CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 07/27/2021

HELLO,

JUST POSTED:

The C.D.C. will recommend that some vaccinated people wear masks indoors again.

Reversing a decision made just two months ago, the Centers for Disease Control and Prevention is expected to recommend on Tuesday that people vaccinated for the coronavirus resume wearing masks indoors in certain areas of the country.

The change follows reports of rising breakthrough infections with the Delta variant of the virus in people who were fully immunized. But the new guidance would mark a sharp turnabout from the agency’s position since May that vaccinated people do not need to wear masks in most indoor spaces.

Advice about thinking through breakthrough infections.

(J. Harris: Excellent NYT summary article regarding “Breakthrough Covid.” I’d have to advise wearing a mask in a crowd in areas where most of the population is unvaccinated.)

MOST OF THE NEW CASES ARE DELTA, YESTERDAYS COUNT:

FROM HOPKINS:

1. Changes in Influenza and Other Respiratory Virus Activity During the COVID-19 Pandemic — United States, 2020–2021 (CDC MMWR) Influenza viruses and human metapneumovirus circulated at historic lows through May 2021. In April 2021, respiratory syncytial virus activity increased. Common human coronaviruses, parainfluenza viruses, and respiratory adenoviruses have been increasing since January or February 2021. Rhinoviruses and enteroviruses began to increase in June 2020. Clinicians should be aware of increased circulation, sometimes off season, of some respiratory viruses and consider multipathogen testing. In addition to recommended preventive actions, fall influenza vaccination campaigns are important as schools and workplaces resume in-person activities with relaxed COVID-19 mitigation practices.

2. Government Affairs & National Security:

Democrats Want To Hold Social Media Companies Responsible For Health Misinformation (NPR) Democratic senators introduced a bill on Thursday that would hold Facebook, YouTube and other social media companies responsible for the proliferation of falsehoods about vaccines, fake cures and other harmful health-related claims on their sites. Co-sponsored by Democratic Senators Amy Klobuchar of Minnesota and Ben Ray Luján of New Mexico, the Health Misinformation Act targets a provision in Section 230 of the Communications Decency Act, which protects platforms from being held liable for what their users post in most cases.

3. VACCINE MANDATES As SARS-CoV-2 vaccines become more widely available, some organizations, schools, and businesses are considering making them mandatory. This week, a US federal judge ruled to uphold a mandatory vaccination policy implemented by Indiana University, which would require SARS-CoV-2 vaccination for students, faculty, and staff before returning to campus this fall. The ruling acknowledges that the university has the authority under the Fourteenth Amendment to the US Constitution to pursue reasonable measures to protect the “public health for its students, faculty, and staff.” The students who filed the original suit are reportedly appealing the judge’s ruling.

On July 22, the American Hospital Association, the country’s largest association of hospitals and health systems, issued a statement in support of mandatory SARS-CoV-2 vaccination for healthcare workers. The statement argues that the vaccines have been demonstrated to be both safe and effective, and they play a critical role in protecting the health of both healthcare workers and their patients, many of whom are at elevated risk of severe COVID-19 disease. There have been several notable examples of hospitals firing employees who refused the vaccine, and the issue will certainly receive ongoing attention, especially until the vaccines receive full FDA approval.

New York City and California will require workers to be vaccinated or face testing.

TWO EXCELLENT ARTICLES ABOUT VACCINE FROM THE ATLANTIC:

1. The Threat of an Unvaccinated South

“…Unvaccinated individuals are efficient fuel [just] like dry wood for the fire of future outbreaks. Vaccinated individuals are like soaked wood—while it can’t easily catch fire, [but] if it’s surrounded by dry wood, the chances are much higher.” In other words, low vaccination rates in the South make this moment less safe for everyone there, and over time could jeopardize the country’s hope of ever getting the novel coronavirus more under control.

2. Vaccinated America Has Had Enough

”….Experts list many reasons for the vaccine slump, but one big reason stands out: vaccine resistance among conservative, evangelical, and rural Americans. Pro-Trump America has decided that vaccine refusal is a statement of identity and a test of loyalty.

…many in the vaccinated majority must be thinking: Yes, I’m very sorry that so many of the unvaccinated are suffering the consequences of their bad decisions. I’m also very sorry that the responsible rest of us are suffering the consequences of their bad decisions…More than a dozen conservative states have legislated drug testing for people who seek cash welfare. It is bizarre that Florida and other states would put such an onus on the poorest people in society—while allowing other people to impose a much more intimate and immediate harm on everybody else…Compassion should always be the first reaction to vaccine hesitation.[?] Maybe some unvaccinated people have trouble getting time off work to deal with side effects, maybe they are disorganized, maybe they are just irrationally anxious. But there’s no getting around the truth that some considerable number of the unvaccinated are also behaving willfully and spitefully. Yes, they have been deceived and manipulated by garbage TV, toxic Facebook content, and craven or crazy politicians. But these are the same people who keep talking about “personal responsibility.” In the end, the unvaccinated person himself or herself has decided to inflict a preventable and unjustifiable harm upon family, friends, neighbors, community, country, and planet…Will Blue America ever decide it’s had enough of being put medically at risk by people and places whose bills it pays? Check yourself: Have you?”

MORE HOPKINS RE FRANCE AND AUSTRALIA:

1. Thousands Of People Protest Coronavirus Lockdowns In Australia (NPR) Thousands of people took to the streets of Sydney and other Australian cities on Saturday to protest lockdown restrictions amid another surge in cases, and police made several arrests after crowds broke through barriers and threw plastic bottles and plants. The unmasked participants marched from Sydney’s Victoria Park to Town Hall in the central business district, carrying signs calling for “freedom” and “the truth.”

2. France Passes Law That Makes A Coronavirus Health Pass Required For Dining And Travel (NPR) France’s parliament approved a law early Monday requiring special virus passes for all restaurants and domestic travel and mandating vaccinations for all health workers. Both measures have prompted protests and political tensions. President Emmanuel Macron and his government say they are needed to protect vulnerable populations and hospitals as infections rebound and to avoid new lockdowns. The law requires all workers in the health care sector to start getting vaccinated by Sept. 15, or risk suspension. It also requires a “health pass” to enter all restaurants, trains, planes and some other public venues. It initially applies to all adults, but will apply to everyone 12 and older starting Sept. 30.

As virus cases rise, another contagion spreads among the vaccinated: anger.

“…As coronavirus cases surge again across the United States, many inoculated people are losing patience with vaccine holdouts who they say are neglecting a civic duty or clinging to misinformation even as new patients arrive in emergency rooms and the nation renews mask advisories…The mounting anger is contributing to political support for more coercive measures. Scientists, business leaders and government officials are calling for vaccine mandates — if not by the federal government, then by local jurisdictions, schools, employers and businesses…And frustration is straining relations even within closely knit families…”

AND LAST BUT NOT LEASED: 

I’M GOING TO START COLLECTING HIGHLIGHTERS.

MARK MY WORD!

