COVID19 🦠 Newsbites
C.D.C. Will Not Investigate Mild Infections in Vaccinated Americans
At least 10,000 vaccinated people were infected with the coronavirus through the end of April. Now the agency has stopped pursuing the mildest cases.

No vaccine provides perfect protection, and so-called breakthrough infections after coronavirus vaccination are rare and unlikely to lead to serious illness. Federal health officials have told fully vaccinated people they no longer need to wear masks or maintain social distance because they are protected, nor do they need to be tested or quarantine after an exposure, unless they develop symptoms.

Now, the Centers for Disease Control and Prevention has stopped investigating breakthrough infections among fully vaccinated people unless they become so sick that they are hospitalized or die.

Earlier this year, the agency was monitoring all cases. Through the end of April, when some 101 million Americans had been vaccinated, the C.D.C. had received 10,262 reports of breakthrough infections from 46 states and territories, a number that was very likely “a substantial undercount,” according to a C.D.C. report issued on Tuesday.

Genomic sequencing could be done on only 555, or about 5 percent, of the reported breakthrough cases. Over half of them involved so-called variants of concern, including the B.1.1.7 and B.1.351 variants.

Some 995 people were known to have been hospitalized, and 160 had died, though not always because of Covid-19, the new study said. The median age of those who died was 82.

The numbers suggest that the vaccines are highly effective and generally working as expected. On May 1, the agency decided to investigate only the most severe breakthrough infection cases, while still collecting voluntary reports on breakthrough cases from state and local health departments.

The agency will carry out vaccine effectiveness studies that include data on breakthrough cases, but only in limited populations, such as health care workers and essential workers, older adults, and residents at long-term care facilities, a spokeswoman said.

Some scientists support the decision to focus on the illnesses that cause deaths, tax hospitals and overwhelm the health care system. Still, the move has been controversial.

Critics say the agency is missing important opportunities to learn about the real-world effectiveness of the different vaccines and to gather information that might help identify trends in the pandemic’s trajectory — for example, how long vaccine protection lasts, or how various vaccines compare in preventing infection with variants, or whether certain patients like older people are more susceptible to breakthrough infections.

... The change was announced quietly in a statement on the agency’s website this month. It said the switch “will help maximize the quality of the data collected on cases of greatest clinical and public health importance.”

Asked to explain the change, a C.D.C. spokeswoman said that no vaccine was 100 percent effective, but that the number of Covid-19 cases in fully vaccinated people was small and that no significant demographic trends had been identified.

... But even relatively mild cases of Covid-19 can lead to persistent long-term health problems, and it will be difficult to know the full scope without tracking mild infections as well.

... Another rationale given for not tracking all breakthrough infections is that they are not likely to result in further spread of the virus. But the scientific evidence for this is not conclusive, some experts say.

... Collecting more data is always preferable to collecting less. “The virus is constantly changing, and we need to stay three steps ahead of it,” said Michael Kinch, an immunologist and associate vice chancellor of the Centers for Research Innovation in Biotechnology at Washington University in St. Louis.

“What if a variant arises that is less responsive or, Lord forbid, unresponsive to the vaccines?” he said. “The way you stop it is good old-fashioned epidemiology, which the C.D.C. has historically done very well. But if you don’t see it coming, you can’t stop it.”
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Just How Big Could India’s True Covid Toll Be?
The official Covid-19 figures in India grossly understate the true scale of the pandemic in the country. Last week, India recorded the largest daily death toll for any country during the pandemic — a figure that is most likely still an undercount.

Even getting a clear picture of the total number of infections in India is hard because of poor record-keeping and a lack of widespread testing. Estimating the true number of deaths requires a second layer of extrapolation, depending on the share of those infected who end up dying.

In consultation with more than a dozen experts, The New York Times has analyzed case and death counts over time in India, along with the results of large-scale antibody tests, to arrive at several possible estimates for the true scale of devastation in the country.

Even in the least dire of these, estimated infections and deaths far exceed official figures. More pessimistic ones show a toll on the order of millions of deaths — the most catastrophic loss anywhere in the world.

India’s official Covid statistics report 26,948,800 cases and 307,231 deaths as of May 24. A Times analysis of the true toll found a best-case estimate of 404.2 million cases and 600,000 deaths. A worst-case scenario puts deaths at 4.2 million.

Even in countries with robust surveillance during this pandemic, the number of infections is probably much higher than the number of confirmed cases because many people have contracted the virus but have not been tested for it. On Friday, a report by the World Health Organization estimated that the global death toll of Covid-19 may be two or three times higher than reported.

