News From Los Alamos County
April 28, 2023
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Inside this newsletter, you will find...
The Epidemiology Corner - COVID-19 Update; Ask An Epidemiologist Q&A Link; News from the White House, CDC & NMDOH; COVID-19 data; and more.
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The next newsletter will be our final issue...
We are doing a special Q&A for our last issue. This is your chance to ASK AN EPIDEMIOLOGIST your burning COVID-19 questions. Click the link below to submit your question BY MAY 8, and we will answer as many as possible in our last issue.
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COVID-19 Update:
FDA/CDC Approve Spring Bivalent Booster For Some - Highly Transmissible Omicron Variants Continue Dominance - Wastewater Surveillance Main Tool to Track Community Transmission...
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COVID-19 Update: National Pandemic Trends Continue to Improve while Omicron Variants Shift Towards Strains with Higher Transmissibility
The highly transmissible Omicron family of variants continues to dominate in the US, with XBB.1.5x variants still in majority prevalence (71%) but gradually waning as the newly ascendant strains XBB.1.9x (13%) and XBB.1.16 (12%) show growth advantage over prior variants. The XBB.1.16 variant, which has been spreading globally over the past several months, has roughly doubled in prevalence over the past four weeks in the US. See Variants Emergence of the XBB.1.9x and XBB.1.16 variants has occurred as US national pandemic metrics trend lower, suggesting no greater severity of disease, but likely somewhat higher transmissibility. COVID-19 symptoms remain largely the same as with prior variants, except XBB.1.16 appears to be uniquely associated with conjunctivitis, especially in children, and with higher fever. See Arcturus Despite improving national pandemic trends, the SARS-Cov-2 virus continues to transmit and cause harm, especially among high-risk populations, including the elderly and persons with weakened immune systems. For the week ending April 26, an average of 1,510 Americans were hospitalized per day for COVID-19 and 150 died of the disease each day. The highest risk of hospitalization and death continues to occur in unvaccinated persons, followed by persons not up-to-date with their vaccination, which CDC now considers as having received just a single dose of the updated bivalent booster. See Vaccine Recommendations
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FDA/CDC Approve Second Bivalent Booster for Seniors and Immunocompromised
Federal health authorities recently approved a second bivalent booster shot for persons 65 years and older (4 months since first bivalent shot) and persons who are immunocompromised (two months since last bivalent shot). See 2nd Bivalent Booster Vaccine effectiveness towards preventing severe disease and hospitalization wanes over time and CDC believes that high risk groups will likely benefit from the added protection offered by another bivalent booster. See Should I Get Boosted In Los Alamos County, 95% of residents 65 years and older have completed the initial primary vaccine series, but only 40% have received an updated bivalent booster. This level of booster coverage is similar to that seen in seniors nationwide, but is notably lower compared to New Mexico statewide (52%) as well many other counties in the state, including the neighboring counties of Santa Fe (69%), Rio Arriba (55%), and Taos (56%). For booster vaccine access, see Vaccine Resources
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CDC Community Level Risk Remains at LOW but Virus Transmission Ongoing at Harmful Levels
For the week ending April 26, the CDC Community Level remained at LOW for Los Alamos County, as it did for the three other counties (Taos, Rio Arriba, Santa Fe) which collectively comprise the regional Health Services Area (HSA) over which CDC hospitalization metrics are calculated. Over the past several months, COVID-19 hospitalization rates in the four-county HSA area have remained relatively stable at 3-5 new admissions per 100,000, indicating continued community transmission and associated harm. For 2023 so far, reported case incidence has similarly remained stable at levels approximating 5-20 cases per 100,000 in Los Alamos County and 40-60 cases per 100,000 in the combined three neighboring HSA counties. The lower reported case incidence in the county is likely an artifact of lower per capita use of reportable PCR testing, and the actual county incidence is likely closer to that seen in the rest of the HSA area. For most of 2023, per capita PCR testing in Los Alamos was three to six-fold lower than in the combined three neighboring HSA counties. For the latest week of data availability (April 19), per capita PCR testing in Los Alamos was 57 per 100,000 (11 PCR tests reported) compared to the 366 per 100,000 in the rest of the HSA (816 PCR tests reported). Beginning April 11, 2023, NMDOH will be reporting NM county-specific COVID-19 hospitalization and emergency department metrics only on a monthly basis the third Tuesday of each month. The next update for Los Alamos County should be May 16.
