Sources and updates, August 20

  • New toolkit for estimating COVID-19 risk from wastewater: Researchers at Mathematica published a new, open-source toolkit for interpreting wastewater data. It includes an algorithm that scientists and health officials can use to identify when a new surge might be starting based on wastewater results, as well as a risk estimator tool that combines wastewater data with healthcare metrics. The researchers developed this toolkit using data from North Carolina during the Delta and Omicron surges; their paper in PNAS last month describes it further, as does a blog post by the Rockefeller Foundation (which funded the project). This tool doesn’t provide real-time updates, as it only includes wastewater data through December 2022, but it offers a helpful model for using this source to inform public health policies.
  • Vaccine delays for uninsured Americans: The CDC estimates that new COVID-19 boosters will become available in late September or early October, as I wrote last week. But Americans without health insurance may have to wait longer to get the shots or pay a hefty price tag, according to recent reporting from POLITICO. A federal government program with national pharmacy chains, which will provide the shots for free to uninsured people, is not slated to start until mid-October. Instead, uninsured people will need to pay out-of-pocket or find one of a small number of federal health centers to get vaccinated; this is likely to discourage vaccinations, POLITICO reports. And the number of uninsured people is only growing thanks to Medicaid redeterminations.
  • Budget cuts at the CDC could mean layoffs: A recent op-ed in STAT News, written by two researchers familiar with the CDC’s organizational structure, warns that budget cuts at the agency could lead to a significant reduction in public health workers. The CDC’s budget was cut as part of the federal government’s debt ceiling negotiations last month, the authors explain. It faces a cut of about 10%, or $1.5 million a year, which could lead to significant layoffs. The reduced jobs are particularly likely to impact staff at the state and local levels, the op-ed’s authors argue, rather than at the CDC’d headquarters in Atlanta. “Reductions there will cut public health services and will have their greatest impact on the most vulnerable populations,” they write.
  • Vaccine effectiveness for young children: Speaking of the CDC: the agency published a study this week in its Morbidity and Mortality Weekly Report describing COVID-19 vaccine effectiveness for the youngest children who are eligible (i.e. under five years old). Researchers at the CDC and partners at healthcare centers across the country tracked COVID-related emergency department and urgent care visits among young children, from July 2022 through July 2023. Effectiveness for the primary series was low: Moderna’s two-dose series scored just 29% effective at preventing ED and urgent care visits, while Pfizer’s three-dose series was 43% effective. Children who received a bivalent (Omicron-specific) follow-up dose were much more protected, however: this regimen was 80% effective. Bivalent boosers should be a priority for young kids along with adults, the study suggests.
  • Immune system changes following COVID-19: Another notable study from this week, from scientists at Weill Cornell Medicine and other institutions, describes how severe COVID-19 cases may damage patients’ immune systems. The researchers analyzed how specific genes were expressed in immune system cells taken from people who had severe cases of COVID-19. They found expression changes as long as a year after patients’ initial infections, and connected those changes to inflammation, organ damage, and other long-term issues. These genetic changes may point to one cause for Long COVID symptoms, though the study is somewhat limited by its focus on patients who had severe symptoms early on (as most people with Long COVID have initially milder cases).
  • Smell and taste loss following COVID-19: While smell loss has long been considered a classic COVID-19 symptom, a new study shows that taste loss is also common, even among people who don’t lose their sense of smell. Researchers at the Monell Chemical Senses Center (a nonprofit center in Philadelphia) studied these symptoms through an online survey, which included about 10,000 participants between June 2020 and March 2021. COVID-positive participants were more likely to report smell issues, taste issues, and both together, compared to people who didn’t get sick, the researchers found. Their survey methodology—which included asking people to self-assess their senses by smelling common household objects—could be used for further large-scale studies of these symptoms, the researchers write.

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