Sending Thanksgiving greetings to you and your families, and wishing you all a Safe and Healthy start to this Holiday Season.
By the numbers: There are as of Friday November 20,2021: 47,762,536 positive cases to date in the U.S. and 793,470 deaths to date in the U.S.. This is up 345,323 and 11,335 respectively over last week. 2021 is proving to be a deadlier year for COVID than 2020 and we have six weeks to go before the end of the year.
As of November 18, the 7-day average of daily new cases was 88,482, a 16.1% increase from the previous week, and COVID-19 cases in the U.S. are up nearly 27 percent in the last three weeks after steadily increasing since mid-October, according to data from the Centers for Disease Control and Prevention (CDC).
In September 2021 U.S. Covid-19 deaths surpassed the Americans dead from the 1918 Spanish flu. According to the Centers for Disease Control and Prevention, that pandemic caused an estimated 675,000 deaths. In September, Covid-19 deaths in the US reached 675,400 people. As of November 20, 2021, approximately 793,470 Americans have died from Covid-19. To put it in perspective, as of December 31,2020, 377,000 people died. To date this is over two times the number of deaths we experienced in 2020. Sobering numbers to reflect on.
Zero-Covid is not going to happen this year. Experts predict a steep rise in US cases this winter: Evidence shows vaccine-conferred protection against hospitalization and death remains high several months after inoculation, vaccines for children older than five can reduce Covid transmission, and new antiviral medications hold the promise of making Covid-19 a treatable disease.
“I do expect to see cases increasing – we’ve started to see this in the last week or so,” said Dr David Dowdy, an associate professor of epidemiology at Johns Hopkins University. “I don’t think what we’re seeing in Europe means we’re in for a huge surge of serious illness and death as we saw here in the US,” last winter.
“Even if cases go up this winter, we’re very unlikely to see the overcrowded [intensive care units] and morgues of a year ago,” said Dowdy.
Vaccine-conferred immunity against infection may allow cases to rise, he said, but far fewer people will need hospitalization. The vast majority of people who were hospitalized or died from Covid-19 this summer, more than 90% in one CDC study, were not fully vaccinated.
“People can still get Covid, there can still be breakthrough infections, but the great news is if you have been vaccinated you are very much less likely to be hospitalized or have severe infection,” said Rupali Limaye, an associate scientist at Johns Hopkins University and an expert in vaccine communication.
Vaccines remain roughly 85% effective at preventing hospitalization and death. Just 58.6% of the nation is vaccinated, lower than vaccination rates in some European nations now struggling with an increase in Covid-19 cases, such as in Germany and France.
“I’ve been predicting a pretty bad winter wave again, and it looks like it’s starting to happen,” said Dr Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Texas Children’s hospital’s center for vaccine development.
“There’s just too many unvaccinated and too many partially vaccinated [people]” to stop the “aggressive” Delta variant, Hotez said.
The Covid-19 pandemic may never be “over”, as many conceived early in the pandemic, Dowdy said. “The point is – when can we get this to a point where it’s tolerable to us as a society? And I think we may be closer to that point than we imagine.
“Zero-Covid is not going to happen.”
All U.S. adults now eligible for both the Pfizer and Moderna Covid vaccine booster shots after CDC gives final approval. All adults in the U.S. are now eligible to receive Pfizer’s and Moderna’s Covid vaccine boosters, after the Centers for Disease Control and Prevention authorized the shots for the general public Friday. The move allows an extra dose of protection for tens of millions of fully vaccinated Americans as cases climb and public officials worry the nation could face another surge during the winter.
CDC Director Rochelle Walensky signed off on the booster shots hours after the agency’s independent panel of vaccine scientists unanimously endorsed opening up eligibility to everyone 18 and older at least six months after they received their second dose.
Face masks and distancing are most effective measures in reducing COVID-19 spread: Wearing a face mask and physically distancing from others are the most effective public safety measures against the coronavirus-borne illness COVID-19 and have a statistically significant impact on reducing the spread, according to a new global study.
