- COVID-19 hospitalizations reached almost 43,000 on Monday, their highest point since August 19. A total of 36 states have seen at least a 5% increase in hospitalizations compared to last week.
- In Utah, ICU occupancy hit nearly 70% and hospitals are prepared to start rationing ICU space this week or next. In El Paso, Texas, occupancy hit 100% and medical workers are taking patients to field or mobile units for care.
- On top of this, some hospitals, including ones in Utah, are understaffed right now. Many hospital staffers are battling physical and emotional exhaustiong from dealing with the pandemic for seven months with no end in sight.
Hospitalizations Go Up
As coronavirus cases inch upwards across the country, hospitalizations are following, setting a trend that worries health experts heading into the winter.
Over the past week, the United States has set its record for the highest single day of cases reported and the highest seven-day average of new cases. Nearly 43,000 hospitalizations were reported on Monday, the highest number since August 19. It is a staggering jump upward from the start of the month when hospitalizations were at 30,700.
CNBC reported that in 36 states, hospitalizations have risen by at least 5% compared to where they were just last week. The caseload is straining hospitals across the country, which are bracing for these spikes to get even worse.
According to the Philadelphia Inquirer, there has been a 157% increase in hospitalizations in Pennsylvania compared to this time last month. New Jersey has seen a 125% jump while Delaware saw 69% growth.
Hospitals and Local Governments Respond to Increases
In Utah, according to the Salt Lake Tribune, 771 people have been hospitalized for the virus in the past two weeks, the highest number of any 14 day period since the start of the pandemic. There, the ICU occupancy hit 68.9% on Monday and state officials and hospital administrators are prepared to ration ICU space this week or next week. This means some ICU patients whose condition is worsening might be forced out of the unit. Older patients, who are more likely to die, will likely be forced out before younger ones. One doctor said capacity is being assessed “on a minute to minute basis, almost.”
The Texas Tribune reported that there has been a 300% increase in hospitalizations in El Paso over the last three weeks. ICU beds have reached 100% capacity and patients are now being taken to mobile and field units to be cared for. The city has put in place a 10:00 p.m. curfew to curb the spread. City officials are also encouraging citizens to stay home as much as possible over the next two weeks.
Impact on Hospitals and Staff
Experts have long predicted that the virus would pick up in the colder months of the year. With such a steep case increase before winter has even arrived, health officials are worried about this trend. But with all these numbers trending upwards at alarming rates, there are a lot of health officials concerned.
“This is a harbinger of a very tough winter that’s coming. I think hospitals are going to be very, very stressed this fall and winter,” Dr. Bill Schaffner, an epidemiologist at Vanderbilt University told CNBC.
On top of this, hospital staffers are suffering from COVID fatigue. Doctors and nurses have been dealing with the pandemic for the majority of the year with no end in sight. This has led to physical and emotional exhaustion. Some hospitals are also understaffed.
“We’re down 20% to 30%,” Greg Bell, the president of the Utah Hospital Association told the Tribune. “Hundreds and hundreds of nurses are not able to work as they were [before] because of their own disease or infection in the family, or they’re moms and dads with school issues. Some are worn out, some are on leave because they’ve been doing this for seven months.”
See what others are saying: (CNBC) (Salt Lake Tribune) (Vox)
Texas Doctor Says He Violated Abortion Law, Opening Matter Up for Litigation
Under the state’s new law, any citizen could sue the doctor, which would make the matter the first known test case of the restrictive policy.
Dr. Braid’s Op-Ed
A Texas doctor revealed in an op-ed published in The Washington Post Saturday that he performed an abortion in violation of the state’s law that bans the procedure after six weeks, before most people know they are pregnant.
The law, which is the most restrictive in the country and does not have exceptions for rape and incest, also allows civilians to sue anyone who helps someone receive an abortion after six weeks.
In the op-ed, Dr. Alan Braid, who has been practicing as an OB/GYN in Texas for 45 years, said that just days after the law took effect, he gave an abortion to a woman who was still in her first trimester but already beyond the state’s new limit.
“I acted because I had a duty of care to this patient, as I do for all patients, and because she has a fundamental right to receive this care,” he wrote. “I fully understood that there could be legal consequences — but I wanted to make sure that Texas didn’t get away with its bid to prevent this blatantly unconstitutional law from being tested.”
Braid went on to say that he understands he is taking a personal risk but that he believes it is worth it.
“I have daughters, granddaughters and nieces,” he concluded. “I believe abortion is an essential part of health care. I have spent the past 50 years treating and helping patients. I can’t just sit back and watch us return to 1972.”
If someone does opt to sue Braid over this matter, he could potentially be the state’s first test case in playing out the legal process. However, it is unclear if anti-abortion groups will follow through, despite their threats to enforce the law.
A spokesperson for Texas Right to Life, which set up a website to report people suspected of violating the ban, told reporters this weekend that it is looking into Braid’s claims but added, “It definitely seems like a legal stunt and we are looking into whether it is more than that.”
Even if abortion opponents hold off on Braid’s case, there are other legal challenges to the Texas law.
Shortly after the policy took effect, the Department of Justice filed a lawsuit attempting to stop it. Last week, the department filed an emergency motion asking a federal judge in the state to temporarily block the ban while that legal battle plays out, with a hearing for that motion set for Oct. 1.
Regardless of what side the federal judge rules for, the other is all but ensured to sue, and that fight could take the question to the Supreme Court in a matter of months.
See what others are saying: (NPR) (The Texas Tribune) (The Wall Street Journal)
Pfizer Says Low Dose of COVID-19 Vaccine Is Safe and Effective in Kids 5 to 11
Pfizer Says Kids’ Vaccine Works
Pfizer announced Monday morning that its joint COVID-19 vaccine with BioNTech is safe and effective in kids ages 5 to 11.
