August 26, 2021

De Blasio: Most New Yorkers hospitalized for COVID were not vaccinated

https://www.nydailynews.com/coronavirus/ny-nyc-de-blasio-covid-vaccination-hospitalization-rates-20210825-uh3tzno7zrdlfil7vih3c7prmu-story.html

By MICHAEL GARTLAND
NEW YORK DAILY NEWS |
AUG 25, 2021 AT 5:34 PM


"The vast majority of New Yorkers who’ve been hospitalized with COVID since January did not receive a vaccination shot before seeking treatment, new statistics from the city revealed Wednesday.

From Jan. 17 to Aug. 7, nearly 97% of people hospitalized in the city with COVID had not been inoculated. More than 97% of people who died from the virus since January hadn’t received the vaccine, city data shows.

In stark contrast, a minuscule .02% of fully vaccinated New Yorkers had to be hospitalized for COVID within the same time frame. About 3% of those hospitalized received only one vaccine dose.

“The bottom line is the vaccine overwhelmingly works in the things we care about the most, which is stopping people from being hospitalized, stopping people from getting the most severe illnesses, and certainly, most importantly protecting lives.” Mayor de Blasio said Wednesday morning. “What the data proves is that breakthrough cases are incredibly rare.”

related link: https://www.nytimes.com/interactive/2021/08/10/us/covid-breakthrough-infections-vaccines.html?action=click&module=Top%20Stories&pgtype=Homepage

August 26, 2021

New CDC studies point to waning immunity from vaccines

By Erin Banco and Adam Cancryn

https://www.msn.com/en-us/health/medical/new-cdc-studies-point-to-waning-immunity-from-vaccines/ar-AANGSj9

"Two new studies from the Centers for Disease Control and Prevention show fully vaccinated Americans’ immunity to Covid-19 is waning as the more-transmissible Delta variant continues to spread across the country.

One study, which focused on frontline health care workers, found that vaccine effectiveness declined by nearly thirty percentage points since the Delta variant became the dominant strain in the U.S. The analysis also concluded that the Covid-19 vaccines were 80 percent effective in preventing infection among the frontline health care workers.

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The second study examined 43,000 Los Angeles residents age 16 and older. It found that 25 percent of new infections from May to July were in fully vaccinated individuals, while 71 percent occurred in unvaccinated people. The study also showed that the hospitalization rate was significantly lower for fully vaccinated people than for unvaccinated people.

The publication of the studies comes a week after the agency released its first three reports on vaccine efficacy, the Delta variant and breakthrough infections. One of those analyses showed that vaccine effectiveness among adults in New York declined from 91.7 percent in early May to 79.8 percent by late July."

I know it's a bit early but does anyone understand that bolded passage?

August 25, 2021

A hospital is giving nurses up to to $40,000 in sign-on bonuses amid a dire nursing shortage

Heather Schlitz
https://www.businessinsider.com/hospital-offers-40000-nurse-hire-bonus-nursing-shortage-covid-surge-2021-8

"Hospitals across the country are struggling to fill tens of thousands of vacant nursing positions.

Some hospitals are offering sign-on bonuses and lucrative hourly rates to entice nurses.

As nurses struggle with burnout and rising COVID cases, staff shortages can put patients at risk.

To help plug shortages, Monument Health in South Dakota is offering a $40,000 bonus for intensive care and operating room nurses, despite the median pay for nurses in the state lingering at $55,660 a year, according to the Watertown Public Opinion. Allegheny Health Network in Pennsylvania offers $15,000 sign-on bonuses and many nursing jobs in Indiana offer $7,500 sign-on bonuses."

August 25, 2021

NYC school reopening: immunocompromised students will get in-home instruction instead of remote lear

by: Kala Rama
Posted: Aug 24, 2021 / 05:11 PM EDT / Updated: Aug 24, 2021 / 07:06 PM EDT

https://pix11.com/news/reopening-schools/nyc-school-reopening-immunocompromised-students-will-get-in-home-instruction-instead-of-remote-learning-doe-says/

NEW YORK — Remote learning remains off the table for immunocompromised students in New York City, but they will be given the option of having a licensed instructor teach them at home, the Department of Education told PIX11 on Tuesday.

A DOE spokesperson said the in-home instruction program has been around since before the COVID-19 pandemic.

“Our home instruction program, which benefits a small number of children who are medically unable to attend school, will continue as it did pre-pandemic, and we will work with families to tailor the instruction based on the medical needs of each child,” the spokesperson said.

August 25, 2021

NYC's School Vaccine Mandate Brings Relief For Parents And Legal Threats

https://gothamist.com/news/nycs-school-vaccine-mandate-brings-relief-for-parents-and-legal-threats
BY JESSICA GOULD, WNYC

"Many parents and teachers are cheering New York City’s new vaccine mandate for public school staff, saying it makes them feel safer about classrooms reopening amid the rise of the highly contagious delta variant. But the mandate is also facing opposition. Some municipal unions are demanding officials bargain over the details such as penalties for non-compliance and are threatening legal action that could delay implementation.

