Chinas abrupt pivot from Covid Zero in early December unleashed a surge of omicron infections and led to 59,938 virus-related deaths in the nations hospitals through Jan. 12, the National Health Commission disclosed this weekend. 

While the number swamps the few dozen deaths previously recorded in the official tally which drew widespread criticism both at home and abroad, including from the World Health Organization experts say its still likely to be an underestimate given the enormous scale of the outbreak and the mortality rates seen at the height of omicron waves in other countries that initially pursued a Covid Zero strategy. 

This reported number of Covid-19 deaths might be the tip of the iceberg, said Zuo-Feng Zhang, chair of the department of epidemiology at the Fielding School of Public Health at University of California, Los Angeles. 

While the figure is roughly in line with what Zhang estimated might be coming from the countrys hospitals, he said its only a fraction of the total Covid deaths across the country. 

Using a report from the National School of Development at Peking University that found 64% of the population was infected by mid-January, he estimated 900,000 people would have died in the previous five weeks based on a conservative 0.1% case fatality rate. That means the official hospital death count is less than 7% of the total mortality seen during the outbreak.

The official toll translates to 1.17 deaths daily for every million people in the country over the course of five weeks, according to a Bloomberg analysis. Thats well below the average daily mortality rate seen in other countries that initially pursued Covid Zero or managed to contain the virus after relaxing their pandemic rules. 

When omicron hit South Korea, daily deaths quickly climbed to nearly seven for every 1 million people. Australia and New Zealand saw mortality nearing or topping four per million a day during their first winters with omicron. Even Singapore, which had a well-planned and gradual shift away from its zero tolerance approach, had deaths peak at about two per million people daily. 

These figures would suggest that China is having a very mild wave, with very few deaths per case, Louise Blair, head of vaccines and epidemiology at the London-based predictive health analytics firm Airfinity, said in an email. It would be the lowest of any country/region abandoning a zero Covid policy.

It could be that many of the countrys deaths occurred in nursing care facilities or at home, explaining some of the undercount, she said, as Chinas latest disclosure only counted hospital deaths. Reports of overwhelmed crematoriums around the country suggest excess mortality is at a high level.

The group currently estimates Chinas total Covid-related death count is about 390,000, with a potential range of 77,000 to 945,000 based on fatalities seen in other countries, she said. 

WHO Director-General Tedros Adhanom Ghebreyesus welcomed the new numbers from China, saying they allow for a better understanding of the situation and the potential impact of the Covid wave in China. He also asked the country to continue sharing such information and provide a more detailed breakdown of data by province over time.

New Definition

China narrowed the definition of Covid mortality after it dismantled its zero tolerance approach, with health authorities asking hospitals to limit Covid deaths to those who died from respiratory failure after contracting the virus. 

That led to a dearth of deaths reported throughout December and early January. Of the 60,000 Covid deaths disclosed over the weekend, a little more than 9% succumbed to respiratory failure, the NHC said. The rest died of underlying diseases following a Covid infection, the agency said.

The number of deaths is expected to increase as the virus continues its relentless trek across the country, since mortality tends to lag infections by a few weeks, officials said. The Lunar New Year Holiday, which starts Jan. 21 and involves millions of people traveling to their hometowns, could increase its spread, said Ali Mokdad, a professor at the Institute of Health Metrics and Evaluation and chief strategy officer for population health at the University of Washington.

The groups modeling efforts forecast 1.2 million to 1.6 million deaths in China by the end of 2023, depending on what mitigation measures the country puts in place, Mokdad said.

China is capable of accurately tracking Covid mortality despite the size of its current outbreak, UCLAs Zhang said, thanks to data from its public security, civil administration and hospital systems.

More detailed information and transparent data on Chinas coronavirus situation need to be shared with the World Health Organization, other countries and Chinas own people, he said. 

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Jewelry brand Shane Co. is offering to fork out $1,500 to a singleton looking to find their perfect match. However, as well as meeting a short list of requirements, the lucky person will also have to report back their date experiences (all 15 of them) with the brand.

On top of that, every date must be with a different person, meaning if you like someone halfway through the process you have to keep dating other people as well until all 15 have been completed.

We know it takes a lot of courage to put your heart on the line and take a chance on someone new. On the other hand, it could be the beginning of many beautiful moments to come, the Colorado-based chain said.

Practice makes perfect, especially when it comes to first dates. Thats why we want to give you a helping hand in shaking off those first-date nerves and making more magical moments happen.

