As many mask mandates are lifted, the federal government extended its travel mask mandate by one month, and a new study illustrates the value in judicious mask use.
Florida’s New Pediatric Vaccine Guidance
On Tuesday, March 8, the Florida Department of Health issued a guidance recommending against the COVID-19 vaccine for healthy children from ages 5 to 17. This update comes a day after Governor Ron DeSantis held a roundtable and heard from various physicians across the nation, including the state surgeon general, Dr. Joseph Lapado, who referenced data showing healthy children are at low risk of dying from the virus while young boys who receive the vaccine have elevated risk of developing myocarditis. This is the first state guidance to go against the Centers for Disease Control and Prevention (CDC) recommendation for children over the age of 5 to get vaccinated.
WHO Now Recommends Getting Boosted
This week, an 18-member advisory group convened by the World Health Organization (WHO) stated it strongly supports the “urgent and broad access” to booster doses. This is a change from the organization’s recommendation last year that boosters are not necessary. The expert group is charged to evaluate the impact of variants of concern and assess vaccine effectiveness against them.
Mask Mandate in Public Transportation Extended By One Month
The Transportation Security Administration’s (TSA) travel mask mandate was set to expire next week on Friday, March 18. This week, the TSA extended the deadline by one month to April 18, giving the CDC time to revise its policy framework to determine when it is safe for the mask mandate to be lifted. This is the second time this deadline has been extended. With the recent change in CDC guidance stating Americans can be maskless in indoor settings and upcoming spring break travels, various stakeholders, including the airline industry, are hoping the agency lifts the mask mandate soon. Currently only three states have mask mandates in place: Hawaii, Oregon and Washington.
HHS Used Up COVID-19 Funding
When the challenge presented by COVID-19 became apparent, Congress allocated significant funds to the U.S. Department of Health and Human Services (HHS). Those funds accelerated availability and affordability of COVID-19 tests, vaccines and other life-saving interventions. By now, those funds have run out. Congress was asked to provide further relief funds, although that now seems unlikely in light of more urgent priorities.
Wearing Masks a Few Weeks Longer Leads to Best Cost-Saving
COVID-19 exerts a substantial cost on health care and economy at large. Vaccinations prevent serious disease and temper virus transmission, making them a cost-effective intervention at an individual level. In order to make a dent in COVID-related costs at a societal level, a high percentage of the population needs to be fully vaccinated and boosted. Additionally, as a recent U.S. modeling study demonstrated, widespread mask use for a few weeks after the high vaccination rate is achieved would maximize cost savings. The authors explain this effect by pointing out that the virus continues to circulate for a while after a “target” vaccination rate is achieved. In the simulation, the “high target rate” of 70-90% still leaves up to 30% of the population unvaccinated and therefore vulnerable to serious disease and death. The unvaccinated also contribute to the virus spread even if they themselves remain asymptomatic. (As a point of reference: as of this week, only 65% of the total U.S. population received either two mRNA doses or one dose of the single-dose vaccine, and only 44% have been boosted. Depending on when the fullest possible vaccination rate is achieved, mask use could save billions of dollars in direct and indirect costs, according to the study. In any case, a 100% vaccination coverage might be unattainable, not least because not everyone can be vaccinated (e.g., young children). That’s why judicious continuation of masking could be helpful, especially during cold seasons. This week’s report from CDC provides another real-world illustration: it was found that schools with a mask mandate had a lower incidence of COVID-19 among students and staff than in schools where masks were optional.
Caution Urged for MAB Use
Just like indiscriminate use of antibiotics can lead to the emergence of drug-resistant bacterial strains, the use of monoclonal antibodies (MABs) against SARS-CoV-2 can lead to the emergence of treatment-resistant SARS-CoV-2 strains. The authors of a recent study documenting such cases urge caution. Appropriate stewardship of MABs is particularly important in light of their varying effectiveness against different viral strains.
FDA Continues Public Outreach and Education
The Food and Drug Administration (FDA) posted responses to several “Frequently Asked Questions” in the form of short video clips. On the agency’s video channel, the director of FDA’s Center for Biologics Evaluation and Research (CBER) clarifies (in a brief video) that a booster is needed even if a person had had a “natural” infection, that children are best protected from COVID-19 through vaccination, and also addresses other commonly raised topics.
Omicron vs. Delta Infectivity
Data from a large study in Norway confirmed that Omicron is more infectious than the Delta variant of SARS-CoV-2. In households with an infected individual, the so-called “secondary attack rate,” or the infection of other members of the household, was found to be 25% for Omicron and 19% for Delta. The unvaccinated had a higher risk of getting infected than the vaccinated.