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Prompt investigation and contact tracing of Covid-19 cases is still one of the best tools to prevent further transmission and to track variants, according to a US Centers for Disease Control and Prevention.
“Source investigation is important to identify origins and transmissions of viral variants or variants of concern,” said Dr. Melanie Taylor, a senior adviser for the contact tracing innovation section of CDC’s Covid-19 emergency response, during the CDC’s Weekly Partner Call.
Source investigation is a method that is used for communicable diseases that investigates the potential source of infection and identify people who may have been exposed or infected within the given pathogen. The CDC encourages that all positive Covid-19 cases are contact traced within a timely six-day window.
The CDC is encouraging employers and school administrators to collaborate with contact tracers for the most effective community public health strategy and contact tracing data.
The CDC’s traditional contact tracing efforts have focused on prompt investigation of people diagnosed with Covid-19 and early identification, notification and quarantine of people who may have been recently exposed.
The CDC estimates there are approximately 60,000 contact tracers in the US, 29% speak a language other than English and 43% are under 30 years old.
Two new studies suggest that the B.1.1.7 coronavirus variant, which was first identified in the United Kingdom, is more transmissible, but the variant does not appear to affect disease severity in someone who gets Covid-19. The new findings clash with separate research that previously suggested the variant may be tied to a higher risk of dying from Covid-19.
One of the new studies, published on Monday in The Lancet Infectious Diseases, found no evidence in a sample of hospitalized patients that the B.1.1.7 variant is associated with severe Covid-19. However, the variant was associated with increased viral load, which supports the growing evidence that it is more easily transmissible.
The other study, also published on Monday in The Lancet Public Health, found no statistically significant association between the B.1.1.7 variant and the types or duration of Covid-19 symptoms people said that they experienced.
The Lancet Infectious Diseases study included data on 496 people who were admitted to hospitals in London and tested positive for coronavirus infection. Nose and throat swab samples were collected from the patients between Nov. 9 and Dec. 20.
Among those samples, 341 underwent genome sequencing. The sequence data showed that 198 of the patients, or 58%, had infections caused by the B.1.1.7 variant while the others were cased by other strains of the coronavirus. The researchers found no difference in severe disease or death between the variant and other strains.
The data showed that 36% of patients in the study with the B.1.1.7 variant infection experienced severe illness or death compared with 38% of those with non-B.1.1.7 infections. For death specifically, 16% of with the B.1.1.7 variant infection died within 28 days compared with 17% of those with non-B.1.1.7 infections, the researchers found.
But the researchers identified increased viral load among the B.1.1.7 patients.
Overall, “patients with B.1.1.7 were younger and had fewer comorbidities than those with non-B.1.1.7 infection, possibly representing the widespread and potential increased transmission of this variant in the community or differences in probability of hospital admission, which we were not able to explore in this hospital-based cohort,” the researchers wrote in their study.
The Lancet Public Health study included data on 36,920 people who reported testing positive for Covid-19 and logged their symptoms into the COVID Symptom Study app between September 28 and December 27. The app — designed by designed by researchers at King’s College London, Guys and St Thomas’ Hospitals and the tech company Zoe Global Limited — helps track the spread of Covid-19 and the range of symptoms experienced.
The study’s authors, based in the UK and the United States, analyzed the data reported in the app along with Covid-19 surveillance data for the UK. The analysis showed that the prevalence of the B.1.1.7 variant in certain regions and over time was not associated with changes in the Covid-19 symptoms reported in the app nor the duration of symptoms.
The researchers found that the rate of coronavirus reinfections was low — with 0.7% of app users who reported a positive Covid-19 test, testing positive again after 90 days — and there was no evidence of increased reinfection rates associated with the B.1.1.7 variant.
The researchers did not have data on risk of dying from Covid-19 and most of the app users get tested only when they have symptoms, so there were relatively few asymptomatic infections in the data. Yet the researchers found a “multiplicative increase” in the reproduction number of the B.1.1.7 variant, suggesting it can spread more easily.
As the state of Michigan continues to see a rise in Covid-19 cases, Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, said on Monday that it will take more than just vaccinations to get the spread of coronavirus under control.
Rather, Walensky said, the answer may be to shut down the state.
“I think if we tried to vaccinate our way out of what is happening in Michigan, we would be disappointed that it took so long for the vaccine to work, to actually have the impact,” Walensky said. “Similarly, we need that vaccine in other places. If we vaccinate today, we will have, you know, impact in six weeks and we don’t know where the next place is going to be that is going to surge.”
Michigan Gov. Gretchen Whitmer has urged people to limit indoor dining and last week called on schools to suspend in-person instruction and youth sports to halt practices and games for two weeks, but said “these are not orders, mandates, or requirements,” calling it instead “a team effort.”
