In this issue:
CDC Issues Guidelines for Vaccinated Americans;
Some Call Them ‘Timid’
Some 9.5% of Americans have received all their COVID-19 shots (two for Moderna and Pfizer/BioNTech and one for Johnson & Johnson) as of Monday, and on that same day the Centers for Disease Control and Prevention (CDC) issued guidelines for those who have been completely vaccinated.
The gist is this: Two weeks after your final shot, you can, without a mask, get together indoors with others who have been completely vaccinated. You can also “gather indoors with unvaccinated people from one other household (for example, visiting with relatives who all live together) without masks, unless any of those people or anyone they live with has an increased risk for severe illness from COVID-19.” Plus, if you have been around someone with COVID, you don’t have to “stay away from others or get tested unless you have symptoms.”
But, says the CDC, you should “still avoid medium or large-sized gatherings,” and you should “still delay domestic and international travel” and observe the same recommendation as people who are not vaccinated: “do not travel at this time…. Stay home to protect yourself and others from COVID-19.”
In addition, says the CDC, “you should still take steps to protect yourself and others in many situations, like wearing a mask, staying at least 6 feet apart from others, and avoiding crowds and poorly ventilated spaces.” These precautions are necessary if you are in public, if you’re gathering with unvaccinated people from more than one other household, or if you are visiting an unvaccinated person at risk of severe illness from COVID or who lives with a person at increased risk.
For example, if you’re eating inside in a restaurant, you have no idea whether the other people are vaccinated. Even if you wear a mask, you have to take it off to eat – which means that you will, at the very least, be endangering others, and maybe yourself as well.
The CDC mentions ventilation as helpful, but ventilation falls far short of the effectiveness that brings peace of mind. Ventilation is a process that exchanges air several times a day, but that means that particles of SARS-CoV-2, the virus that causes COVID-19, can be hanging in the air between changes. Ventilation also causes particles to be blown from one side of the room (perhaps the side with an infected person) to another.
Another answer is technology that actively blasts out submicroscopic particles that hunt down and destroy airborne SARS-Cov-2 and other viruses, bacteria, and mold. One company that manufactures PPD technology, Dallas-based ActivePure Technologies, has received Class II medical device clearance from the Food & Drug Administration (FDA).
It’s also important to understand that none of the three vaccines that have received Emergency Use Authorization has 100% efficacy. In other words, Phase 3 trials found that some people who were vaccinated did come down with a COVID-19 infection. As the CDC warns, even if you were completely vaccinated, “you should still watch out for symptoms of COVID-19, especially if you’ve been around someone who is sick. If you have symptoms of COVID-19, you should get tested and stay home and away from others.
Some experts were unhappy that the CDC did not go farther. “While some guidance is better than no guidance,” wrote Leana S. Wen, the former health commissioner of the City of Baltimore and a columnist for the Washington Post, “the guidelines are too timid and too limited, and they fail to tie reopening guidance with vaccination status. As a result, the CDC missed a critical opportunity to incentivize Americans to be vaccinated.”
The CDC admits that scientists are “still learning how effective the vaccines are against variants of the virus that causes COVID-19. Early data show the vaccines may work against some variants but could be less effective against others.” An advantage of active seek-and-destroy systems is that, as mass-pathogen neutralizers, they are likely to be just as effective against SARS-CoV-2 variants – not to mention airborne bacteria.
After Trader Joe’s Worker Asks for Protection
Against Airborne COVID, He Is Fired, Then Reinstated
Six days following a report in Newsweek that a Trader Joe’s employee was fired after writing a letter to the grocery chain’s CEO asking for better protections against the COVID-19, the company issued an update on how it is “caring for crew members and customers” during the pandemic.
Trader Joe’s cited wellness checks, mask mandates, reduced store hours, enhanced cleaning, extra pay, plexiglass barriers, and other steps. The company’s update, however, did not appear to address the main complaint in the letter from Ben Bonnema, the worker who was fired.
Bonnema’s letter was reproduced in a Tweet that went viral. That letter referred to a Feb. 15 letter from 13 scientific experts, including three members of President Biden’s COVID-19 task force, to Jeffrey Zients, the President’s COVID coorindator; Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC); and Tony Fauci, director of the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (NIH). The letter from the experts demanded that the Administration update guidance on battling the spread of COVID-19 through the air in enclosed spaces.
