(NEW YORK) — It’s perfectly acceptable for 5- to-11-year-olds preparing to receive a vaccine against COVID-19 also to receive other protective shots they may have missing during the pandemic lockdown.
For some children, that could mean five or six shots in a single visit, but it’s safe to do so, doctors told ABC News.
“You can’t overwhelm the immune system with these vaccines,” said Dr. Margaret Fisher, a pediatric infectious disease specialist in New Jersey and chair of the AAP Global Immunization Advocacy Project.
Autumn is often less hectic at pediatricians’ offices, which is serendipitous for parents looking to schedule COVID-19 vaccine appointments.
“We’re kind of in a sweet spot,” said Dr. Natasha Burgert, a pediatric specialist in Kansas, with most children flooding doctors offices for back-to-school checkups over the summer.
Routine childhood vaccinations — jabs that help stave off devastating illnesses such as polio, measles, diphtheria and pertussis — are carefully laid out in Centers for Disease Control and Prevention guidelines, and all states require these vaccines for children attending public school.
While most kids are up to date on routine vaccines, according to Burgert, a significant number missed appointments over the summer. In August, the nonprofit group Health Efficient estimated that community health centers would need to increase the number of childhood vaccinations by 265% to match pre-pandemic levels — and maintain that pace for at least six months.
“If kids need routine shots, either we are giving them at the same time, or we are prioritizing the COVID shot right now,” Burgert added. “This is still a global emergency.”
Pediatricians of children who need to get back on a regular vaccination schedule should consult the CDC schedule for vaccine catch-ups, even if that means some kids will be getting their shots slightly later than would be ideal, said Dr. Alok Patel, a pediatric hospitalist at Stanford Children’s Health.
“I also have parents that prefer to space them out,” said Burgert, especially kids historically more reactive to the flu shot. “Parents are a little bit more hesitant to do both at the same time, just because they don’t want them to feel bad. And I understand that.”
Patel said he hears similar concerns: “A lot of parents say, ‘Hey, this is too many shots for my child to handle.'” But spacing out the vaccines, Patel added, is not without risk.
“The problem with spacing out the vaccines is you leave your child at risk to get the diseases while you’re spacing them out,” said Fisher, the pediatric infectious disease expert. “There’s no advantage. There’s no evidence that giving them at the same time increases the adverse events. And the disadvantage is you leave your child susceptible.”
According to Patel, parents should focus most on “getting their children the right protection, and getting them fully vaccinated against COVID-19 as soon as possible, but also making sure that they’re getting complete protection against the other major vaccine-preventable illnesses.”
Pediatricians are urging eligible patients to seek out COVID-19 vaccines as soon as possible — and to stay up to date on other routine vaccines.
“The last thing we want to do,” Patel told ABC News, “is see a resurgence of these preventable diseases because of lapses in coverage.”
Burgert also noted how children are eager to do their part.
“These kids have been living all of this stress with us,” Burgert said. “They have been living through it, and they want it to be over too. They want it to be over for their friends, and they want it to be over for their parents.”
Lauren Joseph, a student at Stanford Medical School, is a contributor to the ABC News Medical Unit. Dr. Tushar Garg and Dr. Jay Bhatt contributed to this report.
(WASHINGTON) — With winter closing in and coronavirus case rates creeping up once again, White House chief medical adviser Dr. Anthony Fauci is warning that the vaccines’ waning immunity combined with the highly transmissible delta variant will make for a “double whammy” that will impact “even the vaccinated people.”
“The somewhat unnerving aspect of it is that if you keep the level of dynamics of the virus in the community at a high level — obviously the people who are most most vulnerable are the unvaccinated — but when you have a virus as transmissible as delta, in the context of waning immunity, that dynamic is going to negatively impact even the vaccinated people. So it’s a double whammy,” Fauci said in a pretaped interview aired at the 2021 STAT Summit Tuesday afternoon.
“You’re going to see breakthrough infections, even more so than we see now among the vaccinated,” he added.
His grim prediction meets a chorus of alarm bells already being sounded about COVID’s renewed spread as more people head inside as the holidays approach, heralding a season of family gatherings.
The national reported average for new cases each day has surged to more than 80,000, according to federal data — the highest in nearly a month. Forty states are currently showing high transmission, and total hospitalizations have increased for the first time in nearly 10 weeks.
Combatting any impending viral onslaught this winter hinges on how many more sleeves roll up for more shots, Fauci said. It won’t only be important to persuade the roughly 60 million “recalcitrant” people who have yet to get their first dose, but also “how well we implement a booster program,” he said.
