Even a correct decision is wrong when it was taken too late. - Lee Iacocca
We are now faced with the fact that tomorrow is today. We are confronted with the fierce urgency of now. In this unfolding conundrum of life and history, there "is" such a thing as being too late. This is no time for apathy or complacency. This is a time for vigorous and positive action. - Martin Luther King, Jr.
By the numbers: As of August 28, in the U.S. 52% of the population is fully vaccinated and 61.3% have at least received one shot. There were 190,370 positive cases and 1304 deaths. The trend is that the numbers are going up and not down which is not looking good for the fall when people will be spending more time indoors. At this current rate current projections point to between 710,000 to 810,000 deaths in the U.S. by years end.
50% of adolescents have been vaccinated. The importance of vaccinating our young is because if they catch COVID-19 (Delta Variant) they are of high risk of developing Multi System Inflammatory Syndrome.
in which different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.
The rate of breakthrough cases among vaccinated people who are not immunocompromised is less than 1%. Immunocompromised People Make Up Nearly Half Of COVID-19 Breakthrough Hospitalizations according to the FDA and CDC data. Both organizations officially recommended on Aug. 12 and Aug. 13, 2021, respectively, that people who are moderately to severely immunocompromised receive a third dose of the COVID-19 vaccine.
Unvaccinated Americans hospitalized with COVID-19 cost the U.S. health care system $2.3 billion in June and July according to The Peterson Center on Healthcare and the Kaiser Family Foundation, and that’s “likely an understatement,” the researchers wrote. The report analyzed CDC data, finding there were 37,000 preventable COVID hospitalizations in June and another 76,000 in July among unvaccinated adults in the U.S. An average COVID hospitalization costs roughly $20,000, the report said. The report only focused on hospitalizations of adults in the U.S., as some children are still ineligible to receive the vaccine. An estimated 98.3% of the adults hospitalized due to COVID in June and July were unvaccinated, the report said.
The three COVID-19 vaccines approved for use in the United States are much less effective against the Delta variant of the virus, but still protect against severe illness in most cases, according to data released Tuesday, August 24, by the Centers for Disease Control and Prevention. As of Aug. 7, unvaccinated adults between 18 and 49 years old were 25 times more likely to be hospitalized with COVID-19 than vaccinated adults of the same age. It’s not as simple to measure the number of times more likely this unvaccinated demographic is to die from the disease because there have been “virtually no deaths in vaccinated members of this age group,” according to Public Health officials.
Meanwhile, unvaccinated adults over age 50 were nearly a dozen times more likely to be hospitalized than their vaccinated counterparts, and 17 times more likely to die.
About 85 percent of coronavirus RNA detected in COVID-19 patients’ breath was found in fine aerosol particles less than five micrometers in size, researchers in Singapore report August 6 in Clinical Infectious Diseases. The finding is the latest evidence to suggest that COVID-19 is spread mainly through the air in fine droplets that may stay suspended for hours rather than in larger droplets that quickly fall to the ground and contaminate surfaces. The Pennsylvania Department of Health reported 2,128 additional coronavirus cases on Friday 8/20/2021. The seven-day moving average of newly reported cases was 2,270 cases per day, up 31% from a week prior and up 442% over the last 30 days.
To date, there have been 1.26 million infections statewide. The seven-day moving average of deaths per day is 14.6, compared with 8.4 a week ago, an increase of 73% in the last seven days. There are 6.90 million fully vaccinated people in Pennsylvania, accounting for 54% of the population. An additional 1.78 million people are in need of their follow-up shot. In total, 15.05 million shots have been put into the arms of 8.69 million people, or 68% of Pennsylvania residents. Data from the Israeli Ministry of Health suggests vaccine protection against severe disease is still nearly 92% for people 50 and younger and 85% for those older than 50.
In the U.S., 4.4 million children have tested positive for COVID-19 since the pandemic began, with more than 121,000 cases in the week ending Aug. 12, according to the American Academy of Pediatrics (AAP). Cases in children have risen substantially since the beginning of July and now account for 18% of newly confirmed weekly cases, making up 2.5% of hospitalizations.
Vaccinations are a crucial part of mitigating the spread: Health officials reported that unvaccinated individuals account for more than 97% of hospitalization and over 99% of COVID-related deaths. Their decision to remain unvaccinated leaves children and immunocompromised people even more vulnerable to contracting the virus.