Outdated guidelines from the Trump Administration “have not been…strengthened to address and limit inhalation exposure to small aerosol particles,” said the letter.
Bonnema, who was employed in a New York City store and reinstated on March 3 after widespread media attention, asked for better ventilation, with more air changes per hour, and improved filtration. “We should be following the guidelines of scientists who study respiratory transmission,” he wrote. Bonnema did not mention proactive pathogen destruction devices, which dispatch particles to seek out and eliminate the SARS-CoV-2 virus that causes COVID-19.
And Trader Joe’s, in its “Coronavirus Update” on safety steps, made no reference to ventilation, filtration, or more active measures.
David Michaels of George Washington University, one of the 13 authors, Tweeted on Feb. 28, after the Newsweek article appeared: “A reminder to all employers: it is a violation of the Occupational Safety and Health Act to retaliate against a worker for raising safety concerns. Workers often have the best understanding of hazards they face, and how they can, and must, be protected.”
At first, a Trader Joe’s spokesperson said that Bonnema’s “suggestions were listened to” but that he was “terminated…because of the disrespect he showed our customers.” He was then reinstated and the update issued.
A Pill for COVID Patients Who Aren’t Hospitalized
"I'm as enthusiastic about vaccines as anybody you've ever met. But at the same time, I'm a realist," said Francis Collins, director of the NIH in an interview on CBS’s 60 Minutes on March 7. "We know that vaccines are not going to reach everybody across the entire planet in the next couple of weeks. People are going to continue to get sick in the meantime.... We need treatments for those people."
So far, NIH recommends only two pharmaceuticals for treatment of patients hospitalized with COVID-19 and requiring supplemental oxygen: remdesivir, which now goes by the brand name Veklury, and dexamethasone, a corticosteroid used to treat rheumatic problems and other diseases. Both are administered intravenously. But another drug is on the horizon – one that may fill a crucial gap.
“A big need right now,” said Collins, “is for a drug that you could take by mouth, that you could be offered as soon as you have had a positive test, and that would reduce the likelihood that the virus is going to make you really sick.”
The subject of the 60 Minutes segment was just such a drug. Called fluvoxamine, it was approved in 2007 to treat obsessive-compulsive disorder. It has been used and monitored for side effects for over a decade. “Fluvoxamine could certainly be something you want to put in the tool chest,” said Collins. “If it is a way of getting us further towards that goal of having fewer and fewer people really sick from this disease, then we want to pursue it as vigorously as we can.”
Eric Lenze, of the Deparment of Psychiatry at the School of Medicine of Washington University in St. Louis, led a small randomized trial of fluvoxamine that was reported in a peer-reviewed article on Nov. 20 in JAMA, the Journal of the American Medical Association. One of Lenze’s colleagues, a fellow psychiatrist, told him she suspected the drug might work against COVID-19.
The trial found that not a single patient who took fluvoxamine within 7 days of the onset of COVID-19 suffered a clinical deterioration about 15 days, compared with 6 patients, or 8.3% of the sample, who took a placebo. The authors called this difference “statistically significant” but said that determination of clinical efficacy would require larger randomized trials with more definitive outcome measures.” A larger trial is now underway, with 1,100 participants in five sites in the United States and Canada.
One advantage of fluvoxamine besides its being a pill and not an intravenous treatment: It is an inexpensive generic drug.
Meanwhile, another therapeutic, Molnupiravir, is showing promise. The antiviral was originally developed at Emory University and was later acquired by Miami-based Ridgeback Biotherapeutics, which partnered with the global giant Merck & Co. to continue development.
A study published in Science Translational Medicine last April found that the drug “inhibits SARS-CoV-2 in human airway epithelial cell cultures and multiple coronaviruses in mice.” A study in December, published in Nature Microbiology found the drug “blocks SARS-CoV-2 transmission in ferrets.” On March 8, the publication PrecisionVaccinations.com reported:
On January 25, 2021, Merck stated Molnupiravir is currently being evaluated in Phase 2/3 clinical trials in both the hospital and out-patient settings. The primary completion date for the Phase 2/3 studies is May 2021. The company anticipates initial efficacy data in the first quarter of 2021, which Merck plans to share publicly if clinically meaningful.