The undercount of cases and deaths in India is most likely even more pronounced, for technical, cultural and logistical reasons. Because hospitals are overwhelmed, many Covid deaths occur at home, especially in rural areas, and are omitted from the official count, said Kayoko Shioda, an epidemiologist at Emory University. Laboratories that could confirm the cause of death are equally swamped, she said.

Additionally, other researchers have found, there are few Covid tests available; often families are unwilling to say that their loved ones have died of Covid; and the system for keeping vital records in India is shaky at best. Even before Covid-19, about four out of five deaths in India were not medically investigated.
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Wisconsin Catholic pastor who preached against Covid-19 vaccine ordered to step down
James Altman of the St. James the Less Catholic Church claims he's a victim of the "cancel culture".

The pastor of a Roman Catholic parish in Wisconsin who told his congregation to shun the Covid-19 vaccine and preached right-wing politics from the pulpit has been asked to step down by his bishop.

The Rev. James Altman, of the St. James the Less Roman Catholic Church in La Crosse, made the announcement during his sermon at Sunday Mass, calling himself a victim of the “cancel culture.”

“If the left whines, like they do, like a spoiled brat often enough, they succeed in canceling so many voices of truth,” he said. “And now that they are whining like, if I may say it, the pansy babies that they are, to cancel me.”

Altman, whose sermon was posted on YouTube, said Bishop William Callahan of the Diocese of La Crosse asked him to resign Friday and called him “divisive and ineffective.” He said he’s engaged a canon lawyer and intends to fight the bishop’s decision, but that this could be his last sermon as pastor.

“I am no expert on canon law, but understand only that while we are contesting the Bishop’s request — and we are — he could in theory appoint a parish administrator whilst I remain a pastor without duties until the appeal goes through Rome, which can take up to a year or more,” he said.

Some members of the congregations could be heard on the video saying “No.”

... Altman has courted controversy in recent years by denouncing the Black Lives Matter movement and making other conspiratorial false claims about climate change and systematic racism and homophobia that are common in right-wing media.

Before the presidential election, he insisted in a video produced and posted on YouTube by a right-wing group that “you cannot be Catholic and a Democrat.”

As for the pandemic that has killed nearly 594,00 people in the United States and sickened more than 33 million, Altman called it a “hoax” during Easter weekend services that attracted 300 to 500 worshippers, few of whom wore masks or practiced social distancing, The La Crosse Tribune reported.

Also, church bulletins approved by Altman have been rife with more Covid-19 misinformation and baseless claims about the efficacy and safety of the vaccines.

... "None of Altman's hateful words or dangerous actions speak for the Gospel of Jesus Christ, and now Bishop Callahan has thankfully made it clear that Altman does not speak for the Catholic Church, either," Nathan Empsall, head of the Christian watchdog group Faithful America, said in a statement.

"We pray for all who have fallen victim to the lies and bullying of false prophets like James Altman, and we encourage all our siblings in Christ to receive a safe and effective Covid-19 vaccine as soon as they can," said Empsall, an Episcopalian whose group has also criticized Protestants for things like fanning anti-Islamic hate.
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Half Of All U.S. Adults Are Now Fully Vaccinated Against COVID-19
The U.S. COVID-19 vaccination program has gone from zero to 50% in less than six months.

As of Tuesday afternoon, the Biden administration said, half of the country's adults are now fully vaccinated against the coronavirus.

"This is a major milestone in our country's vaccination efforts," Andy Slavitt, a White House senior adviser on the COVID-19 response, said during a midday briefing. "The number was 1% when we entered office Jan. 20."

Nearly 130 million people age 18 and older have completed their vaccine regimens since the first doses were administered to the public in December, the Centers for Disease Control and Prevention said. Another 70 million vaccine doses are currently in the distribution pipeline, according to the agency.

Vaccinations have risen sharply in children 12 years and older, weeks after the Food and Drug Administration said that cohort is eligible to receive the COVID-19 vaccine made by Pfizer-BioNTech. Nearly 5 million adolescents have received at least one dose of the vaccine, according to the CDC's latest data.

The U.S. is pushing to add millions more people to the ranks of the vaccinated. President Biden said this month that his new goal is to administer at least one dose of a COVID-19 vaccine to 70% of U.S. adults by the Fourth of July.

Nine states have given at least one vaccine shot to 70% of their adult population, Slavitt said at Tuesday's briefing. Acknowledging the welcome return to a more normal life taking place around the country, he urged more people to get the vaccine: "Unless you're vaccinated, you're at risk."

... The stunning speed of the vaccines' development and rollout has helped tame COVID-19 in the U.S., which remains the worst-hit country in the world, despite having less than 5% of the world's population. The U.S. has reported more than 33 million COVID-19 cases, and more than 590,000 people have died from the disease.

