The Dubai Supreme Committee of Crisis and Disaster Management and the Abu Dhabi Emergency Crisis and Disasters Committee for COVID-19 Pandemic in the United Arab Emirates (UAE) have introduced new measures to curb the second wave of COVID-19 cases.
On Feb. 1, the Dubai Committee announced that, effective the following day and for the duration of the month of February, all pubs and bars in Dubai must close, while restaurants and cafes must close by 1:00 am. Shopping malls, hotels, private beaches in hotels and swimming pools may operate at 70 percent capacity. Theaters, other indoor venues and sports venues must operate at a maximum capacity of 50 percent. Entertainment activities in restaurants and cafes are no longer permitted.
The Dubai Committee has urged the public to report violations by calling the Dubai police or by using the Dubai police app. There have been reports of recent prosecutions for violations, including the imposition of fines.
On Feb. 7, the Abu Dhabi Committee announced that, effective the same day and until further notice, parties and gatherings are prohibited and theaters shall be closed. No more than 10 persons may attend a marriage ceremony or a family gathering, and no more than 20 may attend a funeral or mourning service.
Malls are limited to 40 percent capacity, and gyms, private beaches and swimming pools are limited to 50 percent capacity. Restaurants, coffee shops, hotels, public beaches and parks may operate at 60 percent capacity. Taxis and buses may operate at 45 percent and 75 percent capacity, respectively.
The Abu Dhabi Committee also announced new rules on entry into the Emirate of Abu Dhabi, effective Feb. 1. Any individual entering Abu Dhabi from another emirate must enter Abu Dhabi within 24 hours of taking the DPI (Diffractive Phase Interferometry) test instead of 48 hours. The same DPI test result cannot be used for two consecutive entries into Abu Dhabi. Those who entered Abu Dhabi on the basis of a DPI test and who plan to continue their stay for more than 48 hours must take a PCR (Polymerase Chain Reaction) test on the third day following entry and another PCR test on the seventh day.
The validity of the PCR test result to enter Abu Dhabi continues to be 48 hours; however, another PCR test must be performed on the fourth day and on the eighth day following entry. The day of entry into Abu Dhabi is considered as day one. These requirements are not applicable to volunteers in clinical trials or to persons who have been vaccinated.
Moreover, all employers in Abu Dhabi have been directed to require their staff who have not been vaccinated to undergo a PCR test at least once a week.
In addition, Abu Dhabi has updated the "green list" of countries for travelers arriving by air. The new green list as of Feb. 7 is:
Individuals travelling from these countries are not required to quarantine upon arrival; however, they must perform a PCR test on arrival and repeat another PCR test on day six following arrival. Persons arriving from other countries must quarantine for 10 days following arrival and must also take a PCR test on arrival and again on day eight following arrival.
Finally, Ministerial Resolution 21 of 2021, promulgated by the Federal Minister of Health and Prevention and effective Feb. 7, provides that PCR tests will be given free of cost at all Ministry centers. The provision applies to all UAE nationals and all persons holding UAE visas.
Charles S. Laubach is an attorney with Afridi & Angell in Dubai, UAE.Dimple Soni is a paralegal with Afridi & Angell in Dubai. 2021 Afridi & Angell. All rights reserved. Reposted with permission of Lexology.
UAB experts explain why women should not have concerns about the COVID-19 vaccines impacting their fertility goals.
UAB experts explain why women should not have concerns about the COVID-19 vaccines impacting their fertility goals.As more data and information become known about the COVID-19 vaccinations available to the public, more questions arise from specific populations about how the vaccine could potentially impact their health.
For women of child-bearing age and those wishing to pursue pregnancy in the near future, weighing the risks and benefits of receiving a COVID-19 vaccine are a top priority. Is there any reason to have concerns about the vaccines impact on fertility? Two University of Alabama at Birmingham School of Medicine experts explain why the vaccine is a safe and effective way to protect oneself from COVID-19, regardless of fertility aspirations.
In a joint statement from leading womens reproductive professional organizations the American College of Obstetricians and Gynecologists, the American Society for Reproductive Medicine, and the Society for Maternal-Fetal Medicine, experts say:
As experts in reproductive health, we continue to recommend that the vaccine be available to pregnant individuals. We also assure patients that there is no evidence that the vaccine can lead to loss of fertility. While fertility was not specifically studied in the clinical trials of the vaccine, no loss of fertility has been reported among trial participants or among the millions who have received the vaccines since their authorization, and no signs of infertility appeared in animal studies. Loss of fertility is scientifically unlikely.
Deidre Gunn, M.D., assistant professor and fertility specialist in UABs Division of Reproductive Endocrinology and Infertility, echoes the organizations statement and agrees there is no reason to believe that the vaccine would be harmful to pregnant or lactating women or to those trying to conceive.
Based on the available data in both humans and in animals the vaccine does not affect fertility, but it does significantly lower the risk of COVID infection and the risk of severe complications from COVID, Gunn said. Individual circumstances may vary, and patients should talk to their doctors about any questions or concerns; but in general, the benefits of the COVID vaccine outweigh the risks for most pregnant women and women trying to conceive.
