As we head into year three of the SARS-CoV-2 pandemic, attention is turning to this next year and beyond. The complexities of a transition from epidemic to endemic are addressed in several recent articles, which describe the interplay of factors that drive viral evolution and our efforts to control the virus.
Last year began with positive expectations. The pandemic was on the decline in Colorado and effective vaccines against SARS-CoV-2 were available after only a year, far more rapidly than anticipated. The new year starts with fear about the surge of the Omicron variant in progress, and its disrupting impact on our lives.
Only a month has passed since the World Health Organization named Omicron a variant of concern. We have learned that it is highly infectious, but there is mounting evidence that its virulence is less than Delta’s.
Since Omicron was first named a variant of concern (VOC) on November 26 by the World Health Organization, we have learned much about its alarming transmissibility and immune escape but only a little about its virulence.
In the face of widespread alarm about the consequences of the Omicron variant and the surge of Delta, the multi-pronged and multi-level attack on public health measures continues. Personal choice about vaccination has emerged as a “right” without consideration of responsibility to others.
Not surprisingly, Colorado has its first two cases of COVID-19 due to the Omicron variant. But some good news; after charting the epidemic’s upward course since September, the curve reflecting the number of hospitalized Coloradans is in decline.
The Thanksgiving holidays were already worrisome for the possibility of increased transmission as people traveled and gathered. The news of a new SARS-CoV-2 variant—Omicron—is now an additional concern.
Heading into the Thanksgiving holiday, Colorado’s epidemic curve has continued to rise. The origins of the COVID-19 pandemic remain obscure and controversial; last week, a paper in Science offered a forensic epidemiological analysis. Controversy will persist since definitive evidence will likely never be forthcoming.
Governor Polis is emphasizing use of monoclonal antibody therapy, which is effective in preventing hospitalization and death if administered early in the course of infection. Remarkably, in the face of an uncontrolled pandemic, challenges to fundamental public health measures continue including a measure to protect U.S. workers.
Colorado’s epidemic curve continued its inexorable surge last week. While COVID-19 hospitalizations are still far short of the 2020 peak, the threat to healthcare capacity is more severe because of utilization and strained staffing. How long will the surge continue and how high will the epidemic curve rise? These questions were addressed in the most recent modeling report.
Throughout the pandemic, the “North Star goal” has been to avoid exceeding hospital care capacity, whether for COVID-19 or all the other causes of hospitalization. Now, implementing crisis standards of care (CSC) is under consideration for Colorado.
If you were listening to the radio in 1962, you may remember that Neil Sedaka’s “Breaking Up Is Hard to Do” was omnipresent on the airways. This remembrance was prompted by the recent break-up of the Tri-County Health Department, which opened in 1948.
"Prediction is hard, especially about the future.” This quote, variably attributed to Yogi Berra (what quote isn’t?), physicist Niels Bohr, and a Danish cartoonist, fits well with the pandemic in Colorado at the moment.
The association between the rate of vaccination and mortality is clear; across the states, the mortality rate drops steeply and inversely with the vaccination rate. Put simply, our public health measures work and not using them causes avoidable hospitalizations and deaths; how many can be estimated, and inevitably someone will do so.
In many contexts, evidence and decision-making are paired with implicit acknowledgement that actions taken can be justified by what we know. Uncertainty about what is not known inevitably complicates decision-making, and the level of uncertainty needs to be understood in informing judgments about decisions.
The number of Coloradans hospitalized with COVID-19 has dropped and the latest modeling report shows that the effective reproductive number is also dropping. If the drop is sustained for a few more days, perhaps Colorado is on the verge of a decline in the fifth surge. Meanwhile, we await the FDA's decision on booster vaccinations after seemingly conflicting conclusions were released last week.
Modeling predicts a continued rise that could bring the peak to well above 1,000 hospitalized COVID-19 patients over the next few weeks. Fortunately, we are unlikely to overwhelm hospital capacity, but news reports speak to stressed healthcare systems and healthcare workers in Colorado.
Contrary to hope and expectation, COVID-19 is not in retreat, but resurgent, more than tripling the inpatient census of Coloradans with COVID-19 since July 1. And it’s been another bad week for the planet with extreme weather continuing. Reflecting this urgency, an editorial was published on Sept. 6 by 220 health and medicine journals.
Schools across the nation have started in-person, including the three campuses of the Colorado School of Public Health. Two recent posts in the CDC’s Morbidity and Mortality Weekly Report address the pandemic and the safety of K-12 students and staff.