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Monday, January 3, 2022

Florida surgeon general blasts 'testing psychology' around COVID-19

 Florida Surgeon General Joseph Ladapo said on Monday it was time to "unwind" the "testing psychology" many Americans have developed throughout the pandemic, as COVID-19 cases surge in his state. 

"We are going to be working to unwind the sort of testing psychology that our federal leadership has managed to, unfortunately, get most of the country in over the last two years," Ladapo said at a news conference Monday. 

He added that people were planning and living their lives around testing but said it was "really time for people to be living, to make the decisions they want regarding vaccination, to enjoy the fact that many people have natural immunity."

Lapado's comments come as COVID-19 cases are surging in Florida and around the country. 

The Florida Department of Health reported 298,455 new cases with a positivity rate of 26.5 percent for the week of Dec. 24 through Dec. 30, compared to 128,186 cases the week of Dec. 17 and 29,514 cases the week of Dec. 10.

Gov. Ron DeSantis (R) acknowledged at Monday's press conference that Florida was struggling with testing shortages as people flood the state's testing sites but said the federal government has “total control” over testing supplies, according to WFLA.

DeSantis added that Ladapo would be releasing new testing guidance focused on testing “if you have a reason,” per WFLA. 

Lapado cited an example of prioritizing an elderly grandmother over a third grader and said the focus would be on testing that could "likely change outcomes," according to WTSP.  

Ashish Jha, dean of Brown University's School of Public Health, said in a tweet that the surgeon general's comments were "completely backwards."

"Florida Surgeon General says we need to stop testing and get back to our lives," Jha said. "In fact, with ubiquitous testing, we can keep infections low and safely get back to our lives."

In 2020, then-President Trump also suggested that less testing would be beneficial for the pandemic. 

"If we stop testing right now, we’d have very few cases, if any," Trump said during a White House event about the administration's actions to help senior citizens.

Republicans have recently upped the pressure on President Biden over testing shortages, with people struggling to buy at-home tests or schedule appointments for tests amid the omicron surge. 

Two top Republican senators on Monday called on the Biden administration to provide answers about how it has spent billions of dollars in testing funds for COVID-19 amid shortages in such tests across the country.

https://thehill.com/policy/healthcare/588075-florida-surgeon-general-blasts-testing-psychology-around-covid-19

How COVID-19 transformed genomics and changed handling of disease outbreaks

 If the pandemic had happened ten years ago, what would it have looked like? Doubtless there would have been many differences, but probably the most striking would have been the relative lack of genomic sequencing. This is where the entire genetic code—or "genome"—of the coronavirus in a testing sample is quickly read and analyzed.

At the beginning of the pandemic, sequencing informed researchers that they were dealing with a virus that hadn't been seen before. The quick deciphering of the virus's  also allowed for vaccines to be developed straight away, and partly explains why they were available in record time.

Since then, scientists have repeatedly sequenced the virus as it circulates. This allows them to monitor changes and detect variants as they emerge.

Sequencing itself is not new—what's different today is the amount taking place. Genomes of variants are being tested around the world at an unprecedented rate, making COVID-19 one of the most highly tested outbreaks ever.

With this information we can then track how specific forms of the virus are spreading locally, nationally and internationally. It makes COVID-19 the first outbreak to be tracked in near real-time on a global scale.

This helps with controlling the virus. For example, together with PCR testing, sequencing helped reveal the emergence of the alpha variant in winter 2020. It also showed that alpha was rapidly becoming more prevalent and confirmed why, revealing that it had significant mutations associated with increased transmission. This helped inform decisions to tighten restrictions.

Sequencing has done the same for omicron, identifying its concerning mutations and confirming how quickly it's spreading. This underlined the need for the UK to turbocharge its booster program.

The road to mass sequencing

The importance of genomic sequencing is undeniable. But how does it work—and how has it become so common?

Well, just like people, each copy of the coronavirus has its own genome, which is around 30,000 characters long. As the virus reproduces, its genome can mutate slightly due to errors made when copying it. Over time these mutations add up, and they distinguish one variant of the virus from another. The genome of a variant of concern could contain anywhere from five to 30 mutations.