Gunn notes that, although pregnant women were not included in the first vaccine trials, some women did become pregnant during the study period; in fact, a similar number got pregnant after receiving the vaccine as those who got the placebo, suggesting that there was no adverse effect on fertility.
Similarly, Jodie Dionne-Odom, M.D., associate director of Global Health in the UAB Center for Womens Reproductive Health and infectious diseases consultant on the American Society for Reproductive Medicines COVID-19 Task Force, explains that misinformation can be a factor in why women are objecting the vaccine, if eligible.
Some women are hearing dangerous myths about the COVID-19 vaccine, Dionne-Odom said. In response to misinformation, I find it helpful to be direct and clear: There is no scientific data that supports a link between COVID-19 vaccine and changes in fertility. When I talk to women who are interested in becoming pregnant now or down the road, I strongly encourage COVID-19 vaccination since it offers the best protection.
For women who anticipate becoming pregnant in the next few months or near future, both Gunn and Dionne-Odom caution that the risk of COVID-19 infection during pregnancy could be more detrimental to a womans health, a risk that receiving the COVID-19 vaccine could prevent.
COVID infection is much more dangerous for pregnant women compared to women the same age who are not pregnant, Gunn said. If you get COVID while pregnant, you are much more likely to be in the ICU, on a ventilator, with a higher risk of death. There is also a higher risk of preterm birth and related complications. Knowing that the benefit of vaccination outweighs the potential risk of infection complications should give those contemplating pregnancy a sense of relief. We have the protection we need; it is important to encourage those who are healthy and eligible to become inoculated.
Notably, Gunn adds that preliminary vaccine evidence is starting to suggest that a woman who receives the vaccine during pregnancy actually passes on helpful antibodies to the baby.
There are some clues already. Researchers have identified an association between type O and rhesus negative blood groups, and a lower risk of severe disease. But while scientists have hypothesised that people with certain blood types may naturally have antibodies capable of recognising some aspect of the virus, the precise nature of the link remains unclear.
But Bobe is far from the only scientist attempting to tease apart what makes Covid-19 outliers unique. Mayana Zatz, director of the Human Genome Research Centre at the University of So Paulo has identified 100 couples, where one person got Covid-19 but their partner was not infected. Her team is now studying them in the hope of identifying genetic markers of resilience. "The idea is to try and find why some people who are heavily exposed to the virus do not develop Covid-19 and remain serum negative with no antibodies," she says. "We found out that this is apparently relatively common. We received about 1,000 emails of people saying that they were in this situation."
Zatz is also analysing the genomes of 12 centenarians who have only been mildly affected by the coronavirus, including one 114-year-old woman in Recife who she believes to be the oldest person in the world to have recovered from Covid-19. While Covid-19 has been particularly deadly to the older generations, elderly people who are remarkably resistant could offer clues for new ways to help the vulnerable survive future pandemics.
But while cases of remarkable resilience are particularly eye-catching for some geneticists, others are much more interested in outliers at the other end of the spectrum. Over the past couple of months, studies of these patients have already yielded key insights into exactly why the Sars-CoV-2 virus can be so deadly.
Disrupting the body's alarm system
Last summer, Qian Zhang had arrived for a dental appointment when her dentist turned to her and asked, "How come some people end up in intensive care with Covid-19, while my sister got it and didn't even know she was positive?"
As a geneticist working at The Rockefeller University, New York, it was a question that Zhang was particularly well equipped to answer. Over the past 20 years, Rockefeller scientists have probed the human genome for clues as to why some people become unexpectedly and severely ill when infected by common viruses ranging from herpes to influenza. "In every infectious disease we've looked at, you can always find outliers who become severely ill, because they have genetic mutations which make them susceptible," says Zhang.
Volunteers in the Snohomish School District will undergo testing and contact tracing to determine how to best prevent COVID-19 outbreaks.
SNOHOMISH, Wash. Like other school districts, Snohomish schools have implemented new hygiene, social distancing and ventilation protocols for the small number of students who have returned to class. But those only go so far.
With that in mind, for the first time, all of the district's elementary schools are partnering with University of Washington researchers to see if there are better ways to make schools safer from COVID-19 outbreaks.
"Personally, I've been a little more reluctant to go back, but in looking at the needs of our students, I want to see them get back," said Elizabeth Harms, a Snohomish School District assistant.
At the Snohomish elementary schools, the University of Washington is studying whether regular testing stops outbreaks before they spread, which would allow more schools to open.
Volunteer students and staffers will get tested every week. They'll take the tests at home and drop their swabs in bins placed at schools. Positive tests will trigger contact tracing.
It's a science experiment Harms never thought she'd see in one of her classrooms.
"I was a little anxious about getting the test," she said. "But it was negative and it makes me feel safer for my co-workers and students."
"This could have real implications for how you roll this out nationwide," said UW's Dr. Helen Chu.
She said studies in other countries have shown schools are safe for kids with the proper protocols in place.
Asymptomatic spreaders are the wildcard in the coronavirus equation. Chu believes this study will help identify them more quickly.
