News From Los Alamos County
March 17, 2023
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Inside this newsletter, you will find...
The Epidemiology Corner - COVID-19 Update, FDA Approval
of Boosters for Children Under 4, Why We Didn't Have a Winter Surge,
Does Paxlovid Work, Weekly Survey, COVID-19 data, and more.
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COVID-19 Update:
National Decline in Hospitalizations and Deaths Continues as Low-Level Transmission Remains in
Los Alamos County...
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COVID-19 Update: Omicron XBB.1.5 Variant Predominates – XBB.1.5.1 Subvariant Slowly Rising
CDC projects the Omicron variant XBB.1.5 to now account for 90% of COVID-19 cases nationwide. CDC has begun tracking the slowly ascendant XBB.1.5.1 subvariant, which appears to have some growth advantage over it’s dominant XBB.1.5 cousin. All other previous Omicron variants are stable or declining in prevalence. See HERE National surveillance data continue to show the XBB.1.5 ascent to dominance was not associated with a surge in hospitalizations or deaths in the US or elsewhere in the world. Severe disease indicators have continually declined since 2023 began, but still remain at meaningfully high levels. A total of 1,700 COVID-19 deaths were registered in the US for the week ending March 15. Daily hospitalizations averaged about 2,600 per day over the same time period. Virus is still circulating and infecting people, with the elderly and the immunocompromised being the ones most likely to end up with severe disease. This will likely continue to be the case as COVID-19 prevention measures have all largely been dropped in favor of a pre-pandemic lifestyle where people leave their guard down.
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CDC Community Level Risk Remains at LOW for the County as Reported Cases Remain Low
For the week ending March 15, 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. Reported cases in the county rose to 4 from the prior two weeks reporting of 1 case each per week. An increased reported case incidence was also observed in the remaining three counties of the HSA. The HSA hospitalization rate has remained relatively stable at 4 to 5 new admissions per 100,000 over the past several months, which indicates ongoing transmission and progression to severe disease among some persons. No new hospital admissions among county residents were reported by NMDOH for the month of March so far. However, NMDOH is now only reporting data every other week, so there is a gap in this surveillance measure. CDC reports no COVID-19 deaths in county residents over the past month.
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Emergency Department Visits for COVID-Like Illness Remain at Stable Low Level
NMDOH reports the percentage of emergency department (ED) visits in county residents for COVID-like illness remained stably low at 2.3% for the two-week period ending March 15. These data are indicative of continual low level virus transmission in the community. Statewide, the percentage of ED visits for COVID-like illness remains stable at about 3%. ED visits for flu-like illness have declined sharply from a peak of 18% in December and remain stable at 4%. See HERE
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COVID-19 Virus Continues to be Detected in County Wastewater
SARS-CoV-2 virus in county wastewater continues to be detected at levels consistent with on-going disease transmission in the community. The uptick in viral concentrations for the most recent week may correlate with the corresponding uptick seen with reported cases. For the week of February 27, the CDC/Biobot contractor reports that the XBB.1.5 variant accounted for all virus detected in county wastewater. See https://biobot.io/data/
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Stable Trend in County PCR Testing Interrupted by Recent Increase
The stable trend in county PCR testing that began in mid-January 2023 has been interrupted with a two-fold rise in testing for the week ending March 9. An increase in persons seeking a laboratory PCR test may be indicative of increasing transmission in the county, and would be consistent with the recent rise in reported cases and increase in wastewater surveillance levels.
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New Mexicans Encouraged to Self-Report Positive COVID-19 Home Tests
To assist with more complete case monitoring in New Mexico, NMDOH encourages residents to download the NM Notify app and to report positive COVID-19 home tests on the app, or for a fast and easy way to report your at-home test results online, visit https://makemytestcount.org/.
The NMDOH/CDC COVID-19 incidence data reviewed here are based on PCR-confirmed testing results and do not include data on positive at-home antigen tests. As such, case counts are incomplete and underestimated, but by how much cannot be determined precisely at any given time point.
