As the days shorten and people come indoors, what should we expect as we head into our second COVID-19 autumn and winter?
Last year, Thanksgiving and Christmas triggered a pandemic spike. Over holiday season 2020, California’s daily case counts climbed as high as 54,000. In contrast, the state is now reporting about 5,500 new cases a day.
While nothing is certain, there is more optimism. “We’re in a much better place than we were last year,” said UC San Francisco epidemiologist Dr. George Rutherford.
“I think we’ll see a small to moderate winter surge,” Rutherford predicted. It won’t be as pronounced as last winter’s pandemic but may mimic the smaller spike in cases experienced in August, he said.
Why? There’s growing immunity — and several pending steps by federal authorities to fight the virus. While there are still pockets of unvaccinated people in the Bay Area, overall vaccination rates in some counties for residents 12 and up have surpassed 80%. Statewide, 71% of eligible Californians are fully vaccinated. This population-wide protection is expected to climb still higher once children are eligible to get shots.
Here’s a look at what the months ahead will bring.
Children will start to be vaccinated.
On Thursday, Pfizer submitted clinical trial data to the U.S. Food and Drug Administration to authorize emergency use of their vaccine for kids ages 5 to 11. Pfizer’s data shows that the vaccine is safe and triggers a robust strong immune response in kids.
The agency will meet on Oct. 26 to consider this plan — suggesting we may see a decision and distribution of the vaccine for kids between Halloween and Thanksgiving.
The pediatric vaccine is not as straightforward as it sounds. It will hold one-third the dosage of the vaccine for older youth and adults, according to Pfizer. This likely requires dilution and perhaps a different formulation.
If successful, that move would help protect another 28 million Americans.
“It’s an important advance,” said Rutherford. “The number of COVID-19 hospitalizations is right up there with the worst of the childhood infectious diseases. We want to extend the existing technology — not just to protect them from getting sick, but to prevent transmission.”
Waning immunities will get a boost.
There’s concern that as immunity levels in communities start to subside, there will be a new resurgence of cases. So far, only Pfizer’s vaccine has been authorized for booster doses. And it’s offered only to older and other vulnerable Americans, such as people with medical conditions or jobs that place them at higher risk of exposure. There are no imminent plans to expand the eligible population.
Americans are welcoming this third shot, according to new Centers for Disease Control and Prevention data. Of the 6.6 million shots given from Sept. 30 to Oct. 6, more than 2.6 million of them were booster shots, compared to 2 million first doses and 2 million second doses.
Next week, on Oct. 14 and 15, an FDA committee plans to discuss Moderna and J&J booster vaccines. If authorized, these vaccines may be offered to a narrower group of people than the Pfizer vaccine. That’s because overall immunity after the initial round of Moderna and J&J vaccines seems to hold up better over time than the Pfizer vaccine.
There will be more mixing-and-matching of vaccines.
Also next week, the FDA committee plans to discuss whether people should be allowed to get a booster shot of a different vaccine than the one they originally received.
So-called “mixing and matching” of vaccines — getting a first dose of Pfizer, followed by a second dose of Moderna — is already used in Europe and other places, so it will likely be approved in the U.S. In fact, there have been recent studies suggesting that using two different vaccine technologies — getting both the J&J and Pfizer vaccines, for instance — may offer more vigorous protection than sticking with one type.
That could boost convenience. It could also assure better protection on university campuses, where a large number of Chinese and other international students have gotten the Sinovac or Sinopharm vaccines, which work less well than their foreign counterparts.
Pharmaceutical companies don’t conduct mix-and-match clinical trials; they only research their own product. So the National Institutes of Health has structured a giant comparison study to help answer the mix-and-match question.
There will be more testing.
Earlier this year, we thought vaccinated people couldn’t spread the virus. That’s changed.
“For now, testing and knowing your status is going to be extremely important to keep businesses and schools running,” said Dr. Michael Mina, an epidemiologist at Harvard University’s Department of Immunology and Infectious Diseases.
This past week, the FDA authorized a new COVID-19 home test that is expected to double the nation’s limited supply of non-prescription tests. The FDA’s emergency use authorization of ACON Laboratories’ Flowflex COVID-19 home test means that tens of millions of additional tests will soon be available. While the consumer price is not yet known, large retailers such as Walmart, Amazon and Kroger have agreed to sell at-home tests at the cost they pay for them.
Production could double to 200 million monthly tests by February, according to the FDA. That could be enough to supply the schools and companies who carry out President Biden’s “vaccinate-or-test” mandate for businesses with 100 or more employees.
It’s important to test yourself promptly before traveling or attending an event, said Mina. Currently, many places allow testing up to three days before.
“That’s like going through a TSA security checkpoint at the airport and then being allowed to go back home for three days and repack your bags,” he said. “Then when you come back, you don’t have to go through security again. That’s not a good way to screen.”
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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