In today's edition:

  • Omicron is concerning but this isn’t our first time around
  • Recognizing the advances and setbacks of the HIV pandemic
  • The real-life public health impacts of abortion policy
Omicron's Uncertainties
South African public health officials last week released a warning that a new variant with an alarming number and placement of mutations had been detected. Early testing showed that the variant was driving a surge of COVID-19 cases in the country and the WHO was quick to categorize omicron as a “variant of concern,” says Andy Pekosz in a bonus episode of the Public Health On Call podcast.

On paper, omicron looks concerning because of the specific placement of mutations, says Pekosz. “It has mutations that are predicted to knock out binding sites for antibodies. It has mutations that should make it bind more tightly to cells in the human respiratory tract. And it has mutations that may make it faster to get in and establish that infection in human cells.”
How it plays out in the real world, however, has yet to be seen. In the meantime, here’s what you need to know:
What will researchers be looking for?
Community spread in countries with documented cases and data from labs on how sensitive or resistant the variant is to antibodies from vaccines or previous infections, among other things, Pekosz says. 
How long before we know more about the potential threats posed by omicron?
It will take two to three weeks for data collection in labs and from testing, sequencing, and contact tracing before we know more. 
What can you do to protect yourself?
Get your booster or your vaccine. Even if omicron is less sensitive to existing vaccines, Pekosz says, they’ll still provide some protection against severe disease, hospitalization, and death.
Other things to keep in mind:
Omicron still represents a small portion of all COVID-19 cases, meaning there’s still hope for it to be less virulent, says David Dowdy in a Twitter thread. Also, “There’s every reason to think that the vaccines are going to work with this variant … This is not something that needs to be scary, especially if you’ve been vaccinated. It’s something for us to keep an eye on, but not to fear.”
Travel restrictions, by themselves, won’t halt the spread of omicron, says Pekosz. “At best, [they are] one part of a larger, comprehensive strategy that includes more testing, contact tracing, sequencing of viruses, and understanding people’s travel history so you can target testing and sequencing to individuals who might be at increased risk of infection with omicron.” 
One thing we know for sure right now:
“The faster we get vaccines globally, the better off we’ll be. This is just another example of how we have focused on the U.S. vaccination campaign so strongly—almost perhaps at the expense of thinking about this as a global pandemic—that variants can emerge anywhere, and because of the ease of travel, [they] can be a threat to the U.S. irrespective of where they emerge. We have to think about this more as a global pandemic and get effective use of vaccines in these countries that have such low access to them right now.”
—Andy Pekosz
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World AIDS Day
December 1 is World AIDS Day. In the 40 years since HIV was first detected, there have been incredible advances in testing, prevention, and treatment. 
But there are new challenges including health care for a generation of people now aging with HIV. Antiretroviral therapy has made it possible for people with HIV to have lifespans similar to those of people without HIV. But aging with HIV brings an increased risk of other health conditions, including cancer, diabetes, and kidney disease. A new study projects the number and ages of people on Antiretroviral therapy (ART) in the coming decade—and suggests that U.S. health systems need to prepare to meet the needs of this growing and aging population.
Some key stats:
  • 36%: Increase in number of people using ART in the next decade, if current rates of new HIV infections persist
  • 7%: Increase over same time period if federal Ending the HIV Epidemic program goals are met (including a 75% reduction in new infections by 2025)
  • 23%: Share of ART users who will be 65 and older (up from 11% currently)
In a related Q&A, Keri Althoff, the study’s lead author, explains how we may need to shift care models for people with HIV to address this population’s burden of comorbidities. “From all the preliminary data we've run, it is a big burden: Most persons who are older with HIV will have three or more additional conditions,” she says. 
Another challenge for this global pandemic is the other global pandemic. COVID-19 disrupted global gains in prevention and has exacerbated comorbidities like substance abuse. In tomorrow’s episode of the podcast, Chris Beyrer will talk to Stephanie Desmon about where HIV currently stands in the US, Africa, and around the world. Look for the podcast here.
Global Health NOW is also publishing a series of profiles about activists with different perspectives on HIV. You can read the first one about Kenyan research scientist Kawango Agot and her work with HIV prevention programs here. The next in the series will appear in tomorrow’s Global Health NOW newsletter

ICYMI: Special Episode: Public Health In The Field—The Supreme Court and Abortion in Mississippi

A potentially landmark battle is in play over abortion rights, and it’s headed to the US Supreme Court on December 1. In a special episode of the podcast, guest hosts Annalies Winny and Alissa Zhu explore the real-life public health impacts of abortion policy on parents and families and how the upcoming Supreme Court case, Dobbs v. Jackson Women’s Health Organization, could have major repercussions for the future of abortion rights in the US Read more about the public health case for abortion rights here.
There are many theories about the origin of SARS-CoV-2. Was it a natural emergence, a laboratory accident, or the deliberate creation of a biological weapon? Gigi Gronvall's published article aims to address scientific misinformation. 
What Do We Know About the Omicron Variant so Far? (Verywell Health)
The Omicron variant contains more unusual mutations than previous strains, and it could be more transmissible and vaccine-resistant potentially. Though Andy Pekosz says it’s difficult to predict the severity of a virus mutation without real-world data. “We just don’t know where Omicron is going to fall right now,” he says. “We have to wait for the initial epidemiology and contact tracing results to start coming in before we can make an estimate as to how dangerous it's going to be as a global pathogen.”
Should you get a COVID booster vaccine while sick? Here's what experts say (WUSA9)
With the announcement of booster doses coming amid cold and flu season, experts are advising people to wait until they’re healthy before getting a booster. “If you are sick with COVID, and in the isolation period, you should not be getting a booster," Kawsar Talaat says. "If you have another illness, if you have a fever...if you feel pretty bad. If you have diarrhea or vomiting, I wouldn't go out and get a vaccine at that time.”
Can COVID Pills End the Pandemic? (AARP)
Unlike current COVID-19 treatments that are administered in health care facilities by injection or an IV, these oral antivirals can be dispensed at pharmacies and taken at home, making them more accessible and convenient for patients and health care providers. Although these pills will not help with prevention of the virus like vaccines do, David Dowdy says they could be a “game changer” by keeping people out of the hospital when they’re infected with COVID. 
Copyright © 2021 Johns Hopkins Bloomberg School of Public Health, All rights reserved.

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