Costumed people attend Anime NYC at the Jacob K. Javits Convention Center in New York City on November 20, 2021.Photo: Kena Betancur/AFP (Getty Images)
The Center for Disease Control released a study yesterday that the 2021 Anime NYC convention was not a superspreader event, despite the attendance of one of the first known people in the U.S. to have been infected with the Omicron variant of the coronavirus. But this wasn’t just luck—the event had several measures in place to minimize infection, which means it can be used as a model for other fan conventions in the future.
The reason Anime NYC was suspected to be a superspreader (even assumed to be, one might say) is because Omicron is significantly more infectious than previous iterations of covid-19, and more than 53,000 anime fans came to the con, held in New York City at the Javits Center. The CDC says the event’s “good air filtration, widespread vaccination, and indoor masking” helped minimize spread of the virus. Additionally, Anime NYC required attendees to have at least one vaccination dose, while the convention center used HEPA filters in its ventilation.
According to the New York Times, “The share of attendee tests that came back positive was similar to the share of coronavirus tests that were positive across New York City around the same time, the CDC said. What’s more, the few positive samples that were genetically sequenced were largely of the Delta variant, not Omicron. And conventiongoers who became infected were more likely than those who tested negative to have gone to bars, nightclubs, or karaoke clubs.”
However, don’t go packing your bags for San Diego Comic-Con just yet. There are still a lot of additional factors that likely kept infection rates down. For instance, the CDC reported that had Omicron been more prevalent around the city at the time, things likely wouldn’t have gone so well. And, of course, Omicron is far more prevalent now across the country.
Still, this means Anime NYC could stand as a model for other conventions to follow in the future in order for relatively large groups of fans to come together and celebrate comics, anime, gaming, and more in relative safety. There’s obviously no timeline in sight where 160,000 people are all going to crowd into the San Diego Convention Center anytime soon, but man, it would be nice to hang out with some fellow nerds in person again eventually.
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An image of the HIV virus taken with transmission electron microscopy.Image: BSIP/Universal Images Group (Getty Images)
Researchers in a new paper this week say that a highly virulent variant of HIV has been silently circulating in the Netherlands, likely for decades. Thankfully, the variant still responds to conventional treatments and its spread appears to have declined in recent years. But the discovery may offer a timely lesson about the nature of germs like HIV and how they can evolve over time to become more dangerous.
The researchers, based in the UK and elsewhere, had been working on the BEEHIVE project, a study meant to figure out why some strains of HIV can cause more harm to a person’s immune system than others when left untreated—the end result of which leads to AIDS. To do this, they studied samples from people infected with HIV throughout Europe and Uganda, including those collected by earlier studies, hoping to find common mutations that could make the virus more damaging.
During this search, they found a group of 17 people, mostly from the Netherlands, who all carried the same variant of HIV-1, the most common type of HIV. This version of the virus—eventually christened as the “VB variant”—appeared to be exceptionally high in virulence. In practice, this meant that people with VB had far higher viral loads than usual and their levels of CD4 cells, the immune cells that HIV primarily infects and kills, dropped off very rapidly as well.
To confirm their suspicions, the team dug into another database of HIV patients living in the Netherlands. Sure enough, they found the variant in more people there as well. All told, they’ve identified VB in 109 people so far. And these individuals seemed to be no different from other residents in the country living with HIV in their age, sex, or other characteristics, further indicating that the virus itself is responsible for the increased virulence seen in their cases. The team’s findings were published Thursday in Science.
“Before this study, the genetics of the HIV virus were known to be relevant for virulence, implying that the evolution of a new variant could change its impact on health. Discovery of the VB variant demonstrated this, providing a rare example of the risk posed by viral virulence evolution,” said lead author Chris Wymant, a researcher at the University of Oxford’s Big Data Institute and Nuffield Department of Medicine, in a statement from the university.
VB certainly does pose an added danger for those unlucky enough to contract it. Because CD4 cells decline so rapidly with this infection, Wyant and his team estimate that it would take as little as nine months for someone to develop AIDS (typically, it can take years). People’s higher viral loads would also likely make them more infectious to others. But fortunately, VB doesn’t seem to behave any differently from other HIV strains once people get on antiretroviral therapy, meaning the treatments can still suppress the infection and make people less or even completely unable to pass the virus to others.
