Future Mask Use Depends on Lots of Variables

Celebrities Infected After Full Vaccinations

Statistics Show Only 6000 COVID Cases Among Vaccinated People With Seven Percent Hospitalized and One Death

Steris has a Range of Pharmaceutical Facemasks Using Meltblowns

UK Cases of the Variant First Identified in India More Than Double in a Week

Fully Vaccinated People Do Not Need Masks In Many Situations

CDC Guidance On Masks "Went From One Extreme To Another,"

Asian Countries in Danger of Suffering the Fate of India

160 Million Cases of COVID in the World and 3.3 Million Deaths

Mexican COVID Death Toll Over 600,000

Growing Support to Provide Vaccines and Support for Latin American Countries

Herd Immunity is Not Likely

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Future Mask Use Depends on Lots of Variables

Unvaccinated people should wear masks whether there is a low or high positivity rate in their environment.  Vaccinated people can avoid masks most of the time and in most locations; but in certain locations they will be recommended.

The reason is first that vaccinated people can become infected and communicate the disease.  Articles on two celebrity examples are included below.

A second but weaker justification is infection of the vaccinated people. Of 85 million Americans who have been fully vaccinated 6,000 have become infected. Seven percent of them have been hospitalized and one has died.  So one out of 85 million is a pretty low risk.

On the other hand, this is the experience after just a few months. Will more vaccinated people become infected in the future?  Will the efficacy diminish with time?

What about the variants? Will the variants increase the risk to vaccinated individuals?

Will COVID be similar to other flu viruses and become an annual threat? Those that predict this outcome also advise that it may be less virulent as an annual disease.

The bottom line is that there will be some avoided risk if vaccinated people wear masks. This risk may be so low that people will determine that the inconvenience outweighs the risk but many will not board planes or enter crowded football stadiums without their masks.

 

Celebrities Infected After Full Vaccinations

A taping of Bill Maher's weekly HBO show was canceled after the host tested positive for COVID-19.

Maher, who is fully vaccinated, is “asymptomatic and feels fine," according to a statement Thursday from HBO. “No other staff or crew members have tested positive at this time,” the channel said.

The taping of Friday's episode of “Real Time with Bill Maher” will be rescheduled, HBO said. Guests were to include astrophysicist Neil deGrasse Tyson and podcast host Dan Carlin.

Maher was tested as part of the Los Angeles production's weekly protocol for staff, the channel said, adding that “every precaution” is taken in accordance with the Centers for Disease Control and Prevention guidelines regarding the coronavirus.

The comedian and political gadfly moved back to in-studio shows with a limited audience late last summer, after taping episodes at his home in the early months of the pandemic.

TV and filmmaking gradually resumed after last year's pandemic-forced shutdown, but despite strict safety rules there have been other production holds caused by a cast or crew member's positive virus test.

Zach Binney is a sports epidemiologist and assistant professor of quantitative theory and methods at Oxford College of Emory University. Thursday on Twitter, he tried to explain what’s going on with the Yankees and emphasized that things aren’t as bad as they seem.

A lot of people may be wondering, with 8 vaccinated breakthrough cases on the Yankees - is this evidence the vaccines aren’t as effective as we thought? The short answer is no. A brief thread:

First and most importantly, the Yankees are data from about 50 people. We have data from tens of thousands in trials and millions in the real world that the vaccines work to prevent severe disease, infection, and transmission. Don’t lose sight of that!

Second, we know there’s a lot of variability in how much different people spread the virus, and that the vaccines aren’t 100% effective. The Yankees had an unlucky high-load index case, creating a perfect storm. Because a baseball team, like many workplaces, spends a lot of time indoors together, including in cramped and poorly ventilated spaces. If transmission is going to happen, there’s a lot of chances for it to here. It may be nothing short of a vaccine miracle there were *only* 8 cases!

Which brings me to my last point: How many Yankees *would* have gotten infected *without* the vaccine? Difficult to estimate without a thorough epidemiologic investigation. But say it’s 24 (a bit over half the travel party, plausible based on other sports outbreaks). That would translate to 8 cases instead of 24, or a vaccine that reduces infections/transmission by 67%. That’s within the realm of prior estimates - in other words, what we expected.

