Covid-19 Updates & Info

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Re: Covid-19 Updates & Info

#826

Post by ponchi101 »

Suliso wrote: Thu May 06, 2021 6:59 pm ...

What Western governments ought to do is help subsidise this cost for those countries where even this is too much, also pay for extra doctors and distribution networks. In the more medium term incentivize vaccine production regionally by capable pharma partners (for sure there ought to be a big producer in Latin America).

...
I know I am extreme in this position, but L. America simply could not care less about science, so, as far as I am concerned, we can go to hell in that aspect. Western govts could try to subsidize our vaccine production facilities and rest assured, that money would go into some fat cat's pockets. Remember I said this: Colombia has ZERO vaccine production capabilities, not for C19 but for any kind of vaccine because years ago the GOVT decided to drop all support for that sector of health care. All vaccines are purchased from abroad because, I suspect, some people make money from the imports.
So now we are screwed. And this country asked for it.
Ego figere omnia et scio supellectilem
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Re: Covid-19 Updates & Info

#827

Post by ti-amie »

The sad thing is you can't ignore these idiots because their lies spread so quickly on social media.



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Re: Covid-19 Updates & Info

#828

Post by dryrunguy »

Yet again, I forgot to share the most recent Situation Report distributed on Friday. So it's probably a little out of date. I haven't read it myself, yet.

::

EPI UPDATE The WHO COVID-19 Dashboard reports 156 million cases and 3.2 million deaths worldwide as of 5:30am EDT on May 7.

India continues to set new global records in terms of total daily incidence. It is currently reporting a 7-day average of nearly 390,000 new cases per day, and it could surpass 400,000 in the next several days. India has reported more than 400,000 new cases on each of the past 2 days, including a new global record of 414,188 on May 6. Among the top 10 countries globally, India is the only one currently reporting increasing daily incidence.

As India’s COVID-19 epidemic continues to surge, Asia is the #1 continent globally in terms of total daily incidence. Countries in Asia are reporting more than 4 times the daily incidence as any other continent. South America and Europe are #2 and #3, respectively, reporting nearly the same daily incidence. North America is reporting slightly more than half of the daily cases in Europe and South America. Countries in Africa and Oceania continue to largely contain their respective COVID-19 epidemics, with approximately 8,500 new cases per day in Africa and 100 in Oceania. On a per capita basis, Asia (107 daily cases per million population) is sitting right at the global average (102). It is not surprising that the global average aligns closely with Asia, considering that the continent represents approximately 60% of both the global population and the current global daily incidence. North America is reporting similar per capita daily incidence, with 104. At 269 daily cases per million, South America’s per capita daily incidence is more than 150% higher than the global average, followed by Europe, with 146 daily cases per million. As with total daily incidence, Africa and Oceania are reporting much lower per capita totals—only 6.4 and 2.6, respectively.

In terms of total cumulative incidence, Europe is still #1 globally, with more than 45 million cases. Asia (42 million) surpassed North America (38 million) on April 26 to become #2, and if it continues on this trajectory, it will soon overtake Europe. South America is #4, with 25 million cases. The epidemics in Europe and North America are both tapering off, while Asia’s and South America’s are still accelerating. There have been 4.6 million cases in Africa and fewer than 45,000 in Oceania. Notably, there are 6 individual countries—the US, India, Brazil, France, Turkey, and Russia—that have each reported more cumulative cases than the whole of Africa. On a per capita basis, North America (#1), Europe (#2), and South America (#3) have all reported 3 times the cumulative global average or more. Asia is #4, but it has reported less than half the global per capita average. Africa has reported 17% of the global average, and Oceania is at 5%.

Global Vaccination
The WHO reported 1.17 billion doses of SARS-CoV-2 vaccines administered globally, including 597 million individuals with at least 1 dose. Our World in Data reported 1.24 billion cumulative doses administered globally. This is an increase of 11% over the previous week, slightly less than the 13% weekly increases exhibited over the previous several weeks. The daily doses administered continues to decrease, down from a high of 20.6 million doses per day on May 1 to 17.4 million—a 16% decrease in just a week. Our World in Data estimates that there are 298 million people worldwide who are fully vaccinated, although reporting is less complete than for other data.

Of the 191 countries and territories reporting COVID-19 incidence data, 125 are reporting data on the number of people who are fully vaccinated. These predominantly represent Europe, North and South America, and South and Southeast Asia. Data are missing for numerous countries in Africa and the Caribbean, Central Asia, and Eastern Mediterranean regions. Other notable countries missing data include Australia and China. In terms of the proportion of the population that is fully vaccinated, Seychelles (61%) has surpassed Israel (59%) as #1 globally. These are the only 2 countries reporting more than 50% coverage. The UAE (39%) is #3, followed by Chile (37%) and Bahrain (33%) to round out the top 5. By region, 5 of the top 10 countries are in Europe, 2 are in the Eastern Mediterranean, and 2 are in the Americas. Seychelles is the only country in Africa. Among the reporting countries, the median coverage is 6.8%, and most countries fall between 1.4% and 13.0%.

UNITED STATES
The US CDC reported 32.4 million cumulative cases and 576,238 deaths. Daily incidence continues to decrease, down to 45,816 new cases per day, the lowest average since October 7, 2020. Daily mortality has increased over the past week or so, up from a recent low of 631 deaths per day on April 27 to 674 on May 4—a 7% increase over that period—before decreasing to 656 on May 5. Over the course of the US epidemic, trends in daily mortality have generally lagged 3-4 weeks behind trends in daily incidence; however, since early April, the trends appear to be slightly disconnected. For example, following the brief surge in daily incidence from mid-March to mid-April, we did not observe a similar surge in mortality, as we would have expected based on historical trends. We will continue to monitor these trends over the coming weeks.

