Clinicians work after intubating a COVID-19 patient in the Intensive Care Unit (ICU) at Lake Charles Memorial Hospital on August 10, 2021 in Lake Charles, Louisiana.
Mario Tama/Getty Images
More than 800,000 people have died of COVID-19 in the US as of Tuesday.
This comes a day after the US surpassed 50 million infections — the highest number of cases in the world.
The tragic milestone comes as the Omicron variant spreads and only 61% of Americans are fully vaccinated.
More than 800,000 Americans have died from COVID-19, nearly two years since the onset of the pandemic.
As of Tuesday, 800,266 people have died in the US, according to data compiled by Johns Hopkins University. The milestone comes a day after the country surpassed 50 million COVID-19 infections — the highest number of cases than any country in the world.
According to data from the Centers for Disease Control and Prevention, despite the distribution of vaccines in the past year, more people have died from COVID-19 in 2021 than in 2020. In 2020, more than 385,000 COVID-19 deaths were reported in 2020, compared to more than 410,000 so far this year.
Only 61% of the US population is fully vaccinated, and only 27.2% of those have gotten a booster shot, according to CDC data.
In September, the Centers for Disease Control and Prevention (CDC) gave the first comparison between booster shots of all three vaccines available in the US: Pfizer and Moderna (both mRNA shots), and Johnson & Johnson (an adenovirus vaccine).
It’s one of the most comprehensive looks at how people are responding to boosters to date.
Broadly, the CDC found that people who’d received three doses of either Pfizer or Moderna saw more local reactions — pain, itchiness, redness, or swelling at the injection site — after dose three compared to dose two. Other side effects such as fatigue, muscle aches, or headaches were less common, affecting 74% after their third dose, compared with 77% after dose two.
A second dose of J&J’s vaccine yielded the fewest side effects of all: Only 10% of J&J booster recipients said their side effects prevented them from performing normal daily activities — usually on the day after their booster shot — while the rest said they were able to go about their day as normal.
By comparison, 28% of Pfizer or Moderna booster recipients said the shots hindered their daily routine. However, the study included far more data on mRNA boosters — 12,000 people, compared to 48 who received two J&J doses.
The following table shows how booster shots affected people who got three doses of Moderna, three doses of Pfizer, or two doses of Johnson & Johnson’s vaccine, according to CDC data.
Aside from local reactions at the injection site, fatigue was most common among people who received a Pfizer or Moderna booster.
Overall side effects were more prevalent after Moderna's third dose: Half of Moderna booster recipients reported muscle aches and headaches, and around 60% reported fatigue.
Meanwhile, less than 40% of Pfizer booster recipients reported muscle aches and headaches and around 50% reported fatigue.
Just one-quarter of those who received a J&J booster had injection site reactions, compared with 70% who got a Pfizer booster and 80% who got a Moderna booster. And 20% of J&J booster recipients reported muscle aches and headaches.
The CDC recommends boosters for all adults and allows you to mix and match
The CDC now recommends booster shots for all Americans ages 16 and older. People who received two doses of Pfizer's or Moderna's vaccine should get boosted at least six months after their second shot, the CDC advises, whereas J&J recipients can get boosted as early as two months after their first dose.
The CDC has also approved a "mix and match" approach so people can select a booster of a different vaccine type or different manufacturer than their original dose.
An October study funded by the US National Institutes of Health (which has yet to be peer-reviewed) found that mix and match boosters yielded similar side effects to initial vaccine doses. More than half of the study's 458 participants reported malaise, headaches, and muscle aches after their booster while more than 70% experienced mild arm pain.
A UK study similarly identified fatigue, headaches, and pain at the injection site as the most common side effects. The study looked at nearly 2,900 people who had received two doses of Pfizer or AstraZeneca, followed by one of seven different COVID-19 boosters. Overall, side effects from boosters were more common in people ages 30 to 69 than those ages 70 and up, the study found — regardless of which vaccines the participants received.
Fatigue, headaches, and muscles aches were also common after first and second doses
The mRNA vaccines from Pfizer and Moderna instruct the body to produce a harmless viral protein, then develop antibodies against it. The first dose of these vaccines generally produces the mildest side effects, since our bodies are being introduced to the instructions and the resulting protein for the first time.
