CLEVELAND, Ohio Five Northeast Ohio bars four in Cuyahoga County and one in Summit County were cited Saturday for violating the orders put in place by the Ohio Department of Health in order to try and curb the spread of the novel coronavirus.
None of the bars have previously been cited by the Ohio Investigative Unit. Here are the establishments cited Saturday, in alphabetical order by city, according to a news release from the OIU:
Papa Dons Pub, Akron
Papa Dons Pub, on East Market Street near Interstate 76, was cited about 8:50 p.m. Saturday. OIU agents went to the bar and saw more than 50 patrons packed inside, with no social distancing measures in place. Every seat at the bar was occupied, and people were standing shoulder-to-shoulder, an OIU news release says. The bar received a citation for improper conduct disorderly activity.
Backstage Bar, Cleveland
Backstage Bar, on Lorain Avenue in Clevelands Kamms Corners neighborhood, was cited about 10:40 p.m. Saturday. OIU agents cited the bar for improper conduct disorderly activity after they observed numerous patrons still inside drinking alcohol, with bartenders still serving drinks. Gov. Mike DeWine put a cut-off on alcohol sales at 10 p.m. over the summer.
In the Drink, Fairview Park
In the Drink, a bar on Lorain Road near Fairview Parks border with Cleveland, was cited about 10:25 p.m. Saturday for improper conduct disorderly activity. Patrons were still inside and drinking alcohol past the 10 p.m. cut-off.
Riverwood Caf, Lakewood
Riverwood Caf, on Detroit Road on the west end of Lakewood, received a citation for improper conduct disorderly activity about 9:15 p.m. Saturday. Agents cited the bar after observing about 100 patrons inside, standing shoulder-to-shoulder while the bar was packed. There were no social distancing measures or physical barriers in place.
Shadows Bar & Grill, Parma Heights
Shadows Bar & Grill, on West 130th Street near the intersection with Pearl Road, was cited about 8:15 p.m. for improper conduct disorderly activity. OIU agents were joined by Parma Heights police in their investigation. Authorities saw about 100 patrons at the establishment, with many closely congregating. There were some safety precautions in place, but the social distancing measures or physical barriers to separate groups were not.
These administrative cases will be heard by the Ohio Liquor Control Commission for possible penalties, including fines or the suspension or revocation of liquor permits, according to the OIU. You can find cases that have been heard by the liquor control commission and their findings here.
Read more coronavirus-related coverage on cleveland.com:
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Try to focus on the blessing: Concord woman keeps positive thoughts despite long-haul coronavirus Coping Through Covid
Illinois seven-day average positivity rate fell for an eighth straight day, now down to 6.3%, the lowest that indicator of transmission has been since Oct. 26.
Heres what else happened in Chicago and around Illinois in coronavirus-related news.
More than 103,000 Illinois residents so far have been fully vaccinated against the coronavirus, public health officials said Saturday, as the state reported COVID-19 has killed an additional 130 people and spread to 5,343 more.
The new cases were diagnosed among 102,372 tests submitted to the Illinois Department of Public Health, keeping most of the states metrics trending in the right direction as they have since the holidays.
Illinois seven-day average positivity rate fell for an eighth straight day, now down to 6.3%, the lowest that indicator of transmission has been since Oct. 26.
And COVID-19 hospitalizations are as low as theyve been since Nov. 1, with 3,406 beds occupied statewide as of Friday night. Of those patients, 711 were receiving intensive care and 379 were on ventilators.
But Saturdays death count is well above the states average of 107 deaths per day so far this year. A total of 1,704 Illinois lives have been lost to COVID-19 since New Years Day.
Read the full story from Mitchell Armentrout here.
Friday was confusing. Documents were emailed to media. Websites that allegedly outline the states entire sports policy during coronavirus werent updated (and then they were). The Illinois High School Association had a last-minute meeting with Deputy Gov. Jesse Ruiz.
Gov. Pritzker hit on high school sports very briefly in his COVID-19 update.
