Twenty-three new cases detected in MC over the last week
(Editor’s note: As of Monday, the Virginia Department of Public Health reported 1,023 confirmed COVID-19 cases in Middlesex County — up 23 cases over the previous week. There were 35 Middlesex patient COVID-19-related hospitalizations and 33 deaths involving Middlesex residents. The Virginia Department of Public Health cautions that because of limited testing, the actual number of cases in Middlesex County is likely much higher than reported.)
The omicron variant is continuing to spread worldwide and in the commonwealth. The first case of omicron was reported in Virginia last week in a person who had not traveled.
The omicron variant is dominant in South Africa, and is quickly rising in the U.K. Authorities in the U.K. are concerned that omicron may become the dominant variant this month.
The omicron variant mutation pattern is of concern to evolutionary biologists, and it is proving to be more highly contagious than the Delta variant. Preliminary evidence suggests there may be an increased risk of reinfection with omicron (i.e., people who have previously had COVID-19 could become reinfected more easily with omicron), as compared to other variants of concern, but information is limited.
It is still not known whether the omicron variant causes more serious COVID-19 disease; health authorities are carefully watching hospitalization rates and disease severity.
We do not yet know the potential impact of this variant on vaccines, current tests, and current treatments. Most public health authorities remain optimistic that our current vaccines with booster shots will provide a degree of protection.
COVID-19 vaccination remains the most important tool to protect people from SARS-CoV-2 and its variants. In addition to vaccination, the layering of other public health recommendations for stopping the spread of COVID-19 (e.g., masking, distancing, hand washing, avoiding crowds and poorly ventilated spaces, getting testing and isolating at home as appropriate) remain important. Everyone should continue to keep up good prevention practices to protect themselves and others.
We will watch the evolution of the omicron variant carefully. We will know much more in the coming weeks.
Although the omicron variant is spreading rapidly across the globe, the Delta variant remains responsible for the vast majority of COVID-19 disease in Virginia.
The VDH has established a COVID-19 variants of concern dashboard. The dashboard can be accessed at https://www.vdh.virginia.gov/coronavirus/covid-19-data-insights/variants-of-concern/.
Evidence has emerged indicating immunity wanes at about the six-month mark from vaccine-induced immunity and probably from natural immunity as well. Studies agree that vaccination following natural infection provides enhanced protection. This is the evidence underlying the current public health recommendation that everyone, including those who have been naturally infected, receive COVID-19 vaccination. For information, a CDC document entitled Science Brief: SARS-CoV-2 Infection-induced and Vaccine-induced Immunity, can be found at https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/vaccine-induced-immunity.html#anchor_1635539757101.
Cases up across Virginia
Virginia COVID-19 cases have increased; currently we have about 2,520/day, seven-day average, new cases.
Cases in Three Rivers Health District, which includes Middlesex County, have increased as well; we had 280 cases across all jurisdictions last week.
The current seven-day average number of people hospitalized in Virginia with COVID-19 has increased; it is currently 1,278.
Levels of community transmission remain high or substantial across the Three Rivers Health District. A VDH map showing indicators of community transmission can be found at https://www.vdh.virginia.gov/coronavirus/covid-19-in-virginia/community-transmission/.
Everyone age 5 and older is now eligible for vaccination in Virginia. Please visit vaccinate.virginia.gov or call 1-877-VAX-IN-VA to find vaccination opportunities near you. Appointment opportunities in Three Rivers Health District vaccination clinics are available at the Three Rivers Health District Website: https://www.vdh.virginia.gov/three-rivers/.
On Dec. 9, the FDA amended the EUA for the Pfizer-BioNTech COVID-19 vaccine, authorizing the use of a single booster dose for administration to individuals 16 and 17 years of age at least six months after completion of primary vaccination with the Pfizer-BioNTech COVID-19 Vaccine. Booster doses of the Pfizer vaccine are now available for 16 and 17 year olds. More details on the recommended COVID-19 vaccination and booster schedules for all ages may be found at http://vaccinate.virginia.gov/.
Flu vaccine is now widely available. This flu season is likely to be far more severe than we saw last year. Please get your flu shot this fall. There is no problem getting the flu vaccine and the COVID-19 vaccine at or near the same time.
Vaccination rates increasing
Vaccination rates continue to slowly climb. About 66.3% of the total population in Virginia is fully vaccinated.
With all three vaccines authorized for booster administration, everyone older than 16 recommended for boosters, and vaccination authorized for 5-17 year olds, vaccine doses administered in the commonwealth have increased. Current VDH data show about 47,600 average daily vaccine doses administered across Virginia.