By studying its genetics, the team also found evidence that VB may have first emerged in the 1990s. And though it might have spread more rapidly in the early 2000s, its spread has likely slowed in the last decade. In other words, while VB is an important discovery, it doesn’t appear to be a major public health threat at this time.
VB might also offer some broader lessons about viral evolution, which are all the more relevant in our pandemic times. It’s often claimed by those seeking to downplay the pandemic, for instance, that harmful viruses inherently and inevitably become milder over time, since it would allow them to infect more people who don’t die from it. In truth, the process of viral evolution is more complicated than that.
The transmission potential of a germ can be negatively affected by its fatality, such as with Ebola. But viruses like SARS-CoV-2 are so transmissible early into an infection that it may not be pressured to change much at all, and even a deadlier version of it can still easily thrive, since it can take weeks for people to die as a result of infection. Indeed, we probably saw this happen with the emergence of the Delta variant of covid-19, which appears to have caused more severe illness than past strains. With HIV, its ability to cause illness and eventually kill people seems to be tied to the same attributes that allow it to be transmitted more easily. So a variant that’s deadlier may still gain a foothold if it’s also more transmissible, at least up to a certain point, as VB and possibly other strains seem to have done. Other factors outside of the germ itself, like our preexisting immunity to it, also play a role in determining how mild it can be as an illness.
That’s not to say that widespread strains of a virus can’t become milder either—something we’ve perhaps now seen with the Omicron variant of covid-19. It just means that predicting the trajectory of virulence for any germ isn’t so easy, including for the coronavirus. In an op-ed discussing the new findings, Joel Wertheim, an evolutionary biologist from the University of California, San Diego, makes a similar point.
“Although it is certainly possible that SARS-CoV-2 will evolve toward a more benign infection, like other ‘common cold’ coronaviruses, this outcome is far from preordained,” Wertheim warns.
As for VB, the researchers say its emergence isn’t a sign that our current strategy against HIV isn’t working. Some researchers have argued that treating certain infections can actually promote the evolution of highly virulent variants, possibly including HIV. But the researchers argue back that VB seems to have arisen in spite of these treatments, not because of it. And since even people with VB given early treatment are less infectious, it only shows that effectively containing the virus is still the best way to keep variants like VB from spreading further.
“Our discovery of a highly virulent and transmissible viral variant therefore emphasizes the importance of access to frequent testing for at-risk individuals,” they wrote, “and of adherence to recommendations for immediate treatment initiation for every person living with HIV.”
Almost one year ago, the universal rollout of COVID-19 vaccines began in the United States.
While some initial hesitancy was expected, it was widely assumed the public would embrace a safe, effective, free vaccine once readily available. That a significant percentage of the eligible population would reject such vaccines — too often at the cost of death to themselves or family members — seemed unfathomable. And yet that is precisely what has occurred.
Paradoxically, of the hundreds of unvaccinated patients treated in my hospital over the course of this pandemic, I have yet to see one refuse therapies such as monoclonal antibodies, all of which carry many more side effects than the vaccines they have declined.
Though mandates have boosted the vaccine numbers among certain groups, incentives, outreach and appeals continue to meet stiff resistance. There is little reason to believe that will change. Having survived the winter 2021 COVID surge, health care systems experienced a relative lull for an extended period. In my own hospital, the number of COVID patients declined from a high of over 700 during the first wave to single-digit numbers in the spring and summer of 2021. The delta wave that arrived this fall, followed rapidly by omicron, has swelled the number of cases dramatically with rising admissions by the day.
Waning immunities from the initial vaccines — requiring booster shots — has compounded the problem. It must also be noted that current vaccines and boosters were engineered against a virus that no longer exists. While further boosters will inevitably be required (most diseases require chronic therapies), the current vaccine/booster regimen offers the best protection now available. But we are still vulnerable.
Breakthrough cases routinely occur among the vaccinated and boosted. Twenty-five percent of our current COVID hospitalizations have been in vaccinated patients, with a small percent having been boosted as well. These numbers will surely grow in the coming months as vaccine immunities continue to wane. While their prognosis will be better than their unvaccinated counterparts, vaccinated patients will still be hospitalized, suffer and potentially die, particularly if they are afflicted with comorbidities.
As COVID cases surge, there is a corresponding increase in the demand for treatments.
