Internet Explorer 11 is not supported

For optimal browsing, we recommend Chrome, Firefox or Safari browsers.

Long COVID May Cost U.S. $3.7T; California Considers Masks

As many expect another winter surge for COVID-19, cities across California are updating their policies and response to the virus. Meanwhile, former President Clinton tests positive, Paxlovid is safe for pregnancies and other updates.

(TNS) — As signs grow of the expected winter COVID-19 surge, health experts in the Bay Area offer new advice on how to protect yourself and others, including whether it's time to put back on masks when you're out in public. Former President Bill Clinton has tested positive for the coronavirus and says he's experiencing mild symptoms and working at home. New research suggests emerging subvariants in the BQ and XBB family show "alarming antibody evasion." And a San Jose church that defied pandemic orders to halt in-person services won't have a pay a penalty after the California Supreme Court followed a U.S. Supreme Court ruling.

L.A. County poised to bring back indoor mask mandate as cases rise 180 percent

Los Angeles County officials on Thursday said they will bring back an indoor mask mandate if COVID-19 community levels rise to the "high" category, which could happen as early as next week but more likely by the end of the month. During a public briefing, the county's Health Director, Barbara Ferrer, said that during the past week an average of 2,700 cases were reported per day — an 85 percent increase over the 1,500 daily cases reported in the prior week and a 180 percent increase since Nov. 1. Daily hospital admissions have increased 200 percent since the beginning of the month with 192 per day, she added. The numbers are "significantly higher than what we saw this time last year," she said. "There is this common line of thinking that the pandemic is over and COVID is no longer of concern. But these numbers clearly demonstrate that COVID is still with us," Ferrer said.

Los Angeles County currently falls under the "medium" community tier, according to metrics from the U.S. Centers for Disease Control and Prevention. But at the current pace of rising cases, it could soon meet the criteria for "high" transmission. "If both hospital indicators — the new COVID-19 admissions and the proportion of staffed in-patient beds occupied by COVID patients — surpasses the threshold for 'high,' and our case rate is at or above 200 new cases per 100,000 people, L.A. County will follow the CDC guidance for communities designated at the 'high' community level, including universal indoor masking."

She clarified later in the briefing that she did not expect the county to meet both those metrics next week but more likely around Christmastime. "I anticipate that it could get there later in the month of December but I don't think it'll be there next week," she said. "I'd be very surprised. it would mean that hospitalizations are really going up very, very quickly — much more quickly than we usually see."

What will the latest surge in cases and hospitalizations mean this time?

California is seeing a sustained rise in coronavirus cases and hospitalizations, with numbers climbing at the same alarming rate that the state experienced ahead of previous COVID-19 surges. Nearly a year to the day the first case of the omicron variant in the United States was identified in a San Francisco resident, the daily number of newly reported cases in the state has climbed to 5,466, up 157 percent from a month earlier. More worrisome, new hospital admissions of patients with confirmed COVID are at 3,793, up 133 percent over the same period, according to health department data published Thursday. Bay Area public health experts say they can't predict how bad things will get, given the high level of overall immunity in the population from vaccination or prior infection. Read more about the new winter surge and how it could affect us during the holidays and beyond.

U.S. men's soccer team promotes updated COVID vaccines

With World Cup fever in full swing, the Department of Health and Human Services has partnered with the U.S. national men's soccer team to promote the bivalent COVID-19 boosters, which only 12 percent of Americans have received. Starting Thursday, the team will post messages on its social media channels encouraging people to get the updated shots, Axios reports. The debut clip features defender Walker Zimmerman telling the team's fans that the vaccine will protect them from "COVID's worst possible outcome." HHS Secretary Xavier Becerra said in a statement, "Our message is simple: Don't wait. Get the updated COVID-19 vaccine this fall. It's safe and effective."

Pandemic accelerated aging in teenagers' brains, Stanford study finds

Teenagers' brains showed physical signs of accelerated aging after experiencing pandemic-related lockdowns and other stresses, a new Stanford University study found. Researchers compared MRI brain scans of two groups of teens from the Bay Area, about 16 years old on average, before and after COVID-19 shutdowns. Brains of teens amid the pandemic showed physical features "more typical of individuals who are older or who experienced significant adversity in childhood," according to the study published in Biological Psychiatry: Global Open Science. Those teens "not only had more severe internalizing mental health problems, but also had reduced cortical thickness, larger hippocampal and amygdala volume, and more advanced brain age," lead author Ian Gotlib, a Stanford professor of psychology, said in a news release.

