Most Americans Still Not Fully Vaccinated
As Variants and Heat Rise Across Nation
The U.S. is unlikely to reach President Biden’s goal of having 70% of adults vaccinated for COVID-19 by July Fourth, but we’ll be close – an estimated 68%. The seven-day average for coronavirus cases has dropped to 11,672 as of June 24, the lowest figure in 15 months, and deaths are down to 314, or an average of six per state, a decline of more than 90% since the January peak.
But serious threats remain:
Dormant or Resurgent
We may not be getting good data, either. There has been a big decline in testing: just 500,000 on June 14, compared with 1.8 million on April 1. A lot more people could have COVID than we know, including people who have been vaccinated but have asymptomatic infections and can spread the disease further. In addition, the CDC is no longer tracking transient infections.
Also, understand that the proportion of Americans over age 18 with at least one shot, currently 66%, isn’t the whole story. The figure for all Americans who are fully vaccinated (two Pfizers or Modernas, or one J&J) is 45%. And in lightly vaccinated states, especially, cases are on the rise. According to CDC data, the states with the highest number of new cases per 100,000 over the past seven days are, in order: Missouri (far and away the worst), Wyoming, Utah, Nevada, Arkansas, Florida, Louisiana, and Colorado.
The essential question is whether the pandemic is dormant and will reemerge in the late summer and fall – when we will have a difficult time reviving mask-wearing and distancing measures -- or whether we have beaten it down for good. But when it comes to mitigating interior spread of the virus, it really doesn’t matter. Even if the SARS-CoV-2 bug leaves, there are many others that need addressing.
As COVID Falls, Other Illnesses Rise
As the pandemic is waning, a new and surprising problem is arising: Americans are getting sicker with non-COVID diseases. We know because of data gathered by California-based Kinsa, a young tech firm that has developed a network of two million smart thermometers that provide early-warning notice of illness around the country.
Kinsa recently took a close look at Texas, as a possible harbinger: “On March 10, 2021, as any other states braced for another wave of the epidemic, Texas took the bold steps of lifting mask mandates and removing other precautionary measures designed to slow the spread of COVID-19.”
COVID cases continued to decline after March 10 in Texas, although at a slightly slower rate than before. But something else happened:
Following the loosening of restrictions, Texas experienced the highest levels in Kinsa’s overall illness signal in more than a year, driven not by COVID, but by other common contagious illnesses like strep, RSV and even some flu, according to diagnostic data.
Especially alarming in Texas has been the sharp increase in RSV, or respiratory syncytial virus, which produces only mild symptoms that last about one or weeks in most people but can be dangerous to infants and the elderly. RSV positivity soared from 0.1% of tests in early April to over 5% by late May, according to Kinsa. The Centers for Disease Control (CDC) notes that “RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lung) in children younger than one year of age in the United States.”
The precautions taken to prevent COVID also prevented other infectious diseases, but when those precautions were lifted, the other illnesses spiked. From late March to early May, for example, the total Texas population with a fever rose from 0.4% to 1.5%. “Though [it is] initially alarming to see so much illness,” writes Kinsa’s Matt Albasi, “this is simply a return to normal…. The road back to normal is paved with illness.”
While much of the media is missing this story, an article in STAT News last month predicted a resurgence in non-COVID viruses -- “perhaps a big one.” The piece, on May 27, quoted Ben Cowling, an infectious disease researcher at Hong Kong University saying, “When they come back there’s going to be vulnerability and probably greater levels of infections.”
In an Axios piece on June 7 with the headline “America’s Next Big Wave of Sick,” Ryan Langlois, associate professor in the microbiology and immunology department at the University of Minnesota, made the point that “you’ve lost one pathway to immunity, which is natural infection” from the previous flu season, when people were masked and socially distant and flu was at the lowest levels on record. "We’ve never been in this situation."