The virus's genome is made from RNA, and each of its 30,000 characters is one of four , represented by the letters A, G, C and U. Sequencing is the process of identifying their unique order. Various technologies can be used for this, but a particularly important one in getting us to where we are is nanopore sequencing. Ten years ago this technology wasn't available as it is today. Here's how it works.

First the RNA is converted to DNA. Then, like a long thread of cotton being pulled through a pinhole in a sheet of fabric, the DNA is pulled through a pore in a membrane. This nanopore is a million times smaller than a pin head. As each building block of DNA passes through the nanopore, it gives off a unique signal. A sensor detects the signal changes, and a computer program decrypts this to reveal the sequence.

Amazingly, the flagship machine for doing nanopore sequencing—the MinION, released by Oxford Nanopore Technologies (ONT) in 2014—is only the size of a stapler; other sequencing techniques (such as those developed by Illumina and Pacific BioSciences) generally require bulky equipment and a well-stocked lab. The MinION is therefore incredibly portable, allowing for sequencing to happen on the ground during a disease outbreak.

This first happened during the 2013–16 Ebola outbreak and then during the Zika epidemic of 2015–16. Pop-up labs were set up in areas lacking scientific infrastructure, enabling scientists to identify where each outbreak originated.

This experience laid the foundation for sequencing the coronavirus today. The methods honed during this time, in particular by a genomics research group called the Artic Network, have proved invaluable. They were quickly adapted for COVID-19 to become the basis on which millions of coronavirus genomes have been sequenced across the globe since 2020. Nanopore sequencing of Zika and Ebola gave us the methods to do sequencing at a never-before-seen scale today.

That said, without the much larger capacity of the benchtop machines from Illumina, Pacific Biosciences and ONT, we wouldn't be able to capitalize on the knowledge gained through nanopore sequencing. Only with these other technologies is it possible to do sequencing at the current volume.

What next for sequencing?

With COVID-19, researchers were able to monitor the outbreak only once it had started. But the creation of rapid testing and screening programs for other new diseases, as well as the infrastructure to conduct widespread sequencing, has now begun. These will provide an early warning system to prevent the next pandemic taking us by surprise.

For instance, in the future, surveillance programs may be put in place to monitor wastewater to identify disease-causing microbes (known as pathogens) present in the population. Sequencing will allow researchers to identify new pathogens, allowing an early start on understanding and tracking the next outbreak before it gets out of hand.

Genome sequencing also has a role to play in the future of healthcare and medicine. It has the potential to diagnose rare genetic disorders, inform personalized medicine, and monitor the ever-increasing threat of drug resistance.

Five to ten years ago, scientists were only just beginning to trial sequencing technology on smaller viral outbreaks. The effects of the past two years have resulted in a huge increase in the use of sequencing to track the spread of disease. This was made possible by technology, skills and infrastructure that have developed over time.

COVID-19 has caused untold damage worldwide and affected the lives of millions, and we're yet to see its full impact. But recent advances—particularly in the field of sequencing—have no doubt improved the situation beyond where we'd otherwise be.

https://medicalxpress.com/news/2022-01-covid-genomics-disease-outbreaks.html

Severe illness, viral coinfection common in children with COVID-19 hospitalization

 Many pediatric patients with COVID-19-related hospitalization have severe illness, according to research published in the Dec. 31 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Valentine Wanga, Ph.D., from the CDC COVID-19 Response Team, and colleagues reviewed medical record data for patients younger than 18 years with COVID-19-related hospitalizations during July to August 2021. Of the 915 patients identified, 713 were hospitalized for COVID-19, 177 had an incidental positive severe acute respiratory syndrome coronavirus 2 test result (unrelated to hospitalization), and 25 had multisystem inflammatory syndrome in children.

