POST 148. April 7, 2021. CORONAVIRUS. While the Biden administration accelerates vaccinations to ward off numerous variants and as more young people are being hospitalized, states, even with increasing case rates are on paths to fully reopen. Politics v. public health!

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“Doctors are warning that specifically with the B.1.1.7 variant, which was first identified in the UK, children could play a major role in the rate of transmission.

A report out of the National Institutes of Health stated it is “considerably more contagious” than the original virus, with evidence showing an increased risk of severe illness and death.

“Please understand, this B.1.1.7 variant is a brand new ball game,” said Dr. Michael Osterholm, an epidemiologist.

Osterholm said this variant is making him re-evaluate his own advice about sending kids back to school. In Florida, thousands of students have been back in the classroom since last fall.

Nationally, more and more young people are being hospitalized as cases of this new variant rise. And Osterholm said, “kids now are really major challenges in terms of how they transmit.”

“It infects kids very readily. Unlike previous strains of the virus, we didn’t see children under 8th grade get infected often or they were not frequently very ill, they didn’t transmit to the rest of the community,” Osterholm said.” (A)

“Michigan reported 8,413 new Covid-19 cases on Saturday, bringing the state’s total pandemic case count to 692,206, according to the state’s health department.

Saturday’s daily case count is the highest the state has reported since December 7, when the reported case count was 9,350, state statistics show.

Just eight weeks ago, state data showed the daily reported case count was as low as 563 cases.

Michael Osterholm, director of the University of Minnesota Center for Infectious Disease Research and Policy, said the Upper Midwest is beginning to see its fourth surge.

“I think it was a wake-up call to everyone yesterday when Michigan reported out at 8,400 new cases, and we’re now seeing increasing number of severe illnesses, ICU hospitalizations, in individuals who are between 30 and 50 years of age who have not been vaccinated,” Osterholm said Sunday on NBC’s “Meet the Press.”

Osterholm said that over the past year, there have been surges of cases that cycle between US regions, starting in the Upper Midwest and Northeast, which then subside, and move to the southern sunbelt states, which then subside and go back to the original regions.

Michigan also reported 57 Covid-19 deaths Saturday, with 51 of the deaths having been identified during a vital records review that the state conducts three times per week, the health department said. The state has recorded 9,947 Covid-19 deaths since the pandemic began.

In the first three weeks of March, hospitalizations due to Covid-19 rose 633% for unvaccinated people between the ages of 30-39 and 800% for those aged 40-49, according to the Michigan Health and Hospital Association.

Dr. Justin Skrzynski, a Covid hospitalist for Beaumont Health in Royal Oak, Michigan, said a random sampling of the Covid-19 tests in the state that are sent for DNA analysis indicate a worrying sign — a sharp increase in the variant first found in the UK, which experts say may be more contagious and possibly more lethal.

More than 12,500 cases of the B.1.1.7 variant have been reported across the United States, according to CDC data, including more than 1,200 in Michigan.

Michigan had the second-highest number of cases of the variant, after Florida.

“Right now the regular Covid test we do still just shows Covid/no Covid. But we do send a lot of those out to the state, and we are seeing something like 40% of our patients now with B.1.1.7,” he told CNN’s Miguel Marquez.” (B)

“At an event for veterans in Chesterfield Township,  (Michigan Governor) Whitmer said the surge is not a failure of policy, it’s a failure of following protocols. She reiterated that the state is moving as fast as it can to vaccinate people.

“If we see serious hospital numbers or increased variants, we may have to make some changes,” she said.

In an interview with 7 Action News, Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said it’s “very likely” Michigan may have opened up too soon which could be causing the massive surge in COVID-19 cases.

Fauci said the pressure to pull back could be causing the spike.

“I think the idea of pulling back prematurely, under pressure, it’s understandable why you might want to do that, but the results, I think, are being manifested in what you’re seeing in Michigan,” he said.

“I hesitate to criticize anything the governor did because she’s really quite a good governor,” Fauci said.

In response, Whitmer said that while she respects Dr. Fauci, Michigan is not in the same position compared to other states that have dropped mask mandates.