Unvaccinated Americans hospitalized with COVID-19 cost the U.S. health care system $2.3 billion in June and July: according to The Peterson Center on Healthcare and the Kaiser Family Foundation — and that’s “likely an understatement,” the researchers wrote. The report analyzed CDC data, finding there were 37,000 preventable COVID hospitalizations in June and another 76,000 in July among unvaccinated adults in the U.S. An average COVID hospitalization costs roughly $20,000, the report said. The report only focused on hospitalizations of adults in the U.S., as some children are still ineligible to receive the vaccine. An estimated 98.3% of the adults hospitalized due to COVID in June and July were unvaccinated, the report said. Roughly 51.5% of the total population is now fully vaccinated, and 71% of those who qualify for the vaccine have received at least one shot.
A quick word about the anti-parasitic Ivermectin which is being touted to cure COVID-19. Aside from the FDA saying it is not an accepted treatment the maker of the drug, Merck, has also said there is “no scientific basis” to claim that ivermectin is effective against COVID-19.
If you are looking for a safe, effective and low-cost treatment for COVID-19 then one of the three approved vaccines is it. They are safe, effective and is free.
Researchers discover hidden SARS-CoV-2 'gate' that opens to allow COVID infection: Since the early days of the COVID pandemic, scientists have aggressively pursued the secrets of the mechanisms that allow severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to enter and infect healthy human cells. University of California San Diego's professor of chemistry and biochemistry and a senior author of the new study Rommie Amaro, a computational biophysical chemist helped develop a detailed visualization of the SARS-CoV-2 spike protein that efficiently latches onto our cell receptors. Amaro and her research colleagues from UC San Diego, University of Pittsburgh, University of Texas at Austin, Columbia University and University of Wisconsin-Milwaukee have discovered how glycans—molecules that make up a sugary residue around the edges of the spike protein—act as infection gateways. "We essentially figured out how the spike actually opens and infects," said Amaro, "We've unlocked an important secret of the spike in how it infects cells. Without this gate the virus basically is rendered incapable of infection."
"We showed that without this gate, the RBD of the spike protein can't take the conformation it needs to infect cells," said Jason McLellan, an associate professor of molecular biosciences at UT Austin and his team and one of the co-authors of this study.
Health Experts Say Benefits Of COVID-19 Vaccine Booster Shots Outweigh Concerns: Booster shot of Pfizer's vaccine slashes the risk of catching Covid FOURFOLD in people 60+, Israel's health ministry says. It found that people given a booster shot were four times less likely to catch the virus after 10 days compared to those only given two doses. The findings, believed to be based on real-world data, were presented at a meeting of a ministry panel of vaccination experts on Thursday. But full details of the study are yet to be released. Israel became the first country in the world to start administering booster shots to the over-60s at the end of July — with more than a million already receiving the booster shot.
While a booster is available right now in the U.S. for immunocompromised people, the rest will need to wait. The new coronavirus vaccine data released on Wednesday August 18 by the CDC confirms what other recent research has been saying: The coronavirus vaccines' effectiveness against infection decreases over time. Pfizer and Moderna's effectiveness against infections among nursing home residents over time, and found that it dropped from 75% pre-Delta to 53% when Delta became dominant.
Using New York state data, they found that all three vaccines' effectiveness against infection dropped from 92% in early May to 80% at the end of July, but the effectiveness against hospitalization remained relatively stable.
Although there is still some debate, lab tests suggest the Delta variant is not particularly good at evading the antibodies produced by vaccines or previous infection. That leaves two more probable explanations for the rise in breakthrough cases: Delta’s ferocious infectiousness (60% more infectious than the original strain) or a gradual waning in vaccine-induced immunity. David Dowdy, an infectious disease epidemiologist at Johns Hopkins University, notes that the apparent decline in protection could have other causes, including changes in individual behavior and the rate of transmission in the community. Dowdy notes that in the New York study, the efficacy of COVID-19 vaccines dropped most in the 18- to 49-year-olds and least in those older than 65. That suggests an increase in risky behavior among younger people—such as visits to restaurants, bars, and concerts—may also account for the trend. “People’s behavior has changed substantially” since the last wave, he says, with fewer masks and more large gatherings. “The potential for more frequent—and more intense—exposure over time” plays a role alongside Delta or possible waning vaccine immunity.
If and when the boosters for Pfizer and Moderna are approved, the earliest they’ll become available is September 20, 2021 and only for those who received their second shot at least eight months before.
The latest recommendation for boosters was issued in light of data from Israel, vaccine makers and several U.S. studies suggesting that vaccine-induced immunity to COVID wanes after six months, and that the vaccines are less effective at preventing mild or moderate disease from the coronavirus’s notorious Delta variant than they were against earlier strains. Two doses of the mRNA (Moderna and Pfizer) vaccines still appear to provide excellent protection against severe disease and death.