Fauci added that booster doses of the COVID vaccine may become the standard for a “full” vaccination.
It comes as a growing roster of states and local jurisdictions have pushed ahead of federal regulators’ timeline, electing to endorse the expansion of booster shots to all adults at least six months after their second Pfizer or Moderna shot.
Though Pfizer formally asked the Food and Drug Administration to expand their booster’s authorization last week, right now federal agencies only recommend the mRNA booster for people over the age of 65, have an underlying medical condition or are at high risk for exposure, at least six months after their second dose.
All Johnson & Johnson recipients over the age of 18, however, are eligible for a boost at least two months after receiving their first dose.
“I happen to believe as an immunologist and infectious disease person, that a third shot boost for an mRNA is likely — should be part of the actual standard regimen, where a booster isn’t a luxury; a booster isn’t an add on; and a booster is part of what the original regimen should be — so that when we look back on this, we’re going to see that boosters are essential for an optimal vaccine regimen,” Fauci said.
ABC News’ Arielle Mitropoulos contributed to this report.
(NEW YORK) — With COVID-19 infection rates steadily increasing across the country, a growing list of states are now moving ahead of federal authorization, to recommend booster shots for all residents 18 years or older, six months after receiving their second COVID vaccine dose.
Last week, Pfizer formally asked the Food and Drug Administration to allow all Americans over the age of 18 to be eligible for booster shots.
However, in recent weeks, leaders from seven states — Arkansas, California, Colorado, New Jersey, New Mexico, New York and West Virginia — have moved to formally and informally endorse the expansion of booster shots to all adult residents who are at least six months out of their second Pfizer or Moderna vaccine.
At this time, booster shots are recommended by federal agencies for anyone over the age of 18 who has received the Johnson & Johnson vaccine, two months after receiving their first dose. Moderna and Pfizer recipients are encouraged to get a booster shot six months after receiving their second dose, if they are over the age of 65, have an underlying medical condition or are at high risk for exposure.
Earlier this fall, West Virginia Gov. Jim Justice was the first state legislator to call for all residents regardless of their age or status of underlying condition, to receive a booster.
“I think that is absolutely the message that I’ve been trying to get out to people,” Justice reiterated on Monday. “I absolutely believe that if you’re 18 years of age, you can get your booster shot.”
On Monday, Arkansas Gov. Asa Hutchinson adjusted state policy recommendations to green light boosters for adults, adding that the current Centers for Disease Control and Prevention recommendations on boosters are “somewhat confusing and limiting.”
Two states — Colorado and New Mexico — which have seen significant increases in COVID-19 infections and hospitalizations have gone as far as to sign executive orders, urging all fully vaccinated adults to get boosters once they meet the six- or two-month thresholds, given the high risk for exposure and transmission in those states.
“We want to ensure that Coloradans have every tool they need to protect themselves from this deadly virus and to help reduce the stress on our hospitals and health care workers,” Colorado Gov. Jared Polis wrote.
The concerns over high transmission have also pushed other officials to pull the trigger on booster shots for all adults.
New York Gov. Kathy Hochul said on Monday that she is “strongly encouraging all New Yorkers who live or work in a high-risk setting to get the booster,” and in New York City, Health Commissioner Dr. Dave Chokshi, announced during a press conference on Monday that he is issuing a Commissioner’s Advisory to all health care providers to allow boosters for all adults.
Last week, in California, Health Secretary Dr. Mark Ghaly also announced that he was encouraging residents to “absolutely” sign up to get a booster shot.
With winter holidays just weeks away, and millions of Americans expected to travel and gather with family members, some officials say the expansion of boosters is now more critical than ever.
“We think this is a big step we can take with the holidays coming up. We need as many people boosted as possible. It’s that simple,” New Jersey Gov. Phil Murphy said on Monday during a press conference.
Murphy signaled that he would likely formally support boosters for all adults, adding that “if you’re in doubt, get the darn booster.”
To date, more than 30 million people nationwide have received an additional dose of a COVID-19 vaccine since early August, according to federal data.
(NEW YORK) — Several dozen New York City sanitation workers have been accused of submitting falsified vaccination cards to satisfy the city’s COVID-19 vaccine mandate, and they’ve been suspended without pay, according to a city official.
The city’s Department of Investigation is looking into the allegations, with spokesperson Diane Struzzi adding: “DOI is aware of allegations involving the issuance of bogus vaccination cards and declines further comment.”
New York City’s Sanitation Department also is investigating the situation in coordination with the DOI, according to Sanitation Department spokesman Joshua Goodman.