The study, which was published in the British Medical Journal on Thursday, was conducted by researchers at Monash University in Melbourne, Australia; the University of Edinburgh in Scotland; and Zhejiang University School of Medicine in Hangzhou, China, and looked at data from 30 studies around the world. It found that wearing a face mask reduces the incidence of COVID by 53%, while social distancing reduces it by 25%.
Handwashing also indicated a substantial 53% reduction in Covid incidence, although this was not statistically significant after adjusting for the small number of handwashing studies included.
This Global study was welcomed by health experts who have increasingly been calling for people everywhere not to rely solely on vaccines to end the pandemic, but rather to embrace the full range of measures that have proven successful in those countries that have arrested the spread of the virus.
While vaccines are safe and highly effective in preventing serious COVID, hospitalization and death, they are not 100% effective, and breakthrough infections are occurring. Most of the current new cases and deaths are in unvaccinated people, meaning it is remains vital for people to get their shots.
Pennsylvania coronavirus update: 40,044 weekly cases highest in 10 months; 3,095 hospitalized.
The Pennsylvania Department of Health reported 7,604 additional coronavirus cases on Friday, continuing a recent rapid increase in case numbers. The seven-day moving average of newly reported cases was 7,923 cases per day, up 66.1% from a week ago, and up 86.9% over the last 30 days.
Pennsylvania has added 55,458 cases in the past seven days, including 15,414 reinfection cases added on November 13,2021. Even without those cases, the 40,044 weekly case total is the highest seen since January 21,2021 when the state was coming out of its largest wave of the pandemic that peaked in mid-December. The infectious rate without the reinfection cases is up 26.2% since last week, and 35% in the last 30 days.
Research links COVID-19 in pregnancy with stillbirths. The federal Centers for Disease Control and Prevention released a report Friday that examined 1.2 million deliveries in 736 hospitals nationwide from March 2020 through September 2021.
Stillbirths were rare overall, totaling 8,154 among all deliveries. But the researchers found that for women with COVID-19, about 1 in 80 deliveries resulted in stillbirth. Among the uninfected, it was 1 in 155.
As of September, about 97 percent of pregnant people hospitalized with confirmed COVID-19 this year were unvaccinated. Among those with COVID-19, stillbirths were more common in people with chronic high blood pressure and other complications, including those in intensive care or on breathing machines.
“These findings underscore the importance of COVID-19 prevention strategies, including vaccination before or during pregnancy,” CDC researcher Carla DeSisto and co-authors said.
While the absolute risk for stillbirth is low, anyone who is pregnant shouldn’t underestimate the dangers of COVID-19, said Dr. Mark Turrentine, a professor at Baylor College of Medicine in Houston. He helped write the American College of Obstetricians and Gynecologists’ recommendations for COVID-19 vaccination in pregnancy.
Vaccinated Health Care Workers Shed Less COVID-19 Virus Than Unvaccinated. The study was published Nov. 17 in the journal Open Forum Infectious Diseases. The research was conducted before the recent Delta variant surge, but its findings are consistent with other research showing that the spread of COVID-19 is lower among vaccinated people.
Vaccinated health care workers with breakthrough COVID-19 infections shed less virus than those who are unvaccinated and infected, according to University of California, Los Angeles researchers.
"SARS-CoV-2 viral loads are known to be a critical driver of transmission," wrote authors led by Dr. Paul Adamson, an assistant professor of medicine in the division of infectious diseases. "Thus, our findings using real-world data suggest that COVID-19 vaccination might translate into decreased transmissibility of SARS-CoV-2
"This is another benefit of the vaccines and yet another reason to get vaccinated against COVID-19," Adamson added. "The Delta variant has been shown to contain higher amounts of virus than that of prior variants, though recent data also show that vaccinated individuals still clear infections with Delta variant quicker and have a more rapid decline in viral loads."
Health and COVID -19 Updates:
Myocarditis: The CDC, in a study presented Friday, found 54 preliminary cases of myocarditis and myopericarditis among nearly 26 million Pfizer and Moderna booster doses administered, or about 2.1 cases per 1 million shots administered. However, only 12 of those reported cases have been attributed to the vaccines so far, while 38 are under review and four were ruled out.