There was some good news for high school athletes. Low-risk sports will be allowed when regions move to Tier 2. Rockford, Peoria and southern Illinois hit Tier 2 on Friday and some regions in the Chicago area could be there as early next week.
There are regions that are moving into lower tiers of mitigations, Pritzker said. In those tiers there are [sports] that are opening up. Thats a good beginning.
Low-risk sports (boys and girls bowling, cheerleading, dance, girls gymnastics and boys swimming and diving and badminton) will be allowed to play conference and intra-region games.
Medium-risk sports will be allowed to conduct full practices and high-risk sports (basketball and wrestling) will be allowed to hold no-contact practices in Tier 2. There are no IHSA medium-risk winter sports.
Read the full story here.
NEW DELHI India started inoculating health workers Saturday in what is likely the worlds largest COVID-19 vaccination campaign, joining the ranks of wealthier nations where the effort is already well underway.
India is home to the worlds largest vaccine makers and has one of the biggest immunization programs. But there is no playbook for the enormity of the current challenge.
Indian authorities hope to give shots to 300 million people, roughly the population of the U.S and several times more than its existing program, which targets 26 million infants. The recipients include 30 million doctors, nurses and other front-line workers, to be followed by 270 million people who are either over 50 or have illnesses that make them vulnerable to COVID-19.
For workers who have pulled Indias battered health care system through the pandemic, the vaccinations offered confidence that life can start returning to normal. Many burst with pride.
I am happy to get an India-made vaccine and that we do not have to depend on others for it, said Gita Devi, a nurse who was one of the first to get a shot. Devi has treated patients throughout the pandemic in a hospital in Lucknow, the capital of Uttar Pradesh state in Indias heartland.
Read the full story here.
An employee of Cook Countys Office of the Chief Judge tested positive for the coronavirus, raising the total number of employees with positive tests to 253.
The employee works in the Juvenile Temporary Detention Center, the chief judges office said Friday in a statement. A new resident at the detention center who had already been released also tested positive.
In addition to the 253 employees who tested positive for the coronavirus, 19 judges have also tested positive since the start of the pandemic, according to the statement.
Read the full story here.
A city investigation into Gibsons Bar & Steakhouse found it to be in compliance with coronavirus safety regulation after a fire Wednesday evacuated the restaurant.
The fire, which started about 9 p.m. in a second-floor fireplace, was quickly extinguished, and while no one was injured in the blaze, the restaurant did have to evacuate patrons from the building, according to Chicago fire officials.
That led to an investigation from the office of Business Affairs and Consumer Protection, which had inspected the famed Gold Coast steakhouse just days before the fire and found them compliant with COVID-19 regulations.
BACP has reached the same conclusion after another investigation on Thursday, according to spokesman Isaac Reichman.
Reporter Sam Kelly has more.
Illinois cash-starved bars and restaurants will be allowed to welcome customers inside sooner than originally ordered by Gov. J.B. Pritzker, but that reopening is still a ways off for Chicago.
The Democratic governor announced Friday that limited indoor service will be allowed for regions of the state that see their COVID-19 metrics improve enough to move down to the states Tier 1 mitigation level.
Thats a shift from the original plan laid out by Pritzkers health team, which wouldve required regions to improve even further to return to the states Phase 4 of reopening.
Still, most of the states 11 regions remain in Tier 3, including Chicago and its suburbs.
Pritzkers layers of tiers and mitigations have caused confusion for the thousands of establishments that have seen revenue dry up since the governor shuttered indoor service statewide in November in an effort to stem a record-breaking COVID-19 resurgence.
Reporter Mitchell Armentrout has more.
Who knew?
Apparently, only a few.
Who figured Americas presidential inaugural would be recalibrated by a gruesome twist in American history: sedition fueled by an accelerator named President Donald Trump and his thug acolytes.
The recent attack of domestic terrorism by the latest version of the historic Plug Uglies, is not expected to force President-elect Joseph Bidens inauguration off the steps of the nations Capitol this week.