“These are very concerning allegations and we take them very seriously,” Goodman said. “Getting vaccinated is important to public health, and we do not tolerate anyone faking something that is a requirement of city employment.”
Over 87% of the department’s roughly 10,000 employees are either fully or partially vaccinated, according to ABC New York station WABC-TV.
“Anyone found to have faked their vaccination will be suspended without pay,” Goodman added.
The employees allegedly submitted real CVS cards listing that they had received the single-dose Johnson & Johnson vaccine, but, upon verifying, officials realized CVS hasn’t administered the J&J vaccine since May.
Employees allegedly lied about taking the J&J dosage because it was easier to fake receiving a single shot. The cards all came from the same CVS in southern Brooklyn but were distributed to multiple sanitation garages.
As of now, the accused sanitation workers are facing up to three works of suspension without pay.
(NEW YORK) — The rate of babies born premature in the United States has declined for the first time in six years, but experts warn it is not a cause for celebration, as a maternal and infant health crisis still exists.
Preterm birth rates in the U.S. decreased 0.1% from 10.2% in 2019 to 10.1% in 2020, according to a report published Monday by the March of Dimes, a nonprofit organization focused on improving the health of pregnant people and babies.
Even with the decrease, the U.S. — where 1 in 10 babies are born premature — maintained a “C-” grade for its preterm birth rate, according to the report.
And the report also found preterm births increased over the past year for Black and American Indian/Alaskan Native people, who are up to 60% more likely to give birth prematurely as compared to white women.
“I think it’s really important to understand that around the issue of premature birth, we still have significant issues around health and equity, and we still have far too many women who are more likely to give birth prematurely than others,” said Stacey D. Stewart, president and CEO of March of Dimes. “So we don’t see this report card as a reason to really celebrate.”
“It just means that we have a lot more work to do, especially in the communities that are most impacted,” she said.
In addition to increases this year, the the rate of preterm birth for Black people has increased by nearly 8% since 2014, and by 11% for American Indian/Alaskan Native people, according to March of Dimes.
Preterm, or premature birth, is any birth that happens before 37 weeks of pregnancy have been completed, according to the Centers for Disease Control and Prevention (CDC).
Babies born premature have higher rates of death and disability including breathing problems, cerebral palsy, feeding difficulties, developmental delays and vision and hearing problems, according to the CDC.
What causes a pregnant woman to deliver early is not always known, but risk factors include everything from a history of preterm birth to stress and substance abuse to socio-economic factors like being over the age of 35, having a low income and being Black, according to the CDC.
An emerging area of research has grown in recent years to look at why a pregnant person’s race, especially Black and American Indian/Alaskan Native, plays a role, according to Mirella Mourad, MD, a maternal fetal medicine specialist and co-director of the Preterm Birth Prevention Center at NewYork-Presbyterian/Columbia University Irving Medical Center.
“We are just starting to delve into understanding why women of color are at increased risk, where before it was just a risk factor,” she said. “Now we can with confidence say that discrepancies in socio-economic status or baseline health, education level, do not explain the entire picture.”
Mourad continued, “That’s kind of a good conclusion face to reach, so that we can focus on other factors and things that have recently become a big focus, like areas of racism-related stress and institutional systemic racism.”
In addition to race, March of Dimes’ report card also showed disparities in preterm birth rates based on where people live.
The rates of preterm births increased in 13 states, with Alabama, Arkansas, Louisiana, Mississippi, South Carolina, West Virginia and Puerto Rico earning an “F,” meaning they had a preterm birth rate of 11.5% or more.
Only the state of Vermont earned an “A” grade with a preterm birth rate of 7.7%.
Overall, the southern states, Appalachia and pockets of western states have higher levels of vulnerability, according to the March of Dimes.
Stewart said the report card looks at social vulnerability, like where a person lives, because they can contribute to maternal health, which also plays a role in preterm birth.
“We know that how any of us live, the social determinants of health, are primary determinants in our health overall,” she said. “So whether or not mothers have access to health care, whether or not they live in safe neighborhoods, have access to good nutrition, have access to health care, if those things are lacking, those issues can certainly increase the risk of a mother’s health declining and sometimes lead to premature birth.”
This year’s report card — released annually in November, National Premature Awareness Month — also looked for the first time at low-risk C-sections, defined by the March of Dimes as one that takes place when a pregnant person is at least 37 weeks pregnant and has not given birth before.
The low-risk C-section rate in 2020 in the U.S. was 25.6%, according to the report, around 10 points above the maximum of what the World Health Organization (WHO) considers the ideal rate for C-section births.