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Coronavirus (COVID-19) Update: FDA Authorizes Bivalent Pfizer-BioNTech COVID-19 Vaccine as Booster Dose for Certain Children 6 Months through 4 Years of Age
Today, the U.S. Food and Drug Administration amended the emergency use authorization (EUA) of the Pfizer-BioNTech COVID-19 Vaccine, Bivalent to provide for a single booster dose of the vaccine in children 6 months through 4 years of age at least 2 months after completion of primary vaccination with three doses of the monovalent (single strain) Pfizer-BioNTech COVID-19 Vaccine.
What Parents and Caregivers Need to Know:
- Children 6 months through 4 years of age who completed their three-dose primary series with the monovalent Pfizer-BioNTech COVID-19 Vaccine more than two months ago are now eligible to receive a single booster dose of the Pfizer-BioNTech COVID-19 Vaccine, Bivalent.
- Since December 2022, children 6 months through 4 years of age who receive the first two doses with monovalent Pfizer-BioNTech COVID-19 Vaccine should complete their three-dose primary series with the Pfizer-BioNTech COVID-19 Vaccine, Bivalent. These children in this age group are not eligible for a booster dose of a bivalent vaccine at this time and are expected to have protection against the most serious COVID-19 outcomes. Today’s authorization is for those children 6 months through 4 years of age who completed their 3-dose primary vaccination series with the monovalent Pfizer-BioNTech COVID-19 Vaccine, before the Pfizer-BioNTech COVID-19 Vaccine, Bivalent was authorized to provide the third dose in the 3-dose primary series.
- The Pfizer-BioNTech COVID-19 Vaccine, Bivalent includes an mRNA component corresponding to the original virus strain to provide an immune response that is broadly protective against COVID-19 and an mRNA component corresponding to the omicron variant BA.4 and BA.5 lineages to provide better protection against COVID-19 caused by the omicron variant.
FDA Evaluation of Available Effectiveness Data
For the authorization of a single booster dose of the Pfizer COVID-19 Vaccine, Bivalent for children 6 months through 4 years of age at least 2 months after completion of primary vaccination with three doses of the monovalent Pfizer-BioNTech COVID-19 Vaccine, the FDA evaluated immune response data from 60 children in this age group who had completed primary vaccination with three doses of monovalent Pfizer-BioNTech COVID-19 Vaccine and received a booster dose of Pfizer-BioNTech COVID-19 Vaccine, Bivalent in a clinical study. One month after receiving the Pfizer-BioNTech COVID-19 Vaccine, Bivalent, the study participants demonstrated an immune response to both the original SARS-CoV-2 virus strain and to omicron BA.4/BA.5.
In addition, the authorization is supported by the FDA’s previous analyses of the effectiveness of primary vaccination with the monovalent Pfizer-BioNTech COVID-19 Vaccine in individuals 16 years of age and older and individuals 6 months through 4 years of age, and previous analyses of immune response data in adults greater than 55 years of age who had received one booster dose with an investigational Pfizer-BioNTech bivalent COVID-19 vaccine (original and omicron BA.1).
FDA Evaluation of Available Safety Data
The safety of the Pfizer-BioNTech COVID-19 Vaccine, Bivalent as a booster dose in children 6 months through 4 years of age at least two months after completion of primary vaccination with three doses of the monovalent Pfizer-BioNTech COVID-19 Vaccine is based on the following safety data previously evaluated by the FDA:
- A clinical study which evaluated a booster dose with Pfizer-BioNTech’s investigational bivalent COVID-19 vaccine (original and omicron BA.1), in individuals greater than 55 years of age,
- Clinical studies which evaluated primary vaccination with the monovalent Pfizer-BioNTech COVID-19 Vaccine in individuals 6 months of age and older,
- Clinical studies which evaluated booster vaccination with monovalent Pfizer-BioNTech COVID-19 Vaccine (previously, but no longer, authorized) in individuals 5 years of age and older, and
- Postmarketing safety data with the monovalent Pfizer-BioNTech COVID-19 Vaccine and Pfizer-BioNTech COVID-19 Vaccine, Bivalent.