“We’ve had a very strategic response to the virus,” she said. “Variants are here, and with that, increased abandonment of protocols and mobility.”

The state shut down in mid-November due to a surge, but reopened bars and restaurants in February to 25% capacity, then increased it to 50% on March 5.

The number of active cases in the state coincides with the surge in new cases. It went from 32,400 active cases on March 1 to 86,700 active cases on March 31, the highest number of active cases since early January.” (C)

“Michigan Gov. Gretchen Whitmer (D), battling a surge of coronavirus infections in her state, appealed on Tuesday to White House officials to shift away from a strict population-based formula for vaccine allocation and instead rush more doses to hard-hit parts of the country.

“I know that some national public health experts have suggested this as an effective mitigation tool,” she said during the White House coronavirus response team’s weekly call with governors, according to a recording of the conversation obtained by The Washington Post. “And I know we’d certainly welcome this approach in our state.”

The inquiry reflects growing unease among state officials on the front lines of what health experts say could be a new wave of the virus already afflicting parts of Europe. And it illustrates the pressure President Biden is under, even from members of his own party, to show he is taking steps to address disquieting trends after a prolonged period of declining infections.

The accelerating pace of inoculations has not been sufficient to fend off case increases as more-transmissible variants circulate in the United States, especially among young people who have fallen sick in outbreaks tied to schools. As of Monday, Michigan’s seven-day average of new daily cases stood at 5,157, a 58 percent increase from a week ago and the steepest increase nationwide, according to Post data. The state, where restrictions were recently relaxed, also reported the largest growth in that same time frame in coronavirus hospitalizations, which rose by more than 47 percent.

But Jeff Zients, the White House’s coronavirus coordinator, told Whitmer the Biden administration is not inclined to change its formula for allocating vaccines. The federal government sends all three authorized vaccines to states and other jurisdictions based on the size of their populations, while setting aside separate portions for retail pharmacies, federally run mass vaccination sites and community health centers…

As manufacturing continues to ramp up, some experts have suggested further changes to how vaccines are distributed.

Citing outbreaks in particular states such as Michigan, Scott Gottlieb, a former commissioner of the Food and Drug Administration, said over the weekend that the Biden administration should “surge vaccine into those parts of the country.”

With “the incremental vaccine that’s coming onto the market, I think the Biden administration can allocate to parts of the country that look hot right now,” he said on CBS News’s “Face the Nation.”

By diverting some of the expanded supply to hot spots, the government could avoid cutting any current allocations to states, he told The Post on Tuesday.

Arnold Monto, an epidemiologist at the University of Michigan and the chairman of the FDA’s vaccine advisory committee, said the government may also need to adjust its formula to reflect waning demand for the shots in some parts of the country while others face continued scarcity.

“I’m not sure what the solution is, but clearly there are some problems with distribution,” he said.

Data released this week by the Michigan Department of Health and Human Services shows hundreds of students and staff have been infected at schools throughout the state — with the most significant outbreak occurring among 36 students at Lake Superior State University in Sault Ste. Marie in Michigan’s Upper Peninsula.

Earlier this month, Whitmer loosened capacity limits for restaurants and other businesses, and eased restrictions on both indoor and outdoor gatherings. Joneigh Khaldun, the state’s chief medical executive, told reporters last week that there was no single metric officials were using to decide whether to reimpose restrictions.”  (D)

“While vaccinations in Michigan are helping to protect senior citizens and other vulnerable people, the upswing is driving up hospitalizations among younger adults and forcing a halt to in-person instruction at some schools.

“It’s a stark reminder that this virus is still very real. It can come roaring back if we drop our guard,” said Democratic Gov. Gretchen Whitmer, who does not plan to tighten restrictions on indoor dining, sports and other activities that were eased in recent months….

“It’s very troublesome and very worrisome,” said Dr. Dawn Misra, an epidemiology and biostatistics professor at Michigan State University.

She cautioned that the trend should not be blamed solely on a variant that has been identified more in Michigan than in all but one other state, Florida, noting that lags and disparities in the amount of genetic analysis being done on the virus around the U.S. make comparisons difficult.

