COVID-19 Policy Update #406
Monday 1/3/2022
Happy New Year! Hope you had a restful break. Pulling together tonight's update left me with a strange case of déjà vu from the January 4, 2021 update. But here we are, so let's get to some of the recent developments.
Top Three
CDC Quarantine and Isolation Guidance: There is some confusion over the CDC quarantine and isolation guidance. The reduction from 10 to 5 days issued last week does not appear to apply to schools. According to the CDC site for schools:
"People can spread the virus that causes COVID-19 for a full 10 days from when they develop symptoms, even if they are feeling better."
"A person diagnosed with COVID-19 can be around others when at least 10 days have passed since their symptoms began, or since the date of their initial positive test (use the date the test was collected) if they did not develop symptoms."
So it seems like we have three conflicting pieces of guidance (here is an overly simplified summary):
For Healthcare workers, 7 days and a negative test.
For Individuals, 5 days followed by 5 days of mask (no test required).
For Schools, "at least 10 days have passed since their symptoms began."
Others have pointed this out so hopefully we'll see some clarification this week. If you have a different read of this, shoot me an email.
FDA Authorizes First Covid-19 Booster Shot for Teens 12 to 15: FDA announcement which also includes shortening the time period between vaccine and booster to 5 months from 6. Also allows a third dose of vaccine for immunocompromised children 5-11. Stat with the details.
"A panel of independent experts that advises the Centers for Disease Control and Prevention on vaccination policy will meet Wednesday to discuss the policy change. It’s possible the ACIP will issue what’s known as a permissive recommendation — saying youths aged 12 to 15 may get a booster if they wish, but stopping short of urging them to do so."
COVID-19 Vaccine Safety in Children Aged 5–11 Years: CDC study. "More than eight million doses of the Pfizer vaccine have been given to children 5 to 11...but the CDC said that it had received very few reports of serious problems. The agency evaluated reports received from doctors and members of the public, as well as survey responses from the parents or guardians of roughly 43,000 children in that age group."
"A CDC analysis found only 100 serious adverse event reports in vaccinated kids ages 5-11, out of 8.7 million doses administered (0.0011%) the last two months," reports NBC.
Omicron
The CDC’s Defense of Its New COVID Guidelines Is Complete Nonsense: Slate article capturing some of the frustration, confusion, and criticism.
"The key in those arguments and policies, though, is the negative test. The CDC’s new guidance, in contrast, does not recommend a test before exiting isolation. This is a huge difference—one that could mean many, many people exit a period of careful isolation only to walk around and spread the highly contagious virus."
BUT, Dr. Fauci said CDC is now considering including the negative test as part of its guidance after getting significant “pushback” on its updated recommendations last week.
Decreased Severity in Africa: New study showing lower levels of hospitalization and death.
New York Changes Hospitalization Reporting: Good practice other states should replicate: "Gov. Kathy Hochul on Monday announced hospitals, beginning Tuesday, will provide separate numbers on how many people are hospitalized because of COVID-19 and those who were admitted for other reasons, but subsequently tested positive for the virus and may have a mild or asymptomatic case."
With No Way to Identify Omicron and Delta Patients, Doctors Struggle With Treatment Decisions: Via The NYT.
"High-risk patients carrying the Delta variant could benefit greatly from two particular monoclonal antibody treatments shown to reduce hospitalization and death. But those medications would most likely do nothing for patients with Omicron, who would only respond to a third antibody treatment that is in very short supply."
U.S. Struggles to Avoid Widespread Shutdowns:
“Officials across the United States, from President Biden on down, have been insisting that they are no longer in the shutdown business, and will not order any closures to contain the latest surge in coronavirus cases,” the NYT reports.
“But Omicron may be taking the decision out of their hands. So many workers are testing positive or calling in sick that businesses, schools, government agencies and more are being crippled by staff shortages that may force them to close some operations anyway.”