Improving Indoor Air as an Antidote
But should the road back to normal be “paved with illness”? While we can’t expect mask-wearing to persist, now appears to be the time for those responsible for schools, office buildings, hotels, restaurants, theatres and all indoor spaces to improve the quality and safety of indoor air. Two lessons from the COVID pandemic are that, first, this pathogen, like nearly all pathogens, spreads most effectively through indoor air, and, second, our indoor air is not nearly as clean and safe as it should be.
This unclean and unsafe air might be seen as an indictment of the ventilation industry, whose HVAC systems do a good job of keeping rooms at a comfortable temperature but, we are learning, have been inadequate to prevent disease.
These two lessons about interior air should also be seen in the context of a changing environment of public awareness. The pandemic has made people much more conscious of the air around them, and they are almost certain to demand its improvement – COVID or no. The good news is that the funds that the federal government is providing states and localities to battle airborne SARS-CoV-2 in schools and other buildings will also support combatting other pathogens.
If you deploy the right technology, the COVID virus, in fact, is among the easiest pathogens to inactivate because it is an enveloped virus with a vulnerable shell. Harder to kill are non-enveloped viruses, bacteria, and mold spores.
A Future 'New Norm' in India
India has had a rough spring, mainly because of variants and a lack of vaccinations, but in the past two weeks, new cases of COVID-19 have dropped 49%. The experience inspired Rachna Aggarwal to imagine a future world that’s changed because of the pandemic. In the venerable daily New Delhi-based national newspaper The Pioneer, Aggarwal wrote on June 21:
Air purification systems which regulate the PM [particulate matter] level of air are now passe; we must upgrade to technologies that can eliminate biological aerosol contents from the air…. The recent turn of events will bring in a ‘new norm’ wherein air quality certification will be required to gain people’s trust.
Will the public want to enter any building whose air isn’t trusted, in India or anywhere else? It’s doubtful.
‘Meeting Code’ Is Not Enough, Says Harvard’s Allen
Joseph Allen, an expert on interior environments at the Harvard T.H. Chan School of Public Health, puts the situation well, “If you’re still feeling uncomfortable or anxious, that’s totally understandable. “This pandemic has affected all of us in profound ways, and people are going to be ready to re-enter life again or re-enter interacting with people at different times.”
Quoted in a June 11 New York Times article, Allen advised, “One thing you can do before you go back to work is simply [to] ask them what they’ve done. And if you hear things like, ‘Yes, we’re meeting code,’ then that’s a flag that something’s not right. They should be going above and beyond the bare minimum ventilation and filtration rates.”
The article continued:
Although the ideal ventilation rate varies, in general, employers should maximize the amount of fresh air coming in from outdoors, he said. In a relatively small space — say, the size of a typical school classroom — employers should aim for four to six air changes per hour, meaning that the air inside the space is being completely refreshed every 10 to 15 minutes.
Few HVAC systems produce such vigorous air changes, and upgrading a system to do so, as well as to carry heavy-duty filters, means added power – and potentially added damage to the environment. One good solution is supplementing ventilation with air-cleaning technologies that can either be added to an HVAC system without causing a pressure drop or arrayed in stand-alone devices.
Confidence and Caution: ‘This is Not Just a COVID Thing’
In an article headlined, “Consumer expectations: Restoring confidence in the travel experience,” Adam Perkowsky of HotelBusiness.com wrote that hoteliers and guests are, of course, concerned about “air quality as it relates to the transmission of COVID-19 particles and other airborne pathogens.”
The piece quoted one industry expert as saying, “This is not just a COVID thing. The links between air quality and cognition and susceptibility for long-term disease are supported by years and years of research. The pandemic was an ignition switch to raise awareness that what we breathe matters—that indoor air quality is oftentimes a lot worse than outdoor air quality and that needs to be addressed.”
Actually, it is rare that indoor air quality is not worse than outdoor air quality. The aim of the best air purification systems is to produce chemical changes to render indoor air as clean as outdoor, which has the advantage of solar cleansing.
