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Expert Panel Tackles Boosters, Younger Patients, Rising COVID Cases

Find the latest COVID-19 news and guidance in Medscape’s  Coronavirus Resource Center .

It’s been 18 months sine a public health emergency was declared in the United States because of SARS-VoV-2 and questions still swirl around the crisis, as evidenced by an expert panel on Tuesday trying to come up with some hard answers.

Even as the debate over the timing and need for COVID-19 booster shots continues, how safe is it for the fully vaccinated to get a third dose? As cases and hospitalizations rise in some younger people and some areas of the country, are deaths truly down or just delayed? Could the delta variant eventually make ‘long haul’ COVID-19 symptoms worse?

Experts from the Centers for Disease Control and Prevention (CDC) and the Infectious Diseases Society of America (IDSA) addressed these and other uncertainties during a media briefing July 13.

But first a snapshot of the current pandemic picture in the US. “After several months of falling numbers of cases, followed by a prolonged plateau period, we are seeing an increase in the number of cases in many parts of the country,” said Jay C. Butler, MD, deputy director for infectious diseases at the CDC.

Missouri, Arkansas, Nevada, Utah, and Florida, for example, are seeing greater increases in cases than elsewhere, Butler said. “So [its] those areas where CDC is working closely with state, local or tribal health officials to be able to address the flare-ups.”

Nationwide, the reported cases of COVID-19 are around 15,000 daily,up from approximately 10,000 just a few weeks ago. The test positivity rate nationwide “is also bumping up a bit” to 3.5%, Butler said.

Currently we have not seen an increase in the number of deaths,” he added, “but I would caution that the number of deaths generally lags a couple of weeks behind any increases in the number of cases.”

As an example, in Utah average weekly cases recently have increased 2.5-fold, Andrew T. Pavia, MD, said during the media briefing.

“it has not reached the levels of January or December” but the differences in cases is “pretty substantial,” added Pavia, chief of the Division of Pediatric Infectious Diseases University of Utah School of Medicine in Salt Lake City.

Pavia added that Utah’s ICUs are “again running at above 100% capacity” but they have not yet had to open auxiliary units.

Given the recent numbers, Pavia shared Butler’s concern that death rates could increase in the coming weeks.

How Safe Is a Third Vaccine Dose?

Butler emphasized that the available COVID-19 vaccines continue to be effective for protection against severe illness and death. “We see some breakthrough infection in people who are vaccinated. However, we are not seeing evidence that earlier vaccination during the period of availability of the vaccine is driving that.

“Put another way, we’re not seeing evidence at this point in time that waning immunity is occurring among people who are vaccinated,” Butler said.

Even so, controversy continues to swirl around the need and timing for a booster shot. This issue has even pitted a vaccine manufacturer, Pfizer, against US health officials. High-level meetings this week left US scientists unconvinced of an urgent need.

In the meantime, a reporter asked: how safe is it for fully vaccinated people to seek a third or booster vaccine on their own?

“That’s an important question,” Butler said, adding that the CDC is collecting data on any possible safety concerns regarding booster shots.

Rare vaccine side effects and local site reactions to COVID-19 vaccination tend to occur more frequently after a second dose, he pointed out.

“So we’re keenly interested in knowing whether or not a third dose may be associated with any higher risk of adverse reactions, particularly some of those more severe although very rare side effects,” he said.

Why Timing Is Important

Pavia pointed out that there is a balance associated with the timing of a booster shot.

Premature widespread administration of booster shots “would use up a lot of vaccine that much of the world needs, as well as divert our efforts from getting people their first dose of vaccine,” Pavia said.

“But if we wait too long then we’re going to have a lot of people who become susceptible again,” he added.

“This is an area where people want answers before we have data,” Pavia said. The National Institutes of Health have several ongoing studies evaluating a third dose, including people who continue with the same brand or who switch vaccines in a “mix-and-match fashion,” he added. 

“We hope to get answers soon,” Pavia said.

