COVID Again

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January 11, 2023

Welcome to the Virus Briefing, your comprehensive guide to the latest news and expert analysis on the coronavirus pandemic and other outbreaks.

Find the latest updates here, and check out our maps and vaccine tracker.

A masked shopper in downtown Chicago last month.Jamie Kelter Davis for The New York Times

What to know about XBB.1.5

By Jonathan Wolfe

A highly contagious version of the Omicron variant — known officially as XBB.1.5 or by its subvariant nickname, Kraken — is quickly spreading in the U.S.

The young subvariant was first detected in New York State in the fall. It currently makes up about 28 percent of cases in the U.S. and about 72 percent of cases in the Northeast, according to the C.D.C. It’s a highly mutated version of the virus that appears able to better evade immune defenses and invade cells, with some experts calling it the most transmissible variant yet. Scientists say it remains rare in much of the world, but they expect it to spread quickly and globally.

To understand more, I spoke to my colleague Carl Zimmer, a science reporter who covers the coronavirus.

What should we know about XBB.1.5?

It looks like XBB.1.5 is a cut above the other Omicron subvariants in terms of getting around our defenses, and it’s also a very transmissible virus. We won’t know the full XBB.1.5 story until it’s over, but right now it’s definitely looking like it could potentially become dominant in the United States, maybe even the world.

Is it more deadly than other variants?

Unfortunately, there’s not a lot of data on its effects. From what I’ve heard from experts, it doesn’t look like it’s any more severe, which is good. But it takes time for a variant to become common enough that it infects people in large numbers, and then for some of those people to end up in the hospital, and then to analyze all those numbers. It’s really surging here in the northeastern U.S., but we don’t have great medical information systems to get quick answers on that.

Where did XBB.1.5 come from?

XBB.1.5 descends from something called XBB. And XBB is a very unusual form of Covid. It may have emerged in the spring or summer last year, possibly in India.

What’s unusual about XBB is that it was the product of two different forms of Omicron that both infected someone. As they were replicating inside that person, their genes were mixed together, and then we got a new hybrid. And this hybrid is very good at evading defenses from vaccines and infections.

So it caused a big surge in Singapore in the fall, but it didn’t really become that common elsewhere because it was competing with so many other subvariants. But as it multiplied, it started gaining more mutations. So XBB gave rise to XBB.1, and then XBB.1 mutated again into XBB.1.5. And it looks like XBB.1.5 gained a really crucial mutation that helps it grab tightly onto cells, which makes it more transmissible on top of doing a better job of escaping antibodies. So it looks really concerning. And in places like the northeastern U.S., it’s the fastest-growing variant out there.

How worried should we be?

It depends on how you were before. If you weren’t worried before, you should have been. And you should remain worried. A year ago, the first Omicron subvariant surged to dominance. Since then we have seen an explosion of new forms of Omicron. And they continue to gain mutations that help them to spread. In December, we had really fast-spreading viruses out there, and now we have one that’s even faster. So it’s a good time to take it seriously.

What will this do to the course of the pandemic in the U.S.?

I’ve been talking to scientists who are watching this really closely, and nobody thinks that we’re looking at something like what we saw a year ago, when Omicron first slammed into the U.S. Back then, we had the record-breaking caseload and record-breaking hospitalizations. It won’t be that bad, but how bad it will be, it’s hard to say. There probably will be a surge. And we’re already dealing with a lot of Covid in the U.S., so it’s a bad time for an even faster-spreading virus to show up.

How will this affect the outbreak in China?

In China, which experienced a large surge of cases in late 2022, its prospects are hard to predict. One possibility is that once other subvariants sweep through China, it will be XBB.1.5’s turn to reinfect some people there.

How protective are the new boosters against XBB.1.5?

The preliminary studies are, thankfully, looking pretty good. If you’ve been boosted, it looks like it probably reduces your chances of getting infected, and it definitely is good for keeping you out of the hospital, especially if you’re older.

Unfortunately, our rates of boosting are not great. Even if you’ve had the two shots of the primary vaccination, you’re still quite vulnerable. The updated booster can really protect a lot of people.

What’s next in the virus’s evolution?

Forecasting evolution is harder than forecasting the weather. But what’s interesting is that scientists do have some glimpses into possible futures.

The mutations that have produced XBB.1.5 have actually made it easier for this virus to gain the ability to evade more antibodies. It’s become more evolvable, you could say. So an even more evasive form of XBB.1.5 could be showing up soon.

Scientists are able to track the evolution of this virus in a way that they were never able to do in previous years with things like influenza or measles. But they still aren’t seeing things exactly in real time. So it’s possible that the next new variant is already here. It’s possible that someone walking around Rhode Island or Connecticut has already incubated the next big thing.

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One final question

In early March 2020, we sent the first edition of the Coronavirus Briefing newsletter, the parent of this newsletter, the Virus Briefing.

Nearly three years later, as the acute phase of the pandemic fades in the U.S., and as more of us are trying to pick up the pieces and move on, we’re winding down this newsletter. We may appear in your inbox again if the pandemic takes a drastic turn, but at the end of this month, we will pause the Virus Briefing.