How a Chain of Alaska Exercise Clubs Encases
Its Members in a Sanitized Envelope
In an interview with station KTUU-TV, the NBC affiliate in Anchorage, Alaska, the CEO of the state’s largest chain of exercise clubs explained how he created “a full envelope sanitizing system” to keep members coming. Robert Brewster, CEO of the Alaska Club said that hand sanitizers, masks, and additional cleanings were obvious operating procedures, but he went much further with “a significant amount of capital improvements.”
They included upgrades for touchless entry, commercial-grade HEPA filters, electrostatic sprayers and foggers as well as “the installation of ActivePure throughout our facilities,” Brewster said, referring to a technology that evolved from the NASA space program in the 1990s and has been cleared by the FDA.
As a result, said Brewster, “we’ve had over 800,000 visits to the facilities since we’ve reopened and the pandemic has been underway, and we’ve had zero reported cases of COVID among our membership or among our employees that seem to have been transferred here at the club.”
Charlie Sokaitis, the KTUU reporter, also interviewed Joseph Urso, CEO of ActivePure Technologies, who explained how his devices at the Alaska Club work using an old video game analogy: “Imagine that you have a million different Pac-Men flying through the air gobbling up pathogens safely while you’re in the room.” Urso said that his company’s devices are being used in hospitals, schools, office buildings, homes, and more.
Brewster said that the Alaska Club has not yet returned to the same level of member activity as before the pandemic, but the gap has started to shrink.
Open Letter in NY Times Urges Biden to Back
Technology to Eliminate COVID Virus in Indoor Air
“Any plan to bring America back must deploy technology that can eliminate SARS- CoV-2, the COVID virus, from interior air – safely and immediately,” stated an open letter to President Biden, published in the New York Times on Feb. 25.
The letter also quoted Linsey Marr, Charles P. Lunsford Professor of Civil and Environmental Engineering at Virginia Tech University, as saying, “It’s time to stop pussyfooting around the fact that the virus is transmitted mostly through the air.” Marr was one of 13 public health experts to sign a letter to Biden’s COVID Coordinator, CDC Director, and Dr. Anthony Fauci, warning of the dangers of contaminated aerosols lingering indoors and calling for action to limit transmission.
Urso, the author of the New York Times open letter, noted that his company has a system “that destroys the COVID virus in the air and [has] deployed it for decades…. It evolved from the NASA space program and is now used by hospitals, schools, offices, restaurants, and other businesses, and in hundreds of thousands of homes.”
Urso added, “By contrast, ventilation does not seek out the virus. Other systems are passive, slow, trap pathogens but don’t destroy them. Many are so dangerous, people can’t even be in the room. By contrast, our technology blasts out sub-microscopic particles that attack viruses and bacteria and destroy them in real time. Our system is safe for people and pets, and it works continuously.
The letter called such technologies, which actively and immediately seek and destroy pathogens, “the missing link.” Urso wrote, “Other U.S. companies may have similar solutions in the future, but spending billions on inferior systems now is wasteful.”
He added, “Every school in America should be benefiting from the science. So should meat-packing plants, grocery stores, health clinics, arenas and restaurants struggling to survive…. Bringing America Back depends on it.”
Providing Health Equity in the Pandemic
This newsletter focuses on innovation in the fight against COVID-19, so it makes sense for us to take note of the way President Biden is addressing the disproportionate impact of the pandemic on America’s most vulnerable communities.
Last month, he announced the members of his COVID-19 Health Equity Task Force. A White House statement said that, with the outbreak of the pandemic, “inequities were quickly evident by race, ethnicity, geography, disability, sexual orientation, gender identity, and other factors.”
The Task Force is headed by Marcella Nunez-Smith, associate professor of medicine and epidemiology at the Yale School of Medicine, where she also founded the Equity Research and Innovation Center. Dr. Nunez-Smith is also one of the three co-chairs of the overall COVID-19 Task Force, announced in November.
In a press conference on Feb. 9, Dr. Nunez-Smith said that the Administration would “be partnering with federally qualified health centers, also known as community centers.” There are more than 1,300 of these around the country, serving 30 million people, two-thirds of whom live at or below the poverty line “and 60 percent of patients…identify as racial or ethnic minorities.” These health centers will now become direct recipients of vaccine doses as soon as next week.