“We included information about low-risk C-sections as as a way of thinking about the overall state of maternal health,” said Stewart, noting that C-sections are associated with increased risk of maternal morbidity and increased rates of NICU admission.
“The fact that the U.S. is considered the most dangerous developed nation in the world in which to give birth is very shocking and surprising to a lot of people,” said Stewart. “One of the reasons we want to make sure that people have this information from the report card is to shine a brighter light on the fact that we have a lot of issues in this country, still even the wealthiest country in the world, with respect to maternal and infant health.”
“It requires a lot more attention and awareness and action to make sure that every mom and every baby is healthy,” she said.
(NEW YORK) — A nursing home in Connecticut is recovering from a significant coronavirus outbreak, after 89 residents and staff tested positive for the virus, facility leadership reported Monday.
The outbreak at Geer Nursing and Rehabilitation Center in North Canaan, Connecticut, began in late September. Eight residents with “serious underlying health issues” died as a result of the outbreak, nursing home leadership said in a statement.
They said 78 residents and staff have since recovered since testing positive, and there are now only three active cases within the community of individuals living within the nursing home.
“We are encouraged to see only 3 active cases of covid-19 remaining within our nursing home. Of the total 67 residents affected over the course of this outbreak, 56 are fully recovered and off isolation. Sadly, we have lost 8 individuals with serious underlying health issues to Covid,” Kevin O’Connell, the Geer Village Senior Community CEO, wrote.
Facility leaders said 87 of the 89 infected residents and staff were fully vaccinated, so leaders are “obviously concerned we experienced some level of waning immunity.”
The outbreak occurred prior to boosters being made available, O’Connell told ABC News.
“We had it scheduled for Nov. 2, and then that got put aside because of the pandemic,” O’Connell said, stressing that officials from the nursing home reached out to Walgreens “right away,” when they were told that the booster was made available to residents.
However, O’Connell said that scheduling booster shots can be logistically complicated, because it entails coordinating it for all the staff and residents. “It takes a while to get that all set up,” he said.
Booster shots will be made available to all eligible staff and residents when there are no new positive cases for two full weeks.
“We’re following the guidance of the Department of Health,” said O’Connell, “and they do not recommend providing booster to anybody with active infections for 14 days after the outbreak.”
The CDC currently recommends that all individuals, 18 and older, who live in long-term care facilities, receive a COVID-19 booster shot, given the fact that residents are likely to live closely together, and are often older adults with underlying medical conditions, which cause them to be at “increased risk of infection and severe illness from COVID-19.”
“We continue to monitor the situation closely and will provide updates for residents, staff, families and community stakeholders as the situation changes,” officials from the home said over the weekend.
(WASHINGTON) — Half of parents in a new ABC News/Washington Post poll are skeptical about the safety and effectiveness of COVID-19 vaccines for children, potentially a key barrier as the government seeks to boost uptake.
Numerous recent surveys have found substantial numbers of parents hesitant to have their child vaccinated against the coronavirus. This poll explores these compunctions by assessing parents’ views of whether the vaccines are safe and effective, both well-established motivators of uptake.
The results: Just 46% of adults with a child younger than 18 at home are confident that the vaccines are safe for children age 5 to 17. It’s about the same, 47%, for confidence that the vaccines are effective at preventing serious illness and death in this age group. Fifty-two percent are not so or not at all confident in their safety or effectiveness.
These are far from ABC/Post results in September asking about the vaccines generally, not specifically for children. Among all adults, 71% called the vaccines safe and 72% saw them as effective. Results on safety were similar last April for the Pfizer and Moderna vaccines, less so for the Johnson & Johnson vaccine, measured during a pause in its use.
This poll, produced for ABC News by Langer Research Associates, finds that strength of sentiment is a further challenge: Twice as many parents are not at all confident that the vaccines are safe for children age 5 to 17 than are very confident of this, 41% versus 21%. The gap is smaller on effectiveness, but still 12 percentage points, 38% versus 26%.
Groups
As with many pandemic attitudes, partisan and ideological preferences inform views on vaccines for children. While sample sizes for parent subgroups are small, skepticism about the vaccines’ safety and effectiveness in 5- to 17-year-olds peaks among Republicans and Republican-leaning independents, as well as among conservatives.
In other gaps, mothers are more apt than fathers to be confident in the vaccines’ effectiveness, 55% versus 38%. (The difference between the sexes in views of safety is smaller, and not statistically significant.) Confidence in safety, for its part, is much higher among parents who are members of racial or ethnic minority groups, compared with white parents. (On effectiveness, the racial/ethnic gap shrinks, and is not significant.)