Personally, it’s bittersweet. For years, I’ve waited for the day when we would happily put this newsletter to rest. In the early days, I thought that moment would come when we reached herd immunity, when we had an effective vaccine or when treatments would render the virus powerless. But over time, I think we realized that we would never experience that total release and that the virus would most likely be with us long term. While we’re certainly in a better place than when this newsletter was created, I had hoped for more closure as it came to an end.

Without a doubt, what I will miss most about this experience are the conversations with you. Over the last three years, many of you have generously opened up your lives, sharing details with us about how the virus was affecting you and your families. Thank you for trusting us with your words.

Before we go, here’s one final question, a simple one. How have three years of life during a once-in-a-generation pandemic changed you? We’re interested in the good, the bad and messy responses in between.

If you’d like to share your thoughts, you can fill out this form here. We may use your response in the final versions of our newsletter.

What else we’re following

China’s infection rates are dropping, The South China Morning Post reports, but it could experience a surge after the Lunar New Year this month. The R.S.V. wave in the U.S. has peaked and flu cases are slowing, but Covid cases are on the rise, NPR reports. A furious, wide-ranging argument is unfolding on the internet in China over the reversal of the government’s strict pandemic policies and the enormous Covid surge that followed.

The aftermath

We recently asked readers about the lingering aftereffects of the pandemic.

I am less affected by the virus than my mother is. Ever since the news first came out about a novel virus, she has holed up in her house with boxes of gloves, masks and tests and an endless stream of CNN talking heads. When my wife and I visited, we sat on couches covered in sheets and my mother sat in another room to avoid any risks of exposure. Once we were all vaccinated, her mind eased and she removed the sheets from the couches and we could hug again. Fast-forward to late summer 2022 and my mother became infected. She had some scary side effects that luckily disappeared over a few weeks. While I believed that by finally getting the virus she would be more free from the clutches of living a hermit lifestyle, it made it worse. She barely leaves the house now except to take the trash out and complete her weekly trip to do errands. As her son, I want her to move on. I miss everything about how we were prepandemic. — Paul M., Riva, Md.

Thanks for reading. I’ll be back next Wednesday. — Jonathan

Email your thoughts to virusbriefing@nytimes.com.

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Florida man buys $4.9M mansion using funds from PPP loan scheme, Attorney’s Office says

TAMPA, Fla. (WFLA) — A Florida man who was caught using fraudulently obtained Paycheck Protection Program funds to buy several cars and a $4.9 million mansion in Seminole County learned his sentence, according to a release from the U.S. Attorney’s Office.

https://local.newsbreak.com/seminole-county-fl/2888572677488-florida-man-buys-49m-mansion-using-funds-from-ppp-loan-scheme-attorneys-office-says?

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British parliament member booted from Conservative Party after comparing COVID-19 vaccination to Holocaust

(JTA) — Andrew Bridgen, a member of British Parliament, has been booted from the Conservative Party after calling COVID-19 vaccination in the United Kingdom “the biggest crime against humanity since the Holocaust” in a tweet on Wednesday.

https://www.jta.org/2023/01/12/global/british-parliament-member-booted-from-conservative-party-after-comparing-covid-19-vaccination-to-holocaust?

ps:Good for them!!

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Were Diamond and Silk Fired from Fox News for COVID-19 Falsities?

Online users were curious about this rumor after the January 2023 death of Lynette Hardaway, who was known as "Diamond."

https://www.snopes.com/fact-check/diamond-and-silk-fired-fox-news-covid/?

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China reports 60,000 COVID-related deaths, says peak passed

BEIJING (AP) — China on Saturday reported nearly 60,000 deaths in people who had COVID-19 since early December, offering hard numbers for an unprecedented surge that was apparent in overcrowded hospitals and packed crematoriums, even as the government released little data about the status of the pandemic for weeks.

https://apnews.com/article/health-china-beijing-covid-425a5de577126b042d4eea915c174bc0

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WHO appeals to China to release more COVID-19 information

BEIJING (AP) — The World Health Organization has appealed to China to keep releasing information about its wave of COVID-19 infections after the government announced nearly 60,000 deaths since early December following weeks of complaints it was failing to tell the world what was happening.

https://apnews.com/article/health-world-organization-south-korea-china-covid-5a3ba286fc84659b96b319b76bb717a4

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January 18, 2023

Welcome to the Virus Briefing, your comprehensive guide to the latest news and expert analysis on the coronavirus pandemic and other outbreaks.

Find the latest updates here, and check out our maps and vaccine tracker.

A drive-through Covid-19 testing site in Los Angeles last month.Mark Abramson for The New York Times

The state of the virus

By Jonathan Wolfe

It’s a confusing time in the pandemic.

For those of us who track the virus, we’re used to looking at a bunch of signals and trying to discern where things are headed. But over time, those signals have gotten more complicated — especially as some states have begun reporting their Covid data less frequently or reliably.

One thing seems likely: This winter will not look like last year, when Omicron drove up cases, hospitalizations and deaths into the stratosphere — an anomaly that some experts say we may never see again. Instead, the winter of 2023 in the U.S. will likely be defined by the strength of XBB.1.5, a highly contagious and immune- evasive Omicron subvariant that’s gaining ground across the country.