"Our hope is if we find these asymptomatics early and contain the spread then we prevent a larger transmission event. Really, a strategy where you can identify cases early is the key to preventing outbreaks," Chu said.
The plan is for students or staff who test positive to isolate before returning to the classroom, limiting those exposed.
The study brings some peace of mind for Harms as she heads into the unknown part of a science experiment that aims to bring safer classrooms to everybody.
'We're just rolling with it day by day," she said. "It just feels great, like coming home."
PORTSMOUTH, Va. (WAVY) What is Virginia doing wrong? Thats what several WAVY-TV 10 viewers are asking about vaccines or rather, a lack thereof for those over the age of 75.
Getting an appointment for a COVID-19 vaccine continues to frustrate and stress out many older people in Hampton Roads.
On Tuesday, WAVY News 10s Stephanie Harris talked with frustrated folks and tried to get some answers.
Norfolk resident Karen Coffman is 77 and has stage four lung cancer. Shes at the end of her rope.
The vaccine isnt just something she wants her doctor told her its imperative.
Its the nuttiest thing what do you do? she said. My oncologist told me to get a COVID vaccine. He said because if I get COVID, if I ever run into COVID, Im dead. Theres no way they can help me.
Virginia vaccine coordinator Dr. Danny Avula noted that retail pharmacies are vaccinating only those 65 and older, which he said is another way the Virginia Department of Health is prioritizing older adults.
But because those appointments with pharmacies like CVS, Walgreens, Kroger and more are made online, many, including Coffman, find it more frustrating than helpful. Many older Virginians are not computer savvy.
Avula said people in their 70s and 80s are also in category 1b the current group eligible for vaccinations unless they are in long-term care facilities. Those residents are in group 1a.
Gov. Ralph Northam also made people 65 and older part of group 1b.
Other states are prioritizing more by age, so why not Virginia? Avula said age 75-plus skews more toward the white population, which has a longer life expectancy. Including the 65-plus age group appropriately allows for better representation across higher risk African-American populations, Avula said.
Avula added that 1a and 1b make up about half of the eligible population in Virginia and patience is important.
Leigh Vitasek says thats not good enough.
Since older people are dying at higher rates, she thinks they should get the shot before others in group 1b.
She has been trying for weeks to get a shot for her 87-year-old mother at an independent living center in Chesapeake.
I have friends in Colorado all over the United States whose parents had gotten both of their shots and they are nowhere in their 80s. Whats up with Virginia? she said.
Locally, Virginia Beach is setting aside a quarter of its shots each week for those 75 and older, another quarter for those 65 to 75.
Chesapeake Health District Director Dr. Nancy Welch also told 10 On Your Side Tuesday that there are currently more than 33,000 persons on Chesapeakes waitlist and the average age is 62.
So that tells me that a major portion are seniors, Welch said.
Welch added that more than half of the health districts 2,800 doses allocated per week go to community partners providers, pharmacies and hospitals which have agreed to vaccinate those over age 65. About 25% of our appointments at Chesapeake clinics are for those over the age of 65, and they pull from the waitlist.
However, the community partners are not required to use the Chesapeake Health Districts waitlist because it can be cumbersome.
In Chesapeake, a little more than 13% of the population has been vaccinated, Welch said.
Coffman also reached out to Congresswoman Elaine Lurias office for help.
Luria told our Stephanie Harris that people like Coffman with underlying conditions should receive the vaccine on an expedited timeline.
She added unfortunatelly the failure to develop and implement a national strategy in the months leading up to the vaccine rollout, coupled with the unprecedented scale of vaccinations needed, has caused unacceptable delays to vulnerable populations throughout Virginia.
She vowed to keep working on it.
Starting next week, some teachers and staff in Auburn will be the first to take part in a rapid COVID-19 testing program.
AUBURN, Wash. Starting next week, some teachers and staff in Auburn will be the first to take part in a rapid COVID-19 testing program.
School districts in Washington state are partnering with Seattle Children's Research Institute for the pilot program.
So far, the Auburn School District has received 7,680 test kits. The school district has more than 16,700 students and 2,600 staff members.
Students 11 years and older will be able to participate, as well as family members and district staff.
Auburn School District Assistant Superintendent Rhonda Larson said district leaders are excited to be the first to take part in the program.
"Being able to offer [this to] asymptomatic people ensures that we are having yet another layer, beyond our quality mitigating factors, to be able to help keep schools safe to help everybody feel safe about having their children at school," Larson said.
"We want to stay open, we want to be able to phase in more and more students being able to come to school, and [we want] parents knowing and staff knowing that we are doing our very best to stay up and keep the learning going," she continued.
Seattle Children's Research Institute staff will be a part of the training process.
"We have a mobile van that travels around the state of Washington to primarily title one eligible schools to provide them STEM education. And it is this team that that will be traveling around in the mobile science adventure lab to train the school districts how to use these rapid COVID-19 tests," said Dr. Eric Tham with Seattle Children's Research Institute.
Test results will be confidential and available within 15 minutes of taking the test.
The pilot program will eventually reach 139 schools. This means 6,000 staff members and about 12,000 students will be tested each week.
The program is optional, and will not be required for students or staff.
