By David E. Hogan, DO, MPH, FACEP, Chair, TeamHealth Emerging Infectious Disease Taskforce
The Centers for Disease Control (CDC) released a national health alert in late July about the current state of the COVID-19 pandemic. What does the alert mean, and what are the core facts?
The Nature of Pandemics
Most serious, modern pandemics take about three years to resolve. Influenza is our best teacher here. Throughout time, influenza cases spike in a year, then the next year is better. Then, influenza again worsens in cycles until the virus eventually becomes less dangerous and people become more resistant. Sometimes the virus becomes endemic or even seasonal like influenza. In the case of COVID-19, we have reserves – a booster vaccine.
The Game Changer – Vaccines
In modern times, it usually takes about three years for a new vaccine to be produced. That assumes a vaccine can be produced. The vaccines using mRNA technologies for COVID-19 are a new paradigm. They were created in less than a year. Yet, they are the safest and most effective vaccines ever produced. No vaccine is totally free of possible side effects, but the new mRNA vaccines are for the most part. Vaccines will end this pandemic.
The CDC Health Alert on the Pandemic
Let’s look at the information in the CDC’s latest health alert and refine the meaning of these recommendations based on what the evidence supports.
Core items from the CDC July 27 health alert:
- COVID-19 cases have increased over 300% nationally from June 19 to July 23, 2021, along with parallel increases in hospitalizations and deaths, driven by the highly transmissible B.1.617.2 (Delta) variant.
- Overall, the majority (81.4%) of counties with high COVID-19 rates are found in communities with low vaccination coverage.
- Most cases of COVID-19 and hospitalizations are in unvaccinated individuals. From January through May 2021, of the more than 32,000 adult COVID-19 hospitalizations tracked, less than 3% occurred in fully vaccinated persons.
- The COVID-19 Delta variant is widely prevalent and more infectious than any prior strains.
- Emerging evidence suggests that even fully vaccinated people who do become infected with the Delta variant are at risk for transmitting it to others. This is one of the reasons for suggesting that even fully vaccinated people use face coverings in high-risk environments.
- Vaccination is a priority national strategy to interrupt SARS-CoV-2 transmission, protect our personal and public health and preserve healthcare system capacity.
- The available vaccines in the United States are very effective against all current SARS-CoV-2 viral variants – including Delta.
- Vaccination limits viral spread and significantly minimizes opportunities for mutation and more dangerous variant development.
- One concerning risk is that mutations can produce future variants (like Delta) that are more virulent and capable of getting around our current vaccines, diagnostic tests and treatments.
- COVID-19 vaccination coverage at skilled nursing facilities (SNF) helps prevent infection. It is critical to fully vaccinate residents and staff with an available mRNA vaccine.
Along with these facts, the CDC recommends some urgent actions:
- We need to increase our efforts to get everyone vaccinated, especially in areas with low vaccine coverage and in groups with low vaccine acceptance.
- Individuals not fully vaccinated need to follow all the recommended prevention measures such as face coverings and social distancing. This is to help protect themselves, but also to protect the rest of us.
- People who are immunocompromised should be counseled about the potential for reduced immune response to a COVID-19 vaccine. They should continue to follow other preventive measures and guidance from their healthcare provider.
- We need to ensure that we are providing a tailored, culturally responsive and linguistically appropriate communication of vaccination benefits at the community level for each community. This means finding local community champions to help explain and promote vaccination.
There are also some specific recommendations for clinicians:
- If you are a clinician and not fully vaccinated, get vaccinated as soon as possible. This is to protect yourself, your family, your patients and the rest of us. The evidence supporting vaccine effectiveness and a high level of safety is undeniable.
- We need to increase patient outreach efforts to encourage, recommend and offer COVID-19 vaccination. This should happen in all clinical settings.
- We need to remind patients that vaccination is recommended for all persons 12 years of age and older, even for those with prior SARS-CoV-2 infection.
- Strongly recommend that your fellow clinicians and patients follow only trusted and well-vetted sources for general pandemic information. This is particularly true of any new recommendations in vaccine guidance.
- When we give COVID-19 vaccines, we need to support efforts to ensure people receive their first dose of a Pfizer-BioNTech or Moderna and return for their second dose to complete the series.
- We need to increase communication and conversation with unvaccinated colleagues, staff, patients and others to increase their confidence in vaccination.
- Finally, remember to recommend that fully vaccinated, immunocompromised patients continue to practice all recommended prevention measures for their own protection.
Stay Safe and Vaccinate
The guidance provided here by the CDC is well-researched and sound. While there is continuing noise about the pandemic, remember that history clearly suggests we are winning the battle, despite how it feels. Below, the Emerging Infectious Disease Taskforce has provided links to reputable sources.
Stay safe – and vaccinate.
- CDC Health Alert. Vaccination to Prevent COVID-19 Outbreaks with Current and Emergent Variants — United States, 2021. July 27, 2021, 4:00 PM ET CDCHAN-00447
- CDC Weekly Morbidity and Mortality Weekly Report (MMWR)
- CDC. Interim Public Health Recommendations for Fully Vaccinated People
- CDC. COVID Data Tracker
- NIH. COVID-19 Treatment Guidelines
- WHO. WHO Coronavirus (COVID-19) Dashboard