Today, we’re taking a look at what the Covid data is telling us, and the forces that may shape the pandemic this winter.

Signs in the Northeast

Coming out of the holidays, the country saw a large uptick in cases, hospitalizations and deaths, and it looked like we were possibly headed for another deadly winter wave. But in recent days, cases and hospitalizations have begun to level off or come down nationally.

Consider the Northeast: The Omicron subvariant XBB.1.5 was first discovered in New York in the fall, and for the last month or so it has been driving up cases and hospitalizations in the region. The subvariant now makes up about 83 percent of cases in the Northeast, according to C.D.C. data.

But over the last 10 days or so, those trends have started to reverse. Wastewater data show cases in the region dropping, and hospitalizations have also begun to decline.

“In New York, I do think it’s reasonable to say that XBB.1.5 has peaked in terms of infections and hospitalizations,” said Dr. Ashish Jha, the White House coronavirus response coordinator. “That is all heartening and important, and I do think that it says that XBB.1.5 is certainly not leading to a major wave in the Northeast.”

While that might be positive news for the region, most of the rest of the country has yet to have its own turn with the new variant, and when it spreads it will likely lead to an increase in cases, hospitalizations and deaths.

“I think based on everything we know right now, I don’t think we’re expecting some major waves because, again, we didn’t see it in the Northeast,” Dr. Jha said.

The best estimates from the White House as to how many people are currently infected, Dr. Jha said, is at about the same level as during the BA.5 wave this summer, but with much less severe outcomes.

“What you’re seeing is a transition to ongoing transmission but much milder infections,” Dr. Céline Gounder, a senior fellow at the Kaiser Family Foundation, told my colleagues at The Morning.

Tracking hospitalizations, it looks as though the wintertime surge of 2022-23 is less severe than winter surges in the past two years.

Data is through Jan. 12, 2023; chart shows a seven-day daily average. | Source: U.S. Department of Health and Human Services

That said, our death rate is still way too high — we’re averaging about 540 deaths per day. Dr. Jha told me that many of those deaths are the result of the increase in infections during the holidays, and that “almost all of them are people who are either not up-to-date on their vaccines, or did not get treated, and often, both.”

Viral interference

While recent signs out of the Northeast are trending positive, there’s a new curveball that’s disrupting our understanding of the pandemic this year: viral interference.

It’s the theory that when we have multiple viruses during a season — as we did this year with R.S.V., the flu and Covid — they won’t peak at the same time.

“The idea is that you’re going to see viruses take turns, one after the other,” said my colleague Apoorva Mandavilli, a science reporter who tracks the virus. “That’s because when our bodies are exposed to one virus, our immune systems go on high alert, and we are better able to defend against viruses.”

This year, R.S.V. surged and peaked in mid-November. The flu peaked next, reaching highs in December. “So now with Covid we have to wait and see,” Apoorva said, “because last year, by this time, Omicron was blazing but that may all just be pushed out this year because R.S.V. and flu were there first.”

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How the pandemic changed you

Last week, we let you know that this newsletter is winding down and will be paused at the end of this month. We also asked you one final question: How has the pandemic changed you? Thank you to everyone who wrote in.

(If you’d like to send us a response, you can do so here. We may use your response in the final edition of the newsletter next week.)

“There is no easy way to build up to the answer to this question so I’ll just say it: the pandemic years have made me so much more fearful. I lost people during these years, and now I think about death so much more often, and feel afraid my time is somehow coming soon too. I feel scared and anxious just leaving my apartment. I fear that I am retreating into some sort of shell that I will never be able to fully come out of again. We have all experienced a huge, collective trauma and it’s as if the world wants us to forget it all and somehow be “normal” again. I don’t think I can be, or want to be.”

— Kellye R., New York, N.Y.

“I caught Covid on March 3, 2020. It turned into pneumonia, then a bewildering array of symptoms nobody understood and many doctors didn’t believe were real. I was one of the first wave of long Covid sufferers, and it has completely destroyed my life. I had been self-employed as a freelance translator, but I haven’t been able to work for almost three years, or do much of anything beyond trying to manage countless medical appointments and treatments. I used to be a dancer, and now I am lucky to manage a slow walk of a few blocks. I have lost almost all of my friends, as I am no longer “fun” and don’t have the energy to do anything social. I don’t recognize myself anymore.”

— Tascha Babitch, Portland, Ore.

“Three years ago this March, I met my husband on a Hinge date. We barely knew each other two weeks when the world ground to a halt, but we both knew (well, hoped) that we had something special. We decided to spend the lockdown together. For everyone in our lives, the pandemic accelerated relationships, for better or for worse. Some broke up; others shacked up. We (1) moved in together; (2) got engaged; and (3) got married inside of a year and a half. As we saw it, we were spending 24 hours a day together, and a 1.5-year-long relationship during Covid was easily equivalent to a three, nay, five-year relationship in normal times. He’s my soul mate, and I can thank the pandemic for giving us more hours together than I could’ve ever dreamed possible.”

— Cayman Mitchell, New York, N.Y.