 

 

Statistics Show Only 6000 COVID Cases Among Vaccinated People With Seven Percent Hospitalized and One Death

COVID-19 vaccines have provided an opportunity to slow the spread of the virus and end the pandemic. Now scientists are trying to learn just how much the vaccines can prevent transmission from occurring at all. New data from the CDC shows that COVID-19 infections do occur in vaccinated people, but they appear exceptionally rare.

As of April 14, the Centers for Disease Control and Prevention had received reports that 5,814 fully vaccinated people had developed COVID-19 infections. Nearly half of these infections (45 percent) were in people at least 60 years old. Seven percent of people with breakthrough infections—infections that occur after complete vaccination—were hospitalized and one percent died.

With more than 85 million people in the United States fully vaccinated against COVID-19, the CDC has been cautiously expanding guidelines about what those fully vaccinated people can safely do. The expansion has been gradual as experts awaited data on not just how well the COVID-19 vaccines prevent disease, but also whether a fully vaccinated individual could develop an infection—without symptoms—and unknowingly pass the virus along to someone else.

The distinction is important because many people do not realize that vaccines primarily prevent the disease but not necessarily infection. That means not all vaccines block fully vaccinated people from transmitting the pathogen to others.

“The holy grail of vaccine development always is to stop people from ever getting infected, but it is monumentally difficult to get that,” says Jason Kindrachuk, an assistant professor of virology at the University of Manitoba in Winnipeg, Canada. That holy grail is called sterilizing immunity, completely protecting a person from disease as well as stopping the microbe from getting into cells in the first place, he says.

Four months after the Food and Drug Administration authorized the first vaccines against COVID-19, the CDC has enough data to suggest the vaccines substantially reduce infections—and therefore reduce the possibility of a vaccinated person infecting others.

Vaccines work by mimicking an infection in the body to trick the immune system into mounting a defense against it—and then remembering what to do if they see the same pathogen again, explains Juliet Morrison, an assistant professor of microbiology at the University of California, Riverside.

After any infection, “you have white blood cells, specifically T and B cells, that hang around and remember that initial infection so that if you do become infected again, these memory cells respond by immediately multiplying their numbers,” she says. The B cells produce antibodies that bind to circulating viruses and infected cells while T cells “basically punch holes in the infected cell and pump them full of these toxins that tell the infected cell to commit suicide.”

A vaccine induces the same immune memory as an infection so if the real virus comes along, the immune system switches on immediately and produces T cells, B cells, and antibodies.

“That will allow you to clear the infection without you even recognizing that you’ve gotten sick,” Morrison says.

What’s key, however, is that you did actually have an infection. That is, the virus entered cells and began replicating. The immune system simply shut it all down before the virus or the immune system itself began damaging tissue—the disease process, explains Kindrachuk.

If the virus enters cells and begins replicating but never causes disease, that’s an asymptomatic infection. With presymptomatic infections, on the other hand, a person goes on to develop symptoms and is especially contagious in the days before symptoms appear, says Natalie Dean, an assistant professor of biostatistics at the University of Florida in Gainesville.

“We know from contact tracing data unrelated to vaccines that people Morrison adds that asymptomatic people probably have an excellent initial immune response to slow down how quickly the virus can copy itself, “but not enough that viral replication is completely shut off,” she says. “That’s why they could still shed virus but we’re not seeing any disease symptoms.”

Supporting that idea is the fact that the severity of COVID-19 disease tends to correlate with the total number of viruses in the body, called viral load, Kindrachuk says. Early research showed that people with lower viral loads transmit less virus, further suggesting that asymptomatic infections are less contagious than symptomatic ones. But less is not zero: People with asymptomatic infections still have replicating viruses in their system that they can transmit to others.

When the vaccines were authorized, experts did not yet know whether the shots could prevent infections entirely or whether vaccinated people could develop an asymptomatic—but still contagious—infection.

Steris has a Range of Pharmaceutical Facemasks Using Meltblowns

Sterile cleanroom face masks are available in a variety of styles to meet the preferences of each manufacturing area. The most popular styles include a unique set of side extensions, which expand the coverage of the face mask. These face masks are made from an inner and outer facing of spunbonded polypropylene and a 100% meltblown polypropylene media layer. Styles are available with either tie or top and bottom elastic loops to secure the face mask in place. Features of these face masks include 99%+ bacterial filtration efficiency (@ 3 microns), high breathability, a large, pleated facial pocket and an aluminum nosepiece for superior fit.

