Tulane Outbreak Daily – July 23, 2021

Featured Headlines

The Delta Variant Will Drive A Steep Rise In U.S. COVID Deaths, A New Model Shows – NPR

The current COVID-19 surge in the U.S. — fueled by the highly contagious delta variant — will steadily accelerate through the summer and fall, peaking in mid-October, with daily deaths more than triple what they are now.

CDC warns this is ‘pivotal moment’ in fight against delta variant – Washington Post

The delta variant, first detected in India, now represents more than 83 percent of cases circulating in the United States, according to the Centers for Disease Control and Prevention. People infected with the variant appear to carry a viral load that is more than 1,000 times that of those infected with earlier forms of the virus, allowing the virus to spread rapidly among unvaccinated people, scientists have found.

Why the Vaccinated Are Still at Risk From Coronavirus – Washington Post

With Covid-19 shots reaching billions of people, reports have grown more common of people getting infected with the coronavirus despite being vaccinated. Just as a natural infection doesn’t guarantee protection from reinfection with the virus, neither does immunization provide a perfect shield. Still, those who have immunity — either from vaccination or infection — carry a fraction of the risk of those who have none. So-called breakthrough cases among the immunized are a reminder that as long as the pandemic virus is prevalent in the world, it remains a threat to everyone.

Tokyo Olympics Cases Jump as Games Start, Athletes Infected – Bloomberg

Japan’s Olympics organizers reported a record number of new daily coronavirus infections linked to the Games, including three athletes, bringing the total to 110 just hours before the opening ceremony is scheduled to start in a nearly empty stadium in Tokyo.

With 50,000 Cases a Day, One Country Opens Up as Another Suffers – Bloomberg

The pandemic has a new epicenter, with Indonesia taking the lead in the dismal Covid-19 stakes after a recent streak of 50,000 infections a day. The surge in the world’s fourth-most populous country is being accompanied by what are now tragically familiar stories. Hospitals are short of life-saving oxygen and drugs, and people are dying alone, their loved ones absent or behind protective screens. Indonesia is seeing more than 1,000 virus fatalities every day, with a fresh record of 1,566 deaths registered on Friday.

Covid Increase in Hot-Spot U.S. States Is Forecast to Worsen – Bloomberg

The recent rise in Covid-19 cases shows no signs of abating in the U.S. states that have fueled the uptick as the delta variant proliferates. Nationally, cases are likely to rise to 306,909 for the week ending Aug. 14, up 39% from last week, according to an ensemble of forecasts from the Centers for Disease Control and Prevention.

Texas has seen nearly 9,000 COVID-19 deaths since February. All but 43 were unvaccinated people. – Texas Tribune

Preliminary data shows 99.5% of COVID-related deaths in Texas were among unvaccinated people, according to the Department of State Health Services.

China sets back search for covid origins with rejection of WHO investigation proposal – Washington Post

Chinese officials on Thursday rejected a World Health Organization proposal for next steps in the search for the origins of the coronavirus, deepening questions about if and how the roots of the pandemic will be fully investigated and complicating a standoff among the WHO, China and the United States.

Vaccine Headlines

When will COVID-19 vaccines be fully approved—and does it matter whether they are? – Science

In many U.S. regions, the Delta variant of SARS-CoV-2 has caused the COVID-19 pandemic to surge once again. Last week’s 7-day average of daily new cases increased by nearly 70%, to more than 26,000; hospitalizations have jumped by more than one-third, according to the Centers for Disease Control and Prevention.

American Hospital Association Joins Others in Support of COVID Vax Mandates – MedPageToday

The American Hospital Association (AHA) — which represents nearly 5,000 hospitals and healthcare systems in the U.S. — publicly affirmed its support for COVID-19 vaccine mandates for healthcare workers in a statement released on Wednesday.

Countries Move Ahead With Mix-and-Match COVID Vaccines – NPR

Germany, Canada, and others promote heterologous approach in the face of supply challenges. While the data remain preliminary, some countries are moving ahead with mixing and matching mRNA and adenoviral vector COVID-19 vaccines, often driven by supply challenges.

L.A.’s Fully-Vaccinated People Made Up 1-in-5 Infections – Bloomberg

Los Angeles County’s top health official said fully vaccinated people made up one-in-five Covid-19 infections in June and warned that the figure may rise in July with a higher level of community transmission.

Pfizer Shot Halts Severe Illness, Allows Infection in Israel – Bloomberg

Pfizer Inc.’s Covid-19 vaccine provided a strong shield against hospitalization and more severe disease in cases caused by the contagious delta variant in Israel in recent weeks, even though it was just 39% effective in preventing infections, according to the country’s health ministry.

Johnson & Johnson Vaccine Far Less Effective Against Delta Variant, Study Suggests – Forbes

A study from a team of New York University researchers found the one-shot Johnson & Johnson vaccine is far less effective at preventing coronavirus infections from the Delta variant and other mutated forms of the virus than from earlier strains, a concerning find since the Delta variant now accounts for almost all U.S. Covid-19 cases. [link to preprint study]

CDC Staff Hint at Vax Boosters for the Immunocompromised – MedPageToday

Both regulatory and non-regulatory efforts may be needed to help immunocompromised patients receive additional doses of COVID-19 vaccine, CDC staff said during a meeting of the Advisory Committee on Immunization Practices (ACIP) on Thursday.

EU Talks With U.S. on Vaccine Passports Making Little Progress – Bloomberg

Negotiations between the European Union and the U.S. to recognise each other’s vaccination passes are struggling to make headway due to the absence of a federal certification system in America, according to a diplomatic memo seen by Bloomberg.