Unfortunately, while many devices make claims, few are effective and safe enough to have 501k FDA clearance as a Class II Medical Device. One that does have such clearance is the Medical Guardian, which deploys the same Advanced Photocatalysis (AP) technology used in all products made by Dallas-based ActivePure, whose corporate roots go back nearly a century. AP technology evolved from photocatalytic oxidation (PCO), a process which, unlike proprietary AP, can, in its more rudimentary early forms, generate ozone and volatile organic compounds (VOCs).
New purveyors of air-cleaning products are popping up, and the HotelBusiness article urges caution: “There are so many gimmicks out there. [There is a] need to separate fact from fiction as it relates to manufacturers’ claims on what their units can do.”
An article in a Missouri newspaper on June 21 noted that Kansas City schools purchased devices that rely on technology that involves emitting ions that cause particles in the air to cluster, which, the manufacturer says, makes them easier to trap in an HVAC system. The company behind the technology, says the article, “is facing a federal lawsuit filed by a consumer who bought one of its devices, alleging the company ‘continues to defraud consumers by concealing material information regarding the true performance’ of its products.” (The company says the suit is baseless.)
In another example, a study by researchers from Colorado State University, Portland State University and the Illinois Institute of Technology found that in chamber and field tests “an ionizing device led to a decrease in VOCs [such as] xylenes, but an increase in others, most prominently oxygenated VOCs (e.g., acetone, ethanol) and toluene, substances commonly found in paints, paint strippers, aerosol sprays and pesticides.”
A release issued by Colorado State about the study stated:
According to the EPA, exposure to VOCs has been linked to from eye, nose and throat irritation, headaches, loss of coordination and nausea, to damage to liver, kidney and central nervous system, and some organics can cause cancer in animals, some are suspected or known to cause cancer in humans. The study, published May 15 in the journal Building and Environment, mimicked real-world operating conditions for these ionization devices to test the effectiveness and potential to form chemical byproducts in environments similar to where we all live, work, and learn.
Former Surgeon General’s Advice
The reference to “real-world operating conditions” is important, and it reminds us of the set of five questions that former Acting Surgeon General Kenneth Moritsugu posited in an article we cited in our newsletter No. 6. The original piece appeared on the RealClearHealth site on May 20, and its aim was to help the many school, state, city and country administrators, as well as owners of private businesses and facilities managers that have to decide the best way to mitigate the dangers of SARS-CoV-2 and other pathogens.
Ventilation is part of the answer, but another layer of protection is needed. Here are the five questions from Dr. Moritsugu:
Survey Finds Big Mitigation Outlays With Limited Success
Reinforcing the need to ask the right questions is a recent survey of 430 facilities managers, reported June 23. It found that 60% improved their HVAC systems to battle COVID-19. But, according to a CleanLink article, “HVAC upgrades are quite expensive, typically costing more than $500,000 and in some cases as much as $5 million.” The survey found that managers “vastly underestimated” the cost of these improvements. The article continued:
Additionally, for an upgraded HVAC system to improve air quality, it must operate continuously while the building is occupied, which is very expensive. In other cases, businesses felt compelled to try relatively new and unproven ionization technologies, which are increasingly under attack from academics and government agencies for being ineffective and possibly dangerous.
The survey found that 60% of surveyed companies spent more than $500,000 upgrading or installing HVAC systems and that nearly all respondents took some kind of measure to stop interior spread. But, said the article, the survey found that the managers “often made subpar investments, spending millions of dollars with limited success.”
Said Paul de la Port, the CEO of Omni ClearAir, a commercial manufacturer of air purification systems and sponsor of the survey: “The noisy environment, lack of transparent and easily understood real-world efficacy data, and unscrupulous COVID-19 opportunists appear to have clouded the landscape so much that many businesses simply were unable to make informed investment decisions about indoor air quality solutions.”
He added, “What many businesses don’t realize is that HVAC systems, even when they can eliminate the virus, require large amounts of electricity to operate, so the long-term cost will be very burdensome and the resulting air often won’t be adequately cleaned.”
