SCHOOLS:
1 - At Your Local Epidemiologist, Katelyn Jetelina has pulled together a post (8/26/21) with a lot of helpful material for children and adults who are heading back to school this fall in the U.S. and beyond. The piece starts by explaining why COVID-19 protection measures in schools should include ventilation, masks, and testing plans in addition to hand-washing and distancing students. The piece links to a New York Times interactive showing how air flows in a classroom of nine, including one infected student, with and without open windows, a simple air cleaner, and a box fan pulling air out of the room (by Nick Bartzokas, Mika Grondahl, Karthik Patanjali, Miles Peyton, Bedel Saget and Umi Syam, 2/26/21). Jetelina then cites an 8/20/21 study finding that “open windows in classrooms can have up to a 14-fold reduction in [SARS-CoV-2] transmission,” though the reduction varies with the time of year and number of windows, she writes. She also cites an 8/20/21 study that simulated the flow of SARS-CoV-2 and demonstrated that wearing a surgical mask decreases transmission 8-fold. However, these masks don’t fit children well, so she recommends “ASTM-certified surgical or tight-fitting cloth masks for kids,” KN95s, or KN94s made for kids. “N95s are not made for kids, so do not buy them for kids to wear,” she writes. The piece sites two guides for children’s masks – one by Eva Enns of the University of Minnesota School of Public Health and one by aerosols expert Linsey Marr of Virginia Tech.
2 - This first-person piece, “6 answers to parents COVID-19 questions as kids return to school,” by Sujata Gupta at Science News is very good. As the story’s sub-headline states, “Universal masking in schools could be key to making the 2021-2022 school year go smoothly.” The story cites a couple research efforts suggesting that “less distancing, or even no distancing, is safe, as long as everyone wears a mask,” as Gupta puts it. At schools without mask mandates, “other COVID-19 precautions become essential,” including distancing, quarantines for close contacts, intensive screening (testing), “and even limiting or canceling sports or music,” the story describes Dr. Kanecia Zimmerman, a Duke pediatrician and epidemiologist, as saying. Those mask-affirming studies were done in the pre- or early-delta era. Do masks still work well in schools now that the delta variant is so widespread in the U.S.? The story describes Dr. Daniel Benjamin, a Duke pediatrician, as saying that “evidence from school this summer in Los Angeles suggests that spread [of SARS-CoV-2] even with the delta variant remained relatively low with universal masking and regular screenings [testing].” Quarantine requirements after kids have contact with an infected person are tough to endure, even as they are important for controlling outbreaks. But I see glimmers of hope for shorter quarantine periods. I think I heard Dr. Daniel Griffin on the This Week in Virology podcast recently question the duration—7- to 14-days—of the home quarantine that the Centers for Disease Control (CDC) recommends for anyone not fully vaccinated (so, most U.S. kids under 12) who has had “close contact” with someone infected with SARS-CoV-2. Similarly, Gupta’s story describes Zimmerman suggesting that the CDC eliminate quarantine recommendations “in masked environments to avoid unnecessary disruptions.” (8/11/21): https://www.sciencenews.org/article/coronavirus-covid-kids-school-return-parents-questions.
3 - Nearly 100 school districts in various U.S. states are relying on so-called antigen tests this fall to determine if students and staff are positive for SARS-CoV-2. These tests (which retail for about $20 to $35 apiece) are somewhat less accurate than PCR tests (which reportedly can run up to $100 apiece), but they give results within minutes. (In New York City, my various PCR test results have come in a day or so after I’m swabbed.) For Popular Science, Betsy Ladyzhets reports on such a biweekly approach at an elementary school in Delaware, with mentions of a similar program put in place in Baltimore’s schools (8/18/21). Kids tolerate the nose swab with no trouble, the story suggests. “A lack of data on these efforts makes it difficult to evaluate just how effective regular testing may be at preventing COVID-19 outbreaks in classrooms,” Ladyzhets writes. However, some evidence from New York City schools and the Delaware school district suggest that the antigen tests weed out infected individuals and help “keep school transmission in check,” the story states. “Delaware’s contact tracing program has found that cases [SARS-CoV-2 infections] tend to come into schools from family gatherings, extracurriculars, and other community activities—not the other way around,” the story states: https://www.popsci.com/health/rapid-antigen-test-covid-schools/.