In addition, among individuals 6 months of age and older, safety was assessed in participants in two clinical studies. In one study participants 6 months through 11 years of age who were previously vaccinated with a 3-dose primary series of monovalent Pfizer-BioNTech COVID-19 Vaccine received a booster dose of the Pfizer-BioNTech COVID 19 Vaccine, Bivalent. Among 24 participants 6 months through 23 months, the most common side effects included irritability, drowsiness, injection site redness, pain and swelling, decreased appetite, fatigue, and fever. Among 36 participants 2 years through 4 years of age, the most common side effects included fatigue, injection site pain, redness and swelling, diarrhea, vomiting, headache, joint pain, and chills. Among 113 participants 5 through 11 years of age, the most common side effects included, fatigue, headache, muscle pain, joint pain, chills, fever, vomiting, diarrhea, injection site pain, swelling and redness, and swelling of the lymph nodes in the same arm of the injection.
The safety data accrued with the investigational bivalent vaccine (original and omicron BA.1) and with the monovalent Pfizer-BioNTech COVID-19 Vaccine are relevant to the Pfizer-BioNTech COVID-19 Vaccine, Bivalent because these vaccines are manufactured using the same process.
To view the full news release, click HERE!
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The winter COVID wave that wasn't: Why the US didn't see a surge
Cases and deaths were much lower this winter compared to previous winters.
When the United States saw COVID-19 cases and deaths rise around this past Christmas and New Year's, many Americans feared the country was in for a third winter wave.
But as quickly as both metrics went up, they also came down. Weekly cases and deaths in late winter 2022-23 are on par with what was seen in spring 2022, according to data from the Centers for Disease Control and Prevention.
Last year, the Biden administration issued a bleak warning that as many as 100 million Americans could be infected during a COVID-19 wave in the fall and winter.
However, as the third anniversary of the World Health Organization declaring the virus to be a global pandemic passes, it appears that the U.S. has survived its first winter without a massive COVID-19 surge.
Experts told ABC News that a combination of more immunity, better treatments, less severe infections and more people following mitigation measures likely played a role.
Comparison between winters
During the first winter wave, weekly cases peaked at 1,714,256 the week of Jan. 13, 2021, as did weekly deaths at 23,378, according to CDC data.
Subsequently, during the second winter wave -- due to the omicron variant -- weekly infections reached their high point of 5,630,736 the week of Jan. 19, 2022, and weekly deaths saw a high of 17,373 the week of Feb. 2, 2022, the data shows.
By comparison, according to the CDC, the highest number of weekly cases seen during the most recent winter wave was 472,601 the week of Dec. 7, 2022 -- the first time the peak has not surpassed 1 million.
Meanwhile, weekly deaths peaked at 4,448 the week of Jan. 11, 2023 -- five times lower than the peak during the first winter wave and nearly four times lower than the peak during the second wave.
Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children's Hospital and an ABC News contributor, said there is some inconsistency when comparing past winter surges to this winter because there was a lack of overall testing and a declined use of home tests this winter.
However, the lower number of hospitalizations and deaths is likely a good indication of a less severe season this year compared to previous years, he said.
More immunity
Experts told ABC News that as winters have gone by, more immunity has built up in the population.
During the first winter wave, COVID-19 vaccines were not widely available. They only began being rolled out in mid-December and only for specific groups, including health care workers and adults aged 65 and older.
By the time the second winter wave rolled around, most of the U.S. population had gotten a primary series, according to CDC data, and the first booster was available to the general population.
During this most recent winter, an updated bivalent booster is also available, which -- although only 16.2% of the population has received it -- has likely offered at least some protection.
Evolution of treatments
The experts said another reason this season may not have been as severe for COVID is that we have more effective treatments.
During the first winter wave, remdesivir was the only drug approved to treat patients with severe COVID cases.
Since then, we've seen the introduction of antiviral pills, including molnupiravir from Merck and Ridgeback Biotherapeutics and Paxlovid from Pfizer.
People following mitigation measures
[Even] as mask mandates and other mitigation measures have been removed, everyday Americans are being more thoughtful about staying home when sick, about wearing a mask in public situations or testing before attending a gathering, the experts say.
[This] likely also helped protect people from other diseases that were circulating this past winter including influenza and RSV.
Importance of staying vigilant
The experts told ABC News it's important to remain vigilant because a new, more transmissible variant or a new outbreak could easily lead to another wave in the U.S.
Earlier this year, it was revealed the U.S. Food and Drug Administration is considering a new COVID-19 vaccine strategy that would see Americans getting a single annual shot, similar to the flu vaccine.
