• In today’s Recommendations for Industry, we discuss this week’s COVID Matrix statistics and what this means to businesses seeking to move forward in putting COVID behind us (as much as feasibly possible). Read more below.
• Every adult in Ontario Canada will be eligible to book a COVID-19 vaccine appointment by May 24.
• A study recently published in Science has found that those previously infected with COVID-19 who later received at least one dose of the Pfizer vaccine were found to have significant neutralizing antibodies effective against both the B117 and B1351 variants.
• COVID-19 continues to highlight the inequities inherent throughout our world between poor and rich countries, NYT breaks down these issues.
• In the U.S., President Biden’s new COVID-19 goal is to get 70% of the U.S. population vaccinated by July 4^th. That'll be done by increasing funds for access to “walk-in appointments”, community vaccination sites, increased vaccine access, and vaccine education in hard-to-reach places including rural health clinics.
• NYT reports that, in the first three months of 2021, Pfizer has generated $3.5B in revenue! They are now hoping to seek clearance for their vaccine to be used in children aged 2 – 11 by September.
• The CDC has updated its advice regarding “People with Certain Medical Conditions” as it pertains to COVID-19. See more information here.
• Children now account for about 22% of new U.S. COVID-19 cases; this is up from 3% of cases last year at this time.
• In the public health realm:
  • The DRC has declared the end to its Ebola outbreak which first began in February 2021!
  • The first genetically modified mosquitoes have been released in the U.S. in Florida. The concept is that these mosquitoes will breed with other mosquitoes that carry severe diseases like (Zika, yellow fever, etc.) and eliminate.

Contending with a New Unknown of COVID

This week’s matrix statistics are continuing to show a progressive direction in the US in both reduced COVID rates and increased vaccinations. This is in contrast, however, with the continued or even rising issues in much of the rest of the world, which has led to international travel restrictions and limitations.

As the US trends continue, TAG sees the nation as heading into a new uncharted area of COVID. That is, considering that we are unlikely to reach herd immunity, how do we best balance continuing risks (e.g., number of unvaccinated persons) with recovery efforts and risk mitigation measures (e.g., masking and distancing)? It is still unclear what this will look like, but it’s likely that over the next two to three months, we’ll need to be working to consider these factors and looking to resume some sort of normalcy – likely against a background of COVID noise, similar to that of the flu which we face on an annual basis.

We are heading into a new unknown, but we spend our lives dealing with risks and need to eventually determine how to deal with them while resuming our lives. TAG is continuing to follow the trends and assisting businesses in making those critical return-to-work decisions. Give us a call if you have questions.

Risk Matrix

This week’s risk matrix is continuing to show some encouraging trends, but cases are still at a risk level and vaccines not yet widely disseminated enough to reach population immunity.

• The Government Stringency Index is 36 this week. This is the same as last week, indicating a stabilizing in government stringencies. Five (5) states’ (Arizona, California, Colorado, New Mexico, and Oregon) businesses are in mixed opening stages.
• In Figure 1, this week, we compare the case rate/100K (Table 1) in the population to the percentage of a state’s population that has been fully vaccinated (Figure 1). Table 2 compares the previous week’s percentage of states’ populations that have become fully vaccinated full dose (and the rate of change between the last week and this week).

Table 1.

Figure 1.

Table 2.

• Michigan is the only state with a TPR ≥ 10% and a case rate ≥ 25/100K people indicating that testing may not be adequate to fully characterize the true severity of the outbreak in the state (Table 3).
• 4 states have a TPR < 10% and a case rate≥ 25/100K people, indicating that adequate testing is likely finding most symptomatic cases of illnesses. This is down from 8 last week. These states are Pennsylvania, Minnesota, Colorado, and Rhode Island (Table 3)

Table 3.