The researchers found that of the 713 patients hospitalized for COVID-19, 24.7, 17.1, 20.1, and 38.1 percent were aged younger than 1, 1 to 4, 5 to 11, and 12 to 17 years, respectively. About two-thirds (67.5 percent) had one or more underlying medical condition, most commonly obesity (32.4 percent); 61.4 percent of those ages 12 to 17 years had obesity. Overall, 15.8 percent of patients hospitalized for COVID-19 had a viral coinfection (66.4 percent had respiratory syncytial virus infection). Only one of the 272 vaccine-eligible patients hospitalized with COVID-19 was fully vaccinated (0.4 percent). Of the patients hospitalized for COVID-19, 54.0, 29.5, and 1.5 percent received oxygen support, were admitted to the , and died, respectively. Of those requiring respiratory support, 14.5 percent needed invasive mechanical ventilation.

"These data highlight the importance of COVID-19 vaccination for those aged ≥5 years and other prevention strategies to protect children and adolescents from COVID-19, particularly those with obesity and other underlying health conditions," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry; one author reports application of a patent with a pharmaceutical company.


Explore further

Severe COVID-19 outcomes not up during Delta predominance

More information: Abstract/Full Text

Plenty of Evidence for Recombination in SARS-CoV-2

 Recombination—the exchange of genetic material between genomes—is common in coronaviruses because of the way they copy their RNA genomes. During replication, the RNA-synthesizing enzyme these viruses use duplicates shorter sections close to the end of the genome in addition to making the long template it needs for generating whole-genome copies. Furthermore, the enzyme is prone to switching from one template to another, so if a cell has multiple viral genomes in it, the enzyme may stitch together bits from different viruses to create a kind of Frankenstein genome.

RNA viruses can leverage recombination to fix deleterious mutations or acquire new characteristics, which is why virologists say it’s important to keep tabs on any recombination events that may be occurring in SARS-CoV-2. While it’s not yet clear exactly what role recombination is playing in the virus’s evolution, researchers are continuing to monitor and investigate it in an effort to better understand its biology—and, perhaps, develop novel strategies for fighting it.

Recombination from the beginning

Early on in the pandemic, research suggested recombination likely played a pivotal role in SARS-CoV-2’s emergence as a human pathogen. In a study published in July 2020, for instance, Bette Korber, a researcher at Los Alamos National Laboratory, and colleagues reported that a portion of the receptor binding domain of SARS-CoV-2’s spike protein—the part of the spike that directly interacts with the ACE2 receptor that the virus uses to gain entry into cells—came from recombination with pangolin coronaviruses.

It’s no surprise, then, that the virus continued to recombine after it began infecting people. “It should be happening because it’s a very important evolutionary mechanism for these viruses,” explains Korber. At the same time, she adds, “quantifying how much it’s there can be tricky because . . . it’s computationally not easy to look at vast data sets,” and the search can be confounded by genetic changes that can come about in the lab.

Recombination happens in many viruses, including influenza, HIV, and other coronaviruses. It “could, in principle, be a meaningless event where two viruses swap some pieces of RNA, but they don’t really change themselves,” says Penn State biologist Maciej Boni. But researchers want to keep an eye on recombination in SARS-CoV-2 because it’s one way the virus could evolve to be more virulent or to infect more people—potentially faster than mutating one nucleotide at a time. 

Recombination can bring together mutations that occurred in different lineages of a virus, potentially creating a more pathogenic strain.
CREATED BY LARA HERRERO USING BIORENDER, REPRINTED WITH PERMISSION FROM THE CONVERSATION

Most efforts thus far have focused on surveillance: figuring out whether or not recombination is happening in as close to real time as possible, and exploring what recombination may mean for viral evolution. It’s still early days for this work, because identifying recombination events can also be challenging if circulating genomes don’t look very different from one another. The computational methods used to identify recombinant events rely on comparisons of different sections of genetic material. The bigger the differences between one strain and another, the easier recombination is for algorithms to pick out. But “in the first months of the SARS-CoV-2 outbreak, most of the viruses were quite similar to each other,” Boni tells The Scientist. “Even by summer 2020, there wasn’t enough diversity to say anything meaningful about whether the viruses were swapping genes.”

Most researchers assumed that SARS-CoV-2 viruses were mixing and matching bits of their genomes because recombination is common in coronaviruses. It wasn’t until about a year into the pandemic that there was enough variation to confirm that hypothesis, says Ben Jackson, a postdoc in Andrew Rambaut’s group at the University of Edinburgh.