But its a good bet the nations House, invaded last week by soldiers of Trumps alternative universe, will be hovered by a Star Wars sized military force ostensibly protecting celebrants looking sideways and facing the possibility of a pat-down rather than a pat on the back.
Sadly, our nations inaugural transfer of power used to be a ball, a bash to celebrate the success of democracy.
Read the full column from Michael Sneed here.
PIERRE, S.D. (KELO) Twenty-three more COVID-19 deaths were reported, as active cases in the state continue to remain below 5,000. The last time South Dakota had fewer than 5,000 active cases was on October 8.
On Saturday, 266 new total coronavirus cases were announced bringing the states total case count to 105,544, up from Saturday (105,278). Total recovered cases are now at 99,226, up from Saturday (98,808).
The death toll is now at 1,656. New deaths reported on Saturday were 13 men and 10 women in the following age ranges: 50-59 (2), 60-69 (3), 70-79 (8), and 80+ (10).
Active cases are now at 4,662, down from Saturday (4,837).
Current hospitalizations are at 213, up from Saturday (209). Total hospitalizations are at 6,063, up from Saturday (6,039).
Total persons negative is now at 285,878, up from Saturday (285,242).
There were 902 new persons tested reported on Saturday. Saturdays new person tested positivity rate is 29.4%.
The latest seven-day all test positivity rate reported by the DOH is 10.9%. The DOH calculates that based on the results of the PCR test results but doesnt release total numbers for how many PCR tests are done daily. The latest one-day PCR test positivity rate is 10.3%.
40 South Dakota counties are listed as having substantial community spread, while 17 South Dakota counties are listed as moderate community spread and 9 South Dakota counties are listed as minimal community spread.
Vaccine tracking is now being reported by the state. As of Saturday, 29,034 doses of the Pfizer vaccine and 27,591 doses of the Moderna vaccine have been administered to 46,796 total persons. Theres been 9,829 persons completed two doses of the Pfizer vaccine and no one has completed two doses of the Moderna vaccine. Vaccine data does not include vaccine given to South Dakota Indian Reservations because that is federally allocated.
Denton County Public Health has been allocated an additional 6,000 doses of the Moderna COVID-19 vaccine, according to the Texas Week 6 allocation list.
Last week, Texas began a shift away from its previous vaccine distribution model of sending shipments in the low hundreds to numerous providers throughout the state. The state named 28 vaccination hubs, chosen for their capability to administer the shots in large numbers.
As a result of the states distribution shift, only one other provider in Denton county was allocated a shipment: Health Services of North Texas in Denton, which will be receiving 100.
DCPH spokesperson Jennifer Rainey said earlier in the week that the department was told it will continue to receive large shipments, making for a significant improvement in communication with the state compared to the start of the vaccine rollout, in which the department was not allocated any and could not reach the state for information on why.
DCPH Director Matt Richardsons weekly COVID-19 presentation at Tuesdays Denton County Commissioners Court Meeting will likely offer more details on the new shipment and DCPHs administration plans moving forward. He will also likely discuss Thursdays 3,000-vaccine clinic at C.H. Collins Athletic Complex, which he said would be a test for the department.
Now is the time to lift our nation from the quicksands of racial injustice to the solid rock of brotherhood.
NEW ORLEANS Dr. Martin Luther King Jr. was born January 15, 1929 in Atlanta, Georgia.
He was a Baptist Minister, activist and Civil Rights Leader, whose mission was to bring awareness to racism, end racial discrimination and bring unity to all races across the country.
Dr. King's "I Have a Dream" speech in 1963, brought out about 250,000 people to listen to what is described as a call for equality and freedom.
I have a dream that one day this nation will rise up and live out the true meaning of its creed we hold these truths to be self-evident: that all men are created equal, Dr. Martin Luther King Jr. " I Have a Dream".
He fought for equality and racial justice up until his assassination on April 4, 1968.