In this issue:
“We expect clean water from the taps. We expect to have clean, safe food when we buy it in the supermarket. In the same way, we should expect clean air in our buildings and any shared spaces,” said Lidia Morawska, an aerosol physicist at Queensland University of Technology in Australia. She was one of 39 scientists, including Joseph Allen of Harvard and William Bahnfleth of Penn State who, writing in Science magazine on May 14. called for a “paradigm shift” in the way policy makers and individuals think about the quality of indoor air.
In a New York Times article, Aporova Mandavilli called the Science magazine article “a manifesto of sorts” and noted, “The pressure to act on preventing airborne spread has recently been escalating.” She wrote: “Clean water in 1842, food safety in 1906, a ban on lead-based paint in 1971. The sweeping public health reforms transformed not just our environment, but expectations of what governments can do.”
COVID-19, of course, was the catalyst for this new interest in clean interior air, but the need for mitigating pathogens extends well beyond the end of the pandemic. The failure to address airborne dangers is not merely regulatory. Large companies engaged in ventilation bear a good deal of the blame as well because the technology exists to mitigate the problem. It is just not being applied. The Science manifesto states:
Airborne pathogens and respiratory infections, whether seasonal influenza or COVID-19, are addressed fairly weakly, if at all, in terms of regulations, standards, and building design and operation, pertaining to the air we breathe. We suggest that the rapid growth in our understanding of the mechanisms behind respiratory infection transmission should drive a paradigm shift in how we view and address the transmission of respiratory infections to protect against unnecessary suffering and economic losses. It starts with a recognition that preventing respiratory infection, like reducing waterborne or foodborne disease, is a tractable problem.
Questions for Officials (and the Rest of Us) to Ask Before Buying Devices to Mitigate the Spread of Airborne Virus
In the U.S., COVID-19 cases are falling, but more than 140,000 Americans were infected last week, and public health authorities have at last recognized that the main culprit is interior spread of the SARS-CoV-2 virus. The federal government is allocating billions of dollars to state and local government for mitigation efforts inside buildings.
The American Rescue Plan, signed into law March 11, includes $130 billion to help schools reopen in the fall. That money can go to such uses as reducing class sizes, purchasing personal protective equipment, and buying devices to prevent interior spread of the COVID-19 virus through the air.
On May 10, the U.S. Treasury specified the way that a separate tranche of $350 billion in Coronavirus State and Local Fiscal Recovery Funds under the Rescue Plan may be used by state, county, large-city, and tribal governments. One of those uses was “prevention, mitigation or other services in congregate living facilities or schools”; another was addressing the safety of air in “key settings like health care facilities.”
Imagine you’re a public school, university, or hospital administrator. Or a mayor, county executive, or governor. Or someone in charge of a childcare or senior facility or recreation center. The federal government has bestowed millions or billions of dollars on your office – a windfall of enormous importance. You want to spend a significant portion of the funds on protecting citizens against airborne and surface SARS-CoV-2 and other pathogens, but how do you decide which technology is best?
In a RealClear Health article on May 20, former Acting Surgeon General Kenneth Moritsugu, tackled the problem by providing a set of five questions that officials and other purchasers should be asking. Moritsugu is a retired Rear Admiral, a physician and public health administrator who was the first Asian-American to serve as Surgeon General.
“Demand for equipment that can help mitigate and prevent the spread of COVID has exploded,” he wrote, “but don’t buy in a panic. Ask the right questions and invest in the technologies that are best suited for the specific need, based on science and proven evidence. Good choices made today can help keep students and others safe from COVID-19 and other viruses, bacteria, and molds.”
Here are the questions that purchasers of equipment should ask:
Moritsugu notes that, “while improved ventilation systems can help, conventional air filters try to trap pathogens but may miss a large proportion of virus-sized particles. Look for technologies with filters that work at the viral level or deploy microscopic particles to search and destroy pathogens in the air and on surfaces rather than just trying to filter them out.”