ATLANTA -- A new study finds that teachers may be more important drivers of COVID-19 transmission in schools than students.
The paper released Monday by the U.S. Centers for Disease Control and Prevention studies nine COVID-19 transmission clusters in elementary schools in the Atlanta suburb of Marietta in December and January, That included one cluster where 16 teachers, students and relatives of students at home were infected.
In only one of the nine clusters was a student clearly the first documented case, while a teacher was the first documented case in four clusters. In another four, the first case was unclear. Of the nine clusters, eight involved probable teacher-to-student transmission. Two clusters saw teachers infect each other during in-person meetings or lunches, with a teacher then infecting other students.
Educators played an important role in the spread," CDC Director Dr. Rochelle Walensky told reporters in an online briefing Monday. "COVID-19 spread often occurred during in-person meetings or lunches and then subsequently spread to classrooms.
The findings line up with studies from the United Kingdom that found teacher-to-teacher was the most common type of school transmission there, and a German study that found in-school transmission rates were three times higher when the first documented case was a teacher. In some American districts, schools have had to go all-virtual because so many teachers have been exposed to the virus.
Other research has suggested that there's low transmission of viruses in schools and that they should reopen for in-person instruction, a message that President Joe Biden's administration has been pushing in recent weeks to mixed success. The 8,700-student Marietta district, like all but a handful in Georgia, has been offering in-person classes since the fall. Superintendent Grant Rivera said more than 90% of elementary students came back in person, making some classrooms relatively crowded.
All the Marietta clusters also involved less than ideal physical distancing, with students often less than 3 feet apart, although plastic dividers were placed on desks.
The two main reasons for the spread of COVID-19 in these schools were inadequate physical distancing and mask adherence, Walensky said.
In seven cases, transmission may have taken place during small-group instruction sessions where teachers were close to students. Although the authors said they observed students wearing masks, interviews found that inadequate mask use by students could have contributed to the spread of infection in five clusters.
The CDC again advised that schools need to pursue multifaceted strategies to prevent the spread of the virus, including cutting down on teacher-to-teacher meetings, making sure masks are worn correctly and increasing physical distancing, especially during mealtimes when people cant wear masks.
Rivera said the school district reengineered instruction in elementary classrooms, making sure students and teachers spend fewer than 15 minutes at a time huddled in small groups and that children are spaced out when they gather on rugs for reading or other activities.
Rivera said the district had been using Fridays not for class time, but for teacher collaboration. Now, the district is encouraging teachers to stay separate.
We told teachers that all teacher collaboration should occur virtually, Rivera said.
He also said chairs had been removed from teacher workrooms, that copy machines have in some cases been moved to other places, and that teachers who plan to eat with a colleague have been told they must eat outdoors.
Student mealtimes pose the biggest challenge, Rivera said.
To be honest, Im really struggling with it, he said.
Students had been kept in classes to limit movement and keep students in isolated pods, but now classes are being encouraged to eat outdoors, with some especially full classrooms going to larger spaces like cafeterias, gyms or auditoriums.
The Marietta district has also continued extensive virus testing after the study ended, Rivera said.
The study also said that in addition to those strategies, it might be desirable to vaccinate teachers to protect educators, cut down on in-school transmission and keep schools operating in person, although the CDC restated that teacher vaccination is "not a requirement for reopening schools.
American Federation of Teachers President Randi Weingarten said the study validates" the CDC's guidelines.
School buildings can be safe for teachers and kids, but the layered mitigation and testing and tracing must be implemented to curb the risk of transmission, with vaccine availability as another layer of protection, the teacher union chief said in a statement.
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An earlier version of the story misspelled Dr. Rochelle Walensky's last name.
For more than two months now, the US has been vaccinating its population with two Covid-19 vaccines one by Pfizer/BioNTech, the other by Moderna that are highly effective at preventing illness, hospitalization, and death.
Despite that fact, public health officials and media outlets have been warning that vaccinated people need to behave largely how they did before they were vaccinated. Thats because we dont know as much about the vaccines effectiveness at preventing transmission to others. A vaccinated person may be well-protected from Covid-19, but if they carry the virus, could they possibly infect the people around them?
But a growing body of evidence suggests the Pfizer/BioNTech and Moderna vaccines do, in fact, cut down on viral transmission. Two recent studies show some pretty favorable results one from the UK that found that two doses of the Pfizer/BioNTech vaccine cut down by 86 percent someones chances of developing an infection that they could pass along, the other a study in Israel that found an 89.4 percent reduction (though it should be noted that the Israeli study has yet to be fully released). These findings are consistent with what we know about vaccines and transmission in general.
In other words, even as we wait for more definitive studies on the vaccines effects on transmission, more and more scientists think we do have enough information to feel pretty good about the vaccines capacity to give us back a semblance of normalcy as we approach a year of life in a pandemic.
In an opinion piece, Johns Hopkins epidemiologists M. Kate Grabowski and Justin Lessler argued, We are confident vaccination against COVID-19 reduces the chances of transmitting the virus.
