Weekly News From Los Alamos County
November 5, 2022
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Inside this newsletter, you will find...
The Epidemiology Corner - COVID-19 Update (- New Variants Continue Rapid Emergence - Rising Trend of Reported Cases in the County - CDC Community Level for the County Remains at LOW - LAPS Reported Cases Suggest Significant Undercount in Official Case Data).
Other Articles and More: Making Holiday Plans with a COVID Wave (NYT), RSV is Surging (NPR), How Long Does COVID Immunity Last (NYT), Study Shows Booster Improves Protection for Older People (NYT).
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COVID-19 Update:
New Variants BQ.1/BQ.1.1 Continue Rapid Emergence as Transmission Rates Continue Rising in the County.
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Omicron Variants BQ.1 / BQ.1.1 Continue Rising in US and Now Predominate in Some Regions
CDC reports that the estimated nationwide prevalence of Omicron variants BQ.1 and BQ.1.1 (BQ.1x) rose from 23% to 35% over the past week in the US. The BQ.1x variants first emerged in the Northeast US, including New York City, and now dominate at 52% prevalence in this region. See HERE. Health authorities expect the BQ.1x variants to soon predominate nationwide, which is concerning as COVID-19 deaths nationwide remain high as the winter approaches. Hospitals could face a “negative trifecta” this winter from the BQ.1.x variants as well as resurgent flu and respiratory syncytial virus (RSV). Furthermore, the BQ.1x variants are resistant to Evusheld, a long-acting antibody treatment given to persons immunocompromised due to a medical condition or immunosuppressive medications, as well as those individuals for whom COVID-19 vaccination is not recommended. This places these individuals at much greater risk of severe disease than the general population. See HERE
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COVID-19 in the County: Rising Trend in Reported Cases Remains Intact
An average of 5 cases per day were reported for the week ending November 2 compared to 4.6 cases per day for the immediately preceding week. A sustained pattern of increasing case transmission has been observed since mid-September, which is consistent with the Fall/Winter COVID-19 case wave anticipated by many health authorities. The number of average weekly reported cases has roughly doubled between mid-September and the end of October. According to the NMDOH, the percentage of emergency department (ED) visits in county residents for COVID-like symptoms was 2.3% for the two-week period ending November 1. See HERE. NMDOH reported no new hospital admissions for COVID-19 among county residents during the week ending October 30.
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Wastewater Surveillance Reflects Rising Case Transmission in the County
SARS-CoV-2 virus continues to be detected in county municipal wastewater with a rising short-term trend consistent with the rising short-term trend in reported cases. See https://biobot.io/data/
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CDC Community Level Remains at LOW for Los Alamos County Based on Official Case Reports
For the week ending November 2, the CDC Community Level for Los Alamos and Santa Fe counties remains at LOW, but is at Medium for neighboring Taos and Rio Arriba counties due to elevated case transmission. Although new COVID-19 hospital admissions in the four-county Health Services Area (HSA) decreased from 9.9 to 5.8 per 100,000 for the current week, case transmission rates notably increased over the week in all four HSA counties. Transmission rates now exceed the CDC Community Level criteria of 200 per 100,000 in both Taos and Rio Arriba, and are close approaching that level in Los Alamos and Santa Fe counties. Based on the analysis of case reporting in county grade-school age children described below, it is reasonable to assume that the actual Los Alamos County transmission rate (positive PCR tests + positive rapid at-home antigen tests) likely now exceeds the CDC criteria threshold for a Medium risk assignment.
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LAPS Case Reporting Suggests Significant Undercount in Official Case Data
Reported COVID-19 case data publicly available on the Los Alamos Public Schools (LAPS) website were compiled for all elementary schools and the middle school and compared to NMDOH reported case data for 5-14 year-olds. The LAPS case data includes both students and staff, so the two populations are not equivalent, but roughly approximate each other as students represent the majority of the school populations. In September, a total of 12 LAPS cases were reported compared to zero cases reported to NMDOH. In October, where case numbers quickly rose towards the end of the month, a total of 74 LAPS cases were reported compared to 12 cases reported to NMDOH. This large multi-fold differential likely reflects high prevalence use of rapid at-home testing within the school population. Public health authorities have for some time recognized that official case counts based on positive PCR test reporting undercount actual COVID-19 cases. The extent of the undercount is unknown, leaving health experts to suggest that a personal accounting among family and friends may be a better gauge of local COVID-19 transmission than official case data. See HERE.