While Pfizer’s vaccine candidate for younger children is the same version the FDA has already approved for people 12 and older, the children’s dose is only one-third of the amount given to adults and teens. Still, Pfizer said the antibody response they’ve seen in kids has been comparable to the response seen in older participants.
Similarly, the company said side effects in children have been similar to those witnessed in adults.
Pfizer said it expects to finish submitting data, which still needs to be peer-reviewed and then published, to the FDA by the end of the month. From there, the agency will ensure that Pfizer’s findings are accurate and that the vaccine will be able to elicit a strong immune response in kids at its current one-third dosage.
That process could take weeks or even all of October, but it does open the possibility that the vaccine candidate could be approved around Halloween.
While experts like Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, have called Pfizer’s announcement largely predictable, they’ve also urged people to let the research run its course.
With cases among children skyrocketing in recent months, some parents have begun urging pediatricians to give their children the jab early. Those kinds of requests are likely to increase with Pfizer’s announcement; however, officials have warned parents about acting too quickly.
“No one should really be freelancing — they should wait for the appropriate approval and recommendations to decide how best to manage their own children’s circumstances,” Bill Gruber, Pfizer’s senior vice president of vaccine clinical research and development, said according to The Washington Post.
See what others are saying: (The Washington Post) (The New York Times) (Axios)
Contradicting Studies Leave Biden’s COVID-19 Booster Plan Up in the Air
While some studies show that the effectiveness of Pfizer and Moderna’s COVID vaccines decrease over time, other publications argue the decline is not substantial and a full-flung booster campaign is premature.
Booster Rollout in Flux
President Joe Biden’s plan to offer COVID-19 booster shots is facing serious hurdles just a week before it is set to roll out. Issues with the plan stem from growing divisions among the scientific community over the necessity of a third jab.
The timing of booster shots administration has been a point of contention for months, but the debate intensified in August when Biden announced that, pending regulatory approval, the government would start offering boosters on Sept. 20 to adults eight months after they received their second dose of Pfizer or Moderna.
The announcement was backed by the director of the Centers for Disease Control and Prevention (CDC), the acting commissioner of the Food and Drug Administration (FDA), and White House chief medical advisor Dr. Anthony Fauci, among others.
However, many scientists and other health experts both inside and outside of the government have continually criticized the plan. They have claimed the data supporting boosters was not compelling and argued that, while the FDA approved third doses for immunocompromised Americans, the push to give them to the general public was premature.
The plan also drew international backlash from those who argued the U.S. should not launch a booster campaign when billions of people around the world have not gotten their first dose yet. Earlier this month, the World Health Organization (WHO) extended its request that wealthy countries hold off on giving boosters until at least the end of the year.
Those arguments appeared to be bolstered when federal health regulators said earlier this month that they needed more time to review Moderna’s application for booster shots, forcing the Biden Administration to delay offering third shots to those who received that vaccine.
Now, Pfizer recipients will be the only people who may be eligible for boosters by the initial deadline, though that depends on a forthcoming decision from an FDA expert advisory committee that is set to vote Friday on whether or not to recommend approval.
Debate Continues in Crucial Week
More contradictory information has been coming out in the days leading up to the highly anticipated decision.
On Monday, an international group of 18 scientists, including some at the FDA and the WHO, published a review in The Lancet arguing that there is no credible data to show the vaccines’ ability to prevent severe disease declined substantially over time, so boosters are not yet needed for the general, non-immunocompromised public.
The experts claimed that any advantage boosters may provide does not outweigh the benefit of giving the extra doses to all those who are unvaccinated worldwide.
On the other side, a study released Wednesday in The New England Journal of Medicine found that people who received a third shot of Pfizer in Israel were much less likely to develop severe COVID than those who just had the first two jabs.
The same day, both Pfizer and Moderna published data backing that up as well. Pfizer released an analysis that said data on boosters and the Delta variant from both Israel and the U.S. suggested “that vaccine protection against COVID-19 infection wanes approximately 6 to 8 months following the second dose.”
Moderna also published data, that has not yet been peer-reviewed, which also found its jab provided less immunity and protection against severe disease as time went on.
Further complicating matters was the fact that the FDA additionally released its report on Pfizer’s analysis of the need for a booster shortly after Pfizer’s publication. Normally, those findings would shine a light on the agency’s stance on the issue, but the regulator did not take a clear stand.
“Some observational studies have suggested declining efficacy of [Pfizer] over time […] while others have not,” the agency wrote. “Overall, data indicate that currently US-licensed or authorized COVID-19 vaccines still afford protection against severe COVID-19 disease and death.”
It remains unclear what the FDA panel will determine when they meet Friday, or what a similar CDC expert panel that is expected to meet next week will decide regarding vaccination policies.
Notably, officials at the two agencies are not required to follow the recommendations of their expert panels, though they usually do.
Even if the FDA approves Pfizer’s application as it stands to give boosters to those 16 and older, people familiar with the matter said the CDC might recommend the third jabs only for people 65 and older or those who are especially at risk.
Regardless of what is decided, experts have said that it is absolutely essential for the agency to stand firm in its decision and clearly explain its reasoning to the public in order to combat further confusion and misinformation.
“F.D.A. does the best in situations when there are strongly held but conflicting views, when they’re forthcoming with the data and really explain decisions,” Dr. Joshua Sharfstein, a vice dean at the Johns Hopkins Bloomberg School of Public Health told The New York Times. “It’s important for the F.D.A. not to say, ‘Here’s our decision, mic drop. It’s much better for them to say, ‘Here’s how we looked at the data, here are the conclusions we made from the data, and here’s why we’re making the conclusions.’”