Current therapies such as Sotrovimab, a monoclonal antibody with activity against omicron, and the oral agents, Paxlovid, and Molnupiavir, exist in very short supply. Already the demand has far outstripped our capacities raising the specter of rationing and a host of medical, social and ethical issues.
The use and administration of these therapies – funded by the federal government without cost to the end-user – are governed by the Centers for Disease Control and Prevention and state prioritizations. Although immunosuppressed patients are appropriately atop the list, most unvaccinated patients will be granted the next highest level of priority.
For example, a 35-year-old unvaccinated former smoker with asthma gains priority over a 66-year-old vaccinated cancer patient. Similarly, an unvaccinated 25-year-old smoker with depression takes precedence over a 64-year-old vaccinated patient with chronic pulmonary disease. Indeed, the highest priority on the CDC list does not include a single profile of vaccinated patients other than the immunosuppressed, regardless of other comorbidities. Based on current supplies, unvaccinated patients will receive most of these lifesaving medications.
Beyond its inherent unfairness, the decision to prioritize unvaccinated patients for scarce therapies is based on assumptions regarding risk factors, and the data regarding which risk factors contribute to a poor prognosis is weak at best. It is this very paucity of evidence that explains the lack of clear prioritizations in the initial vaccine rollout.
Health systems and society are benefiting greatly from a renewed focus on health equities. Underpinning it all is the question of fairness. The decision to refuse vaccination is a matter of personal choice, but with choice comes consequence. To date, the adverse consequences of such rejections have shifted from the individual to the community.
The financial cost of caring for sick and hospitalized unvaccinated patients is being borne largely by the taxpayer. The additional cost of the unvaccinated spreading the virus, even to those who are vaccinated and boosted, tears at our social fabric. Personal freedom to refuse a vaccine takes away freedom from nearby susceptible individuals. It deprives them of safe social contact with others. Without personal consequences, refusing vaccination becomes an easier decision. Denying the unvaccinated priority to remedial treatments and therapies needs to be reevaluated.
Summoning consensus over divisive issues, especially in times of crisis, will always pose a great challenge to a free society. Self-determination and choice are fundamental to our way of life, but so too are the principles of personal responsibility and fairness.
Bruce Farber, MD, is chief of Public Health and Epidemiology at Northwell Health, and the chief of Infectious Diseases at North Shore University Hospital and LIJ Medical Center. Farber is a fellow of the Infectious Disease Society of America.
The World Health Organization (WHO) recommended two new drugs to combat COVID-19 infections.
The first new drug that is recommended for critical COVID-19 cases is baricitinib, an oral drug that suppresses the immune system when overstimulated.
The WHO recommends baricitinib is given with corticosteroids.
The second drug which should be used for mild cases where a person has a high chance of hospitalization is sotrovimab, a monoclonal antibody drug.
This should be given to individuals who are unvaccinated, older, have a compromised immune system or are obese, according to the WHO.
“The extent to which these medicines will save lives depends on how widely available and affordable they will be,” the WHO said in its statement.
The recommendations come as concerns arise that existing COVID-19 treatments will not be effective against the omicron variant.
The two drugs were also invited on Friday to go through the WHO’s Prequalification Unit, which “assesses the quality, efficacy and safety of priority health products to increase access in lower income countries.”
The WHO recommended the two drugs after evaluating evidence gathered in seven trials examining 4,000 mild, severe and critical COVID-19 cases.
The Food and Drug Administration has already approved baricitinib and sotrovimab for emergency use.
The WHO has recommended against ruxolitinib and tofacitinib due to their uncertain effects.
An official from Europe’s top medical product regulation agency said Tuesday that the COVID-19 omicron variant may be pushing the pandemic into becoming endemic.
Marco Cavaleri, head of vaccine strategy for the European Medicines Agency (EMA), told reporters on Tuesday that that the natural immunity conferred by the highly-infectious omicron strain may be fast-tracking the progress towards endemicity.
“With the increase of immunity in population – and with Omicron, there will be a lot of natural immunity taking place on top of vaccination – we will be fast moving towards a scenario that will be closer to endemicity,” Cavaleri said during a media briefing, according to Al Jazeera.
When a virus becomes endemic it means a population has gained enough widespread immunity — either from infection or vaccination — that transmissions, hospitalizations and deaths will start to go down.