Sterile cleanroom face masks are sterilized in lots using ethylene oxide gas. Each face mask is packaged in a clean-peel pouch and can be double or triple packaged. Each pouch includes a lot number for traceability.

• Side extensions provide wider coverage and improved fit eliminating exposed skin
• Ties or top/bottom elastic for secure fit and to prevent mask slippage
• Adhesive nose strip to eliminate fogging goggles
• Design prevents mask slippage to reduce regowning
• Addresses regulatory issues cause by skin exposure
• Double or triple packaged to meet your gowning protocols

UK Cases of the Variant First Identified in India More Than Double in a Week

UK cases of the Covid-19 variant first detected in India have risen from 520 to 1,313 cases this week, according to Public Health England (PHE).  

Health authorities say they plan to implement “additional control measures,” including rapid testing and tracing, in areas where there is increased spread.

The Indian variant was named a "variant of concern" by the UK last week after a rise in cases. The variant has spread most across the North West and in London, where measures such as mobile testing, door-to-door testing and vaccine buses, PHE said in a statement on Thursday. 

“We need to act collectively and responsibly to ensure that variants do not impact on the progress we have all made to drive down levels of Covid-19 and the increased freedom that brings,” said Dr. Susan Hopkins, Covid-19 strategic response director at PHE.

England enters phase two of its plan to lift restrictions on Monday, under which indoor dining will reopen.

 

Fully Vaccinated People Do Not Need Masks In Many Situations

People fully vaccinated against Covid-19 do not need to wear masks or practice social distancing indoors or outdoors, except under certain circumstances, the director of the US Centers for Disease Control and Prevention announced Thursday.

"If you are fully vaccinated, you can start doing the things that you had stopped doing because of the pandemic," Dr. Rochelle Walensky said during a White House Covid-19 briefing. "We have all longed for this moment when we can get back to some sense of normalcy.

CDC says masks not necessary for fully vaccinated people under most conditions.

People fully vaccinated against Covid-19 do not need to wear masks or practice social distancing indoors or outdoors, except under certain circumstances, the director of the US Centers for Disease Control and Prevention announced Thursday.

"If you are fully vaccinated, you can start doing the things that you had stopped doing because of the pandemic," Dr. Rochelle Walensky said during a White House Covid-19 briefing. "We have all longed for this moment when we can get back to some sense of normalcy.

Calling it an "exciting and powerful moment," Walensky said the science supports the updated CDC guidance that "anyone who is fully vaccinated can participate in indoor and outdoor activities -- large or small -- without wearing a mask or physical distancing."

She cited three studies -- one from Israel and two from the United States -- that show vaccines work.

The Israeli study, which was published in the Journal of the American Medical Association, showed the vaccine was 97% effective against symptomatic Covid-19 and 86% effective against asymptomatic infection in over 5,000 health care workers.

There have been reports of "breakthrough" infections among vaccinated people in the United States -- a small number among more than 117 million people in the United States who are now fully vaccinated. Walensky noted that "the resulting infection is more likely to have a lower viral load, may be shorter in duration, and likely less risk of transmission to others."

Walensky's announcement has a few caveats. She warned that people who are immune compromised should speak with their doctors before giving up their masks.

The requirement to wear masks during travel -- on buses, trains, planes and public transportation -- still stands, Walensky said. Guidance for travel will be updated as science emerges.

People who develop Covid-19 symptoms, even those who are vaccinated, should put their mask back on and get tested, Walensky said.

The science is clear, too, for unvaccinated people, Walensky said: "You remain at risk of mild or severe illness, of death, or spreading the disease to others. You should still mask and you should get vaccinated right away."

But once someone is fully vaccinated -- two weeks after the final dose -- "you can shed your mask," she said.

Some people may choose to continue wearing masks even if they are fully vaccinated, and that's OK, federal Covid-19 response leaders said Thursday.

"People have to make their own personal choice," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said during the White House Covid-19 briefing.