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 07/26/2021

HARRISON COUNTY FROM NYT:

AREA COVID TRACKER FROM NYT 26 JULY:

American Academy of Pediatrics recommends masks in schools for everyone over 2, regardless of vaccinations

“The American Academy of Pediatrics released new Covid-19 guidance for schools on Monday that supports in-person learning and recommends universal masking in school of everyone over the age of 2, regardless of vaccination status — a stricter position than that taken this month by the US Centers for Disease Control and Prevention.

“The AAP believes that, at this point in the pandemic, given what we know about low rates of in-school transmission when proper prevention measures are used, together with the availability of effective vaccines for those age 12 years and up, that the benefits of in-person school outweigh the risks in all circumstances,” …

One of the main interventions put forward by the AAP is that all students over the age of 2 and all school staff should wear masks at school unless they have a medical or developmental condition that prohibits this.”’

(J. Harris: I agree with this Mask use in schools until the Delta wave dissipates. There is a lot of pressure being levied onto school board members in apposition to masks — mostly by folks who’ve never watched people die even when on a respirator.)

FROM HOPKINS:

1. BEST SIGNS TO IDENTIFY  COVID: LOSS OF SMELL AND TASTE—Anosmia, Ageusia, and Other COVID-19-like Symptoms in Association with a Positive SARS-CoV-2 Test, Across Six National Digital Surveillance Platforms: an Observational Study (Lancet Digital Health) Between April 1 and July 31, 2020, 514 459 tests from over 10 million respondents were recorded in the six surveillance platform datasets. Anosmia–ageusia was the strongest, most consistent symptom associated with a positive COVID-19 test (robust aggregated rank one, meta-analysed random effects OR 16·96, 95% CI 13·13–21·92). Fever (rank two, 6·45, 4·25–9·81), shortness of breath (rank three, 4·69, 3·14–7·01), and cough (rank four, 4·29, 3·13–5·88) were also highly associated with test positivity. The strong association of anosmia–ageusia with self-reported positive SARS-CoV-2 test was consistently observed, supporting its validity as a reliable COVID-19 signal, regardless of the participatory surveillance platform, country, phase of illness, or testing policy. These findings show that associations between COVID-19 symptoms and test positivity ranked similarly in a wide range of scenarios.

2. The Lambda Variant: What You Should Know And Why Experts Say Not To Panic (NPR) The lambda variant, first identified in Peru, is also making headlines as it has started to be identified in several states. Houston Methodist Hospital reported its first case of the variant this week. Scientists at the Medical University of South Carolina recently announced they had found the variant in a virus sample taken in April. According to a database for scientists tracking coronavirus variants, fewer than 700 cases of the lambda variant have been sequenced in the U.S. so far out of more than 34 million coronavirus cases reported to date. But the U.S. has sequenced only a tiny fraction of its cases, so that number does not reflect the actual number of lambda cases in the country. Fewer than 1% of U.S. cases in the last four weeks have been identified as the lambda variant, according to GISAID, a repository for genome data. 

3. EXPIRING VACCINES With demand for SARS-CoV-2 vaccination largely leveling off in the US over the past 3 weeks, millions of SARS-CoV-2 vaccine doses are set to expire in the next few months. Several states and some global health experts are calling for the excess doses to be redistributed to other countries, but so far the US government has rejected those requests, citing legal and logistical challenges. However, states are now able to request a specific number of vaccine doses instead of having doses distributed to them based on their population. Delayed reporting, everyday wastage, and waning demand, including those who did not go back for second doses, are among the sources for a pile up of inventory. The FDA previously extended the shelf-life of the Pfizer-BioNTech and J&J-Janssen vaccines, and some hope an additional extension for the Pfizer-BioNTech vaccine will be approved. Meanwhile, the federal stockpile of vaccine doses continues to grow, with approximately 390 million of the 1.41 billion doses purchased by the US having been delivered, and another 562 million doses from Moderna, Pfizer-BioNTech, and J&J-Janssen expected to be delivered by the end of 2021. The White House has pledged to donate 80 million doses of its vaccine supply, and will purchase an additional 500 million doses for low- and lower-middle-income countries. But some experts note the doses currently sitting in states are ready to be administered, not waiting to be manufactured, and those doses could have a positive impact in other countries if states were permitted to redistribute them.  

FROM THE HOUSTON CHRONICLE:

Dr. Peter Hotez: Delta variant ‘like nothing we’ve seen before — expect rise in hospitalizations

(J. Harris: An interview with audio which considers pertinent, current questions and answers from a Texas expert who is a real pro. This is worth the read.)

“…The problem is, it’s twice as transmissible as the original lineage. This is like nothing we’ve ever seen before. It’s not quite as transmissible as something like measles, but it’s getting up there in terms of its reproductive number….Maybe a third immunization is not such a bad idea. Because that third immunization for the mRNA vaccines, or a second for Johnson & Johnson, will really jack up your virus-neutralizing antibodies. And in the arms race between antibody and virus, enough antibodies will be put into your mucous membranes that they will potentially cause shedding to stop…What do we know about what’s going on with delta and kids? Does it affect them differently than the original?…I get asked that a lot. I don’t think delta is specifically targeting children, and I don’t think children are more predisposed to delta than any other unvaccinated population. I think what’s happening is, delta is so aggressive that everyone’s getting infected and kids are getting swept up along in that.

OPINION PIECE FROM MNM:

David M. Shribman: History is full of Americans hating each other

AND LAST BUT NOT LEASED:

The following card was sent to me by a Baptist Decon’s wife, so I feel like it is OK to send it out. (Well, she did grow up a Catholic.)

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 07/24/2021

UH OH:

FROM BECKERS

3 states responsible for 40% of COVID-19 cases

“…Florida, Texas and Missouri accounted for 40 percent of new COVID-19 cases reported nationwide this week, Jeff Zients, the White House’s COVID-19 response coordinator, said July 22…”The data is clear: The case increases are concentrated in communities with low vaccination rates,” Mr. Zients said during a news briefing, pointing to the three states. 

(J. Harris: Here we go again.)

FROM NEJM:

1. Vaccine Effectiveness Studies in the Field

(J. Harris: English studies showing that with two jabs, vaccines work almost as well against Delta Variant as the original Alpha Covid-19 virus.)

FROM HOPKINS:(SOME YOU HAVE SEEN)

1. Public Health Officials Have Tools to Beat Back Covid Again. Does Anyone Want to Use Them? (STAT News) Before Covid-19 vaccines, public health officials fought off the pandemic with the only tools they had: mask-wearing, social distancing, school closures, and limits on the size of gatherings. Now, with cases surging again in much of the United States due to the highly transmissible Delta variant, those tools could still make a measurable difference at a critical moment — but not if the public is unwilling to use them. A year and a half after Covid restrictions were first implemented, people have had it with the pandemic. Other than highly effective vaccines, which haven’t been accepted by enough people to quash spread of the new SARS-CoV-2 variant, there are no new tools in the public health toolbox, and people have absolutely no interest in reusing the ones that it does contain.

2. France Forced to Soften Rules After Coronavirus Green Pass Backlash (Politico)

The French government, which last week introduced some of Europe’s toughest measures against COVID-19, has been forced to row back on some restrictions following a pushback from industries and street protests. Among the new rules, French President Emmanuel Macron sought to turbo-drive vaccinations by making proof of vaccination or immunity mandatory to enter cafés, restaurants and a range of other venues this summer. The scheme, which goes further than other big EU countries, was introduced to help break a fourth wave of COVID-19 infections in France, driven by the more contagious Delta variant.

