Weekly News From Los Alamos County
July 29, 2022
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Inside this newsletter, you will find...
The Epidemiology Corner - COVID-19 Update, Last Night's Community Briefing, Upcoming Vaccine Clinics, Survey & Results, COVID-19 data, and more.
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COVID-19 Update: Hospitalizations Continue
To Rise As Transmission
Remains High...
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Highly Transmissible and Immune-Evasive BA.5 Variant Causing Most Cases in U.S.
For the week ending July 23, CDC estimates that Omicron variants BA.4/BA.5 accounted for 95% of US cases nationwide, with BA.5 alone accounting for 82% of cases. See HERE. At this point, scientists have no clear indication of what may come next or how long BA.5 may remain in dominant circulation. See HERE. One new variant being closely monitored along with BA.5 is BA.2.75, which was first detected in India in May and since then has been detected in at least a dozen other countries, including the U.S. See HERE Rising COVID-19 hospitalization in the U.S. likely reflects rising BA.5 infection rates, which leaves health authorities concerned that the fall return-to-school and more indoor crowding may result in increased transmission and a possible need for indoor masking and other preventive measures. See HERE
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COVID-19 in the County: Reported Daily Cases Continue Declining But Still Comparatively High
Average daily reported cases continue to decline from the recent early June peak, but community transmission remains comparatively high. An average of 7.7 cases per day were reported for the week ending July 26, which represents a roughly 8% decline from the 8.4 daily cases reported the prior week. In comparison, an average of one case per day was being reported in the county during late-March/early-April 2022. For the most recent 14-day time period July 12-26, NMDOH reports that 8.5% of all Emergency Department (ED) visits in county residents were for COVID-19 related symptoms. In comparison, only 1.8% of ED visits were for COVID-19 symptoms during the low incidence period of March 15-29. See HERE A total of three COVID-19 deaths were registered in the county during the June-July 2022 time period.
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CDC Community Level Risk MEDIUM But Transmission Risk Remains Comparatively High
For the week ending July 26, the CDC Community Level remains at MEDIUM due to Health Services Area (HSA) hospitalization metrics being below CDC threshold criteria levels. The county transmission rate (279 cases per 100,000) remains above the CDC criteria threshold of 200 cases per 100,000, but also remains at a level entirely comparable with rates seen in the three neighboring HSA counties (Santa Fe, Taos, Rio Arriba). The CDC rationale for relying mainly on HSA hospitalization metrics to establish Community Level public health recommendations is available HERE.
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All Ages Contributing to High Transmission in the County - Including the Elderly
NMDOH data on reported COVID-19 cases show that all age groups in the county, including the elderly, contributed to the recent surge in reported cases beginning in early June. Incidence rates at least doubled between May and June for all age groups, with the highest reported case rates generally occurring among adults aged 20-49 years. Workplace testing requirement might account for the higher rates seen in this working-age group. For the 7-week time period June 1- July 21, a total of 147 COVID-19 cases were reported in county residents 65+ years, which included 38 cases aged 65-69 years, 57 cases aged 70-79 years and 52 cases aged 80+ years. Seniors are at particularly high risk of severe disease and hospitalization, with persons 80+ years at highest risk. See HERE. According to the CDC, 95% of county residents 65 years and older have received the first two primary vaccine shots, whereas only 83% have received at least one booster shot. A recently released White House strategy to manage the BA.5 variant strongly recommends all persons 50+ years receive a booster shot to provide the highest protection possible against severe disease, hospitalization, and death. See HERE. NMDOH recommends all persons 65+ testing positive for COVID-19 receive oral anti-viral treatments within 5 days of symptoms or positive test results. See HERE.
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State-Licensed Pharmacists Able to Prescribe Paxlovid as of July 6, 2022
The U.S. Food and Drug Administration (FDA) recently revised it’s Emergency Use Authorization (EUA) for the anti-viral drug Paxlovid, to authorize state-licensed pharmacists to prescribe Paxlovid to eligible patients, with certain limitations to ensure appropriate patient assessment and prescribing of Paxlovid. See HERE. The FDA recommends that persons who test positive for COVID-19, or believe they may have COVID-19, should first consider seeking care from their regular health care provider or locating a Test-to-Treat site in their area. The closest Test-To-Treat site for Los Alamos County residents is in Santa Fe, and there are also sites in Rio Rancho and Albuquerque. See HERE. Community pharmacies not participating as a Test-to-Treat site can decide if or how they will offer Paxlovid prescribing services to patients. Persons seeking pharmacist-prescribed Paxlovid would need to provide the pharmacist with recent electronic or hardcopy medical records sufficient to assess kidney (renal) and liver (hepatic) function, as well as for potential drug interactions. Without sufficient information, the pharmacist is obligated to refer patients for clinical evaluation with a medical care professional authorized under state law to prescribe drugs.
