13,000 NY Nursing Home Residents, Nearly Half Of Staff Decline COVID-19 Vax

 New York will be reallocating unused COVID-19 vaccines after more than ten thousand nursing home residents and nearly half of staffers declined the jab, according to Gareth Rhodes, a member of Governor Andrew Cuomo's COVID-19 Response Task Force.

Rhodes said that out of 70,000 nursing home residents, 57,000 have been vaccinated, while 13,000 have declined. Meanwhile, out of 89,000 nursing home staff, 41,000 have declined.

Overall, 105,000 first-doses of the vaccine have been used so far in nursing homes, while 120,000 doses remain.

"We’re gonna reallocate those that are used in the long-term facility program to the state program, but we’ll make sure that the residents who want to take it and the staff who want to take it, we will reserve their doses," said Cuomo, who in July came under fire for ordering nursing homes to accept coronavirus patients from hospitals.

The reallocation comes more than a week after New York came under scrutiny over discarded vaccines - with officials changing regulations which required that extra doses to be tossed.

In a Monday letter to Health and Human Services Secretary Alex Azar, Cuomo called on the federal government to beef up vaccine supply, claiming that Azar falsely claimed that doses would be held in reserve, when they were in fact distributed to states.

New York has received approximately 1.2 million doses, of which around 860,000 have been administered. The figure doesn't include shots allocated to nursing homes, while the CDC claims New York has received 1.8 million doses. 

Cuomo last week extended the shots to anyone age 65 and over, but has repeatedly insisted the state has nowhere near enough doses to cover everyone who is now eligible.

The governor also sent a letter Monday to Pfizer chairman and CEO Albert Bourla asking him to let New York purchase COVID-19 vaccines directly from the company. -NY Post

"My job as governor of New York is to pursue every avenue," said Cuomo, adding "The federal government increased eligibility dramatically but never increased the supply for the dosages."

https://www.zerohedge.com/covid-19/13000-ny-nursing-home-residents-and-nearly-half-staff-decline-covid-19-vaccine

NY still not allowing immunocompromised to receive COVID-19 vaccine

 Immunocompromised New Yorkers still aren’t eligible to receive the coronavirus vaccine — a week after Gov. Andrew Cuomo announced that they would be added to the list — and say they feel forgotten amid the state’s troubled inoculation rollout.

“At this point, I am wallpaper, I am not in the conversation,” Swati Bhise, 61, told The Post Monday. 

“I just feel it’s almost like saying anyone with comorbidities, you are allowed to be dispensed, you are not important.” 

Bhise, an educator and filmmaker who lives in Midtown East, is at high-risk of getting seriously sick if she catches COVID-19.

Three years ago, she suffered from acute respiratory distress syndrome, which ravaged her lungs and left her intubated in an ICU, fighting for her life. She’s overweight, can’t walk more than a few blocks without needing supplemental oxygen because of her reduced lung capacity and requires medication to keep her type-2 diabetes at bay.

Catching COVID-19 “would be a certain death sentence for her,” Bhise’s son Aditya Bhise said.

So for nearly a year, Swati has been locked up inside, unable to rejoin society because of her condition.

“I am living in fear, I don’t go out,” Swati said by phone. 

“Don’t pretend we don’t exist. We do exist,” she implored. 

Cuomo announced last Tuesday that the immunocompromised would be made eligible for the vaccine alongside people aged 65 and older, in line with federal guidance.

But the state has been dragging its feet, with Cuomo saying he’s waiting for federal authorities to better define “immunocompromised” and which conditions should be prioritized. 

Other states like New Jersey and Florida haven’t waited for the explanation and are already permitting those with qualifying conditions to receive the booster.

The Centers for Disease Control and Prevention regularly updates a long list of medical conditions that put people at a higher-risk of a bad COVID-19 case, which include cancer, chronic kidney disease, type 2 diabetes, obesity and a host of other issues. 

New Jersey is now allowing anyone who has a condition from the CDC’s list to have equal access to the vaccine in an effort to prevent distribution from becoming “overly bureaucratic,” Gov. Phil Murphy said last week. 

Meanwhile, New York has been consistently criticized for a slow rollout and initially tight restrictions — and now says it is running low on doses.

Cuomo placed blame on the federal government Monday, saying he’s trying to avoid a major backlog of appointments after the feds increased who is eligible without increasing the supply of doses.

“Now you have 7 million New Yorkers chasing 300,000 [vaccines],” Cuomo griped.

“Why did you raise that expectation? You tell me I’m going to be eligible for a vaccine. Great, I’m all excited. By the way, it’s going to take seven months to get to you.”