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But, with the new requirement hinting at stricter rules for the general workforce, the Municipal Labor Committee (MLC) voted Monday to take legal action and force the city to negotiate details of implementation, including penalties and medical exceptions. “Our members’ bargaining rights in this situation must be preserved,” Harry Nespoli, president of the MLC, which represents 350,000 city workers, said in a statement. The union is considering an injunction or lawsuit.

Crucial questions remain about what kind of consequences there will be for school staff members who refuse the shot in New York City. Under the vaccine-or-test mandate for the city’s municipal employees, workers could be suspended without pay for failing to comply. De Blasio said he would be “working through” the penalties with unions under the new policy for public schools."

August 25, 2021

Covid-19: C.D.C. Reverses Testing Advice for Fully Vaccinated

Published July 28, 2021
Updated Aug. 12, 2021

https://www.nytimes.com/live/2021/07/28/world/covid-delta-variant-vaccine

"Anyone who has been potentially exposed to the virus should get tested, the C.D.C. now says. Previous guidance recommended testing only for fully vaccinated people who were symptomatic.

In addition to revising its mask guidance on Tuesday, the Centers for Disease Control and Prevention also quietly updated its testing recommendations for people who are fully vaccinated against the coronavirus.

The agency now advises that vaccinated people be tested for the virus if they come into contact with someone with Covid-19, even if they have no symptoms. Previously, the health agency had said that fully vaccinated people did not need to be tested after exposure to the virus unless they were experiencing symptoms.

“Our updated guidance recommends vaccinated people get tested upon exposure regardless of symptoms,” Dr. Rochelle P. Walensky, the agency’s director, said in an email to The New York Times. “Testing is widely available.”

Fully vaccinated people should wear a mask in public indoor spaces after exposure, the agency said. Three to five days later, they should be tested for the virus.

If the results come back negative, they can stop wearing masks indoors. If results are positive, the infected should isolate at home for 10 days."

August 24, 2021

Doctors in North Texas considered taking COVID-19 patients' vaccination status into account

when determining who got ICU beds

https://www.businessinsider.com/texas-doctors-considered-making-icu-decisions-based-on-vaccination-status-2021-8

Ashley Collman Aug 20, 2021

"A North Texas doctors' group said in an email to members this week that vaccination status could be taken into account when determining which COVID-19 patients get beds in intensive-care units if the region experiences another crisis.

The memo from the North Texas Mass Critical Guidelines Task Force was leaked to The Dallas Morning News, which published details about it on Thursday.

The memo boiled down to this: Since vaccination vastly improves a person's chance of surviving COVID-19, a patient's vaccination status could count as a plus or a strike when determining whether they get an ICU bed, though it could not be the sole factor.

The guidelines were designed for a Level 3 crisis stage, which Dr. Robert Fine, a co-chair of the task force, told The Dallas Morning News could happen in two weeks. The task force's guidelines are not enforceable but are generally followed, the newspaper said.

Shortly after The Dallas Morning News published its story, a spokesperson for the task force walked back the memo.

Dr. Mark Casanova, the director of clinical ethics for Baylor University Medical Center, had told NBC Dallas-Fort Worth on Thursday that the memo was meant to help guide doctors in triaging patients in limited situations.

Hours later, he told NBC the memo was merely a "homework assignment" that members could respond to with their own suggestions.

He said that going forward, vaccination status would not be among the factors that hospitals would be told to consider when triaging patients.

"In the midst of this reconvening, and exploration and discussion with various triage committee members, the consensus is vaccination status, or more specifically a lack of a vaccine will not be considered as part of any exclusion criteria for treating patients," he told the outlet.

August 24, 2021

You aren't legally allowed to know which variant gave you COVID-19 in the US, even if it's Delta

https://www.businessinsider.com/covid-patients-cant-know-which-variant-infected-them-delta-2021-8
Aria Bendix Aug 23, 2021

"Sam Reider, a musician from San Francisco, got a call from the California Department of Public Health in June. Though fully vaccinated, Reider had recently tested positive for COVID-19 after teaching music at a summer camp. The health department asked him to take a second test at a local Kaiser Permanente.

Reider assumed it was because authorities wanted to find out whether he had a Delta infection. He, too, was curious — but when he got the test results back, he was surprised to learn that doctors couldn't give him any information about his variant.

"When I got the follow-up from Kaiser, they said it's positive, but they didn't have any of the sequencing information," Reider told Insider. That "felt odd to me," he said.

Several legal barriers prevented Reider and his doctors — as well as nearly all Americans who have tested positive for the coronavirus — from knowing which variant was to blame.

