NEW YORK (AP) — The flu virus is hanging on in the U.S., intensifying in some areas of the country after weeks of an apparent national decline.

Centers for Disease Control and Prevention data released Friday showed a continued national drop in flu hospitalizations, but other indicators were up — including the number of states with high or very high levels for respiratory illnesses.

“Nationally, we can say we’ve peaked, but on a regional level it varies,” said the CDC’s Alicia Budd. “A couple of regions haven’t peaked yet.”

Patient traffic has eased a bit in the Southeast and parts of the West Coast, but flu-like illnesses seem to be proliferating in the Midwest and have even rebounded a bit in some places. Last week, reports were at high levels in 23 states — up from 18 the week before, CDC officials said.

Flu generally peaks in the U.S. between December and February. National data suggests this season’s peak came around late December, but a second surge is always possible. That’s happened in other flu seasons, with the second peak often — but not always — lower than the first, Budd said.

So far, the season has been relatively typical, Budd said. According to CDC estimates, since the beginning of October, there have been at least 22 million illnesses, 250,000 hospitalizations, and 15,000 deaths from flu. The agency said 74 children have died of flu.

COVID-19 illnesses seem to have peaked at around he same time as flu. CDC data indicates coronavirus-caused hospitalizations haven’t hit the same levels they did at the same point during the last three winters. COVID-19 is putting more people in the hospital than flu, CDC data shows.

The national trends have played out in Chapel Hill, said Dr. David Weber, an infectious diseases expert at the University of North Carolina.

Weber is also medical director of infection prevention at UNC Medical Center, where about a month ago more than 1O0 of the hospital’s 1,000 beds were filled with people with COVID-19, flu or the respiratory virus RSV.

That’s not as bad as some previous winters — at one point during the pandemic, 250 beds were filled with COVID-19 patients. But it was bad enough that the hospital had to declare a capacity emergency so that it could temporarily bring some additional beds into use, Weber said.

Now, about 35 beds are filled with patients suffering from one of those viruses, most of them COVID-19, he added.

“I think in general it’s been a pretty typical year,” he said, adding that what’s normal has changed to include COVID-19, making everything a little busier than it was before the pandemic.

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By Amber Dance

Loss of pandemic funding endangers care for poor, uninsured

Safety-net hospitals, which provide care regardless of patient’s ability to pay, received a sorely needed financial boost during the pandemic thanks to billions in emergency federal funds. As that funding comes to an end, hospitals are struggling to provide care for people who’ve come flooding in with health problems after delaying treatment during the pandemic, writes Noah Weiland at The New York Times.

Even before COVID, such hospitals operated on slim margins, said Beth Feldpush of the trade group America’s Essential Hospitals.

As a result of 2020’s CARES Act, the government distributed $178 billion to hospitals and other health care providers to cover expenses and lost revenue.

The federal COVID-19 Uninsured Program handed out more than $20 billion to cover testing, vaccination and treatments for people without health insurance, but the program is now out of funds.

And the federal public health emergency declaration boosted coverage for Medicare and Medicaid patients, but that’s currently set to expire in July.

These temporary measures helped safety-net hospitals, but only to a certain extent. Michele Johnson, director of the aid group the Tennessee Justice Center, likened the pandemic aid to “some rouge on the corpse.”

More CARES Act money flowed to rich hospitals and large academic centers than to small clinics in rural areas, according to research by the nonprofit RAND Corporation.

Still, for hospitals that barely scrape by, every bit of aid is a boost. Now, while COVID hospitalizations remain low, people who put off care are returning to a severely strained system. Weiland describes everything from advanced cancers because people skipped screening, to broken bones left to fester for months, to an excess of bunions. At the same time, costs for medicines and staff have skyrocketed, creating a situation that’s overwhelming safety-net hospitals.

There’s no additional help in sight: The latest $10 million pandemic aid bill, which would cover more free treatments and vaccines for all Americans, remains stalled in Congress.

New variants keep coming

The coronavirus continues to develop new mutations and combinations of mutations at a rate too fast for scientists to keep up. The latest variants to watch — but not panic over — are new flavors of omicron known as BA.4, BA.5, and BA2.12.1.

Currently, the BA.2 variant, which is about 30% more transmissible than BA.1 that came before it, makes up more than half of U.S. cases.

And the virus is still spreading effectively. For example, despite stringent requirements for vaccination and day-of COVID testing, several attendees of the April 30 White House Correspondents Dinner have since tested positive for the virus.

BA.2.12.1 is now coming on strong, at just over one-third of U.S. cases and rising. This one is 25% more transmissible than BA.2

Scientists are also watching the BA.4 and BA.5 variants, now surging in South Africa.

“It just seems like the latest chapter of a never-ending saga,” Dr. Peter Chin-Hong of UC San Francisco told the Los Angeles Times.

All three variants seem to be better at evading the immune response than what’s come before. They each have mutations that likely help them bind more tightly to target cells and avoid antibodies that try to get in the way, reports Brenda Goodman at CNN.

It’s not yet known if these variants cause milder or more severe disease.

“The data all point to the possibility of more reinfections from newer omicron subvariants,” writes Beth Mole at Ars Technica. “This could drive yet more waves of infection in the U.S. and around the world — though experts don’t expect another towering wave like the BA.1 surge in January.”

The continued evolution of the omicron variant could undermine the efficacy of vaccines based on the BA.1 version that are now under development, Mole writes.

It could also be a sign that the coronavirus is moving towards more flu-like behavior, writes Megan Molteni at STAT. With influenza, variants tend to drift from one similar version to another, in contrast to the arrival of markedly different variants as happened with the coronaviruses beta, delta, omicron and the like.

“This could be good news, because more stable, predictable evolution would make it easier to develop meaningful COVID-19 vaccines and boosters,” writes Molteni.

That said, there’s no guarantee there aren’t more wild-card, Greek-letter variants in the future. Scripps Research physician Dr. Eric Topol writes on his blog that preparing for novel variants will require vaccines that create broad protection and more antiviral medications.