To honor his memory, MLK Day is seen as a day of service where individuals and groups come together to better their community by engaging in community service activities. But many MLK Day events have been canceled or altered to follow COVID restrictions.
Here is a list of events to commemorate MLK Day:
Orleans
Covington
Lake Charles
Kenner
Slidell
Stay up-to-date with the latest news and weather in the New Orleans area on the all-new free WWL TV app. Our app features the latest breaking news that impacts you and your family, interactive weather and radar, and live video from our newscasts and local events. LOCAL & BREAKING NEWS * Receive r...
COVID-19 vaccine rules spark confusion for some in Philly. Others are jumping the line. The Philadelphia Inquirer
Posted: Jan 17, 2021 / 03:53 PM EST / Updated: Jan 17, 2021 / 06:29 PM EST
SCI Albion is reporting the first death of an inmate from COVID-19.
The 67-year-old inmate died on Saturday from the virus.
The inmate had underlying medical conditions and was sent to the hospital last Wednesday where he contracted COVID-19.
There are currently 186 current cases of COVID-19 with inmates and 32 active staff cases.
BOSTON (WPRI) Massachusetts has announced its first identified case of the COVID-19 variant B.1.1.7, the same variant initially discovered in the United Kingdom.
The Massachusetts Department of Public Health (DPH) said a Boston woman in her 20s developed symptoms in early January and tested positive for COVID-19. She had traveled to the United Kingdom and became ill the day after she returned.
A genetic sample was sent to an out-of-state laboratory as part of U.S. Centers for Disease Control and Preventions (CDC) surveillance protocol to identify COVID-19 variants.
The state laboratory was notified of results on Saturday night.
The CDC has reported 88 cases of the variant from 14 states in the United States. Rhode Island has not yet identified any cases of the variant.
Abstract
We are currently faced with the question of how the CoV-2 severity may change in the years ahead. Our analysis of immunological and epidemiological data on endemic human coronaviruses (HCoVs) shows that infection-blocking immunity wanes rapidly, but disease-reducing immunity is long-lived. Our model, incorporating these components of immunity, recapitulates both the current severity of CoV-2 and the benign nature of HCoVs, suggesting that once the endemic phase is reached and primary exposure is in childhood, CoV-2 may be no more virulent than the common cold. We predict a different outcome for an emergent coronavirus that causes severe disease in children. These results reinforce the importance of behavioral containment during pandemic vaccine rollout, while prompting us to evaluate scenarios for continuing vaccination in the endemic phase.
Humans have regularly been threatened by emerging pathogens that kill a substantial fraction of all people born. Recent decades have seen multiple challenges from acute virus infections including SARS, MERS, Hendra, Nipah and Ebola. Fortunately, all were locally contained. When containment is not immediately successful, as is likely for the novel betacoronavirus SARS CoV-2 (CoV-2) (1, 2), we need to understand and plan for the transition to endemicity and continued circulation, with possible changes in disease severity due to virus evolution and build-up of host immunity and resistance.
CoV-2 is an emerging virus that causes COVID. The virus has a high basic reproductive number (R0) and which is transmissible during the asymptomatic phase of infection, both of which make it hard to control (3). However, there are six other coronaviruses with known human chains of transmission, which may provide clues to future scenarios for the current pandemic. There are four human coronaviruses (HCoVs) that circulate endemically around the globe; they cause only mild symptoms and are not a significant public health burden (4). Another two HCoV strains, SARS CoV-1 and MERS, emerged in recent decades and have higher case fatality ratios (CFRs) and infection fatality ratios (IFRs) than COVID-19 but were contained and never spread widely (5, 6).
We propose a model to explore the potential changes in both transmission and disease severity of emerging HCoVs through the transition to endemicity. We focus on CoV-2 and discuss how the conclusions would differ for emerging coronaviruses more akin to SARS and MERS. Our hypothesis is that all HCoVs elicit immunity with similar characteristics, and the current acute public health problem is a consequence of epidemic emergence into an immunologically nave population in which older age-groups with no previous exposure are most vulnerable to severe disease. We use our estimates of immunological and epidemiological parameters for endemic HCoVs to develop a quantitative model for endemic transmission of a virus with SARS-CoV-2 -like characteristics, including the age-dependence of severity. Our model explicitly considers three separate measures for immune efficacy that wane at different rates (fig. S1).
