US & Global Hotspots Prompt Recommendation for Continued COVID Protections

• In today’s Recommendations for Industry, we discuss TAG’s Weekly COVID-19 Matrix, U.S. and global hotspots, continued masking, and vaccine booster shots. Read more below.
• The FDA has authorized Moderna and J&J booster shots. Additionally, they are allowing for the mixing and matching of different COVID-19 vaccines [NYT].
• French pharmaceutical company, Valneva’s COVID-19 vaccine has demonstrated good performance in Phase 3 trials, with a seroconversion rate above 95% and is outperforming the AstraZeneca vaccine. This vaccine uses an inactivated whole virus.
• As Moderna has “reiterated on several occasions that they will not enforce their intellectual property during the pandemic,” the WHO has hired Afrigen Biologics and Vaccines to “figure out how to make an mRNA vaccine against COVID that is as close as possible to the version produced by Moderna” as there is increasing promise that mRNA vaccines can be effective against malaria and tuberculosis. [NPR]
• The WHO reports that last week, Europe was the only region with rises in COVID-19 cases, about a 7% rise (ABC News). The UK currently has one of the highest COVID-19 infection rates right now, owing to a variety of reasons including “half-hearted mask adoption [and] large indoor gatherings.” Additionally, it is speculated that the UK’s hesitation in vaccinating younger teenagers and its early vaccination rollouts may also be contributing (CNBC). There is a potential new COVID-19 Delta variant; it is currently being closely watched as it accounts for about 6% of all UK cases, at this time (BBC). Additionally, Latvia is now the first country to “reimpose lockdown in Europe’s new COVID wave” (The Guardian).
• The CDC Director has announced that there is “no evidence a new sub lineage of the Delta variant is having any significant effect in the United States.” Additionally, there is currently no evidence indicating that the subvariant would impact vaccine and therapeutics effectiveness. [CNN]
• A new CDC MMWR has found that 2 doses of the Pfizer vaccine is “93% effective at preventing COVID-19 hospitalizations among 12 – 18 years old.” Read the full report here.

Public Health & Food Safety

• Recent experiments conducted in Norway have found that common medications can alter flu virus activity. Medications with ingredients like atorvastatin, candesartan, and hydroxocobalamin may alter viral interaction with our cells. As the research explains, “Some of the medicines amplify the effect of viruses in the cells, while others dampen them. The response depends on the target of the drugs in our cells. If the drug target is important for the spread of the virus, we can curb virus activity. But if the target of the medicine is part of the immune system that protects us from viruses, and we inhibit it with the medicine, the virus activity can increase.”
• This time the USDA is serious about reducing Salmonella illness by 25%, in accordance with the Health People 2030 plan.
• Public health is facing a crisis across the U.S.; read more on why and how.

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US & Global Hotspots Prompt Recommendation for Continued Protections

TAG’s weekly COVID-19 matrix is continuing to show a steady downward trajectory in COVID-19 cases and transmission rates – with some hotspots continuing, particularly in northern areas of the U.S.

This contrasts with case increases in Europe, particularly in the UK, without any clear cause that we are able to see. Some thoughts are the early vaccinations conducted in the country, for which immunity may be starting to wane, along with the government’s stringency having been quite robust, but then nearly completely undone, with little masking or distancing once the stringency was released.

Thus, because of continuing hotspots in the U.S. and around the world, easily spread through individual’s travel, TAG continues to recommend businesses encourage vaccinations and retain protections:

• TAG has begun to receive some questions on whether masking needs to continue as cases decrease in many areas. To which we strongly respond: Yes, keep it going. Since the implementation of COVID protections, there has been minimal spread within work environments, with spread occurring more frequently within the home and community. This tells us that what is being done is working, so keep doing it. Don’t rock the boat now.

We also continue to recommend that businesses encourage employee vaccinations (regardless of the eventual publication of the OSHA Vaccination/Testing standards). And with FDA now authorizing Moderna and J&J booster shots, along with Pfizer, and allowing for the mixing and matching of different COVID-19 vaccines, the high-risk and other eligible persons now have more options for increasing their immunities.