Delta is also still lurking in the wings, meaning it could re-emerge with new variants, writes Judy Siegel-Itzkovich at The Jerusalem Post.

Topol notes that there’s no reason to believe the next variant will cause milder disease than the ones that came before. Future variant severity is unpredictable, as is the ceiling on coronavirus transmissibility, so things could get worse before they get better.

Paxlovid fails to prevent infection

Recent data dashed hopes that the antiviral Paxlovid could be used as a post-exposure prophylactic to prevent infection in people who share a home with COVID patients.

While disappointing, these results are not wholly unanticipated, reports Matthew Herper at STAT. Dr. Daniel Barouch of the Beth Israel Deaconess Medical Center told him, “The biology of treating infection is different from the biology of preventing infection.”

It’s not clear exactly why the treatment didn’t help; it could be that the drug needed to be provided sooner after exposure to stop the virus in its tracks.

Reports have also surfaced recently that some people who take Paxlovid, after they’re infected, become sick again after they’ve finished treatment.

“Little is yet known about the rebound cases, such as whether the highly transmissible omicron variant plays a role,” reports Bloomberg. “While there’s no proof it’s caused by the drug, doctors say they need more information about what action to take when the virus surges in someone who’s just been treated.”

Pfizer says that in its studies, people who took placebo pills had the same rate of rebound as those on the real drug, suggesting the treatment isn’t causing the renewed symptoms.

Both the NIH and the FDA are looking into the problem, as are other research groups. There are a number of questions to answer, notes Dr. Paul E. Sax at the New England Journal of Medicine’s Journal Watch blog. For example, should the standard treatment course be longer, or should people who relapse take a second course of the drug?

Despite these issues, relapses seem to be rare, and experts told STAT’s Herper they remain confident in Paxlovid’s ability to thwart the virus.

Barouch said, “These new data would not make me less enthusiastic in prescribing Paxlovid for therapeutic purposes.”

FDA imposes limits on J&J vaccine

Johnson & Johnson’s coronavirus vaccine will now be accessible only for people who can’t take one of the other vaccines — due to allergy to an ingredient, for example, or because the others are unavailable — as well as those who flat-out refuse vaccines made with the messenger RNA technology used by Pfizer and Moderna.

The Johnson & Johnson shot uses a different formula: a virus that delivers the coronavirus spike DNA.

The FDA made this announcement last Thursday, citing 60 cases of blood clotting problems linked to the vaccine.

There have been nine deaths from the condition.

The agency and the CDC had temporarily paused the vaccine’s use back in April of 2021 when it had knowledge of just six cases of the clotting disorder.

The Johnson & Johnson vaccine initially showed promise because it was meant to be a one-shot, easily transported and stored inoculation, compared to the mRNA vaccines that each started with a two-dose series and required very cold storage.

But it never took off; 18.7 million J&J shots have been administered, compared to more than 558 million of the two mRNA vaccines combined.

Pfizer hopes for little-kid booster data within weeks

Pfizer, which is testing a three-dose regimen of its COVID-19 vaccine in children younger than five, now says it should have the results ready for regulators by late May or early June, AP News reports.

That would put it in line behind Moderna, which has already filed for authorization of its two-dose protocol for the youngest children, but still in time for anticipated meetings of the FDA’s outside advisory committee on vaccines.

While the vaccine can’t come soon enough for some parents, others aren’t in a rush. The latest poll from the Kaiser Family Foundation finds that 18% of parents with kids in this age group will hurry to the pharmacy, while 38% plan on a wait-and-see approach.

More than half of the parents surveyed said they didn’t have enough information to evaluate the vaccines’ safety and efficacy for their young children — a fair point, as the full data have not yet been made publicly available.

The poll also found that 27% of parents “definitely” would not vaccinate their kids under 5, and a further 11% would do so only if it were required.

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WASHINGTON (AP) — From the inaugural platform, President Joe Biden saw American sickness on two fronts — a disease of the national spirit and the one from the rampaging coronavirus — and he saw hope, because leaders always must see that.

“End this uncivil war,” he implored Americans on Jan. 20, 2021. Of the pathogen, he said: “We can overcome this deadly virus.”

Neither malady has abated.

For Biden, it’s been a year of lofty ambitions grounded by the unrelenting pandemic, a tough hand in Congress, a harrowing end to an overseas war and rising fears for the future of democracy itself. Biden did score a public-works achievement for the ages. But America’s cracks go deeper than pavement.

In this midterm election year, Biden confronts seething divisions and a Republican Party that propagates the delusion that the 2020 election — exhaustively vetted, validated many times over, fair by all measures — was stolen from Donald Trump. That central, mass lie of a rigged vote has become a pretext in state after state for changing election rules and fueling even further disunity and grievance.

In the dispiriting close of Biden’s first year, roadblocks stood in the way of all big things pending.

The Supreme Court blocked his vaccinate-or-test mandate for most large employers. Monthly payments to families that had slashed child poverty ran out Friday, with no assurance they will be renewed. Biden’s historic initiative to shore up the social safety net wallowed in Congress. And people under 40 have never seen inflation like this.

Only two days after Biden’s lacerating speech in Atlanta invoking the darkest days of segregation, he saw his voting rights legislation run aground when Democratic Sen. Krysten Sinema of Arizona announced her opposition to changing Senate rules to allow the bill to pass by a simple majority.

Her rationale: Altering the rules would only “worsen the underlying disease of division infecting our country.”

For all of that, Barack Obama was on to something when he paid his old vice president an odd compliment late in the 2020 campaign. Elect Joe Biden, he said, and after four years of flamboyant Trump dramas and crazy tweets, folks could feel safe ignoring their president and vice president for a spell.

“You’re not going to have to think about them every single day,” Obama said. “It just won’t be so exhausting. You’ll be able to go about your lives.”

Indeed America saw normalcy, some say dignity, return to the White House. Pets came back and so did daily press briefings for the public.

The Trump-era political muzzle came off public health authorities, freeing them to confuse the public all on their own.

