and a population that skews young…
And that would be my state, too. Add to that people testing with at-home tests (results not reported anywhere) or not testing at all, and there is a false sense of security that “all is well here.”
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The new monoclonal antibodies which will be effective against omicron may be available next week.
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I am guessing that hospitals which currently restrict access to unvaccinated & over 65 patients will do so with the antibodies that target Omicron?
Sorry, not sure what you mean. Hospitals that restrict care/don’t treat unvaccinated?
I cannot locate the article where I first read about this, but here is the basic story. Yale is also expanding their ER into the parking drop-off loop outside the Children’s Hospital, but the need is not due entirely to CV, but to longer stays for non-CV patients who delayed treatment during CV and are now presenting as more complex cases.
I also read that St. Francis, a heart hospital on Long Island, is using criteria similar to Yale, but I do not have a source for that. IIRC, Yale’s policy change will apply to all five hospitals within its network.
“Starting the week after Thanksgiving, the demand for the monoclonal [antibodies] started to far exceed our capacity to deliver it, so we needed to move to a more restrictive criteria,” said LeeAnn Miller, Yale New Haven’s chief pharmacy officer. “If you are fully vaccinated, you’re not going to be prioritized as high as those who are not fully vaccinated.”
Under Yale New Haven’s new criteria, vaccinated people 65 and older who have not received a booster shot may still receive monoclonal antibodies, along with other vaccinated people who have severely weakened immune systems. Unvaccinated people, on the other hand, may receive monoclonal antibodies as long as they are 65 or older or have any of a long list of underlying conditions, including obesity, diabetes, cardiovascular disease and more.
It’s basic triage. They’re dedicating limited resources to those likely to have positive outcomes.
I understand, but this policy represents a change. Prior to last week, fully-vaccinated patients were also eligible to receive treatment, and now they aren’t.
That’s a squishy definition.
Obviously Yale feels boosted patients stand a better chance.
Yes, hospitals in the south were triaging people similarly in late summer/early fall when they were going through the Delta surge. Using a point-based system, people would get points for age, vaccination status, etc.
The point is to try to keep people out of the hospital, to try to preserve precious hospital resources/staffing. Who is more likely to be admitted, a vaccinated or an unvaccinated person? Unvaccinated. So they get more points and all other things being equal will get MAb before a vaccinated person. IF MAb are in short supply. We won’t know that for a while, or how many people would even need MAb. Hopefully disease severity is not that bad. Pfizer also has a pill, not FDA approved yet, that will hopefully be available soon.
I’m trying to pack for an early morning departure so please forgive me but I heard something very briefly in the talk below, presenter about halfway through wearing a headset, was there some suggestion that this variant behaves like the common cold type of coronavirus (not SARS-CoV-2)? Sorry, didn’t have the time to listen.
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They looked at sera from those with previous infection and those with Px2, Mx2, Jx1, Ax2 vaccines, as well as boosted Px3 and Mx3 vaccines. All had large drops in antibody neutralization for Omicron versus B.1 (with just the D614G mutation). Moderna held up the least worst, probably due to its large dose of mRNA which stimulated the highest number of antibodies to begin with.
Note that this is only an antibody study. Remember that antibodies are not the full picture of immune response, so those previously vaccinated or infected may have some protection (e.g. from CD4+ helper and CD8+ killer T-cells that recognize parts of the spike protein) despite lack of antibody protection, which could be the reason for reports of relatively mild infections in vaccinated people or populations with high rates of previous infection. But it means that people vaccinated with current vaccines and/or depending on immunity from previous infection are likely depending on the non-antibody parts of the immune response.
Unfortunately, Omicron is not mild enough to be like a common cold, since it is still putting some people in the hospital. And, even with a lower percentage of those infected having to go to the hospital, rapid spread could still overwhelm hospital capacity.
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Perhaps you mean like the theory that the OC43 human coronavirus that now causes some common colds came from the 1889 “flu” pandemic?
However, Omicron is still putting some people in the hospital, so it is not as mild as OC43 or other common cold viruses.
EDIT: perhaps you mean the talk from 52:17 to 53:37 in the video?
Regarding the video at CDC/IDSA COVID-19 Clinician Call: Omicron Update Plus the Latest on Molnupiravir , at about 30:00 there is an interesting bit about how vaccination both before and after a COVID-19 infection appears to reduce the risk of “long COVID”. It references Reduced Incidence of Long-COVID Symptoms Related to Administration of COVID-19 Vaccines Both Before COVID-19 Diagnosis and Up to 12 Weeks After .
Basically, it found that those who got breakthrough infections after vaccination had a 4.5 times lower risk of “long COVID”, but also that those who got vaccinated after getting infected had a 1.3 to 2.6 times lower risk of “long COVID”, depending on how long after infection they got vaccinated (odds relative to those who got infected and never got vaccinated before or after).
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HKU researcher finds that Omicron replicates faster in the bronchus, but slower in the lung.
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I will not be microchipped. That is taking this a bit too far.
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Just received word from our hospital:
As we communicated last Thursday, data is showing sotrovimab to currently be the only monoclonal antibody treatment effective against the omicron variant. We anticipate receiving a very limited allocation, so we will begin with the following prioritization criteria to ensure that those at highest risk are able to receive it.
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Patients who have immunosuppressive disease or on immunosuppressive treatment:
- Patients on active treatment for solid tumor and hematologic malignancies
- Receipt of solid-organ transplant and taking immunosuppressive therapy
- Receipt of CAR-T-cell or hematopoietic stem cell transplant (within two years of transplantation or taking immunosuppression therapy)
- Moderate or severe primary immunodeficiency (e.g., DiGeorge, Wiskott-Aldrich syndromes)
- Advanced or untreated HIV infection
- Active treatment with high-dose corticosteroids (i.e., ≥20mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, TNF blockers, and other biologic agents that are immunosuppressive or immunomodulatory.
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Persons 65 years of age or older with at least one coexisting medical condition that confers a higher risk of progression to severe COVID-19.
- Obesity (BMI >25 kg/m2)
- Pregnancy
- Chronic kidney disease
- Diabetes
- Cardiovascular disease or hypertension
- Chronic lung diseases (e.g. COPD, asthma, interstitial lung disease, cystic fibrosis and pulmonary hypertension)
- Sickle cell disease
- Neurodevelopmental disorders (e.g. cerebral palsy) or other conditions that confer medical complexity (e.g. genetic syndromes and severe congenital anomalies)
- Having a medical-related technological dependence (e.g. tracheostomy, gastrostomy, or positive pressure ventilation not related to COVID-19)
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Just wondering how many women over 65 do you see that are pregnant? 
Thanks for your posts. They are very informative and helpful to me
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Good pick up!
And thanks.
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There appear to be very few incidents of that, apparently all through IVF.
There might be some grandmas surrogating for their kids. 
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