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.

Here is a headline: The spokesperson for the Minnesota Department of Health, Erin McHenry said, “Our most recent data shows that 99.9% of Minnesotans who are fully vaccinated have not contracted the virus.”

But maybe the news that most people who have been vaccinated are quite safe is like the news that most banks were not robbed today. It’s not much news.

So my first item today is about context. I want to give you some deeper details about a COVID-19 outbreak in Barnstable County, Massachusetts. This is the case that alerted experts at the Centers for Disease Control and Prevention to a new understanding about whether vaccinated people can pass the virus to others. This new evidence led the CDC to alter its recommendation about whether vaccinated individuals should wear masks indoors.

The data is unsettling if it has been replicated in other places … which raises a question: Why has this data has not been replicated in other places? There have been plenty of gatherings since vaccinated people stopped wearing masks. The CDC has not explained why this one outbreak is such an outlier. Unless it isn’t.

In Oregon, outbreaks seem to be related to birthday and graduation parties. The public health physician with Oregon Health Authority, Dr. Paul Cieslak, is urging Oregonians to avoid multi-family gatherings and trips, especially if they are planning indoor events where there would be prolonged close contact. The Oregon governor even said some businesses may have to close if the cases keep rising.

NBC News points out that if states kept better track of infections, we might see more breakthrough cases:

For states that publish data like Utah, it’s clear breakthrough cases have accelerated in the past two months. In Utah on June 2, 2021, just 27 or 8 percent of the 312 new cases in the state were breakthrough cases. As of July 26 there were 519 new cases and almost 20 percent or 94 were breakthroughs, according to state data.

The Barnstable County case is an important microcosm because it involves 469 COVID-19 cases among people who traveled to one small community between July 3-17. Three-fourths of the people who got infected were vaccinated. Nearly all of the people who were infected got the delta variant of the virus. (Note: The town manager reports that the Barnstable County outbreak now involves 833 people.)

Journalists, before we dive into this new data, remember that when the CDC relaxed its mask recommendations in May, the delta variant represented about 1% of all new cases. Today, the delta variant accounts for 83% of new cases.

In May, the main virus was the “alpha” version of COVID-19. The data then showed that vaccinated people did not, or probably would not, pass along the virus.

But viruses keep kicking to survive, they morph and change. The delta variant not only spread faster, it found a way to end-run the vaccines so even people who do not feel sick can infect others who are not vaccinated. And so, based largely on the data I am showing you here, the CDC recommended that even vaccinated people wear masks indoors so they would not spread the virus to unvaccinated people.

Vaccinated people still have a very low chance of getting seriously ill. But in this one instance, lots of people did get infected. Some got seriously ill.

Here are the facts that the CDC released about the Barnstable outbreak:

• By July 26, 469 COVID-19 cases were identified among Massachusetts residents. Half of them were residents of Barnstable County.
• Among the 469 cases, 346 (74%) occurred in persons who were fully vaccinated. Of these, 301 (87%) were male, with a median age of 42 years. (The event that attracted the people who were infected was marketed to mostly middle-aged men, so the demographics might not be as significant as they may seem.)
• Vaccines received by the people experiencing breakthrough infections were Pfizer (46%), Moderna (38%) and Johnson & Johnson (16%).
• 346 (74%) of the patients who tested positives showed symptoms. The others were asymptomatic. Among people with breakthrough infections, 274 (79%) reported signs or symptoms, with the most common being cough, headache, sore throat, muscle pain and fever. The study found that vaccinated individuals carried as much virus in their noses as unvaccinated individuals.
• Five people were hospitalized; no deaths were reported. One of the hospitalized patients was not vaccinated. The four others were vaccinated. This data point is so important to keep in mind. Four people out of 346 who tested positive were hospitalized, which is 1.1% of the positive cases. But, and this is important, all of the vaccinated individuals who were hospitalized had underlying health issues. Don’t skim over that fact.
• 89% of the COVID-19 cases were identified as being the delta variant. The other cases might have also been but the sequencing for the virus was not completed.