The process for completing the challenge and collecting the cash begins with setting up dates via your preferred method be it a dating site, blind dates, in person, or anything else. While on the date, youll be required to document the event with a photo before filling out a worksheet provided by the brand.

Dates can also be whatever the individuals want to try, whether its a romantic dinner, a walk in the park or a movie. The business added that second dates are strongly encouraged, they just wont count towards the final total.

On top of its guidelines for the dating process, Shane Co. also has a list of requirements for its ideal candidate. Firstly, the applicant must be single, saying: cheaters never win, and winners never cheat. The person must also willing and able to secure 15 dates in five months.

Dates dont have to be strangers but they must be 15 different people. Applicants must be 18 years or older and a U.S. citizen or permanent resident to apply. It added: Disregarding any of these requirements is grounds for immediate disqualification.

The brand has also shared safety precautions to consider before setting up the dates, adding: The safety of all participants is our top priority, so be sure to catch up on best practices before entering our contest. We encourage the winner to plan their dates in public places and enact buddy systems and backup plans so theyre adequately prepared for any situation.

But beware: if the dates go well, they may go viral.

Should the winner have a unique, budding love story to share and wants to share it publicly we would love to feature their story on The Loupe, the Shane Co. blog, the firms director of digital marketing Johnray Strickland told CNN.

What are the most popular dating apps?

For those wondering where to start looking for dates, theyll find the most users on the Tinder app with around 80 million monthly users in 2021.

According to Business of Apps, Badoo comes in second, with around 60 million a month however this is used more widely in Europe and South America.

Further down the list are Bumble at 45 million, Hinge at 20 million and Grindr at around 15 million.

The contest comes as the dating services industry continues to boom across the United States. Industry researchers IBISWorld said the market by revenue is worth $4.3 billion in 2023. After growing its market size by 3.1% annually between 2018 and 2023 the sector is predicted to expand again this year, increasing by another 2.4%.

And Shane Co. which has 21 stores across the U.S. is optimistic about the outcomes of the project. Who knows, maybe the winner will find their person throughout their journey and seal the deal with a Shane Co, engagement ring, the company said.

Further details can be found on the Shane Co website.

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But its only now that the New Yorker is feeling better. His longest lasting symptombrain fogis finally clearing up and hes performing well at his new remote position in construction management. 

Im coming up on a year out since the last time I had COVID and Im just now really starting to mentally and physically feel like Im getting beyond this, he says.

Doctors are still trying to understand brain fog, which some studies estimate may affect up to 70% of COVID patients, and experimenting with treatments that may improve symptoms for those dealing with it months out from their illness. Studies show those who have had COVID demonstrate measurable increases in brain fog compared to their counterpartseven if they didnt notice itbut also that those symptoms cleared up around six to nine months later. 

Theories on what causes the feeling of brain fog are still up for debate, and treatments vary widely. OConnor sought treatment from Dr. Raphael Kellman, an internist and functional medicine physician at Kellman Wellness Center in New York, last summer. Kellman treats patients based on the idea that inflammation of the brain causes these symptoms. 

Brain fog is a very prominent issue, recall, feeling out of it, and the number one issue is chronic inflammation, Kellman says. The immune system has just not shut off and its in a constant hyperinflammatory state.

Doctors at the University of Pittsburgh Medical Center have taken a different approach with their Post-COVID-19 Recovery Clinic, launched in November of 2020. They say the cause of brain fog in COVID patients has not been determined with conclusive evidence. Doctors have instead focused on treating the symptoms in more than 500 patients with long-haul COVID. 

Probably the most common complaints we see patients for are for decreased exercise tolerance, sometimes with a shortness of breath, says Karla Yoney, a Senior Advanced Practice Provider for the UPMC Post-COVID-19 Recovery Clinic. Brain fog is probably second most common as well as fatigue.

Those with brain fog are typically referred to speech therapists for cognitive rehab where patients go through a battery of brain exercises week after week to get things working smoothly again. 

Were focusing on symptom management, says Yoney. Bottom line is we cant even really speculate if its inflammation until we have enough data across the board.

Long COVID brain fog symptoms

OConnor first noticed something wasnt right when he returned to work. Suddenly, all he could manage to do was put in a full day before coming home and heading to bed. Simple tasks took longer, and colleagues noticed he was missing things here and there. 