“It has made me realize that my fellow countrymen are not as interested in helping out their fellow man. I have far less of an allegiance to my country then I ever had in my previous 39 years of life. I am disappointed in the societal response, and will no longer be nearly as patriotic, and will not have the same urgency to lend a helping hand to others, knowing it was not reciprocated in the past. I find myself hating people I used to love, and feeling indifferent toward people I respected. I am now in it for myself and will think of me first in situations where I used to consider what was best for most. I no longer care about others.”

— Matt Benedetti, Anchorage, Alaska

“As a nurse who graduated at the beginning of the pandemic, the past three years have been a roller coaster of emotions. At first, I was excited to be on the front lines, helping to fight this new virus. But as the months went on, the reality of the situation set in. The long hours, the constant fear of bringing the virus home to my loved ones, and the emotional toll of seeing so much suffering took a heavy toll on me. I eventually became burned out and had to step away from the job for a while. But as the pandemic continued, I couldn’t shake the feeling that I needed to be back in the fight. So, I decided to return to nursing, but this time with a new perspective and a deeper understanding of the importance of self-care. I am grateful for the opportunity to have been a part of this once-in-a-generation event, and for the compassion and strength it has helped me to find within myself.”

— Steven Walker, New York, N.Y.

What else we’re following

China said on Saturday that it had recorded nearly 60,000 fatalities linked to the coronavirus in the month since the country lifted its strict “zero Covid” policy. China’s vast machinery of virus surveillance and testing has collapsed, and now angry pandemic-control workers are demanding wages and jobs. The Chinese economy had one of its worst performances in decades last year as growth was dragged down by numerous Covid lockdowns followed by a deadly outbreak in December. A new report found that Covid was the leading cause of death for law enforcement officers in the U.S. for a third year in a row, ABC reports. A study found that pregnant women infected with Covid are seven times more likely to die than those who were not infected, The Washington Post reports. My boss told my co-workers that I had Covid. Is that illegal? Several celebrities, including Colin Farrell, Jamie Lee Curtis and Michelle Pfeiffer, tested positive for Covid after the Golden Globe Awards, BBC reports. Sister André, a French nun who lived through two world wars and survived Covid, died on Tuesday in France at the age of 118.

Thanks for reading. I’ll be back Wednesday. — Jonathan

Email your thoughts to virusbriefing@nytimes.com.

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COVID surge on the wane in Florida: Here's why

It seems the worst of the current COVID-19 wave is ending across Florida.

https://www.palmbeachpost.com/story/news/state/2023/01/21/florida-covid-surge-waning-as-hospitalizations-cases-fall/69806664007/?

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Did Moderna CEO 'Admit' to Making COVID-19 Vaccine Before the Disease Had a Name?

The fact that a pharmaceutical company was working on a vaccine for a pandemic disease that had been discovered a month earlier is not a revelation.

https://www.snopes.com/fact-check/moderna-ceo-davos-covid-vaccine/?

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US proposes once-a-year COVID shots for most Americans

WASHINGTON (AP) — U.S. health officials want to make COVID-19 vaccinations more like the annual flu shot.

https://apnews.com/article/health-immunizations-covid-cdd627b7daee5c2f7ebc984a3d9357db

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Fact check: COVID-19 vaccination decreases chances of hospitalization, contrary to post's implication

The claim: Post implies COVID-19 vaccine increases risk of ICU admittance

https://www.usatoday.com/story/news/factcheck/2023/01/24/fact-check-post-wrongly-implies-covid-vaccine-doses-increase-icu-risk/11066142002/?

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Fact check: Post falsely claims change in FAA guidelines linked to COVID-19 vaccine

The claim: FAA loosened pilot ECG parameters due to COVID-19 vaccine impact

https://www.usatoday.com/story/news/factcheck/2023/01/24/fact-check-post-falsely-links-new-faa-guidelines-covid-19-vaccine/11105247002/?

 

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Fact check: No, coronavirus is not a Latin word for 'heart attack virus'

The claim: Coronavirus is a Latin word for 'heart attack virus'

https://www.usatoday.com/story/news/factcheck/2023/01/24/fact-check-no-coronavirus-not-latin-heart-attack-virus/11105266002/?

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Fact check: No, Ireland doesn't list 'sudden death' as COVID-19 vaccine side effect

The claim: Poster from Ireland health authority shows 'sudden death' as side effect of COVID-19 vaccine

https://www.usatoday.com/story/news/factcheck/2023/01/23/fact-check-fabricated-poster-lists-supposed-covid-19-side-effects/11092463002/?

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January 25, 2023

Bridget Ryan, an assistant nurse manager, and Christina Burke, a nurse, at Christiana Hospital in Newark, Del., in 2020. Their unit was dedicated almost exclusively to Covid patients.Erin Schaff/The New York Times

A farewell, for now

By Jonathan Wolfe

On Jan. 6, 2020, The New York Times first reported on a mysterious “pneumonia-like illness” that sickened 59 people in Wuhan, China. Symptoms included high fever, trouble breathing and lung lesions, but Chinese health officials said there was no evidence of human-to-human transmission.

Two days later, Chinese scientists identified the source of the new disease: a previously unidentified coronavirus. Within weeks, the pathogen was sickening scores of people in Wuhan, and China took the drastic step of locking down the city, effectively sealing off its 11 million inhabitants from the world.