A connection with attitudes on school policies is apparent as well. Parents who support their local school district’s pandemic policies are more apt than those who see these policies as too strict to express confidence in the vaccines. That again connects with politics: Seeing school policies as too strict rises sharply among leaned Republicans and conservative parents.
Methodology
This ABC News/Washington Post poll was conducted by landline and cellular telephone Nov. 7-10, 2021, in English and Spanish, among a random national sample of 1,001 adults, including 240 adults with children living at home. Results among adults with children at home have a margin of sampling error of 7.5 percentage points, including the design effect.
The survey was produced for ABC News by Langer Research Associates of New York City with sampling and data collection by Abt Associates of Rockville, Maryland. See details on the survey’s methodology here.
(NEW YORK) — State and local health officials are once again raising the alarm about the renewed threat of COVID-19 spread in communities across the country as people head indoors during the colder months and are set to gather for the holidays.
“Winter is coming,” California Gov. Gavin Newsom warned during a press conference on Tuesday. “COVID is not taking the winter off.”
For weeks throughout the early fall, the U.S. had seen steady declines in coronavirus infections and hospitalizations, offering hope that perhaps the pandemic was finally subsiding in the U.S. after a significant summer surge across the South and a renewed push for vaccinations.
However, the U.S. appears to be once again at an inflection point, with cold weather setting in across much of the North, COVID-19 restrictions relaxed and gatherings growing more frequent. On average, the U.S. is reporting approximately 75,000 new COVID-19 cases each day, according to federal data, still significantly lower than the country’s most recent surge over the summer, but higher than at any point last spring.
Since mid-October, the average number of new COVID-19 cases has risen by approximately 17%, marking the first consistent increase in national cases in nearly 10 weeks. While some health officials caution that case numbers may not be the best indicator of the prevalence of COVID-19, hospitalizations are also on the rise in a number of states.
Experts say a confluence of factors is likely driving the country’s recent uptick besides cold weather — largely the more than 107 million Americans who remain completely unvaccinated and continue to account for the majority of new infections and hospitalizations.
People who have not been fully vaccinated are 6.1 times more likely to test positive with the virus and 11.3 times more likely to die from it, compared with people who are vaccinated, according to federal data.
But there is also the factor of waning immunity for those who are fully inoculated, something that other countries have seen as well.
“Lowering temperatures, increased population mixing, reduced masking, fully open schools and the more contagious delta variant all contribute to the increases in cases and hospitalizations in many parts of the country. Despite widespread availability of the vaccine, we still have pockets of under-vaccinated communities that consistently provide opportunities for the virus to spread,” said John Brownstein, an epidemiologist at Boston Children’s Hospital and an ABC News contributor.
“While we should all be more optimistic than this time last year, we are not yet in a position to declare victory on the pandemic,” Brownstein said.
COVID-19 cases on the rise in nearly 2 dozen states
Over the last two weeks, 22 states — many of them with colder temperatures — have seen an uptick in daily cases of 10%.
Similarly, 14 states — Arizona, Colorado, Connecticut, Iowa, Kansas, Michigan, Minnesota, Missouri, New Hampshire, Rhode Island, South Dakota, Utah, Vermont and Wisconsin — have seen an increase of about 10% or more in hospital admissions over the last week.
And after nearly 10 weeks of declines, national hospitalizations have also begun to increase. Although hospitalizations have declined significantly from the country’s summer surge, when more than 104,000 patients were hospitalized at one time, 47,000 patients currently in the hospital with COVID-19 — an increase of 2,000 from last week.
“We need to stop talking as though covid is over,” Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, tweeted last week. “More than 40% of the country remains unvaccinated. That’s a lot of warm water for hurricane delta. I’m concerned about yet another surge beginning after Thanksgiving (just like last year).”
Jennifer Nuzzo, epidemiology lead at the Johns Hopkins University Coronavirus Resource Center, called the stall in the national decline “worrisome.”
“We’re stalling at a level of weekly case numbers that are still well above what we saw at the lower periods at the end of June and in early July,” Nuzzo said during a briefing last week. “There are a number of states where these increases have persisted for two or more weeks, and that’s usually the metric we look for to say a trend is happening. So there are some early signs that we’re headed in the wrong direction.”
Even states with high vaccination rates see upticks
Despite states across the Northeast boasting high vaccination rates, with several jurisdictions reporting full vaccination rates above 70%, several states are struggling through their worst surge yet.