Whitmer has urged people to get vaccinated, and appealed for more vaccine doses to be sent to the state. President Biden spoke and Whitmer spoke last week about surging federal resources to the state, but those resources would not include a surge in vaccine doses, a White House official told CNN.
The White House said on Monday that it will be sending aid to Michigan to help with administering vaccine, Covid-19 testing and therapeutics.
“In states like Michigan, where we are seeing troubling metrics, we are taking action by deploying resources for critical areas — shots in arms, personnel, testing, therapeutics,” Andy Slavitt, the White House’s senior adviser for Covid-19 response, said during Monday’s virtual briefing.
“There are other things that we can do. We have offered to surge the amount of monoclonal antibodies, testing, there’s a CDC team on the ground, we just sent 140 FEMA vaccinators,” Slavitt said. “We know there are appointments available in various parts of the state, and so that means that we have excess vaccine in some parts of the state — so we’re going to help work with the state, and any state quite frankly, to help the rebalancing, which occurs in a situation like this.”
Though risk assessment will vary person-to-person, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Monday he “would not hesitate” to eat outdoors or go to a baseball game in current Covid-19 conditions.
“At an outdoor restaurant right now, where we are, I would not hesitate to do that, but the fact is I just haven’t done it,” Fauci told CNN’s Wolf Blitzer, adding that his “crazy obligations and jobs” make it hard to sit down at a restaurant.
Fauci added that attending baseball games is also something he’s personally comfortable with now.
“I would not hesitate to go to an outdoor baseball game. I will wear a mask because I’m out there in the community, my risk would be extremely low,” Fauci said. “I’m someone that is a bit risk averse, but I would not hesitate to sit in an open stand and watch the Nats play.”
The United Kingdom has reached its Covid-19 vaccination target of offering a dose to all adults over 50, the clinically vulnerable and social care workers, the British government said in a statement on Monday.
“We will now move forward with completing essential second doses and making progress towards our target of offering all adults a vaccine by the end of July,” he added.
The statement said the target had been reached ahead of schedule, with the government having pledged to offer a first dose to priority cohorts 1 to 9 by April 15.
Nearly 40 million vaccines have now been given in total, with adults under 50 expected to begin to be invited in the coming days, the statement added.
The Oxford-AstraZeneca Covid-19 vaccine is to be recommended only for people aged 60 years and older in Ireland, according to a revised advice from Ireland’s National Immunisation Advisory Committee (NIAC) on Monday.
The new advice reads: “Vaxzevria COVID-19 vaccine AstraZeneca is not recommended for those aged under 60 years including those with medical conditions with very high or high risk of severe COVID-19 disease.”
It also recommends not giving a second dose of the AstraZeneca vaccine “to anyone who developed unusual blood clots with low platelets after the first dose.”
However, it says people aged under 60 years with a very high risk or high-risk medical condition should receive their second dose 12 weeks later as scheduled, while those aged under 60 years without a very high risk or high-risk medical condition should have the scheduled interval between doses extended to 16 weeks to “allow further assessment of the benefits and risks as more evidence becomes available.”
Commenting on the new advice, NIAC Chair Karina Butler said:
“All the authorised COVID-19 vaccines – Pfizer, Moderna and AstraZeneca and the newly approved Janssen, are highly effective in preventing hospitalisation and severe COVID-19 disease. Vaccination with Vaxzevria COVID-19 AstraZeneca vaccine is highly effective and substantially reduces the risk of severe COVID-19 disease across all age groups,” she added.
The decision by NIAC follows the announcement by the European Medicines Agency that it had found a possible link between the vaccine and the occurrence of rare blood clots.
New York Gov. Andrew Cuomo announced new updated guidance for graduation and commencement ceremonies organized by schools, colleges and universities.
Effective May 1, indoor and outdoor graduation and commencement ceremonies will be allowed with limited attendee capacity, depending on the event size and the location.
Outdoor Events:
Indoor Events:
“We’re once again approaching the end of the academic year which means we need strict rules in place to ensure commencement ceremonies are done safely in the context of the ongoing pandemic,” Cuomo said.
“With more people getting vaccinated every day, we are so close to the light at the end of the tunnel, but we all need to continue being vigilant and I am urging everyone to celebrate smart,” he added.
All public and private schools in Puerto Rico must stop all in-person learning for two weeks due to a rise in Covid-19 cases, according to a statement tweeted by Puerto Rico’s Secretary of Health Carlos Mellado López.
The decision comes just a little more than a month after some schools on the island reopened for in-person learning for the first time since the pandemic hit, for K-3 students and high school seniors.