Tracking recombinant viruses

Jackson, Rambaut, Boni, and others collaborated on a paper that came out as a Cell pre-proof on August 17, which tracked recombination events in the UK throughout winter of late 2020 and early 2021. This time period in the UK had conditions that made recombination both likely and detectable: high SARS-CoV-2 prevalence overall and several genetically distinct variants infecting people in the same areas.

The authors analyzed viral sequencing data and, out of about 279,000 SARS-CoV-2 genomes collected, 16 showed evidence of recombination—mostly between the B.1.1.7 (Alpha) and B.1.177 variants—based on the mosaicism of their genomes.

Work is also underway to detect recombination on a larger scale and in real time. In a preprint released on bioRxiv on August 5, Russell Corbett-Detig, who focuses on genomic epidemiology at the University of California, Santa Cruz, and colleagues describe a new phylogenetic tool, Recombination Inference using Phylogenetic PLacEmentS (RIPPLES). 

Using RIPPLES, the researchers identified 606 recombination events among a continuously updated phylogenetic tree with 1.6 million SARS-CoV-2 genome entries. “Approximately 2.7% of sequenced SARS-CoV-2 genomes have recombinant ancestry,” Corbett-Detig and colleagues write in the preprint. They also determined that recombination appears to be concentrated in the region of the Spike protein.

“If we can use all of the viral genetic diversity that we have in a given area, you have quite a lot more information to work with than if you have to subsample very few sequences to look for recombination,” says Corbett-Detig. “The idea is that, in any rapidly evolving pathogen situation, even if it’s not a pandemic, the ability to use all the information you’ve already gathered and then add on top of that to extend your analysis is going to be a really important design feature of how we study and track these things in the future,” he tells The Scientist.

A public health connection?

What’s a bigger risk: another Delta appearing [through mutation], or a recombinant virus appearing that’s got two brand new phenotypes that make it more transmissible and more dangerous? I don’t think we know that.

—Maciej Boni, Penn State

From these scientists’ work, as well as that of other groups, it’s now clear that recombination has played a role in both the emergence and ongoing evolution of SARS-CoV-2. What the effects are of this recombination on viral spread and immune evasion, and thus public health, remains an open question. One big concern is that recombination might generate a “super variant” that’s markedly more infectious or more deadly than previous versions—or both. “When you have multiple lineages circulating, the danger is that the viruses could combine one dangerous phenotype with another dangerous phenotype into a single virus that has two dangerous phenotypes,” says Boni.

But while Korber says recombination is “definitely happening,” she says it likely hasn’t produced a unique threat to public health. In the UK study, for instance, of the 16 putative recombinants, only one group of three closely related sequences appeared to have circulated within the community, and their reach was limited. Korber’s group has similarly seen only low levels of community transmission after a recombination event. In Texas, for instance, she and her team were able to find recombination events between the Kappa and Delta variants that were both circulating in the state, “but they didn’t go very far. They were in a small cluster of people.”

Korber is quick to point out that these data don’t mean recombination can’t or won’t generate a bigger, badder virus. The real question, says Boni, is how likely that actually is.  “What’s a bigger risk: another Delta appearing [through mutation], or a recombinant virus appearing that’s got two brand new phenotypes that make it more transmissible and more dangerous? I don’t think we know that,” he says. “We don’t know ahead of time what mutations and what phenotypes will appear.”

“Right now, the effect of recombination within human populations has probably been relatively small relative to the emergence of new mutations,” says Corbett-Betig. But “it’s reasonable to suppose that as there are more and more genetically divergent strains, recombination will make new combinations that might be important.”

Daniel Jacobson, a systems biologist at Oak Ridge National Laboratory, disagrees that the effect of recombination has thus far been minor. In a preprint posted on bioRxiv on August 8, he and colleagues propose that recombination has already driven the emergence of new SARS-CoV-2 variants.