In Maine, COVID-19 infections and hospitalizations have been steadily rising across the state, despite the fact more than 70% of the state’s total population fully inoculated.
Since the onset of the pandemic, LifeFlight of Maine, which provides critical care transport across the state, has not seen a decline in the steady stream of patients in need of urgent care.
“The number of COVID patients we’re transporting is remaining the same as it was for the last 19 months. We’re continuing to say the hospitals are full to capacity,” Thomas Judge, executive director of LifeFlight of Maine, told ABC News.
This issue is not unique to Maine, Judge explained, adding that his colleagues across the country, and in the Northeast, are all still struggling.
“Because the hospitals can’t absorb all these patients, they’re just under such pressure for beds, especially the ICU beds,” Judge said.
Judge explained that they are frequently flying patients out of state, at times, as far away as Connecticut or New York, depending on bed availability.
“We’re taking patients across state lines routinely. Just because of these challenging beds, and we’re taking patients much further than we would normally take them which you can imagine,” Judge added. “The patients we’re seeing are primarily unvaccinated and the vast majority of patients in the ICU, and on ventilators are unvaccinated, and that continues to be the challenge.”
Vermont sees record surge in COVID-19 infections
In neighboring Vermont, which has the highest vaccination rate of any state with nearly 72% of the population fully vaccinated, COVID-19 cases increased by 50% over the last 14 days. According to a recent report by the Department of Financial Regulation, people who are not fully vaccinated continue to report infection rates 3.7 times higher, per capita, compared to people who are fully vaccinated.
Further, according to the report, 67% of hospitalizations, over the last seven days, are among the unvaccinated.
The patterns observed in communities with current spikes in infections and hospitalizations suggest that they are driven not only by those still unvaccinated, but also the decline of vaccine efficacy over time.
“Waning immunity likely is also contributing to increases in cases especially among those with increased vulnerability because of underlying conditions. Boosters can at least play a supporting role in averting a larger surge this winter,” Brownstein said.
Experts say the key to getting through the winter will ultimately be to get more Americans fully vaccinated and boosted when eligible.
“As we go into the winter months with the challenge of a respiratory infection being worse in the winter months, we can get through this if we really put a lot of effort into getting as many people vaccinated as we possibly can,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases said in an interview with NPR, this week.
Health experts also say that it will also be critical for people to get the flu vaccine, in addition to their COVID-19 shots, as both vaccines only protect against their respective diseases. According to the Centers for Disease Control and Prevention, it is safe to get the COVID and flu vaccines during the same visit.
At this time, booster shots are recommended for anyone over the age of 18 who has received the Johnson & Johnson vaccine. Moderna and Pfizer recipients are encouraged to get a booster shot six months after receiving their second dose, if they are over the age of 65, have an underlying medical condition or are at high risk for exposure. On Tuesday, Pfizer requested the Food and Drug Administration allow all Americans over 18 to be eligible for booster shots.
(NEW YORK) — State and local health officials are once again raising the alarm about the renewed threat of COVID-19 spread in communities across the country as people head indoors during the colder months and are set to gather for the holidays.
“Winter is coming,” California Gov. Gavin Newsom warned during a press conference on Tuesday. “COVID is not taking the winter off.”
For weeks throughout the early fall, the U.S. had seen steady declines in coronavirus infections and hospitalizations, offering hope that perhaps the pandemic was finally subsiding in the U.S. after a significant summer surge across the South and a renewed push for vaccinations.
However, the U.S. appears to be once again at an inflection point, with cold weather setting in across much of the North, COVID-19 restrictions relaxed and gatherings growing more frequent. On average, the U.S. is reporting approximately 75,000 new COVID-19 cases each day, according to federal data, still significantly lower than the country’s most recent surge over the summer, but higher than at any point last spring.
Since mid-October, the average number of new COVID-19 cases has risen by approximately 17%, marking the first consistent increase in national cases in nearly 10 weeks. While some health officials caution that case numbers may not be the best indicator of the prevalence of COVID-19, hospitalizations are also on the rise in a number of states.
Experts say a confluence of factors is likely driving the country’s recent uptick besides cold weather — largely the more than 107 million Americans who remain completely unvaccinated and continue to account for the majority of new infections and hospitalizations.
People who have not been fully vaccinated are 6.1 times more likely to test positive with the virus and 11.3 times more likely to die from it, compared with people who are vaccinated, according to federal data.
But there is also the factor of waning immunity for those who are fully inoculated, something that other countries have seen as well.