"There's absolutely nothing wrong with an individual who has a certain level of risk aversion, as we know the risk is extremely low of getting infected whether you're indoors or outdoors. But there are those people who don't want to take that bit of a risk and there's nothing wrong with that and they shouldn't be criticized."

 

CDC Guidance On Masks "Went From One Extreme To Another,"

CNN medical analyst Dr. Leana Wen said she was surprised to hear the updated recommendation from the US Centers for Disease Control and Prevention that vaccinated Americans can largely end mask use.

“Frankly, I was shocked by this announcement. I think they went from one extreme to another,” said Wen, former Baltimore City health commissioner. “And the major step that’s missing here is how do we know that people are telling the truth?”

While Wen said she was pleased to hear a strong message on the effectiveness of vaccines, she said the guidance may be more confusing than clear-cut.  

“If you’re go to the grocery store, maybe you’re fully vaccinated … but who is going to be checking to see if others are also vaccinated? So what does that mean if I’m bringing my son — my 4-year-old, who is not fully vaccinated — now he’s going to be in a grocery store potentially exposed to people who are not vaccinated, who could be of danger to him. And so I guess I am kind of befuddled as to where this guidance came from. I think there are a lot of steps that are missing,” Wen said. 

She said that she thinks the "right incentive" needs to be in place.

"If now we're saying you can do whatever you want, we're not going to check whether you're vaccinated, then what's in it for people to get vaccinated?" she asked.

 

Asian Countries in Danger of Suffering the Fate of India

Most of Nepal is under lockdown, its hospitals overwhelmed. Bangladesh suspended vaccination sign-ups after promised supplies were cut off. Sri Lanka’s hopes of a tourism-led economic revival have collapsed.

As India battles a horrific surge of the coronavirus, the effects have spilled over to its neighbors. Most nearby countries have sealed their borders. Several that had been counting on Indian-made vaccines are pleading with China and Russia instead.

The question is whether that will be enough, in a region that shares many of the risk factors that made India so vulnerable: densely populated cities, heavy air pollution, fragile health care systems and large populations of poor workers who must weigh the threat of the virus against the possibility of starvation.

Though the countries’ outbreaks can’t all be linked to India, officials across the region have expressed growing dread over how easily their fates could follow that of their neighbor.

I feel like it’s a world war situation,” said Dr. Rajan Pandey, a physician in Banke, a Nepali district along the India border, who said he was turning away 30 patients asking for hospital beds every day.

If lockdown was enforced two weeks ago, borders were closed and migrant workers returning from India were quarantined better, this situation could have been avoided,” he said.

As is, he added, “we are still waiting for the worst.”

Nepal shows most clearly how the crisis has rippled. After an initial wave last year, cases in the Himalayan nation of 30 million had plunged by January. Residents gathered for Nepali New Year celebrations last month, and hundreds of thousands of migrant workers returned to India, where they go each year in search of jobs.

But as the new surge began raging across India, many of those workers returned across the porous, 1,100-mile border. With them came the virus.

Now, Nepal is recording as many as 9,000 infections per day, with more than 40 percent of tests coming back positive. More than 4,200 people had died by Wednesday evening. Experts say the cases are likely being undercounted.

Still, imported cases are not the only reason for the crisis engulfing Nepal.

As in India, the government did not expand health facilities when coronavirus cases appeared to be under control last year, and it was slow to enforce social distancing restrictions when it became clear that they were not.

Critics have pointed to huge, mask less rallies in India hosted by Prime Minister Narendra Modi even as infections rose. Likewise, both the ruling and opposition parties in Nepal held large political gatherings after the prime minister dissolved Parliament in December.

Because of this, the virus reached every corner of the country,” said Dr. Krishna Prasad Paudel, the director of the epidemiology and disease control division at Nepal’s health ministry.

 

160 Million Cases of COVID in the World and 3.3 Million Deaths

The global tally for the coronavirus-borne illness climbed above 160.4 million on Thursday, according to data aggregated by Johns Hopkins University, while the death toll rose above 3.3 million. The U.S. continues to lead the world in cases and deaths by wide margins, with 32.8 million cases and 583,685 deaths, or about a fifth of the worldwide tallies.