It was relatively simple things, like Id leave somebody off of an email thread or someone would say do you know forget to attach a document? he says. It was embarrassing.

Outside of work, he realized his chess game was suffering. He often plays with his son but after contracting COVID, he needed a handicap if he wanted a shot at winning a game. 

Doctors say brain fog is defined by short-term memory loss and trouble concentrating. Some might feel confused as well. Like the name suggests, patients often feel as if theyre having to take more time and effort for the same tasks the way a driver might when navigating a heavy fog on the roads. 

Memory, name recall, confusion, trouble concentrating, etc, Kellman says. When patients come to him theyve often identified COVID as marking the start of their symptoms, but he believes there are many patients out there struggling without realizing what kicked off their symptoms. 

Some realize they developed this after COVID and some dont make that connection, he says. Sometimes they have an autoimmune disease and you dont know if it developed from the COVID, but usually you can see the timeline. 

In short, theres a lot of overlap between long COVID and autoimmune disorders, Kellman says. He looks at it as a web of issues, and depending on what the patient knows about their own symptoms it may or may not be diagnosed as long COVID. 

Sometimes people complain about processing speeds or being more forgetful, trouble with focus and attention and concentrationthese are kind of the hallmark symptoms, says Dr. Erik Won, president and chief medical officer at Wave Neuroscience in Newport Beach, California.

What causes Long COVID brain fog

Some doctors agree brain fog is the result of inflammation of the brain, which happens when the body works in overdrive to fend off viruses such as COVID. Its unclear why some experience brain fog and others dont, but many patients complaining of the symptoms are assumed to have inflammation. 

There are ways to test for certain, but many of these tests are costly and unnecessary, says Kellman. Some tests look for interleukins and cytokines, small proteins  in the blood produced by the immune system which causes inflammation. 

Instead, many doctors opt to treat brain fog as inflammation, which can also affect the microbiome in the gut and lead to autoimmune disorders, Kellman says. 

So these are the underlying issues and if you address these people can get betterand they doyou just have to know whats going on, he says. 

Yoney says the causes are still not clear. Instead, patients can self refer to the clinic for long haul COVID symptoms, which they define as symptoms lasting for more than two months after an initial bout of COVID. Patients who complain of brain fog during this time period are first tested at the clinic for thyroid and B12 levels to confirm that feelings of fatigue, for example, are not part of another underlying issue. From there, those with brain fog might undergo some cognitive tests to confirm deficiencies. Many patients also undergo an MRI, but so far Yoney says those with brain fog do not show signs of damage. 

The good news is when patients come in, depending on red flags and symptoms, well sometimes order head imaging before they get to neurology, Yoney says. I have not found structural changes. These are normal head CTs and brain MRIs, which is reassuring for the population, but I cant speak to functional scans. 

Yoney explains that functional scans might reveal more about how brain fog manifests in the brain. 

Long COVID brain fog treatments

OConnor sought treatment in the summer of 2021, between his second and third bout of COVID, after seeing an email from his sons doctor listing some symptoms of long haul COVID. 

Kellman started him on a course of herbal compounds and supplements aimed at reducing his inflammation. 

Dr. Kellman says there is some evidence that infrared light can help reduce inflammation as well. 

Patients on his regimen have seen improvement in a matter of weeks, he says.

I definitely saw results, OConnor says. 

Won performs a different kind of treatment on his patients, one developed after studying its effectiveness in chemo patients suffering from chemo brain, which causes similar feelings of brain fog. He can test for evidence of inflammation with an electroencephalogram, or EEG. 

Transcranial magnetic stimulation (TMS) uses magnetic fields to stimulate those nerve cells, restoring function. 

When neurons slow down, in our experience, they just need some stimulation, Won says. 

Kellman believes time and treatment can help combat brain fog, but doesnt believe theres a way to retrain the brain on your own to overcome the symptoms. 

Stress reduction helps, but in my experience its not sufficient, he says. 

Won says good sleep hygiene is important, and mindfulness and meditation can sometimes help as well. Plus daily activity is proven to improve brain health. 

Thirty minutes of activity three to four times a week can help restore function faster than someone who is sedentary, he adds.

But hoping that the condition resolves with time isnt advised either. 

Brain inflammation can lead to chronic problems, including early dementia, and there is already a link between COVID and dementia, Kellman adds.

So while he views the condition as both urgent and serious, he says patients shouldnt feel discouraged. 

People should feel hopeful because there is treatment, Dr. Kellman says. 