Gotlib added it is "not clear" if those changes are permanent or linked to changes in mental health. Study authors noted that the pandemic "appears to have been particularly difficult" on the mental health of children and adolescents who experienced school closures, social restrictions and other disruptions. They noted the Stanford study involved teens of high socioeconomic status from the Bay Area and that research has shown "more severe" psychosocial and health consequences of the pandemic among people in socially marginalized groups.

Long COVID may cost the U.S. economy $3.7 trillion

About 23 million Americans are living with long COVID, which could cost the U.S. economy trillions of dollars, according to estimates by the U.S. Centers for Disease Control and Prevention analyzed by CNBC. Up to 30 percent of Americans who have gotten COVID-19 have developed long-haul symptoms, according to the U.S. Department of Health and Human Services. The aggregate cost could be $3.7 trillion, based on a report released earlier this year by Harvard University economist David Cutler that highlighted medical expenses, lost earnings and the cost of insurance benefits. "Long COVID will be around long after the pandemic subsides, impacting our communities, our health-care system, our economy and the well-being of future generations," a November HHS report said. "We can reduce the severity and breadth of that impact, however, if we act collectively and urgently."

S.F. test-positive rate tops 8 percent for first time since summer

San Francisco's seven-day rolling test-positivity rate, which tracks the percentage of lab test results that are positive for COVID-19, has topped 8 percent for the first time since August, when the city was coming out of the summer BA.5 surge. The rate fell to a low of 4.5 percent in October following the wave but has sharply increased since then, according to city data that forecasts the rate hitting the double-digits in the next few days. The average number of new daily COVID-19 cases in the city is also ticking up, jumping from 67 to 141 in the same period — a 110 percent increase. There were 90 patients hospitalized with confirmed COVID-19 in San Francisco as of Nov. 30, nearly twice the 46 reported a month ago.

Hospitalizations growing nationwide post- Thanksgiving holiday

New admissions of patients with confirmed COVID-19 in the U.S. have increased substantially since the Thanksgiving weekend, with a 20 percent jump among older adults compared to the week prior, according to numbers updated overnight by the U.S. Centers for Disease Control and Prevention. The overall seven-day average of new daily admissions for all age groups is 4,126, up from the prior average of 3,503. The agency's national ensemble predicts that the number of new daily confirmed COVID-19 hospital admissions will likely increase, with 1,600 to 11,000 additional patients likely to be reported on Dec. 23. California is likely to see up to 1,000 new admissions in that time, based on state-level forecasts.

BQ and XBB subvariants have "alarming antibody evasion" properties, study finds

The emerging coronavirus omicron BQ and XBB subvariants, which are rapidly expanding in the U.S., have additional spike mutations that may give them altered antibody evasion properties, according to a preprint study by researchers at Columbia University. The authors found that neutralization of BQ.1, BQ.1.1, XBB, and XBB.1 by sera from vaccines and infected persons was markedly impaired, including sera from individuals who received the updated bivalent booster shot. Compared to the ancestral strain of the virus, they found that the new subvariants were "barely susceptible to neutralization" by sera from vaccinated individuals with or without prior infection. Treatment options were also impacted.

"A panel of monoclonal antibodies capable of neutralizing the original omicron variant, including those with emergency use authorization, were largely inactive against these new subvariants," they wrote, adding that the spike mutations that conferred antibody resistance were individually studied and structurally explained. They said that the new strains have "alarming antibody evasion" properties: "Taken together, our findings indicate that BQ and XBB subvariants present serious threats to the efficacy of current COVID-19 vaccines, render inactive all authorized monoclonal antibodies, and may have gained dominance in the population because of their advantage in evading antibodies."

FDA pulls authorization for last remaining monoclonal antibody treatment

The U.S. Food and Drug Administration said on Wednesday that it has pulled its emergency authorization for bebtelovimab from Eli Lilly, which was the last remaining COVID-19 antibody therapy in use, because newer BQ and XBB subvariants of the coronavirus have rendered it ineffective. "Given that a COVID-19 infection is likely to be caused by a non-susceptible SARS-CoV-2 variant, and consistent with the terms and conditions of the Letter of Authorization, bebtelovimab is not currently authorized for emergency use in any U.S. region at this time," the FDA said in a statement. It added that Eli Lilly has paused commercial distribution of the drug until further notice. The agency recommended that remaining supplies of bebtelovimab be held in case another variant that is more susceptible to the treatment becomes prevalent in the future. Eli Lilly confirmed it has complied with the order and is working on new potential treatments. " Lilly will continue to search and evaluate monoclonal antibodies to identify potential candidates for clinical development against new variants," the company said in a statement.