He also points out that to “use ultraviolet (UV) light to deactivate COVID viruses, the light has to be so strong that it could damage the retina – which is why surgical theaters are cleared when UV is utilized. Other systems, especially those using outdated version of photocatalytic oxidation (PCO), generate ozone and toxic byproducts. Be sure to ask for data and evidence that a system is safe.”
That last point is critical. Very few devices are equipped with technology that has FDA clearance, and few companies that sell equipment can provide testing data. Be demanding. Lives are at stake.
‘A Wave of Liability Claims’ for COVID Infection Is Expected
An article published in Risk & Insurance, a trade journal, says that business interruption cases, which were popular in the early stages of the COVID pandemic, are being replaced by “a wave of liability claims [that] is rolling in.” Says the piece: “Though plaintiffs will have a tough time blaming businesses for exposure to the virus, [insurance] carriers are nonetheless prepping defense strategies and emphasizing risk mitigation to clients.”
The reporter, Kate Dwyer, writes, “Of course, the best way to limit exposure to liability claims and ensure an expeditious closure to any that do come forward is to keep premises as safe as possible.” She quotes Stephen Jones of Praedicat, a data firm, as predicting that “COVID-related liability litigation could reach roughly $19.6 billion, with another $1.4 to $3.8 billion in associated securities lawsuits.”
In a piece on Bloomberg Law’s Daily Labor Report, Chris Marr concurs: “Business groups fear [a] flood of lawsuits as yet unseen.”
Liability Shields in the States Vary Widely
Many states have offered protections to businesses through liability shields. While some of these laws are close to expiration, others are being extended as the disease continues to afflict Americans. Florida, Oklahoma, and West Virginia have even enacted shields with no expiration date.
The Florida law, signed March 29, is particularly favorable to businesses. If a business makes a “good faith effort to substantially comply with authoritative or controlling government-issued health standards or guidance at the time the cause of action accrued,” then the business is immune from liability. Under South Dakota’s law, plaintiffs can only bring cases if they get sick as a “result of intentional exposure with the intent to transmit COVID-19.”
About half of all states have extensive COVID liability shields. They are mainly in the South and Midwest, and nearly all have Republican legislatures. States with limited shields, or none at all, are concentrated in the Northeast and West Coast but also include Illinois, Minnesota, and Colorado, according to a Bloomberg Law analysis. Rhode Island, for example, extends ample protections to health care workers but “not all businesses are insulated,” writes attorney Samantha Vasques of the firm Locke Lord.
In a May 11 article, Vasques cites Tennessee’s law as typical. It…
…provides that individuals or businesses cannot be liable for loss, damage, injury, or death that arises from COVID-19 unless the party filing suit against them proves by clear and convincing evidence that they caused the injury by an act of omission constituting gross negligence or willful misconduct.
Marr quotes Thomas J. Mew, a plaintiffs-side employment lawyer in Atlanta as saying that places such as nursing homes face a bigger risk of litigation. “From a practical level,” he said, “it’s generally going to be challenging to prove that one contracted COVID-19 at a particular place,” especially one that a customer visits for only a few minutes or an hour.
Still, said Ashley Cuttino, a Greenville, S.C., lawyer, we are seeing virus-related liability suits. “We’re just not seeing tens of thousands of them.” Cuttino said that the shield laws are working to limit lawsuits “and get businesses reopened in a safe manner.”
Rumrill v. Princess Cruise Lines Ltd., filed in April 2020, was of the earliest cases. Cited in the Risk & Insurance article, it involved a couple that claimed they contracted COVID on a ship because of the cruise line’s “lackadaisical approach to safety.” A federal judge tossed out the case but let the plaintiffs amend their suit. Wrote Dwyer:
To build a stronger argument, the couple must demonstrate they were likely exposed on the ship given the exact date they began experiencing symptoms and the virus’s incubation period. Building that link between time of exposure, incubation period and symptom onset would be “a key fact necessary to render the causation allegations plausible, not merely possible,” the judge said, essentially laying the foundation for future plaintiffs’ arguments.
Dwyer concludes, “Insurers expect this type of claim to increase in frequency as restrictions continue to loosen and courts open back up.”