Cuomo senior advisor Rich Azzopardi said the state is staring down a severe vaccine shortage and needs more doses if they’re going to meet the demand.

“We’re working on next steps,” Azzopardi said.

“But this would be easily solved if Washington kept its word and increased the number of doses to the states as promised.”

https://nypost.com/2021/01/18/ny-still-not-allowing-immunocompromised-to-receive-covid-vax/

Covid-19 immunity likely lasts for years

 Covid-19 patients who recovered from the disease still have robust immunity from the coronavirus eight months after infection, according to a new study. The result is an encouraging sign that the authors interpret to mean immunity to the virus probably lasts for many years, and it should alleviate fears that the covid-19 vaccine would require repeated booster shots to protect against the disease and finally get the pandemic under control.

“There was a lot of concern originally that this virus might not induce much memory,” says Shane Crotty, a researcher at the La Jolla Institute for Immunology in California and a coauthor of the new paper. “Instead, the immune memory looks quite good.”

The study, published January 6 in Science, contrasts with earlier findings that suggested covid-19 immunity could be short-lived, putting millions who’ve already recovered at risk of reinfection. That predicament wouldn’t have been a total surprise, since infection by other coronaviruses generates antibodies that fade fairly quickly. But the new study suggests reinfection should only be a problem for a very small percentage of people who’ve developed immunity—whether through an initial infection or by vaccination. 

In fact, the new study does show that a small number of recovered people do not have long-lasting immunity. But vaccination ought to offset that problem by ensuring herd immunity in the larger population. 

The new paper studied blood samples from 185 men and women who had recovered from covid-19—most from a mild infection, although 7% were hospitalized. Each person provided at least one blood sample between six days and eight months after their initial symptoms, and 43 of the samples were taken after six months. The team that ran the investigation measured the levels of several immunological agents that work together to prevent reinfection: antibodies (which tag a pathogen for destruction by the immune system or neutralize its activity), B cells (which make antibodies), and T cells (which kill infected cells). 

The researchers found that antibodies in the body declined moderately after eight months, although levels varied wildly between individuals. But T-cell numbers declined only modestly, and B-cell numbers held steady and sometimes inexplicably grew. That means that despite decreases in free-flowing antibodies, the components that can restart antibody production and coordinate an attack against the coronavirus stick around at pretty high levels. Crotty adds that the same mechanisms that lead to immune memory after infection also form the basis for immunity after vaccination, so the same trends ought to hold for vaccinated people as well. 

And while immunity to other coronaviruses has been less than stellar, it’s worth looking at what happens in people who recovered from SARS, a close cousin of the virus that causes covid-19. A study published in August showed that T cells specific to SARS can remain in the blood for at least 17 years, bolstering hopes that covid-19 immunity could last for decades.

The new study isn’t perfect. It would have been better to collect multiple blood samples from every participant. “Immunity varies from person to person, and uncommon individuals with weak immune memory still may be susceptible to reinfection,” Crotty cautions. And we can’t make any firm conclusions about covid-19 immunity until years have passed—it’s simply too early. Nonetheless, this latest result is a good indication that if the vaccination rollout goes well (a big if), we might soon be able to put the pandemic behind us.

https://www.technologyreview.com/2021/01/06/1015822/covid-19-immunity-likely-lasts-for-years/

Yellen says U.S. must 'act big' on next coronavirus relief package

 Janet Yellen, U.S. President-elect Joe Biden’s nominee to run the Treasury Department, will tell the Senate Finance Committee on Tuesday that the government must “act big” with its next coronavirus relief package.

Biden, who will be sworn into office on Wednesday, outlined a $1.9 trillion stimulus package proposal last week, saying bold investment was needed to jump-start the economy and accelerate the distribution of vaccines to bring the virus under control.

“Neither the president-elect, nor I, propose this relief package without an appreciation for the country’s debt burden. But right now, with interest rates at historic lows, the smartest thing we can do is act big,” Yellen, a former Federal Reserve chair, said in a prepared opening statement for her hearing before the committee.

“I believe the benefits will far outweigh the costs, especially if we care about helping people who have been struggling for a very long time,” she said in the statement, which was obtained by Reuters.

The proposed aid package includes $415 billion to bolster the U.S. response to the virus and the rollout of COVID-19 vaccines, some $1 trillion in direct relief to households, and roughly $440 billion for small businesses and communities particularly hard hit by the pandemic.

Many Americans would receive stimulus payments of $1,400, which would be on top of the $600 checks approved in a pandemic relief bill passed by Congress last month. Supplemental unemployment insurance would also increase to $400 a week from the current $300 a week, and it would be extended to September.