The Centers for Medicare and Medicaid Service (CMS), which oversees the regulatory process for US labs, requires genome-sequencing tests to be federally approved before their results can be disclosed to doctors or patients. These are the tests that pick up on variants, but right now, there's little incentive for the labs to do the work to validate those tests.

"I don't think there's a lot of motivation, quite honestly, to get that done," Kelly Wroblewski, director of infectious diseases at the Association of Public Health Laboratories, told Insider.

August 24, 2021

A grim warning from Israel: Vaccination blunts, but does not defeat Delta

https://www.sciencemag.org/news/2021/08/grim-warning-israel-vaccination-blunts-does-not-defeat-delta

By Meredith Wadman Aug. 16, 2021 , 6:55 PM

“Now is a critical time,” Israeli Minister of Health Nitzan Horowitz said as the 56-year-old got a COVID-19 booster shot on 13 August, the day his country became the first nation to offer a third dose of vaccine to people as young as age 50. “We’re in a race against the pandemic.”

His message was meant for his fellow Israelis, but it is a warning to the world. Israel has among the world’s highest levels of vaccination for COVID-19, with 78% of those 12 and older fully vaccinated, the vast majority with the Pfizer vaccine. Yet the country is now logging one of the world’s highest infection rates, with nearly 650 new cases daily per million people. More than half are in fully vaccinated people, underscoring the extraordinary transmissibility of the Delta variant and stoking concerns that the benefits of vaccination ebb over time.

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"What is clear is that “breakthrough” cases are not the rare events the term implies. As of 15 August, 514 Israelis were hospitalized with severe or critical COVID-19, a 31% increase from just 4 days earlier. Of the 514, 59% were fully vaccinated. Of the vaccinated, 87% were 60 or older. “There are so many breakthrough infections that they dominate and most of the hospitalized patients are actually vaccinated,” says Uri Shalit, a bioinformatician at the Israel Institute of Technology (Technion) who has consulted on COVID-19 for the government. “One of the big stories from Israel [is]: ‘Vaccines work, but not well enough.’”

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"Yet boosters are unlikely to tame a Delta surge on their own, says Dvir Aran, a biomedical data scientist at Technion. In Israel, the current surge is so steep that “even if you get two-thirds of those 60-plus [boosted], it’s just gonna give us another week, maybe 2 weeks until our hospitals are flooded.” He says it’s also critical to vaccinate those who still haven’t received their first or second doses, and to return to the masking and social distancing Israel thought it had left behind—but has begun to reinstate.

Aran’s message for the United States and other wealthier nations considering boosters is stark: “Do not think that the boosters are the solution.”

August 24, 2021

Can the Vaccinated Develop Long Covid After a Breakthrough Infection?

While the vaccines are effective at preventing serious illness and death, the risk of developing post-Covid health problems after a breakthrough infection isn’t known.

https://www.nytimes.com/2021/08/16/well/live/vaccine-long-covid-breakthrough-infection.html

By Tara Parker-Pope
Published Aug. 16, 2021
Updated Aug. 17, 2021

"While some breakthrough cases among those who are fully vaccinated against Covid-19 are inevitable, they are unlikely to result in hospitalization or death. But one important question about breakthrough infection that remains unanswered is: Can the vaccinated develop so-called long Covid?

Long Covid refers to a set of symptoms — such as severe fatigue, brain fog, headache, muscle pain and sleep problems — that can persist for weeks or months after the active infection has ended. The syndrome is poorly understood, but studies suggest that between 10 and 30 percent of adults who catch the virus may experience long Covid, including those who experienced only mild illness or no symptoms at all.

But the vast majority of data collected about long Covid has been in the unvaccinated population. The risk of developing long Covid for the fully vaccinated who get infected after vaccination hasn’t been studied.

While preliminary research suggests that it is, in fact, possible for a breakthrough case to lead to symptoms that can persist for weeks to months, there are still more questions than answers. What percent of breakthrough cases result in lingering symptoms? How many of those people recover? Are the persistent symptoms after breakthrough infection as severe as those that occur in the unvaccinated?

“I just don’t think there is enough data,” said Dr. Zijian Chen, medical director at the Center for Post-Covid Care at Mount Sinai Health System in New York. “It’s too early to tell. The population of people getting sick post vaccination isn’t that high right now, and there’s no good tracking mechanism for these patients.”

One recent study of Israeli health care workers published in the New England Journal of Medicine offers a glimpse of the risk of long Covid after a breakthrough infection. Among 1,497 fully vaccinated health care workers, 39 of them — about 2.6 percent — developed breakthrough infections. (All of the workers were believed to be infected after contact with an unvaccinated person, and the study was conducted before the Delta variant became dominant.)

While most of the breakthrough cases were mild or asymptomatic, seven out of 36 workers tracked at six weeks (19 percent) still had persistent symptoms. These long Covid symptoms included a mix of prolonged loss of smell, persistent cough, fatigue, weakness, labored breathing or muscle pain.