3. Southern California Cities Rebel Against New Mask Mandate, Hinting at Delta Variant Drama to Come (Washington Post) Barely a month after state officials lifted nearly all pandemic restrictions — and even as the White House continues to insist that vaccinated people need not wear masks — the nation’s largest county clamped back down this past weekend, announcing a new requirement for everyone to wear masks indoors regardless of vaccination status.The backlash was immediate.

Comparison of Neutralizing Antibody Titers Elicited by mRNA and Adenoviral Vector Vaccine against SARS-CoV-2 Variants (SENT OUT EARLIER)

Abstract: The increasing prevalence of SARS-CoV-2 variants has raised concerns regarding possible decreases in vaccine efficacy. Here, neutralizing antibody titers elicited by mRNA-based and an adenoviral vector-based vaccine against variant pseudotyped viruses were compared. BNT162b2 [PFIZER] and mRNA-1273 [MODERNA]-elicited antibodies showed modest neutralization resistance against Beta, Delta, Delta plus and Lambda variants whereas Ad26.COV2.S [JOHNSON &JOHNSON]-elicited antibodies from a significant fraction of vaccinated individuals were of low neutralizing titer (IC50 <50). The data underscore the importance of surveillance for breakthrough infections that result in severe COVID-19 and suggest the benefit of a second immunization following Ad26.COV2.S to increase protection against the variants.(J. Harris: What is poorly said above is that J &J Vaccine does not work as well as do the other vaccines to protect against Delta and other variants tested.)

FROM THE CDC;

SARS-CoV-2 Superspread in Fitness Center, Hong Kong, China, March 2021

(J. Harris: Markedly enhanced ventillation helped prevent super spreading in a Gym.)

FROM SCIENTIFIC AMERICAN:

1. How the Delta Variant Spreads So Quickly

“…The combination of a high number of viruses and a short incubation period makes sense as an explanation for Delta’s heightened transmissibility…And the short incubation makes contact tracing more difficult…”

2.˚People with COVID Often Infect Their PetsPeople with COVID Often Infect Their Pets

“… pet owners transmitting the virus to their furry friends is more common than originally thought. That result makes sense,… given the closeness of person-pet relationships. “Often we’re snuggling and even sleeping in the same beds with them,…S..Beyond the pathogen posing a risk to our pets’ health, researchers worry that it will multiply in the animals and possibly mutate, jumping back into humans at some point. “The main concern is … the potential risk that pets could act as a reservoir of the virus and reintroduce it into the human population… Denmark and the Netherlands culled their mink stocks, killing almost 20 million of the furry animals in total to stop the virus from spreading further..So far…. there is no evidence of such retransmission from dogs and cats back into humans. But … the current studies simply are not set up to answer that exact question…“If you have COVID-19, my advice is to keep your distance from your pet and don’t let them into your bedroom,” Bienzle says. Hamer reiterates that the recommendations are the same as with any other humans in your household: if you’re infected, stay as far away as possible….

Several studies have shown that pigs, cows, ducks and chickens seem to be largely resistant to the virus.

(J. Harris: Of course, most people don’t sleep with pigs, cows, ducks, and chickens — do they?)

OPINION PIECE: Forget Mask Mandates. Vaccines Are the Only Answer for Fighting Covid-19.

(J. Harris: But, masks are often utilized by the Vaccine Hesitant and, in my opinion, should again be worn, mandated or not, when the Virsus is at the door — like now in East Texas.)

LAST BUT NOT LEASED AND SPEAKING OF COWS:

IF A COW DOES NOT PRODUCE MILK IS IT A MILK DUD OR AN UDDER FAILURE?

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FABULOUS HOPKINS CITATIONS–ALL OF THEMS – 07/24/2021

If you like facts, you will want to read this article. If you don’t like facts and prefer liviing in a bubble — move on.
Ron Munden

EPI UPDATE The WHO COVID-19 Dashboard reports 192.3 million cumulative cases and 4.14 million deaths worldwide as of 11:11am EDT on July 23.

Countries around the world are combating new COVID-19 surges, generally believed to be driven, in part, by increasing prevalence of the Delta variant (B.1.617.2). Unlike in previous surges, there do not appear to be strong regional trends, with the countries facing the largest surges distributed around the world. In fact, looking at the biweekly trends, there are approximately 50 countries where daily incidence has more than doubled, and they are spread across nearly every continent and region, with the notable exceptions of Central and South America.

In terms of total daily incidence, there are 15 countries reporting more than 10,000 new cases per day, including 6 reporting more than 25,000. Among these countries, 5 are in Asia (including Iran in the Eastern Mediterranean region), 4 are in Europe, 3 are in South America, and 2 are in North America. South Africa is the only African country, and none are in Oceania. Ten (10) of these countries are reporting increasing daily incidence over the past 2 weeks, including the US (+142%), Spain (+146%), and France (+287%), which more than doubled over that period. India and Argentina have exhibited decreasing trends since at least mid-June, and Brazil, Colombia, and South Africa passed their respective peaks since the beginning of July. These 16 countries account for nearly 75% of the global daily incidence. Among the countries with available data on the Delta variant, all* are exhibiting sharp increases in Delta prevalence over the past several months. India, where the variant was first reported, was first in March, and Delta prevalence began increasing in most of the other countries by late May/early June. Of the 10 countries with data available for July 12 or later, 8 are reporting higher than 70%, including 6 higher than 90%.

*Argentina does not have data available after May 17.

Similarly, the top countries in terms of per capita daily incidence represent most regions around the world. Among the top 20 countries, nearly half (9) are in Europe, 4 are in Africa, 3 are in Latin America and the Caribbean, and 3 are in Asia. Fiji is the only country in Oceania, and none are in North America. Argentina, Colombia, Malaysia, Spain, and the UK are on both lists, and considering their large populations compared to the other top per capita countries, this further illustrates the severity of their respective epidemics. All but 5 countries—Argentina, Colombia, Mongolia, Namibia, and Seychelles—are reporting increasing daily incidence over the past 2 weeks, including 9 that more than doubled over that period. Notably, Malta’s daily incidence increased nearly 1,500% over the past 2 weeks (peaking at more than 3,000% on July 16), bringing its daily average to approximately 200 new cases per day—up from 1 in mid-June. Only a small handful of these countries have data available regarding the prevalence of the Delta variant, and 4 of the 8 countries were also among the highest total daily incidence. All of these countries** reported major increases in Delta prevalence starting in May, and 5 of the 6 countries with data available for July 12 or later are reporting 80% or higher.

**With the exception of Argentina, which has no data available after May 17.

Global Vaccination

The WHO reported 3.57 billion doses of SARS-CoV-2 vaccines administered globally as of July 20. The WHO reports a total of 1.37 billion individuals have received at least 1 dose, and 656 million are fully vaccinated. Analysis from Our World in Data shows that the global daily doses administered fell sharply once again, now down to 29.1 million doses per day. Our World in Data estimates that there are 2.09 billion vaccinated individuals worldwide (1+ dose; 26.9% of the global population) and 1.05 billion who are fully vaccinated (13.5% of the global population).

