NOVEL CORONAVIRUS (COVID-19) - Update Randall Culpepper, MD, MPH Frederick County Deputy Health Officer March 25, 2021 - Frederick ...

NOVEL CORONAVIRUS (COVID-19)
          Update
         Randall Culpepper, MD, MPH
    Frederick County Deputy Health Officer
               March 25, 2021

Worldwide: COVID-19 (03/25/21)

         https://covid19.who.int/ accessed March 25, 2021

Global COVID-19 Update (March 25, 2021)
CASES                         DEATHS
• Global: 124,924,906         • Global: 2,746,147
• US: 30,012,351              • United States: 545,282
• Brazil: 12,220,011 (inc)    • Brazil: 300,685 (inc)
• India: 11,787,534           • Mexico: 199,627
• Russia: 4,442,492
• France: 4,374,785
• United Kingdom: 4,326,685
• Italy: 3,440,862

COVID Daily Cases by WHO Region

United States COVID-19 Cases and Deaths (March 25, 2021)

United States COVID-19 Cases (March 25, 2021)

United States COVID-19 Deaths (March 25, 2021)

United States COVID-19 Case Rate per 100K Last 7 Days (March 25, 2021)

US: COVID-19 Hospitalizations

US: COVID-19 Vaccinations

7-day Moving Average New Cases (DC, MD, VA, PA, WV) (March 25, 2021)

Maryland Daily Trends in Number of COVID-19 Deaths (March 25, 2021)

Current Trends in Maryland (March 25, 2021)

Cases                                Deaths

                       Note: different scales on graphs.
                                                           https://coronavirus.maryland.gov/

Maryland – Current ICU and Acute Hospital Beds for COVID-19
(March 25, 2021)

Maryland : COVID Vaccinations

Frederick County (March 25, 2021)

Frederick County (March 25, 2021)

Frederick County COVID-19 Deaths by Week (March 25, 2021)

New Variant Classification Scheme

• Variants of Interest
• Variants of Concern
• Variants of High Consequence

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/variant-surveillance/variant-info.html

New Variant Classification Scheme
•   Variants of Interest
      o   Variant with specific genetic markers associated with changes to receptor binding, reduced
          neutralization by antibodies generated against previous infection or vaccination, reduced efficacy of
          treatments, potential diagnostic impact, or predicted increase in transmissibility or disease severity
•   Variants of Concern
      o   Variant with evidence of an increase in transmissibility, more severe disease (increased hospitalizations
          or deaths), significant reduction in neutralization by antibodies generated during previous infection or
          vaccination, reduced effectiveness of treatments or vaccines, or diagnostic detection failures.
•   Variants of High Consequence
      o   Variant with clear evidence that prevention measures or medical countermeasures (MCMs) have
          significantly reduced effectiveness relative to previously circulating variants.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/variant-surveillance/variant-info.html

New Variant Classification Scheme

COVID Variants of Interest B.1.427/B.1.429 (California)

• Emerged around May 2020 in California, increased from 0% to
  >50% of sequenced cases from Sept. 1, 2020 to Jan. 29, 2021
• 18.6-24% increase in transmissibility
• 2-fold increased viral shedding in vivo
• Antibody neutralization assays showed decreases in
  neutralizing titers
   o 4.0 to 6.7-fold decrease among convalescent patients
   o 2.0-fold decrease among vaccine recipients

COVID Variants of Interest B.1.525 / B.1.526 (New York)

• Emerged in New York, with a steady increase in the detection
  rate from late December to mid-February
• Patients with this novel variant came from diverse
  neighborhoods in the metropolitan NYC area, and they were
  on average older and more frequently hospitalized.
• Unique set of spike mutations may pose an antigenic
  challenge for current interventions

US COVID-19 Cases Caused by Variants (March 23, 2021)

Increased mortality in community-tested cases of
SARS-CoV-2 lineage B.1.1.7
 •   Analyzed a dataset linking 2,245,263 positive SARS-CoV-2 community tests and
     17,452 COVID-19 deaths in England from Sept 1, 2000-Feb 14, 2021
 •   For 51% of these tests, the presence or absence of B.1.1.7 can be identified
     because of S gene target failure (SGTF).
 •   Estimate that the hazard of death associated with SGTF is 55% (95%CI 39–72%)
     higher after adjustment for age, sex, ethnicity, deprivation, care home
     residence, local authority of residence and test date.
 •   Corresponds to the absolute risk of death for a 55–69-year-old male increasing
     from 0.6% to 0.9% (95% CI 0.8–1.0%) within 28 days after a positive test in the
     community.
 •   Analysis suggests that B.1.1.7 is not only more transmissible than preexisting
     SARS-CoV-2 variants, but may also cause more severe illness

      Davies, N.G., Jarvis, C.I., CMMID COVID-19 Working Group. et al. Increased mortality in community-tested cases of
      SARS-CoV-2 lineage B.1.1.7. Nature (2021).

Emerging U.K. Variant Cases in the United States (March 23, 2021)
50 states (+0), 7,501 cases (+2,815)
                                295 cases in MD (+86, +42 week before)

Emerging S. African Variant Cases in the United States (March 23, 2021)
27 states (+2), 219 cases (+77, +51 week before)
                                 25 cases in MD (+3)

Emerging Brazilian Variant Cases in the United States (March 23, 2021)
18 states (+6), 61 cases (+34, +12 week before)
                                1 case in MD (+0)

Reporting Adverse Events (AEs) after COVID-19 Vaccine

• Healthcare providers required to report to the Vaccine
  Adverse Event Reporting System (VAERS) after COVID-19
  vaccination under EUA:
   o Vaccine administration errors, whether or not associated
     with an AE
   o Serious adverse events

Reporting Adverse Events (AEs) after COVID-19 Vaccine
•   Serious AEs regardless of causality include:
•   Death
•   A life-threatening AE
•   Inpatient hospitalization or prolongation of existing hospitalization
•   A persistent or significant incapacity or substantial disruption of the ability to conduct
    normal life functions
•   A congenital anomaly/birth defect
•   An important medical event that based on appropriate medical judgement may
    jeopardize the individual and may require medical or surgical intervention to prevent
    one of the outcomes listed above
•   Cases of Multisystem Inflammatory Syndrome
•   Cases of COVID-19 that result in hospitalization or death

Reporting Adverse Events (AEs) after COVID-19 Vaccine

• Healthcare providers are encouraged to report to VAERS any
  additional clinically significant AEs following vaccination, even
  if they are not sure if vaccination caused the event.

Percent of Cases Entered into covidLINK Identified as Living in
Congregate Facilities*, Maryland, 6/14/20 - 3/13/21

Maryland Cases with Vaccine Breakthrough
Dashboard in covidLINK

                      214 cases to date with specimen collection date ≥14 days
                      after the final vaccine dose

Thank you!