By the time we receive a second and third dose, our bodies have learned to recognize that protein quickly, so are ready to attack it. That's why side effects are generally more pronounced. (If you've had COVID-19 before, though, your first dose may yield more intense side effects than your second or third, according to one preprint.)
The following chart shows common vaccine side effects based on your age group, vaccine manufacturer, and which dose you received. Data is from each vaccine's clinical trial.
As with a booster shot, fatigue, headaches, and muscles aches were common after doses one and two.
In general, older people experience fewer side effects than younger adults because immune responses gradually weaken with age. That's also the reason why older people are in particular need of boosters: While vaccines still protect against severe disease for now, the Omicron variant seems to increase the risk of reinfection relative to other coronavirus strains.
It's also better than the original virus at evading antibodies from two vaccine doses, early lab studies suggest.
Cornell University shut down its Ithaca campus Tuesday amid a “rapid spread of COVID-19” among students.
As of Sunday, 469 active COVID-19 cases were reported, 214 of which were new positive tests.
The university’s president said evidence of the Omicron variant was present in a “significant number” of positive tests.
Cornell University shut down its Ithaca campus on Tuesday amid a “rapid spread of COVID-19” among students, the university president announced.
As of Sunday, 469 active COVID-19 cases were reported, 214 of which were new positive tests, according to university data.
Cornell University President Martha E. Pollack said in a statement Tuesday evidence of the Omicron coronavirus variant was present in a number of positive tests from Monday.
“While faculty and staff case numbers currently remain low, just last evening our COVID-19 testing lab team identified evidence of the highly contagious Omicron variant in a significant number of Monday’s positive student samples,” Pollack said.
Pollack added that the evidence of the Omicron coronavirus variant is still preliminary and additional sequencing will be done.
The university moved into “alert level red,” which entails moving all final exams to an online format effective immediately. All university activities, including a recognition ceremony for December graduates, have been cancelled.
Libraries, fitness centers, and gyms were closed to students, though offices and labs remain open.
“It is obviously extremely dispiriting to have to take these steps,” Pollack said in the statement. “However, since the start of the pandemic, our commitment has been to follow the science and do all we can to protect the health of our faculty, staff, and students.”
She added: “We have faced many challenges together over the last many months. I am confident that we can once again rise to meet this current challenge so we can all take a well-deserved break.”
Rochelle Walensky, director of the Centers for Disease Control and Prevention, previously said early data shows that the Omicron variant, though highly contagious, “is demonstrating some decreased severity.”
A man takes a COVID-19 test at Sydney International Airport on November 28, 2021.
James D. Morgan/Getty Images
Omicron raises questions about how much more infectious or dangerous the coronavirus can get.
In scientists’ best-case scenario, the virus could become endemic by the end of the decade.
But in a worst-case scenario, a more lethal variant could spill over from animals to humans.
For nearly six months, Delta seemed capable of vanquishing all other coronavirus variants — so much so that scientists wondered whether the virus had reached the apex of its ability to infect humans.
In November, Omicron threw scientists for a loop: After driving up cases in South Africa, it spread to dozens of countries seemingly overnight. Early lab studies now suggest that Omicron increases the risk of reinfection relative to other strains and is better than the original virus at evading antibodies from two vaccine doses.
Now scientists are wondering: Is Omicron as infectious as it gets?
There’s no easy answer, but scientists have a few guesses about the virus’ future. In the best-case scenario, they say, the coronavirus will become endemic, meaning cases will persist at low levels, perhaps resulting in seasonal outbreaks of relatively mild disease. In a middle-of-the-road scenario, the virus could get even better at resisting vaccines, exposing more vaccinated people to severe illness. And in a frightening scenario, the virus could recombine with another coronavirus to form a more lethal, hybrid variant.
Some scientists aren’t betting on that last outcome.
The virus “seems unlikely to do much worse than what we’re already dealing with,” Vaughn Cooper, director of the Center for Evolutionary Biology and Medicine at the University of Pittsburgh, told Insider.
Still, he added, “I keep getting fooled.”