In her prepared testimony, Yellen also says the U.S. economy must be rebuilt “so that it creates more prosperity for more people and ensures that American workers can compete in an increasingly competitive global economy.”

Senator Ron Wyden, a Democrat who is set to take over as chairman of the committee soon after Biden and Vice President-elect Kalama Harris are sworn in on Wednesday, said in a statement that “nobody is better qualified than Secretary-Designate Yellen to lead an economic recovery.”

Wyden added that the hearing on Tuesday “will provide a great opportunity to hear about what worked and what didn’t during the Great Recession, and what we need to do to get this economy back on track.”

Yellen will replace Treasury Secretary Steven Mnuchin if confirmed by the Senate. Mnuchin will step down on Wednesday.

A Biden ally said Yellen’s confirmation is expected to be among the least controversial of Biden’s picks to fill key roles in his administration, but that she would still be likely to face questions over his tax and spending proposals.

https://www.reuters.com/article/usa-biden-treasury/yellen-says-u-s-must-act-big-on-next-coronavirus-relief-package-idUSL1N2JT1NC

COVID-19 cases fell in 36 states and territories in last week

 After several bleak weeks of sickness and death in the U.S., figures from the COVID Tracking Project indicate that there may be some light at the end of the tunnel in the current surge of COVID-19.

The COVID Tracking Project reports that in the past week, new cases of COVID-19 have been falling in 36 states and territories across the U.S. In another 12 states and territories, cases are holding level, while cases are only rising in three.

The only states and territories where new cases of COVID-19 are on the rise are Maine, Virginia and Wyoming.

According to the COVID Tracking Project, the seven-day rolling average of new COVID-19 cases has plummeted by about 30,000 in the past week. Though daily case numbers remain extremely high at 213,707, the downward trend indicates that the current surge — which health experts suspect might have been caused by holiday travel — may be coming to an end.

And while hospitals across the country remain overcrowded, hospitalizations linked to the virus have come down in the past week as well. The number of nationwide hospitalizations has decreased by nearly 8,000 since reaching its peak on Jan. 7.

But while the downward trend is encouraging moving forward, deaths may still continue to rise this week. Health experts say that deaths lag behind trends in new cases and hospitalizations by a week or two, meaning that there could still be a surge in COVID-19 deaths this week.

As of Monday, the seven-day rolling average of daily COVID-19 deaths in the U.S. was above 3,300 — a near-record level. For perspective, 2,977 people died in the terror attacks on Sept. 11, 2001.

The dip in new cases and hospitalizations is a welcome sign for the U.S., which is continuing to distribute COVID-19 vaccines to those most at risk for the disease. According to Bloomberg, the U.S. has distributed 14.3 million doses of the vaccine and distributed an average of 898,000 shots a day last week.

President-elect Joe Biden, who takes office Wednesday, has said he wants to deliver 100 million doses of vaccine within his first 100 days in office.

https://www.wcpo.com/news/national/coronavirus/covid-19-cases-have-been-on-the-decline-in-36-states-and-territories-in-last-week-group-says

Cuomo eyes buying vaccine directly from Pfizer

 New York Governor Andrew Cuomo said he asked Pfizer Inc. if the state could buy vaccines directly from the company because the U.S. government has failed to increase supply.

The Centers for Disease Control and Prevention expanded eligibility to more than 7 million New Yorkers, but has not increased -- and in some cases decreased -- the supply to states, Cuomo said Monday at a press conference. New York state will receive 250,000 doses this week, 50,000 fewer than last week. At that rate, it would take seven months to inoculate those eligible, he said.

No state has ever purchased vaccines directly from the producer, but “my job is to pursue every avenue,” he said.

Cuomo said the state will give fewer or no new doses to health-care facilities that are slow to administer the vaccine, while faster facilities will get more doses. He pointed to a wide disparity of administration, with many places using all of their allotment while others have distributed 20% to 50%.

“Places that get it out first will get priority,” he said.

https://www.bloomberg.com/news/articles/2021-01-18/cuomo-says-n-y-to-give-more-vaccine-doses-to-faster-facilities

Which strain should SARS-CoV-2 vaccine candidates target?

 More than a year into the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), several countries are beginning to roll out targeted vaccination efforts.

Under emergency regulatory body approval, countries like the United States and the United Kingdom have started administering vaccines to frontline workers and high-risk individuals. While the current vaccine candidates being used were designed to be multivalent and robust to emerging mutations, the potential for new strains to evade the immunizing response these vaccines are designed to elicit remains a significant risk factor in the current fight against the pandemic.  

A researcher at Clemson University, USA, has recently explored how governments might effectively combat the pandemic through strategic vaccination as new variants and strains of the virus emerge. The study suggests that vaccine candidates should target the fast-spreading variant, even when the initial prevalence is much lower.

