Weekly News From Los Alamos County
October 21, 2022
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Inside this newsletter, you will find...
The Epidemiology Corner - COVID-19 Update, Two Vaccine Clinics for Seniors,
New Vaccine Approvals & Recommendations, COVID-19 data, and more.
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COVID-19 Update:
New Variants BQ.1/BQ.1.1 Rapidly Emerging in US Going into Cold/Flu Season - Case Underreporting in County Estimated...
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Highly Immune Evasive Omicron Variants BQ.1 / BQ.1.1
Quickly Rising in US
For the week ending October 22, CDC reports that Omicron variants BQ.1 and BQ.1.1 roughly doubled in prevalence from the prior week, and are now outcompeting all other Omicron variants, accounting for 17% of cases nationwide. Some areas of the country, including New York City, have seen even greater increases in BQ.1/BQ.1.1 approximating 30% of cases. See HERE
The BQ.1x variants are genetic offspring of the BA.5 variant and appear to be outcompeting all other variants circulating in the US due to a comparatively greater level of immune-evasiveness. As of now, the BQ.1x variants share the same clinical symptoms as other Omicron variants and do not appear to cause more severe disease. The extent to which the new COVID-19 bivalent booster protects against infection is uncertain, however, public health authorities expect existing COVID-19 vaccines and anti-viral therapeutics should still provide effective protective against severe disease and hospitalization. See HERE
The CDC recently recommended adding COVID-19 vaccines and boosters to the child and adult routine immunization schedules (6 months and older), which is not a legal mandate, but solely guidance for decision-makers, including state/local governments and school districts. The interim COVID-19 immunization guidelines can be found HERE.
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COVID-19 in the County: Sustained Case Incidence and ED Visits Suggest Endemic Disease Pattern Going into High-Risk Cold/Flu Season
An average of 3-4 cases per day have been registered in the county throughout October so far compared to 1-2 cases per day during the later part of September. According to the NMDOH, 6.7% of all ED visits in county residents for the two weeks ending October 18 were for COVID-like illness, a percentage unchanged from the preceding two-week period ending October 11. See HERE Both disease occurrence measures suggest a sustained burden from COVID-19 in the county which remains elevated compared to prior periods of lower burden. A similar temporal pattern in ED visits for COVID-19 illness is occurring statewide in New Mexico.
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Wastewater Surveillance Reflects Sustained Case Transmission in the County
Virus continues to be detected in county municipal wastewater and levels have roughly plateaued over the past several weeks around 800 viral copies per ml of sampled sewage. This is roughly twice as high as viral levels seen during September and is consistent with the recent rise in average daily reported case numbers. See https://biobot.io/data/
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CDC Community Level Remains at LOW for Los Alamos County
For the week ending October 18, the CDC Community Level for the county remains at LOW. New COVID-19 hospital admissions per 100,000 increased to 6.7 from the prior week’s value of 3.3, indicating that severe disease is still occurring at modest levels in the four-county Health Services Area (HSA) population. Excluding Rio Arriba, case incidence rates are increasing in all counties from the relative lows seen in September, indicating an increasing COVID-19 burden. Incidence rates in all four HSA counties remain roughly twice as high as those observed during the March-April 2022 low.
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County Age-Specific Analysis Suggests Case Underreporting in Kids and Middle-Age Adults
The widespread availability of at-home antigen testing in 2022 is known to have resulted in significant undercounting of actual COVID-19 cases across the US. At the same time, oral antivirals, such as Paxlovid, became widely available and CDC recommended that elderly persons testing positive or having COVID-like symptoms seek medical care and access anti-viral treatment – a clinical encounter which would likely involve a confirmatory PCR test. Over the past several months, case incidence rates in county residents 65+ years of age have been considerably higher than those in other age groups, a pattern not observed earlier in the year or throughout 2021. To the extent the higher elderly rates reflect a greater likelihood of receiving a reportable PCR test, they may provide the most accurate measure available for true case incidence in the county. If so, the age-specific trends seen in 2021 and earlier in 2022 suggest that rates in the remainder of the county population, especially young and middle-age adults, may currently be underreported by 2-4 fold.