The researchers analyzed more than 900,000 viral genomes with a computational method that assesses evidence for recombination and integrates that information with predictions of protein structure. They found that the combined impact of multiple mutations from different parts of the genome on a phenotype appeared to be synergistic, meaning that de novo mutations that have been associated with new variants of SARS-CoV-2 are likely not the whole story.

“We often see mutations in the Spike protein of SARS-CoV-2 that people are using to define the variants of concern actually occur months or even a year before [the variants] expand rapidly in the human population,” Jacobson writes in an email to The Scientist. These spike protein changes alone do not appear to be sufficient for the variant to spread rapidly; rather, that only seems to happen when mutations elsewhere in the genome also occur, which, combined with the spike mutations, give that variant a selective advantage, he says.

In the preprint, Jacobson and the other authors attribute the accrual of variant-defining mutations to recombination, claiming it’s the simplest explanation for the emergence of some variants. They calculate, for instance, that the chances of the 13 seemingly important mutations present in the Alpha variant accumulating serially given the observed mutation rate is 1 in a quadrillion, and they didn’t find evidence for a precipitous increase in mutation rate before it arose. Instead, they note that many of these consequential mutations were circulating in other sequences months before B.1.1.7 took off, which they interpret as evidence that recombination events more likely played a role in the variant’s emergence.

In an email to The Scientist, Corbett-Detig acknowledges that he hasn’t looked at the preprint in depth, but that other scenarios may explain the emergence of the variants of concern. The mutation profiles seen in SARS-CoV-2, he adds, “are likely to result from recurrent mutation and strong natural selection that produces more transmissible viruses.”

From monitoring to therapeutics

Regardless of the effects that recombination has had on viral evolution thus far, experts agree that it’s important to monitor SARS-CoV-2 genomes for evidence of recombination—both to understand the virus better, and to get early warning if a recombinant “super variant” were to emerge.

Another reason to monitor recombination and study it further is that researchers could potentially target the molecules involved in the process to incapacitate the virus. Like other coronaviruses, SARS-CoV-2 appears to leverage frequent recombination events to evolve, and potentially to fix deleterious mutations that can arise as it replicates in a host.

Some researchers have pointed out that, if the virus were prevented from recombining, mutations might accumulate to the point that it becomes hampered or even unable to replicate and spread.

Some researchers have pointed out that, if the virus were prevented from recombining, mutations might accumulate to the point that it becomes hampered or even unable to replicate and spread. That could mean that drugs that interfere with recombination specifically could help end the pandemic.

A January study in PLOS Pathogens suggests one possible target for such drugs: an enzyme called ExoN that helps proofread viral RNA. Previous studies had implicated it in the virulence of coronaviruses, likely because it checks genome copies for mutations that might be deleterious, but the January paper indicated it’s also important for recombination. When the team removed it from a cultured murine coronavirus, significantly less recombination was observed.

Further study of recombination in coronaviruses and SARS-CoV-2 in particular could reveal additional drug targets. If nothing else, monitoring for recombination by sequencing viruses from positive cases will ensure researchers keep an eye on how this deadly virus is changing and how quickly. Most researchers aren’t saying, “‘Ah, recombination is happening. This is the worst thing in the world,’” says Jackson. “I think that everyone knew that it was going to, and it’s not clear to me that it’s going to make [the pandemic] any worse than what’s happening anyway.”

https://www.the-scientist.com/news-opinion/plenty-of-evidence-for-recombination-in-sars-cov-2-69156

Ontario moves school online, closes indoor dining and gyms as part of sweeping new COVID-19 measures

 

Ontario is moving schools online for at least two weeks, temporarily closing indoor dining and gyms and pausing non-urgent medical procedures as it faces record-high case counts that, according to public health officials, threaten to overwhelm the province's health-care system.

Premier Doug Ford announced the changes at a morning news conference Monday. He was joined by his ministers of health and finance, as well Ontario's chief medical officer of health and the CEO of Ontario Health.

The new restrictions are part of a modified version of Step Two of the province's Roadmap to Reopen, which was first implemented earlier last year.

"Our public health experts tell us we could see hundreds of thousands of cases every day," Ford said of the ongoing surge of new COVID-19 cases caused by the Omicron variant.

He said that this could mean hospitals end up thousands of beds short.