Clinical Considerations

Sickle Cell Disease Tied to COVID-19 Mortality, Hospitalizations – MedPageToday

Results relevant for policymakers and vaccine prioritization globally, U.K. researchers conclude. Their cohort study showed that having SCD quadrupled a person’s risk for COVID-19-related hospitalization (HR 4.11, 95% CI 2.98-5.66), and more than doubled the risk of death (HR 2.55, 95% CI 1.36-4.75), reported Ashley Kieran Clift, MBBS, of the University of Oxford, and colleagues from the International Investigator Group for Ethnicity and COVID-19.

Why The Delta Variant Is Hyper-Contagious: A New Study Sheds Light – NPR

After months of data collection, scientists agree: The delta variant is the most contagious version of the coronavirus worldwide. It spreads about two to three times faster than the original version of the virus, and it’s currently dominating the outbreak in the United States, responsible for more than 80% of COVID cases.

Many Older Adults With Severe COVID Presented With Atypical Symptoms – MedPageToday

Over a third of older adults who were hospitalized with COVID-19 during the early months of the pandemic had an atypical presentation, with a mix of typical and atypical symptoms, researchers found.

Official Reporting for July 23, 2021

World Health Organization

Weekly Epi Update July 20, 2021 (latest release)

Confirmed Cases: 191,773,590

Deaths: 4,127,963

Johns Hopkins

Confirmed Cases: 192,735,392
Deaths: 4,093,331

Centers for Disease Control and Prevention (CDC)

Total cases: 34,248,054 (+55,132 New Cases)
Total deaths: 607,684 (+406 New Deaths)

Science and Tech

Geneticists criticize poor sequencing efforts in US – MedPageToday

“Know your enemy” has been the mantra of generals at least since the 5th century BC when the Chinese military strategist Sun Tzu coined the phrase in The Art of War. The principle is just as important when your enemy is a rapidly evolving virus that has claimed the lives of more than 4 million people worldwide.

Japan becomes the first country to approve Regeneron Antibody Cocktail for the treatment of Mild to Moderate COVID – Regeneron

Regeneron Pharmaceuticals, Inc. (NASDAQ: REGN) today announced that Japan’s Ministry of Health, Labour and Welfare (MHLW) has approved Regeneron’s casirivimab and imdevimab antibody cocktail to treat patients with mild to moderate COVID-19. This marks the first time the antibody cocktail, known as REGEN-COVTM in the U.S. and Ronapreve™ in other countries, has received a full approval to treat COVID-19. Emergency or temporary pandemic use authorizations are currently in place in more than 20 countries, including in the U.S., European Union, India, Switzerland and Canada.

Psychological and Sociological Impact

‘A search for villains’: As Australia’s outbreak grows, so does covid shaming – Washington Post

Some of them broke the law. Others did nothing wrong. Yet, all have become familiar figures in a country where relatively few coronavirus cases and efficient contact tracing have enabled politicians, health officials and journalists to home in on individuals.

Published Research

Symptoms, complications and management of long COVID: a review – Journal of the Royal Society of Medicine

Patient Factors and Hospital Outcomes Associated With Atypical Presentation in Hospitalized Older Adults With COVID-19 During the First Surge of the Pandemic – Journal of Gerontology

Tocilizumab in COVID-19 therapy: who benefits, and how? – The Lancet

Misinformation, Disinformation, and Conspiracy Theories

The Life Cycle Of A COVID-19 Vaccine Lie – NPR

Misinformation about COVID-19 vaccines can appear almost anywhere: from an uncle’s Facebook post to a well-trusted news commentator. But where does it come from, and why do some myths spread further than others?

Czech Olympic Team Investigates Charter Flight After 4 Athletes Test Positive – NPR (Spoiler alert – There was an antivax Dr. on board)

Czech Olympic officials are looking into a cluster of coronavirus cases that are linked to a charter flight that brought a contingent of athletes and staff to Japan. The country’s team has six coronavirus cases in total.

Vaccine Hesitancy


Coping with COVID

Traveling back to the U.S. from Europe was a bit weird. In the Frankfurt airport there were several checkpoints for verifying documentation for a negative COVID test. They didn’t care about vaccines, just a negative PCR test 24 hrs before the flight. Upon entering the airport, “medical masks” were mandated. The cute fabric printed masks that were worn in the U.S. were not allowed. There were armed Polizei patrolling in pairs enforcing the mask mandate. In every line (security, immigration, etc) there were marks on the floor to for social distancing. I accidently got too close to a German woman in the security line, and she yelled at me for stepping over the green line in her direction.

Landing at Dulles was a very different approach to the rising COVID cases. No mask mandates, and only suggested distancing protocols in the lines. There were signs around requesting masks be worn, but no enforcement, no distancing. The lines were an hour+ long for passport control, hundreds of people from all over the world tightly packed winding through the maze of rope barriers. I sure hope my vaccine and mask protected me from infection. I won’t be flying again anytime soon.

Indonesian Covid-positive man disguises himself as wife on Citilink flight in order to fly – CNN

(Sorry, no photos in this story!) The man, who has been publicly identified only by the initials “DW,” boarded a Citilink domestic flight from Jakarta to Ternate while wearing a niqab that covered him from head to toe, reports CNN affiliate CNN Indonesia. The disguise was intended to enable the man to fly even though he had reportedly tested positive for Covid-19. His wife, however, had tested negative, so he used her ID and negative PCR test results in order to board the plane at Halim Perdana Kusuma Airport in Jakarta, says the report.

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