COVID-19 vaccines

To date, the World Health Organization (WHO) reports that there are 235 vaccines developed against SARS-CoV-2. Of these, 63 are undergoing clinical evaluation or trials, while 172 are in pre-clinical development. A total of 15 vaccines are now in the last phase of human trials.

In the first week of December, following Medicines and Healthcare products Regulatory Agency (MRHA) approval, the United Kingdom has vaccinated over 130,000 people with the first dose of the Pfizer / BioNTech jab. In the first week of January, the second doses are to be given.

The UK’s Scientific Advisory Group for Emergencies (SAGE) endorsed the government’s move to pursue coverage of a high proportion of the population amid the surge of a new strain, which appears to be more infectious and fast-spreading.

Meanwhile, the United States has authorized and recommended two vaccines to prevent COVID-19 – Pfizer-BioNTech COVID-19 vaccine and Moderna’s COVID-19 vaccine.

Fast-spreading variant

Starting September, a new strain of SARS-CoV-2, named VOC 202012/01, has recently exploded across southeast England, prompting the government to impose lockdown orders once again in the region.

The new variant is deemed to be fast-spreading and up to around 70% more infectious, since it is a version of the virus with 23 mutations, eight of which are in the spike proteins, which is the part that the virus uses to attach onto and enter human cells.

The novel mutations include the N501Y mutation that allows the virus to bind more tightly to the human angiotensin-converting enzyme 2 (ACE2) receptor. It also has the D614G deletion that appears to make the virus more transmissible between people.

As of December 26, 2020, more than 3,000 cases of the new variant, which was confirmed by genomic sequencing, have been reported in the UK. The initial investigation by scientists confirmed that the new variant has increased transmissibility compared to previously spreading variants, but there is no observed increase in the severity of the disease.

Since December 2020, other countries have also reported cases of the new variant, including Denmark, Belgium, Germany, France, Ireland, Iceland, Finland, Italy, Netherlands, Portugal, Norway, Sweden, Spain, Australia, Hong Kong, Canada, India, Israel, Jordan, Japan, Lebanon, South Korea, Switzerland, and Singapore.

Another fast-spreading variant has been reported in South Africa, known as the 501.V2 variant. It is now the dominant form of the virus and has increased transmissibility. However, similar to the UK’s new variant, there is no evidence that the 501.V2 is tied to a higher severity of the infection.

The study

The study, published on the preprint journal medRxiv* server, shows that it is better for vaccines developed against SARS-CoV-2 to target the faster spreading strain, which could lead to surging cases in many countries.

Because the current vaccines developed were based on the previous strains of the virus, the study aimed to determine a solution for developing vaccines that can target the newest viral variant, or target the dominant but potentially less transmissible strain.

To arrive at the study findings, the investigator used a stochastic simulation to study how the choice of vaccine target affects outcomes of an outbreak of COVID-19 consisting of two different viral variants.

The study suggests that it is better to develop vaccines that target the variant that can spread more easily in populations. Even if the slower spreading variant is 100 to 1000-fold more prevalent at the onset of the vaccination period, targeting the faster-spreading strain is more effective.

However, the researcher also said that a mixed strategy, wherein 50 percent of the population receives a vaccine against one strain, and the other 50 percent receives a vaccine against the other strain, can perform well.

Overall, my model suggests that, except in very rare instances, monovalent COVID-19 vaccines should target the fastest-spreading strain of the virus, regardless of how prevalent that strain is at the outset of the vaccination period, and regardless of the degree of cross-protection offered by either vaccines or natural immunity,” the researcher concluded.

As the pandemic evolves, new strains of COVID-19 will continue to emerge that are more transmissible than the current variants. These strains may evade immune responses from the current vaccines being rolled out. Though this cannot be prevented, but governments can make strategic decisions about vaccination strategies to reduce surges of cases and save many lives.

To date, there are over 87.19 million COVID-19 cases worldwide. The death toll has topped 1.88 million people.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal references:

• COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU) - https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
• European Centre for Disease Prevention and Control (ECDC). (2021). https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-risk-related-to-spread-of-new-SARS-CoV-2-variants-EU-EEA.pdf
• Bewick, Sharon. (2021). Viral Variants and Vaccinations: If We Can Change the COVID-19 Vaccine, Should We? medRxiv. doi: https://doi.org/10.1101/2021.01.05.21249255 https://www.medrxiv.org/content/10.1101/2021.01.05.21249255v1

https://www.news-medical.net/news/20210107/Which-strain-should-SARS-CoV-2-vaccine-candidates-target.aspx