"If we don't do everything possible to get this variant under control, the results could be catastrophic. It is a risk I cannot take." 

The province announced all publicly funded and private schools will move to remote learning starting Jan. 5 until at least Jan. 17. 

Ford said the decision to close schools, a move that would last at least two weeks, was taken because the province couldn't guarantee schools would be fully staffed with so many teachers expected to be off sick.

The move comes after last Thursday's announcement, when Chief Medical Officer of Health Dr. Kieran Moore said the return to school date would be pushed by two days to Wednesday but would still be in-person. Moore said the province wanted to give schools extra time to provide N95 masks to staff and to deploy 3,000 HEPA filter units.

Though they were asked repeatedly by reporters on Monday, provincial officials did not provide a list of any other specific steps they plan to take in order to ensure a safe return to school on Jan. 17.

Indoor dining closed, new capacity limits

The new restrictions announced today also include:

  • Indoor dining at restaurants and bars closed.
  • Only outdoor dining, takeout, drive through and delivery permitted.
  • Social gathering limits reduced to five people indoors and 10 people outdoors.
  • Retail stores, malls, public libraries and personal care services limited to 50 per cent capacity.
  • Saunas, steam rooms and oxygen bars closed.
  • Capacity at weddings, funerals and religious services limited to 50 per cent capacity per room.
  • Outdoor services must have two-metre distancing between all attendees.
  • Employees must work remotely unless their work requires them to be on site.
  • Gyms and other indoor recreational sport facilities closed, except athletes training for the Olympics and Paralympics and certain professional and elite sports leagues.
  • Outdoor facilities are permitted but with a 50 per cent capacity limit on spectators.
  • Museums, galleries, zoos, science centres, historic sites, amusement parks, festivals and other attractions closed.
  • Outdoor establishments allowed with restrictions and capacity limits.
  • Indoor meeting and event spaces closed with limited exceptions, except those with outdoor spaces, which can operate with restrictions.

The new measures will kick in on Wednesday, Jan. 5 at 12:01 a.m. and will remain in effect for at least 21 days, until Jan. 26.

New modelling from Public Health Ontario shows that the Omicron variant could eventually overwhelm the entire health system. 

The projections suggest hospitalizations could peak by the end of this month, but health officials noted that tightened public health measures will blunt the rate of Omicron's spread.

(Provided by the Government of Ontario)

Non-urgent surgeries paused

As part of the modified step two of the province's re-opening plan, Moore reinstated a directive ordering hospitals to pause all non-urgent surgeries and procedures in order to preserve critical care capacity.

That measure had been taken during earlier waves in the pandemic, contributing to a large backlog of procedures the health system had been working to clear in recent months.

Elliott said the decision was made due to staffing pressures and the need for bed spaces in light of Omicron's growth across the province.

The chief executive officer of Ontario Health, which oversees the province's health system, said the directive would affect between 8,000 and 10,000 procedures a week.

"It was a tough decision, a big cost, but something that is necessary given what we're seeing in the numbers," Matt Anderson said.

Between 1,200 and 1,500 additional beds have been designated to provide care to patients with Omicron, Moore said.

"We anticipate through the modelling that those 1,200 to 1,500 beds will be essential to be able to provide oxygen and care," he said.

Moore noted that the number of hospitalizations will dictate when restrictions can be relaxed.

The "tsunami" of Omicron cases is expected to result in 20 to 30 per cent absenteeism for employees in all sectors across Ontario in the coming weeks, he said.

Expanded rebate program for businesses affected

Employers are asked to let employees work remotely "unless the nature of their work requires them to be on-site."

The government said free child-care will be provided for frontline workers with school-aged children. The decision to move to virtual learning comes less than a week after the government said it would open schools in person on Wednesday.

Also announced Monday was an expanded rebate program for businesses affected by the new slate of closures.

The government said certain businesses ordered to close will be reimbursed for 100 per cent of property tax and energy costs, and those that must reduce capacity to 50 per cent will receive a rebate payment for half those expenses.