Building on ideas from the vaccine modeling literature, immunity may provide protection in three ways (7). In its most robust form, sterilizing immunity can prevent a pathogen from replicating, thereby rendering the host refractory to reinfection. We term this property immune efficacy with respect to susceptibility, IES. If immunity does not prevent reinfection, it may still attenuate the pathology due to reinfection (IEP) and/or reduce transmissibility or infectiousness (IEI). Indeed, experimental reexposure studies on endemic HCoVs provide evidence that the three IEs do not wane at the same rate (8, 9). Callows experimental study (8) shows that reinfection is possible within one year (relatively short IES); however, upon reinfection symptoms are mild (high IEP) and the virus is cleared more quickly (moderate IEI). Details on the derivation of the model can be found in section 2 of the supplementary materials (SM).
We reanalyze a detailed dataset that estimates age-specific seroprevalence based on both IgM (acute response) and IgG (long-term memory) against all four circulating HCoVs in children and adults (10) to estimate parameter ranges for transmission and waning of immunity (see Fig. 1A). The rapid rise in both IgM and IgG seroprevalence indicates that primary infection with all four endemic HCoV strains happens early in life, and our analysis of these data gives us an estimate for the mean age of primary infection (MAPI) between 3.4 and 5.1 years, with almost everyone infected by age 15 (see SM section 1 for details). The absence of detectable IgM titers in any individual over the age of 15 years suggests reinfections of adults causes a recall response, indicating that while CoV specific immunity may wane it is not lost. Whether immunity would wane to nave levels in the absence of high pathogen circulation remains an open question.
(A) Mean proportion seropositive for IgG (green, top lines) and IgM (purple, bottom lines) against the four endemic HCoV strains [dots connected by dashed lines; vertical lines represent the 95% CI; data from Zhou et al. (10)]. The mean age of primary infection (MAPI) based on IgM data with 95% CI is shown in text inside each panel (see SM for details). (B) MAPI as a function of waning of sterilizing immunity (, y axis) and transmissibility of reinfections (, x axis). The MAPI was calculated from the equilibrium dynamics of the model shown in fig. S1 and supplementary equations 3 to 9 with a plausible basic reproductive number (R0 = 5) and 0 < < 2 and 0 < < 1. See SM section 2.1 for details. The white band in indicates the plausible combinations of values of and consistent with the MAPI for HCoVs estimated in (A). [See fig. S1 for parallel figures calculated at extreme plausible values for R0 (i.e., R0 = 2 and R0 = 10).]
For most people to be infected so early in lifeyounger even than measles in the pre-vaccine erathe attack rate must exceed transmission from primary infections alone. The model shows a high attack rate can arise from a combination of high transmissibility from primary infections (i.e., high R0), waning of sterilizing immunity and significant transmission from reinfections in older individuals. The rapid waning of sterilizing immunity is also reported in experimental HCoV infections of humans which showed that reinfection is possible 1 year after an earlier infection, albeit with milder symptoms (IEP) and a shorter duration (IEI) (11). Figure 1B shows the plausible combinations of waning immunity and transmission from reinfected individuals that are required to produce the MAPI observed in Fig. 1A, based on steady-state infection levels (see SM section 2.1 for details). Table 1 shows the ranges of the parameters used in our simulations.
Characteristics of coronavirus-immune interactions and relevant parameter ranges.