Vaccination rates vary sharply across the nation. On the state level, more than half of all adults were fully vaccinated in just 25 states, along with the District of Columbia and Guam.

The lowest overall vaccination rates in the U.S. remain in the South, where Mississippi, Alabama, Louisiana and Arkansas have administered the fewest doses per 100,000 adults, according to the CDC. The highest rates are in Vermont, Massachusetts, Hawaii and Connecticut.
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Americans abroad can now enter the U.S. on expired passports.
The State Department’s new exception for expired passports applies both to adults, whose documents are valid for 10 years, and to children, whose passports expire after 5 years. It applies only when entering the United States; travelers leaving the country will still be required to have current documents.

New parents should note that the exception does not apply to babies born overseas who have not yet been issued a passport or an official record of a child’s claim to U.S. citizenship, known as a Consular Report of Birth Abroad.

To take advantage of the exception, citizens must be in possession of their expired passport, and must be flying to the United States, either directly or on a connecting flight with a short layover. Expired passports cannot be used for travel from one foreign country to another.

All American citizens returning to the country must still show proof of a negative Covid-19 test result taken within 72 hours of departure.
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Fauci Optimistic Over Moderna Vaccine for Teenagers

Moderna said Tuesday that its Covid-19 vaccine was 100 percent effective in a study of adolescents ages 12 to 17. Dr. Anthony S. Fauci, the infectious disease expert, was optimistic about the vaccine’s ability to ensure in-person school in the fall.

The significance of the Moderna press release that they will have 12 to 18-year-old — that they will have an application in next month.” “Yeah, well, certainly that’s one of the things we would like to have, because if you put the Pfizer together, which already will be able to vaccinate, and are vaccinating 12 to 15-year-olds, together with the recent data from Moderna, which likely would lead as we enter into the beginning of the new fall term, that hopefully we’ll be able to get adolescent vaccine. I mean, high school students vaccinated actually before they enter the fall term, which is really very good news. So now we have not only a single company, Pfizer, but it looks very much like we’ll have the source of another similar vaccine in mRNA for Moderna. So all good.
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C.D.C. Director Warns Unvaccinated Remain at Risk
As of Tuesday, 50 percent of those 18 or older in the U.S. were reported as fully vaccinated, according to data from the C.D.C. More than 61 percent of adults have received at least one shot, though the pace has been slowing. President Biden set a goal on May 4 of at least partly vaccinating 70 percent of adults by July 4 as the administration has shifted its strategy in order to reach those who may still not have gotten shots.

But Dr. Walensky also urged those who remain unvaccinated to add a new activity to their Memorial Day rituals. “I want to encourage you to take this holiday weekend to give yourself and your family the gift of protection by getting vaccinated,” she said. “We are on a good downward path, but we are not quite out of the woods yet.”

Dr. Walensky’s remarks come after the C.D.C. said this month that it was no longer necessary for fully vaccinated people to mask or maintain social distance in many settings. The change was a major step for the federal government toward coaxing Americans closer to a post-pandemic world, even as the spread of the virus persists the globe.

And as U.S. states and retailers gradually began adopting the guidance, being able to distinguish who was vaccinated or who was not essentially turned into an honor system that relies on unvaccinated people keeping their masks on in public.

Vaccination requirements have become a cultural flash point as the shots become more accessible.

Republican governors in Alabama, Arizona, Florida, Georgia, Idaho, Montana and Texas have denounced vaccine passports, or digital proof of vaccination, and have issued executive orders restricting their use. On Tuesday, Gov. Brian Kemp of Georgia signed an executive order that prohibits state agencies from using a vaccine passport program or requiring proof that people have been vaccinated against Covid-19.
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Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first case was identified in Wuhan, China, in December 2019. It has since spread worldwide, leading to an ongoing pandemic.

Symptoms of COVID-19 are variable, but often include fever, cough, fatigue, breathing difficulties, and loss of smell and taste. Symptoms begin one to fourteen days after exposure to the virus. Most people (81%) develop mild to moderate symptoms (up to mild pneumonia), while 14% develop severe symptoms (dyspnea, hypoxia, or more than 50% lung involvement on imaging) and 5% of patients suffer critical symptoms (respiratory failure, shock, or multiorgan dysfunction). At least a third of the people who are infected with the virus remain asymptomatic and do not develop noticeable symptoms at any point in time, but can spread the disease. Some patients continue to experience a range of effects—known as long COVID—for months after recovery and damage to organs has been observed. Multi-year studies are underway to further investigate the long term effects of the disease.

Source: Coronavirus disease 2019 - Wikipedia