"Schools Grapple With How to Stay Open Amid Omicron Surge," reports the Washington Post.
Federal
ED:
"I still believe very firmly and very passionately, not only as an educator but as a parent, that our students belong in the classroom and that we can do it safely," Secretary Cardona said on CBS Face the Nation.
Secretary Cardona conceded short-term or “emergency” K-12 school closures might be necessary in the coming days as principals and administrators confront Covid-spurred staffing shortages, Politico reports.
COVID-19 Research
Pfizer and Teens: A new CDC study from University of Arizona researchers found Pfizer's vaccine is 92% effective at preventing COVID-19 in children ages 12 to 17.
Children Seriously Ill With COVID-19 Were Not Fully Vaccinated: New CDC study.
"Among these patients, approximately one third aged <5 years had a viral coinfection (approximately two thirds of which were respiratory syncytial virus) and approximately two thirds of those aged 12–17 years had obesity; only 0.4% of age-eligible patients were fully vaccinated."
A WHO Official Weighs In On Covid, Vaccines, and Mistakes That Were Made: Via Stat.
“What’s shocked me most in this pandemic has been that absence or loss of trust,” he said of people’s unwillingness to follow the advice of public health leaders and the containment policies set out by governments."
"The biggest collective failing has been that we’ve underestimated this microbe. We’ve always made judgments assuming the best-case scenario. And I’m not one for assuming the worst-case scenarios as a modus operandi, because otherwise, you can strangle society. But I think at every opportunity we’ve seem to have taken the best-case scenario as the basis for our policy. And this virus, I think, has sequentially exploited that."
"But I think for me just personally as a public health physician, the biggest tragedy has been the vaccine equity issue. It really has been horrific. Horrific. The world just has not ever come to terms with the fact that vaccinating the most vulnerable people first would have been a better bet, not only epidemiologically but just from an equity perspective."
"I shudder to think of going into a more severe pandemic with that level of community distrust. It has had a real negative impact on people’s awareness and willingness to sustain measures. Because they can constantly find lots of material and reasons not to do what they’re being asked to do, because there’s so much out there telling them that what’s going on there is a government conspiracy, what’s happening is hurting them."
Children’s Better Immune Response to Covid-19 Explained: In this Wellcome Sanger Institute study.
"They found a stronger innate immune response in the airways of children restricts early replication of the virus. Adults, however, have a less rapid immune response, which means the virus is able to invade other parts of the body, where the infection is harder to control."
"The findings could be used to predict personal risk from the SARS-CoV-2 virus via a nasal swab to measure the immune response in newly-infected adults."
We Need Better Data from Hospitals for Omicron: Via Emily Oster
"We can no longer rely on case counts to predict hospitalizations, at least not in the same way."
"Our current data on hospitalization, in most cases, is extremely crude. In general, hospitalization rates are simply the count of the number of people admitted to the hospital with a positive COVID test per 100,000 population. This is problematic in two ways. First: everyone admitted to the hospital is tested for COVID. This means that if someone is admitted with an injury or mental health issue or anything else and they have asymptomatic COVID-19 infection, they appear as a COVID case."
"A second issue is that these raw counts do not provide any detail that would be helpful in prediction. To what extent are the hospitalizations for breakthrough infections versus unvaccinated? Which demographic groups are most at risk for needing significant care? How much do boosters matter? Are ICU beds being used most by unvaccinated younger people, unvaccinated older people, vaccinated older people?"
School Closures: Via Burbio:
"In the last week we saw an increase to 1,591 schools that will close for in-person learning for at least one day the week of January 3rd."
"Closures tend to fall into two categories: a) The majority of district closures are one or two week virtual learning breaks due to rising Covid 19 cases b) A handful of big districts are spending the first one to three days of the New Year distributing testing kids to staff and families. The average closure length for schools closing the week of January 3rd is 6 days."