First lady Jill Biden’s studded “Love” jacket at a global summit not-so-subtly countered the “I Really Don’t Care, Do U?” jacket her predecessor wore on her flight to a migrant child detention center.

Instead of promising the world and delivering a Potemkin village (as when Trump declared the virus “very much under control” in February 2020), the Biden White House set pandemic and other goals that were modest to a fault, then exceeded them. The old game of lowering expectations and then taking credit for beating them was back, though such boasting was gone when the dual punch of the delta and omicron variants landed.

Even so, the discipline, drive and baseline competence from the new White House produced notable results. Biden won a bipartisan infrastructure package that had eluded his two predecessors, coming away with a legacy-shaping fix for the rickety pillars of industry and society.

The first signs of that law in action came this month when Washington approved New York City’s Second Avenue subway project to a final engineering phase before shovels hit the ground. The project, which would add three train stops in East Harlem, stalled under Trump.

Americans everywhere will be seeing plenty more orange construction cones for years to come. In just one initiative under the program, 15,000 highway bridges are in line for repairs.

Biden steered more judges through Congress to the federal bench than any recent predecessor. He won approval of a Cabinet that was half women and a minority of white people for the first time. More than 6 million people are back at work and half a billion COVID-19 vaccines have been put in arms, but the nation has a long way to go to return to its pre-pandemic state.

“I think it’s a lot of achievements, a lot of accomplishment, in the face of some very serious obstacles,” Biden’s chief of staff, Ron Klain, told The Associated Press on the cusp of Biden’s second year in office. “The Biden presidency remains a work in progress.”

Matthew Delmont, a civil rights historian at Dartmouth, expected more from Biden by virtue of Biden’s decades of experience as a savvy operator in the capital.

He had anticipated a far more effective COVID-19 response and more urgency, sooner, in countering the rollback of voting rights and tilting of election rules that Republicans are attempting across the country.

“There’s something to be said for the professionalism of the White House and not going from one fire to the next,” Delmont said. “What I worry is that the Washington he understands isn’t the Washington we have anymore.”

Political science professor Cal Jillson at Southern Methodist University in Dallas said Biden has displayed “warning track power” — the ability in baseball to hit long but not, as yet, over the fence.

“There are not so much wins and losses as partial progress on many fronts,” he said.

In Biden, Jillson sees a leader who brought the even keel that Obama had talked about from the campaign stage but also one who only rarely delivers a speech worth remembering.

“While there are vast partisan differences in how Biden is seen, in general he is seen as stable but not forceful,” he said.

That’s how Biden has come across to John Ferguson, a retired diplomatic officer in Lovettsville, Virginia, who considers Biden “infinitely better than Trump” but adds: “He seems to give a speech every four hours and he’s not very good at it.”

In large measure, Biden’s innate civility and predictability brought the sort of climate change that the world could get behind.

Here once more was a president who believed deeply in alliances and vowed to repair an American reputation frayed by the provocateur in office before him.

There would be no more puzzling feelers about buying Greenland. No more doting looks at Russian President Vladimir Putin; instead, Biden stepped up diplomatic confrontation over Putin’s designs on Ukraine. There would be no eerie uplit gatherings around glowing orbs with rulers of dissent-crushing Arab countries like Trump’s photo op with the Saudis.

But the world also witnessed Biden’s debacle in Afghanistan, a chaotic withdrawal that brought more than 124,000 to safety but stranded thousands of desperate Afghans who had been loyal to the United States and hundreds of U.S. citizens and green card holders.

Discounting warnings from military and diplomatic advisers, Biden misjudged the Taliban’s tenacity and the staying power of Afghan security forces that had seen crucial U.S. military support vanish. He then blamed Afghans for all that went wrong. Millions of Afghans face the threat of famine in the first winter following the Taliban takeover.

“He needs to be honest about the mistakes that were made,” said Republican Rep. Peter Meijer of Michigan, who served with aid workers in Afghanistan after a military career and voted in Congress to impeach Trump. ”He will say, ‘The buck stops with me,’ after he’s blamed everybody else for how something turned out.”

All presidents enter the world’s most powerful office buoyed by their victory only to confront its limitations in time. For Biden, that happened sooner than for most. A polarized public, Trump’s impeachment trial and an evenly divided Senate saw to that.

Biden entered office with a list of to-dos amassed by his party. His quest for a sweeping “Build Back Better” program of social spending turned into a months-long slog, hostage to disagreement between Democrats of the left and center and sometimes to just one man, West Virginia Sen. Joe Manchin, or Manchin and Sinema together.

“There is a fine political line between forcing Congress’ hand with detailed guidance and short timelines and allowing Congress to spin its wheels endlessly,” Jillson said. “Biden has not found the sweet spot, but in such a narrowly divided Congress there may be no sweet spot.”

Biden came late, by some reckonings, to the Trump-inspired Republican efforts in state capitals to revise how people can vote, how those votes are counted and who oversees elections. Defending democratic processes is a universal concern but also, in Delmont’s view, the overarching civil rights issue of this time.

“Right now it feels like there’s a lot more passion and energy from folks who would like to restrict or roll back voting rights,” Delmont said. Absent an effective defense of those rights by Biden, “I can’t say that he’s doing enough to repay the Black Americans who put him in the White House.”

Meantime, day after day, event after event, it was the virus that commanded Biden’s attention. “That challenge casts a shadow over everything we do,” Klain said. “I think we’ve made historic progress there but it’s still a challenge.”

PANDEMIC POLITICS

Biden is the second U.S. president to be humbled by the coronavirus, which has killed some 846,000 people in this country.

The U.S. is now much better equipped against COVID-19. America’s medical arsenal is stronger by orders of magnitude than in the pandemic’s first year and the relief money pumped to households, communities and states also made a big difference, though at a cost of stirring inflation.

The Biden administration has been strikingly successful in procuring vaccines and clearing the way for new antiviral medicines that can be taken at home, which should relieve the strain on hospitals once those pills become widely available.

But testing continues to be a core failure, and millions of Americans still refuse to get vaccinated.

