“Shared expectations lead to predictability.”
281. Update on achieving the risk thresholds on the 4 “Mandatory Metrics”
Q: How close are we to reaching the 4 mandatory metrics allowing a decision to be made to reopen?
A: We are monitoring the pandemic to identify when it will be safe to reopen. Some modifications to the building and program may also be required, but we are continually viewing the five data metrics from the website Covid Act Now to identify when there is an acceptable risk for meeting inside. www.covidactnow.org is the website to find this data. Click on the Connecticut map on opening, and scroll down to view the 5 graphs.
The Policy Board has approved four mandatory metrics that must be reached for 21 consecutive days before the Policy Board will decide to reopen. These mandates are:
X Daily new cases per 100,000 population: Threshold = at or below 5 / 100,000.
Status on May 21 = 5.4 /100,000. This is only 0.4 / 100,000 over the threshold
- Infection Rate: Threshold = .at or below 0,9%
Status on May 21 = 0.67%. This remains under the threshold, and qualifies.
- Positive Test Rate: Threshold = at or below 3%
Status on May 19 = 1.4%. This remains under the threshold and qualifies.
- ICU Capacity Used: Threshold = at or below 70%
Status on May 22 = 54%. This remains under the threshold and qualifies
Once the daily new cases per 100,000 population reach the threshold of 5 or fewer per 100,000 population, all 4 metrics must remain below their thresholds for 3 weeks to allow a recommendation to be made to the board for reopening. Unless there is a surge, this 21-day countdown should start sometime this week!
282. A Covid Act Now metric could be adversely affected by CDC changes.
Q: The new CDC guidance for fully vaccinated people no longer requires testing. Will this affect the mandatory metric we are using, the “Positive Test Rate?”
A: The traditional epidemiologic data used to evaluate infectious diseases is the “Positive Test Rate.” This is based on a sample of the entire population, randomly selected, being tested with a resulting percentage being found positive. This tool helps to find those infected with COVID-19 who are asymptomatic who are spreading the disease unaware they have the disease. It also identifies those who are infected before their symptoms emerge allowing early isolation to reduce infection of others.
Recent changes to their May 13th CDC guidelines now state that for fully vaccinated people who have no COVID-19-like symptoms, there is no need to be tested even if they come in contact with someone who is known to be infected. Nationally, this, in effect, reduces the population to be tested to just unvaccinated people. No consideration is given to the possible bias people may have who are avoiding vaccinations might also avoid testing. Data collected after this change needs to include only tests given to the unvaccinated group. If others are included, the data may not accurately measure if the number of tests being given is sufficiently large enough for the State of Connecticut. The Emergency Preparedness Task Force will review this at its next meeting to evaluate if any future Positive Test Rate data should remain a “mandatory metric.”
283. “Fully vaccinated people have greater and longer immunity than those who get only one Pfizer or Moderna shot – but even those people have some benefit
Q: Do people who don’t get their second Pfizer or Moderna shots have any immunity?
A: UUS:E has chosen “fully vaccinated” people as the metric to follow because these people have greater immunity than those who take only one of the Pfizer or Moderna shots. They also have immunity that early evaluation showed lasts longer than those who took only one of the two required shots. But that doesn’t mean they have no immunity.
The CDC reports that 8% of those who got the first jab did not return for their second. This was not surprising, however. An example of this phenomenon was the history of people getting the two-dose shingles vaccine between 2017 and 2019. Only 70% to 80% of the people getting those shots finished the two-dose vaccine. The precise reason why second doses are missed remains uncertain, and studies are continuing. But studies of the protection provided by a single dose of Pfizer or Moderna COVID-19 vaccine is encouraging.
A study of 3,950 healthcare personnel found that one dose of either of the mRNA vaccine provided roughly 80% protection at least 14 days after the injection. Another study in the United Kingdom, yet to be published, showed an effectiveness of 72% 21 days after injection. Chise Broussard, a molecular scientist at Moderna answers the question: why bother to go back for a second shot if the first is that effective? He stated, “Because each shot awakens different players in the immune system.” The first dose activates what are known as helper T cells. The second dose is a booster supercharging the defenses the first dose activated. This boosts the effectiveness to more than 90%. And this second shot makes that immunity last longer. This recent research validates the UUS:E decision to focus on the metric of “full vaccinations.”
284. Pfizer vaccines can now be stored longer and at warmer temperatures.
Q: How come Pfizer vaccines are now used in more remote areas with delayed delivery?
A: The initial FDA approval for Pfizer’s vaccine was based on early research that indicated once multi-dose vials were opened and thawed, they had to be used within 5 days or be destroyed. Pfizer has continued its testing, and now finds it can remain viable after it is thawed for a period up to one month if stored in a refrigerator between 35°F and 46°F. The FDA has issued a revised authority to permit this longer storage time using more readily available equipment. “Making COVID-19 vaccines widely available is key to getting people vaccinated and bringing the pandemic to an end,” says Dr. Peter Marks, director of the FDA’s Center for Biologics and Research.
285. “Covax” is off to a very slow start to help poorer nations become protected.
Q: What can we do to help other countries control COVID so it won’t spread to the U.S.?
A: “Covax” is a joint venture between the World Health Organization (WHO), the Center for Epidemic Preparedness and Innovation (CEPI), Gavi – the Vaccine Alliance (founded by Bill and Melinda Gates), and UNICEF. It was set up in August 2020, designed to channel COVID-19 vaccination doses, pre-purchased in very large quantities from major manufacturers, and to portion these out globally to ensure worldwide equity in protection against this disease.
Covax is funded from several sources, The Bill and Melinda Gates Foundation, the World Bank, and UNICEF among them. The bulk purchasing program would allow the smaller nations to get the vaccines at the same price as larger nations, and nearly 100 of the world’s poorest nations would get theirs free. Almost every country in the world has signed up. After all, this is a global pandemic. If any nation has controlled the disease within their borders, a surge from other countries could set off a resurgence.
The main premise and goal of the project are to ensure by the end of 2021 at least 20% of everyone in the world would be vaccinated. But that target will probably not be met. Peter Singer, the assistant director-general of the WHO stated recently, “Covax works. It’s an effective mechanism for distributing vaccines. It has already distributed 65 million vaccines to more than 100 countries – and about a quarter of them wouldn’t have had any vaccines at all right now without Covax.”
The problem is a lack of supply. Wealthy nations have bought up huge portions of the available supplies for the foreseeable future for their own use. The Serum Institute of India, one of the largest producers of vaccines in the world, has not delivered any doses since March, diverting all their products to help curb the dramatic surge in cases within India. “We’ve had a gap of over 150 million doses already up to May,” says Bruce Aylward, a senior advisor to the director-general of the WHO. “And that could get greater still going into June.”
President Biden last week announced the U.S. will be releasing 1.5 million doses of vaccine to Covax. That is a very important symbolic donation, but will require many other nations to respond in kind to have any effect in curtailing the pandemic for all the world’s citizens.
