Today’s Headlines: February 14, 2022
Editors: Divya Hosangadi, MSPH; Natasha Kaushal, MSPH; Marc Trotochaud, MSPH; Prarthana Vasudevan, MS, MSPH; and, Rachel Vahey, MHS

This Week’s Hearings
Addressing the Gaps in America’s Biosecurity PreparednessSenate Committee on Homeland Security and Government Affairs. 2/17/2022, 10:15 AM. Location: SD-342 Senate Dirksen Building and online. 
Exploring Pathways to Affordable, Universal Health CoverageHouse Committee on Education and Labor, Subcommittee onHealth, Employment, Labor, and Pensions. 2/17/2022, 12 PM. Online.
Clinical Practice
Waning 2-Dose and 3-Dose Effectiveness of mRNA Vaccines Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance — VISION Network, 10 States, August 2021–January 2022 (CDC MMWR) Vaccine effectiveness (VE) against COVID-19–associated emergency department/urgent care (ED/UC) visits and hospitalizations was higher after the third dose than after the second dose but waned with time since vaccination. During the Omicron-predominant period, VE against COVID-19–associated ED/UC visits and hospitalizations was 87% and 91%, respectively, during the 2 months after a third dose and decreased to 66% and 78% by the fourth month after a third dose. Protection against hospitalizations exceeded that against ED/UC visits.
Risk of Persistent and New Clinical Sequelae Among Adults Aged 65 Years and Older During the Post-acute Phase of SARS-CoV-2 Infection: Retrospective Cohort Study (BMJ) Among individuals who were diagnosed with SARS-CoV-2, 32% (27 698 of 87 337) sought medical attention in the post-acute period for one or more new or persistent clinical sequelae, which was 11% higher than the 2020 comparison group. Respiratory failure (risk difference 7.55, 95% confidence interval 7.18 to 8.01), fatigue (5.66, 5.03 to 6.27), hypertension (4.43, 2.27 to 6.37), memory difficulties (2.63, 2.23 to 3.13), kidney injury (2.59, 2.03 to 3.12), mental health diagnoses (2.50, 2.04 to 3.04), hypercoagulability 1.47 (1.2 to 1.73), and cardiac rhythm disorders (2.19, 1.76 to 2.57) had the greatest risk differences compared with the 2020 comparison group, with similar findings to the 2019 comparison group.
Heart-disease Risk Soars After COVID — Even With a Mild Case (Nature) Even a mild case of COVID-19 can increase a person’s risk of cardiovascular problems for at least a year after diagnosis, a new study shows. Researchers found that rates of many conditions, such as heart failure and stroke, were substantially higher in people who had recovered from COVID-19 than in similar people who hadn’t had the disease. What’s more, the risk was elevated even for those who were under 65 years of age and lacked risk factors, such as obesity or diabetes. Al-Aly and his colleagues based their research on an extensive health-record database curated by the United States Department of Veterans Affairs. The researchers compared more than 150,000 veterans who survived for at least 30 days after contracting COVID-19 with two groups of uninfected people: a group of more than five million people who used the VA medical system during the pandemic, and a similarly sized group that used the system in 2017, before SARS-CoV-2 was circulating.
Casirivimab and Imdevimab in Patients Admitted to Hospital with COVID-19 (RECOVERY): a Randomised, Controlled, Open-label, Platform Trial (Lancet) Casirivimab and imdevimab are non-competing monoclonal antibodies that bind to two different sites on the receptor binding domain of the SARS-CoV-2 spike glycoprotein, blocking viral entry into host cells. We aimed to evaluate the efficacy and safety of casirivimab and imdevimab administered in combination in patients admitted to hospital with COVID-19. In patients admitted to hospital with COVID-19, the monoclonal antibody combination of casirivimab and imdevimab reduced 28-day mortality in patients who were seronegative (and therefore had not mounted their own humoral immune response) at baseline but not in those who were seropositive at baseline. Public & Global Health
Association of COVID-19 Vaccination With Symptomatic SARS-CoV-2 Infection by Time Since Vaccination and Delta Variant Predominance (JAMA) In this test-negative, case-control study that included 1 634 271 tests from symptomatic adults, the odds ratio for prior mRNA vaccination and SARS-CoV-2 test positivity was lower before than during Delta variant predominance. The attenuation in effect size related to time since vaccination was greater than the attenuation related to the Delta variant. The findings are consistent with a steady decline in estimated mRNA vaccine effectiveness over time, separate from variant-specific differences in protection.
Science & Technology
Vaccine Scientists Have Been Chasing Variants. Now, They’re Seeking a Universal Coronavirus Vaccine (Washington Post) Volunteers are rolling up their sleeves to receive shots of experimental vaccines tailored to beat the omicron variant — just as the winter coronavirus surge begins to relent. By the time scientists know whether those rebooted vaccines are effective and safe, omicron is expected to be in the rearview mirror. Already, mask mandates are easing. People are beginning to talk about normalcy. The disconnect highlights the exhausting scientific chase of the last year — and the one that lies ahead. And it underscores a more pressing, overarching conundrum: Is chasing the latest variant a viable strategy? Instead of testing and potentially deploying a new shot when a new variant pops up, what if a single vaccine could thwart all iterations of this coronavirus and the next ones, too?