CDC Director Rochelle Walensky says the Massachusetts data was supplemented by other studies from around the world and the trends seem clear. Her message remains, “If you are vaccinated you are protected from severe illness.” This graphic from Fox News tells the story:

(CDC data via Fox News)

The graphic comes from an interview that Walensky did with Fox News’ Bret Baier. It is a slow-paced, thoughtful conversation in which Baier asked solid, thoughtful, fact-based questions and Walensky smartly talked to the Fox News audience. It is worth your time because it is pretty newsy.

When it comes to so-called breakthrough cases, there are several facts — as we know them — to keep in mind.

For starters, breakthrough cases are likely underreported partly because so many are asymptomatic. People who take tests at home have no obligation to report positive cases.

Also, as I have been saying for months, governments slowed serious data collection on breakthrough cases unless they occurred in people who ended up in the hospital, which few do. The Provincetown Independent is pressing for more data for this overwhelmingly important local story.

NBC News reports:

But the total number of breakthrough cases is likely higher than 125,683, since nine states, including Pennsylvania and Missouri, did not provide any information, while 11, like Covid hotspot Florida, did not provide death and hospitalization totals. Four states gave death and hospitalization numbers, but not the full tally of cases.

And vaccinated adults who have breakthrough cases but show no symptoms could be missing from the data altogether, say officials.

CDC’s most recent published data says that as of July 26 there have been 6,587 hospitalizations among fully vaccinated Americans and 1,263 deaths. Research by NBC News indicates that the number who have been hospitalized or died has already passed 7,300 in just the 30 states providing data.

Journalists, I would think it would be useful for you to press state officials this week to ask why they are not collecting that data. How would we be reacting differently if we knew that significantly more people were being infected? What would we demand of our governments, employers and maybe each other? Have counties all but given up on contact tracing? Should they reconsider that?

One more note about the Provincetown outbreak. We owe a big debt of thanks to Dr. Michael LeVasseur, a Drexel University epidemiologist. He is the one who called on the CDC to take a closer look at what was unfolding. Shepard Smith talked to Dr. Levasseur on CNBC.

Provincetown, by the way, just imposed an indoor mask mandate.

97% of people currently hospitalized with COVID-19 in the U.S. have not been vaccinated.

For some hospitals, pediatric ICU beds are filling, but not all from COVID

I spoke with the pediatrician who cared for our children after church on Sunday. She told me she is seeing COVID-19 cases every day among her young patients.

You probably have seen stories over the weekend about pediatric intensive care unit wards filling up. But look closely at why. The Oklahoman in Oklahoma City reports:

Pediatric bed space is scarce at Oklahoma Children’s Hospital, but COVID-19 isn’t to blame, a leader of the hospital said Thursday.

Rather, it’s largely RSV, or respiratory syncytial virus, driving high numbers of hospitalizations for kids. The virus — normally seen in the winter months — has gone “absolutely, exponentially off the charts” over the past two months, said Dr. Cameron Mantor, chief medical officer for Oklahoma Children’s Hospital OU Health.

The same thing is happening in South Carolina. Pediatric beds are filling up with summer seasonal cases like injuries. There are some COVID-19 cases, but the bigger issue is that illnesses that usually arrive in the fall and winter are here now.

Pediatric wards in Florida, Louisiana, Alabama and Arkansas also report full ICU beds. Many of those cases are COVID-related. And hospitals say they are concerned about what is ahead as schools reopen.

And once again, the data reporting on this is really unreliable. Forbes explains:

It’s unclear whether the trend is occurring nationwide because there is no regularly updated, comprehensive data on child Covid-19 cases available. The last report from the Centers for Disease Control and Prevention (CDC), in early June, found hospitalization rates among children peaked at 2.1 per 100,000 in January 2021. The American Academy of Pediatrics (AAP) releases a weekly report on child cases and hospitalizations, but not all states regularly submit data.