The FDA has authorized all persons 18 and older who have completed a primary series of mRNA vaccination (Pfizer-BioNTech/Moderna) to receive a booster vaccine, and the CDC updated its recommendations to match. Adults 18 years of age and up who received a J&J vaccine are already recommended for a booster vaccine. The ability to “mix and match” a booster vaccine after the primary series of vaccine remains.
The 5-11 year old vaccination program continues. More than 1,100 children ages 5-11 have been vaccinated with at least one dose in Three Rivers thus far. Our Public Health Nurse teams are offering vaccines in schools and our partners are continuing their vaccination efforts for this age group. In the clinical trials study, the vaccine was 90.7% effective in preventing COVID-19 in children 5 through 11. The vaccine is also safe; the vaccine was studied in approximately 3,100 children age 5 through 11 who received it and no serious side effects have been detected in the ongoing study.
The COVID-19 vaccines are among the best and safest vaccines ever developed. As with all vaccines and medications, there are potential adverse effects. All the adverse events following vaccination are extremely rare, and the risk of COVID-19 disease far exceeds the risk of any of the adverse events that have been reported.
COVID-19 vaccines have been highly effective in preventing infection, serious disease, hospitalization, and death from COVID-19 infection. VDH data show that unvaccinated people get infected with COVID-19 at many times the rate of fully vaccinated people. The VDH COVID-19 Cases by Vaccination Status dashboard can be found at https://www.vdh.virginia.gov/coronavirus/covid-19-data-insights/covid-19-cases-by-vaccination-status/.
Vaccines will remain readily available to all unvaccinated individuals as our highest priority. We recommend COVID-19 vaccination for everyone eligible in the strongest possible terms.
Monoclonal antibody (MAB) therapy is readily available in Virginia. Monoclonal antibody therapy is administered in the outpatient setting to COVID-19 positive individuals who are at increased risk for developing serious disease requiring hospitalization.
Merck and Ridgeback announced their oral antiviral drug Molnupiravir reduced the risk of hospitalization or death by approximately 50 percent for patients with mild or moderate COVID-19 disease. Molnupiravir has been authorized in the U.K. An FDA panel recommended authorizing Molnupiravir in the US as well, but the vote was close at 13-10. The FDA is considering further action at this time.
Pfizer data indicates their new antiviral drug (Paxlovid) prevents severe COVID-19 disease at the 89% effectiveness level. The FDA will consider authorization of Paxlovid this month. These are the first examples of a new series of medications to further reduce the risk of COVID-19 illness.
The CDC released current guidance for COVID-19 safety during the holidays. Vaccination and exposure prevention are critically important to protect ourselves against infection. The CDC holiday guidance can be found at https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays/celebrations.html.
Health depts. give tests
We are conducting COVID-19 testing in our local health departments in conjunction with our continued vaccination outreach. COVID-19 Rapid Testing and PCR Testing are available through the Three Rivers Health District COVID-19 Testing Team by appointment. Please call your local health department or call 804-815-4191 to schedule an appointment for testing.
Our containment team is conducting full case investigation and contact tracing in accordance with established VDH recommendations.
Delta hits school sports teams
We have seen COVID-19 transmission in-school and in athletic teams at higher rates with the Delta variant, but outbreaks are usually limited to several students. Exposure prevention and containment measures in the schools are limiting the extent of outbreaks and schools are able to remain open for in-person learning.
We will follow each school system closely and be ready to support them in any way we can as we progress into the season of highest respiratory disease transmission risk.
Useful links
Additional useful links include:
• The FDA fact sheets for recipients and caregivers for the Pfizer vaccine can be found at https://www.fda.gov/media/144414/download.
• The FDA fact sheet for recipients and caregivers for the Moderna vaccine can be found at https://www.fda.gov/media/144638/download.
• The FDA fact sheet for recipients and caregivers for the Johnson and Johnson vaccine can be found at https://www.fda.gov/media/146305/download.
• The Virginia Department of Health is maintaining COVID-19 Vaccination Dashboards, which are available at https://www.vdh.virginia.gov/coronavirus/covid-19-vaccines-received/ and at https://www.vdh.virginia.gov/coronavirus/covid-19-vaccine-summary/.
• The VDH COVID-19 outbreak dashboard can be found at https://www.vdh.virginia.gov/coronavirus/covid-19-data-insights/.
Links to useful information about COVID-19 myths and facts:
• American Academy of Family Physicians: https://www.aafp.org/dam/AAFP/documents/patient_care/public_health/COVID19-Vaccine-Myths.pdf.
• CDC: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html.
• American Association of Medical Colleges: https://www.aamc.org/news-insights/transcript-vaccinevoices-covid-19-vaccine-myths-debunked.
(Richard Williams is the director of Three Rivers Health District of the Virginia Department of Health. The district includes Middlesex County. Williams’ email address is richard.williams@vdh.virginia.gov.)