Then, time seemed to accelerate.

Seismic events began to take place, one after the next: Professional sports leagues around the world suspended seasons. Stocks plunged. Donald Trump cut off travel from Europe. The World Health Organization declared the virus a pandemic.

Soon, entire countries began shutting down. Popular tourist sites and metropolises across the world became ghost towns. By early April, authorities had told four billion people — roughly half of humanity — to stay home.

“If you look at the very beginning, we found ourselves in — at least in our memory — the unprecedented situation of the evolution of what would turn out to be one of the most devastating pandemics in more than a century,” Dr. Anthony Fauci, who helped lead the U.S. government’s response to the pandemic, told me this week. “That, at first, was complicated by the opaqueness of the Chinese authorities and letting the rest of the world know what was actually going on.”

In those initial days, there was so much we didn’t know — and so much speculation and misinformation — that The New York Times started a newsletter on March 2, 2020, to serve as an informed guide to the global outbreak.

“There was a fire hose of alarming information,” said Adam Pasick, The Times’s editorial director of newsletters and a frequent editor and occasional writer of this one. “We needed a way to help people understand a rapidly changing story that was affecting every single person on the planet.”

The Coronavirus Briefing began as a daily update that eventually went to more than a million readers a day, tracking the latest developments and offering expert advice about treatment and prevention. It was meant to be temporary. But it didn’t take long to realize that the pandemic was not going away quickly. Over the last three years, readers across the world opened the newsletter more than 300 million times.

“We thought that we were going to have a big burst of infections, and, like every other outbreak, it was going to peak, turn around, come back down and then, essentially, if not disappear, go to a low enough level that it didn’t bother anybody,” Dr. Fauci said. “And here we are three years later, into our fifth or sixth variant.”

As the virus evolved, so did the newsletter. We explored the pandemic’s effects on health care, education, politics, mental health, minority groups, workplaces, travel, relationships and families. Times reporters from across the world — in China, Brazil, India, Israel, Canada, Britain, Hong Kong and more — gave us on-the-ground reports of outbreaks.

We also covered the fault lines that the pandemic revealed and exacerbated. Our frequent conversations with Dr. Fauci took place as he was vilified by many who vehemently opposed the U.S. government’s lockdowns, mandates and vaccine efforts.

“The other lesson that to me was particularly impactful and painful, because unfortunately I found myself in the middle of it, was the extraordinary amount of divisiveness in our own country,” he said, “which, really, I believe, impeded an optimal response to the outbreak.”

“In this case, the common enemy is the virus,” he added. “And yet, if you look at what was going on in our own country, it looked like we were fighting with each other.”

Now, after three years, we’re pausing this newsletter. The acute phase of the pandemic has faded in much of the world, and many of us have tried to pick up the pieces and move on. We promise to return to your inbox if the pandemic takes a sharp turn. But, for now, this is goodbye.

Without a doubt, what I will miss most about these last three years is hearing from all of you. We’ve received tens of thousands of responses to our questions about your pandemic lives. You’ve shared heart-wrenching stories of illness and death as well as thoughts on a changing world and silver linings.

As I was reading your final submissions, many of you told me that it was stories from your fellow readers that helped get you through your darkest days.

As Michelle Hey from Chester, N.J., wrote: “Some gave me a chuckle, some gave me hope and others broke my heart. These vignettes taught me that my family and I were a few of millions experiencing the pandemic each in our own unique ways, just trying to keep our heads above water.”

Thank you for following along with us these last three years, sharing your stories and helping one another feel a little less alone.

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Parting thoughts

Throughout the pandemic, we relied on a team of New York Times journalists to explain what was happening. Today, for our final edition, we asked some of them for their parting thoughts.

“The past three years of writing about Covid have been heartbreaking, disorienting, exhausting. Every time I thought we were done with the virus, it came back with another nasty surprise. But I also have renewed respect for the basic tenets of virology and immunology. We’ve learned that the coronavirus can be carried aloft in tiny aerosols, that infected people can have a range of symptoms and that while vaccines may not prevent reinfections, they will keep people out of hospitals. All of this is true of many other pathogens, and none of it should have come as a surprise.” — Apoorva Mandavilli, science reporter

“Nearly 4,000 American died just last week of Covid-19 — from a disease that did not exist four years ago. Worldwide, that figure is over 14,300 deaths, although the true number is certainly higher. Sixty-five million people are estimated to have long Covid. More people will get long Covid, and more people will die in 2023. Meanwhile, SARS-CoV-2 is continuing to evolve in surprising ways, and we are now increasingly aware of a number of potential pathogens in other animals. This story is not over, even if we want to look away.” — Carl Zimmer, science reporter

“Three years since this awful virus started spreading through our country, I’m struck by how far we have come and how far we have not. There are vaccines that reduce the risk of severe illness and death, antivirals that can help curb symptoms and a society that long ago returned to the mundane joys of in-person school, work and recreation. But dreams that once felt so attainable — herd immunity, a conclusive end to the pandemic — have faded. Covid, rather than becoming a past-tense plague, has remained a present-tense threat, even if it’s less of one than before, even if it’s one we don’t spend as much time thinking about.” — Mitch Smith, national reporter

