarily debilitating. These include severe fatigue, brain fog, sleep disturbance, dizziness, nerve pain and more.

Weighing the decision to vaccinate.  The decision to vaccinate against COVID-19 should be based upon the patient’s age, other health problems, relative risk from vaccines, how much and what type of COVID-19 is in your community and the patient’s and/or family’s preference.

The CDC and the Public Health Agency of Canada have suggested two options to decrease the risk of COVID-19 vaccine myocarditis. 

• Opt for the Pfizer vaccine - Pfizer has slightly lower rates of myocarditis than Moderna
• Space your doses out by at least eight weeks.

Adults who are immunocompromised or have other medical problems known to worsen COVID-19 disease severity, still carry the highest risk of severe disease and should follow the CDC’s COVID-19 vaccination schedule with additional boosters, if advised by their physician.

Thankfully, kids have fared better from COVID-19 than adults. The primary risks for children are among babies, infants, children with health problems that put them at high risk, children with the most significant types of congenital heart disease or those with other medically complex conditions.

The risk of immunization will never be zero because of variability in immune system responses

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://news.yahoo.com/nasal-vaccines-promise-stop-covid-131447644.html
• https://news.yahoo.com/research-shows-risks-myocarditis-covid-122811623.html
• https://finance.yahoo.com/news/everyone-kind-tired-given-covid-210004214.html
• https://www.cbsnews.com/news/arcturus-covid-pink-eye-new-variant-symptoms-xbb116/