“Lowering temperatures, increased population mixing, reduced masking, fully open schools and the more contagious delta variant all contribute to the increases in cases and hospitalizations in many parts of the country. Despite widespread availability of the vaccine, we still have pockets of under-vaccinated communities that consistently provide opportunities for the virus to spread,” said John Brownstein, an epidemiologist at Boston Children’s Hospital and an ABC News contributor.
“While we should all be more optimistic than this time last year, we are not yet in a position to declare victory on the pandemic,” Brownstein said.
COVID-19 cases on the rise in nearly 2 dozen states
Over the last two weeks, 22 states — many of them with colder temperatures — have seen an uptick in daily cases of 10%.
Similarly, 14 states — Arizona, Colorado, Connecticut, Iowa, Kansas, Michigan, Minnesota, Missouri, New Hampshire, Rhode Island, South Dakota, Utah, Vermont and Wisconsin — have seen an increase of about 10% or more in hospital admissions over the last week.
And after nearly 10 weeks of declines, national hospitalizations have also begun to increase. Although hospitalizations have declined significantly from the country’s summer surge, when more than 104,000 patients were hospitalized at one time, 47,000 patients currently in the hospital with COVID-19 — an increase of 2,000 from last week.
“We need to stop talking as though covid is over,” Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, tweeted last week. “More than 40% of the country remains unvaccinated. That’s a lot of warm water for hurricane delta. I’m concerned about yet another surge beginning after Thanksgiving (just like last year).”
Jennifer Nuzzo, epidemiology lead at the Johns Hopkins University Coronavirus Resource Center, called the stall in the national decline “worrisome.”
“We’re stalling at a level of weekly case numbers that are still well above what we saw at the lower periods at the end of June and in early July,” Nuzzo said during a briefing last week. “There are a number of states where these increases have persisted for two or more weeks, and that’s usually the metric we look for to say a trend is happening. So there are some early signs that we’re headed in the wrong direction.”
Even states with high vaccination rates see upticks
Despite states across the Northeast boasting high vaccination rates, with several jurisdictions reporting full vaccination rates above 70%, several states are struggling through their worst surge yet.
In Maine, COVID-19 infections and hospitalizations have been steadily rising across the state, despite the fact more than 70% of the state’s total population fully inoculated.
Since the onset of the pandemic, LifeFlight of Maine, which provides critical care transport across the state, has not seen a decline in the steady stream of patients in need of urgent care.
“The number of COVID patients we’re transporting is remaining the same as it was for the last 19 months. We’re continuing to say the hospitals are full to capacity,” Thomas Judge, executive director of LifeFlight of Maine, told ABC News.
This issue is not unique to Maine, Judge explained, adding that his colleagues across the country, and in the Northeast, are all still struggling.
“Because the hospitals can’t absorb all these patients, they’re just under such pressure for beds, especially the ICU beds,” Judge said.
Judge explained that they are frequently flying patients out of state, at times, as far away as Connecticut or New York, depending on bed availability.
“We’re taking patients across state lines routinely. Just because of these challenging beds, and we’re taking patients much further than we would normally take them which you can imagine,” Judge added. “The patients we’re seeing are primarily unvaccinated and the vast majority of patients in the ICU, and on ventilators are unvaccinated, and that continues to be the challenge.”
Vermont sees record surge in COVID-19 infections
In neighboring Vermont, which has the highest vaccination rate of any state with nearly 72% of the population fully vaccinated, COVID-19 cases increased by 50% over the last 14 days. According to a recent report by the Department of Financial Regulation, people who are not fully vaccinated continue to report infection rates 3.7 times higher, per capita, compared to people who are fully vaccinated.
Further, according to the report, 67% of hospitalizations, over the last seven days, are among the unvaccinated.
The patterns observed in communities with current spikes in infections and hospitalizations suggest that they are driven not only by those still unvaccinated, but also the decline of vaccine efficacy over time.
“Waning immunity likely is also contributing to increases in cases especially among those with increased vulnerability because of underlying conditions. Boosters can at least play a supporting role in averting a larger surge this winter,” Brownstein said.
Experts say the key to getting through the winter will ultimately be to get more Americans fully vaccinated and boosted when eligible.
“As we go into the winter months with the challenge of a respiratory infection being worse in the winter months, we can get through this if we really put a lot of effort into getting as many people vaccinated as we possibly can,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases said in an interview with NPR, this week.
Health experts also say that it will also be critical for people to get the flu vaccine, in addition to their COVID-19 shots, as both vaccines only protect against their respective diseases. According to the Centers for Disease Control and Prevention, it is safe to get the COVID and flu vaccines during the same visit.