“For me, one lasting lesson of the pandemic is how interconnected the world is. That goes for people, of course — we saw how quickly the virus can travel around the globe and how the emergence of a new variant somewhere can rapidly become a problem everywhere. But these connections go beyond our links with other humans. We saw pets and zoo animals catch the virus. We transmitted the virus to mink, which gave it to each other and then passed it back to us. The pandemic even altered larger ecosystems, as people stepped back from their normal routines. The past few years have driven home the message that infectious disease is truly a global problem — and will require global solutions.” — Emily Anthes, science reporter

“In writing about long Covid, I’ve been moved by the challenges that many people are facing as they struggle with symptoms that have upended their lives. I’ve also been struck by the energy and determination of the long Covid community to find answers that can lead to effective therapies and to share their experiences with other patients and with doctors and researchers. There is still a long way to go, but some hints are beginning to emerge, and I plan to continue keeping readers apprised of significant developments so that people can understand more about this condition and its implications.” — Pam Belluck, health and science reporter

How the pandemic changed you

In our final question to readers, we asked how the pandemic reshaped their lives. Thank you to everyone who wrote in.

“My husband’s Lewy body dementia took a turn for the worse in early 2020. He was in and out of the hospital from April until he died in October 2020. Because of Covid precautions, I was not allowed to be with him either at the hospitals or the care facilities. Advocating for him from afar was extremely difficult considering the overworked staff and facilities, but I did the best I could. After he died, I was unable to have a service for him, and I was unable to be hugged and comforted by family and friends. I still think about how things might have been easier on him through it all if I could have been beside him. That’s a sadness I will always carry with me, along with the memories of that awful year.” — Carol L., Maryland

“I was a senior in college when the pandemic hit. It feels like I’m in a completely different world now to where I was in 2020. Anger, disillusionment and anxiety riddled the lives of me and my friends as we watched our ‘role models’ at each others’ throats over inconsequential issues, while millions died and leaders profited. My friends and loved ones have been trauma-bonded through the experience of supporting each other when the system and leaders abandoned us. We’re cynical and have no trust in authority. But we’re here and fighting to find some stability and security.” — Meredith, Washington, D.C.

“In an unusual way, living in N.Y.C. at the beginning of the pandemic almost teetered on exciting. Banging pots and pans, sending one another letters or gifts and still showing empathy during the unknown. I later escaped to Texas, where it retrospectively felt like running from the eye of the storm to the crest of a tidal wave. Since then, I feel like I’ve become a shell of who I am. I gain anxiety at the mere thought of long-term exposure to the public. I’ve spent much of the past three years surrounded by four walls and persistent waves of depression. At times, I thought heavily about the repercussions of suicide for those around me. Gratefully, I’m still here today, and I now have my wife to remind me that life doesn’t have to be so scary.” — Eric, Austin, Texas

“As an Asian-American woman, my street smarts have morphed into constant vigilance when I’m out in public. I carry pepper spray and am always alert. That’s probably the hardest change, because it means I no longer feel safe in my hometown, and I’m not sure when or how that feeling will go away. My fear for my own safety has also supplanted my compassion and desire to help others, which is difficult to reconcile even now.” — Nelly, New York City

“It made me single. A 10-year relationship couldn’t rise above his enthusiastic embrace of anti-vaccine rhetoric and conspiracy theories.” — Carolyn, Phoenix

“In 2019, I was a long-term cancer survivor living a vibrant life. But Covid brought my life to a virtual standstill as a high-risk individual. My husband and I will have missed my son’s adolescence’s worth of school concerts, the family ethnic restaurant outings he loved and getting to know his friends. I lost the simple joy of taking my daughter and her friends to lunch, as no safe visits were possible through her four years of college. I am disappointed in how easily the fortunate and healthy have left behind those of us who are not.” — Ellen Kornmehl, West Newton, Mass.

“I have never, before or after, experienced the level of gratitude I felt about reconnecting with people I love as we first emerged from lockdown. Being with my friends and family ‘in 3-D’ — as opposed to on a flat Zoom screen — flooded me with a visceral sense of gratitude. I will always remember. The freedom to hug my adult children and siblings for the first time in many months was simply extraordinary.” — Joan Markoff, Sacramento

“I understood personal loss after losing my dad to Covid. I helped manage his care through phone calls with medical staff and FaceTimed with him during his two-month hospital stay. When he didn’t wake up after being put on the ventilator, we FaceTimed him daily and sang songs and told him the daily news to try to get through to him. We watched him pass away through a video stream. I felt so removed from his death. It was traumatizing. My family and friends helped me, but the biggest help was through the Covid Grief Network. I have more empathy for people grieving, and I try to be a support to those around me who have suffered a loss.” — Kim Burke, New York City

“Covid increased my circle of friends as we banded together to make 77,000-plus masks on ‘remote’ assembly lines to share with homeless shelters, the fire departments and others. My husband and I volunteered in the vaccine trials and at this point have had seven vaccines and boosters. We found ways to cope. We realized humans really are social animals and need each other. Zoom cocktail parties and funerals as well as celebrations and wakes on driveways. We rediscovered the joys of the outdoors.” — Linda Robertson, St. Charles, Ill.

