- CDC expected to ease Covid-19 recommendations, including for schools
- Biden administration declares monkeypox a public health emergency
- Updated Covid-19 boosters are expected in September. Will it be too late?
- 'The next public health disaster in the making': Studies offer new pieces of long Covid puzzle
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CDC expected to ease Covid-19 recommendations, including for schools |
The US Centers for Disease Control and Prevention is expected to update its guidance for Covid-19 control in the community, including in schools, in the coming days, according to sources familiar with the plan. A preview of the plans obtained by CNN shows that the updated recommendations are expected to ease quarantine recommendations for people exposed to the virus and de-emphasize 6 feet of social distancing. The agency is also expected to de-emphasize regular screening testing for Covid-19 in schools as a way to monitor the spread of the virus, according to sources who were briefed on the agency's plans but were not authorized to speak to a reporter. The plans say it may be more useful to base testing on Covid-19 community levels and whether settings are higher-risk, such as nursing homes or prisons. The changes were previewed to educators and public health officials. Sources say the tweaks reflect both shifting public sentiment toward the pandemic -- many Americans have stopped wearing masks or social distancing -- and a high level of underlying immunity in the population. Screening of blood samples suggests that as of December, 95% of Americans have had Covid-19 or been vaccinated against it, reducing the chances of becoming severely ill or dying if they get it again. The CDC's recommendations are not legally binding. Many cities, states and school districts will review them, but may ultimately follow different strategies. Still, the agency's guidance continues to be important as a baseline, and when cities or states try to go beyond what the CDC recommends, they sometimes face pushback. |
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Biden administration declares monkeypox a public health emergency |
The Biden administration has declared monkeypox a public health emergency as cases continue to rise across the US. The administration has been heavily criticized by some public health experts for not moving faster to address the crisis. One of the criticisms of the administration's response was that the Department of Health and Human Services waited more than three weeks after the first reported case of monkeypox in the US to order bulk stocks of the monkeypox vaccine, which the government owns and stores in Denmark, be bottled and sent to the US for distribution. The delay was in part out of concern that once those vaccines were taken out of bulk storage, they would lose years of shelf life. Now, the government is moving forward with a plan change to how the vaccine is administered so it can stretch the available supply. The shift involves administering Jynneos vaccine shots intradermally instead of subcutaneously, US Food and Drug Administration Commissioner Dr. Robert Califf said last week. "We're considering an approach for the current doses of Jynneos that would allow health-care providers to use an existing one-dose vial of the vaccine to administer a total of up to five separate doses," Califf said. The monkeypox vaccine is currently given subcutaneously, meaning it's delivered below the skin. But with an intradermal vaccination, "basically, you're staying in the skin; you're not going through the skin," said Dr. Daniel Griffin, an infectious disease specialist at Columbia University. Using a smaller dose with intradermal injection has been done with vaccines for flu and rabies, epidemiologist Dr. Jay Varma told CNN in an email. "If you're able to give the monkeypox vaccine intradermally, you can give a smaller dose. ... They just would need to have some sort of demonstration that you get the same immune response," Griffin said. |
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Updated Covid-19 boosters are expected in September. Will it be too late? |
This fall, Americans could get boosted with a mRNA Covid-19 vaccine unlike any that has come before. Both Pfizer and Moderna are working on bivalent boosters: vaccines made up of both the old formula and a new one that targets the Omicron BA.4 and BA.5 subvariants of the coronavirus. If the shots meet FDA standards, they could be available as early as September, the agency says. But Covid-19 cases are high right now. There are more than 100,000 new cases reported each day -- far from the levels reported during the first Omicron surge but nearing peak case rates from the Delta wave -- and cases are more undercounted than ever. Some experts wonder whether the Omicron-specific boosters will come in time to make a difference and if they will actually offer more protection than the current shots. Dr. Michael Chang, a pediatric infectious disease specialist at Memorial Hermann Health System in Houston, thinks vaccines with an Omicron component will be helpful -- within limits. "I just wish that the timing had been sooner so that we could actually be dealing with the kind of BA.5 surge that we have right now," he said. "I do think, anytime you can introduce additional strains or variants into a vaccine, the human body's immune response tends to be a little bit broader and more durable and potentially longer-lasting," he said. But it's impossible to know at this point what variant will be dominant a couple months from now, how different it will be from the currently circulating variants or even how many cases there will be, because