• In today’s Recommendations for Industry, we introduce TAG’s new infectious disease and public health coverage, in addition to our COVID-19 coverage and perspectives. Read more here.
• The S. TSA is extending its mask mandate for U.S. transportation (e.g., airplanes, buses, trains, etc.) through mid-September (September 13).
• Starting tomorrow (Tuesday, May 04, 2021), the state department puts a “Do Not Travel” restriction from those coming from India.
• Over 100M individuals in the U.S. are now vaccinated. This is juxtaposed with declining vaccination rates. As such, public health experts do not believe the U.S. will achieve herd immunity.
• The double-mutant variant first identified in India has now been found in the U.S. in Michigan.
• NYT breaks down a “summer travel” perspective, including, should you consider traveling and what might that look like?
• Pfizer will send 4.5M COVID-19 vaccine doses to South Africa.
• According to the Guardian, starting in June, the E.U. plans to reopen its doors to fully COVID-vaccinated foreign tourists.
• A recent study (summarized in CIDRAP) has found that text message “nudges” reminding individuals to get their seasonal flu vaccine” increases vaccination rates. This adds to the repertoire of intervention steps that can allow us to continue encouraging public health positive messages. The complete study is available at PNAS.
• In Friday’s Recommendations for Industry, we provide a wrap-up of COVID news and events of the week. Read more here.
• The WHO is sending COVID-19 aide to India. India is nearing 400,000 daily new cases.
• In other global news, cases in Europe are declining while cases in Brazil are stabilizing. The P1 variant, first identified in Brazil is starting to become dominant in Brazil’s neighboring countries (including Lima, Peru, and Uruguay). In Lima, Peru, the P1 variant accounts for 40% of infections while it accounts for 75% of all new infections in Uruguay.
• While we’ve discussed this before, a new manuscript out in Clinical Infectious Disease has determined that the 2020 Sturgis Motorcycle Rally did indeed result in “widespread transmission of SARS-CoV-2 across the country.” At least 649 COVID-19 cases were identified (including secondary and tertiary spread to close contacts).
• Two recent studies, reported by CIDRAP, in England and Mexico highlight severe COVID outcomes for obese individuals, even for those who are young adults. In one study, researchers “found a significant link between BMI and age, with higher H.R.s for hospitalization.” In the other study, due to metabolic distinctions leading to the likelihood of “early-onset overweight or obesity,” “younger Mexican patients were infected early in the pandemic.”
• ^{New York will fully reopen on July 01}.
• Disneyland, in California has reopened to visitors. This is a move that California is slowly reopening too.
• Moderna has announced that its COVID-19 vaccine can be stored at refrigerator temperatures for 3 months and up to 7 months at -4F.
• Scientific American discusses that “Flu Has Disappeared Worldwide during the COVID Pandemic” and scientists and public health officials think it’s because “measures taken to keep the coronavirus from spreading also stop the flu.”
• There is a new experimental design for understanding COVID-19 disease progression and potential therapies, producing and utilizing lung organoids that can be infected with SARS-CoV-2. Read a summary of the study here.
• COVID Act Now answers some frequently asked questions about the COVID-19 vaccine including: What are the ingredients of the vaccines?
• In last Wednesday’s Recommendations for Industry, we discussed the CDC’s newly published concessions for fully vaccinated people. Read more here.
• Yesterday, the CDC announced that fully vaccinated Americans can be maskless outdoors when doing activities (biking, running) and during outdoor gatherings with friends or outdoor dining at restaurants. However, the CDC continues to recommend mask-wearing when one is in large outdoor gatherings (like concerts or sports events) because there may still be unvaccinated individuals in these circles. The CDC recommends that you continue considering current COVID-19 spread in your community, “the number of people participating in the activity, and the location of the activity.” See the charts of activities considered safe for fully vaccinated individuals both indoors and outdoors.
• NPR reports on why Michigan continues to experience the highest rate of new US COVID-19 cases. Last week, Michigan had over 70 young children in hospitals. Michigan was especially hit hard by the B117 variant.

CIDRAP reports on a Cleveland Clinic study, published in JAMA Network Open, that found that early in the COVID-19 pandemic, early virus subgroups were associated with higher death rates. However, as the pandemic continued, “strains quickly became less diverse and the once-dominant variants were outcompeted by more transmissible variants which were tied to improved survival in hospitalized patients.” Additionally, researchers also noted that, “Early public health mitigation measures likely prevented more strains from entering the community, leading to a rapid reduction in virus strain diversity and lowering the overall death rate.” Ultimately, researchers found that “the continued evolution of SARS-CoV-2 leads to less virulence.” This study showed how different strains arrived and were outcompeted, at least in Cleveland.