Minorities Twice as Likely to Die
This focus on vulnerable communities is urgent. The CDC reported on Feb. 12 that African Americans were 10% more likely than whites to become infected with COVID-19 and 90% more likely to die. Hispanics were 30% more likely to become infected than whites and 130% more likely to die. Native Americans appear to be most vulnerable of all, by comparison. They are 90% more likely to become infected and 140% more likely to die.
Taken together these three minority groups, are about one-third more likely than whites to become infected but more than three times as likely to be hospitalized and more than twice as likely to die. In other words, when they do get the disease, they get far sicker.
Nor is it a secret that minorities are reluctant to be vaccinated. According to Healthline:
A recent report from UnidosUS, the NAACP, and COVID Collaborative revealed that just 14 percent of Black Americans and 34 percent of Latinx Americans say they have trust in the safety of a new COVID-19 vaccine. The study also found that 18 percent of Black and 40 percent of Latinx respondents say they trust COVID-19 vaccine effectiveness.
One reason is the legacy of the Tuskegee experiments on syphilis treatments, which tested black men for 40 years, through 1972, without their informed consent. Blacks have a history of serving as unwitting guinea pigs in health research. No wonder they are reluctant to try a new vaccine. In addition, in many states, securing a vaccine reservation requires advanced computer skills or the leisure to stay on the phone for hours.
We’re already seeing the results. A Kaiser Family Foundation study looked at the 36 states that report vaccination information by race as of March 1. African Americans and Hispanics are being vaccinated at rates dramatically lower than their proportion of the population. For example, in Washington, DC, Black people represent 45% of the total population and 76% of COVID deaths, but they have received only 26% of the vaccinations. In Georgia, Blacks are 31% of the population, 34% of deaths, and just 19% of vaccinations. In California, Hispanics represent 40% of the population, 46% of COVID deaths and just 19% of vaccinations. In Oregon, Hispanics are 13% of the population, 34% of deaths, and 5% of vaccinations. Similar ratios exists across the states.
Increased efforts are absolutely necessary to encourage African Americans and Hispanics to be vaccinated, but the truth is that any plan to mitigate the greater dangers to vulnerable groups needs to include means to destroy COVID-19 indoors – especially in the close-quarters situations in which many minorities work. Restaurant kitchens, health care settings, grocery stores and meat-packing plants are some obvious examples. In addition, many vulnerable groups live in multi-generational households, where older men and women are exposed to younger children, who are often asymptomatic.
The Equity Task Force also includes James Hildreth, an immunologist who was the first African American full professor in the 125-year history of the Johns Hopkins School of Medicine and who is now president of the Meharry Medical College in Nashville; Mary Turner, president of the Minnesota Nurses Association; and Homer Venters, chief medical officer of the New York City jail system and a faculty member at the New York University School of Medicine.
It’s Unlikely COVID Will Ever Get Out of Our Heads
When will life get back to normal? In an interview with LA Times Today recently, Dr. Fauci said, "Hopefully, by the time we start entering 2022, we really will have a degree of normality that will approximate the kind of normality we've been used to.”
An ABC News piece noted that this was a “departure from previous predictions,” including remarks Fauci gave in January. At a conference hosted by the Association of Performing Arts Professionals, he said, "If everything goes right … by the time we get to the early to mid-fall, you can have people feeling safe performing onstage as well as people in the audience," he said on Jan. 9.
For his part, President Biden, at a CNN Town Hall last month, suggested that life could feel normal again during "Christmas."
In fact, life may never get back to normal if normal means that Americans will be unconcerned about what viruses and other pathogens are floating in the air they breathe, especially indoors. The COVID-19 pandemic has made us conscious of the dangers in the air, and that is something that we can’t really unlearn.
A new awareness of such threats is not necessarily a bad thing. For example, the CDC reports that the influenza rate so far this flu season is only 0.7 per 100,000 population: “This is much lower than average for this point in the season and lower than rates for any season since routine data collection began in 2005, including the low severity 2011-12 season. During that season, rates were 2.3 times higher.
Consider New York state. From Oct. 1, 2019 to April 4, 2020, some 19,713 residents were hospitalized with the flu, but from Oct. 1, 2020 through Feb. 26, 2021, only 183 were hospitalized. There are several reasons for the decline, but one is the increased vigilance inspired by the COVID-19 pandemic. We can expect that vigilance to continue well beyond late fall, or Christmas, or early 2022.
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.