The best-case scenario: The virus becomes a ‘seasonal annoyance’
People take COVID-19 tests at a pop-up testing site in New York City, on December 7, 2021.
Reuters/Brendan McDermid
Viruses have one major objective: survival. Scientists generally agree that the best way for the current coronavirus, SARS-CoV-2, to survive long-term is to become endemic in the population, similar to the way influenza or other human coronaviruses have evolved.
Becoming more lethal could put the virus at a disadvantage, since people need to stay alive to keep infecting others. And because the virus is already skilled at transmitting, future variants may not need to drastically alter how the virus behaves.
“Are we playing whack-a-mole forever with SARS-CoV-2? No. It’s going to become an endemic coronavirus that is going to become a seasonal annoyance,” Cooper said, adding, “That’s going to happen this decade, maybe before the end of this decade.”
While Cooper think some years will have worse coronavirus outbreaks than others, overall he expects vaccines to continue to ward off severe disease. That’s because antibodies aren’t the body’s only form of protection: White blood cells known as T cells and B cells also remember foreign invaders, often for longer periods than antibodies.
“One thing I am confident about is that my three doses of the original vaccine has created a diversity of cellular immune responses that are going to protect me against the virus several years from now,” Cooper said. “I will bet good money on that. I may get sick, but it’s not going to make me really sick because my T cells and B cells have seen something like this before.”
The middle-of-the-road scenario: Vaccines become less effective as the virus evolves
Jolanta Gawlik, left, gives Juliana Cepeda the Pfizer COVID-19 vaccine in New York.
Mark Lennihan/AP Photo
The coronavirus may ultimately encounter a limit to how much it can spread when everyone capable of being infected has some degree of immunity. At that point, the virus might have to get better at circumventing the body’s immune defenses — whether from vaccines or natural infection — to stay alive.
“The easiest way for the virus to cause new epidemics is to evade immunity over time,” Adam Kucharski, a mathematical epidemiologist at the London School of Hygiene and Tropical Medicine, told Nature in December. “That’s similar to what we see with the seasonal coronaviruses.”
In that case, widespread immunity could put pressure on the virus to form new variants that render vaccines less and less effective.
“The evolutionary forces that could undermine vaccination — those are coming,” Andrew Read, who studies the evolution of infectious diseases at Pennsylvania State University, told Insider. The virus, he added, “is a long way from having tapped all of its own mutational potential.”
The worst-case scenario: The virus combines with another coronavirus inside an animal, then spills back into humans
A white-tailed deer in Pineland Park, Pennsylvania, on November 2, 2021.
Ben Hasty/MediaNews Group/Reading Eagle/Getty Images
As the coronavirus continues to spread widely, it’s possible that an animal could get infected with two coronaviruses at once: the current virus, SARS-CoV-2, plus another coronavirus found in wildlife. In a nightmare scenario, those viruses might form a hybrid variant that spills over to the human population and is more lethal than its predecessors.
“We’ve got an awful lot of SARS-2 around, so the potential for something to spill into humanity and recombine with SARS-2 is pretty high,” Read said.
Already this century, three coronaviruses capable of causing severe disease — SARS-CoV, MERS-CoV, and SARS-CoV-2 — have spilled over from animals to humans. Coronaviruses also have a high capacity to recombine, Read said. A May study found evidence of a recombinant coronavirus in a hospitalized person with pneumonia. The study’s researchers traced the origin of the virus to coronaviruses in cats and dogs. Although scientists are still investigating the origins of SARS-CoV-2, a December 2020 study suggested that the virus emerged from a recombination of bat and pangolin coronaviruses.
So the possibility of another spillover event “seems pretty worrying to me,” Read said.
But Cooper cautioned that it’s rare for a human or animal to be infected with two viruses at once.
“We should be worried about it, but where does it stand among our worries? It’s still quite low,” he said, calling recombination “more of a long-term concern.”
“Most recombination events fail because the parts don’t work well together,” Cooper said. “But if we’ve learned anything about this pandemic, when you have really huge numbers, really weird things happen.”
“There are white-tailed deer all over the place in my neighborhood outside of Pittsburgh and I can’t help but look at them as all having had, or currently having, SARS-CoV-2,” Cooper said. “The virus is evolving in them, too. We know this. How is it evolving? We don’t know.”