US Vaccination
The US has distributed 325 million doses of SARS-CoV-2 vaccine and administered 252 million doses. Daily doses administered* continues to decrease, down from a high of 3.3 million (April 11) to 2.1 million. Approximately 1.3 million people are achieving fully vaccinated status per day, down from a high of 1.8 million per day on April 12.

A total of 149 million individuals have received at least 1 dose of SARS-CoV-2 vaccine, equivalent to 45% of the entire US population and 57% of all adults. Of those, 109 million are fully vaccinated, which corresponds to 33% of the total population and 42% of adults. Among adults aged 65 years and older, progress has largely stalled at 83% with at least 1 dose and 70% fully vaccinated. In terms of full vaccination, 56 million individuals have received the Pfizer-BioNTech vaccine, 45 million have received the Moderna vaccine, and 8.6 million have received the J&J-Janssen vaccine.
*The US CDC does not provide a 7-day average for the most recent 5 days due to anticipated reporting delays for vaccine administration. This estimate is the most current value provided.

The Johns Hopkins Coronavirus Resource Center is reporting 32.6 million cumulative cases and 580,076 deaths in the US as of 10:15am EDT on May 7.

VACCINE INTELLECTUAL PROPERTY In an historic move, the US government on May 5 announced its support for temporarily waiving intellectual property (IP) rights for SARS-CoV-2 vaccines, vowing to actively participate in negotiations at the World Trade Organization (WTO) on a proposal aimed at increasing vaccine production to reach low- and middle-income countries (LMICs). The administrations of former US presidents have supported patent protections, so the move represents a major shift in US policy and shocked many on both sides of the issue. In a statement, US Trade Representative Katherine Tai said the US government “believes strongly in intellectual property protections,” but its support of a waiver is “in service of ending this pandemic” and will bolster the government’s goal “to get as many safe and effective vaccines to as many people as fast as possible.” US support of a waiver does not mean the measure will pass, as the WTO requires unanimous consent to approve any proposal. The leaders of some countries, including Germany, continue to express opposition, although sentiment appears to be shifting, with Canada and the European Commission voicing support for discussions after initially opposing the proposal. WTO Director-General Ngozi Okonjo-Iweala welcomed the US government’s willingness to participate in negotiations on the body’s Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement. India and South Africa, which have presented the waiver proposal 10 times previously, signaled they will revise the plan prior to another discussion later this month and a formal meeting of the TRIPS Council scheduled for June 8-9.

Even if WTO members adopt the proposal, an increase in vaccine production is not guaranteed. Experts note that several steps need to happen in order for countries to be able to produce generic versions of the vaccines safely and effectively. If IP rights are waived, countries would have to remove any national-level policies hindering generic production; pharmaceutical companies and manufacturers would need to transfer technologies and know-how; massive investments in manufacturing capacity would need to occur; and finally, plans to equitably distribute the vaccines would need to be developed and implemented.

Essentially, waiving IP rights might provide the recipe for vaccines, but having a recipe does not mean the end result will be successful without properly trained workers, raw ingredients, equipment, supplies, knowledge, and funding. And without full support from the pharmaceutical industry, whose lobbying organization opposed the US’s move, the issue could become wrapped up in litigation, preventing any of the next steps from happening, some experts warn. IP rights are simply one obstacle to increasing SARS-CoV-2 vaccine supply. Reportedly, Moderna in October 2020 vowed it would not enforce any of its Covid-19-related patents during the pandemic, but it’s unclear whether anyone has reproduced the company’s vaccine, underlining the difficulties in boosting global manufacturing capacity.

PFIZER-BIONTECH VACCINE EUA & FULL APPROVAL APPLICATION Following reports that the US FDA is expected to soon issue an Emergency Use Authorization (EUA) for the Pfizer-BioNTech SARS-CoV-2 vaccine in children aged 12-15 years, new reports are emerging that Pfizer is expected to apply for an EUA for younger children as well as full approval in adults. During a quarterly earnings call this week, Pfizer officials indicated that the company intends to apply for an EUA for children aged 2-11 years in September. Pfizer also anticipates applying for full FDA approval for the vaccine in individuals aged 16-65 years later this month. Full approval could facilitate businesses, schools, and other organizations mandating vaccination, but the extent to which this will happen remains uncertain. Pfizer’s chief scientific officer discussed the potential for a third dose of the company’s vaccine, suggesting populations at higher risk of COVID-19 disease or complications, including the elderly or those with chronic medical conditions, should be the first to receive any authorized booster shots, although that recommendation would be made by the US CDC. At least one study supports the theory that neutralizing antibodies following vaccination might not develop as robustly or could wane more quickly among older populations (>80 years old).

In addition to the FDA applications, Pfizer expects to have clinical trial safety data for pregnant people available by August. The vaccine’s current EUA does not explicitly omit pregnant people, but initial clinical trials were not designed to collect data on that population. Currently available clinical trial data do not indicate any safety concerns for pregnant people or their infants. Existing CDC guidance states that pregnant people can receive a SARS-CoV-2 vaccine, noting they are at elevated risk for severe COVID-19 disease and death and that the disease might put them “at increased risk of adverse pregnancy outcomes, such as preterm birth.”

