(Above, Inset: Clockwise from top left): Dr. Peggy Honein, who leads the State, Tribal, Local, and Territorial Support Task Force in CDC’s COVID-19 response; Dr. Cindy Friedman, who worked with The Division of Global Migration and Quarantine in 2020; Dr. Kevin Chatham-Stevens, a Medical Officer at Centers for Disease Control and Prevention; and Dr. Jennifer Layden, who plays key roles in public health responses to COVID-19, EVALI, Hepatitis A, and synthetic cannabinoid contamination at the state and local level. (Siliconeer/EMS)

At a briefing organized by Ethnic Media Services, Sept. 2, CDC experts – Dr. Peggy Honein, who leads the State, Tribal, Local, and Territorial Support Task Force in CDC’s COVID-19 response; Dr. Cindy Friedman, who worked with The Division of Global Migration and Quarantine in 2020; Dr. Jennifer Layden, who plays key roles in public health responses to COVID-19, EVALI, Hepatitis A, and synthetic cannabinoid contamination at the state and local level; and Dr. Kevin Chatham-Stevens, a Medical Officer at Centers for Disease Control and Prevention – gave updates on the state of the pandemic.

“We have experienced a number of waves in this pandemic and unfortunately we’re now in the midst of a fairly large surge that is related to a number of factors including the delta variant which is a highly transmissible variant. In June we had reached a low at one point of less than 12,000 cases a day being reported as a seven-day average, right now we’re at nearly 150,000 cases a day being reported,” said Dr. Honein.

The average number of new hospital admissions is up and we’re having about 1,000 deaths a day reported to the Centers for Disease Control (CDC) from COVID-19.

There have been almost 640,000 deaths and nearly 40 million cases reported which means this pandemic continues to take a major toll despite the availability of proven mitigation measures and very effective vaccines.

Through this surge over the summer, particularly in July and August the CDC has been tracking all of the cases, emergency department visits, and hospitalizations but they are particularly concerned about children. The states that have the lowest vaccination coverage have seen the greatest increases in emergency department visits and hospitalizations in children.

There is no vaccine authorized for children under 12 right now but we can all do our part to protect children by vaccinating as many people as possible that are age 12 and over and using other mitigation strategies like wearing masks to reduce transmission.

Overall we’re just under 53% fully vaccinated. The age ranges from a high of almost 82% of 65 years or older being fully vaccinated, down to about 40% of 12 to 17 years, but there’s also a lot of variation by geography.

If we look just at the adolescents from age 12 to 17, while the national average for being fully vaccinated is about 40% that ranges from a low of about 11 in Mississippi up to a high of about 60% in Vermont.

Dr. Honein said, “In Georgia, schools opened about a month ago in most counties but over the coming weeks, schools will be open across the nation as they’re opening in more and more places every day, and I think the great news from last year during the 2020-2021 school year is that we can prevent transmission in schools with comprehensive layered prevention approaches.”

Using many types of prevention, which include – promoting vaccination, using face masks for everyone, universal masking consistently, and correctly physical distancing, using screening testing as a way to identify cases so that they can be isolated quickly, improving ventilation, washing hands often, and staying home when you’re sick – we need to do a better job of all of that to keep disease rates low and keep our schools open for in-person education.

“We certainly see some disparities in vaccination, but we’ve made important progress in vaccine equity over the last eight months. During the initial rollout we were seeing larger gaps in the equity of distribution and there have been very conservative efforts that have narrowed those gaps and removed access barriers and tried to find ways to reach communities that might have lower levels of access.

“We’re certainly seeing a narrowing of those disparities for vaccine equity,” said Dr. Honein.

Dr. Friedman said, “If you remember only one thing today, it should be that everyone who is eligible should get fully vaccinated for COVID-19 before they travel because of the delta variant. Vaccinated people who travel still need to take precautions such as masking and social distancing.”

Dr. Layden reviewed some vaccine-related news that has happened since the last briefing, in mid-August, CDC recommended that people with moderately to severely compromised immune systems receive an additional dose of an mRNA COVID-19 vaccine at least 28 days after a second dose of either of the mRNA vaccines.