Sandra Lindsay, a nurse at Long Island Jewish Medical Center, is inoculated with the COVID-19 vaccine by Dr. Michelle Chester, at Long Island Jewish Medical Center, on December 14, 2020.
Mark Lennihan/AFP/Getty Image
The first person in US to receive a COVID-19 vaccine said healthcare workers are “tired.”
New York nurse Sandra Lindsay made the remarks on the one-year anniversary of her shot.
Lindsay said more must be done to get people vaccinated as new variants like Omicron emerge.
The first person in the US to receive a COVID-19 vaccine exactly one year ago said on Tuesday that healthcare workers are “tired” and “concerned” as the pandemic drags on, CNN reported.
Sandra Lindsay, a nurse in New York, was the first person to get vaccinated against COVID-19 outside of clinical trials on December 14, 2020, at the Long Island Jewish Medical Center.
Lindsay said she looks back with “tremendous gratitude” that she was able to get vaccinated.
But, she added: “I can speak on behalf of health care workers at my organization when I say that we are tired, and we’re concerned, especially because we know that the public now has options,” she said.
Last year’s milestone kicked off a nationwide vaccination campaign in the US, with over 485 million doses administered across the country, according to the latest figures from the Centers for Disease Control and Prevention.
Fully vaccinated people make up 60.9% of the population — or over 202 million people — according to the CDC, though that figure includes children who were unable until recently to get the shots. Over 72% of Americans over the age of 18 have been fully vaccinated, according to the CDC.
“Although we’ve made some progress, we still have some way to go,” Lindsay told CNN. “My hope is that here as Americans and around the world, we can unite to finally put an end to the pandemic.”
But the one-year anniversary of the historic jab comes as the nation faces an increasing presence of the new Omicron variant, which was first detected in the US on November 15, according to the CDC.
Health officials such as CDC Director Rochelle Walensky have urged people to get vaccinated and boosted, saying that while Omicron may appear to be less severe, a fresh wave of COVID-19 cases would mean “a lot of people” will get sick.
A passenger who arrived from Italy administers a self-collected nasal swab at Los Angeles International Airport on December 3, 2021.
Mario Tama/Getty Images
Early data suggests Omicron could evade some types of protection from vaccines.
Most has been about antibody responses, with less attention to another mechanism: T cells.
T cells could stop the worst ravages of Omicron, but may not stop mild infection.
As studies and predictions flood in about the Omicron coronavirus variant, much attention has focused on the prospect that vaccines won’t work as well against it.
Nations have thrown up travel bans, issued dire warnings, and supercharged their booster programs in the hope of holding back the new strain.
However, much of the warnings and decision-making do not address the fact that the body has two distinct ways to protect from a virus, and so far only one of those might be found wanting against Omicron.
Early research suggests that Omicron might be able to get around the human immune system’s first line of defense — the antibodies produced either after infection or vaccination.
But there are signs that its backup force of so-called T cells, also primed after infection or vaccination, may yet provide a strong defense.
In a lab, Omicron escapes antibodies from vaccines
When a new variant comes to the fore, scientists run a series of tests in a lab to try and determine its characteristics.
The quickest is a test that analyzes how well antibodies fare against a virus, so that’s usually the one the world hears about first.
Those tests are what drove recent news headlines warning that even two doses of vaccine may be insufficient.
Early lab data found antibodies in those with two doses of Pfizer vaccine working markedly less well against Omicron, producing an effect 25 to 40 times weaker than with other variants.
This could be because Omicron’s dozens of mutations make it harder for existing antibodies to do their job of recognizing patterns on the virus and attacking them.
An annotated schematic of the Omicron Spike protein. Deletions are marked in blue, mutations in red.
Ulrich Elling, Institute of Molecular Biotechnology/Insider
Enter the T cell
The way T cells behave in the body takes much longer to work out. They patrol the blood and are meant to pounce and kill the virus, a reaction that does not require effective antibodies.
