COVID Community Update
Dr. Amanda Green, Chief Medical Officer for PRMC
May 3, 2021
COMMUNITY AND REGION
Most of the US and Paris are suspended in a COVID plateau phase. Our infection rates are much better, but not yet at the cut off level indicating that the risk of transmission is reduced enough for precautions to be abandoned. Several of the positive tests at the health department this week were re-infections. Community clinics have seen a rise in COVID pneumonia this week as well. The hospital was down to 1-2 COVID inpatients a week or so ago, but over the last week we have had 4-6 COVID patients in house daily and have a had some COVID deaths this month after having none for a while.
CDC masking recommendations were pulled back a tiny bit this week – with the recommendation that fully-vaccinated people two weeks out from their vaccination can be mask-less if outside and not in large groups of other people. Please continue masking when around non-vaccinated people, practice good hand hygiene, and keep distance from others as this helps lower rates of spread in the community until our vaccination rate is higher.
Vaccination is still thought to be the road back to normalcy. The Paris Lamar County Health District hub will switch to a smaller venue as we are seeing what the nation is seeing – a decrease in vaccine update in rural areas. It is thought that if we do not achieve 70% infection rate or vaccination, we will continue as we are now, with mini breakouts that continue indefinitely. The US is averaging about 55,000 new cases a day compared with 66,000 a day last week. Earlier this week, 37.3% of US adults had received a COVID vaccine. When Israel passed 40% vaccination rates, they saw a sharp decline in new cases.
Johnson and Johnson has been approved for use again, with a reported rare development of antibodies against platelet factor 4 causing blood clots in women under 50.
Overall vaccine hesitancy has been related in part to fertility concerns despite the social media post that started the concern being debunked, and in part to the general concern from people “not wanting to be guinea pigs.” I encourage community members that the vaccine is safe and is the way for us to safely be around each other again. The health district has had several outreach programs, and is happy to work with groups to bring the vaccine into the community and get life-saving shots into arms.
The COVID vaccines developed by Pfizer and Moderna were 94 percent effective at preventing hospitalizations in people 65 years and older who have been fully vaccinated per the Morbidity and Mortality Weekly Report from the CDC. Researchers looked at 417 patients admitted to 24 hospitals in 14 states between January 1 and March 26 and compared those who had received COVID vaccines with those who had not. Among adults older than 65 who had received both shots of vaccine at least two weeks previously, the risk of hospitalization from COVID dropped by 94 percent. Adults 65 and older who were partially vaccinated and had received only one shot at least two weeks prior to their admission had their hospitalization rates drop 64 percent. The CDC found no meaningful difference in hospitalization rates among people for whom less than two weeks had elapsed since their first vaccine dose. This highlights the continued risk for severe illness shortly after vaccination before a protective immune response has been achieved.
CDC, which has been tracking breakthrough cases since February, on Wednesday said roughly 5,800 people who have been vaccinated against the coronavirus have subsequently contracted the virus, with about 396—or 7 percent -- requiring hospitalization and 74 people passing away. About 29 percent of the infections were asymptomatic. According to CDC, the data hasn't revealed any "unexpected patterns…in case demographics or vaccine characteristics." However, the agency noted that while breakthrough cases were reported among all people of all ages eligible for vaccination, a little over 40 percent of the infections were in people 60 or more years of age.
Receiving the COVID vaccination has improved symptoms in about 30 percent of long hauler patients.
India is having daily new cases over 300,000, breaking world records daily (US was over 100,000 cases daily in our Dec/Jan surge). A combination of reducing precautions at the same time a surge of variants started spreading in India is thought to be the reason behind their rise in cases. Forty percent of their cases are in people 26-44 years old, with a 10 percent death rate. They are seeing the UK B.1.1.7 variant, the Brazilian P.1 variant, as well as a different “double mutant” variant thought to be more infectious and less susceptible to the immune response. This double mutant had been detected in 20 cases in the US by late March.
TESTING & TREATMENTS
Requesting testing for COVID variants in Texas has not proved to be simple, and locally we have not had many tested for variants. For regular testing, PRMC can perform a rapid pcr or antigen with a doctor’s order at registration, and PJC and the health department both are still offering free antigen testing. Primary care doctors and local pharmacies also have made testing available.
We do still have monoclonal antibody infusions at PRMC, and while we are not running the antibody infusion clinic regularly due to decreased demand, we can schedule an infusion if we have a referred patient who would benefit.
Please continue to take care of each other by wearing a mask, keeping social distance and practicing good hygiene. Hopefully, if we can keep our rates falling a little bit longer, we can prevent our vulnerable community members from getting sick before we are completely done with this phase of the pandemic.