A plan to begin offering COVID-19 vaccine booster shots this fall was recently announced.

The U.S. Food and Drug Administration as well as recommendations by CDC’s advisory committee on immunization practices is conducting an independent evaluation to determine the safety and effectiveness of a booster dose of the mRNA vaccines and will decide whether to issue a booster dose recommendation based on a thorough review of the evidence the COVID-19 vaccines authorized in the United States continue to be highly effective in reducing risk of severe disease hospitalization and death even against the widely circulating delta variant. However, as COVID-19 constantly evolves, experts at CDC are looking at all available data to understand how well the vaccines are working including against new variants like delta and what the vaccine effectiveness is against this virus.

Data was recently released on vaccine effectiveness in essential front-line workers including healthcare personnel before and during the emergence of the delta variant. This data showed that the risk of COVID-19 infection remained low for workers who received a COVID-19 vaccine.

The estimated effectiveness of vaccines against any infection whether symptomatic or asymptomatic declined from 91% to 66%, once the delta variant became predominant, however, the vaccine still provided strong protections for the workers.

COVID-19 vaccines continue to work and are safe and effective.

“We have seen clear evidence that the delta variant is highly transmissible and there are papers suggesting each person who is infected is likely to transmit to more people than was the case with earlier variants,” said Dr. Layden.

She echoed the earlier suggestion of same prevention strategies being effective – universal masking, keeping as much physical distance as possible, improving ventilation, screening, testing in high density places which could be congregate living or schools where people might be very close together in crowded settings. Think carefully, particularly about indoor public places where there could be crowding and particularly in communities that have high levels of transmission.

There is now a county checker up on the CDC website where one can put in their state and county name and see the level of transmission in their county, that gets updated every day, and that can be a really useful tool right now.

According to Dr. Kevin Chatham-Stevens, within the U.S. there’s a lot of diversity of opinions and viewpoints on vaccinations and it ranges from people who were very eager and lining up and trying to get to the front of the line, in December and January of last year, for the vaccines when they first came out to people that have some hesitancy and want more information. Then at the other end there are people that feel pretty firmly that they, based on what they know right now at least, don’t want vaccination, but we do have that spectrum of opinions and we are continually working to get good information to people so they can make the best decisions for themselves and for their families.

Some people saw the full approval by FDA and thought it was enough to convince them that it was important to vaccinate. It’s a lot of diversity in how people look at this and we’re just going to continue from a public health perspective to provide the best information possible to inform those decisions.

Sandy Close asked Dr. Friedman, “I am supposed to get on the plane. I haven’t been on a plane except for one brief travel up to northern California a couple of weeks ago. I haven’t been on a plane since before the pandemic and I’m really nervous. The plane will take me to the East Coast so it’s a five or six hour flight. What really are your tips for traveling on a plane or would you just say steer clear if you’re older and wiser than the rest of us don’t risk it?”

“I’m hoping that you’re vaccinated because I want to tell everyone that if they’re getting vaccinated no matter what their health status or their age they should be vaccinated before they travel. That’s probably the number one thing. Also there is a regulation that you must wear a mask when you’re traveling on public transportation within the United States, and going out of the United States and just in terms of air travel, most viruses and other germs don’t really spread easily on flights because of how the air circulates and how it’s filtered on planes but air travel as you know requires a lot of time in security lines and airport terminals in crowded spaces so that brings you into close contact with other people so keeping your distance is hard.

“There are these layered approaches to air travel for you – get vaccinated, wear a mask,” said Dr. Friedman.

On the inefficacy of a single cloth mask, Dr. Friedman said, “There are many types of masks you can use to protect yourself and others from getting and spreading COVID-19.

“The first thing is to choose one that fits properly and snugly, but for cloth masks, we should wear one that has multiple layers of tightly woven breathable fabric and a nose wire is also helpful to help it fit snugly. Don’t wear masks with the exhalation valves or a single layer mask of a thin fabric.”