They too learn from previous infection and vaccination and it could be that their effect remains intact with Omicron
“It suggests that T cell responses remain largely intact and should remain largely intact against Omicron,” Andrew Redd, a virologist at the National Institute of Allergy and Infectious Diseases said, per NBC news.
The issue with T cell responses, however, is that they are slower to act than neutralizing antibodies, Eric Topol, founder and director of the Scripps Research Translational Institute, said in a blog post.
This means that, while it may ultimately help the body defeat the virus, it could allow a mild infection to develop first, and could allow sick people to spread the virus, Topol said.
“It should, I hope, keep the majority of infected people from having to go to the hospital,” Rachel Graham, an assistant professor in the department of epidemiology at the University of North Carolina at Chapel Hill, told NBC news.
A man receives the COVID-19 vaccine at a drive-through COVID-19 vaccination site in Gaborone, Botswana, on October 12, 2021
Tshekiso Tebalo/Xinhua/Getty Images
Boosters could bring antibody levels back up
At this stage, there’s not enough data to say for sure how these mechanisms function in the context of Omicron.
Early real-world data from South Africa, published Tuesday before peer review, suggested that two doses of Pfizer vaccine seemed to have reduced the risk of hospitalization by about 70% even at a time when Omicron was a majority of cases. This compares with rates of about 90% for the Delta variant.
Experts, however, warned that it is too soon to conclude how effective vaccines are against Omicron from this data alone, Insider previously reported.
According to data mentioned in a Pfizer press release, which had not been released to the public, boosters caused a 25-fold increase in neutralizing antibody levels after two doses of vaccine, bringing them back up to levels seen with earlier variants.
The World Health Organization has said that there is not enough data to say that boosters are necessary for most.
This was a drop from about 92% in a previous Delta wave, the researchers from Discovery Health, South Africa’s largest insurer and South Africa’s Medical Research Council, said in a briefing Tuesday.
Glenda Gray, president of the South African Medical Research Council, said that boosters “will help” with the possible reduction in protection against hospitalizations, per local broadcaster eNews Channel Africa.
The preliminary study from South Africa, which hasn’t yet been formally published, is one of the first real-world insights into how much protection COVID-19 vaccines might afford against Omicron — a fast-spreading variant with 32 mutations in the part of the virus that infects cells and existing vaccines target.
The study’s findings may be limited, however, because it assumed 78,000 of 211,000 lab test results from November 15 and December 7 were Omicron but didn’t confirm it. South African health officials said on December 2 that Omicron accounted for 70% of sequenced COVID-19 cases in the country in November.
Simon Clarke, associate professor in Cellular Microbiology at University of Reading, cautioned that three weeks may not be long enough to give an accurate picture of how vaccines work against severe COVID-19. “It shouldn’t be forgotten that in the UK there was a five week gap between the first diagnosis and the first death,” he said in a statement to the Science Media Center Tuesday.
The latest analysis found that, compared with those who had not been vaccinated, the vaccine protected all age groups from admission to hospital with COVID-19 during South Africa’s Omicron wave, with protection ranging from the highest – at 92% – in 18 to 29 year olds, down to 59% protection in 70 to 79 year olds, according to the researchers. Older people were immunized first in South Africa so waning immunity may have contributed to the findings.
Early studies on Pfizer’s vaccine, from various labs worldwide, have already found a 20 to 40 fold reduction in antibody response against Omicron versus other variants.
It wasn’t clear from the experiments how well the vaccine would perform in real-life especially against severe disease, which relies on other components of the immune system, called T cells and memory cells, rather than antibodies. Antibodies stop the initial infection and then T cells and memory cells stop you from getting sick or dying, although a few people will inevitably become severely unwell from the virus.
The South African researchers also said Tuesday that Pfizer’s vaccine was 33% effective against infection during the Omicron wave compared with 80% in the Delta surge. Antibodies are the first line of defence against infection so the reduction in protection could be in keeping with the lab studies.
Real-world data from the UK published Friday found that, after a booster, Pfizer’s vaccine was 70% to 75% effective against symptomatic COVID-19 caused by Omicron.
Both fell ill to COVID-19 during the April outbreak.
Craig F. Walker/The Boston Globe/Getty Images
Pfizer’s oral drug cut the risk of severe COVID-19 by 89% when given to high-risk people within three days of symptoms.
