
After a precipitous drop over the past two months, California’s COVID-19 trends have hit a plateau. Cases have fallen only 5% in the past week and the test positive rate inched down a tenth of a percentage point. In a worrisome sign, cases in Europe are starting to climb again as winter approaches. Even so, rules and tracking in the U.S. continue to be eased: The CDC said Thursday that it will stop reporting case and death data on a daily basis and has quietly dropped its masking recommendation for school nurses’ offices. On a brighter note, Moderna released safety data for its bivalent booster and a small NIH-backed study suggests that antiviral medication Paxlovid does not cause COVID-19 rebound.
Fox News drove down vaccination uptake, study shows
People who live in areas with higher Fox News viewership were more hesitant to take life-saving vaccines against COVID-19, according to a study published Friday in the scientific journal Nature. The cable news network had a disproportionate influence on its viewers, the researchers from Switzerland discovered, with “no evidence of the other major networks such as CNN and MSNBC” having had a similar effect. The data show that between March and June 2021, initially robust vaccine uptake swiftly dropped off in U.S. counties with higher Fox News viewership. To get their results, the researchers paired data on county-level vaccination rates with data on viewership of the main cable news providers. “Overall, an additional weekly hour of Fox News viewership for the average household accounts for a reduction of 0.35-0.76 weekly full vaccinations per 100 people during May and June 2021. This result is not only driven by Fox News’ anti-science messaging, but also by the network’s skeptic coverage of COVID-19 vaccinations,” they concluded.
Merck’s antiviral no better than placebo in cutting hospitalization and death, trials find
According to the results of a pair of large clinical trials, Merck’s experimental antiviral pill failed to lower the risks of COVID-19 hospitalization and death among adults at higher risk from the disease. The company, in partnership with Ridgeback Biotherapeutics. conducted two real-world evidence studies evaluating the drug, molnupiravir, In a trial of more than 25,000 people by researchers at Oxford University, the oral antiviral helped shorten the recovery time of acute infection but showed no substantial benefit compared to taking a placebo in most serious adverse COVID-related events. In a separate study conducted in Israel, real-world data showed that while molnupiravir reduced hospitalizations and mortality due to COVID-19 in patients 65 years and above, “no evidence of benefit was found in younger adults ages 40 to 64 years.”
Long COVID a “substantial” burden on health system, experts tell UCSF’s Wachter
The latest edition of UCSF’s Medical Grand Rounds for clinicians focused on the topic of long COVID, with experts speaking to Dr. Bob Wachter describing the burden of the affliction in the U.S. as “substantial.” Dr. Ziyad Al-Aly, an epidemiologist at Washington University in St. Louis, said, conservatively, it is estimated that 4% to 7% of people infected with COVID-19 are likely to report persistent symptoms that can “affect nearly every organ system” in the body. He said the condition will likely lead to a rise in chronic diseases nationwide, particularly cardiovascular disease, diabetes, kidney disease, and neurological disorders. “The best way to prevent long COVID is to prevent COVID in the first place,” Al-Aly said.
Dr. Kekshmi Santhosh, a pulmonary and critical care physician at UCSF Health, added, “One key thing to note is that there is no ‘one long COVID.’ Each patient is unique.” Dr. Michael Peluso, an infectious disease physician at UCSF, said his department developed one of the earliest long COVID studies in the world after patients early in the pandemic complained of persistent symptoms once their acute infection resolved. His data shows that women are more vulnerable, alongside middle-aged individuals and people with poor access to health care. Wachter and the experts noted that reinfections raise the odds of long COVID. “The second infection really matters,” said Al-Aly. “We see patients in our clinic with this air of invincibility about them (after they are infected)… But it absolutely contributes additional risks.”
“Concerning” increase in hospitalizations in the U.K.
U.K. health officials warned of “concerning” increases in COVID-19 hospitalizations in the past week, noting a 37% increase in admissions. The hospitalization rate in England is now 10.8 per 100,000 people, up from 7.5 the previous week, Sky News reported Friday. Three of nine regions are nearly back to levels seen during the July peak of the omicron BA.5 surge, with a 250% week-over-week increase recorded in the South West. “This week’s data shows concerning further increases in COVID-19 cases and hospitalization rates, which are now at their highest level in months,” said Dr. Susan Hopkins, chief medical advisor at UKHSA. “Outbreaks in hospitals and care homes are also on the rise.” Infectious disease experts in the U.S. have noted that what happens in the U.K. and Europe is typically an indicator of where the pandemic is headed at home.