There will be no face-to-face instruction starting Monday until at least April 26. The decision was made by Gov. Pedro Pierluisi and Puerto Rico’s Education Secretary Elba Aponte.
“We urge the public and call for prudence and to continue with the protection protocols,” the statement said.
There are more than 800 schools and nearly 300,000 students in Puerto Rico’s public school system, according to the National Center of Education Statistics’ data from the 2019-2020 school year.
Presidents of the Brazilian Congress and Senate announced Monday that they asked United Nations Secretary-General Antonio Guterres to help accelerate the delivery of vaccines to the country.
Rodrigo Pacheco, head of the Senate, also said he spoke to Guterres and reinforced the need for doses from COVAX to arrival in Brazil.
“I reinforced the request for help from the UN so that the country becomes a priority for the international consortium Covax Facility to anticipate vaccine deliveries,” wrote Pacheco.
Guterres tweeted on Saturday saying, “More countries are beginning to receive vaccine supplies, but most people in low- and middle-income nations are still waiting. Vaccine equity is a moral test of global solidarity. COVAX – the @UN-led initiative to ensure equitable access, must be funded and supported.”
The Brazilian health ministry registered at least 1,803 new deaths and 37,017 cases of the novel coronavirus on Monday. Since the beginning of the pandemic, the country registered 353,137 deaths and 13,482,023 cases of Covid-19.
Brazilian President Jair Bolsonaro meanwhile has shrugged off criticisms that he is “genocidal” in his opposition to Covid-19 restrictions as the country reached new records in cases. The President has repeatedly opposed lockdowns and restrictive measures, and criticized governors and mayors with insulting language for implementing them.
Almost 190 million doses of Covid-19 vaccine have been administered in the United States, according to data published Monday by the US Centers for Disease Control and Prevention.
The CDC reported that 189,692,045 total doses have been administered – about 80% of the 237,796,305 doses delivered.
That’s about 2.6 million more doses reported administered since yesterday, for a seven-day average of about 3.2 million doses per day.
More than 36% of the population – nearly 121 million people – have received at least one dose of Covid-19 vaccine, and more than 22% of the population – about 74 million people – are fully vaccinated, according to CDC data.
Among adults, 46.5% have received at least one dose of Covid-19 vaccine, and 28.6% are fully vaccinated.
The US is on track to reach half of the adult population with at least one dose by the end of the week, according to a CNN analysis of CDC data.
Eleven states have already reached this threshold:
Data published by the CDC may be delayed, and doses may not have been given on the day reported.
The number of people with Covid-19 in intensive care units in Sweden has hit its highest point since the first wave, according to data from the Swedish Intensive Care Registry on Monday.
There are currently at least 393 people in intensive care with Covid-19 across the country.
That topped the 389 who were treated in ICUs in early January, but was below the number in intensive care during the first wave of the pandemic in spring 2020, when the total reached as high as 558.
Covid-19 vaccinations for children aged 12 to 15 may be available as soon as early fall and will likely be administered through pediatricians’ offices, according to the White House.
Clinical trial results of Pfizer/BioNTech’s coronavirus vaccine have shown it is well tolerated and its efficacy is 100% among children ages 12 to 15, the companies announced in late March.
On Friday, Pfizer requested an emergency use authorization amendment to expand use of its coronavirus vaccine in the US to people ages 12 to 15. Currently, the vaccine is authorized for emergency use by the US Food and Drug Administration in people ages 16 and up.
“We would hope that children in high school will be able to be vaccinated by the time we get to the early fall season,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases said during Monday’s briefing.
There have now been seven consecutive weeks of increasing Covid-19 cases and four weeks of increasing deaths globally, Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, said during a news briefing in Geneva Monday.
“In January and February the world saw six consecutive weeks of declining cases,” Tedros said. “We have now seen seven consecutive weeks of increasing cases and four weeks of increasing deaths. Last week was the fourth highest number of cases in a single week so far.”
Several countries in Asia and the Middle East have seen large case increases, he said.
Increases are occurring despite more than 780 million vaccine doses being administered globally, he said, adding that vaccines are a vital and powerful tool, but not the only one.
He emphasized that public health measures – mask wearing, physical distancing, ventilation, hand hygiene, surveillance, testing, tracing and isolation – work to stop infections and save lives.
In the days before all 50 states are set to expand vaccine eligibility to all American adults on April 19, the White House made a plea for seniors and others currently eligible to get vaccinated.
There has been “significant progress” vaccinating seniors, White House senior Covid-19 adviser Andy Slavitt said at Monday’s briefing, pointing to the fact that 78% of Americans over 65 have had their first shot.
“If you have someone in your life, particularly a senior, who has not gotten a shot yet, reach out and see what help they need,” he added.