According to briefing documents, the new approach would simplify public health messaging on when to get COVID vaccines, with the hope that making the guidance easier for people to understand could potentially increase vaccination rates in the U.S.
To read the full article, click HERE!
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FDA: COVID-19 Rebound Occurs Regardless of Paxlovid Use
A rebound of COVID-19 may be part of the natural progression of the disease, regardless of Paxlovid treatment, according to FDA documents.
Over 8 million courses of the treatment have been administered in the U.S., according to federal data. In some instances, like with President Joe Biden and leading infectious disease expert Anthony Fauci, Paxlovid patients experienced a rebound in COVID-19 symptoms and tested positive for the virus after previously testing negative.
But in documents published online this week, agency officials supported the use of Paxlovid, arguing that “rebound may occur as part of the natural progression and resolution of COVID-19 disease, irrespective of PAXLOVID treatment.”
FDA staffers cited an analysis showing that rates of COVID-19 symptom rebound were similar between people who took Paxlovid and people who took a placebo. The documents stated that overall symptom rebound rates ranged from 10-16%.
FDA’s Antimicrobial Drugs Advisory Committee will discuss the data on Thursday when it meets to vote on whether the treatment’s benefits outweigh its risks. The drug was authorized for emergency use in December 2021.
According to Pfizer’s trial of the drug, Paxlovid reduced the risk of hospitalization or death in high-risk, unvaccinated adults by 86%.
To view the full article, click HERE!
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Using this timeline of weekly U.S. COVID case counts from January 2020-March 2023, can you match letters A-E with the following key moments in the pandemic: Omicron variant peak; height of U.S. vaccination campaign; early deadly period; rise of XBB.1.5 variant; arrival of Alpha variant?
William Hanage on COVID lessons we haven’t learned
"We are actively getting in the way of future responses to infectious disease emergencies," epidemiologist William Hanage says.
Epidemiologist looks back and ahead
The pandemic has progressed through a now-familiar pattern the past several months, with the latest variant — XBB.1.5 — infecting a lot of people in December and January before starting to fade. Recent data from the Centers for Disease Control and Prevention show that weekly cases and deaths have fallen by roughly half since January, to 226,618 and 2,023, respectively, on March 1. The Gazette spoke with William Hanage, an associate professor of epidemiology at the Harvard T.H. Chan School of Public Health and co-director of the Center for Communicable Disease Dynamics, about the recent surge, the end of the emergency phase, and the persistence of debates around masks and school closings. The interview has been edited for clarity and length.
GAZETTE: I saw a lot of people come down with mild cases during the winter surge. Does that reflect the broader COVID experience in recent months?
HANAGE: A lot of people had it and most cases were really quite mild. I strongly suspect that many people didn’t even realize they’d been infected but have gotten additional immunity from infection on top of their vaccines. This is not going to protect them forever, but it is going to have an impact as we emerge from the winter. The context for this, though, is that the death toll is still huge by any pre-2019 standard. The only virus that we routinely expect to cause as many as 50,000 deaths a year in the United States is influenza. And from the end of BA.1 last year to now, we’ve seen 150,000 deaths. That’s three bad flu seasons.
GAZETTE: In the past, when we’ve come off winter surges, things have continued to trend downward. Is that a reasonable expectation for this spring into summer?
HANAGE: Yes, because there’s a lot of people who are immune to infection, though that won’t last forever. That means that fewer people get infected over the course of the winter and fewer people carry it home to their relatives, and that’s even before we start talking about benefits in terms of hospitalizations and deaths.
GAZETTE: Do we know more now about how long it takes immunity to wane?
HANAGE: It’s difficult to answer precisely because it all depends: Is it somebody who has been infected? Somebody who’s been vaccinated? And if so, which vaccine have they gotten? What sort of immune system do they have? There is, however, a pretty consistent pattern, which is that you are protected reasonably well from symptomatic infection for a couple of months — maybe as many as four — before it drops away to very little. Being boosted over the winter will provide you with some protection. If you’ve been infected as well, it will last pretty well into the year, new variants allowing. But when we come around to next winter, we’re going to have to revisit things.