“We’re doing a lot of things that lead to increases in risk. That’s where it’s coming from,” said Misra, who urged health officials to emphasize strategies such as double-masking…

Michigan will soon require regular testing of all teen athletes amid outbreaks that occurred after a months long ban on contact sports was lifted. About 100 teams are sitting out the boys’ and girls’ state basketball tournaments.

And some schools are temporarily closing or delaying their long-anticipated reopenings.

The Lansing school district, which has 10,000 students, had planned to resume face-to-face learning for the first time next week, starting with grades four through six. But the reopening was pushed off to April 12, after spring break, because of rising virus cases in the community.

“We’re back to where we were right after Christmas with some of our numbers,” Superintendent Sam Sinicropi said Thursday. “I understand the importance of kids being there and staff being there. But we’re going to make the call because of what’s happening in our area.”  (E)

“Michigan could reduce coronavirus deaths by 2,500 over the next three months by reenacting COVID-19 restrictions and doubling the current rate of vaccine administration for a two-week period, estimates a University of California researcher.

“With regard to the reopening pause, this might be possible by closing indoor dining, indoor bars and indoor gyms for two weeks,” wrote Joshua Schwab, a Berkeley biostatistician.

In an April 3 post, Schwab said his calculations estimated that enacting both strategies — tighter restrictions and faster pace of vaccine administration, each for two weeks — would reduce new hospital admissions by 23,000 and deaths by 2,500 from April 3 to July 1.

Just doubling vaccine administration would reduce hospital admissions by 10,000 and deaths by 1,200, Schwab wrote.

Restrictions on restaurants, bars and gyms would reduce hospital admissions by 16,000 and deaths by 1,700, he projected.

Without interventions, Schwab projects that COVID-19 hospitalizations will peak around May 1 at around 5,500 inpatients or more than 700 new inpatients a day.

That would exceed the previous peak of 4,300 during the first week of November. Michigan hospitals had more than 3,300 coronavirus inpatients on Monday, April 5.

In regards to deaths, Schwab estimates the state will have more than 20,000 coronavirus deaths by July 1 if no interventions are taken. The state has 16,239 confirmed coronavirus deaths as of Monday, April 5.”  (F)

“In the race against COVID’s spread, a vaccine for adolescents might offer an opportunity to sprint toward herd immunity — especially as COVID cases surge among the youngest Michiganders.

In a little more than five weeks, cases involving Michigan residents 19 and younger jumped from 1,526 on Feb. 20 to 6,783 on March 27, a more than four-fold increase, according to state data. Michiganders 10 to 19 years old now make up nearly 16 percent of state COVID cases, up from 8.5 percent before January, the data shows.

It’s not just the more contagious B.1.17. variant that’s causing problems, experts told Bridge Michigan. Prep sports have resumed. And there’s some evidence teens and young adults are less likely to follow safety protocols such as mask-wearing and social distancing as those who feel more at risk, experts said. 

“They don’t tend to get terribly sick, but the infection rates are going up in this population,” said Dr. Arnold Monto, an infectious disease expert at the University of Michigan and national authority on the coronavirus.

“I think the schools have done a great job” in ensuring students follow safety protocols, said Dr. Catherine Bodnar, medical director at Midland Health Department. The outbreaks, she said, are taking root “before and after school and even before and after practice.”..

To be sure, COVID has mostly spared Michigan’s youngest demographic from serious illness. Nearly 90 percent of its COVID-linked deaths are among those 60 and older, according to state data.

Though rare, however, COVID can cause life-threatening symptoms even among the young and healthy. At least 95 Michigan children with COVID infections were diagnosed with multisystem inflammatory syndrome, also known as MIS-C, according to state data.  At least 33 children died nationally from MIS-C, according to the U.S. Centers for Disease Control & Prevention.

The condition can inflame heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs, and other parts of the body. Of the 95 who died, 65 were admitted to an intensive care unit, according to the same data.

“MIS-C is rare, that’s fair. But that’s not to say that it’s not a risk,” said Veronica McNally, founder of Michigan’s I Vaccinate campaign, which aims to increase vaccines among children, and a consumer representative to the CDC’s Advisory Committee for Immunization Practices, or ACIP.

