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.
The president is back in isolation today after testing positive again for COVID-19. Some experts have been critical of people who tested positive, isolated, then — if they have no symptoms after five days — have gone back about their lives without testing again to see if they are still positive and still potentially infectious.
This so-called “rebound” COVID-19 positivity happens sometimes with people like the president who are treated with the drug Paxlovid in the early days of their infection. In May, the CDC warned this could happen. And the CDC’s guidance stirred some controversy when it said if a person was infected, they should isolate for five days, and then if they have no symptoms, they were good to go. Notice, the CDC did not say the infected person should test negative before they leave isolation. The CDC warned:
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to update healthcare providers, public health departments, and the public on the potential for recurrence of COVID-19 or “COVID-19 rebound.”
Paxlovid continues to be recommended for early-stage treatment of mild to moderate COVID-19 among persons at high risk for progression to severe disease. Paxlovid treatment helps prevent hospitalization and death due to COVID-19.
COVID-19 rebound has been reported to occur between 2 and 8 days after initial recovery and is characterized by a recurrence of COVID-19 symptoms or a new positive viral test after having tested negative. A brief return of symptoms may be part of the natural history of SARS-CoV-2 (the virus that causes COVID-19) infection in some persons, independent of treatment with Paxlovid and regardless of vaccination status.
Limited information currently available from case reports suggests that persons treated with Paxlovid who experience COVID-19 rebound have had mild illness; there are no reports of severe disease. There is currently no evidence that additional treatment is needed with Paxlovid or other anti-SARS-CoV-2 therapies in cases where COVID-19 rebound is suspected.
Regardless of whether the patient has been treated with an antiviral agent, risk of transmission during COVID-19 rebound can be managed by following CDC’s guidance on isolation, including taking other precautions such as masking.
The CDC warning also said that people who have recurrent COVID-19 after Paxlovid should isolate for at least five days, then, “should restart isolation and isolate again for at least 5 days. Per CDC guidance, they can end their re-isolation period after 5 full days if fever has resolved for 24 hours (without the use of fever reducing medication) and symptoms are improving. The individual should wear a mask for a total of 10 days after rebound symptoms started.”
Notice the warning did not say the person should test again to see if they are still positive. The CDC says, “Some people continue to test positive after day 10 but are considerably less likely to shed infectious virus. Currently, there are no reports of severe disease among persons with COVID-19 rebound.”
Assuming Biden will be following CDC guidelines, he will be in isolation until at least Wednesday and will wear a mask for another week and a half (10 total days).
Mandatory face masks coming back around the globe
When journalists meet this week in Las Vegas for the NABJ/NAHJ conference, we will all be wearing face masks, which will be mandatory. When journalists meet Tuesday at Poynter in St. Pete, we will be wearing masks there, too. We know that last week at least two people who attended our workshops in Ohio and Pennsylvania reported positive COVID-19 tests over the weekend. Who knows where they were infected, but the point is COVID is everywhere and spreading.
This is the latest national COVID-19 risk map. Everything in the orange color is in the high risk category, including almost all of Florida and big chunks of other states virtually everywhere.
The CDC guidelines say if you are in a high-risk area, you should be wearing a mask when you are around other people indoors. I can assure, you as someone who has traveled to five states in the last four weeks, darn few people in those high-risk areas are paying attention to the guidelines.
But while some school districts are following CDC guidance, which recommends universal masking indoors when community levels are high, others are taking a mask-optional approach. Some school systems have not decided, hoping the virus wanes before they open.
In San Diego, school district officials mandated masks indoors on July 18, when CDC data showed San Diego County hit a high covid level and summer school was in session. But officials said this week they have not made a decision about mask-wearing when the regular school year starts on Aug. 29.
“Local health experts have advised that although cases are high now, our county could be out of the ‘high’ level by the end of August when classes resume,” officials of the San Diego Unified School District said in an email.
Critics condemned the San Diego decision. “The transmission parents fear is the mask mandates spreading across the country,” said Sharon McKeeman, a vocal opponent of masks and the founder of the advocacy group Let Them Breathe.
The Bay Area Transit Authority in San Francisco says it is restarting mandatory masking on trains. The mandate will last until at least Oct. 1.
BART police will continue its education-based enforcement of the mask requirement by offering free masks to anyone who needs one before taking any enforcement action, which could include a citation of up to $75, or being ejected from the paid area.
Schools and universities are starting to think through the masking policies they will have in place when classes begin in a matter of weeks. Some are already warning that their current optional masking policy may change and some are already telling students that masks will be required. For example, Jefferson County schools in Louisville made masks mandatory last week. A school system outside of Atlanta just decided that school employees will be wearing masks when classes begin.