Butler added that researchers are also evaluating the safety and efficacy of a third dose in “the two groups that we’re most concerned about.” Studies of boosters in people over age 75 who are at highest risk for COVID-19, as well as for people who are immunocompromised, are underway as well.

The US Food and Drug Administration and the CDC’ Advisory Committee on Immunization Practices will likely use results from those trials and others “to determine if, when and for whom boosters would be indicated,” Butler said.

Cases Shifting to Younger People

Infection and hospitalization rates are highest among people ages 15 to 45  years old, Pavia noted.

“Even though we’re seeing a higher proportion of cases in younger people, I don’t think we’re seeing more severe illness in those kids who acquire COVID-19,” Butler said. 

Pavia agreed that COVID-19 tends to be less serious in children compared to adults and especially older adults. However, he added, “as somebody who takes care of very sick kids, it drives me crazy to hear over and over again that the virus is not serious for children.”

“By every measure the impact is greater than the impact of influenza,” Pavia added. If the COVID-19 vaccines are proven safe and effective for 6- to-11-year-olds and for younger children, it would be foolish not to vaccinate them.”

“If your child is the one who ends up in the ICU for a week, or if your child develops long COVID and flunks out of a semester of school and doesn’t get to college or loses their athletic scholarship,” Pavia said, “there’s nothing mild about that.”

Unanswered Questions

A journalist asked, now that the delta variant is surging in the US, how that might affect efforts to achieve herd immunity?

“If you talk to a hundred infectious disease specialists, you’ll probably get a hundred different answers in terms of that question about herd immunity,” Butler said. In part because of the continuously changing pandemic picture, “I think that’s a very difficult number to be able to estimate with any degree of certainty.”

Another potential issue that remains to be seen is whether the delta variant could alter ‘long haul’ COVID-19 recovery.

“Certainly there are ongoing studies evaluating long COVID and that will be overlayed with the emerging variant data,” Butler said.

However, it’s too early to discern any difference in outcomes, he added. “The delta variant has been with us only a few weeks.”

Based on a July 13 media briefing sponsored by the Infectious Diseases Society of America.

Damian McNamara is a staff journalist based in Miami. He covers a wide range of medical specialties, including infectious diseases, gastroenterology and critical care. Follow Damian on Twitter:  @MedReporter.

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This post originally posted here Medscape Medical News

Eurozone warning: Delta variant and surging cases could spark crisis – stark analysis

A new survey by Reuters showed nearly nine out of 10 economists polled warned new Covid variants are the biggest risk to the eurozone, which they currently believe will grow by 4.5 percent in 2021. In addition, the latest coronavirus tracker from Reuters has revealed infections, while in most cases remaining below their historic highs, are rising in all but a handful of European countries. Oxford Economics has also collected data that shows the Delta variant now accounts for most new Covid cases in Britain, Portugal and Austria, and over 40 percent of infections in Germany, Spain and Denmark.

The researchers said the impact on the respected economies is hard to predict at the moment.

However, those countries with higher vaccination rates can take some comfort from the muted rise in hospitalisations and death rates in Britain and Israel.

Speaking in Parliament on Monday, the UK’s newly-appointed Health Secretary Sajid Javid confirmed all remaining restrictions in England will be lifted from next Monday, although he and Prime Minister Boris Johnson have urged the population to continue being cautious.

But in a huge warning from a research note from July 12, Oxford Economics said: “Nonetheless if economies reopen and allow cases to surge, the economic gains could prove illusory if Covid-related absences trigger major disruption to businesses and higher cases prompt greater voluntary social distancing.”

Governments throughout Europe are so far refusing a return to full lockdowns over fears of a repeat of the devastating economic impact and the possibility of denting the strong rebound in activity during the last quarter.

But in France, Emmanuel Macron has announced mandatory proof of vaccination or negative tests for some public spaces, coming days after Portugal, the Netherlands and some areas of Spain reintroduced restrictions.

