Weekly News From Los Alamos County
May 25, 2022
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Inside this newsletter, you will find...
The Epidemiology Corner - COVID-19 Update, Long COVID, Vaccine Update,
Don't Overlook Progress, Survey & Results, COVID-19 data and more.
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COVID-19 Update...
"It is believed that all areas of the U.S. are underestimating their case counts due to the increasing use of at-home rapid antigen testing..."
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SARS-CoV-2 Variants Circulating in US: BA.2.12.1 Now Predominates
For the week ending May 21, CDC estimates Omicron variant BA.2.12.1 predominates in the US at 58% prevalence, with the remaining cases attributable to the receding BA.2 variant. Increased severity has not as yet been observed with BA.2.12.1, however, evidence is emerging that the variant does have increased immune evasiveness towards prior variants, and any immunity conferred with infection during the BA.1 / BA.2 January-February surge may not necessarily be protective against re-infection with BA.2.12.1. Health authorities believe that the exceptionally high transmissibility and enhanced immune evasiveness of BA.2.12.1 accounts in large part for the roughly four-fold increase in average daily reported COVID-19 cases seen nationwide since April 1. The increasing case count has lead to increasing hospitalization rates, which have risen by 44% nationwide from 1.6 to 2.3 per 100,000 in all ages since April 1. The elderly continue to be at highest risk of COVID-19 hospitalization. Rates in the 70+ year age group have increased by 63% over the past eight weeks and are expected to continue climbing as the BA.2.12.1 variant ascends towards 100% prevalence. Risk of hospitalization in persons 70+ years is several-fold higher than that in younger age groups, and reaches a maximum ten-fold higher risk compared to those under age 18 years. CDC provides specific protective recommendations for older adults, which begin with up-to-date vaccination in eligible seniors. See HERE.
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COVID-19 Incidence in the County: Modestly Rising Trend Continues
Average daily reported COVID-19 cases continue to rise above the low counts seen in March following the January 2022 Omicron BA.1 peak. Roughly seven cases per day were reported among county residents for the week ending May 23, which translates to 49 cases reported total. It is believed that all areas of the U.S. are underestimating their case counts due to the increasing use of at-home rapid antigen testing, the results of which are often not reported to health authorities. Even with the undercount, however, the rising trend in reported COVID-19 incidence in the county, as well as nationwide, is cause for concern, especially among high-risk groups.
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Reported COVID-19 case incidence has been in a modestly rising trend in the county over the past two months, as it has been in neighboring Santa Fe, Rio Arriba, and Taos counties; the four of which comprise the Health Services Area (HSA) that CDC uses to calculate Community Level hospitalization metrics. For the week ending May 23, three of the four counties had 7-day total incidence rates well exceeding 200 per 100,000, which automatically confers Medium risk status regardless of hospitalization rates. According to the CDC, the hospital admissions rate in the four-county HSA was 5.8 per 100,000 during the week ending May 22. Hospitalization rates that exceed 10 per 100,000 in counties with an incidence rate above 200 per 100,000 result in a CDC classification of high risk, which triggers a CDC recommendation for indoor public masking, regardless of vaccination status. Other more enhanced protective measures are also recommended for High risk counties. See HERE.
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NOTE: The COVID-19 incidence data reviewed here are based mainly on PCR-confirmed testing results compiled by CDC and may not necessarily include positive at-home antigen tests. As such, case counts are likely underestimated, but by how much cannot currently be determined.
To assist with more complete case monitoring in New Mexico, NMDOH provides for on-line reporting of positive at-home antigen results HERE.
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What We Know About Long Covid So Far
Among the many confounding aspects of the coronavirus is the spectrum of possible symptoms, as well as their severity and duration. Some people develop mild illness and recover quickly, with no lasting effects. But studies estimate that 10 to 30 percent of people report persistent or new medical issues months after their initial coronavirus infections — a constellation of symptoms known as long Covid. People who experience mild or moderate illness, as well as those without any underlying medical conditions, can nonetheless experience some debilitating long-term symptoms, including fatigue, shortness of breath, an erratic heart rate, headaches, dizziness, depression, and problems with memory and concentration.
Such lingering medical issues are so varied that one study by a patient-led research group evaluated 203 symptoms that may fluctuate or even appear out of the blue after people seem to have recovered.
As Dr. Ziyad Al-Aly, the chief of research and development at the VA St. Louis Healthcare System and a clinical epidemiologist at Washington University in St. Louis, said, “If you’ve seen one patient with long Covid, you’ve seen one patient with long Covid.”
How doctors currently diagnose long Covid
There is little consensus on the exact definition of long Covid, also known by the medical term PASC, or post-acute sequelae of Covid-19. While the World Health Organization says long Covid starts three months after the original bout of illness or positive test result, the Centers for Disease Control and Prevention sets the timeline at just after one month.
Some researchers and health care providers use other time frames, making efforts to study and quantify the condition more difficult, said Dr. Al-Aly, who has conducted many studies on long-term post-Covid issues.
