Coronavirus Breaking News

The New England Journal of Medicine published the findings from a Correspondence today based on the University of California San Diego Health (UCSDH) workforce experienced with SARS-CoV-2 virus infections.

On September 1, 2021, this Letter to the Editor revealed UCSDH's workforce experienced a dramatic increase in SARS-CoV-2 infections.

Vaccination with mRNA vaccines began in mid-December 2020, and by March 2021, 76% of the workforce had been fully vaccinated.

As planned, SARS-CoV-2 infections decreased dramatically by early February 2021.

Between March and June, fewer than 30 health care workers tested positive for the coronavirus each month.

Furthermore, the percentage of USCDH's fully vaccinated staff had risen to 83% by July.

However, mRNA vaccine effectiveness exceeded 90% until June, then fell to 65.5% in July.

No vaccine effectiveness data for August 2021 was disclosed in this Letter.

July case rates were analyzed according to the month in which workers with Covid-19 completed the vaccination series. For example, in workers completing vaccination in January or February, the attack rate was 6.7 per 1000 persons (95% CI, 5.9 to 7.8).

Whereas the attack rate was 3.7 per 1000 persons (95% CI, 2.5 to 5.7) among those who completed vaccination from March through May.

Among unvaccinated persons, the July virus attack rate was 16.4 per 1000 persons (95% CI, 11.8 to 22.9).

'The dramatic change in vaccine effectiveness from June to July is likely to be due to both the emergence of the Delta variant (90%) and waning vaccine immunity over time, compounded by the end of masking requirements in California and the resulting greater risk of exposure in the community,' wrote these researchers.

'Our findings underline the importance of rapidly reinstating nonpharmaceutical interventions, such as indoor masking and intensive testing strategies, in addition to continued efforts to increase vaccinations, as strategies to prevent avoidable illness and deaths and to avoid mass disruptions to society during the spread of this formidable variant.'

'Furthermore, if our findings on mRNA vaccine waning immunity are verified in other settings, booster doses may be indicated.'

Note: Institutional review board approval was obtained for the use of administrative data on vaccinations and case-investigation data to examine mRNA vaccine effectiveness. The mRNA vaccines, Comirnaty (Pfizer–BioNTech) and SpikeVax (Moderna) have previously shown efficacy rates of 95% and 94.1%,2 respectively, in earlier clinical trials.

The World Health Organization (WHO) stated on August 27, 2021, 'it does not support the requirement of proof of COVID-19 vaccination to travel.'

However, depending on the risk assessment of the countries concerned, information about vaccination against COVID-19 may be used to reduce requirements for quarantine or testing upon arrival.

But this is not the primary purpose of the move towards digital documentation of COVID-19 status.

The WHO recently published a guidance document for countries and implementing partners on the technical requirements for issuing digital certificates for vaccination against COVDI-19.

The guidance is part of a series of planning documents on the digitalization of COVID-19 certificates.

The guidance will, amongst other things, Support Member states in adopting digital tools for documenting COVID-19 vaccination status for effective health care and proof of vaccination should it be needed for other purposes.

The minimum requirements for implementing digital documentation in countries around the world empower Member States the greatest possible flexibility to build a solution appropriate not just for their needs but the diverse needs of individuals around the world.

The WHO guidance was developed in collaboration with a multi-disciplinary group of experts to ensure that it will be useful to governments and implementing partners who have built or who are currently developing systems for issuing or verifying digital vaccination certificates.

The technical content of the WHO guidance has been made available to partner countries and economies that have developed or are in the process of developing national digital vaccination certificates to ensure that these digital certificate products will be interoperable. In addition, technical assistance will be provided to countries and implementing partners to align existing products to WHO specifications.

According to JPost reporting on August 29, 2021, Israel's Health Minister Nitzan Horowitz confirmed that the third COVID-19 vaccination is now available for anyone 12 years of age and older and who has received two previous inoculations for at least five months.

This new vaccination policy is effective immediately.

The joint COVID-19 vaccine task force of the Israel Pediatric Association and the Department of Pediatric Infectious Diseases published Frequently Asked Questions.

As of August 29th, the Israeli data dashboard indicates over 2 million people have already received a 3rd COVID-19 vaccination.

Furthermore, the dashboard reveals Israel has confirmed over 680 new serious COVID-19 cases daily for the past eight days.

Additionally, the Israeli Ministry of Health issued a press statement today 'informing the general public that anyone who came in contact with Dr. S. K., reflexologist, in his clinic at 22 Antwerp Street, Netanya, between August 14 through 24, 2021, is required to test for SARS-CoV-2 coronavirus and inform their primary care physician.

Furthermore, anyone who is not fully vaccinated (2-doses) or recovered from COVID-19 is required to enter immediate isolation and fill in the isolation self-report form on the Ministry of Health's website.

A new cross-sectional study published by the JAMA Network on August 17, 2021, found professional and college football games played during the COVID-19 pandemic found 'no association between higher county-level COVID-19 cases and hosting football games with limited in-person attendance.'

This study's conclusion is important as 'there is currently no evidence on whether limited in-person attendance of (outdoor) games is associated with COVID-19 case numbers on a county-level.'