At the beginning of an outbreak, the age distribution of cases mirrors that of the population (Fig. 2A). However, once the demographics of infection reaches a steady state, our model predicts primary cases occur almost entirely in babies and young children, who in the case of COVID-19, experience a low CFR and a concomitantly low infection fatality ratio (IFR). Reinfections in older individuals are predicted to be common during the endemic phase and contribute to transmission, but in this steady-state population, older individuals, who would be at risk for severe disease from a primary infection, have acquired disease-reducing immunity following infection during childhood. The top panel of Fig. 3B illustrates how the overall IFR for CoV-2 drops dramatically, eventually falling below that of seasonal influenza (approximately 0.001) once the endemic steady-state is reached.
Transition from epidemic to endemic dynamics for emerging HCoVs, simulated from an extension of the model presented in fig. S1 that includes age structure. Demographic characteristics (age distribution, birth, and age-specific death rates) are taken from the United States, and seasonality is incorporated via a sinusoidal forcing function (see SM section 2.2). Weak social distancing is approximated by R0 = 2. (See figs. S9 to S11 for strong social distancing results, R0 < 1.5.) (A) Daily number of new infections (black line, calculations in SM section 2.3). An initial peak is followed by a low-incidence endemic state (years 5 to 10 shown in the inset). A higher R0 results in a larger and faster initial epidemic and more rapid transition to endemic dynamics. The proportion of primary cases in different age groups changes over time (plotted in different colors), and the transition from epidemic to endemic dynamics results in primary cases being restricted to younger age groups. Parameters for simulations: = 1 and = 0.7. (B) Time for the average IFR (6-month moving average) to fall to 0.001, the IFR associated with seasonal influenza. Gray areas represent simulations where the IFR did not reach 0.001 within 30 years. The time to IFR = 0.001 decreases as the transmissibility (R0) increases and the duration of sterilizing immunity becomes shorter. Results are shown for = 0.7. See SM section 2.3 and figs. S4 to S7 for sensitivity analyses and model specifications.
The age dependence of the IFR determines how the overall IFR changes during the transition from epidemic to endemic dynamics for emerging CoVs. (A) Age dependence of the IFRs for the three emerging CoVs. Primary infections with MERS and CoV-1 are consistently symptomatic and the IFR and CFR are therefore assumed to be the same. CoV-1 and CoV-2 have J shaped profiles, with a monotonic increase in IFR with age. The age-specific IFR for MERS is U shaped, with high mortality in the young and old age groups. Details of the statistical smoothing are described in SM section 6. (B) The overall IFR changes during the transition to endemic dynamics. These calculations assume deaths due to reinfections are negligible. We relax this assumption to allow for a slower build-up of immunity and possible death due to secondary infection in figs. S5 to S9 and show the qualitative results do not change.
The time it takes to complete the shift in IFR as endemicity develops depends on both transmission (R0) and loss of immunity ( and ), as is shown in Fig. 2B and fig. S4. The transition from epidemic to endemic dynamics is associated with a shift in the age-distribution of primary infections to lower age groups (Fig. 2A). This transition may take anywhere from a few years to a few decades depending on how fast the pathogen spreads. The rate of spread, measured by R0, is determined by a combination of viral properties and the frequency of social contacts, and may therefore be reduced by social distancing. The top panel shows the effect of reducing R0 to 2, whereas the middle and bottom panels show the dynamics for higher R0, which are more akin to those of CoV-2 in the absence of control measures. If transmission is high, the model predicts a high case load and death rate in earlier years following emergence (Fig. 2 and fig. S5). In Fig. 2B we see that, as might be expected, longer lasting sterilizing immunity slows down the transition to endemicity.
These results are robust to a more biologically realistic distribution for the duration of sterilizing immunity and the possibility that the generation of protective immunity requires more than one infection (see SM section 3 and figs. S5 to S9).
Slowing down the epidemic through social distancing measures that reduce R0 to close to one flattens the curve, thus delaying infections and preventing most deaths from happening early on, affording critical time for the development of an effective vaccine (fig. S10). If vaccine-induced IES and IEP immunity is similar to that induced by HCoV infections, the vaccine may usher in the endemic regime more quickly. The model code (see acknowledgments) provides a flexible scaffolding for studying alternative vaccination scenarios. Notably, the model predicts that once the endemic state is reached, mass vaccination may no longer be necessary to save lives (see SM section 4 and fig. S11).