Yoney says her patients are typically referred to a speech pathologist for cognitive therapy lasting between 4 and 12 weeks. After those weekly sessions, patients are tested again and compared to their initial baseline testing to show improvement. These patients say that the exercises they learn in therapy have improved things like memory recall and their ability to focus. 

The clinic will soon launch a clinical trial comparing the effects of cognitive therapy to a 3-month treatment of Adderall to compare the effects of each. 

In the meantime, Yoney says that for some, long-haul COVID symptoms can resolve on their own. But patients who seek out care at the clinic have typically been dealing with symptoms for a year or more. 

In an interview Sunday with The Associated Press, the former U.S. secretary of state acknowledged that the Emirates and other countries relying on fossil fuels to fund their state coffers face finding some balance ahead.

However, he dismissed the idea that Sultan al-Jabers appointment should be automatically disqualified due to him leading the Abu Dhabi National Oil Co. Activists, however, equated it to asking arms dealers to lead peace talks when authorities announced his nomination Thursday.

I think that Dr. Sultan al-Jaber is a terrific choice because he is the head of the company. That company knows it needs to transition, Kerry said after attending an energy conference in the Emirati capital. He knows and the leadership of the UAE is committed to transitioning.

Still, Abu Dhabi plans to increase its production of crude oil from 4 million barrels a day up to 5 million even while the UAE promises to be carbon neutral by 2050 a target that remains difficult to assess and one that the Emirates still hasnt fully explained how it will reach.

Kerry pointed to a speech al-Jaber gave Saturday in Abu Dhabi, in which he called for the upcoming COP or Conference of Parties to move from goals to getting it done across mitigation, adaptation, finance and loss and damage. Al-Jaber also warned that the world must be honest with ourselves about how much progress we have actually achieved, and how much further and faster we truly need to go.

He made it absolutely clear were not moving fast enough. We have to reduce emissions. We have to begin to accelerate this transition significantly, Kerry said. So I have great confidence that the right issues are going to be on the table, that theyre going to respond to them and lead countries to recognize their responsibility.

Each year, the country hosting the U.N. negotiations nominates a person to chair the talks. Hosts typically pick a veteran diplomat as the talks can be incredibly difficult to steer between competing nations and their interests. The nominees position as COP president is confirmed by delegates at the start of the talks, usually without objections.

Al-Jaber is a trusted confidant of UAE leader Sheikh Mohammed bin Zayed Al Nahyan. He also led a once-ambitious project to erect a $22 billion carbon-neutral city on Abu Dhabis outskirts an effort later pared back after the global financial crisis that struck the Emirates hard beginning in 2008. Today, he also serves as the chairman of Masdar, a clean energy company that grew out of the project.

Skepticism remains among activists over al-Jaber, however. A call by countries, including India and the United States, for a phase down of oil and natural gas never reached a public discussion during COP27 in the Egyptian resort of Sharm el-Sheikh in November.

Activists worry that COP being held in a Mideast nation reliant on fossil fuel sales for a second year in a row could see something similar happen in the Emirates.

Asked about that fear, Kerry said: I dont believe UAE was involved in changing that.

Theres going to be a level of scrutiny and and I think thats going to be very constructive, the former U.S. senator and 2004 presidential contender said. Its going to help people, you know, stay on the line here.

I think this is a time, a new time of accountability, he added.

Still, the Emirates and the U.S. maintain close military relations, regardless of the federation making policy decisions disliked by Washington.

Dubais Jebel Ali Port is the most-used port of call for the U.S. Navy outside of America. Some 3,500 American troops are deployed in the country, including at Abu Dhabis Al Dhafra Air Base and a Navy outpost in Fujairah. The UAE has some $29 billion in pending defense sales with the Americans, including purchasing its most-advanced air defense system known by the acronym THAAD.

For Europeans in particular, Russias war on Ukraine has led to a reckoning on the continents reliance of Moscows natural gas to heat their homes in the winter. Though aided by an unusually warm winter, Europeans are trying to source gas elsewhere while also looking for renewables to fill whatever gaps they can.

No country is advantaged by having a petro-dictator be able to control their future and their prices and their economy with reckless behavior, Kerry said, referring to Russian leader Vladimir Putin.

To the degree theres something thats coming out of it that will change things for the better, that is Europes deep commitment to big reductions in emissions and to a whole shift in the nature of their energy supply, Kerry said.

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