March 29, 2022
The Covid situation in Alabama continues to be quite favorable, with reported cases declining 30% compared to the prior week (net of a data dump of 1,714 positive tests taken prior to February 28). Aside from 5 days last June, Alabama’s 7-day average of reported cases (184 per day) is now the lowest since I began writing this letter on May 1, 2020.
The number of Covid patients in Alabama hospitals (231) also declined another 22% since last week, reaching the lowest level since April 3, 2020. There are just 32 Covid patients occupying ICU beds in the entire state, the lowest total since that statistic was first recorded in July of 2020.
Nationally, reported Covid cases continue to fall but at a slower pace - 9% over the last week. There are 9 states in which cases actually increased by double digits this week, largely centered in the northeast, although Texas also saw a 63% increase in reported cases for the week.
The Ba.2 subvariant now represents a majority of the new cases diagnosed in the United States. This subvariant of Omicron is more transmissible than the original strain but 3 doses of an mRNA vaccine offers essentially the same protection as 2 doses against the Delta variant. Unlike Omicron, which had a high reinfection rate, Ba.2 rarely infects individuals who were previously infected by Omicron.
Today, the FDA authorized a second booster shot of the Pfizer-BioNTech and Moderna coronavirus vaccines for people aged 50+ at least four months after their first booster. The FDA also updated its authorization for people 12 and older who are immunocompromised, saying they are eligible for an additional booster. The CDC followed the FDA’s lead, and the 2nd booster is expected to become available as early as tomorrow, Wednesday.
Now that a 4th dose has been authorized for older and immunocompromised Americans, what should you do if you are eligible? Israel, a country having substantial experience with 4 shots, offers important insights. In one study involving 1,138,681 Israelis aged 60+ who received a 4th dose, the rate of infection was 2 times lower than in those without the last dose, while the rate of severe disease was 4 times lower. In other words, a 4th booster had a meaningful impact for older adults.
However, another study assessed the effectiveness of a 4th dose among young Israeli healthcare workers and found that the added benefit from the 4th dose was not statistically significant.
Bottom line: if you are immunocompromised or well over 65 years old, a 4th dose is highly recommended. On the other hand, if you are only 55 and had a negative reaction to one or more of the earlier doses, your decision may not be so clear-cut. You may want to monitor the data carefully and decide on a 4th dose only if another surge begins to take off.
In any case, it’s clear that another booster is only a short-term solution because it is not practical to get more and more boosters only a few months apart. Additional research is necessary to produce a long-term solution … and that requires additional government funding. The totals:
3/16 - 438
3/17 - 527
3/18 - 494
3/19 - 220
3/20 - Not reporting
3/21 - 155
3/22 - 200
3/23 - 185
3/24 - 398
3/25 - 164
3/26 - Not reporting
3/27 - Not reporting
3/28 - 310 (net of 1,714 positive cases from tests conducted before 2/28)
3/29 - 284