VACCINES:
4 - Last week, The Wall Street Journal reported that U.S. federal officials were considering allowing COVID-19 boosters for people aged 16 and up as few as five months after full vaccination. But on ABC’s “This Week,” Dr. Anthony Fauci, head of the U.S. National Institute of Allergy and Infectious Diseases and chief medical advisor to President Biden, said the interval will stay at eight months unless new data convinces the U.S. Food and Drug Administration and the Advisory Committee on Immunization Practices (a committee within the Centers for Disease Control) otherwise, writes Oren Oppenheim at ABC News (8/29/21). Fauci told ABC News that the FDA “should be examining the data [for COVID-19 vaccines] on children under 12 toward the middle or end of September,” the story states. In the meantime, we can protect children by ensuring that people in their community are vaccinated and by masking in schools, Fauci said: https://abcnews.go.com/Politics/health-officials-sticking-month-covid-booster-shot-timeline/story?id=79700212.
5 - This slide show by Emily Anthes and Mike Kai Chen at The New York Times provides highly accessible answers to five questions about COVID-19 booster shots. The piece notes that the booster recommendation by the U.S. Department of Health and Human Services along with the Biden administration is “controversial” and “many scientists are not yet convinced boosters are needed.” In the U.S., priority will be given to health care workers, nursing home residents and older people, per various sources. Boosters will be free and available at “many of the same locations” as they were earlier this year, including more than 40,000 pharmacies, Anthes writes. “The new [booster] recommendation does not apply to people who got the [Johnson & Johnson] vaccine, which was rolled out later than the mRNA [Pfizer or Moderna] vaccines,” she adds (8/23/21): https://www.nytimes.com/interactive/2021/08/23/health/coronavirus-booster-shots-what-to-know.html.
6 - A second shot of Johnson & Johnson’s COVID-19 vaccine given six to eight months after a first such shot (the J&J vaccine currently is authorized for “one and done” for full vaccination) increases antibodies to SARS-Co-V-2 nine-fold compared to the antibodies typically created a month after a single shot, the company states of its recent research, various media outlets report. The research data were collected in the U.S. and in Europe. J&J will soon be in discussions with public-health officials about authorizing a booster (2nd shot) of its vaccine, the story suggests. Some 14 million people in the U.S. have received the J&J vaccine against COVID-19, per this Maggie Fox story at CNN (8/25/21): https://www.cnn.com/2021/08/25/health/johnson-vaccine-booster-data/index.html.
7 - Pfizer and BioNTech report a similar trend for boosters (3rd shots in the case of their two-shot vaccine) of their COVID-19 vaccine in adults – researchers found that antibodies to SARS-CoV-2 increased three-fold than the level after the second dose, report Sharon LaFraniere and Carl Zimmer at The New York Times (8/25/21). Pfizer and BioNTech reportedly say they planned to “submit all their supporting data” to the U.S. Food and Drug Administration by the end of last week (likely meaning Friday, 8/27/21) for approval of the booster for ages 16 and up, the story states. The companies also plan to submit their data to authorities for approval in Europe and other countries, LaFraniere and Zimmer write: https://www.nytimes.com/2021/08/25/us/politics/pfizer-vaccine-booster-trial-results.html.
8 - Seeking a COVID-19 vaccine for yourself or someone else? You can send a text to 438829 and receive information on nearby places that perform vaccinations. A colleague and I each tested this a week ago and it still worked. I learned about this in an interview that Andy Slavitt gave to The Washington Post about his work through June on the White House coronavirus task force (6/11/21): https://www.washingtonpost.com/politics/2021/06/11/health-202-andy-slavitt-describes-life-white-house-coronavirus-task-force/.