The first groups that should be getting additional doses include highly immunocompromised people: recipients of solid organ transplants, those with AIDS, those taking highly immunosuppressive drugs for cancer or autoimmune disease—these people have less of a response to vaccination. Some will respond to an extra dose but not all. Also, people in nursing homes, where we have seen breakthrough infections.
Two Reason to get Vaccinated by the Numbers: (1) The vast majority, about 95% of COVID patients requiring hospitalization are unvaccinated. The Mayo Clinic preprint found that from January to July in Minnesota, both the Moderna and Pfizer vaccines were effective at protecting against COVID-associated hospitalization (91.6% vs 85%, respectively) and ICU admission (93.3% vs 87%, respectively). There were no deaths in either cohort. "Taken together, these data confirm that while protection against infection may decrease over time, protection against severe disease and hospitalization is currently holding up pretty well," CDC Director Walensky said.
(2) Large health insurers have stopped waiving COVID-19 treatment costs, an analysis found. Hospitalization could cost you thousands. Nearly three-quarters of the largest health plans are no longer waiving cost-sharing for COVID-19 treatment. Across the two largest health plans in each state and D.C. (102 plans), 73 plans (72% of 102 plans) are no longer waiving out-of-pocket costs for COVID-19 treatment. Almost half these plans (50 plans) ended cost-sharing waivers as of April 2021, which is around the time most states were opening vaccinations to all adults. Of the 29 plans still waiving cost-sharing for COVID-19 treatment, 10 waivers are set to expire by the end of October 2021. This includes waivers that tie to the end of the federal Public Health Emergency, which is currently set to expire on October 17, 2021, though may be extended. Another 12 plans state that their cost-sharing waivers will expire by the end of 2021. Two plans specified end dates for COVID-19 treatment waivers in 2022 and 5 plans did not specify an expiration date.
COVID-19 hospitalizations are skyrocketing in the US: On average, daily hospitalizations have risen seven-fold in the last two months, from around 1,600 per day to 11,700 per day. That's similar to levels recorded in February, before vaccines were widely available. The average cost of hospital care for COVID-19 patients without insurance or who receive out-of-network care varies greatly by age – from $51,389 for patients between 21- and 40-years-old to $78,569 for patients between 41 and 60 years old, according to updated cost analysis data from FAIR.
Hospitals are starting to run out of space, staffs are becoming increasing fatigued, and morgues are running out of room. This pandemic is going in the wrong direction.
Hope on the Horizon for a Better Future: New study boosts hopes for a broad vaccine to combat COVID-19 variants and future coronavirus outbreaks. Scientists from Duke-NUS Medical School and National Centre for Infectious Diseases (NCID) found that 2003 SARS survivors who have been vaccinated with the Pfizer-BioNTech mRNA vaccine produced highly potent functional antibodies that are capable of neutralizing not only all known SARS-CoV-2 variants of concerns (VOCs) but also other animal coronaviruses that have the potential to cause human infection. This finding, published in The New England Journal of Medicine, is the first time that such cross-neutralizing reactivity has been demonstrated in humans, and further boosts hopes of developing an effective and broad-spectrum next-generation vaccine against different coronaviruses. “Our study points to a novel strategy for the development of next-generation vaccines, which will not only help us control the current COVID-19 pandemic, but may also prevent or reduce the risk of future pandemics caused by related viruses," said Professor Wang Linfa from Duke-NUS EID program, who is the senior corresponding author of this study.
What we need to appreciate and understand: I have been doing weekly updates since March 2020. In all those writings I have learned 3 key points: (1) COVID has undergone 4 and possibly 5 mutations since it first came to the US in November/ December 2019. This is part of the reason why the Goal Post for Masking and Vaccinations keeps moving. People’s opinion should be more about the science of prevention and not politics or social media of it. (2) Vaccinations reduce but do not eliminate the risk of infection, subsequent transmission (Breakthrough Infections) and severe disease as the virus continues to mutate. Not all medications are 100% full proof and neither is the vaccine. But the science and the numbers show that the majority of positive cases and hospitalizations are occurring in the unvaccinated. (3) The 3 available vaccines currently reduce serious infection, minimize hospitalizations and deaths which is why getting vaccinated is important so we can develop Herd Immunity before we get to a point where the vaccines are no longer working and (4) Sars-CoV-2 is becoming endemic, meaning continued recurrent outbreaks, and that we may be living with this for a long time. We shall all remain at some risk, which is a difficult message for those with extreme anxiety about Covid-19 to accept. But while herd immunity may be an unattainable goal at this moment, every step towards it helps.
Until next time: Stay Safe, Stay Well, Stay Distant, Wear your Mask when appropriate and Get Vaccinated.
James A. Vito, D.M.D.