On May 5, Canada became the first country to authorize the use of a SARS-CoV-2 vaccine in children. Health Canada authorized the Pfizer-BioNTech vaccine for use in children aged 12-15 years.

INDIA With India continuing to set devastating milestones during its 8-week-long second pandemic wave, the country’s Supreme Court on May 5 ordered the government to provide more medical oxygen to hospitals in New Delhi, after 12 COVID-19 patients died when a hospital ran out of oxygen. The government, under pressure to more quickly distribute supplies coming from other countries, agreed to increase the capital city’s medical oxygen supply from 490 tons per day to 730 tons per day. The Supreme Court also reportedly urged the government to prepare for a third wave of outbreak, and the nation’s principal scientific adviser also warned of an “inevitable” third wave, although he did not discuss timing. Assistance from other nations continues to pour into the country, with Pfizer and partners this week offering to supply more than US$70 million worth of medicines, including steroids, anticoagulants, and antibiotics. Though the government opened the nation’s vaccine program to all adults on May 1, supply shortages are hindering progress, exacerbating concerns among experts that the current surge will continue unabated without increased implementation of lockdowns at the state or federal levels.

India’s outbreak now is spilling over to neighboring countries, like Nepal, which is logging record numbers of new daily cases. The national positivity rate is reported to be 47%, with rates even higher in some areas.

THAILAND Thailand is struggling with a third wave of COVID-19, reporting more than 2,000 new cases a day recently. More than half of the 78,855 cases recorded by the Centre for COVID-19 Situation Administration have been confirmed since April 1. The latest surge is reported to have begun in bars and nightclubs in Bangkok and spread to the Klong Toey area, where about 100,000 people live in a 1 square mile area. Healthcare workers in the area are working to vaccinate up to 3,000 people a day to curb the virus’s spread. Nearly 2% of Thailand’s nearly 70 million people have received at least one dose of vaccine. Following reports that the more than 2.5 million foreigners from other countries who live in Thailand would be last in line to receive vaccinations, the director-general of Thailand’s Department of Disease Control on May 6 clarified that foreigners and diplomats will have the same criteria as Thais in order to receive a vaccine. Thailand has authorized SARS-CoV-2 vaccines from J&J-Janssen, AstraZeneca-Oxford, and China’s Sinopharm, but only the latter 2 are currently being administered.

WHO PANDEMIC INTELLIGENCE HUB The World Health Organization and Germany will establish a new hub for pandemic and epidemic intelligence, data, surveillance, and analytics innovation. Called the WHO Hub for Pandemic and Epidemic Intelligence, the global platform will be based in Berlin and incorporate partners from around the world to collaborate, share data, and develop tools that countries can use to prepare, detect, and respond to pandemic and epidemic threats. The hub was created as part of WHO Health Emergencies Programme to increase data availability, develop tools and models for risk assessment, and monitor disease control measures worldwide. The hub also will provide public health experts and policymakers with relevant information to support their work and aid in the rapid decision making process that is critical for prevention and response to public health emergencies. Germany has provided start-up costs for the hub, but efforts to collect additional funding are ongoing.

VACCINES & VARIANTS OF CONCERN The emergence of SARS-CoV-2 variants, particularly those that exhibit increased transmissibility or disease severity, are causing concern regarding the efficacy of existing vaccines, which were developed based on earlier strains of the virus. Recent data provide further evidence that existing vaccines do provide protection against some variants of concern (VOCs), including real-world data from mass vaccination campaigns. A study published in The Lancet utilized data from more than 4.7 million individuals in Israel who were fully vaccinated using the Pfizer-BioNTech vaccine. Overall, the vaccine showed 95.3% effectiveness against infection among people who were fully vaccinated, defined in the study as 7 days or longer after the second dose. Among a subset of nearly 8,500 specimens with the spike gene target failure (SGTF), which is used to identify B.1.1.7 infections, the vaccine demonstrated 94.5% effectiveness against infection for fully vaccinated individuals. Data from 74,000 fully vaccinated individuals in Qatar, published in the New England Journal of Medicine, demonstrate 89.5% effectiveness for the Pfizer-BioNTech vaccine against infection with the B.1.1.7 variant—at 14 or more days after the second dose—but only 75.0% against the B.1.351 variant. Notably, the vaccine demonstrated 100% effectiveness against “severe, critical, or fatal disease” for both variants.

To increase protection against VOCs, some manufacturers are developing and evaluating booster doses. Moderna published, via press release, positive preliminary results from a Phase 2 clinical trial. The trial involves administering a third dose to fully vaccinated individuals, approximately 6-8 months after their second dose, using either the existing vaccine or a variant-specific version. The researchers identified increased neutralizing antibody response against the B.1.351 variant for both versions of the third dose, with higher antibody titers for the variant-specific version. Moderna also is testing a third option, a 50/50 multivalent mix of the standard and variant-specific vaccines. Moderna committed to publishing the full data via a peer-reviewed journal once the completion of the multivalent arm of the trial.

Novavax, developer of another mRNA-based SARS-CoV-2 vaccine, published preliminary findings from its Phase 2 clinical trial in NEJM. The study demonstrated 60.1% efficacy against symptomatic COVID-19 among adult participants who were HIV-negative and seronegative for SARS-CoV-2. Overall, among HIV-negative and medically stable HIV-positive participants, the vaccine demonstrated 49.4% efficacy. Notably, the study was conducted in South Africa, and the B.1.351 variant represented 93% of the sequenced specimens. In post hoc analysis, the vaccine demonstrated 51% efficacy against the variant. As Novavax proceeds with Phase 3 clinical trials, it will include up to 3,000 children aged 12-17 years.

