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WPCNR THE SUNDAY BAILEY. Philosophy By John F. Bailey. January 1, 2022:

The sunlight of the new 2023 streamed in with relentless optimism into  people’s lives today.

You and I were presented with a new set of days to continue working on ourselves.

To deal with our flaws and revive our self-discipline and resolve to defeat them.

Today’s determined sun chased the shadows of yesterday’s cold dismal damp forlorn tired rain. Saturday was a metaphor for 2022 one of the most disappointing years of performance.

This morning’s warmth of light lit up the darkness of the last year.

It beckoned through windows to follow the light. As Hank Williams sang, “I saw the Light.”

The awakens our inner self and eternal optimism of “We can do this,” “We can survive this,” “I can do myself better,” “I can change.”

We may not be able to overcome the dark negatives that keep eating away at our ability to perform at the top of our game. The light that streams in this morning on the first day of the year, whether it’s cloudy or rainy, just stirs that self-analysis, the melancholy of memory when you were a young and callow fellow, or young woman of enthusiasm and effort and the joy of those years when you were moving forward.

Taking those memories into account of younger years should not be viewed as regrets, the light of the new can energize the melancholy into new energy to make more of you.

I was particularly struck by the way sunlight struck the old books I have never read on the bookshelves in a way that showed how within creations of others in the past their light they saw still awaits you the child, the teen, the young adult or if  you’re “aging up,” still thinking like a young “whipper-snapper,” or a woman of adventure back in the day.

My wife is in the downsizing stage of life. House is too big. We have too much stuff.

(With each book I am throwing out, to prepare to move to the appropriate sized cozy apartment is like throwing out an old friend, even though I may not have read them, the work, experience and philosophies the book magically messages me from its presence makes it hard to dedicate them to  momentos I have already disposed of, like my collections of beer cans. )

The tasks you have always wanted to do are still waiting to be done.

The bad habits can be stopped.

The tendency to be defensive when criticized.

Resolutions of last year have long been forgotten. But you know what they were.

I have a few resolutions for this year.

I have to write every day.

I have to kiss my wife good night and good morning.

I have to tell my children how great they are and how to be strong in the face of unfairness or bad things. And always warn them to be careful. And when someone criticizes you, look them in the eye when they tell you how bad you are. (They are just making themselves feel good . And then you do better, proving them wrong. They hate that.)

I have go to Lifetime every day and swim.

I have stop making generalizations about behaviors and other people.

I have to read scripts slower. Use spellchecker.

I have to stop procrastinating (leaving writing to the last moment). After 50 years writing I still do that but this year my 50tieth year as a writer, I have actually finished things before I absolutely have to have them done. I cannot tell how good that makes me feel.

I have to call my sisters more scattered to the four winds.

I have to watch baseball more in person, because I like it.

I have to overcome fear of writing the truth

I have to not work opinions into my news stories, remember–facts tell the story.

One more thing, I have to tell my wife I love her every day.

(Telling her you love her is not a weakness. She may not tell you she loves you, but you tell her you love her. It’s all right, I except that,)

I have to stop forgetting things she tells me.

Go get those “can’ts” in your mind starting today.

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Your Local Epidemiologist

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COVID in China, the U.S., and everything in-between

Well, I was very much enjoying my holiday but COVID continues to do its COVID thing. It’s time for an update.

China: A humanitarian disaster

As expected, the COVID-19 situation in China is out of hand. In an interesting turn of events, China went from a “zero COVID” policy to a “let it rip” policy by dropping all mitigation measures without fully vaccinating the highest of risk or strengthening their healthcare system.

Egregiously, they stopped reporting cases, hospitalizations, and deaths, too. This looks good for them on paper, but when we rely on epidemiology 101 and anecdotal reports, which are plentiful, the situation in China is beyond grim.

Officials estimate between 5,000-10,000 people are dying per day. (At the U.S. peak, we lost 3,800 people per day). Epidemiologists expect death toll to rise in China in the coming months leading to 0.5-1 million cumulative deaths.

A humanitarian disaster.

This outbreak could have implications worldwide, like the emergence of a variant of concern.

The best we can tell, BF.7 is spreading in China, which is an Omicron subvariant about 3 evolutionary steps behind what is spreading in most of the world. But, a new variant of concern could appear.

(This is more possible than probable because transmission is high everywhere).

Just like cases and deaths, though, China is not reporting genomic data.

In other words, we don’t know if and how the virus is changing and what it may (or may not) mean to the international community.

U.S. responds domestically

So, how should the United States respond? Well, it depends on our goal: delay or decrease transmission from China? Identify variants of concern? Pressure the Chinese government to uphold international responsibilities?

Yesterday, the U.S. publicly signaled two goals:

Delay transmission. On a scale from “do nothing” to “ban all travel”, the U.S. chose something in the middle.

Travelers coming to the U.S. from China will be required to have a negative PCR test within 48 hours of departure. This starts on January 5, 2023. I assume the goal is to buy time—delay a wave in the U.S. seeded by travelers.