I have been very cautious due to limited evidence on transmission effects but agree with [Grabowski and Lessler] that a large transmission effect is the best explanation of the limited evidence to date, Harvard School of Public Health epidemiologist Marc Lipsitch said last week.
Even Dr. Anthony Fauci has sounded an optimistic note. The looming question is, if the person whos been vaccinated gets infected, does that person have the capability to transmit it to another person? Some studies are pointing in a very favorable direction, he said in a White House briefing last week.
Studying exactly how much a vaccine affects transmission is very difficult. It requires exceptionally good contact tracing, which few countries have, or inference from lots of different forms of limited evidence. Uncertainty remains about exactly how much the vaccines reduce transmission and that uncertainty has led many public health officials to be cautious in their public statements.
But that cautiousness can end up misleading the public, giving people the impression that scientists have no information at all. That, in turn, could also lead to vaccine hesitancy. Some people may think, if I get vaccinated but I still have to continue masking and social distancing at all times, then why get vaccinated at all?
In their own lives, medical experts and, again, journalists tend to be cleareyed about the vaccines. Many are getting shots as soon as theyre offered one. They are urging their family and friends to do the same, David Leonhardt argues in a New York Times piece. But when they speak to a national audience, they deliver a message that comes off very differently. It is dominated by talk of risks, uncertainties, caveats and possible problems. It feeds pre-existing anti-vaccine misinformation and anxiety.
The vaccines do reduce transmission. They do take us a big step closer toward life beyond the pandemic. And the messaging from our institutions should start reflecting that.
Now that many people have been vaccinated against Covid-19 about 64 million in the US new research is coming out every day that clarifies the transmission picture. Two key new studies look at the rate of disease among people who got two doses of the Pfizer/BioNTech mRNA vaccine. Thats an important figure for judging how effective vaccines are for transmission the lower the rate of infection, the lower the rate of transmission.
A little step back here to explain where things stand on vaccines: There are several vaccines approved in different parts of the world, with various approaches and levels of effectiveness. The best vaccines out there appear to be the Moderna and Pfizer/BioNTech vaccines, which are the only vaccines with emergency use authorization in the US right now. Just to keep the scope of this piece manageable, it will focus on the Moderna and Pfizer/BioNTech vaccines.
A new working paper published with The Lancets preprint publication program on Monday looked at health care workers in the United Kingdom who were vaccinated with the Pfizer/BioNTech vaccine. It finds that the vaccine doesnt just make people less likely to get symptomatic infections (which we already knew from Pfizer/BioNTechs initial trials) it also makes them much much less likely to get infected at all. Vaccine effectiveness was 72% ... 21 days after first dose and 86% ... 7 days after the second dose, the study concludes.
Thats lower than the 95 percent headline number you might have seen, but that 95 percent measures symptomatic infections; this measures all infections, even invisible asymptomatic ones, through routine testing of healthy people.
Another new paper, this time out of Israel, looked at the Pfizer/BioNTech vaccine as well. (A big caveat: The findings were announced in a press release, but the study itself hasnt been released yet.) It found a drop of 89.4 percent in infections among people who got two doses of the vaccine, compared to unvaccinated people. We dont have as much information from this research as wed like yet, as the paper has yet to be made public, and given the methodological challenges of estimating transmission, the details of the paper matter a lot. But that number is similar to the one from the UK study.
Even though the studies focused only on the Pfizer/BioNTech vaccine, theres reason to believe that the results translate to the Moderna vaccine as well. The two vaccines work very similarly. Both contain a set of instructions to the RNA in our cells to build a protein very similar to the spike protein in the coronavirus. Then the immune system notices the intruder and responds, producing antibodies thatll protect against the coronavirus later.
Because the two vaccines work very similarly, the researchers I spoke to said it was overwhelmingly likely that they both block transmission to a similar degree. As a result, we can assume though with some uncertainty that evidence of strong infection reductions from the Pfizer/BioNTech vaccine also likely applies to Moderna.
But even before the most recent research came out, we already knew that the vaccines would help curb transmission. For one thing, the Moderna and Pfizer/BioNTech mRNA vaccines reduce the chances of getting a symptomatic case of Covid-19 by 94 percent and 95 percent, respectively. That is a promising starting point if a person doesnt get Covid-19, then they cant pass it on.
But what about asymptomatic cases?
In their initial clinical trials, Moderna and Pfizer didnt study whether vaccinated people got asymptomatic cases of Covid-19 that is, people who tested positive for the coronavirus but did not suffer any symptoms. However, when people went in for their second shot, Moderna did give them a nasal swab test for Covid-19. In a supplement to its submission to the FDA, Moderna says that 14 of the 14,134 vaccinated people had Covid-19 (with no symptoms at the time) and 38 of the 14,073 people in the control group had Covid-19 (with no symptoms at the time).
That rules out one big worry about the vaccines: that they might make Covid-19 mild in vaccinated people so mild they dont experience any symptoms without actually preventing it. Instead, it was clear from back in December that the vaccines reduce asymptomatic infection as well as reducing symptomatic infection.