IMPACT OF VACCINATION COVERAGE Researchers at several US universities and the Johns Hopkins Center for Health Security adapted a model to project the impact of various timelines and levels of vaccination coverage on COVID-19 incidence and mortality as well as medical costs and productivity losses. The researchers modeled several scenarios, ranging from 10-90% national vaccination coverage and 180-360 days to achieve that coverage, including sensitivity analysis using 50-90% vaccine efficacy to account for varying degrees of real-world vaccine effectiveness. They estimate that even small increases in vaccination coverage could have a major impact in terms of decreasing cumulative incidence and mortality as well as mitigating financial and economic effects. For example, an increase of 1% coverage—in the 40-50% range and on a 270-day timeline—could avert 1.5 million cases and 6,660 deaths and save more than US$600 million in medical costs and US$1.3 billion in productivity losses. Similarly, accelerating the timeline has major effects. Shortening the time to 180 days (ie, by the end of the summer) could prevent 5.8 million cases and more than 25,000 deaths. A shortened timeline also could mitigate US$3.5 billion in medical costs and US$4.3 billion in productivity losses. While the model cannot precisely predict the effects of changes in vaccination coverage or timeline, it illustrates that even minor improvements can have substantial longer-term benefits.

US VACCINATION GOALS & MESSAGING States across the US are preparing for a long SARS-CoV-2 vaccination process, as the demand for vaccines wanes in many regions. Reports show the number of daily vaccinations administered has already fallen by 40% from an earlier peak set in April, as the number of those with interest in getting the vaccine as quickly as allowed dwindles. Earlier this week, the US government set a new goal for COVID-19 vaccinations, aiming to reach 70% of the country’s adult population with at least one dose by July 4th. The government also announced new flexibilities for distributing vaccines to participating agencies and pharmacies in an effort to better match demand and supply. Public health organizations working on vaccine uptake support the focus on a flexible vaccine supply as well as the US government’s signal of greater investment into outreach to help reach underserved communities. Community-based organizations have a more robust understanding of community-specific concerns around the COVID-19 vaccination process and can help identify trusted messengers who may be better positioned to relay vaccine information. Community officials say the government’s increased focus on local efforts will help address current barriers to vaccination, including a lack of materials in different languages, difficulties in scheduling and traveling to appointments, and vaccine hesitancy.

AUSTRALIA & NZ TRAVEL BUBBLE Less than 3 weeks after New Zealand and Australia implemented a “travel bubble” allowing residents from each country to travel to the other without having to enter a mandatory quarantine period, New Zealand officials on May 6 announced a temporary pause to the plan. The lead of New Zealand’s COVID-19 response, Chris Hipkins, announced a 48-hour suspension of flights from New South Wales, the region that is home to Sydney, where officials are investigating the source of 2 COVID-19 cases. The pause on travel does not restrict flights leaving New Zealand headed to Australia.

VACCINE DONATION FOR OLYMPIC DELEGATIONS On May 6, Pfizer and BioNTech announced they will donate SARS-CoV-2 vaccines to all Olympic and Paralympic delegations planning to attend the rescheduled 2020 Summer Olympic Games in Tokyo, Japan. The announcement, welcomed by the International Olympic Committee (IOC), comes as many countries are struggling to obtain enough vaccine doses for their populations. Even Japan is grappling with low vaccination rates, trailing behind many of its economic counterparts, with only 1-2% of its population fully vaccinated. Today, Prime Minister Yoshihide Suga pledged to speed up vaccinations to Japan’s older populations, setting a daily target of 1 million shots and aiming to have the nation’s 36 million elderly fully vaccinated by the end of July. Polling shows that most Japanese favor cancelling or postponing the Olympic Games, and social and political tensions are increasing throughout the country. Prime Minister Suga also announced an extension and expansion of a third state of emergency declaration for Tokyo and several other areas through May 31. He maintained the Olympics can be held safely and securely, despite public sentiment.

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Re: Covid-19 Updates & Info

#829

Post by mmmm8 »

Ponchi/anyone - Can confirm both in residency is no longer required in New York City to get vaccinated, just show up with any official ID. Some Colombian colleagues have traveled here for vaccines. (Another one is travelling to MIami).
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Re: Covid-19 Updates & Info

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Post by ti-amie »

“Do not grow old, no matter how long you live. Never cease to stand like curious children before the Great Mystery into which we were born.” Albert Einstein
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Re: Covid-19 Updates & Info

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Post by dryrunguy »

Here's the latest Situation Report. The paragraph on mental health is interesting though not one bit surprising.

::

EPI UPDATE The WHO COVID-19 Dashboard reports 159 million cases and 3.3 million deaths worldwide as of 4:45am EDT on May 11. The global weekly incidence declined for the first time since early-to-mid February, a decrease of 5% compared to the previous week. Global weekly mortality decreased as well—the first time since early March—down 4% from the previous week. Notably, the weekly incidence decreased in every region with the exception of South-East Asia, and weekly mortality decreased except in South-East Asia and the Western Pacific.