it's hard to predict how humans will behave when cases rise -- and cases will most likely rise. Much like with the flu, scientists think the coronavirus transmits more efficiently in colder weather. It also spreads more easily as people spend more time indoors. The Covid-19 Scenario Modeling Hub, a group of scientists across the country who create projections for the coming year, predicts an upswing in hospitalizations through early fall. But the model suggests that a booster campaign will make a dent in these numbers, according to Justin Lessler, a University of North Carolina epidemiologist who works with the group. While scientists are still trying to determine exactly how well the new vaccines will protect people, Lessler said, the model assumes that the reformulated vaccine would have about 80% efficacy against infection with the currently circulating strains. But that depends on how many people actually get an updated booster. "Absent any real new variants, that kind of efficacy would be enough to really tamp down the current circulation if we have a broad uptake of the vaccines," Lessler said. "A new vaccine could really pay dividends, particularly if we can get it to a broad swath of the population." Ideally, public health campaigns could be built to encourage people to get a flu vaccine and a Covid-19 vaccine at the same time, he said. |
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'The next public health disaster in the making': Studies offer new pieces of long Covid puzzle |
There's no test for long Covid. There's no specific drug to take or exercises to do to ease its symptoms. There isn't a consensus on what long Covid symptoms are, and some doctors even doubt that it's real. Yet with vast numbers of people having had Covid-19, and estimates ranging from 7.7 million to 23 million long Covid patients in the US alone, researchers say it has the potential to be "the next public health disaster in the making." President Joe Biden said in April that long Covid was a priority for his administration and ordered two reports: one that lays out a research agenda for the country and one that sketches out the federally funded services and support available for people in the US with long Covid. "A national, US government-wide coordinated, action-oriented approach is urgently needed," the report says. The plan proposes a new long Covid office within the US Department of Health and Human Services, but does not offer specifics on how to fund or staff the office. A new report from the CDC says kids with long Covid have a much higher chance of serious lung, heart, kidney and pancreatic problems than kids who did not catch the virus. Children with long Covid also had a higher chance of kidney failure and were more likely to develop type 1 diabetes. All of these conditions are rare or uncommon in this age group, the CDC says. As of the last week in July, more than 14 million children in the US have tested positive for Covid-19, according to the American Academy of Pediatrics. But it's unclear how many have had long Covid. Another new long Covid study finds that 1 in 8 adults with Covid-19 may have symptoms months beyond the initial infection. The study, published in the journal The Lancet, found that 12.7% of people with Covid-19 had new or severely increased symptoms at least three months after their initial diagnosis, a smaller percentage than some other research has suggested. The researchers say scientists must do more to determine what long Covid is and how many people get it, as well as how to treat or even prevent it. "Research has been hampered by an absence of a consensus on the prevalence and nature of the post-Covid-19 condition," the study says. "There is an urgent need for empirical data informing on the scale and scope of the problem to support the development of an adequate health-care response." |
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It's hard to live life with Covid-19 hanging over our heads. But even as new variants continue to rear their heads, I think we should take comfort in the fact that one key piece of public health messaging continues to be true: Vaccines and boosters work. The messaging can get messy, especially when you hear about waning antibody levels and the need for updated vaccines, but all of that shouldn't take away from the power of the vaccines we have right now. My CNN colleague Elizabeth Cohen obtained data from New York's largest health-care provider, and it shows that if you're young, healthy and vaccinated, "you're going to be in a pretty good place." That's according to Dr. William Schaffner, a vaccine adviser to the CDC. The Northwell Health data showed that nearly 2,000 people were hospitalized for Covid-19 from May through July; 80% of those were over 60, and nearly 90% of them had an underlying health condition. Importantly, the vast majority of hospitalized patients were not up to date on their Covid-19 vaccinations, and those who were and still needed hospitalization were mostly over 65. About 47% had not received any vaccination. Dr. Jill Kalman, Northwell's chief medical officer, also pointed out that hospitalized Covid-19 patients are having better outcomes than they were before. "The mortality rate now is very low: It's around 2%, and it was around 10 to 12% during Delta," she said. "And if they do get into the ICU, they're not staying as long. In the first wave, we were seeing patients in the ICU for 15, 20, 30 days, and it's a fraction of that now." This should be encouraging news for some and, for others, a reminder about the tools already available to help Covid-19 fade further into the background. |
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