UNITED STATES

The US CDC reported 34.2 million cumulative COVID-19 cases and 607,684 deaths. With more than 40,000 new cases per day, the US surpassed both the peak of the initial surge—31,327 on April 12, 2020—and the low reported following the summer 2020 surge—35,082 on September 13, 2020. The current average is more than 3.5 times the most recent low on June 19 (11,467) and is still increasing steadily. Daily mortality also continues to increase, up to 223 deaths per day, which is more than 40% higher than the most recent low on July 11 (159). Notably, the proportion of emergency department patients diagnosed with COVID-19 has tripled since June 21, up from 0.6% to 1.8%, which is an indication of increasing burden on health systems*.

*In an effort to provide a more accurate analysis of the current epidemiology, we are largely focusing on longer-term trends, as the most recent data are more likely to be affected by changes in the frequency of state-level reporting, particularly over the weekend.

The US CDC added a new feature to its COVID-19 Data Tracker, which displays a combination of vaccination coverage and per capita weekly incidence at the county level. The 2-dimensional coloring scheme will take some time to interpret, but it is fairly clear that the major US COVID-19 hotspots are Missouri, Arkansas, and Louisiana, where counties are reporting lower vaccination coverage and higher weekly incidence. Alabama and Mississippi are exhibiting similar trends, but to a lesser degree. Many counties in Florida are reporting elevated weekly incidence, even with higher vaccination coverage than in neighboring states. No data are available for Texas.

US Vaccination

The US has administered 340 million cumulative doses of SARS-CoV-2 vaccines. Daily vaccinations are increasing slowly, now up to 446,613 doses per day*. A total of 187 million individuals in the US have received at least 1 dose, equivalent to 56.4% of the entire US population. Among adults, 68.6% have received at least 1 dose as well as 10.2 million adolescents aged 12-17 years. A total of 162 million individuals are fully vaccinated, which corresponds to 48.8% of the total population. Approximately 59.7% of adults are fully vaccinated, as well as 7.9 million adolescents aged 12-17 years.

*Due to delays in reporting, estimates for the average daily doses administered are less accurate for the most recent 5 days. The most current value provided here corresponds to 5 days ago.

DELTA VARIANT The US CDC continues to sound the alarm about the rapid spread of the SARS-CoV-2 Delta variant within the United States. Earlier this week, CDC Director Dr. Rochelle Walensky shared that the Delta variant now makes up 83% of domestically sequenced SARS-CoV-2 cases. This is a dramatic rise from the beginning of the month, when the Delta variant made up about half of sequenced cases within the US. There has been a corresponding rise in the number of new COVID-19 cases and related deaths throughout the month, especially impacting unvaccinated parts of the population. In a press conference earlier this week, Dr. Walensky warned that the Delta variant is one of the “most infectious respiratory viruses we know of,” urging individuals to get vaccinated. The CDC has made it clear that this will be another pivotal moment in the United States’ COVID-19 response, cautioning that many communities with low vaccination rates may face challenges of overwhelmed health care systems if preventative actions are not taken.  

US CDC ACIP MEETING The US CDC’s Advisory Committee on Immunization Practices (ACIP) on July 22 concluded the benefits of the J&J-Janssen SARS-CoV-2 viral vector vaccine outweigh the risks of some people developing the rare neurological disorder Guillain-Barré syndrome (GBS) after receiving the shot. Earlier this month, the US FDA updated the J&J-Janssen vaccine’s label to warn of a possible increased risk of GBS. According to data presented at the meeting, the FDA’s Vaccine Adverse Event Reporting System (VAERS) recorded 100 preliminary reports of GBS after J&J-Janssen vaccination as of June 30, out of 12.6 million doses administered at that time. Of those cases, 95 required hospitalization, 1 person died, and 5 cases were non-serious. Dr. Hannah Rosenblum, a researcher with the CDC National Center for Immunization and Respiratory Diseases’ Division of Viral Diseases, presented data showing the risk of vaccine recipients developing GBS remained low when compared to the number of COVID-19 cases and deaths prevented by vaccination. The CDC plans to update its guidance for the J&J-Janssen vaccine to recommend that patients with a history of GBS first consider the 2-dose mRNA vaccines from Pfizer-BioNTech and Moderna, if possible. However, some panel members pointed out there are risks associated with those vaccines as well, including myocarditis and pericarditis, and that information on all of the risks associated with SARS-CoV-2 vaccines should be made available so people can make the best choice for themselves.

The ACIP also considered whether to recommend additional, or “booster,” doses of SARS-CoV-2 vaccines for people who are immunocompromised, who represent about 2.7% of the US population. Dr. Sara Oliver with the CDC National Center for Immunization and Respiratory Diseases presented data based on several small studies looking at vaccine response among immunocompromised people and additional doses in this population. Although emerging data suggest an additional SARS-CoV-2 vaccine dose in immunocompromised people enhances antibody response and increases the proportion who respond, the panel did not make an official recommendation on additional shots and will continue to review available data. Dr. Oliver also noted that serologic or cellular immune testing outside of research studies is not recommended in the US at this time. Some panel members expressed concern over immunocompromised patients getting additional vaccine doses without an official recommendation to do so, saying “the issue is almost running away from us.” Although another ACIP meeting is not yet scheduled, the panel is expected to meet again in August. 

GAO PREPAREDNESS & RESPONSE REPORT The US is concurrently responding to and recovering from the COVID-19 pandemic, with an ongoing national vaccination campaign and widespread loosening of public health measures amid a recent increase in cases. Recognizing this balance as “fragile,” the US Government Accountability Office (GAO) on July 19 released its 7th comprehensive report on the COVID-19 pandemic, providing an additional 15 recommendations to various US government agencies. Previous reports included a total of 72 recommendations on COVID-19, with agencies agreeing to implement 57 of them and having fully implemented 16 to date. The most recent report makes several recommendations related to national pandemic preparedness, including advice to the CDC to develop a plan to enhance surge capacity for laboratory testing and establish contracts for the manufacturing and deployment of diagnostic test kits prior to public health emergencies. The GAO also made suggestions to the US Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) regarding the organization and oversight of the country’s Strategic National Stockpile (SNS), which provides medical supplies and other materials to respond to a broad range of emergencies. Several other recommendations relate to the oversight, timely use, and integrity of COVID-19 relief funds allocated to HHS, the US Department of Education, US Department of the Treasury, US Office of Management and Budget (OMB), and Internal Revenue Service (IRS). According to GAO, if effectively implemented, the recommendations “can help improve the government’s ongoing response and recovery efforts as well as help it to prepare for future public health emergencies.”

