Topline COVID Status Report for the week of 6/20/2022

This week’s People’s Health Briefing provides a pandemic update and discusses Children, COVID 19 and the vaccine. Highlights are provided below. For details view the briefing here.

COVID-19 cases and test positivity continue to climb. Wastewater sampling from East Bay MUD also indicates continued increase of SARS-CoV-2 in our environment.

The CDC approved Pfizer and Moderna COVID vaccines for children 6mo – 4yo on June 18, 2022. This will allow an additional 18.7 million children to receive the COVID-19 vaccine. Vaccines are currently being shipped to doctor’s offices, clinics and vaccine sites.

Many are asking: “How important is it to vaccinate young children against COVID?” Here are some points to consider:

  • It is inappropriate to compare child hospitalization and death to adults. Rather, we must compare them with other issues that affect children. Children 6 months – 4 years of age are at risk of severe illness from COVID-19.
  • COVID-19 has caused >2 million cases, over 20,000 hospitalizations, and over 200 deaths among children 6 mos – 4 yrs of age in the US alone. This does not include hospitalization and death from MIS-C (multisystems inflammatory syndrome in children) or other post-COVID issues.
  • COVID-19 hospitalizations among children ages 6 mos – 4 yrs have similar or increased severity compared to older children and adolescents with 25% of those hospitalized going to the ICU.
  • The vast majority (86 – 87%) of children hospitalized for COVID were admitted BECAUSE of COVID (not a coincidental finding) indicating the seriousness of COVID among these children.
  • More than half of hospitalized children ages 6 mos – 4 yrs had no underlying conditions (gray bars below). We still cannot predict who will do poorly with COVID-19, including among children.
  • The burden of COVID-associated hospitalization and death is higher than that of other pediatric diseases that we routinely vaccinate for – this is because we vaccinate children against these other infectious diseases.
  • COVID-19 is now the #4 or #5 cause of death for all pediatric age groups. It is highly concerning for a new cause of death to make it into the top 10 (let alone top 5) causes, especially among children.
  • COVID is the only infectious cause of death in the top 5 causes of death among children. Any time we can safely prevent an infectious cause of death, we should.
  • Other top causes of death represent issues that are grouped together (e.g., accidents include car crashes, drowning, poisoning, etc.; cancer includes tumors, leukemia, etc.), where COVID is a singular infectious cause. Thus, among children, COVID-19 is a significant cause of death.
  • Prior infection is not providing adequate protection against newer SARS-CoV-2 variants compared with vaccination, and does not prevent reinfection. We cannot rely on prior infection to protect children.
  • Future surges will continue to impact children, with unvaccinated children remaining at higher risk of severe outcomes.

Children’s Pfizer and Moderna COVID-19 Vaccine Information:

  • Both vaccines were proven to be safe for children 6 mos – 4 yrs. There were ZERO cases of myocarditis and ZERO cases of anaphylaxis from either vaccine.
  • Both were shown to provide protection against symptomatic COVID-19 disease, and to cause an antibody response similar to the older age groups.
  • The main side effects were similar to adults: fever, arm pain, etc. Fever is similar to that caused by other childhood vaccines.
  • Pfizer is a 3-dose series and Moderna is a 2-dose series. It is difficult to compare these vaccines head-to-head. The ACIP did not express a preference for one vaccine over the other. Decisions may be based primarily on availability and scheduling/spacing differences.
  • The COVID vaccine can be administered at the same time as other vaccines.

Children should not be going to the hospital or dying of a common infection. We keep children from being hospitalized and dying of infectious diseases by vaccinating them. Now that we have the vaccine we should be able to quickly get this infection out of the top 5 causes of death for children!