Rapid tests are frustratingly difficult to find, and expensive. PCR tests still take three to five days in many cases to get results. That means Americans will continue to be several steps behind the virus, especially with omicron. It remains to be seen if the administration’s new testing push leads to a meaningful change.

Trump was undone by his bluster, his inability to own up to the seriousness of the situation and his failure to communicate the stakes truthfully to Americans. But Biden has not been entirely free of hubris.

His mask-less springtime stroll with Vice President Kamala Harris in the Rose Garden may be remembered as an ill-conceived example to the country. Biden’s July Fourth celebration of American “independence” from the virus was premature, to put it charitably, despite hedging his remarks in recognition of the dangerous delta variant then stirring.

His portrayal of a “pandemic of the unvaccinated,” meant to nudge those who won’t get the needle, further illustrated the country’s us-and-them divide and wasn’t exactly true. Fully vaccinated people account for a growing number of cases across the country, though they are far less likely to suffer from it as much as the unvaccinated do. Equally vexing for Biden is that those most protected against the virus remain most afraid of it.

On the other side of the political divide, prominent Republican governors have actively opposed vaccination and mask mandates.

Anti-government sentiment, nurtured by misinformation, has been aimed at public health advisers and their recommendations, long regarded as beyond the political scrum.

As the pandemic enters its third year, the notion that the U.S. may not be able to crush the coronavirus and may have to settle for living with it — a thought that sparked outrage when it briefly surfaced in Trump’s time — may now be gaining currency.

Biden’s campaign promise from October 2020 hangs in the balance: “I’m going to shut down the virus, not the country.”

___

IN THE WORLD’S EYES

Biden campaigned on a promise to restore U.S. leadership, with dignity, among the democracies. He’s made good on the style of that while disappointing supporters at home and allies abroad on some of the substance.

Apart from his bungled Afghanistan withdrawal, his efforts to bring Iran back into compliance with the 2015 nuclear accord and reverse Trump’s withdrawal of the U.S. from the deal have been met only by Iran moving closer than before to nuclear capabilities.

With some of the autocrats he had promised to confront on human rights, Saudi’s crown prince among them, he has equivocated.

Steven A. Cook, a Middle East expert and senior fellow at the Council for Foreign Policy, branded Biden’s foreign policy “ruthless pragmatism,” especially when it comes to undemocratic Middle East governments. Domestic politics, including Biden’s own concerns about voter abhorrence for high gas prices, have kept him from making America the out-front example of fighting climate change that he’d promised it would be.

While Biden convened global summits for democracies and climate change as promised, and rejoined the Paris climate accord, his biggest effort on climate funding belly-flopped.

That, along with mixed administration efforts at home to keep natural gas and gasoline cheap and flowing while cutting fossil fuel use over the long term, threatens Biden’s aim of making the U.S. a leader by example on the climate.

The U.S. does look much more normal to the world again, though.

Biden and his diplomats are going all out on rebuilding the alliances that Trump trashed. He’s dealing head-on both with Russia and China. People who care about human rights welcome U.S. leadership on tough sanctions for China and Myanmar over their vicious mistreatment of minorities.

Overlaying everything, domestic or foreign, is a constant foreboding in the White House over what Trump might do next.

A year ago Trump left Washington for Florida, breaking one last tradition as president by refusing to attend Biden’s inauguration. He told a sparse crowd of supporters at Joint Base Andrews that they should expect a second act.

“We will be back in some form,” he said. “Have a good life. We will see you soon.”

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Scientists are seeing signals that COVID-19′s alarming omicron wave may have peaked in Britain and is about to do the same in the U.S., at which point cases may start dropping off dramatically.

The reason: The variant has proved so wildly contagious that it may already be running out of people to infect, just a month and a half after it was first detected in South Africa.

“It’s going to come down as fast as it went up,” said Ali Mokdad, a professor of health metrics sciences at the University of Washington in Seattle.

At the same time, experts warn that much is still uncertain about how the next phase of the pandemic might unfold. The plateauing or ebbing in the two countries is not happening everywhere at the same time or at the same pace. And weeks or months of misery still lie ahead for patients and overwhelmed hospitals even if the drop-off comes to pass.

“There are still a lot of people who will get infected as we descend the slope on the backside,” said Lauren Ancel Meyers, director of the University of Texas COVID-19 Modeling Consortium, which predicts that reported cases will peak within the week.

The University of Washington’s own highly influential model projects that the number of daily reported cases in the U.S. will crest at 1.2 million by Jan. 19 and will then fall sharply “simply because everybody who could be infected will be infected,” according to Mokdad.

In fact, he said, by the university’s complex calculations, the true number of new daily infections in the U.S. — an estimate that includes people who were never tested — has already peaked, hitting 6 million on Jan. 6.

In Britain, meanwhile, new COVID-19 cases dropped to about 140,000 a day in the last week, after skyrocketing to more than 200,000 a day earlier this month, according to government data.

Kevin McConway, a retired professor of applied statistics at Britain’s Open University, said that while cases are still rising in places such as southwest England and the West Midlands, the outbreak may have peaked in London.

The figures have raised hopes that the two countries are about to undergo something similar to what happened in South Africa, where in the span of about a month the wave crested at record highs and then fell significantly.

“We are seeing a definite falling-off of cases in the U.K., but I’d like to see them fall much further before we know if what happened in South Africa will happen here,” said Dr. Paul Hunter, a professor of medicine at Britain’s University of East Anglia.

Differences between Britain and South Africa, including Britain’s older population and the tendency of its people to spend more time indoors in the winter, could mean a bumpier outbreak for the country and other nations like it.

On the other hand, British authorities’ decision to adopt minimal restrictions against omicron could enable the virus to rip through the population and run its course much faster than it might in Western European countries that have imposed tougher COVID-19 controls, such as France, Spain and Italy.

Shabir Mahdi, dean of health sciences at South Africa’s University of Witwatersrand, said European countries that impose lockdowns won’t necessarily come through the omicron wave with fewer infections; the cases may just be spread out over a longer period of time.