Israeli MRI study finds heart damage from COVID-19 vaccine is rare and mild. A study conducted by Beilinson Hospital in Petah Tikva, using a detailed scanning technique to examine patients with symptoms of a heart muscle condition after receiving a COVID-19 vaccine, found that damage was rare, mild, and expected to heal. It found that cases of such inflammation occurred in 54 people (51 men, three women) or 2.13 of every 100,000 vaccinees (some two thousandths of a percentage point). Of those, 98 percent of cases were mild (76%) to moderate (22%) and did not cause any damage to heart function. A single person of the 2.5 million experienced a severe case that required hospitalization, and went on to recover, the study found. The new study bore that out, with 69% of cases occurring after the second shot, mostly in males and mostly in the 16-29 age group (where case prevalence was 10.7 for every 100,000).
COVID Booster Shot Significantly Increases Protection for Cancer Patients: Good news for cancer patients. A new research reports show COVID-19 vaccine boosters gives cancer patients — especially those with blood cancer — much-needed protection.
"Our study demonstrates in clear terms how the booster shot can make all the difference for some people with compromised immune systems, such as people with cancer," study co-author Dr. Balazs Halmos said in a news release from Montefiore Health System in New York City. Halmos is director of the Multidisciplinary Thoracic Oncology Program at Montefiore.
Many cancer patients have weakened immune systems that put them at increased risk of severe illness and death from COVID-19.
Uncontrolled Diabetics with COVID at increases risk of hospitalizations: In a new study from Rensselaer Polytechnic Institute in New York, researchers found people with type 2 diabetes who contract COVID-19 are nearly 50% more likely to wind up in intensive care if they have poorly managed their blood sugar levels over the long term than those with better long-term glycemic control. In the study, the team looked at records for more than 16,000 people with type 2 diabetes and COVID-19 between 2017 and 2020. The study found that those with poor glycemic control were 48% more likely to require treatment in an intensive care unit.
They also showed that diabetics who were under control by taking metformin when they contracted COVID-19 faced a 12% lower risk of visiting the ICU, those on metformin and insulin have an 18% lower risk, and those prescribed corticosteroids have a 29% lower risk.
Immunosuppressed/ Immunocompromised: Estimates suggest that there are approximately 10 million immunocompromised people in the U.S. People who take immunosuppressive drugs for organ transplants, autoimmune diseases, cancers and other conditions were considered, at the outset of the pandemic, as being at potentially increased risk of severe outcomes, given their weakened immune systems.
A large, nationwide study of COVID-19 cases led by researchers at the Johns Hopkins Bloomberg School of Public Health has found that people taking medications that suppress the immune system -- for example, to prevent transplant rejection or to treat cancer -- overall do not have a higher risk of dying from COVID-19 or being put on a ventilator than non-immunosuppressed hospitalized COVID-19 patients.
Bad Oral Health could increase your risk of Covid: Research shows that people with poor oral health can end up with more severe symptoms if they catch the coronavirus. Covid patients who also have gum disease are 3.5 times as likely to be admitted to intensive care compared to those without. They're also 4.5 times as likely to need to be put on a ventilator and nine times as likely to die from Covid.
Poor oral health can have an impact on the heart, raise blood pressure and make diabetes worse by raising blood sugar levels. It's been linked to premature births, arthritis, kidney diseases, respiratory disease and even some neurodegenerative diseases, including Alzheimer's.
Final thought: Experts now say Covid-19 will likely transform from a pandemic to endemic disease. Pandemics don’t have an on and off switch. A pandemic’s end has less to do with meeting certain measurements, and more to do with a collective perception of the disease.
It is up to all of us to control the COVID spread and getting it under control sooner rather than later.
Until next time, Stay Safe, Stay Well, Practice Mitigation Factors including Mask wearing, Washing your hands frequently and consider getting Vaccinated if you have not already done so. This will make the difference how we end the year and gain control over COVID -19 in 2022.
James A Vito, D.M.D.