Reminders:

  • Get vaccinated and boosted: To prevent the most severe and tragic outcomes, vaccination and boosters are still remarkably effective at allowing you to survive even if you catch SARS- COV-2.
  • Make a treatment plan: Determine now whether you would be eligible for treatment and how you would obtain it if you test positive. If you do not have a PCP please get one. Make sure you know how to reach them BEFORE you need treatment.
  • Maintain a balanced diet, exercise, manage stress, consider a multivitamin supplement, and get a good night’s sleep!

Find all weekly topline reports here.

Topline COVID Status Report for the week of 6/13/2022

This week’s People’s Health Briefing provides a pandemic update and discusses how to avoid household spread of SARS-COV-2.

  • We continue to be in a surge and have not reached the peak yet. Recorded cases are high, and for every recorded case there are about 8 more positive tests that are not recorded (e.g., home tests).
  • Since April 1st, 41 people in Alameda County have lost their lives to COVID-19.
  • As the contagiousness of new variants increases, it’s getting harder to avoid infection, but it’s not impossible. Even if we did eventually have to catch it there are reasons to delay: we’ll know more about how to prevent severe outcomes, Long COVID, etc.
  • The more contagious BA.4 and BA.5 sub variants are increasing.
  • The Novavax vaccine (more traditional vaccine technology) has been approved, and the under 5 vaccine is likely to become available in the coming weeks.

Avoiding Household Transmission

  • You CAN keep from catching COVID from a household member.
  • Studies have shown that the unvaccinated are more than twice as likely to catch it within the household. If you are due for a vaccine/booster, please get one.
  • The attack rate is lower when the positive person isolates and masks (~40% compared to ~70%).

  • The potential infectious period should be considered 2-3 days before, through 10 days after the index date (date of the positive test result or symptom onset, whichever was first)
  • The most important thing is to avoid sharing the air! You can do this with good ventilation and filtering the air in the room and on your face (N95).
  • Open windows – as many as possible!
  • Ideally the positive person can stay in an isolation room. This room should be considered contaminated.
    • Virus can be removed from the isolation room through ventilation (windows or HVAC), and filtration (HVAC filter, HEPA filtration unit, or Corsi-Rosenthal Box). HVAC units should have a MERV13 filter or higher (install this now, before you need it!).
    • If you only have one HEPA filter/CR Box, put it in the isolation room. If you have a 2nd one, put it right outside the door, or in any space you must share (like a shared bathroom).
    • To keep virus from going into the rest of the house:
      • Block the gap under the door with a towel
      • If there is a return vent in the isolation room, block it by taping plastic over it.

    • If you must go into the isolation room, both you and the positive person should wear a properly fitting N95 (the one with straps that go around your head). An N95 is “source control” for the positive person and protection/filtration for those who are negative. For a child, use a KN95. Limit your time in the room as much as possible.
  • Increasing the air humidity helps drop the virus to the floor so it can’t be inhaled. Use a humidifier, especially in the isolation room.

Shared spaces and items

  • Wear a N95 in all common areas and when in the same room together.
  • Virus can remain suspended in the air even after the positive person leaves. Wait as long as possible before entering a space they were in, and/or wear an N95 mask.
  • The positive person should have their own set of utensils, towels, etc. that are not shared during the infectious period. Sanitize shared surfaces.

Bathrooms

  • If possible, the positive person should use a separate bathroom from everyone who is negative
  • Leave the exhaust fan running at all times (consider taping the switch on), and keep windows open.
  • Wait as long as possible before entering after the positive person, especially if either/both of you are not wearing a mask like brushing your teeth, showering, etc.
  • Remember that humidity helps (i.e., shower) and can be used to your advantage.
  • Close the toilet lid before flushing.

Make a treatment plan. Determine now whether you would be eligible for treatment and how you would obtain it in the event you test positive.

Test yourself every 1-2 days until two days after the positive person tests negative, or at least 10 days past index day, and immediately if symptoms begin. Consider a PCR test for greatest accuracy.

Find all weekly topline reports here.

Topline COVID Status Report for the week of 6/7/2022

This week’s People’s Health Briefing provides a pandemic update and discusses local mask mandates and vaccine updates.