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NOTE: The NMDOH/CDC COVID-19 incidence data reviewed here are based on PCR-confirmed testing results and do not include data on positive at-home antigen tests. As such, case counts are underestimated, but by how much cannot be determined precisely at any given time point.
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Another Covid Wave Could Be Coming. Here’s How to Make Your Holiday Plans. As our third pandemic winter approaches, you can mitigate risk without missing out.
At this stage in the long slog of the pandemic, many of us are forgoing masks in places we previously wore them and getting together indoors when we had formerly avoided it. But the holidays throw new variables at everyone’s risk calculus. People trek across the country to see each other. Families crowd around dinner tables, with older, more vulnerable people sitting beside their younger relatives.
“This is the holiday that everyone’s going to come back together again,” said Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco. With a bit of advanced planning, he said, family gatherings can be safe this year, and resemble something like pre-pandemic times. “We have the tools for a normal life,” he said. “We just have to use them.”
Here’s what to keep in mind as you map out your family’s plans for the holidays.
Plan around the highest-risk member of your family.
Individual risk tolerance may vary among your family members, but in general, plan around the person at your gathering who is highest-risk. That means taking more precautions if you have a family member who is older than 60, on immunosuppressant medications, received a transplant, or is a cancer patient, said Dr. Michelle Prickett, pulmonary and critical care specialist at Northwestern Medicine.
You should talk with your family members ahead of time before gathering and figure out your game plan. Ask if people are up-to-date on their vaccinations, and encourage people to take additional precautions if a high-risk family member is attending, which could include limiting the amount of people you invite to Thanksgiving dinner or investing in a few heat lamps so that you can move the meal outside.
Get the new booster.
The new bivalent booster is a critical tool for warding off infection. You can find the new booster at pharmacies and health centers across the country, and anyone 5 and older can currently receive it.
Pay attention to your symptoms.
In the days leading up to a family event — and especially the morning of — watch out for Covid symptoms: sore throat, congestion, coughing, fatigue, headaches and muscle pain. People infected with BA.5, the dominant variant of Covid, are less likely to report losing their sense of taste and smell, but those are also crucial symptoms to watch for.
The dominant variant currently has a shorter incubation period — which means if you go to a packed bar on a Friday night and don’t have symptoms by Monday, it’s unlikely you have the virus, Dr. Chin-Hong said. If you still don’t have symptoms by Wednesday, you’re probably in the clear, he said, although you should take a test to confirm.
However, it is still possible to have an asymptomatic case of Covid — and as more people build up immunity to the virus through vaccination and prior infection, asymptomatic, or very mild, cases will be more common.
If you do feel sick, stay home — even if you’re negative on a rapid test.
Test wisely.
The question isn’t whether or not to test before a family gathering; it’s when to test, and how many times.
Experts differ on the exact timing and combination of tests you should take, but for the most accurate measure of whether or not you’re contagious before an event, take an at-home rapid test right before.
“Rapid tests are very good, but they’re not perfect,” Dr. Prickett said. P.C.R. tests are more sensitive, but it can take several days to get the results back, she said, and so a five-day-old snapshot of your infection status won’t be helpful in determining if you’re contagious at the moment. If you can get a quick-turnaround P.C.R., that can boost your confidence that you’re negative; if not, take at least two rapid tests, 12 to 24 hours apart.
Consider a “mini quarantine.”
You might want to minimize your exposure in the week before heading home for the holidays, Dr. Prickett said. That means wearing a mask in public indoor spaces and also limiting the time you spend around crowds — like timing trips to the grocery store for when it isn’t super packed, she said.
Mask up while you travel.
While your risk may change slightly depending on which mode of transportation you take, Dr. Gounder didn’t recommend prioritizing one form of travel over another. But whether you’re taking a plane, bus or train, make sure to wear a mask.
Even if you’re the only person on a plane or train wearing one, a high-quality mask can still protect you, doctors said. “It’s way, way better than nothing,” Dr. Ratner said, “and way, way worse than if everyone was masked.” He recommends people use an N95, KN95 or KF94 mask, and that they keep it on for the entire trip, or take it off for as short a time as possible. You might want to fill up on a big meal before your journey, so you don’t have to take off your mask to eat.
Ventilate your space.
If you can’t hold your event outside, you can still increase air circulation and reduce the risk of trapping and transmitting the virus in a tight indoor space. Even cracking open the windows can improve air flow. You can also purchase portable air purifiers with HEPA filters. These devices can be expensive (Wirecutter recommends one that retails for just under $200), but they can effectively capture some virus particles in the air.
Experts acknowledged that these precautions can be exhausting, but stressed that advance planning can help us protect each other over the holidays.