On Tuesday, the World Health Organization said there have been 7 million new COVID-19 cases across Europe in the past week, calling it a “tidal wave sweeping across the region.” WHO cited modeling from Mokdad’s group that predicts half of Europe’s population will be infected with omicron within about eight weeks.

By that time, however, Hunter and others expect the world to be past the omicron surge.

“There will probably be some ups and downs along the way, but I would hope that by Easter, we will be out of this,” Hunter said.

Still, the sheer numbers of people infected could prove overwhelming to fragile health systems, said Dr. Prabhat Jha of the Centre for Global Health Research at St. Michael’s Hospital in Toronto.

“The next few weeks are going to be brutal because in absolute numbers, there are so many people being infected that it will spill over into ICUs,” Jha said.

Mokdad likewise warned in the U.S.: “It’s going to be a tough two or three weeks. We have to make hard decisions to let certain essential workers continue working, knowing they could be infectious.”

Omicron could one day be seen as a turning point in the pandemic, said Meyers, at the University of Texas. Immunity gained from all the new infections, along with new drugs and continued vaccination, could render the coronavirus something with which we can more easily coexist.

“At the end of this wave, far more people will have been infected by some variant of COVID,” Meyers said. “At some point, we’ll be able to draw a line — and omicron may be that point — where we transition from what is a catastrophic global threat to something that’s a much more manageable disease.”

That’s one plausible future, she said, but there is also the possibility of a new variant — one that is far worse than omicron — arising.

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WASHINGTON (AP) — Heading into a critical midterm election year, the top political concerns of Americans are shifting in ways that suggest Democrats face considerable challenges to maintaining their control of Congress.

A poll from The Associated Press-NORC Center for Public Affairs Research finds that management of the pandemic, once an issue that strongly favored President Joe Biden and his fellow Democrats, is beginning to recede in the minds of Americans. COVID-19 is increasingly overshadowed by concerns about the economy and personal finances — particularly inflation — which are topics that could lift Republicans.

Just 37% of Americans name the virus as one of their top five priorities for the government to work on in 2022, compared with 53% who said it was a leading priority at the same time a year ago. The economy outpaced the pandemic in the open-ended question, with 68% of respondents mentioning it in some way as a top 2022 concern. A similar percentage said the same last year, but mentions of inflation are much higher now: 14% this year, compared with less than 1% last year.

Consumer prices jumped 6.8% for the 12 months ending in November, a nearly four-decade high. Meanwhile, roughly twice as many Americans now mention their household finances, namely, the cost of living, as a governmental priority, 24% vs. 12% last year.

The poll was conducted in early December, when worries about the virus were rising as omicron took hold in the country, but before it sparked record caseloads, overwhelmed testing sites and hospitals and upended holiday travel. Still, in recent follow-up interviews with participants, including self-identified Democrats, many said those developments didn’t shake their views.

“If we say anything along the lines of, ‘Let’s wait until the pandemic dies down,’ well, this son of a gun virus has unlimited ability to mutate,” said Mary Small, a 65-year-old pharmaceutical research contractor in Downingtown, Pennsylvania, who hopes efforts to promote gun safety will take center stage in November’s elections, including her state’s race for an open Senate seat. “We might never be done with this.”

That sentiment reflects the challenge for Democrats at the onset of the election year. The party won the White House and control of Congress in 2020 with pledges to manage the pandemic more competently than the Trump administration. After initially earning high marks — roughly 70% approved of Biden’s handling of the pandemic from late February through mid-July — the virus’ persistence has undermined the new president’s message.

Administration officials acknowledge that the public is growing increasingly weary of COVID-19.

“Pandemic fatigue is real, and all of us feel it at some point,” Surgeon General Vivek Murthy said in an interview. “As a doctor, I’ve certainly seen it with my patients over the years. When you get tired and beaten down by a health problem — whether it’s a personal health problem or a broader public health challenge — it can lead to disengagement.”

The White House says COVID-19′s waning as a preeminent concern actually underscores its success rolling out preventative measures, including vaccines. It argues that economic jitters now exacerbated by the pandemic eventually will ease.

Still, with Democrats likely struggling to campaign on the idea that they’ve now defeated the virus, the other issues gaining attention among voters pose more immediate political headaches.

Judy Kunzman doesn’t blame Biden for the ongoing pandemic, calling it “just one of those events that are impossible to predict and almost as impossible to fix.” But she’s worried about continued supply chain disruptions, which affect “a lot of the other issues that we’re having: The rising food prices. The fact that I can’t buy my new car.”

“Everything has chips and the chips aren’t there,” said Kunzman, 75, of Middletown, Pennsylvania, referring to a pandemic-fueled, global shortage of microchips many electronics depend on. She’s waited months for the car she’d like to become available and noted that her sister faced difficulties finding a new cellphone.

“It’s certainly not the victory the Democrats thought it would be,” Adam Brandon, president of the conservative activist group FreedomWorks, said of the government’s virus response. “We’ll have another wave next year, and I just don’t think anyone’s going to care. I think we’re going to get to a point where everyone’s just going to have to learn to live with it. This will die with a whimper as people just lose interest.”

Many respondents in the survey said they’re not suggesting the country ignore the pandemic. But compared with last year, higher percentages of people called out other issues, including immigration among Republicans and gun control among Democrats, as pressing in 2022. Some said they were encouraged by early indications that the latest outbreak, while spreading fast, could have milder effects for many.

“I’m hopeful with omicron,” said Samantha Flowers, a 33-year-old community college teacher in Columbia, Missouri, which has its own open Senate seat on November’s ballot. “Even though more people are getting it, the sickness hasn’t been as harsh for most people. Since we’re all going to end up sick anyway, let it be one that we can recover from better.”

Dorrie Keough from Garrettsville, Ohio, said she’s vaccinated against COVID-19 and gotten a booster shot, but is still staying home as much as possible because of omicron.

