Beware Of Hot Spots

U.S. Hot Spots — 11/21/21 — New York Times

 

Last week on The PediaBlog, we noted with excitement that COVID-19 vaccines were now available for children ages 5-to-11, just in time for the holidays. In just the last two weeks, about 2.6 million American children (around 10% of this age group) received their first Pfizer vaccine, and by Christmas they should be fully vaccinated and protected against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) two weeks after their second dose.

Unfortunately, we also noted a disturbing trend in rising cases, hospitalizations, and deaths recently from COVID-19, also just in time for the holidays. On Friday, more than 113,000 new cases were reported across the U.S. in a single day and that number is expected to rise throughout this holiday week and into December. We know hospitalizations and deaths lag behind rising case rates by several weeks, so by Christmas we can expect more hospitalizations and deaths in excess of the 1,687 who died on Friday, according to the CDC COVID Data Tracker.

For Pennsylvanians either traveling out of state for Thanksgiving or hosting guests from other states, it’s important to know that the Keystone State is now a hot spot for COVID-19 transmission. Eugene Tauber says people who were infected once before are testing positive again and adding to the caseload:

The Pennsylvania Department of Health reported 7,604 additional coronavirus cases on Friday, continuing a recent rapid increase in case numbers. The seven-day moving average of newly reported cases was 7,923 cases per day, up 66.1% from a week ago, and up 86.9% over the last 30 days.

Pennsylvania has added 55,458 cases in the past seven days, including 15,414 reinfection cases added Nov.13. Even without those cases, the 40,044 weekly case total is the highest seen since Jan. 21, when the state was coming out of its largest wave of the pandemic that peaked in mid-December.

 

Sophie Putka asked physicians and public health experts how they plan to celebrate the holidays in light of a holiday surge in cases. Peter Hotez, MD, PhD, Baylor College of Medicine — Pediatrics, Infectious Diseases, will employ every layer of protection available to keep him and his family healthy and safe from COVID-19:

Just a small gathering. … It’s looking increasingly likely that cases and transmission will go up again as we head towards the holidays. So the key to a safe holiday season: 1) ensure everyone is fully vaccinated in your gathering; 2) remember “fully vaccinated” means 3 doses of mRNA or 2 of J&J; 3) keep gatherings small, and if possible outside, if not in a well-ventilated indoor area, possibly near an open door; 4) masks when possible, especially if you find yourself in crowded, large gatherings.

 

Eric Feigl-Ding, ScD, Federation of American Scientists — Epidemiology, agrees with that multi-pronged strategy mostly to protect his own parents and grandparents:

It depends on whether the grandparents are around, and if they’re vaccinated or boosted. My mother just got boosted this week, same with my dad. So the booster should be really important in thinking about holiday gatherings. But any vaccination is critical if it hasn’t been done yet.

So, boosters, getting kids vaccinated, ventilation, and testing are important. It’s not “or” here. It’s all of the above. Vaccination alone isn’t enough. Testing alone isn’t enough. Ventilation alone isn’t enough. A multi-layered strategy is essential.

 

David Boulware, MD, MPH, University of Minnesota — Infectious Diseases, explains why unvaccinated friends and family members aren’t invited to his dinner table this year:

For Thanksgiving 2021, I have a small gathering of 4-5 adult family members, all of whom have received 3 mRNA vaccine doses. With a recent third mRNA booster, I feel quite confident in my own protection from moderate or serious illness.

However, I still would not have a holiday gathering with an unvaccinated family member. Why? First, because they would be a total knucklehead, and second, due to that knucklehead’s risk of spreading a fatal illness to another immunocompromised family member. Five percent of the U.S. population has some immunocompromised condition, thus within one’s extended family someone very well may have a weakened immune system. Fortunately, all of my family members have been vaccinated.

 

The holidays coinciding with the start of influenza season is another reason to be especially careful and keep up precautions, including remembering to get your flu shot, says Stephen Morse, PhD, Columbia University Medical Center — Epidemiology:

We’ve had three doses of mRNA vaccine by now, as have most of my relatives and colleagues who qualify. The vaccine has been a very positive development, but the gaps in vaccine uptake, as well as the much more transmissible Delta variant, make me feel that discretion is still the better part of valor. There’s a temptation to let down our guard prematurely whenever cases decline, and then see the inevitable spike.

 

Robert Schooley, MD, University of California San Diego — Infectious Diseases, will pay careful attention to places he is visiting:

[W]e’re not out of the woods yet since we have relatively large segments of the population who have not yet been vaccinated and they remain at substantial risk of becoming ill if they do get infected in the midst of the holiday travel season. The places where larger segments of the population are unvaccinated are also places where healthcare systems are stressed. People with underlying medical conditions that might require acute care should be wary about traveling to places where access to care might be limited because of concomitant COVID waves.

I expect next year will be even better because by then we will have much more vaccine coverage of the pediatric population and boosters will be more widely used.

 

Too many people have decided that the pandemic is over. Unfortunately, it is not, especially in hot spots like Pennsylvania. Parents should have second thoughts about traveling for the holidays with children who haven’t received a COVID-19 shot yet or are under 5 and too young to be vaccinated. From a public health standpoint, unvaccinated people should take the most responsible course of action to protect themselves and others from transmitting the highly infectious coronavirus by staying home. At the very least getting a negative test before arriving at a gathering should be mandatory for unvaccinated individuals fortunate enough to be invited to any holiday gathering this holiday season.

 

source http://www.thepediablog.com/2021/11/22/beware-of-hot-spots/