GAZETTE: Is the path ahead more of what we’ve been seeing: Milder surges as the years go by?
HANAGE: This is what I think more than 80 to 90 percent of folks in the field would say: Absent a black-swan event like a super variant of some kind, we expect diminishing waves in terms of severe outcomes. It may be a bumpy road sometimes, but overall, we expect the trend to be down because people will keep encountering the virus, they will keep upping their immune response, their T cells will be extremely active at preventing severe illness. Most specialists expect it to become like one of the other seasonal coronaviruses. But we don’t know how long that’s going to take.
GAZETTE: What do you think of President Biden's plan to lift the public health emergency on May 11?
HANAGE: It’s a really stupid idea to schedule the end of a pandemic, because viruses don’t have Outlook calendars. Having said that, it is reasonable to suggest that we need to prepare for the next phase. The big issue with ending the emergency phase is whether it makes it more difficult for folks to get tests, which makes it more difficult to protect those they might infect. It will also make it more difficult for people to access vaccines, which will be most felt by those who are least able to pay and who are more likely to be infected because they’re least able to control exposures. It’s hard enough already to get people boosted, and some will just say, “Oh, we don’t need to be boosted.” That means we will be relying upon repeat infections to build up accumulated immunity in the population. That would happen eventually anyway, but more people will die unnecessarily if it happens this way.
GAZETTE: Are we doing enough, as a society, to think about pandemic lessons?
HANAGE: I don’t think we are, and that’s allowing people to frame narratives in ways that minimize it. We are getting more received wisdom that particular interventions did or didn’t work.
For instance, quality masks as an intervention definitely work for individuals if you are wearing them correctly. Masks at a community level can work, though it does not necessarily mean they will. But by getting into the tizzy that we have over them — for reasons which are mostly not scientific — we are actively getting in the way of future responses to infectious disease emergencies.
Handwashing turned out to not be a big deal for COVID — it doesn’t really spread via the fomite route. But that is not going to help you in the future if you’re worried about Shigella.
There’s received wisdom now that school closures were overkill. Even if they were, that would be true only some of the time for this virus, and if we have a flu pandemic next, flu tends to spread a lot in younger kids and age groups in schools.
We’re also getting relitigation of lockdowns — a phrase which I’d never liked. Lockdowns were never expected to completely expel the virus, but they were expected to slow it down, and the actions that were taken in the spring of 2020 meant the virus did not arrive and get started in places like Florida or Arizona until the summer. That meant that when people there got sick, they could be treated with dexamethasone, which, by then, we knew would work because a trial had been done. So those people who got infected then had a better chance than they would have had in the spring. A delay, even if only for a few months, can save a lot of lives. And amazingly, just six months after that, we had multiple vaccines.
To read the entire article, click HERE!
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Do you use the County website as a resource for COVID-19 information?
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CDC COVID Data Tracker - March 17, 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 - 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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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!
Check out the responses to our last survey:
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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.
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Have a question? Email us. |
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Los Alamos Testing Information |
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The New Mexico Department of Health recommends residents to take advantage of two programs offering free at-home antigen tests, while supplies are available:
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All U.S. households can order a total of four at-home COVID-19 tests that will be mailed directly to them for free. Tests can be ordered from www.COVID.gov/tests.
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Additionally, New Mexico residents can receive free at-home tests through the Rockefeller Foundation’s Project Act program while supplies last at: https://accesscovidtests.org/.
Users can follow up with a PCR test from a medical provider or test site to verify results. Visit findatestnm.org to find a convenient location. Individuals can self-report a positive COVID test at Make My Test Count. The reporting of tests on this site is confidential and no personal information is required to use the site.
It is still important to stay home if you have symptoms to prevent the spread of COVID and other respiratory illnesses such as RSV and flu.
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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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Los Alamos Vaccine & Booster Information |
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Where can I get my COVID-19 Vaccine or Omicron booster?
In addition to the clinics that use the NMDOH scheduling site, Los Alamos has other options available. Click below on the vaccine/booster resources website for more information.
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Los Alamos County COVID Vaccine/Booster Resources
Visit the County COVID Page for information regarding vaccinations/boosters, click below:
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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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Click below to email us your feedback and questions! |
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