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NOTE: The COVID-19 incidence data reviewed here are based on PCR-confirmed testing results compiled by CDC and NMDOH and do not include data on positive at-home antigen tests. As such, case counts are likely underestimated, but how much cannot be determined at any given time point.
To assist with more complete case monitoring in New Mexico, NMDOH provides for online reporting of positive at-home antigen results HERE.
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Watch the COVID-19 community briefing on July 28
Los Alamos County officials held a virtual briefing regarding the community’s COVID-19 status on Thursday, July 28 at 5:30 p.m. Representatives included Deputy County Manager Linda Matteson from the County, Chris Bartlett from Los Alamos Fire Department's EMT Division, Jennifer Guy from the Los Alamos Public Schools, Bernadette Lauritzen from the Los Alamos Retired and Senior Organization, Ryn Herrmann from Los Alamos Commerce & Development Corporation, Joyce Richens from the Los Alamos Medical Center, Richard W. Honsinger, MD, MACP and retired epidemiologist William Athas, PhD.
Topics included what local businesses and the senior centers are doing to stay COVID-safe; reminders on how to protect friends and family from becoming infected with COVID-19; how the schools are preparing for the upcoming school year, and much more.
To watch the meeting, click HERE.
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Did you attend the virtual COVID-19 Community Briefing?
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No, but I plan to watch it later
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Novavax COVID-19 Vaccine
CDC has endorsed the Advisory Committee on Immunization Practices’ (ACIP) recommendation that Novavax’s COVID-19 vaccine be used as another primary series option for adults ages 18 years and older.
Novavax is a protein subunit vaccine. These vaccines package harmless proteins of the COVID-19 virus alongside another ingredient called an adjuvant that helps the immune system respond to the virus in the future.
Vaccines using protein subunits have been used for more than 30 years in the United States, beginning with the first licensed hepatitis B vaccine. Other protein subunit vaccines used in the United States today include those to protect against influenza and whooping cough.
Two doses of Novavax are given in the primary series, 3–8 weeks apart. People who are moderately or severely immunocompromised should also receive 2 doses, given 3 weeks apart (a 3rd primary dose is not currently authorized).
Novavax COVID-19 vaccine is not authorized for use as a booster dose.
To learn more, click HERE.
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How long is COVID infectious? What scientists know so far...
Those with SARS-CoV-2 are often advised to isolate for only a few days. But evidence is mounting that some people can continue to pass on the virus for much longer.
When the US Centers for Disease Control and Prevention (CDC) halved its recommended isolation time for people with COVID-19 to five days back in December, it said that the change was motivated by science. Specifically, the CDC said that most SARS-CoV-2 transmission occurs early in the course of the illness, in the one to two days before the onset of symptoms and for two to three days after.
Many scientists disputed that decision then and they continue to do so. Such dissent is bolstered by a series of studies confirming that many people with COVID-19 remain infectious well into the second week after they first experience symptoms. Reductions in the length of the recommended isolation period — now common around the world — are driven by politics, they say, rather than any reassuring new data.
A numbers game
Although the question is simple — for how long is someone with COVID-19 contagious? — experts caution that the answer is complicated. “We always think of it as a black and white thing … if somebody’s infectious or not infectious — but in reality, it’s a numbers game and a probability,” says Benjamin Meyer, a virologist at the University of Geneva in Switzerland.
And that numbers game has shifting rules and baselines. Emerging variants, vaccination and varying levels of natural immunity provoked by previous infection can all influence how quickly someone can clear the virus from their system, Meyer says, and this ultimately dictates when they stop being infectious. Behavioural factors matter as well. People who feel unwell tend to mix less with others, he adds, so the severity of someone’s symptoms can influence how likely they are to infect others.
Transmission tests
In countries such as the United Kingdom, the relaxation of the isolation guidelines coincided with the withdrawal of free lateral flow tests. So, assuming that many of the people who follow the new recommendations are going to stop isolating after five days without testing, scientists have been investigating in particular how many people with COVID-19 are likely to remain infectious after this point.
