August 27, 2022
The Covid-19 pandemic simply refuses to give up the fight in Alabama. After a two-week head fake, when new reported cases fell to a low of 1,908 per day from the July peak of 2,900 per day, we have seen a two-week reversal in trend. As of Friday, our 7-day average is 2,239 reported cases per day, an 8% rise over last week. Alabama’s current per capita rate of 46 reported cases per 100K population is 3rd highest in the nation, behind only Tennessee and Kentucky. The national average is 27 cases per 100K (the prevalence of at-home tests means the actual number of cases is far higher than the reported number).
Covid-19 hospitalizations in Alabama settled at 724 patients by week’s end, down 6.8% from 777 patients last week. The national rate of hospitalization also declined 5% over the same period. Five states have a higher rate of hospitalization than Alabama’s current rate of 15 patients per 100K population - Delaware, West Virginia, North Carolina, Kentucky & Florida.
NBC News has reported that the FDA plans to authorize bivalent boosters by Labor Day. The new Pfizer and Moderna boosters will target the BA.4 and BA.5 Omicron subvariants, in addition to the original Omicron strain, in a single shot. BA.5 is now responsible for nearly 90% of all new Covid cases in the U.S. while BA.4.6 is responsible for 6.3%. Pfizer is seeking authorization for people 12 and older, while Moderna is seeking authorization for adults 18 and older.
Following FDA authorization, the CDC is expected to sign off, with vaccinations expected to become available as early as the week after Labor Day. The only sticking point involves the decision to move forward without complete data from human trials. The FDA has decided instead to base its decision regarding efficacy largely on tests conducted with mice. This is a controversial decision, generating two schools of thought.
On the one hand, most experts would say, after billions of mRNA shots administered worldwide, we have enough experience to be confident the shots are safe and, with such a rapidly mutating virus, there's not enough time to wait for data from human studies. Pfizer and Moderna will continue gathering data from human studies, but those results won't be available until late October at the earliest. The new boosters will be identical to the original vaccines, except they will contain genetic coding for two versions of the protein the virus uses to infect cells instead of just one. These experts point to flu vaccines, which are altered every year to try and match whatever strains are likely to be circulating, and those altered vaccines aren't subjected to human trials annually.
On the other hand, other experts say mouse experiments are notoriously unreliable, so the boosters may not work as well as the mouse data might suggest. These experts also worry that the reliance on mouse data may further erode efforts to persuade people to get boosted at all.
So, the question of the hour is, should you get the bivalent vaccine as soon as it becomes available after Labor Day? Or, should you wait until human trials are completed at the end of October? Here is how Dr. Katelyn Jetelina, “Your Local Epidemiologist”, answered that question: “Waiting may make sense if someone was recently infected. There’s clearly a risk/benefit balance here, especially for vulnerable adults.”
I honestly haven’t yet decided whether to wait for the data from human trials before getting the bivalent booster. I suspect there will be a lot written on this subject in the coming days and I’d like to see what the CDC’s Advisory Committee says about it when they meet just after Labor Day. For the moment, all I can say is stay tuned. The totals:
8/13 - not reporting
8/14 - not reporting
8/15 - 2,457
8/16 - 2,297
8/17 - 2,617
8/18 - 2,519
8/19 - 2,570
8/20 - 2,199
8/21 - not reporting
8/22 - 1,461
8/23 - 3,512
8/24 - 2,910
8/25 - 3,020
8/26 - not reporting