Using Modernas nasal swab test data, infectious disease biologist Marm Kilpatrick at UCSC estimated that the vaccine, after a single shot, reduces a persons odds of infection with Covid-19 by up to 90 percent. (When I emailed him, we determined that with some more pessimistic assumptions, the reduction might be more like 78 to 88 percent.) Of course, the overall efficacy of the vaccine after both doses will almost certainly be higher.
The new data on the Pfizer/BioNTech vaccine in Israel and in the UK backs up that finding. It suggests that after two shots, the vaccine is 85 to 90 percent effective at preventing infection with Covid-19.
There are some caveats. The data from the UK and from Israel comes from observational studies, not randomized controlled trials: If the people whod been vaccinated differ from people who havent, the studys assumptions might not hold. Researchers do their best to adjust for this, but any adjustment will be imperfect. In addition, getting the vaccine could change behavior the vaccinated might take more risks, and they might be less likely to seek Covid-19 testing or be required to provide negative test results.
So this estimate shouldnt be considered definitive. But it lines up with other sources of evidence, and it suggests that, overall, the vaccine is likely highly effective in the 80 to 90 percent range at preventing infections. And low infection rates mean low transmission rates.
But lets say a person who has been vaccinated still gets infected with Covid-19. Thats not great, but the vaccine likely continues to protect the people around them, according to the research so far. Thats because of another consideration: viral load that is, how much virus can be measured in a patients nose and throat.
Not everyone who has Covid-19 is equally likely to transmit it. A new study published in The Lancet based on research from contact tracing in Spain has found a very strong association between viral load and how many other people the patient infects, as well as how serious the infections in other people are.
This isnt very surprising. Viral load determines how much virus you are coughing or breathing into the air, which determines whether other people get sick. And if they get sick with an unusually large dose of the virus, itll have a head start at infecting them, and theyre likely to get sicker.
In our study, the viral load of index cases was a leading driver of SARS-CoV-2 transmission. The risk of symptomatic COVID-19 was strongly associated with the viral load of contacts at baseline, the study concludes.
The impact of the vaccine on transmission, then, will be the product of two factors, co-author Michael Marks, an epidemiologist at the London School of Hygiene and Tropical Medicine, told me: lower chance of getting infected, and lower viral load if infected.
We already covered the former point above; what about the latter? Do the vaccines cut viral load?
On this front, theres great news in another preprint based on data from Israel: The Pfizer/BioNTech mRNA vaccine appears to cut viral load dramatically, so people who do get Covid-19 after the vaccine have less of the virus in their nose and throat, making them less likely to infect other people.
We find that the viral load is reduced 4-fold for infections occurring 12-28 days after the first dose of vaccine. These reduced viral loads hint to lower infectiousness, further contributing to vaccine impact on virus spread, the study concludes. This research is just a preprint, not yet peer-reviewed, but if the data holds up, it would suggest that vaccinated people who test positive and are infectious are still significantly less infectious than unvaccinated people.
The data is certainly intriguing and suggestive that vaccination may reduce the infectiousness of COVID-19 cases, even if it does not prevent infection altogether, Virginia Pitzer, an infectious diseases modeler at the Yale School of Public Health, told Nature.
Many of the caveats discussed above apply to this study, too. This research from Israel is an observational study, not a randomized controlled trial. However, the vaccinated people had the same average viral load during the first 12 days after vaccination as the unvaccinated people, and only after 12 days did a difference start to emerge, which suggests the vaccine is what is producing the difference.
In total, vaccination unambiguously makes people less likely to get a case of Covid-19. Then, if a vaccinated person does get a Covid-19 case, preliminary Pfizer data from Israel suggests theyll have lower viral loads, which other research has established makes them less likely to pass on the virus. And because of the lower viral load, if they do infect another person, the infection is less likely to be serious.
To be clear, the transmission point is based on early data theres still uncertainty about how exactly lower viral loads in vaccinated people will translate to lower infectiousness. But some data is different from no data.
There isnt significant doubt among epidemiologists that vaccines somewhat cut transmission.
First, almost all vaccines do that, so it was a good starting assumption before we had any data at all. (There are a few exceptions, such as the vaccine for whooping cough, but theyre very rare.)
Second, its where all the data on the Covid-19 vaccines points. Everyone thinks the data indicate a reduction in total infections, as well as symptomatic infections, Kilpatrick told me. People disagree on whether we can accurately estimate how [large is] the reduction in total infections and infectiousness.
In other words: There seems to be consensus that the vaccines dont just keep the vaccinated safe they make the people around them safer, too. The real question is how much safer. Lipsitch, who is more conservative than Kilpatrick at estimating that impact, still says that no effect on transmission would be beyond shocking, and that his best offhand guess is that minimum level of transmission reduction consistent with the evidence is 50 percent.
But the fact that the vaccines make other people safer too hasnt necessarily made it into public messaging. News reports of the vaccine have foregrounded what the vaccine cant guarantee and what we cant do after weve been vaccinated.
Yes, people with coronavirus vaccinations should still distance from each other. Heres why, argued the Washington Post.
Youre fully vaccinated against the coronavirus now what? Dont expect to shed your mask and get back to normal activities right away, begins an Associated Press story in which older people who have all been fully vaccinated are advised not to reunite with each other.