Risk Matrix:

Generally, case rates are dropping around the country (although there is an indication that cases may be slowly ticking up in Northern States as the weather is colder and people may be gathering inside more). Compared with the previous weeks, fewer states have a TPR>10% and case rate >25cases/100K.

• Idaho, South Dakota, and Montana continue to have high TPRs (above 15%).
• Michigan and Ohio have a TPR ~10%.
• Vermont, Maine, and New Hampshire, which had previously had lowered case rates, now have case rates >25 cases/100K (although TPRs are still below 10%).

Table 1.

Figure 1.

Table 2.

Table 3.

• In Tuesday’s Recommendations for Industry, we discussed the conversations, news, and status of influenza, COVID-19, and their vaccines and vaccinations. Read more here.
• Research published through SUNY Geneseo of limiting COVID-19 on college campuses has found that “masking was the most effective non-pharmaceutical way to prevent the spread of COVID-19 on a college campus, followed by frequent testing and isolation of positive cases.”
• CIDRAP is publishing a two-part commentary discussing masks. Part 1 explains “the differences in cloth face coverings and surgical masks, the science of respiratory protection, and the hierarchy of disease controls.” Part 2 outlines “what makes a good mask study and why so many fail.” See Part 1 here.
• The FDA advisory panel has “unanimously approved a third and smaller dose of Moderna’s COVID-19 vaccine for vulnerable groups. Approval aligns with Pfizer risk groups.” (CIDRAP 1). The FDA Panel voted unanimously to “recommend Johnson & Johnson booster shots, most likely clearing the way for all 15 million people who got the company’s one-dose coronavirus vaccine to receive a second shot.” (NYT1). Additionally, the FDA plans to “allow Americans to receive a different COVID-19 vaccine as a booster than the one they initially received, a move that could reduce the appeal of the Johnson & Johnson vaccine and provide flexibility to doctors and other vaccinators. The government would not recommend one shot over another, and it might note that using the same vaccine as a booster when possible is preferable, people familiar with the agency’s planning said. But vaccine providers could use their discretion to offer a different brand, a freedom that state health officials have been requesting for weeks. (NYT2)” Along these lines, the White House vaccination mandates have boosted COVID-19 vaccination rates, with “an average of 90% of employees taking the vaccine” among 3,500 organizations (CIDRAP 2). While mandates increased vaccination, apparently COVID-19 vaccine lotteries didn’t increase vaccine uptake (CIDRAP 3).
• In a recent Nature survey, discussed in CIDRAP, of 321 scientists “who spoke out about COVID-19 to the media or on social media, about 42% said they had emotional or psychological distress afterward, 22% have received threats of physical or sexual violence, and 15% have received death threats.”
• Colin Powell has died from complications of COVID-19.
• In a recent review, the SARS-COV-2 dose “may affect infection rates, but current data do not show an association between viral dose and COVID-19 severity, according to a review of more than 100 SARS-CoV-2 studies that looks at COVID-19 infectious dose, viral load, severity, and variants.”
• Cases are on the rise in Northern US States; this may be due to the incoming winter months leading to more individuals gathering inside or the start of school.

Flu Status:

• A recently published article in Nature explores the possibility that there has been an influenza lineage extinction during COVID-19, specifically of the Influenza B/Yamagata lineage which hasn’t been isolated at all between April 2020 to August 2021.
• This week from the WHO:
  • Globally, despite continued or even increased testing for influenza in some countries, influenza activity remained at lower levels than expected for this time of the year.
  • In the temperate zones of the northern hemisphere, influenza activity remained at inter-seasonal levels. Influenza B predominated among detections and respiratory syncytial virus (RSV) was increased and higher than in previous years in some countries.
  • Worldwide, influenza B (Victoria) viruses predominated.
  • In tropical South America, no influenza detections were reported, however RSV activity remained elevated in some countries.
  • In Southern Asia, influenza detections of predominately influenza B continued to be reported across reporting countries.
• This week from the CDC:
  •