The French President said all health workers in the country must get Covid jabs by September 15, adding vaccination would not be compulsory for the general public for now but stressed that restrictions would focus on those who are not vaccinated.

He said in a televised address to the nation: “We must go towards vaccination of all French people, it is the only way towards a normal life.”

READ MORE: You’re on your own, Emmanuel! Merkel breaks EU ranks with France

Officials in the country are adamant Covid measures should remain in place until more of the country has been vaccinated.

But German Economy Minister Peter Altmaier said a new lockdown would be “absolutely the worst thing and to be avoided at all costs”.

The Netherlands has cited the rising Delta variant as the reason for reintroducing strict measures for nightclubs, festivals and restaurants on Friday.

In Spain, the northern Catalonia region has cut bar opening hours and towns in nearby Valencia have been authorised to bring back curfews.

The whole of Europe is keeping a close eye on developments in England when restrictions are lifted from next Monday, with many officials regarding Boris Johnson’s reopening plan as extremely risky.

Workers will still have to self-isolate when notified by an official app – but that has consistently led to significant labour shortages in hospitality and other sectors.

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This post originally posted here Daily Express :: World Feed

EU Covid panic! Nations reimpose strict measures as cases surge

Spain has seen cases rise from 157 per million to 316, with some areas seeing restrictions reimposed.

Catalonia has reimposed curbs on nightlife in an effort to tame an increase mainly among unvaccinated young people.

After an “exponential” rise in cases in recent days, officials in the autonomous region in the northeast of Spain said they had no choice but to reimpose restrictions.

Patricia Plaja, a spokeswoman for the regional government told a news conference: “The pandemic has not ended, the new variants are very contagious and we still have significant segments of the population that are not vaccinated.”

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The US is averaging about 19,455 new cases over the last seven days, a 47% increase from the week prior. A third of those come from five hotspots, expert says

The US is averaging about 19,455 new cases over the last seven days, a 47% increase from the week prior, according to data from Johns Hopkins University. And a third of those, CNN Medical Analyst Dr. Jonathan Reiner said, come from five hotspots: Florida, Louisiana, Arkansas, Missouri and Nevada.
“In places like Missouri where ICUs are packed, you’re going to see a surprising amount of death,” Reiner said on Sunday.
At Mercy Hospital in Springfield, Missouri, 91% of ICU patients are on ventilators and many are in their 20s, 30s and 40s, Chief Administrative Officer Erik Frederick told CNN Saturday. That is especially concerning, he said, because at the peak last year there were only 40 to 50% of ICU patients on ventilators.
Typically, increases in Covid-19 death rates follow three to four weeks behind spikes in cases, Reiner said. It takes a week for patients to get sick enough to need hospitalization and then often another couple of weeks for the infection to become fatal.
“We will start to see an increase in mortality in this country,” Reiner said.
What is particularly frustrating for many experts, Reiner said, is that the deaths are “completely avoidable” now that vaccines are available.
But about one third of those 12 and older in the US haven’t received the vaccine yet, CDC data shows.
“The vaccines we have work really well against this variant. It doesn’t need to be this way,” Reiner said.

Experts weigh whether vaccinations should be mandated

Much of the rising cases have been attributed to the now dominant Delta variant, which is believed to be more transmissible. And the variant has sparked discussions over local vaccination mandates.
Across the US, 48% of the population is fully vaccinated, but in some states that number is much lower, according to CDC data. Alabama, Arkansas, Louisiana, Wyoming and Mississippi all have around 35% or less of their populations fully vaccinated.
Experts say vaccines are key to managing spread. With information changing rapidly, it is important to be smart about how vaccinations are mandated, Professor of Medicine George Washington University School of Medicine Dr. Gigi El-Bayoumi said.
“In states where there are high vaccination rates, that are like 75 or above, it makes sense to loosen up the restrictions. In places where there are not, such as some of the Southern states, it makes sense” to mandate vaccinations, El-Bayoumi said Sunday.
Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Disease, told CNN he thinks it’s a good idea for mandates at the local level.
“We’re talking about life and death situation. We’ve lost 600,000 Americans already, and we’re still losing more people. There’ve been 4 million deaths worldwide,” Fauci said. “This is serious business.”
He added that he expects vaccine mandate hesitancy to lift when vaccines are fully approved.
Right now, the available Covid-19 vaccines are being administered under emergency use authorizations, which Fauci said has made some people skeptical as to their safety and efficacy. But the amount of data that supports the importance and safety of the vaccines is more than anything experts have seen for an EUA, he said.
“These vaccines are as good as officially approved with all the I’s dotted and T’s crossed,” Fauci said.