More than 300 children have died nationally from COVID-19, according to the CDC.”  (G)

“Many children and teenagers who developed the mysterious inflammatory syndrome that can emerge several weeks after contracting the coronavirus never had classic Covid-19 symptoms at the time of their infection, according to the largest study so far of cases in the United States.

The study, led by researchers from the Centers for Disease Control and Prevention, found that in over 1,000 cases in which information about whether they got sick from their initial Covid-19 illness was available, 75 percent of the patients did not experience such symptoms. But two to five weeks later, they became sick enough to be hospitalized for the condition, called Multisystem Inflammatory Syndrome in Children (MIS-C), which can affect multiple organs, especially the heart.

Published Tuesday in JAMA Pediatrics, the study said that “most MIS-C illnesses are believed to result from asymptomatic or mild Covid-19” followed by a hyper-inflammatory response that appears to occur when the patients’ bodies have produced their maximum level of antibodies to the virus. Experts do not yet know why some young people, and a smaller number of adults, respond this way.

“It means primary-care pediatricians need to have a high index of suspicion for this because Covid is so prevalent in the society and children often have asymptomatic disease as their initial Covid infection,” said Dr. Jennifer Blumenthal, a pediatric intensivist and pediatric infectious disease specialist at Boston Children’s Hospital, who was not involved in the study.”  (H)

“California is aiming to fully reopen its economy June 15, more than a year after the COVID-19 pandemic upended the lives and businesses of millions across the state.

Officials emphasize the move hinges on two factors: a sufficient vaccine supply and stable and low hospitalization numbers.

There also will not be a full return to pre-pandemic life. Notably, California’s mask mandate will remain in place.

But officials expressed confidence that the state, through continued improvement in its coronavirus metrics and the steady rollout of vaccines, is now positioned to begin actively planning for what comes after COVID-19.

“With the expectation of an abundance of doses coming in from the federal government through the end of this month and into May, we can confidently say by June 15 that we can start to open up as business as usual — subject to ongoing mask wearing and ongoing vigilance,” Gov. Gavin Newsom said during a news conference in San Francisco on Tuesday.

“So this is a big day.”

Vaccinated and eager for normal life, Californians are venturing out. Is it too much too soon?

June 15 is expected to be the end of California’s current reopening roadmap, which sorts counties into one of four color-coded tiers based on three metrics: coronavirus case rates, adjusted based on the number of tests performed; the rate of positive test results; and a health-equity metric intended to ensure that the positive test rate in poorer communities is not significantly higher than the county’s overall figure.

“The entire state will move into this phase as a whole. This will not be county-by-county,” Dr. Mark Ghaly, California’s health and human services secretary, said in a call with reporters.

In a statement, officials said those sectors included in the state’s reopening blueprint will be allowed to “return to usual operations in compliance with Cal/OSHA requirements and with common-sense public health policies in place, such as required masking, testing and with vaccinations encouraged. Large-scale indoor events, such as conventions, will be allowed to occur with testing or vaccination verification requirements.”

Ghaly emphasized that, “if we see any concerning rise in our hospitalizations, we will take the necessary precautions. But right now, we are hopeful in what we’re seeing as we continue to build on the 20 million vaccines already administered.”

Though state officials said they will keep a watchful eye on vaccine supply and hospitalizations — including how many fully vaccinated people end up requiring that level of care — they did not establish any hard benchmarks to determine whether California is ready to progress.

“We don’t have a specific number, per se, on the hospitalizations, but are looking at impacts on hospital capacity and the delivery systems’ ability to continue to deliver routine care,” Ghaly said.

On Monday, 1,989 coronavirus-positive patients were hospitalized in California — with 493 of them in intensive care. The state hasn’t seen numbers that low since last spring.

Part of the reason June 15 was chosen as the target date, Ghaly said, was that it falls two months after the state will extend vaccine eligibility to anyone 16 and older.