Newer omicron subvariants show “slow growth”
The omicron BA.5 subvariant made up less than 80% of sequenced cases in the U.S. for the first time since mid-July, according to data published Friday by the U.S. Centers for Disease Control and Prevention. While emerging subvariants are expanding their share, White House COVID-19 Data Director Dr. Cyrus Shahpar described it in a tweet as “slow growth” but warned, “expect more in the weeks ahead.” BA.4.6 made up 13.6% of cases last week, up from 12.8% the week before. BF.7 grew to 4.6% from 3.4%. BA.2.75 nudged forward to 1.8%, up from 1.4%. Health officials have been monitoring these newer variants because many show signs of being able to evade immunity or render some COVID-19 treatments ineffective. “Bottom line: These are all omicron, and we have a new bivalent dose that increases protection against all of them,” Shahpar wrote.
One out of 20 eligible Americans has gotten updated boosters
Uptake of the new bivalent COVID-19 vaccine boosters continues to move at a crawl, with a total of about 11.1 million Americans having received the shots since they became available on Sept. 1, according to data released Friday by the U.S. Centers for Disease Control and Prevention. That marks a slight increase from the tally of 7.6 million reported last week and represents about 5% of the more than 216.2 million people eligible for the updated vaccines. The CDC recommends that everyone over 12 years and older receive an updated Pfizer or Moderna booster at least two months after their last shot. “When I think about patients out there, older patients, think about what is the single most important thing they need to stay protected and safe this fall and winter,” Dr. Ashish Jha, who heads the White House Covid task force, told the American Medical Association. “It’s a COVID vaccine and a flu vaccine. And so making sure that word gets out to clinicians, making sure that doctors communicate that to their patients, that combination, I think, will be really, really important in continuing to get more and more people vaccinated.”
Less than 1% of Americans now in areas of “high” COVID levels
For the first time since April, less than 1% of the American population lives in a community with “high” COVID-19 levels, based on hospitalization and case rates, according to updated data from the U.S. Centers for Disease Control and Prevention. All but four of California’s 58 counties are now classified as having “low” levels. Nationwide, about 79% of Americans now live in places classified in the “low” tier, 20% in “medium” and less than 1% in “high.” Based on a separate metric that tracks the rates of new cases and positive tests, about half of all U.S. counties remain in the “high” virus transmission category. In the latter category, all Bay Area counties are considered to be in the “substantial” transmission tier, the second worse out of four.
S.F. area’s exodus of rich people led to biggest drop in household income of any U.S. city
The San Francisco metro area saw the biggest drop in median household income between 2019 and 2021 among the nation’s most populated regions, as many wealthy residents left during the pandemic. Median annual income fell 4.6% to $116,005 per year, a drop of $5,546 per year, according to new census data. The San Francisco metro area, which includes Berkeley and Oakland, still had the country’s highest median income, but the data is fresh evidence of a sustained loss of high-income earners. Read more here about what the new census data shows for San Francisco.
Europe sees sharp uptick in cases, hospitalizations
Early signs of a winter COVID-19 surge are appearing in Europe as the weather grows cooler. The European Union reported 1.5 million new cases last week, marking an 8% increase from the prior week, according to the World Health Organization’s weekly update. Hospitalizations are also on the rise across the 27-nation bloc, with Italy reporting a 32% jump in admissions and a 21% increase in intensive care admissions. Britain recorded a 45% increase in hospitalizations from the week earlier. “Several countries in Europe are reporting an increase in COVID-19 cases, hospitalizations and deaths,” said Dr. Tedros Adhanom Ghebreyesus, director general of the World Health Organization. “This is to be expected as the weather cools and people spend more time together inside. Most countries no longer have measures in place to limit the spread of the virus.” He added that the WHO and its partners are tracking more than 300 virus subvariants. “But surveillance, testing and sequencing remain weak globally, which makes tracking this virus like chasing shadows. So we continue to call on all countries to increase surveillance, testing and sequencing, and to ensure the most at-risk groups are vaccinated.”
