Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.
If there is one city that is synonymous with restaurant dining, it is New Orleans. If there is one city that is synonymous with an anything-goes attitude, it is New Orleans. And if there is one state that is synonymous with COVID-19 right now, it is Louisiana (OK, and Florida and Texas and Arkansas).
So now imagine New Orleans eateries having to ask customers for proof that they have been vaccinated or to present a negative COVID-19 test. The mayor ordered yesterday that everyone indoors at restaurants must wear masks. Jazz Fest has been canceled, too. The hospitality industry, which was hanging on by its fingernails after last year, is very worried.
A medical strike team from the National Disaster Medical System was called in to help handle a spike in pediatric COVID-19 cases in New Orleans area hospitals.
Meanwhile, San Francisco is ratcheting up the pressure on businesses to become front-line vaccine enforcers. The city will require proof of full vaccination against COVID-19 for a number of indoor activities such as visiting restaurants, bars and gyms.
The mandate will be more stringent than the requirement announced by New York City Mayor Bill De Blasio last week. San Francisco will require proof of full vaccination for all customers and staff, while New York mandated proof of at least one shot for indoor activities.
In addition to the Centers for Disease Control and Prevention paper cards people get when they are vaccinated, California has established an online record with a bar code vaccinated people can use to prove their status.
Los Angeles is considering a similar move requiring people to have at least one dose of a COVID-19 vaccine before going to indoor restaurants, bars, gyms, movie theaters and other venues. City leaders there voted Wednesday to direct city attorneys to work out the details.
So far, restaurants — which expected a loud pushback from customers — say the new requirements have gone smoothly. But city leaders say if the approach to requiring vaccine requirements needs to be more “heavy-handed,” they would offer support so businesses do not have to be in the enforcement business.
Boston says all city employees must get vaccinated or be constantly tested.
NPR is trying to track the fast-changing list of local requirements and prohibitions:
- As of late last week, 9 states have enacted 11 laws with prohibitions on vaccine mandates (Arizona and Arkansas have each enacted two).
- They weren’t all introduced or enacted at this stage of the pandemic — in fact, some were introduced back in February and March, and the most recent took effect in late June.
- Some of these laws are tied only to vaccinations that have emergency use authorization, so the prohibition will no longer apply if the Pfizer and Moderna vaccines get full approval from the U.S. Food and Drug Administration.
- The laws don’t prevent officials from encouraging vaccinations, only from requiring it. So, governors in these states are still pushing for people to roll up their sleeves, just not ordering it.
- The vast majority of these laws apply only to state and local governments, meaning private schools and employers in those states can still pass vaccine mandates.
Parents are sneaking underaged children in for vaccines
USA Today brings us the story of how some parents are not waiting for the Food and Drug Administration to approve vaccines for kids under age 12. They are sneaking their kids in for vaccines now. Pediatricians are pushing the FDA to approve vaccines for younger kids faster but, until then, advise parents not to try to sneak a shot before it is approved.
Third COVID vaccine dose will be for small number of immunocompromised people, for now
The FDA didn’t wait for a CDC advisory committee’s recommendation that should come today to authorize a COVID-19 booster shot for Americans who are most vulnerable and instead authorized it late Thursday night.
That advisory committee will almost certainly recommend today that the Centers for Disease Control and Prevention call for booster shots for immunocompromised people who need the highest protection they can get from COVID-19. About 3% of Americans will be eligible.
As small a group as they are, they comprise 44% of hospitalized COVID-19 breakthrough cases, according to recent data from a CDC advisory group.
The FDA approval is sort of like a preapproved loan. If the CDC decides to go ahead with the recommendation to make the shots available, the FDA is all-in on the idea. The shots could be administered right away.
The FDA’s approval is just for people with weakened immune systems, such as cancer patients.
But nobody will be surprised if that changes in the coming months. CDC Director Rochelle Walensky says the government is working with Pfizer and Moderna to get ready for these new vaccinations.
The FDA’s approval flies in the face of a plea from the World Health Organization to hold off until other countries that have not had any vaccines get the most basic coverage.
The CDC and FDA must carefully communicate this recommendation lest they send a signal that vaccines don’t work. Don’t be surprised if the phrase they use is “additional” doses, not booster doses, meaning the third shot may be needed to give additional protection to people who need it.
Only a month ago, government officials were saying they were not convinced that boosters would be needed, at least not right away. The truth, of course, is that lots of vaccines require booster shots and, for example, in the case of the seasonal flu, different formulations as viruses change year to year.
Some countries, like Israel, are ahead of the U.S. when it comes to boosters. That country is recommending booster shots for everyone over age 50.
ABC News says some people are already sneaking around the system to get booster shots. It reports, “Florida is among the states reporting the highest number of people opting for a booster shot, followed by Ohio, California, Illinois and Tennessee.”
The CDC says it is concerned about these unauthorized boosters because it “undermines safety monitoring.”
How do boosters work?
Nature summarizes what you need to understand about boosters:
Vaccination produces an initial surge in the number of immune cells churning out antibodies and other molecules, which then slowly drops. This leaves behind a small pool of long-lasting ‘memory’ B and T cells that patrol the body for future infections by that pathogen.
A booster does several things to these cells, says Ali Ellebedy, a B-cell immunologist at Washington University in St. Louis, Missouri. It causes antibody-making B cells to multiply, elevating the levels of antibodies against the pathogen once more.