The take-home message is that the prevalence of COVID-19 infection in the county is likely considerably higher than what public health can measure. Furthermore, the CDC recently announced a switch from daily to weekly COVID-19 case and death reporting, which provides less surveillance capacity as we enter the critical winter cold/flu season, which now looks to be dominated by the highly immune-evasive BQ.1/BQ.1.1 Omicron variants. See HERE
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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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Flu & COVID-19 Vaccine Clinics Scheduled at Los Alamos and White Rock Senior Centers
Los Alamos Retired and Senior Organization (LARSO) is hosting two vaccination clinics: Wednesday, Oct. 26 in Los Alamos, and Thursday, Oct. 27 in White Rock from 10 a.m. to 1 p.m.
Both clinics will provide both Flu Shots and COVID-19 bivalent Omicron boosters (Moderna only) for ages 50 and up. Interested individuals must call in advance to make an appointment: 505-662-8920.
This is an indoor event - masks are optional. No walk-in appointments are available.
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New Omicron Subvariants BQ.1, BQ.1.1 Could Help Fuel Next COVID-19 Surge in U.S.
Since omicron first topped delta to become the dominant strain in the U.S. in December 2021, the variant has stuck around in various forms. Subvariant after subvariant of omicron emerged and rose to dominance, only to be replaced by another in a matter of months.
Now, the U.S. is dealing with an alphabet soup of omicron subvariants – BA.5, BA.4.6, BQ.1.1, BQ.1, BF.7, BA.2.75.2, BA.2.75 and BA.4 – as it approaches a potential fall and winter coronavirus wave.
It’s unclear if any of the subvariants will rise to dominance as BA.5 declines or if several of them will continue to co-circulate into the winter. With so many strains circulating, even a small advantage could be what drives a subvariant to dominance.
The Centers for Disease Control and Prevention only started reporting the prevalence of BQ.1.1 and BQ.1 last week, but the pair is already raising concerns. They made up more than 11% of infections last week, according to CDC estimates. That’s up from less than 1% a month ago.
Coronavirus cases in the U.S. are, however, decreasing, but infections are massively undercounted due to at-home tests. Hospitalizations are also down.
The BQ.1.1 subvariant would be problematic for a U.S. coronavirus surge for a couple of reasons. For one, it's more transmissible, meaning it can quickly spread among the population. The subvariant also contains a mutation that could help it evade drugs like Evusheld, which is a preventive antibody treatment for immunocompromised people.
Biden officials have reportedly started looking at alternatives for Evusheld, but they remain optimistic about the updated booster shots authorized in August.
The level of protection provided by the booster shots also depends on how many people take them. Uptake of the shots has so far been slow, raising concerns that declining levels of immunity in the population and incoming colder weather could fuel a wave before a substantial portion of the population gets the shots.
Given that these numbers are low so far – less than 10% of the eligible population has taken an updated booster shot – [doctors] suggests focusing in on populations that are at high-risk for severe COVID-19, like the immunocompromised.
Roughly half of the updated booster shots so far have been administered to seniors, according to the Biden administration. That means that nearly 1 in 5 seniors have gotten the shot, though the administration said that it’s not enough progress.
Beyond BQ.1.1, there are other omicron subvariants to watch out for. Maria Van Kerkhove of the World Health Organization said they are tracking more than 300 sublineages of omicron.
Read the full article HERE.
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CDC and FDA clear Novavax vaccine as a first COVID booster for adults
U.S. regulators on Wednesday granted emergency use authorization for the COVID-19 vaccine made by Novavax to be used as a booster.
The shot can now be administered to people 18 and older who received the Novavax, Pfizer, Moderna, or Johnson & Johnson vaccines as their primary series, at least six months after the completion of those initial doses, according to the Food and Drug Administration.The Novavax booster, however, should not be given to those who have already been boosted with one or more booster doses of the other approved vaccines, the agency said in a fact sheet for health care providers.
The Centers for Disease Control and Prevention said the Novavax booster is an option for some people who may be unable to receive an mRNA vaccine such Pfizer’s or Moderna’s because of an allergy to a component of these shots, or because of “a history of a severe allergic reaction (such as anaphylaxis) after a previous dose of an mRNA COVID-19 vaccine, or a lack of availability of an mRNA vaccine.”
About 50% of Americans who have received their primary series and are eligible for a booster have not yet received one according to the CDC. Boosters, health experts have said, are essential to keep people protected against severe outcomes of COVID-19.
