COVID-19 Scan for Sep 08, 2021

News brief

COVID mRNA vaccine effectiveness high in those 16 and up

The Pfizer/BioNTech and Moderna mRNA-based COVID-19 vaccines have a collective 91% vaccine efficacy against SARS-CoV-2 infection in Americans 16 years and older, according to a test-negative study published in the Journal of Infectious Diseases today.

The researchers looked at 812 people who were seeking outpatient medical care for potential COVID-19 infection. About 29% (236) tested positive, of whom 8.5% were partially vaccinated and 7.2% were fully vaccinated. Of the remaining people who received negative COVID-19 tests, 29% were partially vaccinated and 71% were fully vaccinated.

Vaccine effectiveness was calculated to be 91% for those fully vaccinated and 75% for those who were partially vaccinated (95% confidence intervals, 83% to 95% and 55% to 87%, respectively).

The cohort was enrolled from five study sites in Michigan, Pennsylvania, Texas, Washington, and Wisconsin. Participation began for those 65 years and older on Feb 1 and for those 16 to 64 years on Mar 22 due to vaccine prioritization plans, with both groups closing May 28. At this time, the Alpha (B117) variant was identified in 56% of 36 sequenced samples.

"With the high vaccine effectiveness against mild to moderate COVID-19 observed during the study period, early community vaccination strategies likely had a marked impact on disease burden," the researchers conclude.
Sep 8 J Infect Dis abstract

CPAP may be ineffective for severe COVID-19, study says

Continuous positive airway pressure therapy (CPAP), which is used for respiratory failure, may not benefit COVID-19 patients with severe disease who are not likely to benefit from invasive mechanical ventilation (nIMV), according to a study today in EClinicalMedicine. The researchers say CPAP is often used outside intensive therapy and high-dependency units.

The researchers pooled data from nIMV patients in seven hospitals in the North West of England during the United Kingdom's first and second pandemic waves (Mar 1 to May 31, 2020, and Sep 1 to Dec 31, 2020).

Among 479 patients who either received CPAP (233) or oxygen therapy (246), 30-day mortality did not show significant difference (77.7% in CPAP group vs 75.6% in oxygen group). Thirty-day mortality for the CPAP group had an adjusted odds ratio (aOR) of 0.84 compared with the oxygen group (95% confidence interval, 0.57 to 1.23, p = 0.37).

Higher 30-day mortality rate was, however, crudely associated with advancing age (OR, 1.56 per 10-year increase in age), increasing urea (OR, 2.44 per 10 millimoles per liter increase), and lower SpO₂ (peripheral capillary oxygen saturation; OR, 0.68 per 5% SpO₂ increase). Obese patients had significantly lower mortality rates (OR, 0.55).

While 48.9% of CPAP recipients discontinued the therapy, the researchers say the reasonable duration of use and further sensitivity analyses indicated that those patients did not significantly affect the results.

"Given the resources required to provide CPAP it raises the question as to whether it should be provided to patients who are nIMV, which has been commonplace during the COVID-19 pandemic. Importantly, however, we found no evidence of worsened outcomes in patients treated with CPAP," the researchers write.

The complete cohort was 64% male, with an average of 77 years. People in the oxygen group were slightly older (78 vs 77 years) and had a higher rate of cardiovascular disease (76% vs 64%).
Sep 8 EClinicalMedicine study

News Scan for Sep 08, 2021

News brief

CDC and AmeriCorps announce new public health partnership

The Centers for Disease Control and Prevention (CDC) today announced the creation of Public Health AmeriCorps through a partnership with the federal agency for volunteering and national service, AmeriCorps. The new program will help recruit, develop, and train new public health leaders.

"The experience and networks AmeriCorps brings to this partnership provide a valuable opportunity to engage communities around the United States, including many people who may have never considered a deeply fulfilling career in public health," said CDC Director Rochelle Walensky, MD, MPH, in an AmeriCorps news release. "This program is a critical component of CDC's effort to develop a strong, diverse workforce to face the public health challenges of the future."

The collaboration is funded by $400 million from the American Rescue Plan, which will support 5,000 AmeriCorps positions over the next 5 years. The CDC said the money is part of a larger $7 billion investment in the public health workforce announced by the Biden-Harris Administration.

Applications to join the program are being accepted now through Nov 8. AmeriCorps members work in more than 40,000 locations across the country, and many are already working on pandemic response.

"This is an exciting new partnership that builds upon the expertise, best practices, and lessons learned from both existing AmeriCorps and CDC programs to support communities and also provide much-needed surge capacity for state and local public health agencies that continue to bear the burden of caring for a nation in crisis," said Mal Coles, acting CEO at AmeriCorps, in the release.
Sep 8 AmeriCorps press release

H5N6 avian flu sickens another person in China

China reported another H5N6 avian flu case, marking its 18th case of the year, according to an update today from the Hong Kong Centre for Health Protection (CHP).

The patient is a 48-year-old woman from Guangxi province in southern China who had been exposed to live domestic poultry before her symptoms began on Aug 25. She was admitted to the hospital on Aug 29 and is listed in serious condition.

Since 2014, China has reported 42 human H5N6 cases—often known to be severe or fatal. The virus is known to circulate in poultry, mainly in Asia. So far, China and Laos are the only countries that have reported human cases.

China's last H5N6 case, a 55-year-old man was also from Guangxi province and had contact with poultry before he became ill.
Sep 8 CHP statement
Aug 23 CIDRAP News scan on previous case

Deadly meningitis outbreak strikes DR Congo province

The Democratic Republic of the Congo (DRC) has reported a meningitis outbreak in the northeastern province of Tshopo, where 269 suspected cases have been reported so far, 129 of them fatal, the World Health Organization (WHO) African regional office said in a statement today.

Tests conducted by the Pasteur Institute in Paris confirmed Neisseria meningitidis, a bacterium known to trigger large epidemics.

DRC health officials, with support from the WHO, have deployed an emergency team, and crisis response centers have been set up in the city of Banalia, the outbreak epicenter, and in Kisangani, the provincial capital. The WHO has also sent medical supplies and will send more experts and resources.

So far, 100 patients are being treated in homes and in Banalia's health centers.

Tshopo province is part of Africa's "meningitis belt," which includes 26 nations across the continent that have battled recurrent outbreaks. In 2016, a massive meningitis vaccine campaign in Tshopo reached more than 1.6 million people ages 1 to 26, the group at most risk for the disease.

The WHO said the DRC has battled several meningitis outbreaks in the past, including one in Tshopo's capital in 2009 that sickened 214 people and resulted in 14 deaths.
Sep 8 WHO statement