If the drug was given within five days of symptom onset it was 88% effective, Pfizer said.
The study hasn’t been published or formally scrutinized by other experts.
Pfizer announced Tuesday that its oral pill helped protect those at high-risk of severe COVID-19 in a late stage trial.
The company said in a press release that the drug, called Paxlovid, reduced the risk of hospitalization or death by 89% when given to high-risk people within three days of symptom onset in the study of 2,246 people.
If the drug was given within five days of symptoms starting it was 88% effective, Pfizer said.
The findings are “consistent” with a preliminary analysis from November that found Paxlovid reduced the risk of hospitalization or death by 89% compared to placebo in non-hospitalized, high-risk adults when given within three days of symptom onset, Pfizer said.
The company said that the pill should work against the Omicron variant, citing data from lab studies.
None of the findings have been published and formally scrutinized by other experts.
Andrew Pekosz, vice chair of microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health, told STAT, that the protection from hospitalization was “fantastic” and pointed to Paxlovid being a “really important weapon in our arsenal to fight COVID-19”.
Pfizer said that the latest data had been shared with the Food and Drug Administration as part of an ongoing review.
Albert Bourla, chief executive officer at Pfizer, said in a statement that “emerging variants of concern, like Omicron, have exacerbated the need for accessible treatment options for those who contract the virus.” “We are confident that, if authorized or approved, this potential treatment could be a critical tool to help quell the pandemic,” he said.
This story is developing. Please check back for updates.
It said in a memo those workers will no longer get two weeks paid leave if infected with COVID-19.
It is also adding a $50-per-month charge to some unvaccinated employees’ health plans, the report said.
The grocery chain Kroger will no longer offer paid emergency leave to unvaccinated workers who get infected with COVID-19, The Wall Street Journal reported, citing a memo to employees sent last week.
The policy comes into effect on January 1, 2022, The Journal reported.
The Journal reported that the rule change will apply “unless local jurisdictions require otherwise.”
The company is also adding a $50-per-month charge to the health plans of managers who aren’t vaccinated and of non-union employees, the memo said, according to The Journal.
Kroger earlier this year paid employees $100 to get vaccinated against COVID-19, and let employees who can’t get vaccinated do a health-and-safety course to get the payment. It also gave prizes to people who got vaccinated its stores.
The new policy comes amid a push by President Joe Biden’s administration for companies to ensure their employees are vaccinated against the novel coronavirus.
Biden wants to enforce vaccination for federal government employees and employees at companies with more than 100 workers from January 4. Employees would also be able to get regularly tested instead.
A medical worker shows a COVID-19 rapid antigen test.
PIERO CRUCIATTI/AFP/Getty Images
A Biden official warned “everything points to a large wave” of Omicron hospitalizations and deaths.
The Omicron variant currently appears to spread more rapidly.
“It won’t be as severe, but regrettably, there will be plenty of hospitalizations,” the official said.
The Omicron variant of the coronavirus will bring a “large wave” of COVID-19 infections and hospitalizations to the US soon, a senior Biden administration official told Axios.
“Everything points to a large wave. A large wave is coming,” said the official, who was not named in the report.
“It will be fast. It won’t be as severe, but regrettably, there will be plenty of hospitalizations.”
This means that even if the variant results in milder disease — which early evidence suggests it might — the variant could still bring about more severe infections.
Some European countries said their number of Omicron cases are doubling every two days, and warned of their health systems being overwhelmed. Many countries, such as the UK, are putting in new restrictions and ramping up booster vaccination efforts in response.
Experts are still rushing to figure if the variant is more infectious or more deadly, and if it weakens the effects of existing treatments and vaccines.
The Omicron variant has a high number of mutations, which is why experts are so concerned. Mutations are what can bring about changes in how infectious or deadly the variant is, or how it responds to treatments.
Pfizer announced last week that two doses of its coronavirus vaccine are less effective against the Omicron variant, but that a third dose greatly increases a person’s protection.
The UK has recorded one death of someone with the Omicron variant, Prime Minister Boris Johnson said as he warned that the variant was spreading rapidly.