More than 60 million people in the U.S. have been immunized with the two-dose, mRNA vaccine developed by the two companies. India is second to the U.S. by cases at 23.7 million and third by fatalities at 258,317, although those numbers are held to be widely undercounted as the Indian crisis has overwhelmed its healthcare system. Brazil is third with 15.3 million cases and second by fatalities at 428,034.

Mexico has the fourth-highest death toll at 219,590 and 2.4 million cases, or 15th highest tally. The U.K. has 4.5 million cases and 127,901 deaths, the fifth-highest in the world and highest in Europe.

 

Mexican COVID Death Toll Over 600,000

The coronavirus has killed over 600,000 people in Mexico, according to health researchers who found that the Latin American nation's Covid-19 death toll is almost three times higher than the official total.

The Institute for Health Metrics and Evaluation at the University of Washington School of Medicine published an analysis Thursday estimating that 617,127 people have died from Covid-19 in Mexico based on adjusted excess death rates.

The number is 183 percent higher than Mexico’s official death toll, which rose to 218,007 on Wednesday.

“As terrible as the Covid-19 pandemic appears, this analysis shows that the actual toll is significantly worse,” Dr. Chris Murray, director of the Institute for Health Metrics and Evaluation, said in a statement.

In Mexico, large numbers of people have died at home without being tested for Covid-19. Additionally, Mexico’s testing rate remains low, at about 51,000 tests per million people, according to German statistics portal Statista.

But the challenge to accurately account for all Covid-19 deaths echoes around the world, Murray said, adding that many Covid-19 deaths go unreported because most countries only report deaths that occur in hospitals or among patients with a confirmed infection.

The Institute for Health Metrics and Evaluation estimates the coronavirus has killed approximately 6.9 million people globally, more than double what official numbers show, meaning "Covid-19 deaths are significantly underreported in almost every country."

Based on the estimates, Mexico has recorded the third highest number of Covid-19 deaths, after the United States and India.

Researchers estimate that Covid-19 has claimed the lives of 905,289 people in the United States, which is about 56 percent higher than its official death toll of about 575,000.

In India, researchers estimate more than 654,000 people have died of Covid-19, which is also about three times higher than its official death toll of 221,181.

According to data compiled by Johns Hopkins University, the global Covid-19 death toll is about 3.25 million and Mexico ranks fourth for fatalities, behind the United States, Brazil and India.

Mexican officials admitted in March that the country's true Covid-19 death toll is significantly higher than originally reported, estimating deaths were only 60 percent higher than official data. Their estimate of about 320,000 fatalities is dwarfed by that of the Institute for Health Metrics and Evaluation.

“Many countries have devoted exceptional effort to measuring the pandemic’s toll, but our analysis shows how difficult it is to accurately track a new and rapidly spreading infectious disease," Murray said in the statement. “Understanding the true number of Covid-19 deaths not only helps us appreciate the magnitude of this global crisis, but also provides valuable information to policymakers developing response and recovery plans.”

 

Growing Support to Provide Vaccines and Support for Latin American Countries

Rising rates of COVID-19 infections in Brazil and other countries in Latin America are posing a risk to the U.S. in its own battle to overcome the pandemic.

Advocates are pushing for increased efforts to support global vaccinations, especially in poorer countries, while Latin Americans of means travel to the United States to take advantage of a surplus of shots.

The Biden administration has provided an initial down payment of $2 billion to the global COVID-19 vaccine alliance (COVAX); shipped emergency materials to India to help stock up its vaccine development; and “loaned” millions of vaccines to Mexico and Canada.

Democratic lawmakers have called on the administration to prioritize Latin America in receiving any surplus of vaccines, but officials are tight-lipped over making any immediate and pronounced commitments. 

In Latin America, attitudes toward vaccination have more or less mirrored those in the United States, with some people eager to receive inoculation and others either distrustful or politically disinclined from taking the vaccines.

But the lack of available vaccinations has added complexity to the process in a continent that hosts some of the world's most dense population centers, as well as some of the most difficult-to-access remote areas.

Inequality has been exacerbated throughout the region by the pandemic, as most people can't afford many basic preventive measures, while elites more comfortably access protective equipment, exercise social distancing and seek out vaccines.