We can extend our predictions to two other potentially emerging coronavirus infectionsSARS and MERS. Our model predicts that in the endemic state the IFR of a circulating CoV depends primarily on the severity of childhood infections. In the case of CoV-1, which is more pathogenic than CoV-2, we still expect a low disease burden in the endemic phase because CoV-1, like CoV-2, has a low IFR in the young (Fig. 3). However, data suggest not all emerging HCoVs follow this optimistic pattern; the overall IFR of an endemic MERS-like virus would not decrease during the transition to endemicity as seen in Fig. 3B, and this is because disease severity (and IFR) is high in children, the age group expected to experience the bulk of primary cases during the endemic phase. In the endemic phase, a vaccination program against MERS would therefore be necessary to avoid excess mortality (fig. S11).
The key result from our new model framework that explicitly recognizes that functional immunity to reinfection, disease and shedding are different is that, in contrast with infections that are severe in childhood, CoV-2 could join the ranks of mild, cold-causing endemic human coronaviruses in the long run. A critical prediction is that the severity of emergent CoVs once they reach endemicity depends only on the severity of infection in children (Fig. 3) because all available evidence suggests immunity to HCoVs has short IES and moderate IEI, leading to frequent reinfection throughout adulthood (11, 12) but strong IEP such that childhood infection provides protection from pathology upon reinfection in adulthood, as evidenced by the rarity of severe infections or detectable IgM titers in adults. Strain-specific virulence factors, such as the shared cellular receptor, ACE-2, to which CoV-1, CoV-2 and the endemic strain NL63 all bind (1316), may affect the CFR during the emergence phase but have little impact on the severity of disease in the endemic phase. Because the four endemic HCoVs have been globally circulating for a long time and almost everyone is infected at a young age, we cannot ascertain how much pathology would result from a primary or even secondary case of any of these in an elderly or otherwise vulnerable person.
The key insights come from how our model explicitly incorporates different components of immunological protection with respect to susceptibility, pathology and infectivity (IES, IEP and IEI) and their different rates of waning. In our analysis we hypothesized that these components of immunity for CoV-2 are comparable to those of endemic HCoVs, and this needs to be determined. Additionally, during the transition to endemicity, we need to consider how the IEs depend on primary and secondary infections across ages (17) and how responses differ between vaccination and natural infection.
Longitudinal analysis of CoV-1 patients provides an opportunity to measure the durability of immune memory in the absence of reexposure. The only long-term study we know of that follows CoV-1-specific antibodies suggests they wane faster compared with antibodies to other live viruses and vaccines such as measles, mumps, rubella and smallpox (18) and fall below the threshold of detection in six years (19). In contrast to antibody responses, memory T cells persist for much longer periods (19, 20) and confer protection in animal model systems (21).
We further consider the effects of strain variation both for natural infection and vaccination. Strain variation and antibody escape may occur in endemic strains (22), however the fact that symptoms are mild suggests that immunity induced by previously seen strains is nonetheless strong enough to prevent severe disease. Indeed among HCoVs, frequent reinfections appear to boost immunity against related strains (12). However, the effect of strain variation may differ for vaccine-induced immunity, especially in light of the narrower epitope repertoire of many currently authorized vaccines.
If frequent boosting of immunity by ongoing virus circulation is required to maintain protection from pathology, then it may be best for the vaccine to mimic natural immunity insofar as preventing pathology without blocking ongoing virus circulation. Preliminary results suggest the adenovirus-based vaccine is better at preventing severe than mild or asymptomatic infections (23), and it will be important to collect similar data for the other vaccines. Should the vaccine cause a major reduction in transmission, it might be important to consider strategies that target delivery to older individuals for whom infection can cause higher morbidity and mortality, while allowing natural immunity and transmission to be maintained in younger individuals. During the transition to endemicity, primary CoV-2 infections will frequently occur in older individuals, and we need to determine if immunity induced by infection or vaccination in adulthood is similar to that produced by natural infections in childhood. Thus far, there have been few reinfections reported with CoV-2, and disease severity has varied (24); the only population-level study of reinfection of which we are aware estimates a low rate of reinfection within the first six months after primary infection and mild disease upon reinfection (25), but further analysis and monitoring are vital.