A total of 528 games with in-person attendance (101 NFL; 427 NCAA) were included in this study. The matching algorithm returned 361 matching sets of counties.

The median (IQR) daily new COVID-19 cases in treatment group counties hosting games was 26.14 (10.77-50.25) cases per 100 000 residents on game day. The median IQR daily new COVID-19 cases in control group counties where no games were played was 24.11 (9.64-48.55) cases per 100 000 residents on game day.

The treatment effect size ranged from −5.17 to 4.72, with a mean (SD) of 1.21 (2.67) cases per 100 000 residents, within the 14-day period in all counties hosting the games and the daily treatment effect trend remained relatively steady during this period.

'These findings suggest that NFL and NCAA football games hosted with limited in-person attendance were not associated with substantial risk for increased local COVID-19 cases,' stated these researchers.

In addition, Michael A. Rubin, M.D., Ph.D., MS, wrote an Invited Commentary also published by the JAMA Network, stating 'the sensitivity analysis on the duration of the pretreatment and posttreatment periods demonstrated the robustness of their results, even when the posttreatment period was extended to 21 days.'

'While the message is encouraging, the interpretation of the results requires some caution.'

'Because the authors did not have access to exact attendance figures for the NCAA games, the representation of in-person attendance as a binary value prevented a more precise understanding of how the number (or concentration) of spectators may have influenced the outcome.'

'Additionally, other unmeasured variables not included in the model, such as other types of mass indoor or outdoor gatherings that may have occurred in treatment or control counties, could have biased the observed results toward the null.'

'Furthermore, many NFL and NCAA football stadiums are outdoor, open-air facilities, where aerosols are rapidly dispersed, limiting the relevance of these results to leagues such as the NBA and NHL that largely hold indoor events.'

However, it is worth noting that emerging SARS-CoV-2 virus variants have less predictable implications at this point in time and might lead to more disruptive interruptions in the future.

Note: This work was supported by awards from the National Science Foundation and a grant from the Gordon and Betty Moore Foundation, paid to Johns Hopkins University to support the work of the Society for Medical Decision Making COVID-19 Decision Modeling Initiative. The researchers disclosed relevant industry conflicts.

According to a study published in the journal Nature Medicine on August 19, 2021, healthcare provider videos syndicated on Facebook encouraging people to stay home were associated with a 3.5% decrease in county-level COVID-19 cases in the USA during Thanksgiving and Christmas 2020 holidays.

The first two primary outcomes were holiday travel and fraction leaving home, both measured using mobile phone location data of Facebook users.

The average distance traveled in high-intensity counties decreased by −0.993 percentage points the 3 days before each holiday compared to low-intensity counties.

And the fraction of people who left home on holiday was not significantly affected.

The third primary outcome was COVID-19 infections recorded at the zip code level in the 2-week period starting five days after the holidays.

Infections declined by 3.5% (adjusted 95% CI: −6.2%, −0.7%; P = 0.013) in intervention compared to control zip codes.

'We found a significant effect on new COVID-19 infections reported by health authorities 5–19 days after the Facebook ad campaigns. However, these effects might be underestimated because the treatment and control zip codes are very close to each other, and the reductions in infection in treatment zip codes might also have led to a decrease in infections in neighboring places.'

Furthermore, despite the study's limitations, our findings provide renewed evidence that clinicians can be an effective channel to communicate life-saving information at scale through social media,' concluded these researchers.

Note: Facebook provided the credits used to show the ads. The study authors declare no competing financial interests.

Haaretz News reported today Israel's vaccination committee recommends the Health Ministry expand the third COVID vaccination program to include Israelis aged 40 and up and teachers.

According to Minister Nitzan Horowitz's post on Twitter, the Health Ministry is expected to accept the recommendation.

As of August 18, 2021, Israel has administered over 1.2 million third-doses of the Pfizer-BioNTech COVID-19 (Comirnaty) vaccine since the expanded vaccination program launch in late July 2021.

Yesterday, Health Ministry Director-General Prof. Nachman Ash signed a directive that would allow vaccinating students against the SARS-CoV-2 coronavirus during school hours, reported YnetNews.

These actions are related to the ongoing COVID-19 pandemic in Israel.

On August 18th, the Health Ministry's dashboard revealed 599 individuals were newly classified as 'serious COVID-19' patients. This data compares with one month ago when the dashboard showed only 67 serious COVID-19 patients one month ago.

A non-peer-reviewed study published on August 7, 2021, aimed to determine antibody (Ab) titers three months after the second dose of the BNT162b2 (Comirnaty) vaccine and to explore clinical variables predicting these titers in Japan.

In the age-adjusted analysis of the 384 study participants, the leading risk factors for lower Ab titers were age and smoking.

Moreover, Ab titers were significantly lower in current smokers than in ex-smokers.

In conclusion, these researchers stated, 'The most important factors associated with low Ab titers were age and smoking habit.'

Note: The Ethics Committee approved this study of the National Hospital Organization Utsunomiya National Hospital (No. 03-01, April 19, 2021). No conflicts of interest were disclosed.