Pfizer to brief the US on boosters

Another concern for many experts as variants spread is whether the population will need boosters for their vaccines.
Pfizer will virtually brief US government officials Monday evening regarding the potential need for booster shots of its Covid-19 vaccine, a company spokesperson and two administration officials confirmed to CNN.
The meeting is seen as a courtesy, and federal guidance on boosters is not expected to change immediately following the meeting, a senior health official said.
Last week, Pfizer/BioNTech reiterated their expectation that people may need boosters to their vaccinations in six months to a year, citing waning immunity they are seeing among people who received their vaccine. The company also said it would seek emergency use authorization for a booster from the US Food and Drug Administration in August.
But some experts have argued the data is showing boosters are not necessary yet.
“Americans who have been fully vaccinated do not need a booster shot at this time,” the US Centers for Disease Control and Prevention and the FDA said. “FDA, CDC, and NIH (the National Institutes of Health) are engaged in a science-based, rigorous process to consider whether or when a booster might be necessary.”
Fauci also disputed the need at this time on CNN’s “State of the Union.”
“Given the data and the information we have, we do not need to give people a third shot, a boost, superimposed upon the two doses you get with the mRNA (Pfizer/BioNTech and Moderna vaccine) and the one dose you get with (Johnson & Johnson),” he told CNN’s Jake Tapper
Fauci said that there are ongoing studies evaluating if and when the US will recommend booster shots.

India reports less than 50,000 daily Covid-19 cases for 11 consecutive days

Continuing a declining trend, India has been reporting less than 50,000 daily active cases of Covid-19 infection for 11 continuous days. The country’s Active Caseload on Thursday stands at 4,60,704 and active cases are now only 1.50% of the country’s total Positive Cases.

In the last 24 hours, India has reported 45,892 new cases.

“This is a result of sustained and collaborative efforts by the Centre and the States/UTs,” said the Union Health ministry in a statement.

On another front, India’s cumulative vaccination coverage exceeded 36.48 crore on Thursday as per the provisional report till 7 am.

A total of 36,48,47,549 vaccine doses have been administered through 47,40,833 sessions, as per the provisional report till 7 am. 33,81,671 vaccine doses were administered in the last 24 hours.

The new phase of universalization of COVID19 vaccination commenced from June 21.

“The Union Government is committed to accelerating the pace and expanding the scope of COVID19 vaccination throughout the country,” the Health ministry said.

UK reports another 31,772 coronavirus cases

Britain has reported another 31,772 coronavirus cases in the latest 24-hour period, bringing the total number of coronavirus cases in the country to 5,121,245, according to official figures released Sunday, Trend reports citing Xinhua.

The country also recorded another 26 coronavirus-related deaths. The total number of coronavirus-related deaths in Britain now stands at 128,425. These figures only include the deaths of people who died within 28 days of their first positive test.

More than 45.8 million people in Britain have received the first jab of COVID-19 vaccine and over 34.7 million people have received two doses, the official figures showed.

British Prime Minister Boris Johnson will be able to confirm on Monday that restrictions will be lifted on July 19 as planned despite the surge in cases, Sky News quoted Nadhim Zahawi, the British vaccines minister, as saying.