What Bay Area health experts say about masking amid rising COVID cases

Some people may be wondering how to navigate a period in the pandemic where precautions are largely up to the individual. As the holidays arrive and COVID numbers show signs of climbing again — albeit not so far to previous surge levels — what are currently the best practices to stay healthy? How much safety is needed? We spoke to Bay Area public health experts for their perspectives on masking and other precautions heading into the holidays, and the verdict was to be as careful as you need to be, for yourself and the people around you. Read more about the latest advice on whether to don a mask again when you go shopping and how to prepare for big family gatherings during the festive season.

Hospital entry screenings have little benefit, Yale study suggests

Hospital entrance screenings, such as asking about symptoms or taking the temperature of people entering the facility, offer limited benefits in controlling the spread of COVID-19 infection, according to a study conducted at Yale New Haven Hospital in Connecticut. Of the 951,033 screenings performed at the academic medical center between March 2020 and May 2021 only about 0.07 percent identified people who had a fever, shows the report published in JAMA Internal Medicine. The facility employed 30 full-time equivalent staff members to maintain its 24-hour screening program, which equated to about $1.3 million in total annual compensation. The measures — required by the U.S. Department of Labor — rely on self-reported factors such as symptoms or exposure history and are intended to reduce risk to patients and health care workers, two physicians from UCSF and NYC Health wrote in an editor's note accompanying the study. "Surveillance screening is expensive for healthcare systems and a daily annoyance for those who work there," they said. "The authors suggest that screening may have maximum utility during the early phase of a public health crisis. Nonetheless, self-reported symptoms have a low sensitivity for true infection with COVID-19, so it remains unclear the degree to which screening measures are truly effective in reducing the spread of COVID-19."

San Jose church that defied COVID orders won't have to pay state fines

Bowing to U.S. Supreme Court rulings allowing religious institutions to hold worship services during the COVID-19 pandemic, the California Supreme Court refused Wednesday to reinstate $190,000 in fines against a San Jose church and its pastors for defying state and county limits on indoor public gatherings. Calvary Chapel San Jose and its pastors, Mike McClure and Carson Atherley, were found in contempt of court by a Santa Clara County judge in December 2020 and in February 2021 for violating state and local orders to restrict attendance at indoor services. The restrictions were aimed at limiting respiratory transmission of the deadly coronavirus. Read more about a series of court cases that pitted public health policy against freedom of religion.

Paxlovid safe for pregnant patients and fetuses, study finds

Pregnant women who used Paxlovid tolerated the antiviral medication well and without evidence of an increase in complications affecting them or their fetuses, according to a new study by researchers at Johns Hopkins. In the report published Tuesday in JAMA Network Open, the researchers selected participants from 3,442 pregnant women with mild or moderate COVID-19 infections who were seen within the Johns Hopkins Health Systems between March 15, 2020, and Aug. 20, 2022. From this group, 47 people who met the study criteria were given the combination of drugs nirmatrelvir and ritonavir, which make up Paxlovid, and 96 percent of the participants completed the course of therapy, tolerating it well. Of these, 25 of the participants delivered babies following the treatment, with 12 of the deliveries done by cesarean section. Of those, 9 were scheduled and not related to the Paxlovid treatment. Two participants were hospitalized for pre-existing conditions and not severe COVID. "Based on our results, we feel that the benefit to both the mother and the developing fetus of preventing severe COVID outweighs any potential risks from Paxlovid therapy," said study lead author William Garneau, assistant professor of medicine at the Johns Hopkins University School of Medicine, in a press release accompanying the study.

President Clinton experiencing mild symptoms after testing positive

Former President Bill Clinton said Wednesday that he is experiencing mild symptoms after he tested positive for COVID-19. "I'm grateful to be vaccinated and boosted, which has kept my case mild, and I urge everyone to do the same, especially as we move into the winter months," Clinton said in a tweet. The 42nd president, 76, added, "I'm doing fine overall and keeping myself busy at home."

(c)2022 the San Francisco Chronicle. Distributed by Tribune Content Agency, LLC.
Special Projects