It appears that India’s second COVID-19 wave is peaking. On May 7, India’s average daily incidence decreased for the first time since mid-February, and it decreased for the past 2 days, down to 387,098 new cases per day. Unless India’s daily incidence decreases dramatically, however, we expect it to surpass 25 million cumulative cases in the next 5-6 days. India has reported 249,992 cumulative deaths, and we expect it to pass 250,000 in its next report. Additionally, India reported more than 4,000 deaths on both May 7 and 8. To our knowledge, India is only the third country, after the US and Brazil, to report more than 4,000 deaths in a single day. India’s daily mortality continues to increase, but it appears it may have passed an inflection point over the past week. Based on historical trends, we expect daily mortality to peak in the next 3-4 weeks.

Global Vaccination
The WHO reported 1.21 billion doses of SARS-CoV-2 vaccines administered globally, including 606 million individuals with at least 1 dose. Our World in Data reported 1.32 billion cumulative doses administered globally. This is an increase of 12% over the previous week, slightly less than the 13% weekly increases over the previous several weeks. After a week of declining daily doses administered, the trend is once again increasing, back up to 19.6 million—5% less than the record high (20.67 million on May 1). Our World in Data estimates that there are 319 million people worldwide who are fully vaccinated, corresponding to approximately 4% of the global population, although reporting is less complete than for other data.

UNITED STATES
The US CDC reported 32.5 million cumulative cases and 578,945 deaths. Daily incidence continues to decrease, down to 38,678 new cases per day, the lowest average since September 16, 2020. On May 9, the US reported just 24,080 new cases, the lowest single-day incidence since June 17, 2020 (23,984). In the period between the first and second surges in the US, the lowest average daily incidence was 34,666 new cases per day. If the US continues on its current trajectory, daily incidence could soon fall below that number. Daily mortality is declining slowly, down to 608 deaths per day. With the exception of holiday reporting anomalies, this is the lowest average since April 2, 2020, early in the first surge.

The CDC categorizes states by Level of Community Transmission—Low, Moderate, Substantial, and High—based on the current average per capita weekly incidence and test positivity. The 4 categories for weekly incidence are 0-9.99, 10-49.99, 50-99.99, and 100 or more new cases per 100,000 population, and the categories for test positivity are 0-4.99%, 5-7.99%, 8-9.99%, and 10% or higher*. If the categories for a given state differ between the 2 metrics, the CDC classifies the state at the higher of the 2 categories. Overall, the CDC classifies the national epidemic as Substantial community transmission, with 81.6 weekly cases per 100,000 population and test positivity of 4.09%. In total, 9 states are classified as Moderate transmission, 27 (and Washington, DC) are Substantial, and 14 are High. No states are classified as Low. Unlike earlier in the US epidemic, there does not appear to be a strong geographic correlation.
*The CDC only reports state-level test positivity as 0-5% and 6-10%, so it is unclear exactly which category states fall into for that part of the assessment.

Alabama is reporting the lowest per capita weekly incidence, but at 29.5 weekly cases per 100,000, it is still well above the Low category threshold. Alabama is the only state in the Moderate category currently reporting 6-10% test positivity, so while we can infer that it is less than 8% because of the Moderate classification, it would also need to bring that down below 5% before it could achieve the Low classification. Notably, only 10 total states are reporting test positivity of 6-10%, and none are reporting higher than that. Three states in the High category—Indiana (105.0), North Carolina (105.4), and North Dakota (100.1)—are reporting fewer than 110 weekly cases per 100,000, so they could potentially transition in the near future. Among the 27 states currently classified as Substantial, 7 (and Washington, DC) are reporting fewer than 60 weekly cases per 100,000, including Texas and Washington, DC, that are within 10% of the Moderate category threshold. A

US Vaccination
The US has distributed 330 million doses of SARS-CoV-2 vaccine and administered 262 million. Daily doses administered* continues to decrease, down from a high of 3.3 million on April 11 to 2.0 million. Approximately 1.3 million people are achieving fully vaccinated status per day, down from a high of 1.8 million per day on April 12.

A total of 152 million individuals have received at least 1 dose of SARS-CoV-2 vaccine, equivalent to 46% of the entire US population and 58% of all adults. Of those, 116 million are fully vaccinated, which corresponds to 35% of the total population and 44% of adults. Among adults aged 65 years and older, progress has largely stalled at 84% with at least 1 dose and 72% fully vaccinated. In terms of full vaccination, 60 million individuals have received the Pfizer-BioNTech vaccine, 47 million have received the Moderna vaccine, and 9.0 million have received the J&J-Janssen vaccine.
*The US CDC does not provide a 7-day average for the most recent 5 days due to anticipated reporting delays for vaccine administration. This estimate is the most current value provided.

PFIZER-BIONTECH EUA FOR ADOLESCENTS The US FDA on May 10 expanded the Emergency Use Authorization (EUA) for the Pfizer-BioNTech SARS-CoV-2 vaccine to include adolescents ages 12 to 15, making it the first such vaccine available to children under age 16 in the US. The amendment to the original EUA is based on Phase 3 clinical trial results showing the vaccine is safe and effective among that age group. The US CDC Advisory Committee on Immunization Practices will meet on May 12 to review the data on use among 12- to 15-year olds and is expected to recommend the vaccine be used in this age group. Pfizer-BioNTech are testing the vaccine among children aged 2 to 11 and plan to include children aged 6 months to 2 years in the coming weeks. Moderna and J&J-Janssen also are testing their vaccines in children.