Our discussion about vaccines has been poor, really poor, Dr. Muge Cevik, a virologist, told the New York Times. It has overwhelmingly emphasized the fact that post-vaccine transmission is still possible, rather than frankly discussing the probability of such transmission and leaving it up to people to make their own risk calculation.
Thats because a lot of public health officials worry about encouraging people whove been vaccinated to party like its 1999, potentially spreading the virus to other people who havent had their chance to get vaccinated yet.
Its important to note that for a vaccinated persons behavior to be more dangerous than an unvaccinated persons, theyd have to go really wild. If vaccines reduce infection by 90 percent, then unless your behavior gets 10 times more dangerous after youre vaccinated, you are still safer to be around than you were before the vaccine.
Dont go bar-hopping, but having also-vaccinated friends over is likely fine, Dr. Leana Wen of the George Washington School of Public Health argues in the Washington Post. Letting your grandparents hold your kids? Families might reasonably conclude thats also fine, she says.
Vaccinated people should, of course, respect businesses rules about masks the essential workers asked to enforce those rules have no way to know if youve been vaccinated. And while most people are still unvaccinated, the vaccinated should be thoughtful about protecting those who havent had a chance at the vaccines yet. But those reminders shouldnt drown out an accurate understanding of the fact that the vaccines are really effective.
Advising people that they must do nothing differently after vaccination not even in the privacy of their homes creates the misimpression that vaccines offer little benefit at all. Vaccines provide a true reduction of risk, not a false sense of security, epidemiologist Julia Marcus argued in the Atlantic.
Our recommendations for vaccinated people should reflect our best current understanding of the evidence.
Its true that theres still some uncertainty about the magnitude of the effects of the vaccines on transmission. Its possible that as we learn more from Israel, recommendations will change. And its important that people get fully vaccinated two shots, plus some time for the immunity to fully take hold before they assume the vaccine has fully protected them and the people around them.
But whats important to remember is that we arent operating from complete ignorance. We know a lot about the vaccines, and what we know points toward them being very effective at reducing transmission and protecting those around us. If youre hesitant about taking the vaccine because you heard that it might not protect others, you shouldnt be, because the evidence suggests it does. That message is at least as important as warnings for the vaccinated not to party.
Press Releases
02/22/2021
(HARTFORD, CT) In an effort to ensure that Connecticut continues taking the most equitable and efficient approach to quickly administering the COVID-19 vaccine to as many people as possible, Governor Ned Lamont today announced that the state will continue with an age-based approach to expanding eligibility to the vaccine, explaining that other previously considered scenarios proved overly complex and confusing, would potentially exacerbate inequities in vaccine distribution, and slow down the process of providing it to Connecticut residents.
Age is one of the strongest factors contributing to COVID-19 deaths, with 96 percent of COVID-19 deaths in Connecticut occurring in people over the age of 55.
To provide clarity and predictability, the governor today announced a schedule for age-based eligibility for the next several months. By laying out a clear timeline for eligibility for the vaccine, the strategy allows everyone in the state, including essential workers and those with chronic conditions, to know when they will be able to schedule an appointment. The planned schedule is as follows:
To further ensure equitable allocation of the vaccine, Governor Lamont also announced that he is directing the Connecticut Department of Public Health to set numerical targets and work with vaccine providers to ensure that vaccines are administered to people living in the highest-risk communities in proportion to their population. These targets and the associated strategies will be announced in the coming days.
In addition to the age-based eligibility, preK-12 school staff and teachers, and professional childcare providers will be eligible to receive the vaccine in March at dedicated clinics that will be set up specifically for those sectors. Educators and childcare professionals will soon receive information from their school administrators and employers on when their dedicated clinics will be provided.
Connecticut has been using a phased approach to its COVID-19 vaccine program because of the very limited supply of the vaccine that it has been receiving from the federal government. The program initially began in December with healthcare providers and medical first responders, and then expanded in January to include all individuals over the age of 75 and certain congregate settings, followed by those over the age of 65 in mid-February. All previously eligible individuals and settings will continue to be eligible after March 1.
In a perfect world, we would have enough doses of the vaccine to get it to all 3.6 million people in Connecticut right now, however each state is being given a very limited supply, which is why we must take this phased approach, Governor Lamont said. Connecticuts healthcare providers have been doing an amazing job getting the vaccine to people as quickly as they can, and using age as the only qualifying factor is one of the reasons why theyve had success so far. The last thing we want to do is complicate the process for them and cause delays that slow things down and exacerbate issues regarding equitable access. A vaccination program of this magnitude is unprecedented in recent times, and I appreciate everyones understanding of the fluid nature of this situation. My goal is to get as many people vaccinated as quickly as possible, and I believe this is the best path to meeting that challenge.
We have been in the COVID-19 marathon for approaching a year and now our race becomes a sprint to beat the variants of COVID-19 that are now circulating in the state and elsewhere and to return to a sense of normalcy for ourselves, our families and our communities, Connecticut Acting Public Health Commissioner Dr. Deidre Gifford, who also serves as co-chair of the Governors COVID-19 Vaccine Advisory Group, said. The Department of Public Health is committed to an equitable vaccination program. Sticking with an age-based vaccine rollout allows our vaccine providers to get as many shots as possible as quickly and equitably as possible into the arms of Connecticut residents, and vaccinating our education and childcare workforce will get our children back in the classroom this school year.