Bay Area COVID cases plateau even as the virus is still widely evident
After a precipitous drop over the past two months, California’s COVID-19 trends have hit a plateau. The state reported an average of 3,336 cases a day as of Thursday, only a 5% decrease from the previous week’s numbers, according to health department data. California is tracking about 8.3 daily cases per 100,000 residents, compared to 9 per 100,000 the week before. The statewide test-positive rate has also steadied after a sharp decline, inching down just one-tenth of a percentage point to 4.7%. “There’s still a significant amount of virus circulating and therefore our risk of exposure still remains elevated,” said Dr. Sara Cody, health officer for Santa Clara County. Read more about the leveling off in the numbers and what lies ahead.
CDC ends daily reporting of cases and deaths
For the first time since the start of the COVID-19 pandemic, the U.S. Centers for Disease Control and Prevention announced Thursday that it will stop reporting case and death data on a daily basis, instead shifting to a weekly format for its updates. “To allow for additional reporting flexibility, reduce the reporting burden on states and jurisdictions, and maximize surveillance resources, CDC is moving to a weekly reporting cadence,” the agency wrote in a post. Beginning Oct. 20, state and local health departments will only be required report new COVID-19 surveillance data to the agency on Wednesdays.
Deaths among older adults spiked in the summer, report finds
The number of deaths due to COVID-19 increased for all ages from April to July, but rose at a faster rate for older adults and stayed high through August, according to a report published Oct. 6 by the Kaiser Family Foundation. Virus-related fatalities among people 65 and older topped 11,000 in both July and August. While the numbers dipped in September, they were still higher for those ages 65 and older than in April or May while falling below their April levels for younger Americans. As of the week ending Oct. 1, the U.S. has lost nearly 1.1 million lives to COVID-19, of which about 790,000 are people ages 65 and older. That age group accounts for 16% of the total US population but 75% of all COVID deaths to date. “The rise in deaths is primarily a function of increasing cases due to the more transmissible omicron variant,” the authors of the report wrote. “Other factors include relatively low booster uptake, compared to primary vaccination, and waning vaccine immunity, underscoring the importance of staying up to date on vaccination.”
Paxlovid does not cause rebound infections, study shows
Results from a small federal study funded by the National Institutes of Health show that Paxlovid does not cause rebound infections. The study aimed to define the clinical course and the immunologic and virologic characteristics of COVID-19 rebound in patients who have taken antiviral manufactured by Pfizer. The study included six participants who took Paxlovid within four days of initial symptom onset and then experienced recurrent symptoms; two participants who experienced recurrent symptoms who did not take Paxlovid; and a control group of six people who had COVID-19 but did not experience symptom rebound. All participants were previously vaccinated and boosted against COVID-19, and none developed severe disease requiring hospitalization during acute infection or rebound. “Investigators found no evidence of genetic mutations that would suggest participants who experienced COVID-19 rebound were infected with a strain of SARS-CoV-2 that was resistant to Paxlovid,” the researchers said. “They also found no evidence of delayed development of antibodies in participants experiencing rebound after taking Paxlovid.”
Moderna releases safety data for bivalent booster
The bivalent booster vaccine produced by Moderna targeting BA.4 and BA.5 “elicited neutralizing antibody responses against omicron that were superior” to those with the original vaccine against COVID-19, “without evident safety concerns,” according to data from an ongoing study published on Oct. 5 in the New England Journal of Medicine. For the phase 2-3 study funded by the pharmaceutical company, researchers compared the bivalent vaccine with the previously authorized mRNA booster. “The primary objectives were to assess the safety, reactogenicity, and immunogenicity of (the updated formula) at 28 days after the booster dose,” the researchers wrote. No hospitalizations for COVID-19 were reported among the participants in the trials. “These results are consistent with the evaluation of our bivalent beta-containing vaccine, which induced enhanced and durable antibody responses,” they added. “Together, these findings indicate that bivalent vaccines may be a new tool in the response to emerging variants.”