Covid cases are rising and where the vaccination rates are lower than 40%

More than 9 million people live in counties where Covid cases are rising and where the vaccination rates are lower than 40%, CDC chief warns
“Somehow there has been this understanding that vaccination is just about you, and yes — it’s true, vaccination, of course, protects the individual very well against getting Covid-19 and getting severely ill,” she told CNN Saturday. “But we also get vaccinated to protect people around us … because we know that there is a risk of breakthrough infections.”
Experts have noted clear links between unvaccinated populations and higher incidence of Covid-19 cases, particularly of the highly contagious Delta variant.
Dr. Rochelle Walensky, who heads the US Centers for Disease Control and Prevention, said Thursday that more than 9 million people live in counties where cases are rising and where the vaccination rates are lower than 40%.
“Many of these counties are also the same locations where the Delta variant represents the large majority of circulating virus,” she said.
Friday, the US surpassed 20,000 new Covid-19 cases for the fourth day in a row. The last time the country had back-to-back days of cases topping 20,000 was in May.

Missouri, Arkansas and Mississippi are hit hard

In Missouri, only about 40% of the population is fully vaccinated, and doctors there say the number of hospital rooms and available equipment is running low, especially as more young people become ill.
“We are seeing more people 30 years and older getting sicker and requiring hospitalization. Also, we have seen that in this wave, each person is getting sicker faster,” said Dr. Mayrol Juarez at Mercy Hospital in Springfield, where they’ve had to bring in ventilators from other hospitals due to the sharp increase in Covid-19 patients there.
The state’s health department estimates more than 70% of the virus circulating in the state is the Delta variant.
About 91% of the ICU patients at Mercy Hospital in Springfield are on ventilators, according to the hospital’s chief administrative officer, Erik Frederick.
“That is shocking to us, to have that kind of number,” he told CNN’s “Newsroom” on Saturday. “These are young patients — you have them in their 20s, 30s, 40s — again, it’s alarming, (and) a direct line to the vaccination rates.”
About 35% of Arkansas’ population is fully vaccinated, according to CDC data, and new daily case numbers have recently climbed back to more than a thousand a day, state health officials said.
“Arkansas is on the upward surge of a third wave of Covid-19 here in our state and it’s tilting towards younger people,” said Dr. Cam Patterson, chancellor for the University of Arkansas for medical sciences. “We’re also seeing breakthrough infections in individuals who are immunocompromised.”
A surge is also alarming officials in Mississippi, where only a third of the population is fully vaccinated.
“We’ve seen almost an entire takeover in the Delta variant,” said State Health Officer Dr. Thomas Dobbs.
Case numbers and hospitalizations are trending upward because of the spread of the virus mostly among those who are unvaccinated, State Epidemiologist Dr. Paul Byers said.
While the number of deaths hasn’t risen, Byers said they anticipate that to change because death numbers tend to lag behind case numbers.
The state is advising seniors aged 65 and older to avoid mass gatherings until July 26, regardless of vaccination status.
Overall, 47.9% of the US population is fully vaccinated while 20 states have fully vaccinated more than half of their residents.

Will we need a booster?

After Pfizer announced Thursday that it’s working to develop a third vaccine booster shot, questions emerged about the long-term effectiveness of vaccines.
In response, Dr. Anthony Fauci said people should take booster advice from federal health officials.
“Certainly, they need to listen to the CDC and the FDA, the FDA being the regulatory authority that has control over this. And the CDC, in accordance with their advisory committee on immunization practices, will make the recommendation,” said Fauci, director of the National Institute of Allergy and Infectious Diseases.
“We respect what the pharmaceutical company is doing, but the American public should take their advice from the CDC and the FDA,” he said.
Dr. Peter Hotez, chair of tropical pediatrics at Texas Children’s Hospital, said the current vaccines offer high protection.
“It looks like the two doses of the current vaccine are pretty robust against the Delta variant,” Hotez said Friday. “So yes, we’ll need a booster, but nothing to worry about right now in terms of vaccination.”
Pfizer said it was seeing waning immunity from its vaccine — manufactured in partnership with BioNTech — and was picking up its efforts to develop a booster shot to offer further protection against variants.