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COVID-19 Virus Levels in County Wastewater Continue Indicating Community Transmission
Data reported by the Biobot contractor through the week of April 26 indicate a continued presence of SARS-CoV-2 virus in county wastewater at levels consistent with on-going community transmission. Since July 2022, lower baseline levels of virus detection have stably approximated 300-400 copies per ml, with intermittent short-term peaks rising into the thousands. The notable decline in weekly reported cases that began in 2023 was accompanied by a marked reduction in the number of weekly PCR tests, but not a concurrent reduction in viral wastewater measures. These data suggest that wastewater monitoring may be the only existing epidemiologic tool going forward for population-based COVID-19 surveillance in the county. Biobot reports that Omicron XBB variants accounted for virtually all virus detected in county wastewater during the most recent genomic sequencing week of April 10. See https://biobot.io/data/
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From the White House:
National COVID-19 Preparedness Plan
[This week], the U.S. government is releasing the National COVID-19 Preparedness Plan – which will enable America to move forward safely, sustaining and building on the progress we’ve made over the past 13 months. This plan lays out the roadmap to help us fight COVID-19 in the future as we begin to get back to our more normal routines. We look to a future when Americans no longer fear lockdowns, shutdowns, and our kids not going to school. It’s a future when the country relies on the powerful layers of protection we have built and invests in the next generation of tools to stay ahead of this virus.
The President’s National COVID-19 Preparedness Plan focuses on four key goals:
Protect Against and Treat COVID-19
In January 2021, Americans had very few tools to protect against COVID-19, and the tools we did have were in limited supply. Over the last year, together, with states, localities, and public and private partners, the Administration has mobilized an unprecedented, whole-of-society effort to give Americans the tools they need to protect themselves.
The Administration has put vaccines at the center of our COVID-19 response because vaccines are the best tool we have to prevent hospitalization and death. As a result, today, the vast majority of Americans have the protection of a vaccine – with 215 million Americans fully vaccinated, and an estimated two-thirds of eligible adults having received their booster shot. Vaccinated and boosted people are 41 times less like to die of COVID-19 than unvaccinated individuals. And America’s unprecedented vaccination campaign has saved lives: a December 2021 estimate suggested that vaccines saved over 1 million American lives and successfully prevented over 10 million hospitalizations.
The Administration has also expedited the development, manufacturing, and procurement of COVID-19 treatments, building a diverse medicine cabinet filled with more treatments now than at any point in the pandemic. In total, we have secured 20 million courses of Pfizer’s life-saving antiviral pills, which have been shown to reduce the risk of hospitalization or death by 89%.
The nation’s testing supply has increased dramatically. We now have free testing sites at 21,500 locations around the country. In January 2021, there were no rapid, at-home tests on the market available to Americans; during January 2022, there were more than 480 million at-home tests available to Americans on top of all other testing options. And we stood up COVIDtests.gov so Americans could order tests that shipped directly to their homes — for free. Private insurance and Medicaid now cover rapid at-home tests for free, and Medicare will fully cover these at-home tests starting this spring.
The path forward in the fight against COVID-19 is clear: we must maintain and continually enhance the tools we have to protect against and treat COVID-19. The Administration looks forward to working with Congress to ensure that we have the resources to do just that.
Because we have these tools, we can begin to get back to our more normal routines safely and the use of public health mitigation measures like masking can be less frequent. The Centers for Disease Control and Prevention (CDC) has updated its framework for recommendations on preventive measures like masking, so masks are recommended when and where they matter the most and Americans will be wearing masks less often.
To read President Biden's full statement regarding the new National COVID-19 Preparedness Plan, and learn more about the other three key goals:
- Prepare for New Variants
- Prevent Economic and Educational Shutdowns
- Continue to Lead the Effort to Vaccinate the World and Save Lives
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Additional COVID-19 booster available for high-risk people
Yesterday the Centers for Disease Control and Prevention signed off an additional booster for adults over 65 and people with weakened immune systems. Earlier this week the Food and Drug Administration authorized the additional dose for those 65 and older to receive the vaccine at least four months after their previous updated shot. Those with immune deficiencies would also be eligible, and the vaccines are available free of charge.
“We urge New Mexicans to stay current with their COVID-19 vaccinations and especially encourage those who are over 65 years and those with weakened immune systems to get the additional booster shot available for them,” said Secretary Patrick Allen. “We are all ready to move on from the pandemic and the best way to do that is to get vaccinated to help protect both the vaccinated person and those around them by limiting the spread of the virus.”
In New Mexico, approximately 20% of those eligible for the Omicron booster have received the updated shot.
“The importance of the booster is that over time your protection from COVID-19 vaccines decrease,” said Deputy Secretary Dr. Laura Parajon. “We’d really like to see our Omicron booster vaccination rates for everyone eligible statewide rise in New Mexico to keep our residents healthy and to reduce their risk from hospitalizations and death from COVID-19.”
If you are at least 65 and received your first bivalent booster at least four months ago, you are eligible to get a second one.
If you are immunocompromised and received a bivalent booster at least two months ago, you are also eligible to get a second one.
People with weak immune systems can receive additional doses at intervals decided by their doctors. These include people who have received organ or stem cell transplants, people with advanced or untreated HIV infection, people undergoing treatment for cancer and people who are taking certain medications that weaken the immune system.
Eligibility for extra doses for immunocompromised children 6 months through 4 years old will depend on which vaccine they have already received.
Individuals can sign up for their vaccine appointment by calling 1-855-600-3453 (option 3, option 9 for Spanish), online at vaccineNM.org, vaccineNM.org/kids, vaccine.gov, or through their personal medical provider or pharmacist.
Additionally, New Mexico residents can still receive mail order free at-home COVID tests through the Department of Health’s partnership with the Rockefeller Foundation’s Project Act program while supplies last at: https://accesscovidtests.org/.
For more information on how to stay safe and healthy from COVID-19, visit cv.nmhealth.org.
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What to know about COVID-19 vaccines and boosters
The CDC now recommends that people age 6 months and older get an updated COVID-19 vaccine for better protection against the most prevalent omicron variants.
Vaccines and boosters are a critical part of slowing — and eventually stopping — the spread of COVID-19, and Kaiser Permanente is committed to providing you with vaccine information as it’s available.
Here’s what you need to know about the COVID-19 vaccines and the boosters.
Now is the time for an updated booster
The COVID-19 primary vaccines and the original boosters (also known as monovalent boosters) have been effective at preventing people from getting severely sick. However, the Centers for Disease Control and Prevention recommends that people age 6 months and older get an updated (or bivalent) COVID-19 booster for better protection against the most prevalent omicron variants. These variants are currently causing most cases in the U.S.
“The updated COVID-19 boosters have been designed to better protect against the newer variants,” said Craig Robbins, MD, physician co-lead for Kaiser Permanente’s national COVID-19 vaccination program. “The newer versions of the booster strengthen the protection that has decreased since previous vaccination.”
The CDC recommends people age 6 months and older get an updated COVID-19 booster. Find out which booster is right for you. [View chart.]
Vaccines OK’d for 6 months and older
The Pfizer and Moderna COVID-19 primary series vaccines are available to all people age 6 months and older.
The Pfizer vaccine for children 6 months to 4 years is administered in 3 doses, with the initial 2 doses given 3 weeks apart followed by a third dose given at least 8 weeks after the second dose.
The Pfizer vaccine for children 5 through 11 is administered as a 2-dose primary series, 3 weeks apart.
The Moderna vaccine for children 6 months through 11 years is administered in 2 doses given 4 weeks apart. The appropriate dose is determined by your child’s age at the time of the dose, regardless of the child’s weight or age at the time of a prior dose.
Pregnant? Get vaccinated and boosted
Getting the primary vaccination series and the updated booster (being “up to date”) while pregnant can provide important protection for you and your unborn baby. The CDC recommends COVID-19 vaccination for people who are pregnant, breastfeeding, trying to get pregnant now, or who might become pregnant in the future. Additionally, there is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men.
Kaiser Permanente encourages people who have not been vaccinated to receive their primary COVID-19 vaccination series as soon as they’re eligible. In addition, even after being fully vaccinated, anyone with symptoms of illness should get tested for COVID-19 as soon as possible and isolate at home.
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Will you get a second bivalent booster as soon as you are eligible?
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The End of the Federal COVID-19 Public Health Emergency is Near:
What to Expect as HHS Transitions beyond the Emergency Phase
With less than two weeks left until the end of the federal COVID-19 Public Health Emergency (PHE), which is set to expire on May 11, 2023, the Department of Health and Human Services (HHS) is preparing to transition certain COVID-19 flexibilities. On February 9, 2023, HHS released a COVID-19 PHE Transition Roadmap, which provides guidance on what to expect beyond the emergency phase of the COVID-19 pandemic. While many of the relaxed rules and regulations that helped facilitate an efficient and timely response during the PHE have been permanently signed into law, others, some of which are discussed below, will soon expire.
In its guidance, HHS identified the following flexibilities and programs that will be affected by the end of the PHE:
- Certain Medicare and Medicaid Waivers and Flexibilities: Many COVID-19 waivers, such as Section 1135 waivers, that were issued to ensure flexibility in obtaining access to care during the height of the pandemic will be rescinded.