For now, doctors must rely on their patients’ descriptions of symptoms and rule out alternative explanations or causes. Some post-Covid clinics have multidisciplinary teams of specialists evaluate patients to figure out the best treatment options.
What causes long Covid?
It’s unclear what exactly drives long Covid, but research has begun to offer some clues. Some experts theorize that an immune response that goes into overdrive when you first get sick may lead to inflammation and damage throughout the body, eventually resulting in long Covid symptoms, said Dr. Michael Peluso, an infectious disease physician at the University of California, San Francisco.
Another explanation, experts say, could be that your immune system never fully shuts down after the initial infection.
Who is at risk?
Research offers some hints about which patients might face a greater risk of long-term symptoms. In a study of 209 patients published in January, researchers found four factors that could be identified early in a person’s coronavirus infection that appeared to correlate with an increased risk of having ongoing symptoms two to three months later.
One factor was the level of coronavirus RNA in the blood early in the infection, an indicator of viral load. Another was the presence of autoantibodies — antibodies that mistakenly attack tissues in the body as they do in conditions like lupus and rheumatoid arthritis. A third factor was the reactivation of Epstein-Barr virus, which can cause mononucleosis and infects most people, often when they are young, and then usually becomes dormant.
The fourth factor was having Type 2 diabetes, although experts say that in studies involving larger numbers of patients, diabetes might be only one of several medical conditions that increase the risk of long Covid.
Can vaccines protect against long Covid?
The picture is still coming into focus, but several studies suggest that getting a Covid vaccine can reduce — but not eliminate — the risk of longer-term symptoms.
The United Kingdom’s Health Security Agency conducted an analysis of eight studies that had looked at vaccines and long Covid before mid-January. Six found that vaccinated people who then became infected with the coronavirus were less likely than unvaccinated patients to develop symptoms of long Covid. The remaining two studies found that vaccination did not appear to conclusively reduce the chances of developing long Covid.
In that analysis, one study, which has not been peer-reviewed, of about 240,000 U.S. patients found that those who had received even one dose of a Covid vaccine before their infections were seven to 10 times less likely than unvaccinated patients to report symptoms of long Covid 12 to 20 weeks later. But another large study of electronic patient records at the U.S. Veterans Health Administration, also not yet peer-reviewed, found that those who were vaccinated had only a 13 percent lower risk than unvaccinated patients of having symptoms six months later. Vaccinated patients mostly benefited by being less likely to develop lung problems and blood-clotting difficulties, said Dr. Al-Aly, one of the study’s authors.
Seeking medical care
If you are concerned about any lingering symptoms after a confirmed or suspected coronavirus infection, don’t be afraid to ask for help. Checking in with your primary care provider is a good first step. More doctors are becoming aware of long Covid symptoms and can recommend tests that might at least rule out other causes of your symptoms.
“Even though we say that long Covid is when symptoms last for a month or three months after infection, you don’t have to wait that long to get help,” Dr. Al-Aly said. “People should really honor their symptoms.”
Bring your medical records if you’re visiting a new provider and make a list of all your symptoms, especially if you’re experiencing cognitive issues and are likely to forget some health concerns when your appointment comes around.
Some long Covid issues can be managed with existing medications or treatments for symptoms like headaches or gastrointestinal problems. Physical therapy and “cognitive rehab,” including approaches often used for patients who have experienced strokes or brain injuries, can also be helpful over time. Some people benefit from tailored physical and mental health rehabilitation services and breathing exercises, which can help them slowly build back strength and endurance for physical activities.
Other possible tools against long Covid, including antiviral treatments, are only beginning to be studied. The National Institutes of Health is devoting more than $1 billion to a major research effort called the Recover Initiative, but progress has been slow so far.
To read the full article, click HERE.
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Have you or someone you know experienced symptoms of long COVID?
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Pfizer 3-dose COVID vaccine 80% effective against symptomatic omicron infection for youngest children
Vaccines for youngest children are expected to be available in June or July
In long-awaited data, Pfizer said its three-dose vaccine was 80% effective against symptomatic omicron COVID-19 infection among children 6 months to under 5 years old.
The company cautioned that estimate was preliminary and could be adjusted as more data is collected. The trial wasn't big enough to estimate protection against severe disease, which experts expect to be higher.
Pfizer announced in December that it would not move forward with a two-dose vaccine after disappointing data, instead opting to study three doses for this age group. The company will submit the new data as part of its ongoing “rolling” submission to the FDA.
For anxious parents, the Pfizer news offers reassurance that the vaccine will help protect young children currently not eligible for vaccination.
In the wake of Pfizer's new pediatric COVID-19 vaccine data, the Food and Drug Administration (FDA) has set a new, tentative date of June 15 for its advisers to discuss the COVID-19 vaccine applications for young children, meaning both vaccines could potentially be authorized by the end of June.
Moderna, meanwhile, asked the FDA for authorization on April 28 for a two-dose vaccine for this age range. Moderna’s preliminary analysis found its two-dose pediatric vaccine was 51% effective against symptomatic COVID-19 among children 6 months to under 2 years old, and 27% among children 2 to 5 years old -- roughly the same efficacy seen in adults during the omicron surge. Protection against serious disease and death was higher.