It’s not practical to track direct onward transmission of the virus from large numbers of people and to measure how it reduces over time, so researchers instead rely on proxy measurements to determine the point at which they would expect people to stop being contagious.
Other studies take a step further away from the real world, and use levels of viral RNA measured by PCR tests to infer whether someone is infectious. This makes it easier to work with large sample sizes. For example, a project run by the Crick Institute and University College Hospital, both in London, can draw on PCR tests carried out on more than 700 participants, obtained from when symptoms developed.
A study based on this group suggests that significant numbers of people retain viral loads high enough to trigger onward infection at days seven to ten, irrespective of the variant type or how many vaccine doses people had received. The study was published on the medRxiv preprint server on 10 July.
‘Rebound phenomenon’
Yonatan Grad, an infectious-disease specialist at the Harvard T.H. Chan School of Public Health in Boston, Massachusetts, who has worked on similar PCR-based studies of infectiousness, agrees that ten days is a useful rule of thumb for when people should no longer be contagious. But he cautions that a small number of people could still be infectious beyond that point.
Some such cases in the United States have been linked to the common antiviral drug Paxlovid (nirmatrelvir–ritonavir), he says. “There’s a rebound phenomenon where people will see that their symptoms seem to resolve and they may even test negative on a rapid test, but then a few days later symptoms and the virus come back.”
Barczak says this is one of the key questions that researchers are now studying. “Antivirals change the dynamics of symptoms, change the dynamics of the immune response and change the dynamics of how you shed,” she says. “I think this is really important, because people are out in the world thinking they're not infectious after ten days. But if they have Paxlovid rebound they might be.”
To read the full article, click HERE.
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CDC COVID Data Tracker - July 29, 2022
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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The charts available with this TOOL layout the key metrics for understanding the reach and severity of COVID-19 in a given area.
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Johns Hopkins
COVID-19 Status Report Dashboard for
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NMDOH Epidemiology Reports - Daily and Weekly Data
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 weekly - click HERE
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QUESTION:
It was impossible to fill my Paxlovid prescription in Los Alamos county. We have a large number of older seniors, why is it not more readily available here?
ANSWER:
According to Smith’s pharmacists, they run through their supplies very quickly. More has been ordered. However, stock comes through the state, and how much they receive and when they receive it is really out of their control.
The NM Dept. of Health has a webpage to help you find which pharmacies in New Mexico have COVID treatments (including Paxlovid). The main NMDOH webpage is https://cv.nmhealth.org/
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We are listening to you!
Your feedback is helping to shape future newsletters, inform decisions regarding services, and make Los Alamos County healthier and safer. Make sure to participate each week to be heard!
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Remember, we appreciate your questions! We always try to respond in a timely manner, and if appropriate, we will include those Q&As in future newsletters.
Take a look at these results from the last survey:
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Los Alamos Vaccine & Booster Information |
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Two COVID-19 vaccine clinics coming:
August 1 for children 6 months to 5 years
August 8 for anyone 6 months and older
Premier Medical Group will be working in conjunction with Los Alamos County to provide two COVID-19 vaccination clinics on Monday, August 1 and Monday, August 8, between 10 a.m. and 2 p.m. at First Baptist Church, 2200 Diamond Dr., Los Alamos.
The first clinic on August 1 is intended solely for children between the ages of 6 months to 5 years old, a majority of which will be receiving their second dose of the Pfizer 6 months to 4 years vaccine or the Moderna 6 months to 5 years vaccine.
The second clinic on August 8 is for all eligible age groups, 6 months of age and older.
While appointments are preferred, walk-ins are welcome. Insurance and identification are not required.
Officials indicate that persons requiring assistance to schedule an appointment for themselves or a dependent child can call NMDOH any day of the week from 8 a.m. to 8 p.m. at 1-855-600-3453.
Public Health Nurse Jack Allison with the Los Alamos Public Health Office has indicated that he can also assist in scheduling vaccine appointments. Individuals can call him at 505-662-4038.
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Los Alamos County Vaccine/Booster Resources
Visit the County COVID Page for information regarding vaccinations/boosters, click below:
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Los Alamos Testing Information |
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Los Alamos County Testing Resources
Visit the County COVID Page for information regarding testing, click below:
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Have a question? Email us. |
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