COVID-19 Updates

COVID-19 Public-Private Partner Dental Coordination Group

A few updates with all of you related to the pandemic.

Pause in J&J Vaccine. As FDA and CDC announced yesterday, out of an abundance of caution, they have recommended a pause in the use of the Johnson & Johnson/Janssen vaccine as they review data involving six reported U.S. cases of a rare and severe type of blood clot in individuals after receiving the Johnson & Johnson/Janssen vaccine. They are recommending this pause while they work together to fully understand these events so they can get information out to healthcare providers and vaccine recipients. They have stressed that these events appear to be extremely rare; however, COVID-19 vaccine safety is a top priority for the federal government and they are taking all reports of adverse events after vaccination very seriously. As of April 12, more than 6.8 million doses of the Johnson & Johnson (Janssen ) vaccine have been administered in the U.S. CDC and FDA are reviewing data involving six reported U.S. cases of a rare and severe type of blood clot in individuals after receiving the J&J vaccine. In these cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia). All six cases occurred among women between the ages of 18 and 48, and symptoms occurred 6 to 13 days after vaccination. Treatment of this specific type of blood clot is different from the treatment that might typically be administered. Usually, an anticoagulant drug called heparin is used to treat blood clots. In this setting, administration of heparin may be dangerous, and alternative treatments need to be given. For more information, you may also visit the FDA YouTube site to hear the FDA and CDC held a press conference yesterday to answer questions about this pause in the use of the Johnson & Johnson/Janssen vaccine, or you can view the entire media statement.

Almost 200 Million Doses Administered. On a positive note, according to data from the CDC, over 122 million Americans (36.8% of the population) have received at least one dose of the COVID-19 vaccine, with 75 million (22.7%) fully vaccinated. This includes 62.5% of older Americans over 65 years of age fully vaccinated. Northern and northeastern states have the highest vaccination rates, while the South – AL, AR, GA, MS, and TN – have the lowest vaccination rates.

Travel Updates. Everyone is back traveling, and the CDC has some specific recommendations for domestic and international travel for those vaccinated and those not yet fully vaccinated. Read all of the recommendations here.

Adverse Events are Rare. With the media attention on AstraZeneca and now the Johnson & Johnson vaccine adverse events, it is important to communicate the extreme rarity of adverse events. The CDC reports that anaphylaxis occurs at a rate of about 2-5 people per million vaccinated in the U.S., and that other than the one possible death attributed to the J&J vaccine (which is being investigated), there has not been evidence of vaccination contributing to any patient death.

Disparities Remain in COVID-19 Hospitalizations. A new Morbidity and Mortality Weekly Report (MMWR) released Monday reports that “within each U.S. Census region, the proportion of hospitalized patients with COVID-19 was highest for Hispanic or Latino patients. Racial and ethnic disparities were largest during May–July 2020 and became less pronounced as the pandemic spread throughout the country; however, disparities remained in December 2020 in all regions.” The authors state that “understanding the social determinants of health contributing to geographic and temporal differences in racial and ethnic disparities at a local level can help guide public health prevention strategies and equitable resource allocation, including COVID-19 vaccination, to address COVID-19–related health disparities.”

New Cases Remain High. The CDC reports that since March 20, 2021, the 7-day moving average of new cases has consistently remained higher compared with the previous 7-day moving average, with a 2% increase in cases in just the past week. Certain states – DE, MN, MI, NH, NJ, NY, PA – continue to have high case rates (cases per 100K), while a few states – GA, MT, NJ, and WV – have the highest 7-day death rates (per 100K).

COVID Variants Continue to Rise. The “UK” variant, B.1.1.7, first identified in the UK in December 2020, is by far the most common variant found in the U.S., according to recent CDC data. As of April 10, 2021, there are almost 21,000 cases of the UK variant in the U.S., with CA, CO, FL, GA MA, MI, MN, PA, and TN reporting the most cases. You can read more about the variants on the CDC website; a lot is still not known, but as reported previously by the FDA, these variants can result in false negative COVID-19 tests.
FDA Recommends Transition from Decontaminated Disposable Respirators. Last week, the U.S. Food and Drug Administration (FDA) recommended that health care personnel and facilities transition away from crisis capacity conservation strategies, such as decontaminating or bioburden reducing disposable respirators for reuse. Based on the increased domestic supply of new respirators approved by the Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational Safety and Health (NIOSH) currently available to facilitate this transition, the FDA and CDC believe there is adequate supply of respirators to transition away from use of decontamination and bioburden reduction systems.

SAMHSA Training and Technical Assistance. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a list of training and technical resources to help providers address the mental health impact of the pandemic. These include videos, webinars, and print media.

OSHA Respiratory Protection Plan. OSHA states that “Respirators must be used in workplaces in which employees are exposed to hazardous airborne contaminants. When respiratory protection is required employers must have a respirator protection program as specified in OSHA’s Respiratory Protection standard (29 CFR 1910.134).” Here are some helpful links to share related to this topic: