- Thomas Tuchel split Bayern Munich in half. The plan worked… eventually The Athletic
- Bayern Munich vs. Borussia Dortmund | Bundesliga Highlights | ESPN FC ESPN FC
- Back to the 4-2-3-1: Thomas Tuchel, Thomas Müller, and Joshua Kimmich explain Bayern’s formation vs Borussia … Bavarian Football Works
- Chelsea fans in ‘pain’ at Thomas Tuchel ‘rubbing salt in wound’ after impressive reaction to Bayern’s win v… The US Sun
- Bayern Munich: Top three performers in Der Klassiker Bayern Strikes
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Tag Archives: Eventually
Apple is still working on an iPhone subscription service which should arrive… eventually – PhoneArena
- Apple is still working on an iPhone subscription service which should arrive… eventually PhoneArena
- iPhone hardware subscription program delayed by ‘engineering and technical setbacks’ 9to5Mac
- Apple’s iPhone hardware subscription could arrive by March AppleInsider
- Apple Eyeing Bigger Role In Consumers’ Financial Lives, Says Gurman; Why It’s A Challenging And Long-Draw Benzinga
- Apple’s iPhone Hardware Subscription Service Reportedly Facing Several Setbacks, Forcing It To Be Delayed Wccftech
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STEEL PANTHER’s MICHAEL STARR On OZZY OSBOURNE’s Retirement: ‘It Comes To An End For Everybody Eventually’ – BLABBERMOUTH.NET
- STEEL PANTHER’s MICHAEL STARR On OZZY OSBOURNE’s Retirement: ‘It Comes To An End For Everybody Eventually’ BLABBERMOUTH.NET
- Judas Priest release short statement on Ozzy Osbourne’s tour retirement, future shows Louder
- Frail Ozzy Osbourne seen for the first time since cancelling UK and Ireland shows and retiring from touring… The US Sun
- Zakk Wylde tells Ozzy Osbourne: “When you are ready to roll, we will roll” Guitar World
- Zakk Wylde offers Ozzy Osbourne support in his retirement: “When you are ready to roll – we roll” Louder
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Mets Conducting Interviews For Team President; Sandy Alderson To Eventually Transition To Advisory Role
The Mets announced Thursday afternoon they’ve begun a hiring process for a new team president. Sandy Alderson will remain in the role until a new hire is finalized, at which point he’ll become a “special advisor” to ownership. Andy Martino of SNY reported the development shortly before the team announcement.
Mets owner Steve Cohen settled on Alderson as team president in the fall of 2020, a couple months before his purchase of the franchise from the Wilpon family was even finalized. As soon as that sales process closed, the club parted ways with then-general manager Brodie Van Wagenen and much of his high-ranking staff and announced Alderson’s hiring.
“When I asked Sandy to come back to the team, it was for a defined period of time and with a specific mandate — revive our culture and this iconic franchise for our fans, partners and employees,” Cohen said today in the press release announcing the news. “Sandy has done those very things and more and we have begun a search for his successor. When we find that person, I have asked Sandy to continue in a new role as special advisor to me and the senior leadership team.”
Alderson originally signed a two-year contract, which Martino reports is set to expire at the end of December. According to Martino, Alderson and Cohen mutually agreed it was time to bring in a new team president. None of the specific candidates are yet known, although Martino adds the people currently under consideration primarily come from business backgrounds as opposed to baseball operations careers. No hiring appears imminent, and Alderson is expected to remain team president until a new hire is found, even if that process stretches past the official expiration of his contract.
The team president role is an overhead position, with that individual responsible for impacting both the baseball and business operations of the organization. Alderson is not the team’s day-to-day baseball ops decision-maker, and the incoming hire is not expected to take that role either. Daily baseball operations tasks fall to general manager Billy Eppler, who signed a four-year contract last November. There’s no indication that Alderson’s change will have any impact on Eppler’s job status; Martino writes that Mets ownership has been “pleased” with Eppler’s work thus far, hardly a surprise considering the team is a lock to reach the playoffs and is battling the defending World Series champion Braves for the NL East title.
Alderson had been the Mets daily baseball operations decision-maker in the past, serving as GM from 2010-18. He stepped away in the summer of 2018 after being diagnosed with cancer. He returned to the organization a year and a half later but has seemingly never had any interest in reassuming his old responsibilities. The 74-year-old was pressed into temporarily running the baseball operations department late last season, but Jon Heyman reported at the time that Alderson had no interest in taking the role permanently.
The Mets hired Eppler this past offseason, with Alderson sliding back into his team president position for the second year of his deal. Martino adds that he and Cohen always planned to limit his time in that capacity to two years; his forthcoming move into a less demanding advisory role isn’t tied to any new health concerns, fortunately.
Alderson’s time as team president was not without a notable misfire. Not long after returning to the organization, Alderson helped orchestrate a GM search process that culminated in the hiring of former Diamondbacks executive Jared Porter. Hired in December 2020, Porter held the position for around one month, before ESPN reported he had sexually harassed a reporter four years prior. The Mets promptly dismissed Porter, who was eventually banned by Major League Baseball through at least the end of the 2022 season.
A few months thereafter, The Athletic reported allegations of sexual misconduct against former Mets manager Mickey Callaway, whom Alderson had hired during his stint as the club’s general manager. Callaway, who was working for the Angels at the time those allegations were made public, was ultimately dismissed and likewise declared ineligible by MLB through at least 2022.
In the wake of the Porter debacle, the Mets promoted assistant GM Zack Scott to acting general manager. Scott appeared a strong candidate to take that role permanently, but he was arrested and charged with driving under the influence in September 2021. The Mets placed him on administrative leave and thrust Alderson into control of baseball operations for a few months.
New York parted ways with Scott after the season while his criminal case was still pending. Scott was acquitted this January, with the trial court judge writing that he “performed (field sobriety) tests in a manner in which no neutral observer would conclude he was drunk, especially to the point of intoxication.” Scott hasn’t returned to baseball operations with an MLB team, although Tim Healey of Newsday reported in April that he’d turned down front office jobs to work with a private consulting firm.
In the wake of Scott’s departure, the Mets conducted a highly-publicized search process for their baseball operations leader last offseason. The Mets reportedly made runs at Theo Epstein, Billy Beane and David Stearns (among others) before tabbing Eppler. While the Mets have consistently maintained they’ve been happy with Eppler’s performance, some fans and outside observers have speculated about the possibility of the club making another run at one of those notable executives this winter. Alderson stepping down may add some fuel to that fire, but it’s worth reiterating the team president vacancy is a more overarching position than the jobs that Epstein, Beane and Stearns have held in recent years.
Beane and Stearns remain with the A’s and Brewers, respectively, with both working as their clubs’ president of baseball operations. Milwaukee owner Mark Attanasio blocked the Mets efforts to interview Stearns last winter. He remains under contract with the Brewers through 2023, although a deep postseason run this year (either to the NLCS or the World Series) would reportedly allow him to opt out of that deal at the end of this season. Milwaukee is currently 1 1/2 games out of the final Wild Card spot in the National League. Epstein and Beane were permitted to speak with the Mets last fall, but both eventually took themselves out of consideration for the job.
At this point, the most likely course of action is that the Mets eventually bring in a business-oriented team president while continuing to delegate baseball operations to Eppler. Even if the incoming president isn’t brought aboard to take over daily baseball decisions, it marks a notable hire for Cohen and his staff. For the third straight winter, there’ll be some key changes in the Mets executive hierarchy.
Look past the ‘misery’ and remember that the market will eventually recover, Jim Cramer says
CNBC’s Jim Cramer on Thursday reminded investors to stay the course in the market, as the pain will eventually go away.
“The fact is, if you own stocks right now, the odds favor that you’re going to lose money. So why not just get out and circle back at a better moment? … Because losing money in markets like this one is actually part of the process,” he said.
The “Mad Money” host, who said Wednesday that the Federal Reserve is winning its battle against inflation, reiterated his position that inflation has peaked or is close to doing so.
To illustrate his point, he examined three charts:
“We hoped that we’d get [peak] Producer Price Index numbers, then we hoped to get a peak in oil, we hoped to get a peak in food. Looking at these charts. …They’re all peaking,” he said.
However, the goal posts for where the numbers should be have changed in recent months as fears of a looming recession grow, according to Cramer.
“Six months ago, these peaks would’ve been ridiculously bullish, but now they’re just pictographs of a weakening economy,” he said.
However, he reminded investors that the market will eventually recover.
“I’m sure we aren’t done with this misery. But I’m also sure that one day the goal posts will be at the end of the field, and all will be well. I just don’t know when,” he said.
A Pharmaceutical Scientist Explains How Drugs Know Where to Go in The Body
When you take aspirin for a headache, how does the aspirin know to travel to your head and alleviate the pain?
The short answer is, it doesn’t: Molecules can’t transport themselves through the body, and they don’t have control over where they eventually end up.
But researchers can chemically modify drug molecules to make sure that they bind strongly to the places we want them and weakly to the places we don’t.
Pharmaceutical products contain more than just the active drug that directly affects the body. Medications also include “inactive ingredients,” or molecules that enhance the stability, absorption, flavor and other qualities that are critical to allowing the drug to do its job.
For example, the aspirin you swallow also has ingredients that both prevent the tablet from fracturing during shipping and help it break apart in your body.
As a pharmaceutical scientist, I’ve been studying drug delivery for the past 30 years. That is, developing methods and designing nondrug components that help get a medication where it needs to go in the body.
To better understand the thought process behind how different drugs are designed, let’s follow a drug from when it first enters the body to where it eventually ends up.
How drugs are absorbed in the body
When you swallow a tablet, it will initially dissolve in your stomach and intestines before the drug molecules are absorbed into your bloodstream. Once in the blood, it can circulate throughout the body to access different organs and tissues.
Drug molecules affect the body by binding to different receptors on cells that can trigger a particular response.
Even though drugs are designed to target specific receptors to produce a desired effect, it is impossible to keep them from continuing to circulate in the blood and binding to nontarget sites that potentially cause unwanted side effects.
Drug molecules circulating in the blood also degrade over time and eventually leave the body in your urine. A classic example is the strong smell your urine might have after you eat asparagus because of how quickly your kidney clears asparagusic acid. Similarly, multivitamins typically contain riboflavin, or vitamin B2, which causes your urine to turn bright yellow when it is cleared.
Because how efficiently drug molecules can cross the intestinal lining can vary depending on the drug’s chemical properties, some of the drugs you swallow never get absorbed and are removed in your feces.
Because not all of the drug is absorbed, this is why some medications, like those used to treat high blood pressure and allergies, are taken repeatedly to replace eliminated drug molecules and maintain a high enough level of drug in the blood to sustain its effects on the body.
Getting drugs to the right place
Compared with pills and tablets, a more efficient way of getting a drug into the blood is to inject it directly into a vein. This way, all the drug gets circulated throughout the body and avoids degradation in the stomach.
Many drugs that are given intravenously are “biologics” or “biotechnology drugs,” which include substances derived from other organisms.
The most common of these are a type of cancer drug called monoclonal antibodies, proteins that bind to and kill tumor cells. These drugs are injected directly into a vein because your stomach can’t tell the difference between digesting a therapeutic protein and digesting the proteins in a cheeseburger.
In other cases, drugs that need very high concentrations to be effective, such as antibiotics for severe infections, can be delivered only through infusion.
While increasing drug concentration can help make sure enough molecules are binding to the correct sites to have a therapeutic effect, it also increases binding to nontarget sites and the risk of side effects.
One way to get a high drug concentration in the right location is to apply the drug right where it’s needed, like rubbing an ointment onto a skin rash or using eyedrops for allergies. While some drug molecules will eventually get absorbed into the bloodstream, they will be diluted enough that the amount of drug that reaches other sites is very low and unlikely to cause side effects.
Similarly, an inhaler delivers the drug directly to the lungs and avoids affecting the rest of the body.
Patient compliance
Finally, a key aspect in all drug design is to simply get patients to take medications in the right amounts at the right time.
Because remembering to take a drug several times a day is difficult for many people, researchers try to design drug formulations so they need to be taken only once a day or less.
Similarly, pills, inhalers, or nasal sprays are more convenient than an infusion that requires traveling to a clinic for a trained clinician to inject it into your arm.
The less troublesome and expensive it is to administer a drug, the more likely it is that patients will take their medication when they need it.
However, sometimes infusions or injections are the only effective way that certain drugs can be administered.
Even with all the science that goes into understanding a disease well enough to develop an effective drug, it is often up to the patient to make it all work as designed.
Tom Anchordoquy, Professor of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Macron Says Ukraine and Russia Must Eventually Talk
French President
Emmanuel Macron
said Ukraine would eventually have to hold peace talks with Russia, while Ukrainian troops fought hard to hold back the Russian invasion force in the country’s east.
“At some point, when we will have helped Ukraine as much as possible to resist, when I hope Ukraine will have won and fighting will have stopped, we will have to negotiate,” Mr. Macron told reporters while visiting French troops in Romania.
Mr. Macron’s comments underlined the view in Western European capitals such as Paris and Berlin that the war will ultimately need a diplomatic solution. The Franco-German emphasis on diplomacy is raising hackles in Europe’s east, where several countries believe only a Russian defeat will safeguard wider European security.
Mr. Macron, German Chancellor
Olaf Scholz
and Italian Prime Minister
Mario Draghi
are expected to visit Ukraine on Thursday for talks with President Volodymyr Zelensky, although neither government has officially confirmed the trip.
Russia’s nearly four-month-old war on Ukraine shows no sign of ending or reducing in intensity, as Moscow’s forces inch forwards slowly in Ukraine’s eastern Donbas region at a heavy cost in lives on both sides.
Ukrainian forces were holding out in the strategic city of Severodonetsk against repeated Russian onslaughts, Ukraine’s military said Wednesday, underscoring the difficulties Russian forces are facing in capturing urban centers where their advantage in long-range artillery is less decisive.
Smoke and dirt rise from Severodonetsk during fighting between Ukrainian and Russian troops.
Photo:
aris messinis/Agence France-Presse/Getty Images
While the U.S. and its European allies in the North Atlantic Treaty Organization have united behind a policy of supporting Ukraine, including with arms and money, differences have become apparent about how aggressively to arm Kyiv and what Ukraine can realistically achieve on the battlefield.
France, Germany and some other Western European countries are pessimistic about Ukraine’s chances of battling Russian forces back to their preinvasion positions, which is Kyiv’s declared goal.
Poland, the Baltic countries and others say faster delivery of heavy weapons is needed to deal President
Vladimir Putin
a lasting defeat that would discourage more expansionism by Russia in the future.
The U.S., although Ukraine’s biggest arms supplier, has also acted with a caution that has frustrated Kyiv, reflecting concern in Washington that deeper involvement could lead to an uncontrolled escalation into a direct conflict with nuclear-armed Russia.
Mr. Macron on Wednesday didn’t repeat his recent comment that Russia shouldn’t be humiliated, a formulation that sparked furious criticism in Eastern Europe, where Russian expansionism is widely seen as an existential threat by countries that escaped from Moscow’s domination at the end of the Cold War.
“We must not humiliate Russia so that the day when the fighting stops we can build an exit ramp through diplomatic means,” Mr. Macron said in an interview with French newspapers published on June 4.
Facing accusations of appeasement from Europe’s east, France has in recent days stressed its military support for Ukraine, including the delivery of modern long-range artillery pieces. Mr. Macron stressed his desire for Ukraine to defend itself successfully.
“The only desirable outcome of the conflict is either a military victory of Ukraine, or at some point, a discussion, because fighting will have stopped, allowing an agreement between Ukraine and Russia,” Mr. Macron said.
France and Germany have repeatedly said they won’t pressure Ukraine into making territorial or other concessions, saying only Kyiv can decide which peace terms with Moscow are acceptable.
However, NATO governments acknowledge that Ukraine’s bargaining position will depend on its battlefield position. Increasingly, Ukraine’s military prospects are being determined by its access to Western weapons systems, meaning that the U.S. and European leaders hold enormous sway over Ukraine’s fortunes despite their protestations of deference to Kyiv.
Mr. Macron reiterated his view that the West would have to find a modus vivendi with Russia after the war is over.
“We, Europeans, we share a continent, and geography is stubborn: It turns out that at the end of it, Russia is still there,” he said.
A Ukrainian soldier the front line in eastern Ukraine.
Photo:
GLEB GARANICH/REUTERS
A building damaged by Russian shelling in Borodyanka, Ukraine.
Photo:
Orlando BarrÃA/Zuma Press
The French leader has sought to maintain a dialogue with Mr. Putin via numerous telephone calls before and since the Kremlin launched its invasion of Ukraine on Feb. 24. Eastern European allies have criticized Mr. Macron’s efforts to talk to Mr. Putin, saying the phone calls have yielded no results.
In the battle for Severodonetsk, Russian forces destroyed the last main bridge to the rest of Ukrainian-held territory on Tuesday, impairing Ukraine’s supply lines to the city that has become the war’s focal point in recent weeks.
Fighting in Severodonetsk continued on Wednesday after Ukraine repulsed Russian assaults, the General Staff of the Armed Forces of Ukraine said in a statement.
Oleksandr Stryuk, head of the military-civilian administration of Severodonetsk, said some supply lines into Severodonetsk remain intact. Ukrainian forces are in control of the industrial area of the city, including a large chemicals plant where civilians and soldiers are taking refuge, and were attempting to push back Russian troops into the center of town, Mr. Stryuk told Ukrainian television.
“It’s getting harder, but our soldiers are holding back the enemy on three sides at once,” said regional governor
Serhiy Haidai.
Ukrainian soldiers carry antitank mines in the Donetsk region of eastern Ukraine.
Photo:
Efrem Lukatsky/Associated Press
The bitter resistance of Ukrainian troops in Severodonetsk follows a strategic decision by Ukrainian commanders not to withdraw from cities that appear all but lost, but to stand and fight, depleting Russian forces in close combat where their artillery and air power offer fewer advantages.
“The losses, unfortunately, are painful. But we have to hold on,” Mr. Zelensky said in an address late Tuesday. “It is vital to hold on there, in Donbas. The more losses the enemy suffers there, the less strength they will have to continue the aggression.”
Ukraine’s military said on Wednesday that it had also largely repelled Russian assaults around the city of Slovyansk, which Moscow’s forces have been trying to surround in recent weeks. Still, the General Staff said there was a Russian advance toward the village of Krasnopillya to Slovyansk’s northwest.
Mr. Zelensky issued an urgent appeal for more military aid from the West in a video address late Tuesday. He called for modern antimissile systems, noting that Russia is increasingly using Soviet-designed missiles that are less accurate and therefore more dangerous to civilians.
NATO defense ministers were meeting in Brussels on Wednesday to contend with the disagreements over how much military aid to provide to Kyiv. The meeting was due to be preceded by a gathering of the Ukraine Defense Contact Group, comprising around 50 countries that are providing lethal and nonlethal aid to Ukraine.
Russian forces have used their artillery advantage to pummel Ukrainian forces and push deeper into the country’s east in recent weeks. Mr. Zelensky has called with growing urgency for more heavy weapons to counter the attacks. Kyiv has complained loudly that Western hesitancy is costing Ukrainian lives as its forces suffer heavy casualties against Russia’s preponderant artillery.
Mr. Macron was in Romania on Tuesday and Wednesday to meet with his Romanian counterpart, President
Klaus Iohannis,
and visit the Mihail Kogălniceanu base, which is home to a new NATO force that includes about 500 French and 300 Belgian troops. He is set to then head to Chisinau, Moldova’s capital, where he plans to meet with President
Maia Sandu.
Asked about his expected but unconfirmed visit to Ukraine, Mr. Macron only said new talks were necessary.
A building heavily damaged by a Russian military strike in the town of Dobropillia, Ukraine.
Photo:
GLEB GARANICH/REUTERS
Write to James Marson at james.marson@wsj.com, Noemie Bisserbe at noemie.bisserbe@wsj.com and Marcus Walker at marcus.walker@wsj.com
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Broncos will have to pay Russell Wilson huge money, eventually
The Seahawks wanted to trade Russell Wilson in part because they knew that, come 2023, they wouldn’t want to pay him again. Wilson knew it, too, from the moment his agent, Mark Rodgers, negotiated Wilson’s most recent deal, a $35 million per year contract that, at the time, set the bar for all NFL players.
The Seahawks never really played Wilson like a franchise quarterback, yet they paid him like one. At some point, they wouldn’t.
That point was now, one year before Wilson and Rodgers would have begun asking for a new deal. The acknowledgement by Seahawks G.M. John Schneider that they didn’t believe Wilson would sign another contract with the team represented an admission from Schneider that they wouldn’t be willing to once again make him the highest-paid player in league history.
That honor/privilege/burden will now fall to the Broncos. They’ll get to give Wilson a new market-setting deal, and then they’ll have to fit the contract under the cap. They’ll learn the realities of negotiating with a one-client agent who has no broader concerns potentially diminishing his zeal, such as whether a pissed-off G.M. will take it out on the agent’s other clients.
“We’re open,” Broncos G.M. George Paton told reporters on Friday regarding the possibility of a new deal for Wilson. “We obviously want him here for a long time, but nothing is imminent. I’m sure we will talk soon. We didn’t make this trade not to have him here for a very long time.”
Some would say that Paton shouldn’t be so candid, that doing so will only make it harder to get a contract done. But it’s already going to be hard.
Or maybe it’s going to be easy, because the Broncos have no basis for getting into a protracted back and forth. They targeted Wilson, they have relentlessly praised him, they gave up two first-round picks, two-second round picks, and three players to get him. When it comes to whether they’ll give him a contract a little bit (or a lot) better than the best contract on the books, why wouldn’t they?
The new Aaron Rodgers contract complicates matters, however. With a new-money average of $61.9 million, forget about the $46 million per year deal Deshaun Watson has signed in Cleveland. Mark Rodgers could eventually be looking for Aaron Rodgers money.
The sooner the Broncos do it, the cheaper it will be. With the cap rising and the market potentially exploding, it’s only going to cost more to make Wilson the highest-paid player as more deals are done. Of course, the sooner Wilson gets a new four-year extension (that’s what he has signed twice before), the sooner the Broncos will be on the clock for the next one.
There’s another reason to make it happen now. Eventually, the team will have a new owner. In the event the new owner may not want to make a huge financial commitment to Wilson, it’s better to make the huge financial commitment before an owner is in place to veto it.
Warner Bros. would’ve eventually made a new Matrix without Lana Wachowski
There’s an odd meta moment early on in The Matrix Resurrections where Neo, stuck in a new version of The Matrix and believing that he is legendary video game designer Thomas Anderson (creator of a trilogy of video games called The Matrix), is summoned to the office of his business partner (Jonathan Groff’s Smith) and told that their studio’s parent company, Warner Bros., is going to make a new Matrix game. The implication is that it’s happening with or without him, a nod to the movie’s ongoing theme about binary choices that aren’t really choices at all.
The other implication, though, is that Resurrections director and series co-creator Lana Wachowski recently found herself in a similar meeting, one where Warner Bros. offered her a non-choice between making a new Matrix and stepping aside so they can make a new Matrix without her. Why else would Smith specifically name Warner Bros. as the one pulling the strings? Well, prepare your shocked face, because you’re about to be shocked.
Yeah, that’s pretty much what happened, though things were apparently a little less antagonistic in real life. Speaking with Collider, Matrix series producer James McTeigue explained that there’s “always talk” about keeping a franchise with so much “potential money making capability” going, but Warner Bros. was never able to land on “the right version” of the story.
So, when Lana Wachowski came back with a new story in mind (and some buddies from Sense8 to help write it), the studio jumped at the chance to make more Matrix. A new Matrix movie almost certainly would’ve happened at some point, then, but the reason it happened now is because Lana Wachowski wanted to make it. So it was a decision driven by her, but that doesn’t mean it was always going to work out that way… thanks to free will and all that. You know, Matrix stuff.
At the very least, this all means that the scene in Matrix Resurrections is just a winky joke about sequels and big studios, rather than Wachowski calling for help. Here’s the real question, though: What would’ve happened to the in-universe Matrix video games if Warner Bros.’ video game branch had actually been sold off? Would Thomas Anderson and Smith be working for Tencent or Microsoft instead?
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Covid-19 could eventually be seasonal, scientists say
Sometimes scientists know which factors drive a new rise in cases, but some surges have been inconsistent and hard to predict. Eventually, scientists suspect the rise and fall of coronavirus infections could shift into a more typical seasonal pattern.
Early next year, health officials plan to begin serious talks about what the pandemic’s end might look like and how will we know when we’ve reached that point.
The US isn’t there yet.
As of Thursday, the US is averaging 121,084 new Covid-19 cases each day, according to data from Johns Hopkins University. This is 62% higher than a month ago.
Though Covid-19 cases and hospitalizations in the United States dropped off at the tail end of a summer surge, they’ve risen over the past few weeks. More than half of new hospitalizations over the past month have been in Midwestern states, especially Michigan and Ohio.
Dr. Laolu Fayanju and his colleagues have treated a rotating door of Covid-19 patients year round. Now, once again, they’re bracing for a possible winter surge.
“We have seen an increase in our numbers in just the last month across all 11 of our centers in northern and southern Ohio,” Fayanju, an Oak Street Health physician based in Cleveland, Ohio, told CNN.
“So, we are seeing an increase.”
Scientists have observed “waves” of coronavirus infections during the pandemic that ebb and flow across regions of the United States — but the factors driving these patterns of infections are complex.
While no one can predict the future, “we’re living through an intra-Covid world, and in a post-pandemic Covid world, I think what we would see is an endemic infection, not unlike the seasonal flu,” Fayanju said.
Endemic means that a disease has a constant presence in a population — but it’s not overwhelming health systems or affecting an alarmingly large number of people as typically seen in a pandemic.
Some scientists point to human behaviors, such as travel, as fueling the waves.
Some think the waves are more evidence that Covid-19 is on its way to eventually becoming a seasonal endemic disease, with more cases occurring in the cold winter months at times when outdoor temperatures drop and people gather indoors.
Others argue that seasonal waves of Covid-19 could be more complex, since during the pandemic there have been both expected winter surges and less-expected summer surges, too.
“We need more research to disentangle all the factors that may link seasonality to Covid-19 cases,” Dr. Hawre Jalal, assistant professor at the University of Pittsburgh, told CNN.
But there is one thing many scientists agree on — coronavirus infections in the future could follow seasonal cycles.
‘There will always be this underlying seasonal rhythm’
“Seasonality is real,” said Dr. Donald Burke, professor and former dean of the University of Pittsburgh Graduate School of Public Health.
“We think that it will be seasonal for the foreseeable future,” Burke said.
One study by researchers in Spain, published in October in the journal Nature Computational Science, classifies Covid-19 as a “seasonal low-temperature infection.”
Separately, Burke and his colleague Jalal co-authored two preprint papers that describe the seasonal patterns of the pandemic’s waves so far and suggest that these patterns may repeat in subsequent years. The papers have not published in a peer-reviewed journal but were posted online to the server medrxiv.org in July and November.
For the first paper, the researchers tracked Covid-19 case counts in the United States, Mexico and Canada from early 2020 to May 2021 and built animated maps that illustrate how many Covid-19 cases and deaths were recorded where and when — visualizing trends in the data and revealing patterns. The visualizations showed four dominant waves that occurred from March 2020 to May 2021.
The visualizations showed that the first wave of the pandemic in early 2020 was largely in the Northeast region of the United States — especially when a surge of cases hit New York City. Then, in the summer, a second wave of infections involved the South and traveled northward to the upper Midwest.
“It contradicted the notion that this should be a northern, cold season disease,” Burke said.
Then in the fall, wave three started in the Dakotas before spreading throughout North America and then wave four followed, with cases surging again in the winter in the Northeast, South and West.
In 2021, despite the authorization of coronavirus vaccines and the emergence of the Delta variant, the spread of Covid-19 cases was somewhat similar to the patterns seen in 2020 — even though the number of cases and magnitude of changes was not as great in 2020, the patterns followed a similar seasonal path.
For the second paper, the researchers analyzed the waxing and waning patterns of reported Covid-19 cases the United States, Mexico and Canada from January 1, 2020 through Oct 31, 2021 — an additional five months of data compared to the first paper.
Now in early December 2021, Covid-19 case counts continue to rise. For the first time in two months, the United States is averaging more than 100,000 new cases each day, shortly after millions of Americans traveled for the Thanksgiving holiday.
“Our modeling of this suggests that the rhythm of the future epidemics will be seasonal, but that the amplitude may vary from year to year or time to time. There will always be this underlying seasonal rhythm, being with an extra half beat in the South, but certainly the northern wave in the wintertime,” Burke said.
“That will be modified depending on what proportion of the population is vaccinated, whether or not a new strain is coming in at that moment, and so the amplitude will change,” he said. “But the basic rhythm will probably be the same.”
Biden’s Covid-19 winter plan
Just last week, US President Joe Biden warned of a potential winter surge of Covid-19, announcing a new strategy aimed at fighting the surge without enacting unpopular lockdowns as the pandemic approaches its two-year mark.
“It doesn’t include shutdowns or lockdowns, but widespread vaccinations, and boosters, and testing and a lot more,” Biden said Thursday. He acknowledged a likely rise in cases over the coming weeks, as weather turns colder in much of the country and people begin to gather more indoors.
Biden called for a multipronged approach, with a heavy emphasis on expanding vaccinations to the remaining Americans who have resisted getting shots, and to provide boosters to the now-eligible population of all adults. The Biden administration also now requires insurance companies to pay for at-home tests and has changed international travel rules to require travelers flying into the US from another country to test negative for Covid-19 one day — not the previous three days — before their departure.
Scientists — including Jalal of the University of Pittsburgh — have warned that the United States is likely entering another winter surge of Covid-19 right now.
“Since it has been doing it twice so predictably, it’s highly likely that a winter wave will happen again,” Jalal told CNN.
“That doesn’t mean that we should give up and say, ‘It’s seasonal, we just have to go with that.’ I think a very important distinction to make is that we have some predictable pattern to it, so we can prepare for it,” Jalal said. “You can make the public health services available before the wave starts.”
Even though Covid-19 could become seasonal in the future, it is important to remember that the world is still grappling with a pandemic right now. We have not yet entered an endemic phase, said Sen Pei, assistant professor of environmental health sciences at Columbia University’s Mailman School of Public Health.
So, while seasonality certainly could play a role in an upcoming winter surge this year, so could low vaccination rates and the spread of the highly transmissible Delta variant — which dominates in the United States and around the world — and the newly identified Omicron variant.
“People should take precautions during the winter,” Pei told CNN.
He says this surge may be caused by several factors. “The first one will be the emergence of the new Omicron virus. I think that’s the most important factor right now. And the second one will be seasonality of the virus and impacts of climate factors like temperature, humidity and also human behaviors — people will gather more indoors during the wintertime.”
Pei added that vaccination and booster shots “will also play an important role in reducing severe disease outcomes.”
Yet once the coronavirus becomes endemic — and case rates, hospitalizations and deaths fall to very low numbers — the United States could see more pronounced seasonal patterns in infection rates than what are occurring now.
“I think still we are still far away from that,” Pei told CNN.
“We will not enter into an endemic phase until the large majority of the population has immunity to the virus either from infection or from vaccination,” he said. “The case fatality rate is still very high, much higher than flu, and a large proportion of the population still do not have immunity.”
When will the coronavirus become endemic?
State and local health departments plan to meet with the CDC in the new year to discuss what type of data or metric will be needed to determine that the coronavirus pandemic has ended and shifted into an endemic phase, Lori Tremmel Freeman, chief executive officer of the National Association of City and County Health Officials, told CNN on Wednesday.
“We plan to begin having listening sessions in early January to talk with jurisdictions and their health officials about what we need to be thinking about to transition from pandemic to endemic. The idea is to envision what this looks like long-term and what metrics and considerations would be utilized to make the determination,” Freeman said.
As Covid-19 transitions into an endemic disease, any seasonal patterns the virus might follow warrant discussion, Freeman added.
“We would all like to view that as a possibility — where we’re just tackling the season and trying to manage one season over the next in terms of severity and other aspects of disease transmission,” Freeman said, calling it “crucial” to discuss long-term vaccination and mitigation plans.
“There are still many unknowns that it sometimes feels premature and overwhelming to predict what might happen to even make plans, but it is necessary.”