- Coverage for COVID-19 Testing: Coverage for COVID-19 testing will end or be limited. Private insurers will no longer be required to cover the costs of over-the-counter or laboratory COVID-19 testing. Medicare beneficiaries will no longer receive free over-the-counter COVID-19 tests. However, Medicare will continue to cover, without cost-sharing obligations, laboratory-conducted COVID-19 tests ordered by a provider. Medicaid programs will continue to provide Medicaid beneficiaries with free COVID-19 testing through at least September 30, 2024.
- Reporting of COVID-19 Data: HHS will no longer require laboratories to report COVID-19 test results. Currently, the Centers for Disease Control and Prevention (CDC) is urging states to sign voluntary data use agreements to enable the continued sharing of vaccine administration data.
- FDA Guidance Documents Affecting Clinical Practice and Supply Chains: The FDA will review and revise, as applicable, each of the several dozen guidance documents published by the FDA during the PHE, including documents related to clinical practice and supply chain issues.
- FDA’s Detection of Early Shortages of Critical COVID-19 Related Devices: Manufacturers will no longer need to notify the FDA of (i) the discontinuation of a device or (ii) significant device distribution issues due to manufacturing interruptions. But the FDA has requested that Congress approve an extension of these requirements beyond the end of the PHE.
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Telehealth Prescribing of Controlled Substances without In-Person Interaction: The prescribing of controlled substances to patients without in-person examinations will be restricted. As previously covered by Mintz, the Drug Enforcement Agency proposed rule on prescribing controlled substances via telehealth will require, among other things, for patients to have in-person follow-up examinations to obtain controlled-substance prescription renewals.
HHS identified the following policies and programs that will be unaffected by the expiration of the PHE:
- COVID-19 Vaccinations and Treatments: While subject to change, COVID-19 vaccinations will continue to be covered by most private insurance plans Medicare without cost-sharing obligations. Similarly, Medicaid will cover COVID-19 vaccinations without cost-sharing obligations through at least September 30, 2024.
- FDA Emergency Use Authorization for COVID-19 Products: The FDA may continue authorizing various medical products and treatments for emergency use. Existing authorizations for COVID-19 products will remain unchanged.
- Process for Medicaid Eligibility Redeterminations Will Resume: During the PHE, Medicaid programs received supplemental financial support through the Families First Coronavirus Response Act, which in part required states to maintain continuous enrollment of Medicaid beneficiaries. As part of the Omnibus Bill, effective March 31, 2023, Congress rescinded its financial support and the requirement for states to maintain continuous enrollment. As of April 1, 2023, states began unwinding the continuous enrollment and performing eligibility redeterminations for Medicaid beneficiaries.
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Access to Certain Opioid Use Disorder Treatments: The Substance Abuse and Mental Health Services Administration (SAMHSA) is working to ensure individuals in opioid treatment programs (OTP) can continue to receive (i) buprenorphine by telehealth without first being seen for an in-person examination and (ii) take-home doses of methadone beyond the end of the PHE. SAMHSA will use interim measures to maintain continued access after the end of the PHE while it works on making such access permanent through its proposed OTP regulations.
Other COVID-19 Measures to be Implemented by HHS beyond the End of the PHE:
- Amendments to the Public Readiness and Emergency Preparedness Act Declaration
- HHS Bridge Access Program for COVID-19 Vaccines and Treatments Program
Conclusion
Though the PHE expires on May 11, 2023, HHS has demonstrated that preventing and treating COVID-19 still remains a top priority, particularly with respect to patients that are uninsured, Medicare and Medicaid patients, and patients struggling with substance abuse disorder. In the coming months, it will be interesting to see how HHS and its operating divisions navigate COVID-19 following the end of the PHE and observe the impact of these private-public partnerships on COVID-19 vaccination rates.
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CDC COVID Data Tracker - April 28, 2023
To get today's break down of positive case data, demographics information, vaccine status and more for Los Alamos County or other counties across the United States, click HERE
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NMDOH Epidemiology Reports
As part of the COVID-19 pandemic response, NMDOH collects and analyzes statewide data for COVID-19 positive cases, hospitalizations, and deaths. The reports reflect these critical data and are updated monthly - click HERE
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Don't forget to submit a question for our last issue!
Check out the responses to our last survey:
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Los Alamos Vaccine & Booster Information |
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Los Alamos County COVID Vaccine/Booster Resources
Visit the County COVID Page for more information regarding vaccinations/boosters:
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Los Alamos Treatment Information |
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Los Alamos County COVID Treatment Resources
Visit the County COVID Page for information regarding treatments, click below:
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Los Alamos Testing Information |
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Los Alamos County COVID Testing Resources
Visit the County COVID Page for information regarding testing, click below:
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