Ensuring communities of color have access to vaccines is one of the most important and impactful ways we will get this pandemic behind us, Dr. Reginald Eadie, president & CEO of Trinity Health New England and co-chair of the Governors COVID-19 Vaccine Advisory Group, said. Using age as an eligibility criterion makes it clear to all of our residents, especially those who have been disproportionately affected by COVID-19, that the vaccine is here, its available, and provides for an easier registration process to actually receive the vaccine. Education is important when it comes to addressing vaccine hesitancy, but we must also have a simple process to make sure those who need the vaccine receive the vaccine. This new timeline not only informs residents of when they can anticipate they will be eligible to be vaccinated, but it also provides vaccinators direction on when and where to target their own outreach and education efforts.
Equitable access to vaccine for our communities that have been hardest hit by COVID-19 has always been the priority of the allocation subcommittee, Nichelle Mullins, president and CEO of Charter Oak Health Center, and Zita Lazzarini, associate professor of public health sciences at UConn Health, both of whom serve as the co-chairs of the allocation subcommittee of the Governors COVID-19 Vaccine Advisory Group, said in a joint statement. We agree with the governors approach and, while not ideal, we understand that a continuation of the age-based system simplifies the requirements for vaccination. We also applaud the states commitment to set tangible benchmarks for providers to vaccinate residents living in Connecticuts cities and municipalities with large underserved and high-risk populations. These benchmarks are intended as affirmative steps to increase equity in access to vaccines and to remediate inequities that have accrued so far.
Connecticut Business and Industry Association president and CEO Chris DiPentima said that while essential employers had spent time and resources preparing for the vaccine rollout based on the initial guidance, he understood the need to pivot. We cannot rebuild our economy and recover from the pandemic without first addressing the public health crisis, he said. This new approach allows for more workers across Connecticut to get vaccinated in a short period of time, and it eliminates potentially complicated rules, making it easier and more equitable for everyone to receive their vaccination. It is critical that we vaccinate as many people as possible as quickly as possible.
All eligible individuals in Connecticut are required to make an appointment in advance of receiving the vaccine. Residents aged 55 to 64 should not attempt to make an appointment now they will not be able to schedule one until the program expands to their age group on March 1.
To locate vaccination clinics, individuals should visit ct.gov/covidvaccine and enter their zip code. From there, users will be shown the nearest available clinics and provided with specific directions on how to make an appointment at each one, including over the internet and over the telephone.
Those who do not have access to the internet can call Connecticuts Vaccine Appointment Assist Line at 877-918-2224. The line is open seven days a week from 8:00 a.m. to 8:00 p.m.
An AstraZeneca vaccine production line.
Bloomberg | Bloomberg | Getty Images
The world's largest vaccine maker by volume, Serum Institute of India, has been told to meet domestic demand for Covid-19 shots first before distributing them overseas.
The move implies that foreign governments could face order delays from the company as it places India's needs ahead of others.
"Dear countries & governments, as you await #COVISHIELD supplies, I humbly request you to please be patient," CEO Adar Poonawalla tweeted.
He said the Serum Institute of India (SII) "has been directed to prioritise the huge needs of India and along with that balance the needs of the rest of the world. We are trying our best."
Poonawalla did not elaborate on who gave the directive.
SII declined to comment further about Poonawalla's tweet when contacted by CNBC.
Serum Institute is manufacturing the vaccine developed by British-Swedish pharma giant AstraZeneca and Oxford University, which is known locally as Covishield.
It is one of two vaccines that has received emergency approval to be used in India's mass inoculation campaign which aims to vaccinate some 300 million people in the first phase, most of them frontline workers and those above 50 or in high-risk groups.
The other vaccine that received emergency approval was developed locally by India's Bharat Biotech. It was created in collaboration with the state-run Indian Council of Medical Research and was granted emergency use authorization as clinical trials continue.
Since kicking off the vaccination campaign in January, India has inoculated more than 10.8 million people as of Feb. 20, according to the government. It is expected to ramp up the number of daily vaccinations in the coming months.
An army health worker prepares a dose of Covishield, AstraZeneca/Oxford's Covid-19 coronavirus vaccine made by India's Serum Institute, at an army hospital in Colombo on January 29, 2021.
ishara S. Kodikara | AFP | Getty Images
Covishield was also granted emergency use listing by the World Health Organization (WHO) this month, allowing it to be supplied to low and middle-income countries around the world.
AstraZeneca said it hopes more than 300 million doses will be made available to 145 countries in the first half of 2021 through Covax, a global vaccination initiative led by WHO and others.
Covishield is less expensive compared to some of the other vaccines being used such as the ones fromPfizer-BioNTechandModerna. It also doesn't need to be stored in ultra-low temperatures, which makes it suitable for use in many developing countries that lack necessary storage infrastructure.