Reports from South Africa, where omicron was first detected, have indicated that while the variant is highly-infectious, it does not result in a corresponding spike in hospitalizations and deaths. Another South African study released last month found that omicron may reduce infections caused by the delta variant by building cross-immunity to different strains, an effect that has not been observed in many other mutations of the SARS-CoV-2 virus.
During his briefing on Tuesday, Reuters reported that Cavaleri also expressed doubts about the necessity for a fourth COVID-19 vaccine dose, telling the reporters that such an approach was not “sustainable.”
“While use of additional boosters can be part of contingency plans, repeated vaccinations within short intervals would not represent a sustainable long-term strategy,” he said.
“It is important that there is a good discussion around the choice of the composition of the vaccine to make sure that we have a strategy that is not just reactive … and try to come up with an approach that will be suitable in order to prevent a future variant,” he added.
Cavaleri’s remarks echo those of British infectious disease expert Sir Andrew Pollard who said earlier this month that repeated vaccination every few months was “not sustainable.”
Pollard, who helped to develop the AstraZeneca COVID-19 vaccine, said, “It really is not affordable, sustainable or probably even needed to vaccinate everyone on the planet every four to six months.”
“We haven’t even managed to vaccinate everyone in Africa with one dose so we’re certainly not going to get to a point where fourth doses for everyone is manageable,” he added.
A transmission electron micrograph of SARS-CoV-2 virus particles (in gold) within endosomes of a heavily infected nasal olfactory epithelial cell.Photo: NIH/NAID/IMAGE.FR/BSIP/Universal Images Group (Getty Images)
Researchers in Finland say they’ve created a novel nasal spray treatment that can provide brief but effective protection from the coronavirus and its many variants, including Omicron. In a recent preliminary study of cells in a petri dish as well as mice, the nasal spray appeared to block the virus from infecting cells up to eight hours following a dose. But more research would have to be done before we could expect this therapy to reach humans.
The experimental nasal spray is being developed by scientists at the University of Helsinki, and it relies on a slightly different approach of combatting the coronavirus than other methods.
“Its prophylactic use is meant to protect from SARS-CoV-2 infection,” study author Kalle Saksela told Gizmodo in an email. “However, it is not a vaccine, nor meant to be an alternative for vaccines, but rather to complement vaccination for providing additional protection for successfully vaccinated individuals in high-risk situations, and especially for immunocompromised persons—for example, those receiving immunosuppressive therapy.”
Vaccines work by training the immune system to recognize a germ without causing disease, which then allows us to produce our own natural supply of antibodies and immune cells specifically tuned to that germ if it appears in the future. We’ve also been able to mass-produce antibodies in the lab to the coronavirus, known as monoclonal antibodies, that can be given to people just after an exposure. The Helsinki team’s treatment, however, is a synthetic protein that’s much smaller than an antibody, but one that can still recognize and bind to the spike protein of the virus. To further amplify the protein’s potential, they smushed together three of them into a single package.
In theory, these antibody-like molecules can proactively inhibit any coronavirus they come into contact with from successfully infecting cells, for a short while at least. The ability to deliver the treatment as a nasal spray also means that these bodyguards can be sent directly into the upper respiratory tract, where most SARS-CoV-2 infections begin. Saksela, a virologist at University of Helsinki, is careful to note that the treatment isn’t intended to replace vaccines or other drugs.
In their research, released as a preprint late last month (meaning it has not been peer reviewed), Saksela and colleagues describe how they tested the spray on pseudoviruses made to look like various variants of the coronavirus, both as they tried to infect cells in a petri dish as well as in live mice.
Omicron has become a major problem largely because its many mutations allow it to partly evade recognition from the natural and lab-made antibodies created against the original strain of the coronavirus. Butthe team’s molecule apparently targets a region of the coronavirus spike protein that mutates very little. Ideally, this would mean that even Omicron couldn’t easily escape inhibition.
At least in the lab, that’s what Saksela and his team found. Whether it was Omicron, Delta, or the original SARS-CoV-2, the virus was stopped from infecting cells once even a modest dose of the spray was administered. And in mice exposed to the Beta variant of the virus, treated mice were much less likely to have any viral presence throughout their upper respiratory tract and lungs than a control group, with protection being apparent up to eight hours after a dose. The treatment also appeared to be safe and not associated with any noticeable harm.