EXPIRING VACCINES With demand for SARS-CoV-2 vaccination largely leveling off in the US over the past 3 weeks, millions of SARS-CoV-2 vaccine doses are set to expire in the next few months. Several states and some global health experts are calling for the excess doses to be redistributed to other countries, but so far the US government has rejected those requests, citing legal and logistical challenges. However, states are now able to request a specific number of vaccine doses instead of having doses distributed to them based on their population. Delayed reporting, everyday wastage, and waning demand, including those who did not go back for second doses, are among the sources for a pile up of inventory. The FDA previously extended the shelf-life of the Pfizer-BioNTech and J&J-Janssen vaccines, and some hope an additional extension for the Pfizer-BioNTech vaccine will be approved. Meanwhile, the federal stockpile of vaccine doses continues to grow, with approximately 390 million of the 1.41 billion doses purchased by the US having been delivered, and another 562 million doses from Moderna, Pfizer-BioNTech, and J&J-Janssen expected to be delivered by the end of 2021. The White House has pledged to donate 80 million doses of its vaccine supply, and will purchase an additional 500 million doses for low- and lower-middle-income countries. But some experts note the doses currently sitting in states are ready to be administered, not waiting to be manufactured, and those doses could have a positive impact in other countries if states were permitted to redistribute them.  

VACCINE MANDATES As SARS-CoV-2 vaccines become more widely available, some organizations, schools, and businesses are considering making them mandatory. This week, a US federal judge ruled to uphold a mandatory vaccination policy implemented by Indiana University, which would require SARS-CoV-2 vaccination for students, faculty, and staff before returning to campus this fall. The ruling acknowledges that the university has the authority under the Fourteenth Amendment to the US Constitution to pursue reasonable measures to protect the “public health for its students, faculty, and staff.” The students who filed the original suit are reportedly appealing the judge’s ruling.

On July 22, the American Hospital Association, the country’s largest association of hospitals and health systems, issued a statement in support of mandatory SARS-CoV-2 vaccination for healthcare workers. The statement argues that the vaccines have been demonstrated to be both safe and effective, and they play a critical role in protecting the health of both healthcare workers and their patients, many of whom are at elevated risk of severe COVID-19 disease. There have been several notable examples of hospitals firing employees who refused the vaccine, and the issue will certainly receive ongoing attention, especially until the vaccines receive full FDA approval.

VACCINE EFFICACY AGAINST VOCs A recent bioRxiv preprint study compared neutralizing antibody titers elicited by the 3 SARS-CoV-2 vaccines authorized for emergency use by the US FDA against pseudotyped variants of concern (VOCs) and variants of interest (VOIs). The small study compared blood samples from 17 people who had the 2-dose mRNA vaccines from Pfizer-BioNTech and Moderna and 10 people who received the single-dose viral vector vaccine from J&J-Janssen. Overall, the study showed a high level of antibody cross-neutralization elicited by the Pfizer-BioNTech and Moderna vaccines against VOCs but significantly decreased neutralization by antibodies generated by the J&J-Janssen vaccine. Because the study was conducted using blood samples, it might not reflect real-world performance, but the results counter previous reports of the J&J-Janssen vaccine’s efficacy against the Delta variant. The authors of the bioRxiv study, which is not yet peer-reviewed, said they hoped the findings did not discourage people from getting the J&J-Janssen vaccine but that future recommendations included advice for an additional second dose of that vaccine or an mRNA vaccine. The authors also called for continued surveillance of breakthrough infections to help determine the real-world effectiveness of the vaccines.

Another study evaluating vaccine effectiveness against the Delta variant was published July 21 in the New England Journal of Medicine. This study compared the effectiveness of the Pfizer-BioNTech mRNA vaccine and AstraZeneca-Oxford viral vector vaccine against the Alpha and Delta variants. Following 1 dose of the 2-dose vaccines, effectiveness was notably lower among persons with the Delta variant (30.7%) than among those with the Alpha variant (48.7%), with the results similar for both vaccines. Following a second dose, the Pfizer-BioNTech vaccine was 93.7% effective against Alpha and 88% effective against Delta. The AstraZeneca-Oxford vaccine after 2 doses was 74.5% effective against Alpha and 67% against Delta. The researchers note the differences in effectiveness between the vaccines are considered modest and support public health efforts to maximize uptake of the full 2-dose regimen to protect against VOCs.

REAL-WORLD VACCINE EFFECTIVENESS A study published July 20 in the Annals of Internal Medicine details a test-negative case-control study examining the short-term effectiveness of authorized SARS-CoV-2 mRNA vaccines in preventing infections. The research team used data collected through the US Department of Veteran Affairs’ (VA) COVID-19 Shared Data Resource, a national database containing extensive demographic, clinical, pharmacologic, laboratory, vital sign, and clinical outcome information derived from multiple validated sources. The researchers identified all individuals who tested positive for SARS-CoV-2 infection between December 15, 2020 and March 4, 2021, and matched them with control participants who had similar factors such as sex, age, race, BMI, and geographic location, but who had tested negative for SARS-CoV-2. The main measure of interest was vaccine effectiveness 7+ days after the second vaccine dose, but the researchers also examined vaccine effectiveness among those who received only 1 dose of either the Pfizer-BioNTech or Moderna vaccines. 

The team identified 54,360 matched pairs of veterans. Among those who tested positive, 18% had been vaccinated, compared with 32.8% of those who tested negative. Overall, the vaccines showed 97.1% effectiveness among those who received the second dose at least 7 days prior. Among those who received only 1 dose, effectiveness was 85% overall. The research team concluded the SARS-CoV-2 vaccines being employed by the VA provided a high level of protection against infection. However, they noted several limitations of the study, including a predominantly male study population, a lack of data for currently circulating SARS-CoV-2 variants of concern, and a short follow-up period. 

HEALTH EFFECTS OF LOCKDOWNS Researchers continue to explore the potential unintentional health impacts of COVID-19-related lockdowns. A commentary 

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 07/22/2021

HARRISON COUNTY, TEXAS

FROM HOPKINS:

1. PRIORITY REVIEW OF PFIZER-BIONTECH VACCINE Pfizer-BioNTech on July 16 announced the US FDA granted priority review status for the Biologics License Application for their 2-dose SARS-CoV-2 mRNA vaccine. An FDA official reportedly said a decision on whether to grant full approval for the vaccine’s use in people ages 16 and older will come soon, possibly within the next 2 months. The FDA must make its decision by January under the priority review. Pfizer-BioNTech completed their application in May and expects to apply for full approval for people ages 12 to 15 when data are available. Moderna has begun its application to the FDA for full approval of its 2-dose SARS-CoV-2 vaccine, and J&J-Janssen also is expected to seek full approval of its 1-dose vaccine. Full approval of a vaccine could impact US vaccination coverage by prompting vaccine mandates for some schools, businesses, or the US military, and by swaying some who are reluctant because of safety concerns to undergo vaccination.

2. FRANCE VACCINATIONS In an effort to control the surging Delta variant (B.1.617.2), French President Emmanuel Macron announced that proof of SARS-CoV-2 vaccination or a recent negative COVID-19 test must soon be provided to enter certain public venues or transportation. 

3. HAJJ Historically, the annual Muslim pilgrimage to Mecca draws millions of visitors from around the world. Last year, Saudi Arabia limited visitors to only 1,000 pilgrims, but for the ongoing Hajj (July 17-22), the government is permitting a total of 60,000 visitors, limited to Saudi residents who are fully vaccinated, aged 18-65 years, and have no chronic health conditions. While this is considerably more people than were permitted in 2020, it is still far fewer than the more than 2 million who typically attend Hajj.