In Schools, a Policy of Ventilation-Plus Cuts COVID Cases
“To date, there have been no U.S. studies comparing COVID-19 incidence in schools that varied in implementing recommended prevention strategies,” such as mask wearing and improvements in air circulation and purification, write a dozen researchers from the Georgia Department of Public Health and the Centers for Disease Control and Prevention (CDC).
Those researchers set out to rectify that situation in a study published May 28 in Mortaility and Morbidity Weekly Report (MMWR), the indispensable publication of the CDC. Examining 169 schools with varying policies in Georgia between Nov. 16 and Dec. 11, 2020, they found that “COVID-19 incidence was 37% lower in schools that required teachers and staff members to wear masks and 39% lower in schools that improved ventilation.”
Researchers also look at schools that deployed “ventilation-plus” – that is, they augmented simple ventilation, which exchanges inside air for outside, with “methods to filter airborne particles with high-efficiency particulate absorbing (HEPA) filtration” or with or ultraviolet germicidal irradiation (UVGI). Ventilation-plus caused COVID-19 incidence to fall to 48% below incidence in schools with no air improvements. In other words, adding filtration or UVGI, increases the rate of mitigation over simple filtration by about one-fourth.
The authors conclude that “in rooms that are difficult to ventilate or have an increased likelihood of being occupied by persons with COVID-19 (e.g., nurse’s office), installation of HEPA filters or UVGI should be considered.”
Filtration is slow, and UVGI at high levels is dangerous for people. The research did not examine classrooms that used air cleaning or purification technology that goes beyond these methods, such as enhanced photocatalytic oxidation of the sort developed by ActivePure, a Dallas company that has installed its devices in many schools. This technology can inactivate much smaller particles, at much faster speeds, than filtration.
The authors urge “a multicomponent approach to school COVID-19 prevention efforts” and write that “universal and correct mask use among teachers and staff member and improved ventilation are two important strategies that could reduce SARS-CoV-2 transmission as schools continue, or return to, in-person learning.”
Adult Vaccinations in U.S. Seem to Be Hitting the Wall
More than half of U.S. adults are now fully vaccinated – a proportion exceeded only by Israel, Bahrain, and Chile and a remarkable achievement in just six months. But now, vaccinations are running into a brick wall. “Few who are eager to get a shot remain unvaccinated”: that’s the conclusion that the Kaiser Family Foundation is drawing from its latest survey, released May 28.
“Nearly all adults who are eager to get a COVID-19 vaccine now have already gotten at least one shot,” says KFF in a press release. The foundation’s latest polling shows that 62% of U.S. adults have gotten at least one dose – up just 6 percentage points from April. The share of those who say they want a shot “as soon as possible” dropped from 9% in April to 4% in April.
What’s particularly disturbing is that the proportion saying they will “definitely not” get a shot has been stuck at 13% in every monthly survey since January – and those saying “only if required” has been stuck at 7%. In other words, one-fifth of adults are adamantly opposed to COVID vaccination and haven’t changed their minds.
The proportion saying they will “wait and see” has dropped since January from 31% to 12%, but that number too seems to have stalled out. Also grim: KFF found that 40% of parents of children under 12 answered “definitely not” or “only if required” when asked if they would have their kids vaccinated.
Factors That May Accelerate Vaccinations
Two developments, however, could cause vaccinations to increase. First, Pfizer and BioNTech, developers of the first vaccine to receive Emergency Use Authorization from the U.S. Food & Drug Administration (FDA), last month asked for full authorization. The application process for a Biologics License normally takes about a year, but Pfizer is seeking a priority six-month review. Approval will allow the partners to market the vaccine directly to consumers.
It could also give greater confidence to vaccine-hesitant Americans whose reluctance, despite a flood of positive data, may be based on notion that they’re getting a treatment that has been given swift “emergency” approval rather than longer, more detailed consideration.