Of course, this is all basic research that hasn’t yet gone through the full peer-review process. So while the results are definitely encouraging, time will have to tell whether their spray can work the same magic in humans. Should their work continue to show promise, though, Saksela thinks the spray would be valuable even after the pandemic phase of covid-19 has ended.
“This technology is cheap and highly manufacturable, and the inhibitor works equally well against all variants,” he said. “It works also against the now-extinct SARS virus, so it might well also serve as an emergency measure against possible new coronaviruses (SARS-CoV-3 and -4).”
Saksela doesn’t know how long it might take for the spray to reach clinical trials, and from there, to reach the market. He notes the spray could be considered either a drug or medical device, depending on a country’s regulatory process, which would further affect any timeline of development. But aside from continuing to work on a covid-19 treatment, the team might next try to develop a similar spray for other respiratory infections.
Health and science officials in the U.K. said on Tuesday that administering COVID-19 vaccine booster shots every few months is not necessary, though a short-term booster rollout to combat the spread of the omicron variant is needed.
During a news conference, Sir Patrick Vallance, the U.K.’s chief science adviser, said rolling out booster every few months is not a sustainable plan for combatting the pandemic, Reuters reported.
“It would be a situation that isn’t tenable to say everyone’s going to need to be having another vaccine every three or six months. That’s not the long-term view of where this goes to,” said Vallance, though he added that annual boosters, similar to the flu vaccine, may be necessary.
“We needed to get boosted for this variant at this moment. So I think there’ll be a change over time and this will settle into a much more routine type of vaccine programme,” Vallance said.
Sir Andrew Pollard, an Oxford professor who helped develop the AstraZeneca coronavirus vaccine, echoed Vallance’s remarks, telling BBC Radio 4 that boosters multiple times a year was “not sustainable.” Pollard also currently serves as an adviser on vaccines for the British government.
“It really is not affordable, sustainable or probably even needed to vaccinate everyone on the planet every four to six months,” Pollard said. “We haven’t even managed to vaccinate everyone in Africa with one dose so we’re certainly not going to get to a point where fourth doses for everyone is manageable.”
According to Pollard, booster shots for those with vulnerable immune systems may be needed, but said it was “unlikely” that one will be needed for the general population. Pollard, the director of the Oxford Vaccine Group, added that the U.K. may be in a better position pandemic-wise if future variants are milder as the omicron variant appears to be.
“There will be new variants after Omicron,” said Pollard. “We don’t yet know how they’re going to behave — and that may completely change the view on what the right thing to do is.”
The Michigan Department of Health and Human Services (MDHHS) announced on Friday that it would be changing its quarantine guidance to follow recommendations from the Centers for Disease Control and Prevention (CDC), a shift from earlier in the week.
Michigan’s state government initially said it would not be following the CDC’s new guidelines until it received further information. The new guidance shortened the recommended length of quarantine to five days for asymptomatic individuals regardless of vaccinations status.
The CDC also left out a recommendation to get a negative COVID-19 test before leaving isolation.
On Friday, the MDHHS said in a statement that it would be updating its guidance to “reflect the recent recommendations” from the CDC.
MDHHS chief medical executive Natasha Bagdasarian said, “We have safe and effective tools for preventing the spread of COVID-19.”
“Getting vaccinated continues to be the best protection against severe illness and hospitalization, and we urge all Michiganders over age 5 to get vaccinated as soon as possible,” Bagdasarian said.
“These most recent updates to the quarantine and isolation guidelines are a reflection on our progress as we learn more about COVID — but we are not in the clear as variants like omicron continue to create new challenges in the fight to end this pandemic.”
The CDC’s new recommendations have been criticized by public health experts who warned that the new guidelines may encourage people to leave isolation while still capable of spreading infection. Some experts, like former President TrumpDonald TrumpBiden says Chile ‘powerful example’ for world in first call with president-elect Historians Jon Meacham, Doris Kearns Goodwin to speak at House Jan. 6 event Pentagon streamlines process for requesting National Guard in DC MORE‘s surgeon general Jerome AdamsJerome AdamsMichigan says it won’t adopt new CDC guidelines without ‘additional information’ Fauci defends new CDC isolation guidelines NFL, players union agree to cut COVID-19 isolation time to 5 days MORE, advised people to still get an antigen test before leaving isolation if possible.