Cases continue to rise statewide and nationwide despite significant undercounting. It is estimated that for every one confirmed case, there are another 8 positive home tests that go unrecorded. In Alameda County, 38 people have died of COVID since April 1, 2022. Hospitalizations (including ICU) are continuing to rise sharply. In addition, disparities are beginning to reemerge.

For these reasons, mask requirements have been reinstated in Alameda County as of June 3, 2022. “Rising COVID cases in Alameda County are now leading to more people being hospitalized and today’s action reflects the seriousness of the moment,” said Alameda County Health Officer Dr. Nicholas Moss. “We cannot ignore the data, and we can’t predict when this wave may end. Putting our masks back on gives us the best opportunity to limit the impact of a prolonged wave on our communities.”

Boosters – CDC is recommending:

  • 1st booster for all 5+ at least 5 months after the primary series
  • 2nd booster for all 50+ and 12+ with immunocompromise at least 4 months after the 1st booster

If you are not sure if you or your child is due for a booster, you may use the CDC’s new tool.

The BA4 and BA5 subvariants are much more contagious and evade prior immunity to a greater extent than previous subvariants, and are quickly out-competing the dominant BA2.12.1 variant.

Post-infection vaccination: people who recently had SARS-CoV-2 infection may consider delaying their next vaccine dose by 3 months from symptom onset (or positive test if no symptoms). This is in response to studies showing that an increased time interval between infection and vaccination may result in an improved immune response to vaccination, and the risk of reinfection is lower in the weeks to months following infection.

Note: please seek medical advice for any unexplained rash as we work to stay ahead of the emerging Monkeypox outbreak.

Topline COVID Status Report for the week of 5/23/2022

  • Case rates are far undercounted due to home testing – still, COVID cases and test positivity continue to rise. Hospitalizations are continuing to creep up across the Bay Area as well.
  • Today’s People’s Health Briefing provides a pandemic update and discusses COVID and children.
  • 200,000 children have lost one or both parents to COVID-19 (this number goes up to 214,400 when you include the death of custodial grandparent). Orphanhood due to COVID-19 estimates can be found here.
  • In the US: over 1,200 children have lost their lives to COVID-19; over 8,000 children have experienced multisystem inflammatory syndrome in children (MIS-C). And over 13.3 million children have been diagnosed with SARS-COV-2. We are still learning about the impact of post-COVID / Long COVID on children.
  • Update on the worldwide outbreak of liver failure in children:
    • So far over 600 children have unexplained liver injury worldwide.
    • In the US, at least 180 children in 36 states have unexplained liver injury, 15 have required a liver transplant and 6 have died. The average age in these cases is 2 years old (too young to be vaccinated) and the majority are unvaccinated.
    • A child with liver failure is bumped up to the top of the list for organ transplant because without it they will die. According to the United Network for Organ Sharing, about 400 children are already waiting for a liver transplant.
    • It is unclear what role SARS-CoV-2 plays in this new outbreak, although prior COVID infection has been identified as a potential culprit by several countries, SARS-COV-2 is known to cause liver injury, and the timing of this outbreak is highly concerning for a correlation.
    • This is an evolving situation and an active investigation. We will continue to update as more information becomes available.

CDC expanded eligibility for COVID-19 vaccine booster doses for children 5 through 11, stating these children should receive a booster dose at least 5 months after their primary series. Primary series vaccination in this age group continues to lag behind, leaving young children vulnerable to serious illness and post- COVID issues. Over 18 million doses have been administered to children in this age group with no safety signal – vaccination remains the best way to protect children from severe or long-term consequences.