In order to reduce risk, the Saudi Ministry of Hajj and Umrah implemented additional restrictions and protective measures. Upon arrival, pilgrims are assigned to groups of 20, with no mixing between groups. Individuals are assigned specific dates and times to visit the Grand Mosque, where 6,000 individuals are permitted to enter every 3 hours. Facilities at the Grand Mosque undergo sterilization between each session. Despite the additional protective measures, including the vaccination requirement, the US CDC still has a Level 3 Travel Warning in place (Avoid Nonessential Travel) for the Hajj, due in part to the risk of SARS-CoV-2 transmission associated with mass gatherings.

(J. Harris: Too bad. I surely hope that this type of Covid Caution doesn’t spread to really important super spreader events like  THE 81ST STURGIS MOTORCYCLE RALLY to be held in August in SD [https://sturgis.com/].See you there???)

4. SUPER ANTIBODY In a study published July 14 in Nature, researchers describe a newly discovered “super antibody” capable of protecting against SARS-CoV-2 and a group of related coronaviruses, called sarbecoviruses. The antibody, named S2H97, is believed to work by attaching to a section of the ACE2 receptor binding motif on the virus spike protein that is only exposed when a sarbecovirus is attempting to enter a cell. S2H97 was able to prevent the spread of multiple sarbecoviruses between cells in a lab, and the antibody also protected hamsters from infection with SARS-CoV-2 isolated from the initial Wuhan, China, outbreak. Researchers further described the antibody as a pan-sarbecovirus due to its broad efficacy across the sarbecovirus subgenus. The description of a usually hidden antibody binding region in the ACE2 RBM is important because it could be used as a target for future vaccines and therapeutics. Additionally, a pan-sarbecovirus vaccine could be used to prevent outbreaks from as-of-yet-undiscovered members of the Coronaviridae family of viruses.

NYT COVID TRACKER FOR TODAY:

J. Harris: Our neighbors in LA must have more Covid, more Testing, or (likely) both.

AND LAST BUT NOT LEASED (Thank you George and Sam)

NEW PAINLESS HOME COVID TEST

Click here to see the video — it could save your life

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 07/21/2021

HELLO,

YT COVID BRIEFING

(J. Harris: You can sign up for this and get it daily for FREE)

‘The No. 1’ public health issue

“…The difference between emergency authorization and full approval matters. Right now, the military, schools and other organizations cannot easily require vaccinations. The “lack of F.D.A. licensure leave schools, colleges, businesses in a legal quandary…..If we got F.D.A. approval, we could get another 20 million vaccinated…[estimated].’

FROM HOPKINS:

1. Southeast Asian Countries Struggle To Contain A Devastating Third Wave Of COVID-19 (NPR) A devastating third wave of the coronavirus pandemic is hitting several countries in Southeast Asia as the delta variant takes hold in the region, leading to record levels of infections and death. Southeast Asian countries such as Vietnam, Laos, and Thailand had avoided such largescale outbreaks previously. Now, they’re struggling to contain fresh outbreaks, even as Indonesia and Myanmar are battling low vaccination rates, limited oxygen supplies and overcrowded hospitals. Health care experts say health care systems in both countries are on the brink of collapse.

2. Understanding COVID-19 Vaccine Hesitancy (Nature Medicine) We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines.

3.  PRESS RELEASE

US Surgeon General Issues Advisory During COVID-19 Vaccination Push Warning American Public About Threat of Health Misinformation US Surgeon General Dr. Vivek Murthy is issuing the first Surgeon General’s Advisory of this Administration to warn the American public about the urgent threat of health misinformation. Health misinformation, including disinformation, have threatened the US response to COVID-19 and continue to prevent Americans from getting vaccinated, prolonging the pandemic and putting lives at risk, and the advisory encourages technology and social media companies to take more responsibility to stop online spread of health misinformation. (HHS, 7/15/2021)

4. France mandates Covid health pass for restaurants and cafés

(J. Harris: Wow.)

FROM THE LANCET: 

Will the COVID-19 crisis catalyse universal health reforms?

“The historian Walter Scheidel has argued that reductions in inequality have often emerged after war, revolution, state collapse, and plague.1 On July 12, 2021, there were more than 4 million deaths from COVID-19 globally.2 The disproportionate and unequal impact of COVID-19 on populations has brought renewed attention to deep inequalities. Will the impacts of COVID-19 galvanise efforts to reduce inequality?”

(J. Harris: Good quick read without much speculation about the USA.)

From Reuters:

LONG COVID INFORMATION FROM ENGLAND

? HUMOR FROM MY SHYSTER LAWYER:

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 07/20/2021

As a Doctor, May I Refuse to See Unvaccinated Patients?

A federal judge upholds Indiana University’s vaccination requirement for students.

FROM HOPKINS:

1. Cats Are Better Than Dogs (at Catching the Coronavirus) (New York Time) Dr. Ly, a veterinary and biomedical researcher at the University of Minnesota, knew that humans were the primary driver of the pandemic. But he also knew that many people loved to kiss and cuddle their pets, in sickness and in health. He wondered: How transmissible was SARS-CoV-2 to humankind’s best friends? So he pitched an idea to his wife, Yuying Liang, a researcher in the same department who leads the lab with him, to test cats and dogs for antibodies, which would reveal past infection to the virus. The result of those antibody tests, published recently in the journal Virulence, suggest that household cats are more susceptible than dogs to a SARS-CoV-2 infection. The new study supports recent research that it may be “fairly common” in households where people test positive for SARS-CoV-2 for cats and dogs to become infected, too,

2. Assessment of COVID-19–Related Immigration Concerns Among Latinx Immigrants in the US (JAMA Network Open) In this survey study of 336 adult Latinx immigrants in the US, 89 participants (27%) believed that hospital emergency departments provided the only source for COVID-19–related testing or treatment for uninsured immigrants. A total of 106 participants (32%) agreed that using public COVID-19–related testing and treatment services could jeopardize an individual’s immigration prospects; 96 participants (29%) and 114 participants (34%), respectively, would not identify an undocumented household member or coworker during contact tracing. These results suggest that substantial proportions of Latinx immigrants have immigration concerns about engaging in COVID-19–related testing, treatment, and contact tracing.

3.Acceptability of Adolescent COVID-19 Vaccination Among Adolescents and Parents of Adolescents — United States, April 15–23, 2021 In April 2021, 52% of unvaccinated adolescents aged 13–17 years and 56% of parents of unvaccinated adolescents aged 12–17 years reported intent for adolescent COVID-19 vaccination. The most common factors that would increase vaccination intent were receiving more information about adolescent COVID-19 vaccine safety and efficacy. Efforts focusing on effectively communicating the benefits and safety of COVID-19 vaccination for adolescents to the public could help increase adolescent COVID-19 vaccine confidence and vaccination coverage. (CDC MMWR, 7/16/2021)

FROM LANCET:

Impact of the introduction of pneumococcal conjugate vaccination on invasive pneumococcal disease and pneumonia in The Gambia: 10 years of population-based surveillance

(J. H. This article proves the efficiency of the pneumococcal pneumonia vaccine (s) in preventing “the old man’s friend” — “lobar pneumonia.” This vaccine has been updated and most adult Americans who go to a personal doctor have probably had the new booster in the last two or three years. Have you? 