Ahead of the news conference, Ontario reported another 13,578 new cases of COVID-19. That followed 16,714 cases on Sunday and a pandemic-high 18,445 cases on Saturday.

Public Health Ontario has warned recently that daily case counts are "an underestimate" given changes to testing eligibility and Omicron's quick spread.

Omicron cases surge

Ontario discovered its first case of the Omicron variant on Nov. 28, just days after South African researchers alerted the world to its existence. Around three weeks later, Omicron became the dominant variant, making up the majority of new daily infections in the province.

On Dec. 16, Ontario's COVID-19 science table called for "circuit breaker" restrictions to combat the rapid spread of Omicron and avoid ICU admissions reaching "unsustainable levels" by early January.

In response, Ontario reintroduced capacity limits at restaurants, bars and retailers on Dec. 19, capping most at 50 per cent. It also mandated they close at 11 p.m., imposed limits on the sale of alcohol and limited private indoor gatherings to 10 people.

Some limits were also placed on sports and extracurricular activities, and capacity restrictions on large venues were also imposed.

But some experts warned even those measures weren't strong enough to curb "out of control" transmission of the virus.

Hospitalizations, ICU admissions rising

While a more comprehensive provincial update is expected Tuesday, below are some key pandemic indicators and figures provided by Health Minister Christine Elliott Monday morning.

The number of people with COVID-19 in ICUs across the province rose to 248 on Monday from 224 on Sunday and 214 on Saturday. The seven-day average currently sits at 210. 

 

In total, there are 1,232 people hospitalized with COVID-19, although Elliott noted that not all hospitals report on weekends.

More than 89,000 doses of vaccine were administered on Sunday, Elliott said, and to date, 27,422,363 doses have been administered in Ontario. Nearly 91 per cent of Ontarians aged 12 or older have received one dose of a vaccine, while more than 88 per cent have received two doses.

https://www.cbc.ca/news/canada/toronto/covid-19-ontario-jan-3-2022-ford-public-health-measures-1.6302531

Atlanta schools to go virtual for a week due to COVID spike

 Another one of Georgia’s largest school districts has decided to start 2022 classes virtually because of high numbers of COVID-19 cases.

Atlanta Public Schools announced students will be virtual when classes start back after winter break on Tuesday.

The district is also asking all teachers and other staff to report to their jobs for mandatory COVID-19 testing unless they are ill and will use that information for planning, the district said in a statement.

Currently, Atlanta schools plan to return to regular classes on Jan. 10.

Atlanta schools join Fulton County, Dekalb County, Clayton County and Rockdale County schools in a virtual return after Christmas.

Georgia’s two largest school districts — Gwinnett County and Cobb County — have not announced any changes to returning to school in person as of Saturday.

Georgia has hit new records for COVID infections, with more than 24,000 infections reported on Thursday and Friday.

Six health care systems that serve metro Atlanta said in a combined statement this week they have experienced 100 to 200 percent increases in COVID-19 hospitalizations in eight days, with the vast majority of the patients unvaccinated. They urged people not to come to the hospital just to get tested for the virus.

https://apnews.com/article/coronavirus-pandemic-health-education-georgia-atlanta-7dd87eb4335afd2922c3c15dd9e6b648

Jazz gets orphan drug exclusivity for sleep disorder therapy

 Jazz Pharmaceuticals plc (Nasdaq: JAZZ) today announced that the U.S. Food and Drug Administration (FDA) has granted Orphan Drug Exclusivity (ODE) for Xywav® (calcium, magnesium, potassium, and sodium oxybates) oral solution, for the treatment of idiopathic hypersomnia in adults, making it the second ODE for the medication following the exclusivity granted in the treatment of cataplexy or excessive daytime sleepiness (EDS) in patients 7 years of age and older with narcolepsy.

As Jazz was the first sponsor to obtain FDA approval for idiopathic hypersomnia, Xywav will have seven-year market exclusivity for this indication from its FDA approval on August 12, 2021. The FDA's Orphan Drug Designation program is designed to advance the development of drugs that treat a condition affecting 200,000 or fewer U.S. patients annually.

https://finance.yahoo.com/news/u-fda-grants-orphan-drug-211000548.html