The Novavax vaccine uses an older and more conventional technology called recombinant protein, which has been used for decades in other vaccines targeting influenza, shingles, human papillomavirus (HPV) and hepatitis B.
Even though the mRNA vaccines have gone through rigorous clinical trials and have been proven to be some of the safest inoculations ever, with billions of doses administered globally, many Americans have been skeptical about the shots. Now that the Novavax vaccine has been approved for use as a primary series and as a booster, health experts hope that those who are unvaccinated against the coronavirus will consider this option.
Health experts have said the nation could encounter a surge of COVID-19 as winter approaches and have urged everyone to stay up to date with their COVID-19 vaccination, including receiving the new bivalent boosters developed by Pfizer and Moderna that target the BA.4 and BA.5 Omicron subvariants. The BA.5 subvariant continues to dominate infections, accounting for about 68% of cases in the United States, according to the latest CDC data.
Read the full article HERE.
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Coronavirus (COVID-19) Update: FDA Authorizes Moderna and Pfizer-BioNTech Bivalent COVID-19 Vaccines for Use as a Booster Dose in Younger Age Groups
Today, the U.S. Food and Drug Administration amended the emergency use authorizations (EUAs) of the Moderna COVID-19 Vaccine, Bivalent and the Pfizer-BioNTech COVID-19 Vaccine, Bivalent to authorize their use as a single booster dose in younger age groups. The Moderna COVID-19 Vaccine, Bivalent is authorized for administration at least two months following completion of primary or booster vaccination in children down to six years of age. The Pfizer-BioNTech COVID-19 Vaccine, Bivalent is authorized for administration at least two months following completion of primary or booster vaccination in children down to five years of age.
These bivalent COVID-19 vaccines include an mRNA component of the original strain to provide an immune response that is broadly protective against COVID-19 and an mRNA component in common between the omicron variant BA.4 and BA.5 lineages to provide better protection against COVID-19 caused by the omicron variant. The mRNA in these vaccines is a specific piece of genetic material that instructs cells in the body to make the distinctive “spike” protein of the original virus strain and the omicron variant lineages BA.4 and BA.5. The spike proteins of BA.4 and BA.5 are identical.
With today’s authorization, the monovalent Pfizer-BioNTech COVID-19 Vaccine is no longer authorized as a booster dose for individuals five through 11 years of age. Both the Moderna COVID-19 Vaccine and Pfizer-BioNTech COVID-19 Vaccine continue to be authorized for primary series administration in individuals six months of age and older.
The fact sheets for both of the bivalent COVID-19 vaccines for recipients and caregivers and for healthcare providers include information about potential side effects, as well as the risks of myocarditis and pericarditis are here: MODERNA & PFIZER
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Panel votes to add COVID shots to recommended vaccinations
COVID-19 shots should be added to the lists of recommended vaccinations for kids and adults, a panel of U.S. vaccine experts said Thursday.
The panel’s unanimous decision has no immediate effect — COVID-19 shots already are recommended for virtually all Americans. Rather, it would put the shots on the annually updated, formal lists of what vaccinations doctors should be routinely offering to their patients, alongside shots for polio, measles and hepatitis.
The expert panel’s decisions are almost always adopted by the CDC director and then sent to doctors as part of the government’s advice on how to prevent disease.
State and local officials often look to the lists in making decisions about vaccination requirements for school attendance, but local officials don’t always adopt every recommendation. Flu and HPV shots, for example, aren’t required by many schools.
Usually, vaccines placed on the schedules are fully licensed, but that has not yet happened for every COVID-19 vaccine product in every age group.
COVID-19 shots initially were approved under emergency authorization measures starting in late 2020. Over time, the government has licensed many of the shots, but full approval has not yet happened for booster doses or for shots for kids younger than 12. Because the shots have already been recommended under emergency authorization for Americans older than 6 months, however, the decision makes no real difference, federal officials say.
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Will you continue to get the COVID-19 vaccine annually, similarly to the flu shot?
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Los Alamos Vaccine & Booster Information |
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How do I know if I'm eligible for a vaccine or booster?
Follow these links to review the CDC eligibility guidelines:
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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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CDC COVID Data Tracker - October 21, 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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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!
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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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Have a question? Email us. |
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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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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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What else would you like to see in this newsletter?
Click below to email us your feedback and questions!
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