On May 7, Pfizer-BioNTech announced they have begun a Biologics License Application with the FDA for full regulatory approval of their SARS-CoV-2 vaccine for individuals ages 16 years and older. The companies will submit data to support the application on a rolling basis, with a goal of achieving full approval in the coming months.

US CDC TRANSMISSION GUIDANCE On May 7, the US CDC issued a Scientific Brief on SARS-CoV-2 transmission and updated its associated guidance. Notably, the brief describes respiratory fluid as existing along a “spectrum of sizes,” rather than distinguishing between droplets and aerosols. The CDC emphasizes the role that the volume of exposure plays in transmission risk, including the “concentration of virus in the air” and its viability. The guidance notes that transmission risk is the greatest at close proximity to infectious individuals and that the concentration of virus generally “decreases with increasing distance.” The agency concluded certain conditions can increase the risk of infection at longer distances, including enclosed spaces with inadequate ventilation, increased exhalation rates (e.g., when exercising or singing), and prolonged exposure (e.g., more than 15 minutes). The brief emphasizes that exhaled viruses in the air—whether via inhalation or contact with mucous membranes like the eyes, nose, or mouth—remains the greatest transmission risk, and while fomites do pose some risk, they are not a substantial driver of transmission.

The updated guidance does not explicitly distinguish between droplet (i.e., via small respiratory droplets at close distance) and airborne transmission (i.e., via aerosolized respiratory fluid that can remain aloft for longer periods of time and travel longer distances). Previous iterations of the guidance included separate sections for droplet and airborne transmission, describing droplet transmission as more likely than airborne. The new guidance removes any mention of aerosols and airborne transmission entirely. Instead, the CDC discusses them together, as “droplets and very small particles.” Additionally, the CDC removed the term “close contact” and shifted the focus to the type of exposure—i.e., inhalation, splashes/sprays to mucous membranes, and touching mucous membranes. While the update is viewed by many as an improvement, some critics are still calling on the CDC to more explicitly address the risk of aerosol/airborne transmission, particularly for prolonged exposure in indoor spaces.

WHO EUL FOR SINOPHARM VACCINE On May 7, the WHO issued an Emergency Use Listing (EUL) for the Sinopharm vaccine for use among adults 18 years and older, the sixth SARS-CoV-2 vaccine to receive an EUL. The vaccine—an inactivated vaccine administered in 2 doses given 3-4 weeks apart—is produced by Beijing Bio-Institute of Biological Products Company Ltd., a subsidiary of China National Biotec Group. The WHO noted the listing of the vaccine included on-site inspections of the production facility. The designation facilitates many countries’ efforts to speed their own regulatory approval of the vaccine and is a prerequisite for the vaccine to be distributed by the COVAX facility. The vaccine’s storage requirements make it well-suited for use in low-income countries, according to the WHO, and its vials will be the first to include a small sticker that changes color when exposed to heat, allowing healthcare workers to know whether the vaccine is safe to use.

According to the WHO’s Strategic Advisory Group of Experts on Immunization (SAGE), more than 65 million doses of the Sinopharm vaccine have been administered worldwide in the 45 countries/jurisdictions with existing authorizations, with an estimated 79% efficacy at preventing symptomatic COVID-19 among adults ages 18-59. However, SAGE experts did not estimate the vaccine’s efficacy among people ages 60 and older. The Sinopharm vaccine reportedly is the first-ever Chinese-produced vaccine to receive WHO emergency authorization, although the agency next week is expected to consider another Chinese SARS-CoV-2 vaccine from the company Sinovac.

ASTRAZENECA-OXFORD VACCINE British officials have recommended that people under 40 be given options other than the AstraZeneca-Oxford SARS-CoV-2 vaccine when available, due to a small risk of blood clots. According to data analysis from the UK Medicines and Healthcare Products Regulatory Agency (MHRA), the risk of these rare adverse events is slightly higher among younger age groups compared to older adults, and there are no known risk factors for the blood clotting events. In an update to guidance released on April 7 recommending individuals under age 30 be offered an alternative to the AstraZeneca-Oxford vaccine when possible and only where no substantial delay or barrier in access to vaccination would arise, the UK’s Joint Committee on Vaccination and Immunisation on May 7 expanded that guidance to adults ages 30-39 who are not at increased risk of COVID-19 complications. MHRA Chief Executive June Raine stressed the benefits of the AstraZeneca-Oxford vaccine continue to outweigh the risks for the vast majority of people. UK public health officials hope to vaccinate the entire adult population by the end of July.

NOVAVAX EUA APPLICATION In quarterly earnings results announced May 10, US-based pharmaceutical company Novavax indicated it does not plan to file for US FDA Emergency Use Authorization for its SARS-CoV-2 vaccine until July at the earliest but expects to have the application process complete in the US, UK, and Europe by the third quarter of 2021. The company could announce safety and efficacy data on the vaccine this month, although manufacturing delays have impacted clinical trial progress. Novavax CEO Stanley Erck said the company hopes to have production slowdowns resolved by the fourth quarter, with plans to produce up to 3 billion doses worldwide next year with partner Serum Institute of India. However, the Serum Institute, the world’s largest vaccine maker, has been unable to deliver on its promises of vaccine production for several companies, including AstraZeneca, which has served the company a legal notice over the delays. These delivery delays are heavily impacting supply to the COVAX facility, which is committed to delivering 2 billion doses of SARS-CoV-2 vaccine to low- and middle-income countries in 2021. On May 6, Gavi, the Vaccine Alliance, one of the co-leaders of COVAX, signed an advance purchase agreement with Novavax for 350 million doses of its vaccine to begin delivery in the third quarter. However, with the Serum Institute saying it has “temporarily deferred” some of its delivery commitments and offering refunds for at least one bilateral purchase agreement, it remains to be seen whether the companies can deliver on their obligations.

