Friday Night Update from the ER in Arlington, VA: “Although COVID numbers are continuing to increase in the community, we have seen a leveling off of COVID in both the emergency department and the hospital”

Thanks as always to Dr. Mike Silverman, Chair of the Department of Emergency medicine at Virginia Hospital Center, for these helpful updates!

Friday Night Update from the ER in Arlington, VA

Although COVID numbers are continuing to increase in the community, we have seen a leveling off of COVID in both the emergency department and the hospital. Although new diagnoses of cases has increased the last several weeks in the ER, it never reached a critically high level. This week, the numbers actually dropped a touch as did the percent positivity rate in the emergency department as well. The hospital just has a handful of patients who are COVID-positive. I think we are seeing the clear benefits of vaccinations and boosters. However, we have seen an increase in the community rate in Arlington County and this rate is slightly above 10%. This represents a pretty high transmission level in the community. Fortunately, patients are not getting sick and requiring hospitalization but it doesn’t mean we shouldn’t continue to be cautious in our interactions. And while some people may expect that getting COVID is inevitable, I think we still have a lot to understand about the long-term consequences of COVID.

Let’s start with the positive news on the vaccine front. Moderna announced some preliminary results this week regarding a modified COVID-vaccine. The new vaccine is designed to have a better effect against variants and could be ready by this fall. The company compared booster shots of the modified vaccine to its original vaccine and volunteers and found that the “volunteers produced more than 2 times the levels of antibodies against the omicron variant compared to those who got a booster of the original Moderna vaccine.” There were about 900 volunteers in the study. One third of them got the 50 mcg dose which is the same dosage being given as a booster now. The rest received 100 mcg dose. The lower dose resulted in fewer side effects compared to the 100 mcg dose yet induced higher antibiotic responses than the current 50 mcg booster.

The delays in getting a vaccine for those under 5 continue to frustrate everyone. There are about 20 million kids under 5 in the US and has travel heats up and mask get removed from airports (and everywhere else), I know lots of parents are very upset. It does appear that the FDA is targeting meetings in early June to consider vaccines for those under 5. Moderna also announced this week that they have plans to request an emergency use authorization by the end of the month for its vaccines for kids between the ages of 6 months and 5 years. Pfizer expects to have data in May as well.

THE CDC released a couple of interesting papers today related to provisional mortality data for 2021. The “overall age adjusted death rate increased by 0.7% in 2021 from 2020.” For the second straight year, COVID was the 3rd leading cause of death, trailing heart disease and cancer. The data shows racial and ethnic disparities related to COVID deaths and highlights the need for targeting health policies and interventions for certain populations.

Coronavirus is not done with us yet.

Science matters. Get vaccinated (or your booster). Keep a mask handy.

Mike