“Whoever’s not in power is going to spin it in such a way to make it look worse than it might be,” said Keough, 68, whose state also has an open Senate seat this year. “As much reading as I do — and as much investigating that I do — it’s real hard for me to parse out what is actually happening versus what people are saying is happening.”

Adam Green, co-founder of the Progressive Change Campaign Committee, said the key to Democrats’ 2022 success is easing COVID-19 fears — but also delivering tangible policy results. That includes passing Biden’s “Build Back Better,” the massive social spending bill that remains stalled in the Senate.

“I don’t think we’re going to win an election for lack of anxiety,” Green said, “if we’ve achieved nothing else.”

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The estimate is based on Secret Service cases and data from the Labor Department and the Small Business Administration, said Roy Dotson, the agency’s national pandemic fraud recovery coordinator, in an interview. The Secret Service didn’t include COVID-19 fraud cases prosecuted by the Justice Department.

While roughly 3% of the $3.4 trillion dispersed, the amount stolen from pandemic benefits programs shows “the sheer size of the pot is enticing to the criminals,” Dotson said.

Most of that figure comes from unemployment fraud. The Labor Department reported about $87 billion in unemployment benefits could have been paid improperly, with a significant portion attributable to fraud.

The Secret Service said it has seized more than $1.2 billion while investigating unemployment insurance and loan fraud and has returned more than $2.3 billion of fraudulently obtained funds by working with financial partners and states to reverse transactions. The Secret Service says it has more than 900 active criminal investigations into pandemic fraud, with cases in every state, and 100 people have been arrested so far.

The Justice Department said last week that its fraud section had prosecuted over 150 defendants in more than 95 criminal cases and had seized over $75 million in cash proceeds derived from fraudulently obtained Paycheck Protection Program funds, as well as numerous real estate properties and luxury items purchased with the proceeds.

One of the best-known programs created through the March 2020 CARES Act, PPP offered low-interest, forgivable loans to small businesses struggling to meet payroll and other expenses during pandemic-related shutdowns.

Law enforcement early in the pandemic focused on fraud related to personal protective equipment, the Secret Service said. Authorities have now prioritized the exploitation of pandemic-related relief because the federal funding through the CARES Act attracted the attention of individuals and organized criminal networks worldwide.

“Can we stop fraud? Will we? No, but I think we can definitely prosecute those that need to be prosecuted and we can do our best to recover as much fraudulent pandemic funds that we can,” said Dotson, who is the Secret Service’s assistant special agent in charge of the agency’s field office in Jacksonville, Florida.

JENNIFER McDERMOTT | AP News

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Anxious world awaits answers on omicron variant

“World, meet omicron,” writes Rachel Gutman in The Atlantic. “Omicron, meet a lot of people who are very, very anxious to know more about you.” 

The three big questions on epidemiologists’ minds: Is it better at spreading from person to person than previous variants? Does it make people sicker? And will it evade immunity created by vaccines or previous infection?

The World Health Organization’s speedy action in labeling omicron a “variant of concern” suggests it believes at least one of the answers will be “yes.” 

There are two ways scientists can go about gleaning some early answers. One is to grow monkey kidney cells in a lab, along with the new virus, and test how they interact in a dish. For example, does adding serum from fully vaccinated individuals make it harder for the virus to enter the cells?

The other route is to watch and wait as case counts, hospitalization and death rates come in. Either way, results should start to dribble out within weeks. 

There are reasons to be worried: The new variant sports a stunning number of new mutations, leading scientists to speculate it evolved in a single person with a compromised immune system, or even in an animal population, as Kai Kupferschmidt reports at Science. Such mutations could stymie antibodies trained on older variants. In South Africa, where it was first detected, omicron is spreading fast and causing many reinfections, suggesting either high levels of transmissibility or immune evasion — or both.

But there are also reasons to be optimistic: Early anecdotal reports suggest symptoms are often mild, although this could reflect the younger average ages of those infected so far. And many people already possess at least some level of immunity. Even if antibodies can’t prevent infection, experts predict T cells still stand a chance to vanquish it. Antibodies detect only the spike protein’s exterior, while T cells can bind to bits of viral proteins chopped up and displayed on the surface of infected cells. Studies suggest that T cell responses are less fazed by viral mutations, writes Cory Stieg at CNBC’s Make It.

Omicron also appears to have borrowed sequences from another coronavirus that causes the common cold, which could contribute to both higher transmissibility and milder symptoms. 

Pfizer’s CEO Ugur Sahin told The Wall Street Journal that its vaccine will probably still prevent severe disease. However, Moderna CEO Stéphane Bancel told the Financial Times that vaccine efficacy will probably drop. Both companies have started developing omicron-specific vaccines, which could take just a few months to produce.

As for treatments, some antibody medications — based on just one antibody, with one binding site — may be in trouble. Antiviral medications, such as Pfizer’s pill, have a more generic approach and are more likely to work on variants.

“Omicron could, of course, turn out to be pretty much anything,” writes The Atlantic’s Gutman. She even speculates that a highly contagious but mild variant could out-compete delta to become the main circulating virus, plus possibly give people who catch it some immunity to future variants without the risk of severe symptoms. “That might even be a good thing,” writes Gutman, “a perfect variant, just in time for Christmas.”

Nursing homes open to visitors without mandates or boosters 

In mid-November, the federal government lifted nearly all restrictions on visitors to nursing homes. The move, which took place before the omicron story broke, ends a 20-month policy that distressed residents and loved ones. The guidelines now only restrict visitors who have tested positive for the coronavirus or meet quarantine criteria.

The Centers for Medicare and Medicaid Services, which issued the guidelines, noted that 86% of residents and 74% of employees are fully vaccinated, nationwide.

Yet the American Association for Retired People, while praising the change, noted that the death rate among nursing home residents has recently risen to about 2,000 people per month in recent times, a much greater rate than in early summer, before delta spread widely.

“Some doctors and families now worry that the pendulum has swung too far, that fully reopening will leave an already vulnerable population prey to another surge,” writes Paula Span at The New York Times.