“I was a budding anesthesiology resident when the Covid pandemic hit, and we were in the thick of it. There was no testing at the time, so we were stuck wondering whether we were going to contract this mystery disease, spread it among our peers and families. It was a terrifying time. Observing the burnout and mass retirements seen in our department has left lingering doubts in many of our minds about how our futures will look.” — Pooja Patel, San Diego

“Just today I stopped and sighed as I realized my life has been diminished by the pandemic. My heart is sore. We often tore each other apart, instead of appreciating everyone was suffering. We could have come out of this as a more united and compassionate species. We are capable and often exhibit such care for each other, but now I see how many hearts are too hardened to reach out again. But please, let’s try. Maybe we could all slow down, breathe and smile at one another whenever we can. At least we are still alive.” — Leah Sue Sullivan, San Diego

How to keep track of the virus

While the newsletter is coming to an end, The New York Times will continue covering the pandemic. Much of our reporting can be found here, and we’re still tracking the virus in the U.S. and around the world. We will also continue to cover the virus across many of our newsletters, including The Morning, the Evening Briefing, David Wallace-Wells and Well.

Thank you to the dozens of reporters and editors who contributed to this newsletter. Among them were a few who were extremely generous with their time and whose knowledge formed the backbone of this newsletter: Apoorva Mandavilli, Carl Zimmer, Mitch Smith, Keith Bradsher, Emma Goldberg and Tara Parker-Pope. Thank you.

As for me, I’ll be taking the lessons I’ve learned from the Coronavirus Briefing and applying them across The Times’s newsletters, particularly the inclusion of your voices in our coverage. Thanks for the last three years. Stay safe, and stay in touch. — Jonathan

Email your thoughts to virusbriefing@nytimes.com.

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Utah plastic surgeon injected kids with saline instead of COVID vaccine as part of anti-vaxxer scam

Throughout the global pandemic, Republicans refused to get vaccinated and refused to mask, and before they died, they refused to believe they were dying of COVID. The right-wing media hasn’t helped by both saying that the pandemic is real while also say the pandemic isn’t a big deal—it’s a conspiracy put together by deep-state forces sabotaging the Trump presidency. The results are clear: There are fewer people today who (probably) wore cheaply made red baseball caps than there were in 2020.

https://www.dailykos.com/stories/2023/1/20/2148218/-Utah-plastic-surgeon-injected-kids-with-saline-instead-of-COVID-vaccine-as-part-of-anti-vaxxer-scam?

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President Biden to end COVID-19 emergencies on May 11

WASHINGTON (AP) — President Joe Biden informed Congress on Monday that he will end the twin national emergencies for addressing COVID-19 on May 11, as most of the world has returned closer to normalcy nearly three years after they were first declared.

https://apnews.com/article/biden-united-states-government-district-of-columbia-covid-public-health-2a80b547f6d55706a6986debc343b9fe?

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By German Lopez

Good morning. Doctors are now a major barrier to Paxlovid.

Paxlovid being manufactured in Italy in 2021.Pfizer, via Reuters

Unnecessary deaths

Covid is still linked to hundreds of deaths a day in the U.S. We have a treatment that could bring down those deaths: a prescribed pill called Paxlovid, which reduces the severity of a Covid infection, particularly among older and more vulnerable Americans.

Yet that treatment remains underused. Doctors prescribed it in about 45 percent of recorded Covid cases nationwide during the first two weeks of January, according to White House data. In some states, Paxlovid is given in less than 25 or even 20 percent of recorded cases. (Those are likely overestimates because cases are underreported.)

Why is Paxlovid still relatively untapped? Part of the answer lies in a lack of public awareness. Some Covid patients also may decide that they don’t need Paxlovid because they are already vaccinated, have had Covid before or are younger. (My colleagues explained why even mild cases often still warrant a dose of Paxlovid.) The political polarization of the virus plays a role, too: People in blue states are more likely to use Paxlovid than in red states.

Experts have increasingly pointed to another explanation for Paxlovid’s underuse: Doctors still resist prescribing it. Today’s newsletter will focus on that cause.

Physician resistance

Some doctors have concerns that are rooted in real issues with Paxlovid and inform their reluctance to prescribe it. But experts are unconvinced that those fears are enough to avoid prescribing Paxlovid altogether, especially to older and higher-risk patients.

“What I’m doing for a living is weighing the benefits and the risks for everything,” said Dr. Robert Wachter, the chair of the medicine department at the University of California, San Francisco. In deciding whether to prescribe Paxlovid, he said, the benefits significantly outweigh the risks.

Some of doctors’ doubts will sound familiar to regular readers of this newsletter. The medication is relatively new (in a field that typically takes years to adopt new treatments). They worry about side effects, including diarrhea, muscle pain and an altered sense of taste. They also point to “rebound” Covid cases, which can cause symptoms to come back after subsiding, as happened to Dr. Anthony Fauci and President Biden after they took Paxlovid. (Although Covid symptoms can rebound without Paxlovid.)