  • Given all of the above, we need to PROTECT CHILDREN from catching COVID-19 using masking, distancing, ventilation/filtration, testing, and vaccination. REMEMBER: COVID IS AIRBORNE!
  • CDC also strengthened its recommendations for those 50+ and 12+ with immunocompromise *should* (previously “may”) receive a second booster.
  • If you do catch COVID: determine if you should be treated (here’s the long list of conditions that make you eligible), what treatment you’d get, and where you’d get it from. Ideally you should get it from your primary care doctor – if you don’t have one, please get one! Several locations are providing “Test to Treat” for those who do not have a primary care provider, or who cannot get the medication from them. You can locate sites for Test to Treat here. And here is information on the available treatments, in general order of preference:

Always remember to eat a nutritious diet, get some exercise and fresh air, consider a multivitamin + vitamin D, manage your stress and get a good night’s sleep. COVID is not over. Please continue to protect yourselves, your loved ones and your community.

Topline COVID Status Report for the week of 5/17/2022

  • Cases are on the rise and have surpassed Delta surge levels nationwide and locally. Hospitalizations are slowly increasing as well.

  • Community transmission is considered “High” in Alameda, Contra Costa, Santa Clara, San Francisco, Solano, San Mateo, Marin, Napa Counties and beyond. As a result, the 12 Bay Area Health Officers put out this press release urging individuals to wear a high quality, fitted mask especially indoors. REMEMBER: COVID IS AIRBORNE.

  • Proms, graduations and graduation parties are already resulting in outbreaks. Multi-generational gatherings are of particular concern. If you choose to gather, eat & drink outdoors whenever possible. If indoors, assess ventilation and crowding – mask accordingly. Ensure you are current on your vaccines, including boosters! Use well-fitted KN95/N95 masks, especially indoors. Consider testing immediately pre-event for all attendees. After the event: avoid or mask around high-risk people for the next week, be alert for new symptoms, and consider post-event testing (ideally days 3 & 5).

  • Today’s People’s Health Briefing addresses the question: “Aren’t we all going to get COVID anyway? Why try to avoid it?”

  • According to a recent estimate over 40% in the US still have not caught COVID. That’s a lot of people!

  • Post-COVID effects include organ damage, stroke, and long-term symptoms that are disabling millions already. The current burden of Long COVID in your area can be estimated here.

  • Our children are at risk. 1,213 children have already died in the US as a direct result of COVID (for comparison, in the same time frame, 29 children died of the flu). Over 8,000 more have had multiple organ failure, over 100,000 have been hospitalized, many in the ICU.

  • There is a new worldwide outbreak of liver failure in children. So far 450 children have unexplained liver injury, 26 of them required liver transplants and 12 have died. Although UK and US media are downplaying the connection, prior COVID infection is a lead suspect. This is an evolving situation and we are awaiting more information.

  • You can catch COVID more than once, especially because the latest variant (BA2.12.2) is more contagious, and avoids immunity you may have from previous infections. Every COVID infection is another opportunity for a poor outcome, and another opportunity for Long COVID.

  • We’re continuously learning and developing better ways to deal with COVID. We now have treatments we didn’t have before. We will soon have a vaccine for under 5 year olds. There are promising vaccines and treatments like nasal spray that deliver immunity right where we need it. Scientists all over the world are working on understanding long COVID, post-COVID strokes, hepatitis, and brain fog. Even if you have to catch COVID, the more we know at that point, the better.

  • Based on all of the above, we should continue to assess personal risk and the risk of each activity. If you choose to engage in higher risk activities, take steps to protect those around you. We do not want to lose anyone else to this virus.

  • If you do catch COVID:

    • Determine if you should be treated! Here’s the list of conditions that make you eligible (hint: there are a LOT of qualifying conditions!)
    • Stay isolated until you test negative! Great graphic from Monroe County Indiana:

  • Don’t throw away expired antigen tests! Expiration dates were extended. Look up iHealth and Binax lot numbers if in doubt.

 
Always remember to eat a nutritious diet, get some exercise and fresh air, consider a multivitamin + vitamin D, manage your stress and get a good night’s sleep.
COVID is not over. Please continue to protect yourselves, your loved ones and your community.