This has also contributed to a rise in vaccine tourism to the United States, including by middle-class Mexicans within driving distance of the U.S.-Mexico border.

“Because the border region is so integrated, it's very easy to cross the border to get vaccinated and then return to your place of origin,” said Dolia Estévez, a senior Mexican correspondent in Washington who has covered Mexican vaccine tourism.

By some estimates, more than a million Mexicans have crossed the border by foot, car or plane to get vaccinated.

That includes at least two members of Mexico's Supreme Court, one of whom had to cancel her vaccination trip to Texas after a report by Estévez made her plans public.

The Texas Department of Health says that 99.06 percent of vaccine recipients are residents, with only 0.04 of those who received vaccines hailing from another country. 

 

Herd Immunity is Not Likely

Early in the pandemic, there was hope that the world would one day achieve herd immunity, the point when the coronavirus lacks enough hosts to spread easily. But over a year later, the virus is crushing India with a fearsome second wave and surging in countries from Asia to Latin America.

Experts now say it is changing too quickly, new more contagious variants are spreading too easily and vaccinations are happening too slowly for herd immunity to be within reach anytime soon.

That means if the virus continues to run rampant through much of the world, it is well on its way to becoming endemic, an ever-present threat.

Virus variants are tearing through places where people gather in large numbers with few or no pandemic protocols, like wearing masks and distancing, according to Dr. David Heymann, a professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine.

While the outbreak in India is capturing the most attention, Dr. Heymann said the pervasive reach of the virus means that the likelihood is growing that it will persist in most parts of the world.

As more people contract the virus, developing some level of immunity, and the pace of vaccinations accelerates, future outbreaks won’t be on the scale of those devastating India and Brazil, Dr. Heymann said. Smaller outbreaks that are less deadly but a constant threat should be expected, Dr. Heymann said.

“This is the natural progression of many infections we have in humans, whether it is tuberculosis or H.I.V.,” said Dr. Heymann, a former member of the Epidemiology Intelligence Service at the Centers for Disease Control and Prevention and a former senior official at the World Health Organization. “They have become endemic and we have learned to live with them and we learn how to do risk assessments and how to protect those we want to protect.”

 

Vaccines that are highly effective against Covid were developed rapidly, but global distribution has been plodding and unequal. As rich countries hoard vaccine doses, poorer countries face big logistical challenges to distributing the doses they manage to get and vaccine hesitancy is an issue everywhere. And experts warn the world is getting vaccinated too slowly for there to be much hope of ever eliminating the virus.

Only two countries have fully vaccinated more than half of their populations, according to the Our World in Data project at the University of Oxford. They are Israel and the East African nation of the Seychelles, an archipelago with a population of fewer than 100,000. And just a handful of other countries have at least partially vaccinated nearly 50 percent or more, including Britain, tiny Bhutan, and the United States.

Less than 10 percent of India’s vast population is at least partly vaccinated, offering little check to its onslaught of infections.

In Africa, the figure is slightly more than 1 percent.

Still, public health experts say a relatively small number of countries, mostly island nations, have largely kept the virus under control and could continue keeping it at bay after vaccinating enough people.

New Zealand, through stringent lockdowns and border closures, has all but eliminated the virus. Dr. Michael Baker, an epidemiologist at the University of Otago who helped devise the country’s coronavirus response, said New Zealand would likely achieve herd immunity by immunizing its population, but it has a long way to go with only about 4.4 percent of New Zealanders at least partially vaccinated.

“All of the surveys show there is a degree of vaccine hesitancy in New Zealand, but also a lot of people are very enthusiastic,” Dr. Baker said. “So I think we will probably get there in the end.”

While new daily cases have remained at near-world record levels, the number of deaths has dropped from a peak in February, going against the normal pattern of high cases followed eventually by high deaths. If that trendline continues, it could offer a glimmer of hope for a future scenario that scientists are rooting for: Even as the virus spreads and seems to be hurtling toward becoming endemic, it could become a less lethal threat that can be managed with vaccines that are updated periodically to protect against variants.

“It may be endemic, but not in a life-threatening way,” Dr. Michael Merson, a professor of global health at Duke University and New York University, and a former director of the World Health Organization’s Global Program on AIDS, said. “It may be more like what we see with young kids, a common cold like disease.”