It is like we are sticking our fingers in our ears so we do not hear news we do not like. A pandemic should be a high-water mark for data collection, in part so we can know exactly what is happening to help researchers understand the next pandemic before it unfolds.

FDA is ‘all hands on deck’ trying to get full approval for COVID vaccines

Dr. Anthony Fauci says the Food and Drug Administration might be able to consider full approval of COVID-19 vaccines next month. But others have suggested it could be as late as January before the FDA acts.

That issue often arises among people who are hesitant to take the vaccine, but who knows if they would trust a fast-tracked full approval any more than they trusted the emergency approval or the experience of hundreds of millions of vaccinated people around the world.

The lines are forming for vaccines again. Don’t taunt, punish or mock them.

Americans are stepping up again to get vaccinated. Even in states that have had low vaccination rates, people are showing up. Louisiana saw a 114% increase in vaccinations in the last three weeks. Arkansas is up 96%, Alabama up 65% and Missouri saw a 49% increase in vaccinations.

(Washington Post vaccine tracker)

(Mayo Clinic, data from July 30)

(Mayo Clinic, data updated July 30)

My concern is that our news stories not use this to make the newest people to get the shots seem stupid or stubborn. They have waited for whatever reason and have now made a decision to get vaccinated. It will not help if people who are still waiting see news stories about like-minded people who folded under pressure. Just keep reporting factually and clearly, not judgmentally.

Today, millions of evictions can begin. Will they?

16% of renters are behind on their payments and, starting this week, the federal moratorium on evictions expires. Some states and even local governments have moratoriums that last into September and even longer. The Eviction Lab is trying to track eviction filings week by week in many metro areas.

Here is a sample of what is happening on the state level:

(Eviction Lab)

Now let’s zoom into some sample cities. Since mid-March, Houston has logged a stunning 37,000 eviction filings. Las Vegas has seen 27,000 eviction filings in that time. Phoenix has seen 42,000, Tampa 15,000.

(Eviction Lab)

How will officials possibly serve that volume of notices? Where would that number of people go if they were evicted?

(Center on Budget and Policy Priorities)

The above chart shows about one out of seven renters are behind on their payments. By way of context, the situation is better than at the beginning of this year, when one in five renters was at risk of being evicted.

(Center on Budget and Policy Priorities)

(Center on Budget and Policy Priorities)

The New York Times provides an interactive map that allows you to zoom in on every county to see the estimated percentage of renters behind on their payments.

(The New York Times)

What happened to all of that rental assistance?

$46 billion in federal aid meant to help renters sits in state coffers, unspent. States say it has been too difficult to process the applications quickly. In some states, like Mississippi, only 3% of the federal funds have gone to help renters. NBC News found:

NBC News contacted all 50 states and the District of Columbia about their emergency rental assistance programs. An analysis of responses from 41 states found that 26 of them had distributed less than 10 percent of their first allocations, although several programs had just begun distributing money in June.

• In South Carolina, less than 1 percent of funds had been spent by July 15. Of renters in the state taking the survey, 29 percent said they were behind on payments, the highest percentage in the country. By mid-July, the state’s emergency rental assistance program had processed 226 applications.
• New York is the sole statenot to have paid out any funds through June. The state has received more than 160,000 applications for its program, and expects to send funds for nearly 5,000 requests by early August. A spokesman noted that, “tenants who have submitted a completed application remain protected from eviction,” even as they wait for payments.
• Virginia and Texas have distributed the highest proportions of their funds. Virginia has already spent half of its allocation, while Texas has paid out 45 percent. Both states have aligned their programs with updated guidelines from the Biden administration that can make it easier for renters to get help.

The Center for Public Integrity, working with The Associated Press, is trying to figure out where all of the federal money that was supposed to help renters has gone. Some of it appears to have been diverted to other uses. In Republican-led states, the money has moved out of the pipeline even slower.

(The Center for Public Integrity)

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