Efficacy, safety, and lot to lot immunogenicity of an inactivated SARS-CoV-2 vaccine (BBV152): a, double-blind, randomised, controlled phase 3 trial 

(J. Harris: This vaccine, aka COVAXIN worked on Delta Variants as we have seen before. )

From Houston Chronicle:

Houston Methodist records first lambda variant as COVID cases double since July 1

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 07/19/2021

CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 07/19/2021

Editorial: If Abbott and Trump were true leaders, they’d urge vaccinations

(J. Harris: I generally have avoided “opinion pieces” but this was is so logical that is worth annoying some of my readers — and I agree with it completely.

FROM HOPKINS:

1. Estimating Under-recognized COVID-19 Deaths, United States, March 2020-May 2021 using an Excess Mortality Modelling Approach (Lancet Regional Health: Americas) In the United States, Coronavirus Disease 2019 (COVID-19) deaths are captured through the National Notifiable Disease Surveillance System and death certificates reported to the National Vital Statistics System (NVSS). However, not all COVID-19 deaths are recognized and reported because of limitations in testing, exacerbation of chronic health conditions that are listed as the cause of death, or delays in reporting. We estimated that 766,611 deaths attributable to COVID-19 occurred in the United States from March 8, 2020—May 29, 2021. Of these, 184,477 (24%) deaths were not documented on death certificates.

2. Effect of Physician-Delivered COVID-19 Public Health Messages and Messages Acknowledging Racial Inequity on Black and White Adults’ Knowledge, Beliefs, and Practices Related to COVID-19: A Randomized Clinical Trial (JAMA Network Open) In this randomized clinical trial of 18 223 White and Black adults, a message delivered by a physician increased COVID-19 knowledge and shifted information-seeking and self-protective behaviors. Effects did not differ by race, and tailoring messages to specific communities did not exhibit a differential effect on knowledge or individual behavior. These findings suggest that physician messaging campaigns may be effective in persuading members of society from a broad range of backgrounds to seek information and adopt preventive behaviors to combat COVID-19.

3. LONG COVID UPDATE

Characterizing Long COVID In An International Cohort: 7 Months of Symptoms and Their Impact (Lancet): We conducted an online survey of people with suspected and confirmed COVID-19, and analyzed responses from 3762 participants with confirmed or suspected COVID-19, from 56 countries, with illness lasting over 28 days and onset prior to June 2020. We looked at 203 symptoms in 10 organ systems and traced 66 symptoms over seven months. Patients with Long COVID report prolonged, multisystem involvement and significant disability. By seven months, many patients have not yet recovered (mainly from systemic and neurological/cognitive symptoms), have not returned to previous levels of work, and continue to experience significant symptom burden.

4. The WHO’s Chief Says It Was Premature To Rule Out A Lab Leak As The Pandemic’s Origin (NPR) The head of the World Health Organization acknowledged it was premature to rule out a potential link between the COVID-19 pandemic and a laboratory leak, and he said Thursday he is asking China to be more transparent as scientists search for the origins of the coronavirus. In a rare departure from his usual deference to powerful member countries, WHO Director-General Tedros Adhanom Ghebreyesus said getting access to raw data had been a challenge for the international team that traveled to China earlier this year to investigate the source of COVID-19. He said there had been a “premature push” to rule out the theory that the virus might have escaped from a Chinese government lab in Wuhan — undermining WHO’s own March report, which concluded that a laboratory leak was “extremely unlikely.”

FROM JAMA:

Effect of Oral Azithromycin vs Placebo on COVID-19 Symptoms in Outpatients With SARS-CoV-2 Infection A Randomized Clinical Trial

Question  Does a single oral dose of azithromycin lead to absence of symptoms at day 14 in outpatients with COVID-19 compared with placebo?

Findings  In this randomized trial that included 263 participants with SARS-CoV-2 infection, treatment with a single oral dose of azithromycin, 1.2 g, vs placebo resulted in self-reported absence of COVID-19 symptoms at day 14 in 50% vs 50%; this was not statistically significant.

Meaning  Among outpatients with SARS-CoV-2 infection, treatment with a single dose of oral azithromycin compared with placebo did not result in a greater likelihood of being free of symptoms at day 14.

In Undervaccinated Arkansas, Covid Upends Life All Over Again

(J. Harris: Is it  possible that Arkansas is even more primitive than East Texas.)

MEANWHILE IN MISSOURI:

Delta Is Driving a Wedge Through Missouri

 (J. Harris: Ed Wong for a year and a half has consistently written some of the absolute best articles about Covid. This is another one. I expect Mr. Wong to win a Pulitizer; he deserves it. This magazine has consistently been in the forefront of quality information providers:

“…Those ICUs are also filling with younger patients, in their 20s, 30s, and 40s, including many with no underlying health problems…This dramatic surge is the work of the super-contagious Delta variant, which now accounts for 95 percent of Greene County’s new cases …For many communities, this year will be worse than last…Those ICUs are also filling with [UNVACCINATED] younger patients, in their 20s, 30s, and 40s, including many with no underlying health problems… they’re…much sicker than those they saw last year…[HEALTH CARE WORKERS ARE] “putting themselves in harm’s way for people who’ve chosen not to protect themselves,..The grueling slog is harder now because it feels so needless, and because many patients don’t realize their mistake until it’s too late…Some health-care workers are starting to resent their patients…Doctors can give every recommended medication, and patients still have a high chance of dying. The goal should be to stop people from getting sick in the first place..[WHEN COMPARED TO THE FLU PANDEMIC OF 1918}… Missourians in 1918 might have had a “better overhead view of the course of the pandemic in their communities than the average citizen has now.” Back then, the state’s local papers published lists of people who were sick, so even those who didn’t know anyone with the flu could see that folks around them were dying. “It made the pandemic seem more local,…. “Now, with fewer hometown newspapers and restrictions on sharing patient information, that kind of knowledge is restricted to people working in health care.”

TODAY’S NYT AREA DATA

(HARRISON COUNTY UNDERESTIMATED BECAUSE MOST TESTS AND CARE ARE OUT OF COUNTY)

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 07/17/2021

I have gladly renewed my Norwegian Housekeeper’s contract — for the 55th straight year, today.  She’s pleasant,  intelligent, industrious,  a fabulous cook, a great mother and grandmother and still beautiful after all these years. You can call me “Lucky.”

There aren’t many accurate stats out for Harriso County today. I was told that there are >20 Covid cases in Christus Marshall. Region G stats have been up, but are not updated yet. 

The NYT stats for Harrison County are also behind, but notice the upward trend in the area. 

FROM LANCET:

The Great Gatsby and the challenge of unreliable narrators

(J. Harris: short, provocative, comfortable read.)

Their spouses died of covid-19 from an unsafe workplace, lawsuit alleges. A new Texas law might block the claim.