SOUTH ASIA India’s second wave remains the most severe COVID-19 situation in the world, although it does appear to be peaking. Amid continued calls on Prime Minister Narendra Modi to reinstitute a nationwide “lockdown,” including from White House Chief Medical Advisor Dr. Anthony Fauci, some states are implementing their own restrictions. Reportedly, approximately half of India’s states have implemented a full “lockdown,” and the rest have implemented varying degrees of restrictions.

Neighboring Nepal also is facing its largest COVID-19 surge on a similar trajectory to India’s. Notably, Nepal’s daily incidence has surged from 500 new cases per day on April 16 to more than 8,600 on May 10, a 17-fold increase in less than 4 weeks. Much like India, Nepal’s health system is struggling to manage the wave, so much so that the Ministry of Health issued a statement indicating that it was “losing control of the situation.” Perhaps the most concerning aspect of the current surge is Nepal’s high test positivity. Since mid-March, test positivity surged from 2% to 45%, which indicates that testing is not sufficient to fully capture the scope of the epidemic and that the reported incidence likely is well below the actual total.

Bangladesh, another of India’s neighbors, recently detected its first cases of COVID-19 caused by an emerging SARS-CoV-2 variant first reported in India. The B.1.617 variant is characterized by 3 mutations that are believed to confer increased transmissibility and resistance to existing vaccines. On May 10, the WHO announced that it classified B.1.617 as a variant of concern, although the US CDC still classifies it as a variant of interest. Some preliminary research (preprint) provides some evidence that the B.1.617 variant exhibits “reduced neutralization” to existing vaccines, but further study is needed to more fully characterize the variant’s attributes.

MORTALITY DUE TO COVID-19 As we have covered previously, limitations in public health surveillance and reporting can result in an undercount of COVID-19 deaths. The Institute for Health Metrics and Evaluation recently shifted its modeling approach to use total mortality due to COVID-19, as opposed to official COVID-19 mortality reports. The new approach accounts for historical seasonal fluctuations as well as temporal and geographic variations in testing capacity and reporting. It also takes into account the early months of the pandemic, when a higher proportion of deaths or cases were uncounted, and because of the disproportionate impact on long-term care facilities, COVID-19-related deaths among older individuals may have been overlooked. Additionally, the model aims to estimate the proportion of excess deaths that are due directly to COVID-19 by accounting for changes in historical trends during the pandemic. In order to do this, IHME researchers consider 6 drivers of all-cause mortality that relate to the pandemic and physical distancing requirements, including increases in mortality due to the reduced utilization of healthcare services for non-COVID-19 conditions, increases in deaths due to mental health disorders and drug use, decreases in reported deaths due to cardiovascular and respiratory diseases and accidental injury, and fewer deaths due to other respiratory illnesses, especially influenza. The new IHME model estimates more than 900,000 total COVID-19 deaths in the US, more than 50% higher than official figures. The estimates for some countries—including Azerbaijan, Belarus, Japan, and Kazakhstan—are more than 10 times the reported total. On a global scale, the model estimates nearly 7 million total COVID-19 deaths, more than double the 3.24 million deaths reported at the time of publication.

MENTAL HEALTH Mental health experts are concerned over potential long-term ramifications of the COVID-19 pandemic on the psychosocial health of people worldwide. For some, prolonged feelings of anxiety or depression, a lack of social connection, job uncertainty, or food insecurity during the pandemic are unlikely to dissipate with the loosening of social restrictions. A disproportionate impact could be seen in some individuals, including LGBTQ+ people or those who experience violence at home, as well as Black, Latinx, and Indigenous communities more heavily affected by the pandemic. Another notable population of interest is children, whose formative years have been upended by the pandemic, resulting in familial socioeconomic stress, delays in learning, and an increase in mental health issues. In the US, pediatric hospitals are reporting higher proportions of emergency department visits for mental health conditions during the COVID-19 pandemic. Although the US$1.9 trillion American Rescue Plan earmarks US$3.5 billion in block grants for states and organizations to address mental health in communities and the workforce, experts warn the funding might not be sufficient to bolster already under-resourced mental health care in the country.

COVID SOLIDARITY TRIAL The WHO Solidarity clinical trial, launched in 2020 to test various medical interventions for COVID-19 disease, is beginning a randomized controlled trial of three immune regulating drugs that have shown promise in smaller studies. These three drugs—infliximab, imatinib, and artesunate—were selected for their abilities to dampen inflammatory immune responses, preliminary positive efficacy against severe COVID-19, and widespread global availability. The Solidarity trial previously evaluated remdesivir, hydroxychloroquine, lopinavir/ritonavir, and interferon, with all having little to no effect in managing patients hospitalized with COVID-19. In addition to the Solidarity trial, another large international study called REMAP-CAP is exploring various ways to control immune responses in COVID-19 patients. Taken together, researchers hope the trials will identify more treatments to provide additional support to hospitalized COVID-19 patients.