Biological Agents & Infectious Diseases
Lassa Fever Cases Identified in England, Following Travel to West Africa (UKHSA) The UK Health Security Agency (UKHSA) can confirm that the probable case of Lassa fever under investigation is now confirmed, bringing the total number of cases to 3. Sadly, this individual has died. We are contacting the individuals who have had close contact with the cases prior to confirmation of their infection, to provide appropriate assessment, support and advice. The risk to the general public remains very low.
USDA Increases Efforts to Protect U.S. Poultry and Expands Wild Bird Surveillance for Avian Influenza (APHIS) The United States Department of Agriculture’s (USDA) Animal and Plant Health Inspection Service (APHIS) is announcing the expansion of wild bird surveillance for avian influenza to include the Mississippi and Central Flyways. This expansion also enlarged the existing surveillance program in the Atlantic and Pacific Flyways, which is in place to conduct surveillance of birds that may interact with wild birds from Europe and Asia. APHIS confirmed highly pathogenic avian influenza (HPAI) in wild birds in several states in the Atlantic Flyway in January as well as in a commercial turkey flock in Indiana on February 8, and this additional surveillance will increase our capability to track the disease throughout the United States.
Domestic Preparedness & Response
HHS Awards Nearly $55 Million to Increase Virtual Health Care Access and Quality Through Community Health Centers (HHS) The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), awarded nearly $55 million to 29 HRSA-funded health centers to increase health care access and quality for underserved populations through virtual care such as telehealth, remote patient monitoring, digital patient tools, and health information technology platforms. This funding builds on over $7.3 billion in American Rescue Plan funding invested in community health centers over the past year to help mitigate the impact of COVID-19.
Republicans Call on Biden to End COVID’s Public Health Emergency Designation (NPR) Republicans in Congress have asked President Biden to end the designation of COVID-19 as a public health emergency (PHE), citing the accessibility of vaccines and effective treatments as well as the harms of long-term isolation on public health. Their request for the president to undo the designation comes as calls grow — including from former Biden advisers — for the federal government to chart a course for the next stage of the pandemic. Coronavirus cases and hospitalizations have plunged after the dramatic omicron-driven surge, and deaths have begun falling as well, though the seven-day average was still 2,300 deaths per day, as of Thursday.
FDA Authorizes New Monoclonal Antibody for Treatment of COVID-19 that Retains Activity Against Omicron Variant (FDA) The U.S. Food and Drug Administration issued an emergency use authorization (EUA) for a new monoclonal antibody for the treatment of COVID-19 that retains activity against the omicron variant. The EUA for bebtelovimab is for the treatment of mild to moderate COVID-19 in adults and pediatric patients (12 years of age and older weighing at least 40 kilograms, which is about 88 pounds) with a positive COVID-19 test, and who are at high risk for progression to severe COVID-19, including hospitalization or death, and for whom alternative COVID-19 treatment options approved or authorized by the FDA are not accessible or clinically appropriate. 
Pfizer and FDA Pull Back From Plan to Expedite Review of Covid-19 Vaccine in Young Children (STAT News) Plans to attempt to authorize the Pfizer/BioNTech Covid vaccine for children under 5 before full data are available appear to have run aground. The Food and Drug Administration on Friday canceled a key meeting of its vaccines advisory committee that had been slated for next Tuesday to discuss the submission, saying that the delay “will give the agency time to consider … additional data.” Both the FDA and the companies suggested the application for authorization won’t proceed until there are data showing how well the vaccine works after a third dose. Those data should be available in early April, the companies said.
Other 21st Century Threats
Study Finds Western Megadrought is the Worst in 1,200 Years (NPR) Shrunk reservoirs. Depleted aquifers. Low rivers. Raging wildfires. It’s no secret that the Western U.S. is in a severe drought. New research published Monday shows just how extreme the situation has become. The Western U.S. and Northern Mexico are experiencing their driest period in at least 1,200 years, according to the new study published in the journal Nature Climate Change. The last comparable – though not as severe – multi-decade megadrought occurred in the 1500s, when the West was still largely inhabited by American Indian tribes. Today, the region is home to tens of millions of people, massive agricultural centers and some of the fastest-growing cities in the U.S. — all in an area where there’s less water available than there was in the past, partially due to human-caused climate change.

Published by Johns Hopkins Center for Health Security 



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