White House chief medical adviser Anthony FauciAnthony FauciState Dept warns Americans traveling abroad to ‘make contingency plans’ Amtrak scales back schedule amid spike in COVID-19 among employees Overnight Health Care — Omicron puts pinch on vaccine mandates MORE defended the updated guidelines, saying this week that they were designed to “balance” the pandemic response.
“The reason is that now that we have such an overwhelming volume of cases coming in, many of which are without symptoms, there’s the danger that this is going to have a really negative impact on our ability to really get society to function properly,” Fauci said.
A study out of South Africa found the country may have already passed the peak of it omicron-fueled surge in cases of the coronavirus, with data suggesting the variant has not caused a corresponding jump in hospitalizations and deaths.
The study looked at the rate at which the fourth surge in cases progressed in the South African city of Tshwane, which researchers described as the “global epicentre” of the omicron wave.
Researchers looked at hospital records from a Tshwane hospital system and compared them to prior surges. Based on their analysis, the omicron wave “spread and declined in the City of Tshwane with unprecedented speed peaking within 4 weeks of its commencement.”
The study determined that the wave peaked during the week of Dec. 5, roughly four weeks after an exponential increase in cases was observed.
According to the researchers, peak hospital bed occupancy during the omicron wave was half of what was observed during the delta wave, and the distribution of patient ages was younger. Omicron currently accounts for 95 percent of sequenced cases in the Gauteng Province, where Tshwane is situated.
“The changing clinical presentation of SARS-CoV-2 infection is likely due to high levels of prior infection and vaccination coverage,” researchers wrote, adding that roughly two thirds of Tshwane residents have some form of immunity from COVID-19, either from vaccination or prior infection.
“The speed with which the Omicron driven fourth wave rose, peaked and then declined has been staggering. Peak in four weeks and precipitous decline in another two This Omicron wave is over in the City of Tshwane,” Fareed Abdullah, director of the South African Medical Research Council’s AIDS and tuberculosis research, wrote on Twitter.
“It was a flash flood more than a wave,” he said.
Abdullah also shared a graph showing the rate of COVID-19 deaths and cases in South Africa over the course of the pandemic and noted the significantly lower peak in deaths when compared to previous peaks.
“Is this hybrid immunity or lower virulence?” Abdullah asked.
This graph says it all about the decoupling of cases and deaths in the Omicron Outbreak where it first started in Pretoria in the Gauteng Province of South Africa. Deaths have peaked at a much lower level compared to previous waves. Is this hybrid immunity or lower virulence? pic.twitter.com/4qknUGMZND
— Fareed Abdullah (@fareedabdullah0) December 30, 2021
The study follows anecdotal reports from South Africa that the omicron variant resulted in milder cases of illness, though health experts had warned against taking these reports to heart, as most of the early cases omicron had been among younger individuals.
The new omicron coronavirus variant has been found in at least 10 U.S. states a little over a week after the strain was discovered in southern Africa.
The variant has been found in Maryland, Utah, Missouri, Pennsylvania, New York, Colorado, Minnesota, California, Hawaii and Nebraska.
It is likely the new variant is in other states as well, as the U.S. continues to conduct tests.
The first case was discovered Wednesday in California, in a person who recently traveled to South Africa.
New York has the most omicron cases discovered so far, with five announced on Thursday by Gov. Kathy HochulKathy HochulFive omicron cases detected in New York Minnesota confirms US’s second omicron case The Hill’s Morning Report – Presented by Facebook – The omicron threat and Biden’s plan to beat it MORE (D).
Scientists are still working to answer many questions about the new variant, including how transmissible it is and how effective the vaccines are against it.
Omicron has caused panic around the world due to the more than 30 different mutations it has compared to previous coronavirus strains.
Many countries, including the U.S., have put travel bans in place from southern African countries to try to mitigate the spread of Omicron. But omicron has been found in dozens of countries around the world despite travel bans and new flight restrictions put in place.
The World Health Organization and some scientists have condemned the travel bans, saying they are harmful and unproductive.
President BidenJoe BidenManchin to vote to nix Biden’s vaccine mandate for larger businesses Congress averts shutdown after vaccine mandate fight Senate cuts deal to clear government funding bill MORE has indicated the U.S. will not go back into lockdowns due to the omicron variant and instead focus on the vaccination campaign.