The findings presented here suggest that using symptoms as a surveillance tool to curb the viruss spread will become more difficult, as milder reinfections increasingly contribute to chains of transmission and population level attack rates. In addition, infection or vaccination may protect against disease but not provide the type of transmission-blocking immunity that allows for shielding (26) or the generation of long-term herd immunity (2).
The details of the change in overall IFR through the transient period will be impacted by a wide array of factors, such as age-specific human contact rates (27) and susceptibility to infection (28), as well as improvement in treatment protocols, hospital capacity, and virus evolution. The qualitative result of mild disease in the endemic phase is robust to these complexities, but quantitative predictions for the transient phase will depend on a careful consideration of these realities and how they interact with the dynamics of infection and components of immunity (29).
The changes in the IFR over time predicted by the model have implications for vaccination strategy against current and future emerging HCoVs. Social distancing and an effective vaccine are critical for control during a virgin epidemic and the transition out of it, but once we enter the endemic phase, mass vaccination may no longer be necessary. The necessity for continual vaccination will depend on the age-dependence of the IFR. If primary infections of children are mild (CoV-1 and CoV-2), continued vaccination may not be needed as primary cases recede to mild childhood sniffles. If, on the other hand, primary infection is severe in children (as for MERS), then vaccination of children will need to be continued.
From an ecological and evolutionary perspective, our study opens the door to questions regarding the within-host and between-host dynamics of human immunity and pathogen populations in the face of IEs with different kinetics. It also opens the question of how these IEs interplay with strain cross-immunity, which is likely relevant within the alpha- and beta-coronaviruses. Considering data and model predictions from emergence through endemicity of HCoVs revealed a framework for understanding immunity and vaccination that may apply to a variety of infections, such as RSV and seasonal influenza, which share similar age distributions and immune responses.
NEWS RELEASE
FOR IMMEDIATE RELEASE:
Jan. 15, 2021
Volunteer for COVID-19 Vaccination Response
Atlanta The Georgia Department of Public Health (DPH) is receiving offers from medical professionals and other individuals looking for ways to help with the COVID-19 vaccination response.An effective response relies on volunteers who are pre-credentialed and organized. Georgia Responds is Georgias health and medical volunteer program which matches the skills and credentials of medical and non-medical volunteers to help stop the spread of COVID-19 in Georgia.
Licensed medical volunteers including doctors, nurses, pharmacists and advanced EMS personnel (EMT Intermediate and above) may be used to administer vaccination. Nonmedical volunteers may be used in administrative roles such as registering individuals for vaccination, data input,language interpretation, other administrative areas as needed, and providing guidance and assistance at vaccination administration sites.
To volunteer, log on to https://dph.georgia.gov/georgia-responds and click on the Register Now box. Registering only takes a few minutes. Prospective volunteers will be asked for their name, address, contact information and occupation type. In order to be eligible for some assignments, responders are encouraged to complete a profile summary, which includes skills and certifications, training, medical history, emergency contact and deployment preferences.
Once your skills and credentials are reviewed, you will be notified by a DPH representative.
Even as the COVID vaccine becomes available, all Georgians play a critical role in helping to slow the spread of COVID-19 by adhering to the following guidance:
For updates on the COVID-19 situation as it develops, follow @GaDPH, @GeorgiaEMA, and @GovKemp on Twitter and @GaDPH, @GEMA.OHS, and @GovKemp on Facebook.
For information about COVID-19, visit https://dph.georgia.gov/novelcoronavirus or https://www.cdc.gov/coronavirus/2019-ncov/index.html.