Meanwhile, a federal judge halted the Biden administration’s requirement that all health facility workers be fully vaccinated.

And amid a scattershot booster rollout, there’s little data yet on how much boosting nursing homes have been able to achieve, reports Reed Abelson, also at The Times.

“You need to vaccinate residents and vaccinate staff and you need to get boosters in them,” said Scott LaRue, chief executive of ArchCare nursing homes in New York. “It’s a life-or-death matter.”

Biden administration announces response to new variant

The White House, while encouraging Americans not to panic, has nevertheless promised it’s “pulling out all the stops” against the potential omicron threat. 

The strategies announced last Thursday include more vaccination campaigns, testing travelers, and making at-home rapid test kits reimbursable by private insurance. 

Yet Biden must also keep the economy going, and the public’s fed up with restrictions. Lockdowns are reportedly not on the table.

The new variant quickly led to a travel ban focused on several African nations, though U.S. citizens are allowed to return home. Many experts have criticized such bans, as has the World Health Organization, reports Smriti Mallapaty at Nature. They’re too late to stop the virus’s spread — it’s already here — and may hamper the shipment of key lab supplies for viral genetic surveillance in some nations.

Incoming international travelers will be required to show a negative COVID test within the previous day before boarding their flight; earlier regulations allowed three days. Biden also extended the mask mandate for all major modes of transportation until March 18, 2022.

The new plan also strongly promotes boosters; the CDC last week updated its guidance for low-risk adults from “may” get a booster to “should” get a booster.

“Many of the experts who were opposed to boosters now believe that the shots may offer the best defense against the new variant,” writes Apoorva Mandavilli in The New York Times. Boosters should amp up both antibodies and T cells. The presumption is that a more robust immune response, even if it’s not perfectly matched for omicron, is a better bet.

News outlets face familiar catch-22

As the omicron story broke over Thanksgiving break, news providers pivoted from turkey recipes to epidemiology. That quickly led to a debate over how much coverage was appropriate, as media critic Jon Allsop lays out at Columbia Journalism Review.

Editors and publishers have no good option right now: If they hype the variant and it turns out to be a dud, they look bad. If they minimize the threat and it turns out to be a major turn in the pandemic, they look bad.

“The story here is that we don’t know what’s going to happen next,” writes Allsop. While news articles with headlines like “Here’s what we know about Omicron” proliferated, some outlets focused on the uncertainty, such as MIT Technology Review’s “We still don’t know enough about the omicron variant to panic.”

Washington Post reporter Dan Diamond suggested over-reporting is the safer choice. “No one wants to sound alarm unnecessarily,” he tweeted, “but failing to warn about potential risks is a bigger sin in public health, especially if actions now could protect people.”

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THE HAGUE, Netherlands (AP) — Cases of the omicron variant of the coronavirus popped up in countries on opposite sides of the world Sunday and many governments rushed to close their borders even as scientists cautioned that it’s not clear if the new variant is more alarming than other versions of the virus.

The variant was identified days ago by researchers in South Africa, and much is still not known about it, including whether it is more contagious, more likely to cause serious illness or more able to evade the protection of vaccines. But many countries rushed to act, reflecting anxiety about anything that could prolong the pandemic that has killed more than 5 million people.

Israel decided to bar entry to foreigners, and Morocco said it would suspend all incoming flights for two weeks starting Monday — among the most drastic of a growing raft of travel curbs being imposed by nations around the world as they scrambled to slow the variant’s spread. Scientists in several places — from Hong Kong to Europe to North America — have confirmed its presence. The Netherlands reported 13 omicron cases on Sunday, and both Canada and Australia each found two.

Noting that the variant has already been detected in many countries and that closing borders often has limited effect, the World Health Organization called for frontiers to remain open.

Dr. Francis Collins, director of the National Institutes of Health in the United States, meanwhile, emphasized that there is no data yet that suggests the new variant causes more serious illness than previous COVID-19 variants.

“I do think it’s more contagious when you look at how rapidly it spread through multiple districts in South Africa. It has the earmarks therefore of being particularly likely to spread from one person to another. … What we don’t know is whether it can compete with delta,” Collins said on CNN’s “State of the Union.”

Collins echoed several experts in saying the news should make everyone redouble their efforts to use the tools the world already has, including vaccinations, booster shots and measures such as mask-wearing.

“I know, America, you’re really tired about hearing those things, but the virus is not tired of us,” Collins said.

The Dutch public health authority confirmed that 13 people who arrived from South Africa on Friday have so far tested positive for omicron. They were among 61 people who tested positive for the virus after arriving on the last two flights to Amsterdam’s Schiphol airport before a flight ban was implemented. They were immediately put into isolation, most at a nearby hotel.

Canada’s health minister says the country’s first two cases of omicron were found in Ontario after two individuals who had recently traveled from Nigeria tested positive.

Authorities in Australia said two travelers who arrived in Sydney from Africa became the first in the country to test positive for the new variant. Arrivals from nine African countries are now required to quarantine in a hotel upon arrival. Two German states reported a total of three cases in returning travelers over the weekend.

Israel moved to ban entry by foreigners and mandate quarantine for all Israelis arriving from abroad.

And Japanese Prime Minister Fumio Kishida said Monday that Japan is considering stepping up border controls. Kishida told reporters that he planned to announce new measures in addition to the current 10-day quarantine requirement for travelers from South Africa and eight other nearby countries. Japan still has its border closed to foreign tourists from any country.

Morocco’s Foreign Ministry tweeted Sunday that all incoming air travel to the North African country would be suspended to “preserve the achievements realized by Morocco in the fight against the pandemic, and to protect the health of citizens.” Morocco has been at the forefront of vaccinations in Africa, and kept its borders closed for months in 2020 because of the pandemic.

The U.S. plans to ban travel from South Africa and seven other southern African countries starting Monday. “It’s going to give us a period of time to enhance our preparedness,” the United States’ top infectious diseases expert, Dr. Anthony Fauci, said of the ban on ABC’s “This Week.”