“We wanted to be able to provide at least a couple of weeks, two to three weeks, for individuals interested in getting vaccinated who suddenly become eligible on April 15 to get in line to get their vaccines started,” he said.” (I)

“On NBC’s Meet the Press, Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, called the B.1.1.7 variant a “brand-new ballgame” because of how quickly it has spread among children, citing roughly 750 Minnesota schools that have reported the variant in just the last two weeks.

Osterholm also suggested the U.S. may need to consider new lockdowns before school lets out this summer, saying vaccination alone won’t curb rising cases in the next six to eight weeks and telling Fox News Sunday that “there isn’t a country in the world right now that has seen a big increase in this [variant] that is not locking down.”

“We’re going to have to reconsider what we’re doing,” Osterhold said, noting that the new variant is between 50% to 100% more infectious than previous strains and causes more severe illness about 55% of the time.

He also said experts are “very worried” that variants can evolve in a way that evades the protection of a vaccine and called for the U.S. to rev up its global response measures to vaccinate low- and middle-income countries in order to help curb the development of new strains that could challenge vaccine efficacy; so far, the World Health Organization has said the current slate of vaccines is expected to provide “at least some protection” against new strains….

“I think that there’s enough immunity in the population that you’re not going to see a true fourth wave of infection,” Scott Gottlieb, the former head of the Food and Drug Administration, said Sunday. Roughly 162 million vaccines have been administered domestically, and about 60 million Americans, or nearly 20% of the nation’s population, are fully vaccinated, according to the CDC.” (J)

(A)Kids Could Play Major Role in Transmission of COVID-19 Variant, By Rachael Krause, https://www.mynews13.com/fl/orlando/coronavirus/2021/04/05/kids-could-play-major-role-in-transmission-of-covid-19-variant?web=1&wdLOR=c6C2A1A8C-7B87-42E1-B7FE-A901942CBFC9

(B) Michigan adds more than 8,400 new Covid-19 cases in one day, the most since December, by By Laura Ly and Alanne Orjoux, https://www.cnn.com/2021/04/04/us/michigan-rising-covid-cases/index.html

(C)(Whitmer attributes Michigan’s case surge to rise in variants, failure to follow health protocols, https://www.wxyz.com/news/coronavirus/whitmer-attributes-michigans-case-surge-to-rise-in-variants-failure-to-follow-health-protocols

(D)Michigan’s Whitmer asks White House to surge vaccines to virus hot spots as cases climb, By Isaac Stanley-Becker, https://www.washingtonpost.com/health/2021/03/30/vaccine-supply-michigan-whitmer/

(E)Michigan sees virus surge, but tighter restrictions unlikely, By DAVID EGGERT and ED WHITE, https://apnews.com/article/michigan-coronavirus-surge-unlikely-tighter-restrictions-c24a9b31bfa000c2dfa3e52236ad790d

(F)Michigan could save 2,500 lives by reimposing COVID-19 restrictions, vaccine ‘surge,’ researcher estimates, By Julie Mack, https://www.mlive.com/public-interest/2021/04/michigan-could-save-2500-lives-by-reimposing-covid-19-restrictions-vaccine-surge-researcher-estimates.html

(G)COVID vaccine for kids edges closer to reality, as cases surge in Michigan, by Robin Erb, https://www.bridgemi.com/michigan-health-watch/covid-vaccine-kids-edges-closer-reality-cases-surge-michigan

(H) Many Children With Serious Inflammatory Syndrome Had No Covid Symptoms, By Pam Belluck, https://www.nytimes.com/2021/04/06/health/covid-children-inflammatory-syndrome.html?referringSource=articleShare

(I) California aims to fully reopen its economy June 15, By LUKE MONEY, TARYN LUNA, https://www.latimes.com/california/story/2021-04-06/california-aims-to-fully-reopen-the-economy-june-15

(J)Biden Covid Advisor Warns ‘Game-Changing’ Variant Infects Kids ‘Very Readily’ And Could Spur New Lockdowns, by Jonathan Ponciano, https://www.forbes.com/sites/jonathanponciano/2021/04/04/biden-covid-official-warns-game-changing-variant-infects-kids-very-readily-and-could-spur-new-lockdowns/?sh=3442f34f6b9a