Slavitt said that 120 million Americans have now been vaccinated, including over 72 million fully vaccinated.
At least 46% of adults have had at least their first shot, with 28% of adults fully vaccinated, he said.
New York Gov. Andrew Cuomo announced Monday that the state’s colleges and universities will get direct allocations of Covid-19 vaccines to administer vaccinations directly to their student populations.
State Health Commissioner Dr. Howard Zucker said the goal is to vaccinate students by the end of the spring semester before they return to their families.
“Vaccinating college students statewide before they return to their hometown communities at the end of the semester is the next step in this thought process it is the best way for students to protect themselves, their families and their communities,” Zucker said.
The Biden administration outlined new steps to continue to increase vaccinations and vaccinators, including a new mass vaccination site as one of the steps toward getting more shots in arms.
“We’re excited to announce today a new federally-run mass vaccination site in Central Point, Oregon,” White House senior Covid-19 adviser Andy Slavitt said at Monday’s Covid briefing.
He noted that President Biden had set a goal on March 29 of adding a dozen such new sites by April 19.
The administration is also on track to reach its goal of expanding the number of pharmacies in the federal pharmacy program, Slavitt said, with nearly 40,000 up and running by next Monday.
Additionally, there are 8,500 federal personnel acting as vaccinators or supporting vaccinations, including 4,400 active duty troops. That will increase to 6,000 active duty troops in the coming week, Slavitt said.
Slavitt touted “record pace” of vaccinations, despite “uneven supply from Johnson & Johnson,” pointing to a Saturday record of 4.6 million shots administered.
Breakthrough coronavirus infections – which occur even though someone has been vaccinated – are inevitable because no vaccine is 100% effective, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“Influenza is the most common of this, which mutates rapidly,” he added. But “even if a vaccine fails to protect against infection, it often protects against serious disease.”
Fauci added that, so far, data suggest current Covid-19 vaccines offer some protection against coronavirus variants.
Racial and ethnic minority groups had higher rates of hospitalization for Covid-19 and sought emergency department care more when compared to White people, according to two new studies published Monday in the US Centers for Disease Control and Preventions Morbidity and Mortality Weekly Report.
In every region, Hispanic patients represented the highest cumulative proportion of hospitalized patients with Covid-19.
Disparities in the proportion of hospitalized patients was largest early in the pandemic – from April to July – and became less pronounced as hospitalizations increased among White patients. Declining disparities are not necessarily reflective of reduced risk for minorities, but of increased risk for White patients, the authors said.
However, disparities remained at the end of the study period in all regions, particularly among Hispanics in the West.
The researchers say that these disparities are driven by a higher risk factor for exposure to the coronavirus and a higher risk of severe disease.
The second study found that some racial and ethnic groups, including Hispanic, American Indian or Alaska Native and Black people, received emergency department care for Covid-19 at “disproportionately higher rates” compared to White patients.
There were 282,220 Covid-19 emergency department visits from 13 states between October and December 2020 and racial/ethnic disparities were observed across age groups.
Hispanic patients and American Indian or Alaska Native patients were more likely to seek emergency department care for Covid-19 than White people overall, as well as for each age group examined. Black people age 74 and older were more likely to seek emergency department care than White people, but no differences were observed for those under 75.
The data used in the study came from 13 states, meaning that it may not be generalizable across the country. White people also represent a larger percentage of the population in the 13 states, compared with national population distribution.
The authors say that it is important to prioritize prevention resources, management of underlying health conditions, safe school and work conditions, flexible leave policies and enhanced access to and acceptability of Covid-19 testing and vaccination to reach these disproportionately affected groups.
As many as five million religious pilgrims are expected to flock to the Ganges river as coronavirus cases soar in India.
The country reported at least 168,912 new cases Monday, its highest single-day figure for the sixth consecutive day, according to a CNN tally of figures from the Indian ministry of health. CNN’s Vedika Sud reported on the latest from New Delhi and answered viewers’ questions.
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New York City has administered five million vaccine doses, which the mayor said “keeps us well on target for our overall goal, five million fully vaccinated New Yorkers in June.”
Mayor Bill de Blasio said over a half a million vaccinations were administered just last week, a record for the city, with a record breaking 104,000 administered on April 8 alone.
Approximately 5,106,027 doses have been administered since the beginning of the city’s effort, which is more than the entire population of the state of Alabama.
The city is kicking off a vaccination site in Times Square, the heart of Broadway, to assist the cultural community. De Blasio said the film and television community are “coming back strong,” adding, “We’re going to welcome them to join the vaccination center in Times Square.” The city is working with the unions within the industry, he said.
Several more grassroots vaccination sites at senior centers, houses of worship, public housing and elsewhere come online this week in all five boroughs.