Many countries are introducing such bans, though they go against the advice of the WHO, which has warned against any overreaction before the variant is thoroughly studied.

Fauci says it will take approximately two more weeks to have more definitive information on the transmissibility, severity and other characteristics of omicron, according to a statement from the White House.

South Africa’s government responded angrily to the travel bans, which it said are “akin to punishing South Africa for its advanced genomic sequencing and the ability to detect new variants quicker.”

The WHO sent out a statement saying it “stands with African nations” and noting that travel restrictions may play “a role in slightly reducing the spread of COVID-19 but place a heavy burden on lives and livelihoods.” It said if restrictions are put in place, they should be scientifically based and not intrusive.

In Europe, much of which already has been struggling recently with a sharp increase in cases, officials were on guard.

The U.K. on Saturday tightened rules on mask-wearing and on testing of international arrivals after finding two omicron cases, but British Health Secretary Sajid Javid said the government was nowhere near reinstituting work from home or more severe social-distancing measures.

“We know now those types of measures do carry a very heavy price, both economically, socially, in terms of non-COVID health outcomes such as impact on mental health,” he told Sky News.

Spain announced it won’t admit unvaccinated British visitors starting Dec. 1. Italy was going through lists of airline passengers who arrived in the past two weeks. France is continuing to push vaccinations and booster shots.

David Hui, a respiratory medicine expert and government adviser on the pandemic in Hong Kong, agreed with that strategy.

He said the two people who tested positive for the omicron variant had received the Pfizer vaccine and exhibited very mild symptoms, such as a sore throat.

“Vaccines should work but there would be some reduction in effectiveness,” he said.

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“I don’t know anyone who loved their kids as much as they did, and they made sure they told them every day,” Terri Serey, Daniel’s sister-in-law, told the station. “I want them to be aware of how much they’re loved. And I want them to know how much their parents loved them.”

Daniel and his wife, Davy, were admitted to a hospital intensive care unit days apart last month after being diagnosed with COVID-19. A doctor delivered the couple’s daughter eight days before Davy Macias died. The couple developed symptoms after going on a family trip to the beach and an indoor water park at the end of July, family members said.

Macias’ brother, Vong Serey, told the San Bernardino Sun last month that his sister was not vaccinated against COVID-19 and was hesitant to get the shot because she was pregnant. (The CDC has said the vaccine is safe during pregnancy.) She was a nurse in the labor and delivery ward at Kaiser Fontana Medical Center and had worked throughout the pandemic, he said.

Serey did not know whether his brother-in-law had been vaccinated.

Daniel Macias was a middle school math teacher in the Rialto Unified School District, district spokeswoman Syeda Jafri said.

He is “remembered as a compassionate, kind-hearted, fun-loving and generous teacher at Jehue Middle School but he was also a devoted family man,” the district said in a statement.

The couple’s children, who are 7 and under, are under the care of their grandparents, according to family members.

According to a GoFundMe page set up for the family, both parents were intubated and treated in a hospital intensive care unit “due to the Delta variant.” The page had raised more than $200,000 by Monday morning.

CBS | Contributed

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Public Health Numbers on Upswing Again: After rising in the face of a more aggressive Delta variant of COVID-19, the number of new cases has been on the decline for the past week after reaching a plateau the preceding week. Hospitalizations also appear to have peaked, and though they have yet to come down from their elevated levels, they should begin to follow new cases down as well. California has also made some progress on vaccinations with nearly two-thirds of adults having received their first dose of the vaccine.

U.S. P/E Ratio Improves on Stronger Profits: Following a strong bump in U.S. corporate profits during the second quarter, equity markets valuations make a little more sense. Over the past 18 months, the value of publicly traded companies here at home (as measured by the Wilshire 5000) has reached nearly 18 times the current level of U.S. corporate profits. Last quarter, that number fell to 16.8, which is still elevated relative to the standard range of 7-11 times, but it is a positive sign for overall risk that the two indicators have started to come back into alignment.

Interest Rates Hold Steady for Now: Despite ongoing inflation and improving economic conditions generally, uncertainty about the virus and future economic conditions, particularly in light of the expiration of several key government stimulus programs including forbearance and pandemic unemployment assistance, interest rates remain near historic lows. Although this has yet to show in the mortgage applications or weekly sales figures, it is perhaps preventing a stronger seasonal cooldown after such a strong homebuying season earlier this year. Consumer even showed a slight uptick in homebuying sentiment in our July Housing Sentiment Survey.

REALTORS® Report More Seasonal Cooling Last Week: Last week, REALTORS® reported declines in business activity across the board. Fewer members did a listing appointment (33.3%), fewer added a new listing to the MLS (28.2%), fewer entered escrow (23.7%), and fewer closed a transaction (24.4%). However, more REALTORS® reported an increase in optimism about sales and listings next week, which is consistent with the broader market data that has held up surprisingly well despite ongoing supply constraints and some buyer fatigue. In another positive sign, the number of REALTORS® reporting a transaction falling out of escrow has fallen for the past 3 weeks.

Large Rolls of Unemployed as Pandemic Unemployment Ends: The Pandemic Unemployment Assistance, or PUA program, has now ended with nearly 1.6 million Californians on continuing claims at the end of August. Some of those workers may go over to traditional unemployment insurance, but some may begin to reenter the workforce as well in the coming months as job openings remain near record highs. However, with more than two million workers on some form of unemployment assistance as we began September, the economy still has a lot of healing left to do and the expiration of many forms of assistance will likely usher in more disruption in coming months as stimulus starts to work its way out of our economic system.

Mortgage Applications Corroborate REALTOR® Survey: Despite a modest increase in homebuyer sentiment for California consumers in August, mortgage applications just posted their 16th consecutive year-to-year decline last week. The overall index is showing a similar pattern of seasonal slowing that we observe in the weekly California home sales data, but the home sales figures have avoided more substantive declines up to this point. However, we expect home sales to continue their gradual decline as the market remains competitive and buyers continue to grapple with rising prices and a lack of available units.

California Association of REALTORS | Contributed

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