Doctors also sometimes believe that a patient is not sick enough to prescribe Paxlovid. But the point of Paxlovid is to prevent Covid from getting severe. The medication works best when prescribed in the first few days after a patient shows symptoms, so a doctor does not have time to wait to see how bad an infection gets.

Another concern topped a recent survey of medical professionals by the health care website Medscape: potential interactions between Paxlovid and a long list of other drugs. Doctors might see that their patients are on one of those medications and choose not to prescribe Paxlovid.

That justification is especially concerning to experts because it is more likely to be used to deny Paxlovid to older patients and those with other health conditions, since they are more likely to be on multiple medications. But these two groups are also among the most vulnerable to Covid hospitalization and death.

To avoid harmful drug interactions, experts said, doctors can temporarily get a patient off a medication or provide an alternative during a course of Paxlovid — something they already often do with other treatments. “This is not some extraordinary thing that physicians don’t know how to do,” said Dr. Ashish Jha, the White House Covid response coordinator.

Only two of the 100 most prescribed medications, rivaroxaban (typically prescribed for blood clots) and salmeterol (for lung disease), produce interactions so severe that Paxlovid should be avoided altogether, according to the Infectious Diseases Society of America.

Some doctors would also like to see more evidence for Paxlovid. The arc of Covid has changed since Paxlovid started rolling out by early 2022, with more widespread vaccinations and the emergence of new variants. Some physicians want data demonstrating which patients still benefit from the drug, said Dr. Lindsay Petty, an infectious disease doctor at the University of Michigan.

Wachter agreed that more data would be good, but argued that the existing studies show convincing evidence of Paxlovid’s benefit. “If you’re an impartial reader and sit down to look at the research and compare it to other research we used to decide people should take statins or have their blood pressure treated, Paxlovid feels like it’s in the same category,” he said.

Breaking through

The White House and health organizations are working to get more physicians to prescribe Paxlovid. They have made some progress in increasing use and closing gaps based on race and class, Jha said.

But with Covid still tied to hundreds of deaths and thousands of hospitalizations a day, those advances are slower than anyone would like. As with vaccines and boosters, it’s hard to see what will get more Americans to embrace one of the most effective treatments we have for Covid.

More Covid news

The Biden administration plans to end the coronavirus public health emergency in May, which could limit access to free tests and treatments. Learning loss for children during the pandemic amounted to about one-third of a school year, a study found.

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The claim: Images show an article questioning why unvaccinated didn't 'do more' to warn about COVID-19 vaccines

“THEY KNEW: Why didn’t the unvaccinated do more to warn us?” reads the article's headline.

https://www.usatoday.com/story/news/factcheck/2023/01/31/fact-check-posts-share-fabricated-article-covid-19-vaccinations/11135367002/?

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Fact check: Post wrongly claims 118,000 'died suddenly' after COVID-19 vaccine release

The claim: CDC confirmed at least 118,000 have died suddenly since the rollout of COVID-19 vaccines

https://www.usatoday.com/story/news/factcheck/2023/01/23/fact-check-false-claim-covid-19-vaccines-have-caused-118-000-deaths-uk-kids-england-sean-feucht/10997754002/

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Fact check: False claim that 100% of Canada's COVID-19 deaths caused by vaccine

The claim: 100% of COVID-19 deaths in Canada now due to mRNA vaccine

https://www.usatoday.com/story/news/factcheck/2023/02/22/fact-check-false-claim-canadas-covid-19-deaths-caused-vaccine/11262981002/

Fact check: COVID-19 mRNA vaccines cannot cause the disease, don't have live virus

The claim: The Pfizer/BioNTech COVID-19 vaccine causes COVID-19 

https://www.usatoday.com/story/news/factcheck/2023/02/20/fact-check-no-mrna-vaccines-dont-cause-covid-19/11276014002/

Fact check: False claim CDC official linked ‘debilitating illnesses’ to COVID-19 shots

The claim: A CDC official acknowledged 'debilitating illnesses' are 'related to' COVID-19 vaccines

https://www.usatoday.com/story/news/factcheck/2023/02/17/fact-check-cdc-acknowledged-illness-reports-not-covid-19-vaccine-link/11265485002/

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The other deadly pandemic

Our mental health crisis is the new global killer, contributing to over 14% of all deaths

https://english.elpais.com/opinion/the-global-observer/2023-02-22/the-other-deadly-pandemic.html?

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Symptoms of COVID-19

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. Anyone can have mild to severe symptoms.

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html?

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N. Korea food shortage worsens amid COVID, but no famine yet

SEOUL, South Korea (AP) — There’s little doubt that North Korea’s chronic food shortages worsened due to the COVID-19 pandemic, and speculation about the country’s food insecurity has flared as its top leaders prepare to discuss the “very important and urgent task” of formulating a correct agricultural policy.

https://apnews.com/article/politics-kim-jong-un-south-korea-seoul-north-950fb682af3421c283870b30b5501560?

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Did the Lee County, Florida, GOP Pass a Proposal To Ban COVID-19 Vaccines?

The Lee County (Florida) Republican Party passed a proposal seeking to ban the sale and distribution of COVID-19 vaccines in Florida.

https://www.snopes.com/fact-check/lee-county-covid-vax/?