MOUNT EVEREST China is implementing strict measures to prevent new COVID-19 cases on the Tibetan side of Mount Everest, known as Mount Qomolangma in China. The peak of the world’s highest mountain straddles the border of China and Nepal at 29,032 feet above sea level, with climbers able to approach from either the northern Tibetan side or southern Nepalese slope. China banned foreign mountaineers last year due to the pandemic, but it has issued 21 expedition permits this year for nationals to attempt to reach the summit from the Tibetan side. To prevent commingling of climbers from each side who reach the small peak on the same day, China plans to establish a “line of separation” near the border as part of its “zero contact strategy,” according to state media. Details of how this will be accomplished are not yet known. Additionally, the China Tibet Mountaineering Association has set up a checkpoint 300 meters from the Tibetan base camp to test anyone with a permit to enter. Nepal is experiencing a surge in COVID-19 cases, and cases have been detected in the main Nepalese base camp. Last week, Nepalese officials reportedly confirmed 18 COVID-19 cases at the base camp, but anecdotal reports say the number could be nearly double. The Nepal Mountaineering Association has asked climbers and their Sherpa guides to return spent oxygen canisters instead of abandoning them on the mountainside so they can be refilled to help alleviate oxygen shortages.

https://covid19.who.int/
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MENTAL HEALTH Mental health experts are concerned over potential long-term ramifications of the COVID-19 pandemic on the psychosocial health of people worldwide. For some, prolonged feelings of anxiety or depression, a lack of social connection, job uncertainty, or food insecurity during the pandemic are unlikely to dissipate with the loosening of social restrictions. A disproportionate impact could be seen in some individuals, including LGBTQ+ people or those who experience violence at home, as well as Black, Latinx, and Indigenous communities more heavily affected by the pandemic. Another notable population of interest is children, whose formative years have been upended by the pandemic, resulting in familial socioeconomic stress, delays in learning, and an increase in mental health issues. In the US, pediatric hospitals are reporting higher proportions of emergency department visits for mental health conditions during the COVID-19 pandemic. Although the US$1.9 trillion American Rescue Plan earmarks US$3.5 billion in block grants for states and organizations to address mental health in communities and the workforce, experts warn the funding might not be sufficient to bolster already under-resourced mental health care in the country.
Due to IT issues my daughter had to go into her office to upgrade her laptop. Everyone had to make an appointment and there were restrictions on how many of them could be there at one time.

I would've said she was coping with the situation despite some hiccups (she is a very social person. Me? I go out when I have to - basic introvert personality). She made her walk through Central Park, took some wonderful nature shots, and went to Starbucks. On her way home she texted that she was so happy.

There are going to be major issues. Gang bangers aren't the only ones who are stressed out.
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Even being vaccinated, I am still stressed about being in a public indoor space. I hiked with some vaccinated friends last weekend and we decided to have lunch/beer after our hike. It just so happened to coincide with the removal of all spacing restrictions on restaurants & mask use in our state. (We didn't realize that until we were seated). Not long after ordering, one of my friends overheard 2 people at a nearby table discussing one of them thinking she might have Covid and the other telling her where to go for testing. As they had already taken our order, we were fortunate to be able to move to an outdoor table. Otherwise I would have just paid & left. Vaccinated or not, I don't need to put myself at risk because other people are stupid.
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atlpam wrote: Tue May 11, 2021 8:14 pm Even being vaccinated, I am still stressed about being in a public indoor space. I hiked with some vaccinated friends last weekend and we decided to have lunch/beer after our hike. It just so happened to coincide with the removal of all spacing restrictions on restaurants & mask use in our state. (We didn't realize that until we were seated). Not long after ordering, one of my friends overheard 2 people at a nearby table discussing one of them thinking she might have Covid and the other telling her where to go for testing. As they had already taken our order, we were fortunate to be able to move to an outdoor table. Otherwise I would have just paid & left. Vaccinated or not, I don't need to put myself at risk because other people are stupid.
Now that I'm vaccinated and am feeling safer, I've reached out to some friends about meeting up. It's appalling how many of them haven't gotten vaccinated. No objection to it, just taking their sweet time setting appointments (when you can now make one right before walking in in most locations!)
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My daughter had to be masked entering her office building today.

I'm not going anywhere unmasked specifically because of situations like the one @atlpam mentioned.
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Maybe I'm weird, but I don't feel particularly unsafe even though I'm not vaccinated yet (not possible yet here, hopefully in June). Certainly not when hiking with a friend or two, but also not really when taking a train to work (masked).
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I don't have any issues when hiking or walking outside - that's been my main stress relieving activity throughout this mess.
The indoor dining still makes me nervous because I don't trust the behavior of the people around me. No issue with grocery stores or similar establishments where the businesses are still requiring masks.
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atlpam wrote: Tue May 11, 2021 9:01 pm I don't have any issues when hiking or walking outside - that's been my main stress relieving activity throughout this mess.
The indoor dining still makes me nervous because I don't trust the behavior of the people around me. No issue with grocery stores or similar establishments where the businesses are still requiring masks.
I ate indoors for the first time last weekend. My dining partner and I had both been vaccinated. Our table was definitely 6 feet from another table. They took people's temperature before letting them in the restaurant, which was at maybe 40% capacity. The door was open. And you had to wear a mask unless you were eating. The wait staff and cooks were masked. I think a lot of it boils down to particular situations.

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Agree, due to removed restrictions, in the restaurant I went to, no one wore masks, separation between tables was back to pre-pandemic layouts.
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Six feet really makes no difference at all given what we now know about how the virus spreads, same about wearing masks only intermittently. Simply having less people around does decrease odds and of course being vaccinated decrease them vastly. Speaking about indoor places here.
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