August 29, 2023 - Troubling Recent Trend
Troubling Recent Trend
August 29, 2023
The Centers for Disease Control & Prevention updated its Covid-19 hospitalization data last night. Since the end of the national public health emergency on May 11, 2023, such data, which has been crucial to understanding the spread and impact of Covid, is reported by government sources less frequently, or not at all. The CDC’s latest update covers the week ending August 19, which is 10 days ago.
In Alabama, there were 318 new Covid-19 hospital admissions for the week of August 19, a 47% increase over the prior week. Hospital admissions have risen virtually every week since June 10, when the number of weekly hospital admissions statewide reached a three-year low of 73.
Southeastern states currently lead the nation in terms of Covid hospitalizations. At 9.7 admissions per 100K population, the State of Florida has the country’s highest hospitalization rate by far, followed by Louisiana (6.6 per 100K) and then Alabama (6.49 per 100K) and Mississippi (6.48 per 100K). Hospitalizations are an indicator of the most severe cases, and mRNA vaccines have proven to be highly effective in reducing severity. Therefore, it is not surprising that Southeastern states, which have the lowest vaccination rates, would suffer more severe cases than their counterparts.
While it is clear we are seeing a seasonal spike, it is important to keep the new data in perspective. During the same week in August 2022, Alabama’s Covid hospital admissions were more than double what they are now (815 new admissions). And in mid-August of 2021, the height of the Delta wave, there were 2,551 new admissions, fully 8 times the current total. What is troubling, however, is that the current trend is getting worse with each succeeding week, whereas the overall trend was improving last year at this time.
Part of the problem this summer may have to do with the waning effect of the bivalent vaccines approved for use in the fall of 2022. The mRNA vaccines, produced by Pfizer and Moderna, have shown that they begin to wane after about 4-5 months. An additional bivalent booster shot was approved by the CDC last spring, but eligibility for that booster was limited to populations who were at greater risk of severe reaction (certain adults 65 or older and immunocompromised individuals). As a result, many people who were vaccinated last fall are now largely unprotected because they did not qualify to receive an additional booster shot in the spring. The CDC estimates that only 8% of Alabama’s population are currently up-to-date on their vaccinations.
The current surge appears to be fueled by newer strains of the virus like EG.5 (nicknamed “Eris” - 16.5% of recent Southeastern cases) and FL.1.5.1 (nicknamed “Fornax” - 14.9% of recent Southeastern cases), both of which are Omicron subvariants that descend from the XBB variant. The CDC expects that updated vaccines produced by Pfizer, Moderna and Novavax will be effective against all of the current variants and will be available to the public in mid-September. An independent panel of advisors to the CDC is meeting on Sept.12 to vote on eligibility requirements.
Given the heightened media attention devoted to the recent mini-surge, you may be wondering whether you should run immediately to your local pharmacy for a booster shot. My advice to you is to wait until mid-September so you can receive one of the new vaccines. Also, there is a new player to consider. According to Dr. Katelyn Jetelina, Novavax has produced a new vaccine that has been approved by the CDC and has proven to be more durable in clinical trials (waned less quickly) with fewer side effects, like pain and muscle aches. The Novavax vaccine is not an mRNA vaccine but its effectiveness is considered comparable to its mRNA competitors. Please consult your physician for a vaccine recommendation.
I understand this is a difficult period for many of you. When you or your loved one gets Covid, it is natural to be apprehensive, even scared. I have also begun to hear from friends and close family members who are battling this virus, some for the first time. I realize that numbers tell a story, but not the whole story, and I assure you that I will never forget the human face of this enigmatic and heart-rending pandemic. Although the reporting of Covid data has become less comprehensive and timely, I will continue to analyze it until I see a reversal of the current trend. In the meantime, if you have any questions, please drop me a line.
Thank you for keeping watch, Frank. A trusted medical friend alerted me to the anticipation of a resurgence and also a challenging flu season. We appreciate your alerts and information.
Thank you this helpful update! My husband and I have also been concerned about this latest mini surge. We both considered getting another booster this summer but were told we were "good" in terms of vaccinations. I thought that was a bit of an odd response. I think, perhaps, they meant we should wait for the updated vaccine this fall, but I still wonder if we should have gotten another booster rather than waiting. We have known more than a few people who have gotten infected, I clouding several who had had it before and experienced long COVID. Sadly, one person who recently died from it. But very few people seem to be taking precautions like wearing masks inside in populated places.