Think of the booster as adding more manpower to fight an infection. Now that you know that, let’s add a layer of understanding and add a few new words to your COVID-19 vocabulary.
Scientists typically look at antibody levels, or titres, as a proxy for how well a vaccine has worked. These usually spike along with the surge in short-lived B cells and then fall as the cells dwindle. Memory B cells and bone-marrow plasma cells continue to churn out antibodies, but at reduced levels, for decades. That’s expected. “There isn’t a vaccine where you don’t see a drop over time in antibody titres and T-cell titres,” says (Rafi) Ahmed (an immunologist at Emory University in Atlanta, Georgia). “There is always a drop.”
Early indications suggest that antibody levels triggered by most COVID-19 vaccines are falling, too. What scientists don’t know is whether these drops reflect a decline in protection against the virus. Teams around the world are racing to determine what level of neutralizing antibodies or another immune marker is most closely associated with a vaccine’s effectiveness. They’re seeking what’s known as a correlate of protection.
Keep in mind, this drop in protection is normal for vaccinations. But we do not need a booster for some vaccinations because even a lower level of protection is enough to protect you.
In the future, drug companies will probably offer additional doses that have slight alterations to address emerging variants. Moderna says future boosters may be at a lesser dose than the first vaccine shots.
Researchers are also trying to figure out if boosters might work best with mixed vaccines. For example, if your original vaccine was from Pfizer, perhaps a Moderna booster will protect you more. Other research is exploring whether a nasal spray would work better at protecting nasal pathways from COVID-19 than a shot, since that is a key infection area.
In any case, it seems that we will be taking vaccinations for this virus for years to come, just as we do with the seasonal flu.
Airlines see reservations dropping during the new surge of COVID cases
Southwest Airlines and Frontier Airlines both say they are seeing the beginning of a drop-off in bookings. There may be several ingredients to the drop-off including people putting off vacations, especially to COVID-infected Florida. Hawaii is also starting new restrictions on bigger gatherings. The TSA says screenings this week were the lowest since mid-June.
In its filing with the Securities and Exchange Commission, Southwest said it would probably not be profitable in the third quarter of this year despite Labor Day travel.
Journalists who are in airline hub cities that employ lots of people should keep a close eye on these SEC filings as airlines report quarterly earnings and forecasts.
One in five ICUs is 95% full, mostly with COVID patients
I want to show you a tool that can help you dive into local hospital data.
Every week, the Department of Health and Human Services releases data to show us how hospital intensive care units are faring in the pandemic. You can zero in on any hospital in the country to see how full any hospital is. Just keep in mind the data is one week old.
It seems to me that whatever data you find is better than the hospital is faring today given how fast the COVID-19 situation is deteriorating.
The New York Times used the same data to build an interactive map. With that, you can see the hundreds of hospitals with ICUs where 95% of the beds are full. I see hospitals not far from me in Florida that are 100% full and more than one that is more than 100% of capacity.
Make sure to read this passage that rides along with the data:
“If this continues, and I have no reason to believe that it will not, there is no way my hospital is going to be able to handle this. There is no way the region is going to be able to handle this,” Dr. Esmaeil Porsa, a top health official in Harris County, which includes Houston, told state legislators on Tuesday. “I am one of those people that always sees the glass half-full, I always see the silver lining. But I am frightened by what is coming.”
Newest census data shows the changing face of America
In the months ahead, we will get our hands on new data that tells us how America is changing as the U.S. Census begins reporting what it has learned. Go to the Census website to see an interactive map and the first estimate of state and county populations.
- The White population remained the largest race or ethnicity group in the United States, with 204.3 million people identifying as White alone. Overall, 235.4 million people reported White alone or in combination with another group. However, the White alone population decreased by 8.6% since 2010.
- The Two or More Races population (also referred to as the Multiracial population) has changed considerably since 2010. The Multiracial population was measured at 9 million people in 2010 and is now 33.8 million people in 2020, a 276% increase.
- The “in combination” multiracial populations for all race groups accounted for most of the overall changes in each racial category.
- All of the race alone or in combination groups experienced increases. The Some Other Race alone or in combination group (49.9 million) increased 129%, surpassing the Black or African American population (46.9 million) as the second-largest race alone or in combination group.
- The next largest racial populations were the Asian alone or in combination group (24 million), the American Indian and Alaska Native alone or in combination group (9.7 million), and the Native Hawaiian and Other Pacific Islander alone or in combination group (1.6 million).
- The Hispanic or Latino population, which includes people of any race, was 62.1 million in 2020. The Hispanic or Latino population grew 23%, while the population that was not of Hispanic or Latino origin grew 4.3% since 2010.
And, the Census says, “The largest county in the United States in 2020 remains Los Angeles County with over 10 million people.”
- The largest city (incorporated place) in the United States in 2020 remains New York with 8.8 million people.
- 312 of the 384 U.S. metro areas gained population between 2010 and 2020.
- The fastest-growing U.S. metro area between the 2010 Census and 2020 Census was The Villages, FL, which grew 39% from about 93,000 people to about 130,000 people.
- 72 U.S. metro areas lost population from the 2010 Census to the 2020 Census. The U.S. metro areas with the largest percentage declines were Pine Bluff, AR, and Danville, IL, at -12.5 percent and -9.1 percent, respectively.
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