At the same time, Syracuse University is stopping its masking policy.
Syracuse University will drop its mask requirement on campus Aug. 15 regardless of the vaccination status of students, staff and visitors.
The change announced today is part of revised public health guidelines for the fall semester. The new guidelines recognize that “… for the foreseeable future, Covid-19 will represent a concern that is endemic to life on a college campus,” SU said in a letter to students and employees.
SU will continue to require all students and staff to be vaccinated against Covid unless they have approved religious or medical exemptions.
The school will halt mandatory Covid surveillance testing on campus.
The city of Los Angeles planned to reinstate indoor masking orders Friday but dropped the idea because it said cases are starting to decline.
We will see soon if the CDC will weigh in with new guidance for schools. If so, it has to happen soon to have any hope of having an effect.
The Washington Post reported this weekend:
It is unclear whether the CDC plans to issue more guidance for schools as they reopen. A CDC spokeswoman declined to say. “We are constantly evaluating our guidance and as new science-based evidence emerges necessary updates are made,” CDC spokeswoman Kristen Nordlund said in a statement.
The most recent recommendations came in a CDC update from May.
Daniel Domenech, of the AASA, the national school superintendents association, said intense political pressure affects decision-making. Even in high-risk areas, “there’s such resistance on the part of parents, on the part of the community, on the part of politicians … that a lot of people just throw their hands up in the air, and say, ‘Fine, no masks.’”
Local governments declare monkeypox emergency when federal government won’t
While the Biden administration “is considering” whether to declare monkeypox a health emergency, the State of New York and San Francisco health authorities are not waiting.
“New York City is currently the epicenter of the outbreak, and we estimate that approximately 150,000 New Yorkers may currently be at risk for monkeypox exposure. We will continue to work with our federal partners to secure more doses as soon as they become available. This outbreak must be met with urgency, action, and resources, both nationally and globally, and this declaration of a public health emergency reflects the seriousness of the moment.”
San Francisco’s emergency order takes effect today. The mayor’s office issued the declaration saying in part:
The declaration of a local emergency is a legal action that will mobilize City resources, accelerate emergency planning, streamline staffing, coordinate agencies across the city, allow for future reimbursement by the state and federal governments and raise awareness throughout San Francisco about how everyone can stop the spread of Monkeypox in our community. It will go into effect on August 1.
“San Francisco showed during COVID that early action is essential for protecting public health,” said Mayor London Breed. “We know that this virus impacts everyone equally – but we also know that those in our LGBTQ community are at greater risk right now. Many people in our LGBTQ community are scared and frustrated. This local emergency will allow us to continue to support our most at-risk, while also better preparing for what’s to come.”
Currently, SFDPH has confirmed 261 cases of monkeypox in San Francisco. There are reportedly 799 cases in California, over 4,600 cases in the United States, and more than 19,000 cases globally (in 76 countries).
KRON TV reported monkeypox is spreading fastest in San Francisco’s Latino communities:
30% of cases were in the Latino community. The numbers are striking considering that the Hispanic or Latino population make up 25% of the population of Santa Clara County and 15% of the population of San Francisco — suggesting the region’s public health authorities need to strengthen their outreach in the community.
The Washington Post reported that even with hundreds of thousands of doses of a vaccine to help prevent the spread of monkeypox, the supply is far short of the anticipated need and there will not be additional shipments for months:
Even with the latest shipments, there are only enough vials of the two-dose Jynneos vaccine to cover about a third of the estimated 1.6 million gay and bisexual men who officials consider at highest risk and who are being urged to get the shots.
And with cases in the United States doubling every week or so, some health experts warn a shortfall of vaccines could threaten the nation’s ability to contain the expanding outbreak and prevent the virus from becoming permanently entrenched — a concern that some federal officials privately concede.
Newsweek says college campuses could be vulnerable to monkeypox outbreaks when they open soon.
Members of Congress get $10,000 home security upgrades
The House sergeant-at-arms announced plans to cover the costs of security upgrades to members’ homes, including $10,000 for equipment and installation costs and $150 a month for monitoring and maintenance.
Rep. Tim Ryan (D-Ohio), who chairs an appropriations subcommittee that oversees the Capitol Police, told Axios that “everybody’s on high alert” in the wake of these incidents.
“The threats are real, the increases have been unbelievable,” he said. “We’ve got to do everything we can to try to make sure people are safe. Lot of wild cats out there.”
The times in which we live
This post is from a journalist friend of mine in Kansas City:
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Al Tompkins is senior faculty at Poynter. He can be reached at email@example.com or on Twitter, @atompkins.