And this may be a legitimate concern, as Milan reported that 50% of passengers on flights from China tested positive. However, the extent to which this delays transmission, and by how much, is up for debate:

1. As Adam Kucharski pointed out, “uncontrolled domestic transmission will grow exponentially while importations grow linearly. In other words, we’re much more likely to get an infection from a fellow resident than a traveler.”
2. The policy doesn’t start until next week in order for airlines to prepare, which likely won’t help if transmission is already out of control in China.
3. To test pre-departure within 48 hours of travel is problematic. Studies have shown that this will reduce transmission by only 10%.Figure: The post-arrival transmission for pre-arrival testing. Wells et al., 2022. Int J Public Health. Source here.
4. Finally, buying time is only useful if we actually did something to prepare.

Using back of the napkin math, this policy would prevent ~10,000 infections in the U.S. If a variant of concern did pop up and was 100% immune invasive and every passenger had it (unlikely scenario), we would delay a wave by one week.

In any health crisis, policy decisions are challenging.

Risks (ethics, lack of effectiveness, potential other harms, like xenophobia) must be weighed with benefits (low cost, possibility of delay). Then politics get involved.

Epidemiologically this policy isn’t adding up for me.

Find variants of concern. The second goal is to find potential variants of concern.

Given zero data is being released by China, enhanced surveillance of PCR cases with a travel history to China is worthwhile.

The U.S. will not have access to pre-departure testing results in China, but we can do it once people arrive.

The CDC already has a great program in place (see figure below), but because of the China situation, it expanded to 2 more airports. While this program is proactive, it’s not that big: 10% of passengers at 7 airports. We should expand our capacity even more.

It would be more advantageous to sequence airplane wastewater.

A homegrown problem: XBB.1.5

Regardless of the China situation, current variants in the U.S. are likely more problematic. At least in the short-term.

Specifically, we have a new subvariant on the horizon: XBB.1.5. This is an offshoot of BA.2, which is different from the subvariant currently circulating (BQ.1.1— an offshoot of BA.5).

Both lab and epidemiological data show XBB.5.1 may be cause for concern:

• In the “real world,” and particularly in New York, cases are exponentially increasing.
• Currently XBB.1.5 has a 120% weekly growth advantage, which equates to, on average, 1 infected person infecting 2 others.
• This rate is higher than we’ve seen with any other subvariant this year given our immunity wall.Source: Graph from JWeiland, Analysis from Trevor BedfordSo, as expected, we see a clear uptick in Northeast wastewater.
• This is unwelcome given that admissions for people over age 70, for example, are the third highest since the pandemic began. This doesn’t reflect the new variant or impact of holidays, yet, either.

• In the lab, XBB.1.5 is presenting a more confusing picture.
• It has a similar ability to escape our immunity as other subvariants. Because of this, we wouldn’t think it would cause a massive wave compared to what is circulating right now.
• XBB.1.5 does have higher ACE2 binding affinity—it allows it to latch onto our cells better; it’s more sticky—but that wouldn’t necessarily cause it to be more transmissible.
• So something else may be going on—another part of the virus may have changed that influences transmission. We need to look into this more.

Bottom line

We should be very concerned for the people of China. And it is possible that a variant of concern will arise from their disaster. But the U.S. already has a problem of its own.

I was hoping for a quieter 2023. There may still be a chance, but these are not welcome developments going into the New Year.

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WPCNR SUPREME COURT SURVEILLANCE. From the New York Immigration Coalition. December 27, 2022 updated December 28, 2022;

Today, the Supreme Court of the United States ruled that the Biden administration cannot end the implementation of Title 42. Title 42 was originally slated to end on December 21, before Chief Justice John Roberts granted an appeal to pause the termination on December 19.

The New York Immigration Coalition denounced this decision from the Supreme Court, which they say will continue to jeopardize the safety of asylum seekers, and demanded that President Biden secure additional protections for new arrivals.

Murad Awawdeh, Executive Director, New York Immigration Coalition:

“The Supreme Court’s decision today to prohibit the termination of Title 42 is a devastating failure of justice for the thousands of people and families who have been continually subjected to violence and cruelty because of this policy. For years, Title 42 has proven to be a horrifying distortion of American values, existing as a front for xenophobia and racism.

As Title 42 continues to be shuttled through the courts, it has resulted in untold pain and lives lost for those who are simply seeking freedom and safety in the United States.

This is morally and ethically unacceptable, and the Supreme Court should be ashamed that they continue to sustain such an unsparing policy. We urge the Biden administration to take meaningful action and secure additional protections for asylum seekers, such that a humane and fair asylum system can finally be achieved for all.”

In its order, the high court said it would hear arguments in the case in February. 

Supreme Court Judge Neil Gorsuch wrote in his dissenting opinion (Justices Sonia Santomayor, Elena Kagan, and Ketanji Brown Jackson also dissented) to end Title 42,

“The current border crisis is not a Covid crisis. And courts should not be in the business of perpetuating administrative edicts (Title 42) designed for one emergency only because elected officials have failed to address a different emergency (migrants massing at the border) We are a court of law, not policymakers of last resort.”

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https://www.youtube.com/watch?v=SPB60GZb4Q8

Eighteen minute news conference from the Governor, Mayor of Buffalo, County Executive Everybody pitching in for everyone else. Click RED highlighted white > arrow to view.