At this time, booster shots are recommended for anyone over the age of 18 who has received the Johnson & Johnson vaccine. Moderna and Pfizer recipients are encouraged to get a booster shot six months after receiving their second dose, if they are over the age of 65, have an underlying medical condition or are at high risk for exposure. On Tuesday, Pfizer requested the Food and Drug Administration allow all Americans over 18 to be eligible for booster shots.
(NEW YORK) — Experts agree climate change is exacting a hefty toll on human health — from increasing rates of asthma and heat stroke to depression and anxiety. But now, dermatologists are chiming in, too, saying climate change could also impact your skin.
“There are a lot of ways that the skin interacts with the environment,” said Dr. Misha Rosenbach, associate professor of dermatology at the University of Pennsylvania and co-founder of the American Academy of Dermatology’s climate change and environmental issues expert resource group.
Your skin is your body’s first line of defense against the outside world. Now, some dermatologists are seeing an uptick in some dermatological conditions linked to the burgeoning climate crisis. As the first barrier of protection against different climates, the skin must adjust to these changes, but it can be difficult to adjust to extreme environments.
“As temperatures rise, our skin’s ability to adapt to increasing temperatures has its limits,” said Dr. Sarah Coates, a pediatric dermatologist and assistant clinical professor of dermatology at the University of California, San Francisco.
Common skin conditions
Multiple common skin conditions have been linked to climate change. One of them is eczema, a skin condition that can happen at any age and often involves irritating, itchy rashes that can disrupt sleep and overall quality of life. Eczema can flare up due to multiple triggers, including air pollutants.
“It turns out eczema can be exacerbated by wildfire smoke,” Rosenbach said. A study published in JAMA Dermatology showed a link between an increase in eczema flares in California during the California Camp Fire in 2018.
Air pollution might also be causing flares in psoriasis and lupus, two different immune system medical conditions that can cause skin rashes.
The air pollution that triggers these flares could make it more difficult to treat these already persistent conditions, some dermatologists say.
Experts also say skin cancer is influenced by changes in climate and could happen more in the future because of it.
“It’s warmer in more areas, and so people are outside more, wearing less clothing for most of the year, and that’s more sun exposure,” Rosenbach explained.
Infectious skin diseases
Climate change can also spur infectious disease. Data shows climate change has been contributing to a rise of infections that affect the skin, not only globally but in the United States, which experts say could worsen as the environment changes. This is the result of various factors, including weather changes that affect the vectors that transmit diseases to humans, such as mosquitos and ticks.
Experts say some infectious skin diseases have been occurring during unseasonable times in the U.S., including Lyme disease, according to the U.S. Environmental Protection Agency.
Lyme disease first shows up as a “bull’s-eye” rash, but the infection can later manifest into other skin changes.
According to the EPA, new cases of Lyme disease have nearly doubled since 1991, which they label as an indicator of climate change.
Experts say these changes in infectious skin disease patterns are occurring nationwide. The multiple manifestations of climate change — from air pollution to flooding — all contribute to skin and overall health across the entire country. Flooding, such as that recently seen in the Southeast and Northwest, can carry pathogens that can damage the skin, Coates said.
“I think you would be very hard pressed to find someplace in the country that is completely unaffected,” Rosenbach added.
How to help protect your skin
Experts say there are various things you can do if you experience skin conditions or if they seem to worsen during different weather events.
Seeing a board-certified dermatologist is key for proper diagnosis and management of the condition, especially during different climates.
“It really depends on the condition that you’re talking about,” Coates said. “If you have atopic dermatitis (eczema), and you know that wildfire season is approaching, you can be more liberal with your use of moisturizers and emollients that protect your skin barrier from some of the harmful pollutants that can penetrate the skin barrier.”
For infectious skin diseases, it depends on the disease and what causes it, but experts say there are still extra measures you can take.
“It’s important, when you’re hiking outside, to wear long sleeves and to protect yourself from the elements, including mosquitoes and ticks,” Coates said, also adding that it’s good to stay indoors when it’s hot outside.
At COP26, the ongoing U.N. Climate Change Conference in Glasgow, experts are urging nations to take steps to reduce human impact on the environment. They also say everyday people can also make a difference by taking the train rather than flying, buying a hybrid or electric car, or by committing to eating less meat and dairy.
“Climate change is happening to our health,” Rosenbach said. “Now we know what we have to do. But it’s not just about doing it, it’s about how fast we do it.”
Alexis E. Carrington, M.D. is an ABC News Medical Unit Associate Producer and a rising dermatology resident at George Washington University.