Experts caution that vaccine efficacy against symptomatic infection is a high bar, and experts expect these vaccines will offer excellent protection against severe illness, just as they do for adults.
Though children under five is the last remaining age group that’s yet to be vaccinated, polls indicate there could be sluggish uptake.
A recent survey from KFF found that just under 1 in 5 parents are eager to get their children under five vaccinated right away.
However, the KFF poll more than half of parents said that they feel they do not have enough information about the vaccines’ safety and efficacy for children under age 5 — which could change after the public FDA advisory meetings to discuss the pediatric data.
To read the full article, click HERE.
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Don’t let latest COVID surge overshadow progress
With COVID cases once again on the rise, hopes for a summer relatively free of pandemic anxiety seem to be in jeopardy. William Hanage, an epidemiologist at Harvard T.H. Chan School of Public Health and co-director of the Center for Communicable Disease Dynamics, spoke with the Gazette about the latest surge shortly after the U.S. hit yet another grim milestone: 1 million deaths. The interview was edited for clarity and length.
Q&A with William Hanage
GAZETTE: How does this wave compare with the Omicron surge in January?
HANAGE: Nowhere even close to January. What we’re seeing is being driven by a subvariant of BA.2, which itself was fairly lackluster, at least in these parts. But we’ve been seeing increasing cases due to BA.2.12.1, which is a lineage first detected in upstate New York. It has a mutation in the spike protein which we think makes it better able to reinfect folks who’ve recovered from previous infections — including BA.1 — and which is shared by BA.4 and BA.5, which are surging in South Africa. That’s why we’re seeing a lot of cases, but they’re far fewer than we saw in January, even accounting for the fact that we are undercounting cases because more folks are doing rapid tests and not getting counted in the official numbers.
For a lot of people, myself included, it can seem like COVID is everywhere at the moment. But you should remember that this is a virus that spreads through networks. If you and your network were not overwhelmed by BA.1, it means that you are in a network which is more likely to get BA.2 because the people involved in it are less likely to have had the extra dollop of immunity that came from BA.1. So that’s one reason the transmission patterns are looking so distinctive. It’s also certainly the case that we are seeing more transmission and more cases in schools now than we were with BA.1. When schools close — this means colleges like Harvard and K-12 education — that’s going to change the contact patterns and things may well turn around.
GAZETTE: Would you say we’re in a post-pandemic phase? Is this possibly the first of the post-pandemic waves?
HANAGE: I don’t like having a cutoff because COVID is not going to be eradicated.
There’s going to be a transition between the acute pandemic risk to a point where people like me — infectious disease epidemiologists — pay it a lot of heed in the way that we pay heed to flu. We’re headed in that direction but we’re not there yet. To give some context, I think you’d agree that at the moment, the country is in a relatively good place, death-wise and hospitalizations-wise. But if the weekly death numbers were added up over the year — no fluctuations, no surges, just continuous “good” death numbers — that would still be equivalent to two bad flu seasons. When this virus is “good,” it’s still something that would be considered historically bad in terms of respiratory infections. And, of course, we can expect things to get worse across the South in the summer and pretty much everywhere before winter, and this assumes no curveballs from new variants.
GAZETTE: If you had a case in your household at this point in the pandemic, how would you handle it?
HANAGE: I can tell you what we did — our kids got infected. First of all, sign up for the household transmission studies that are going on. There’s one being done out of Beth Israel. We were fortunate enough to have air purifiers, which we turned on. We wore masks, but not continuously, not religiously. We hugged while wearing masks. We ate outside when we could and, when it was cold, we ate inside. For what it’s worth, neither my wife nor I were infected. We also did very regular rapid tests — we actually did daily PCR tests because we were in the household transmission study.
My advice to a member of the public would be to remember that you could be infectious and not know it. Any time you’re leaving the house and going to a place where transmission matters, like gathering with vulnerable people or attending a large gathering where you might seed a superspreading event, try to do a rapid test beforehand. If you have symptoms, don’t go out, but don’t think that not having symptoms means there’s no chance that you could have it. If the person in your household had it for five days, do not assume they are not infectious anymore. A large number of people in that category will still be infectious. CDC guidance — and my recommendation — is if the person who was infected has to leave the house, make sure that they wear a well-fitting, good-quality mask. That will greatly reduce the risk of transmission to others.
To read the full story, click HERE.
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Testing Resources for Los Alamos County |
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Los Alamos County Testing Resources
Visit the County COVID Page for information regarding testing, click below:
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Los Alamos Vaccine & Booster Information |
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Los Alamos County Vaccine/Booster Resources
Visit the County COVID Page for information regarding vaccinations/boosters, click below:
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CDC COVID Data Tracker - May 24, 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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The charts available with this TOOL layout the key metrics for understanding the reach and severity of COVID-19 in a given area.
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Johns Hopkins
COVID-19 Status Report Dashboard for
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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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