State
California: Gov. Newsom, unions commit to keeping ‘our classrooms open’
Connecticut: Multiple school districts across have canceled classes for Monday because of an increase in COVID-19 cases.
DC: The Mayor said "We expect that schools and classrooms will need to transition to situational virtual learning throughout the semester, especially in the coming weeks."
Georgia: List of schools opening remotely.
Illinois: Chicago Teachers Union gearing up to walk out on Wednesday over COVID-19 safety concerns. List of their requests.
"At a CTU virtual town hall Sunday evening, 80% of the 8,000 members on the call said they did not want to work in-person in Chicago Public Schools classrooms under current conditions."
"In a statement on Monday, CPS officials also restated their support for in-person learning, saying “districtwide, unwarranted and preemptive mass school closures could actually fuel community spread.”
Maryland: Thirteen Baltimore County schools are shifting to virtual learning for the first week of January due to COVID-19 infections, and several more have partial closures.
Massachusetts:
The Governor announced it will send 200,000 at-home rapid antigen tests to school districts so all teachers and staff across the Commonwealth can test for COVID-19 before they return to school after the holiday break.
The state's teachers union is calling on the state to delay the start of school due to test kit delays.
Michigan:
Flint Schools go virtual, citing an increase in COVID-19 cases.
Detroit delays in-person instruction until its 8,000 school employees are tested
The Michigan Department of Health and Human Services sent a letter to schools asking them to maintain mitigation measures.
Ohio:
Ohio Department of Health aligns with updated CDC quarantine and isolation guidance - adopted the 5 day period with a recommended test.
New York:
New York City’s top teachers’ union suggested Mayor Eric Adams delay Monday’s start of in-person classes. “We advised the new mayor that it would be safest to allow our school system to go remote temporarily until we could get a handle on the staffing challenges that each school is about to face as we return,” United Federation of Teachers President Michael Mulgrew wrote Sunday in an email to union members. “However, he feels strongly that schools need to remain open.”
Rochester teachers union pushes for temporary remote learning, concerns over staffing.
Vermont: Gov. Scott announced plans to distribute 87,000 at-home test kits to parents and guardians this week so children can be tested for COVID-19 before heading back to school.
Wisconsin: Milwaukee Public Schools is transitioning to virtual learning after influx of positive COVID tests.
International
Canada: Statement from unions and associations representing Ontario teachers with requests for additional mitigation measures.
France: Broadens mask mandate to children as young as 6.
UK: Children in secondary schools in England will be told to wear masks when they return.
Europe’s Short-term Closures Suggest Long-term Costs: Via the Washington Post.
"One study found "that elementary students performed on average 20% worse on tests than the equivalent cohorts had for the three years before the pandemic. Among students from less-advantaged families, learning losses tended to be even greater — up to 60% larger than for the general population. The Netherlands has spent billions on tutoring, counseling and summer programming for children, but that extra support has not yet caught them up."
One teacher "said more than a dozen of his 80 students are in remedial classes for math and French this academic year, making up for courses they failed during hybrid learning. “They are not very optimistic, and I don’t have the impression they have a lot of hope things will get better,” Betriaux said. “It is very sad for them.”
Resources
Teacher Shortages in New England Force Some Classes Online With Little Notice: Via The NYT.
Education after the Pandemic: Via Rick Hess.
Schools Use Trial and Error for Choosing Edtech, But They Don’t Have To: Via Bart Epstein.
The Great Resignation Hits Schools Across All Positions: Via NBC News. "More than half of school administrators said staffing shortages had gotten more severe since the beginning of the school year."
New Day’s Lyric: New poem by Amanda Gorman. Excerpt:
May this be the day
We come together.
Mourning, we come to mend,
Withered, we come to weather,
Torn, we come to tend,
Battered, we come to better.
Tethered by this year of yearning,
We are learning
Yo-Yo Ma: Wishes you a Happy New Year.
Bentley and Teddy are living their best Berner lives thanks to a snow storm that hit DC today.
