Tony's Diary Package — page 950

New confirmed cases of Covid-19 in US Seven-day rolling average of mew cases: Omicron BA.1 700,000 400,000 200,000 400.000 300,000 Omicron Ancestral > D614G Subvariants BA.2; BAZ.12.1; BA4, BAS 200,000 100,000 US o Mar 1 May Jul Sep Now hari Mar May Jul Sep Mow Jan Mar May Source: Financial Times analps of data from Johns Hopkins CSSE, World Health Organization, UE Government comonaveus dashboard, Government of Peru, Public Health FINAN LDLAL PLA France, lag Health Manian, Slownian Mieeviry of Health, Feith inatieure for Health ond Wellarg and th Swede Public Heath Agency ote opedated duce 8 2022 3.199m BST, imeractive verice: ficomcovid1 > June 9, 2022 Global USA The big discussion items over the past 24 hours have been the growing number of cases of monkeypox which at last count is over 1400 globally and over 70 in the United States. In addition, there was concern about what kind of decision will be made regarding the 4th shot boost with the mRNA vaccines. Although the Moderna data indicate that the bivalent vaccine of wildtype plus omicron gives quite good response to omicron, their data show only a modest protective effect with a three to fourfold decrease in efficacy against BA4 and BA.5. The data from Pfizer are even more dramatic in showing the lack of a good response against BA4 and BA5 when you vaccinate with a bivalent consisting of wildtype and omicron. The real issue is going to be that by the time the Fall comes it is very likely that neither omicron (BA.1) nor BA.4/BA.5 will be dominant since even though BA4 and BA5 are starting to take over dominance, they will likely peak and come down by the time the Fall comes and so we will be making a booster for a virus that very likely does not exist in society at the time that you are using the vaccine. Clearly, this is a major dilemma that we are all facing with the virus that moves so quickly. Good history of the evolving of variants: PRESS: NBC Medical Unit Interview with Akshay Syal;