Read the full article HERE.
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RSV is surging. Here's what to watch for and answers about treatment options
Temperatures are dropping and the risk of COVID-19 and influenza are up. And for the last few months, patients with a different malady — respiratory syncytial virus, known as RSV — have been overwhelming hospitals. Public health officials warn that come winter there could be a "tripledemic."
The unusually high number of RSV infections so early in the year are already pushing hospitals to capacity. In normal years, RSV sends thousands of children to the hospital over fall and winter, but for the second year in a row experts have seen an unprecedented spike in the number of cases beginning during the summer months.
While RSV mostly manifests as a mild illness with cold-like symptoms in adults, it can cause pneumonia and bronchiolitis in very young children. It can be life-threatening in infants and older adults.
But just how concerned should parents be? Here are answers to some of the most common questions about the RSV infection, who is most at risk and what might be causing this year's outbreak.
Why might RSV be particularly bad this year?
While it may be too early to know for sure, health experts agree that the earlier-than-usual surges are a consequence of the broad lifting of COVID-19 precautions, which served to protect the public from a variety of viruses.
"When the pandemic hit the U.S. in March 2020, we saw the rates of all viruses plummet," Dr. Vandana Madhavan, director of advanced pediatrics at Mass General Brigham in Boston, told NPR. That was largely due to people staying indoors, wearing masks and frequently washing or sanitizing their hands, she added.
Once restrictions began to be loosened in the spring of 2021, health experts began seeing odd patterns of circulation of these respiratory viruses. This year, the return to pre-COVID social activities and interactions, travel and in-class teaching has led to another dangerous spike, Madhavan explained.
Why are infants and young children the most vulnerable to respiratory viruses?
Nearly all children get an RSV infection by the time they are 2 years old, according to the Centers for Disease Control and Prevention. In most cases, it will cause mild, cold-like symptoms, much as it does in the vast majority of healthy adults. But it can also cause severe bronchitis or pneumonia in very young children, particularly infants and those under the age of 5.
The problem is that their small lungs and muscles can't muster up the power to cough up or sneeze out the increased secretions and mucus caused in their airways.
According to the CDC's data, each year approximately 58,000 children under 5 are hospitalized for RSV. The next most vulnerable group are adults over 65, in whom the infection causes 14,000 deaths a year.
What precautions can you take to avoid RSV?
Health officials say handwashing, staying hydrated, keeping hands away from the face and disinfecting surfaces help to stave off RSV or keep it from becoming a serious illness.
But for those with newborns or kids under one, Madhavan said the best thing to do is to keep children away from adults who have been recently sick.
Madhavan said the effective way for children and adults to try to stay healthy throughout the remaining fall and winter months, is to get updated COVID booster and influenza vaccines.
How to time your flu shot for best protection
Anyone over six months old can get the flu vaccine. Madhavan noted that it takes a couple of weeks for the shot's full protection to take effect. "If a child is under eight and has never gotten influenza vaccine before, they need two doses one month apart before getting full protection two weeks after that second dose," she added.
The COVID bivalent boosters for people 5 and older became available in September. And children over six months can get any of the three available COVID-19 vaccines. "Don't wait until we're in the middle of another COVID wave to get the booster," Madhavan warns.
When to seek emergency care?
Hospitals, emergency rooms and pediatric ICUs across the country have been teeming with RSV patients for weeks now. So it's important to know when to head for the ER and when it might be a better, healthier idea to stay home, Madhavan said.
She strongly discourages people from heading to the ER to get tested for RSV or other respiratory viruses.
"If you think you or your child has it, it's best to pick up the phone and call your doctor or nurse rather than coming into a setting that might mean a long wait or might mean exposure to other viruses that your child and family don't have and can have risks on their own," she said.
Madhavan said that in most cases, health care professionals can go through a checklist of warning signs and make suggestions for potential at-home treatments.
But, Madhavan warns, it may be time to seek more intensive care when an infant or young child is working extra-hard to breath. That includes a flaring of the nostrils, grunting as they inhale and exhale, or the skin between or below the ribs or collarbone pulls in and out.
To read the full article, click HERE.
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Have you received your flu shot yet?
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I am scheduled to get it soon.
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I plan to get it but it is not scheduled.
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I don't plan on getting the flu shot.
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How Long Does Covid Immunity Last? Will a Second Illness Be Worse? How Can I Prepare?