WELCOME TO MT PLEASANT, TEXAS!

FROM HOPKINS:

1. Virus Outbreaks at Olympic Hotels Sow Frustration, Stoke Infection Fears (Reuters) Coronavirus outbreaks involving Olympic teams in Japan have turned small-town hotels into facilities on the frontline of the pandemic battle, charged with implementing complex health measures to protect elite athletes and a fearful public. Infections here have hit at least seven teams arriving in Japan barely a week out from the July 23 opening ceremony and after host city Tokyo reported its highest daily tally of new COVID-19 infections since late January. Health experts and hotel staff say the outbreaks underscore the risks of holding the world’s largest sports event during the middle of a global pandemic in a largely unvaccinated country.

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 07/16/2021

TODAY’S HARRISON COUNTY STATS FROM NYT

(J. Harris: And the NYT has a small error; our Covid hospital usage stats are increasing.)

NY YANKEES STRIKE OUT AGAIN WITH COVID

“…Six players on the New York Yankees have tested positive for Covid-19, general manager Brian Cashman told reporters Thursday, in the second instance this year of breakthrough cases occurring among some members of the baseball team…The three named players were all vaccinated, according to the team. Two of the players received Johnson & Johnson vaccines and the other was from either Pfizer or Moderna, Cashman says…Earlier this season, eight positive tests were recorded among coaching and travel staff, all of whom had previously taken the Johnson & Johnson vaccine. Of the team members who tested positive, only one showed mild symptoms and his condition improved, the Yankees said.

(J. Harris: Sounds like the Yanks need to take a booster? Most likely the DELTA variant is the culprit this time?)

I MISSED THIS ON THE 14TH IN THE NYT

“… many scientists now believe that breakthrough infections [IN VACINATED PATIENTS] are unlikely to cause the [LONG COVID] syndrome. When a vaccinated person is infected, the virus may go through a few rounds of replication, but “the immune response is so quick and so robust that it basically stops the infection in its tracks,” said Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Canada…”

BECKER NYT EDIT

(J. Harris–quick review)

COVID-19 cases, hospitalizations rising sharply in 4 states — 7 things to know, per NYTThough new COVID-19 cases are rising in most states, the rates per 100,000 residents in Florida, Arkansas, Missouri and Nevada are among the highest in the country. Florida is reporting 5,178 new daily cases per 100,000 people, Arkansas is reporting 1,023, Missouri is seeing 1,608 and Nevada at 676 per 100,000.

FROM HOPKINS SELECTIONS:

1. Pfizer Expected to Brief U.S. Officials in Coming Days on the Need for a Booster Shot (Washington Post) Pfizer  is expected to brief top U.S. government health officials in the coming days about the need for a coronavirus vaccine booster shot after an unusually public spat between the pharmaceutical giant and federal officials over whether a third shot will be necessary, according to the company and six people familiar with the plans. Pfizer and the German firm BioNTech announced on Thursday that they planned to seek regulatory approval for a booster within weeks because they anticipated that people would need a third dose six to 12 months after receiving the companies’ two-shot regimen.

2.  The world is unprepared for new ‘age of pandemics,’ G-20 panel“Rather than thinking we were unlucky with COVID, the lesson may be that we were lucky with Ebola, lucky with SARS, lucky with MERS, lucky with N1H1……. the risks of a coronavirus pandemic have been doubling nearly every decade…The report calls for at least doubling current international spending on pandemic prevention and preparedness to $75 billion over five years. That includes $10 billion a year to finance a Global Threats Fund to improve surveillance for future pandemics and increase the supply of vaccines, treatments, and other medical resources needed to respond to outbreaks more quickly…”

3. Deaths from COVID ‘Incredibly Rare’ Among Children (Nature): A comprehensive analysis of hospital admissions and reported deaths across England suggests that COVID-19 carries a lower risk of dying or requiring intensive care among children and young people than was previously thought. In a series of preprints published on medRxiv, a team of researchers found that COVID-19 caused 25 deaths in people younger than 18 between March 2020 and February 2021. About half of those deaths were in individuals with an underlying complex disability with high healthcare needs. Taken together, the unusually comprehensive studies could provide some comfort to parents who have been shielding children who they thought might be vulnerable to severe complications from COVID-19.

FROM NEJM: JNJ VACCINE WORKS VERY WELL

Durable Humoral and Cellular Immune Responses 8 Months after Ad26.COV2.S Vaccination

“These data show that the Ad26.COV2.S vaccine-elicited durable humoral and cellular immune responses with minimal decreases for at least 8 months after immunization. …with increased neutralizing antibody responses to SARS-CoV-2 variants over time, including after single-shot vaccination, further supports the use of the Ad26.COV2.S vaccine to combat the global Covid-19 pandemic.

(J. Harris: This one jab vaccine will continue to be widely used all over the world because it works and its side effects, which have been widely noted, are, fortunately, rare. It is easy to keep cool and to dispense and it is relatively inexpensive.  Unfortunately, it does have a short shelf life apparently, and  it didn’t completely protect the NY Yankees on two different occassions.)

FROM NEJM: PFIZER VACCINE WORKS WELL AND SAFELY IN AGE 12-16 YOUTHS:

Safety, Immunogenicity, and Efficacy of the BNT162b2 Covid-19 Vaccine in Adolescents

“…Evaluation of BNT162b2 [PFIZER VACCINE] in younger adolescents was undertaken for several reasons. The incidence of Covid-19 is reported to be higher among 12-to-17-year-old adolescents than among younger children.21 In addition, children, especially from low-income families, have been negatively affected by the lack of in-person learning during the pandemic.17,18 Therefore, a demonstration of efficacy and safety in 12-to-15-year-old adolescents is important in order to expand the emergency use authorization to include children 12 years of age or older and make a critical step toward achieving herd immunity. Finally, the favorable safety and side-effect profile and high efficacy, along with the acceptable risk-to-benefit ratio in adolescents, now justify vaccine evaluation in younger age groups….These results have several implications. Vaccination of adolescents is likely to confer the direct benefit of preventing disease along with indirect benefits, including community protection… Although children generally have a lower burden of symptomatic Covid-19 than adults, schools, youth sports, and other community gatherings may represent important sources of ongoing outbreaks and transmission, despite high rates of adult immunization… Vaccination of adolescents will allow them to reintegrate into society and resume in-person learning safely, which are especially important outcomes given the severe mental health effects of the Covid-19 pandemic on this group…. Recent real-world data suggest that BNT162b2 prevents asymptomatic infection….[and] it is likely that vaccination will also prevent asymptomatic infection in children, thereby broadening community

 protection.

AND LAST BUT NOT LEASED:

MY ALL -TIME FAVORITE JOKE, STOLEN FROM DALLAS’ ALL-TIME BEST SPORTS WRITER, BLACKIE SHERROD:

It concerns the dyslectic, agnostic, insomniac who tosses and turns all night wondering if there really is a Dog?.

(and wouldn’t you know it, I now find that the joke has been all over the net for years. I’m glad Blackie didn’t have to see it there, or here?)

THE ONLY THING FLAT-EARTHERS HAVE TO FEAR IS SPHERE ITSELF

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