PUBLIC HEALTH:
9 - At STAT, here’s one of those popular pieces that interviews several vaccinated epidemiologists, immunologists and other infectious disease experts about what activities they would or would not engage in at this point in the pandemic. It’s time for a new installation of this genre given the current dominance of the delta variant of SARS-CoV-2 in several countries and its impacts. For this one, Helen Branswell made the survey “forced choice” – for each activity, the experts could only answer yes, no, or “only if masked.” Easy ones that all or most agreed on: no to movie theaters, no to sending an unvaccinated child to school without a mask, and no to sending a vaccinated teen to school without a mask. The majority of respondents said “no” to indoor dining at a restaurant, too. After that it starts to get nuanced, so start by checking out the bar graph a third of the way down the page (8/17/21): https://www.statnews.com/2021/08/17/whats-safe-to-do-during-summers-covid-surge-stat-asked-public-health-experts-about-their-own-plans/
10 – Is there a positive sign in these data? This U.S. Centers for Disease Control page features forecasts of weekly SARS-CoV-2 infections in the U.S. You can change the settings of the 2 top pull-down menus for “outcomes” and “U.S. or state.” On 8/23/21, the U.S. forecast for four weeks in the future showed a spike of infections heading up toward the January 2021 peak, but by 8/27/21 the forecasted case curve starts turning downward. (Click on “weekly deaths” under “outcomes” for the CDC forecast, however, and you’ll see a lower spike and no clear downturn; trends in deaths usually lags trends in infections/cases): https://covid.cdc.gov/covid-data-tracker/#forecasting_weeklycases.
11 - Those plexiglass or plastic screens that grocery stores, banks, restaurants, and so forth have installed during the pandemic probably do not offer any protection from transmission of SARS-CoV-2, reports Tara Parker-Pope at The New York Times (8/19/21). What they offer is a false sense of security, the story states. SARS-CoV-2 spreads mostly in invisible aerosol particles in the air, as you probably know. These particles can float and remain in the air for hours after release from someone’s airway, I’ve read. So something that looks like a sneeze guard won’t do much good against a virus like SARS-CoV-2 – the small aerosols travel over or around the barrier, within about five minutes, the story suggests. The plastic barriers actually can slow the circulation of air in a room or create dead zones “where viral aerosol particles can build up and become highly concentrated,” Parker-Pope writes. Not good. As you probably know, limited air flow is the opposite of what public health researchers recommend for reducing the risk of spreading the virus. Parker-Pope reports that a study published in June “showed that desk screens in classrooms were associated with an increased risk of coronavirus infection”: https://www.nytimes.com/2021/08/19/well/live/coronavirus-restaurants-classrooms-salons.html.
12 - Some items that stand out in Jillian Kramer’s 8/6/21 story at National Geographic about a recurring big question of the pandemic – “how and when will it end?”: 1) the only diseases affecting humans or other animals that have ever been wiped out—smallpox and rinderpest (a viral disease found in cattle)—were stamped out by “intensive vaccination campaigns,” the story states; 2) the bacteria that causes bubonic plague and pneumonic plague is still out there, making about 500 people worldwide sick annually in recent years; 3) regardless of how widely a bug is circulating and sickening people, in at least one case, society decided the pandemic was over before governing bodies did, the story states. “The public entered the ‘Roaring Twenties’ despite the flu virus still circulating throughout the U.S. population,” Kramer writes: https://www.nationalgeographic.com/science/article/how-will-the-pandemic-end-the-science-of-past-outbreaks-offers-clues.
SCIENCE:
13 - At The New York Times, Apoorva Mandavilli explains how standard practices in science and the incremental nature of knowledge accumulation complicates public confidence in officials’ evolving SARS-CoV-2 guidance on masks, vaccines, school re-openings, and more (8/22/21). The story lays out the scientific process of arriving at solid findings—from hypothesis to experiments, to conference presentations of results, to submission to a journal where experts evaluate the scientific methods and claims for flaws, and finally to manuscripts being rejected, revised, or accepted for publication. Early manuscripts and presentations are dissected, sometimes publicly, sometimes behind closed doors, sometimes online, sometimes harshly, in a honing process that can take years before reliable, publishable results emerge. The scrutiny and revision of knowledge evolves continuously in science, sometimes long after publication. “What researchers have not done is explain, in ways that the average person can understand, is that this is how science has always worked,” Mandavilli writes. “Leaders in the United States have promised too much too soon, and have had to backtrack”: https://www.nytimes.com/2021/08/22/health/coronavirus-covid-usa.html.
ENTERTAINMENT:
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