If you’re one of the millions of Americans who have already had Covid-19, you may be wondering how long you will have immunity from the coronavirus. Earlier in the pandemic, most people assumed that getting infected had at least one upside: that you would be protected against future encounters with the virus. But as the latest wave heads toward the Western region of the country and the virus shows no signs of easing up, reinfections seem to have become common. Already, many people are reporting second or even third infections with newer variants.
Experts have warned that exposure to the coronavirus — through vaccination or infection — does not mean that you are completely protected from future infections. Rather, the coronavirus is evolving to behave more like its closely related cousins, which cause common colds and infect people repeatedly throughout their lives.
However, the coronavirus doesn’t yet fit into clear seasonal patterns like the other common cold viruses. It can also cause debilitating symptoms that persist for months or years in some people, and has claimed the lives of millions of others. So what can you do to protect yourself, not only from infection but also reinfection? We asked experts for answers to common questions.
How long will my immunity last after getting Covid?
Before Omicron, reinfections were rare. A team of scientists, led by Laith Abu-Raddad at Weill Cornell Medicine-Qatar, estimated that a bout with Delta or an earlier coronavirus strain was roughly 90 percent effective in preventing a reinfection in both vaccinated and unvaccinated people. “But Omicron really changed that calculus,” said Dr. Abu-Raddad, an infectious disease epidemiologist.
After Omicron emerged, prior infections only provided about 50 percent protection against reinfection, Dr. Abu-Raddad’s study showed. The coronavirus had acquired so many mutations in its spike protein that newer versions became more transmissible and better able to evade immunity. That means you can catch a version of Omicron after recovering from an older, non-Omicron variant. You can even get sick with one of the newer Omicron subvariants after getting over a different version of it.
Other factors also increase your vulnerability to reinfection, starting with how long it has been since you had Covid. Immune defenses tend to wane after an infection. A study published in October 2021 estimated that reinfection could occur as soon as 3 months after contracting Covid-19. While these findings were based on the genome of the coronavirus and accounted for expected declines in antibodies that could fight off the virus, the study did not account for new variants like Omicron that were radically different from older variants. Because of how different Omicron is, your protection may wane even sooner. In a study published in February that has not yet been peer-reviewed, scientists from Denmark found that some people got reinfected with the BA.2 sublineage of Omicron as soon as 20 days after they got infected with the original Omicron BA.1.
For now, you should treat any new symptoms, including a fever, sore throat, runny nose or change in taste or smell, as a potential case of Covid, and get tested to confirm if you are positive again.
Will subsequent infections be more or less severe?
The good news is that your body can call on immune cells, like T cells and B cells, to quash a reinfection if the virus sneaks past your initial antibody defenses. T cells and B cells can take a few days to get activated and start working, but they tend to remember how to battle the virus based on previous encounters.
Many of these immune cells build up their protections iteratively, Dr. Crotty said. That means that people who are vaccinated and boosted are especially well equipped to duke it out with the coronavirus. Similarly, people who have been infected before are able to keep the virus from replicating at high levels if they get reinfected. And most people who have logged encounters with both the vaccine and the coronavirus build up a hybrid immunity that may offer the best protection.
The result is that second or third infections are likely to be shorter and less severe.
But just because reinfections are less severe, it doesn’t mean that they are not terrible. You may still run a fever and experience body aches, brain fog and other symptoms. And there’s no way of knowing if your symptoms will linger and become long Covid, Dr. Adalja said.
What can you do to reduce your risk of reinfection?
Many of the tools and behaviors that help protect against infection can still help you avoid reinfection, Dr. Abu-Raddad said. “There is no magical solution against Covid reinfection.”
Getting vaccinated and boosted, for example, is a good idea even after you’ve had Covid. You only need to wait a few weeks after an infection to get a shot. The vaccines will bolster your antibody levels, and research shows that they are effective in preventing severe outcomes if you get sick again.
Additional measures, like masking indoors and in crowded spaces, social distancing and improving ventilation where possible, can provide another layer of protection. But because most people and communities have largely dropped these protections, it is up to individuals to decide when to adopt extra precautions based on their risk of getting Covid and how much they’d like to avoid it.
People who are trying to avoid getting Covid because they’re going on a cruise soon or because they need a negative P.C.R. test for some other reason may consider taking precautions. Covid protections don’t have to be one-size-fits-all.”
To read the full article, click HERE.
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Study Shows New Booster Improves Protection for Older People, Pfizer Says Federal officials are hoping that the encouraging results will spur more Americans to get an updated booster before a feared surge in coronavirus cases this winter.
A new study by Pfizer and BioNTech suggests that their updated coronavirus booster released in September is nearly four times as good as its predecessor at boosting antibodies against the currently dominant version of the virus for people over age 55.