The second development is that more employers, schools, airlines, retailers, and other public institutions will start requiring vaccinations. But that change is far more likely to occur after full authorization of the vaccine. As the New York Times reported:
The University of California and California State University school systems, for instance, have announced that once coronavirus vaccines receive full F.D.A. approval, they will require students, faculty and staff members to be vaccinated. The U.S. military, which has seen many troops decline coronavirus vaccines, has said that it would not make them mandatory as long as they have only emergency authorization.
Still, anyone who is responsible for the safety of others should be aware that the U.S. is unlikely to reach herd immunity and as much as one-third of the population may never be vaccinated (the proportion today is 41%, according to Johns Hopkins University). In addition, Anthony Fauci, director of the NIH Institute for Allergy and Infectious Diseases, said on May 26 that booster shots will be needed as the effect of the initial vaccination wears off.
“Even with vaccination efforts in full force, the theoretical threshold for vanquishing COVID-19 looks to be out of reach,” said a recent article in the scientific journal Nature.
The COVID-19 virus or, at the very least, fears of its resurgence, will likely be with us for a long time.
The Problem of Virus Variants
Then, there is the problem of SARS-CoV-2 mutating into slightly different viruses that current vaccines cannot combat as effectively. “The emergence of variant strains is arguably the greatest threat to control of the Covid-19 pandemic,” says a piece in the May 20 issue of New England Journal of Medicine by Kathleen Neuzil of the University of Maryland School of Medicine.
The piece cites two recent peer-reviewed trials reported in the NEJM. They evaluated the performance of vaccines in battling the B.1.351 variant, first identified in South Africa. The variant “has shown evidence of increased transmissibility, a considerable reduction in neutralization by convalescent and postvaccination serum, and significantly decreased neutralization by monoclonal antibodies.”
One of the vaccines, AstraZeneca’s ChAdOx1 nCoV-19, “conferred no efficacy…against mild-to-moderate disease caused by the B.1.351 variant.” No severe cases were reported for either the vaccine or a placebo, so no conclusions could be drawn on that score. Overall, writes Neuzil, “the lack of efficacy against nonsevere disease…is disappointing,” especially because the AstraZeneca vaccine has “has highly favorable stability and storage characteristics, can be produced by multiple global manufacturers to supply billions of doses, and is well positioned for global vaccine distribution.”
The second vaccine, NVX-CoV2373, developed by Novovax, a biotech company based in Gaithersburg, Md., had an efficacy of 49.4% against symptomatic COVID-19 caused by the South African variant – a result that Neuzil characterized as “modest.” But Novovax reported that all five cases of severe disease occurred in the South Africa trial occurred in the placebo group, so the efficacy rate was 100%.
Neuzil also reported data from two other trials that included South African participants. The Johnson & Johnson vaccine (Ad26.COV2.S) “showed significant efficacy against moderate-to-severe disease” at 64%, “with higher efficacy against severe-to-critical disease,” at 82%. The second trial, which included only 800 South African participants, found no cases among those given the Pfizer-BioNTech vaccine (BNT162b2), compared with nine in the placebo group.
Some of these results are encouraging, but Neuzil writes that “SARS-CoV-2 will continue to replicate in humans, mutations with continue to occur, and variants of concern will continue to emerge.” New vaccines will almost certainly be needed to address difficult variants. While drug companies will become even more adept at developing them and “faster production timelines will facilitate the manufacturing of new vaccines,” distributing booster doses will still be an arduous process.
COVID Solutions Bulletin | a publication providing regular updates on new and existing technologies that can help stop the spread of COVID-19, and help clear the air to open America back up.
For more information visit www.COVIDsolutionsbulletin.com.
COVID Solutions Bulletin
Our mission is to educate people on innovative solutions to the COVID-19 crisis in America. We need to get back to work, to school, to play – to enjoying life. We can’t get there without thwarting the current pandemic and preparing for the possibility of other pathogens to come.
COVID Solutions Bulletin is a publication providing regular updates on new and existing technologies that can help stop the spread of COVID-19, and help clear the air to open America back up.