Federal guidance on school in fall encourages in-person learning

Meanwhile, the CDC on Friday said schools should prioritize in-person schooling in the fall but it was crucial to layer safety strategies such as masking and physical distancing, and most importantly, vaccinations for everyone eligible.
Schools that are ready to transition away from pandemic precautions as community transmission reaches low levels should do so gradually, the agency said in a draft of the guidance obtained by CNN.
“If localities decide to remove prevention strategies in schools based on local conditions, they should remove them one at a time and monitor closely (with adequate testing) for any increases in COVID-19 cases before removing the next prevention strategy,” the guidance says, adding that schools need to be transparent with families, staff and the community as they do so.
Fauci agrees, adding that unvaccinated children should wear masks.
“I think that the message from the CDC is clear and I totally agree with them,” Fauci told CNN. “We want all the children back in in-person classes in the fall term.”
Getting more people vaccinated will assist in that effort, many experts say.
“We have to remember that all of us from Little Rock Arkansas to New York City to San Francisco to Boston to Anchorage, we are all in this together,” said Dr. Robert Hopkins, chair of the National Vaccine Committee. “This is an international problem. We need everyone vaccinated, that can be vaccinated.”

Coronavirus cases deaths drop but still too high


New coronavirus cases dropped from 2 683 yesterday to 1 787 and deaths from 55 to 42 but they are still too high as in March Zimbabwe had only 793 cases, in April 1 375, and in May 704.

Cases have already risen to 16 989 this month and deaths to 337, second only to January when there were 854 deaths.

Total deaths now stand at 2 126 and cases at 66 853 but only 20 147 are still active.

Mashonaland West had 584 new cases today pushing the number of active cases in the province to 4 246. Harare is in second place with 2 884 active cases. It had 326 new cases today. Mashonaland East had 191 new cases and now has 2 521 active cases. Bulawayo has 1 539.

Recoveries slowed down to 559 with 164 in Matebeleland North followed by Masvingo with 98 and Harare with 91.

Vaccination also slowed down to 13 000 with 11 437 getting the first jab and 1 688 the second.

The government is aiming to achieve herd immunity in Harare and Bulawayo first to stop the spread of the pandemic and has given the two metropolitan provinces double the doses it allocated to each of seven provinces, excluding Mashonaland West. Each province was allocated 50 000. Mashonaland West will get 90 000.


Update: 22 new corona infection cases registered in Oslo in the last 24 hours

A total of 22 new corona infection cases have been registered in Oslo in the last 24 hours – three below the average for the previous seven days.

In the last two weeks, an average of 22 infection cases has been registered per day.

The infection rates are highest in the Nordstrand district, with 76 infected people per 100,000 inhabitants in the last two weeks. Nordstrand is followed by the districts of Frogner (74) and St. Hanshaugen (67).

The Alna district currently has the lowest infection rates, with 20 infected people per 100,000 inhabitants in the last two weeks.

A total of 37,641 Oslo citizens have been registered as infected with coronavirus since March last year.

Source: © NTB Scanpix / #Norway Today / #NorwayTodayNews

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Africa’s COVID-19 cases surpass 5.87 mln – Africa CDC

The number of confirmed COVID-19 cases in Africa reached 5,873,990 as of Saturday afternoon, the Africa Centers for Disease Control and Prevention (Africa CDC) said, Trend reports citing Xinhua.

The Africa CDC, the specialized healthcare agency of the African Union, said the death toll from the pandemic stands at 150,517 while 5,117,334 patients across the continent have recovered from the disease.

South Africa, Morocco, Tunisia, Ethiopia and Egypt are the countries with the most cases in the continent, according to the Africa CDC.

In terms of the caseload, southern Africa is the most affected region, followed by the northern and eastern parts of the continent, while central Africa is the least affected region in the continent, according to the Africa CDC.