Federal officials are hoping that the encouraging results will bolster what has so far been a dismal public response to the retooled shots. Only about 8 percent of Americans ages 5 and up have received the new boosters from Pfizer and Moderna, which are recommended for people in that age group who have had an initial round of vaccination.
Pfizer and BioNTech announced the study results in a news release. The companies said that one month after getting the new booster, clinical trial participants over 55 had antibody levels that were 3.8 times as high as those who received the original booster. The number of participants in the study was small, with 36 people receiving the new booster and 40 receiving the old one.
The control group included only older adults, and the findings so far are limited to one month after the shot. Results from a similar clinical trial by Moderna are expected soon.
Biden administration officials cast the results as good news in the battle against Covid-19, but whether many Americans will care much remains to be seen. As the pandemic nears the three-year mark, the public seems deeply weary of Covid vaccinations. In a Kaiser Family Foundation poll conducted in September, one in five adults said they had not even heard about the new boosters.
Administration officials said the results of the study offered a new reason for Americans to seek out the updated shots before what experts fear could be a winter surge of the virus that leads to tens of thousands of unnecessary deaths.
Pfizer said study participants in the control group had been boosted about six months earlier, while those who received the updated shot had had their last booster 11 months earlier. Both groups had similar antibody levels before receiving the new booster.
The updated shot targets the version of the virus that now looms largest in the United States, a subvariant of Omicron known as BA.5. But by next month, a new Omicron subvariant is expected to become dominant.
Administration officials say those subvariants are structurally alike enough that the updated shots should continue to provide potent protection. Dr. Marks said that he expected some decrease in the boosters’ ability to neutralize the virus but their overall benefits to hold.
While urging Americans to get the updated shots, Biden administration officials are not casting them as a final answer to the pandemic. For two years, the administration has been engaged in a continual game of catch-up. By the time scientists have revised the vaccine to protect against the virus’s newest incarnation, it has already shifted to another form.
That reality, some experts said, could be part of the reason Americans are showing diminished enthusiasm for each added shot. So far, the administration has not persuaded Congress to allot more money to develop the next generation of vaccines that could end the behind-the-curve cycle.
Asked whether positive clinical trial results would help pique interest in the boosters, Dr. Philip Huang, the health director for Dallas County in Texas, said, “Anything that provides some more reinforcement for people who are on the fence or delaying always helps.” But, he said, “if there is a bump-up in hospitalizations and serious illness, that’s when people start to take it seriously.”
“It’s a shame that’s what it takes to get motivation up,” he added.
To read the full article, click HERE.
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Los Alamos Vaccine & Booster Information |
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How do I know if I'm eligible for a vaccine or booster?
Follow these links to review the CDC eligibility guidelines:
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Where can I get my COVID-19 Vaccine?
This coming week, Los Alamos Public Health Office has spots available on the NMDOH Vaccine Event Calendar website on Monday, November 7 and Wednesday, November 9 (see example image of what the screen looks like below). Other appointments may be available for future dates as well. Visit the site and make sure you are searching for the Los Alamos area.
In addition to the clinics that use the NMDOH scheduling site, Los Alamos has other options available. Click below on the vaccine/booster resources website for more information.
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Los Alamos County COVID Vaccine/Booster Resources
Visit the County COVID Page for information regarding vaccinations/boosters, click below:
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CDC COVID Data Tracker - November 4, 2022
To get today's break down of positive case data, demographics information, vaccine status and more for Los Alamos County or other counties across the United States, click HERE
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NMDOH Epidemiology Reports - Daily and Weekly Data
As part of the COVID-19 pandemic response, NMDOH collects and analyzes statewide data for COVID-19 positive cases, hospitalizations, and deaths. The reports reflect these critical data and are updated weekly - click HERE
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We are listening to you!
Your feedback is helping to shape future newsletters, inform decisions regarding services, and make Los Alamos County healthier and safer. Make sure to participate each week to be heard!
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Remember, we appreciate your questions! We always try to respond in a timely manner, and if appropriate, we will include those Q&As in future newsletters.
Take a look at these results from the last survey:
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Have a question? Email us. |
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Los Alamos Testing Information |
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Los Alamos County COVID Testing Resources
Visit the County COVID Page for information regarding testing, click below:
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Los Alamos Treatment Information |
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Los Alamos County COVID Treatment Resources
Visit the County COVID Page for information regarding treatments, click below:
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What else would you like to see in this newsletter?
Click below to email us your feedback and questions!
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