Darkest Days In Pandemic Lie Ahead, Expert Warns Oregon Lawmakers

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A national infectious disease expert warned Oregon lawmakers that darker days lie ahead in the pandemic as variant strains pose a threat amid a sluggish vaccine rollout. 

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the  University of Minnesota and a member of President Joe Biden’s COVID-19 transition team, told the House COVID-19 Subcommittee on Monday that the B.1.1.7 variant from Britain poses a major threat. 

“The darkest days are just coming upon us,” said Osterholm, who said he has reversed his prior stance that schools should reopen this spring. A similar tone was also struck on Monday by Dr. Rochelle Walensky, the head of the Centers for Disease Control and Prevention, during a White House briefing, according to press reports. She warned of "impending doom." 

"We have so much to look forward to, so much promise and potential of where we are and so much reason for hope," Walensky said. "But right now, I'm scared."

Their stark prognoses came the same week that Oregon elementary schools for students in kindergarten through fifth grade can no longer offer exclusively online instruction. Starting this week, Oregon elementary schools must provide in-person or hybrid models that combine in-person and online instruction, due to an executive order from Gov. Kate Brown. Those schools can no longer exclusively offer online instruction, though they can still provide that mode to families who request it.

Osterholm told lawmakers that the B.1.1.7 variant is “now readily infecting kids in levels I can’t believe.” For example, there was an outbreak of COVID-19 cases, some with the variant, that infected about 100 children in a daycare in Omaha.

“We are seeing it jump like lightning,” Osterholm said. 

The CDC warned in January when the variant emerged in the United States that it would become the dominant strain by March. The B.1.1.7 variant quickly spread in Britain where it was first identified. Scientists say it is 50 to 70% more infectious than many other strains and perhaps 30% more deadly.

Osterholm said he originally was a strong proponent for reopening schools due to the lack of evidence of infection in children. He’s since changed his stance on that, he said, calling at a “180-degree flip.”

The B.1.1.7 variant underscores the need to vaccinate the population, said Osterholm, who is well-known in epidemiology circles for warning about the lack of preparation in the United States for a pandemic years before COVID-19.

“I think B.1.1.7 has a chance to really cause us real damage in the country before we get out of the woods,” he said.

Besides the British variant, health officials are watching variants from Brazil and South African although they have not spread so quickly. Experts believe the vaccines that have been approved for emergency use in the United States are effective against these variants. That’s why public health officials are racing to vaccinate as much of the population as possible to slow their spread. 

Osterholm said the United States is the only high-income nation to open everything up, even as overall COVID-19 case numbers increase. This pattern, he said, aids the spread of B.1.1.7.

Osterholm said the situation should serve as a “tremendous motivator” for vaccine acceptance. 

The good news is that the U.S. has vaccines, but the problem is that the vaccine doses are not getting out quickly enough.

Osterholm criticized moves by states to offer  vaccines to more categories of people while some seniors wait.  That's “not a victory, that’s a defeat,” he said, because it means that providers are “not necessarily vaccinating the people who need it most.”

In Oregon, Brown delayed vaccinating senior citizens to give doses to public school teachers and early childhood instructors to allow  schools to reopen sooner. 

Currently, about 66% of Oregonians age 65 and older have received at least one dose.

Manufacturers are researching vaccines that will work for children under 16. Currently, only Pfizer vaccines are approved for children 16 and older. People have to be at least 18 to receive the Moderna or Johnson & Johnson vaccines.

Osterhold said vaccines for younger children probably will not be available until sometime in the fall. 

Oregon has 16 cases with the B.1.1.7 variant, according to federal Centers for Disease Control and Prevention data. That doesn’t reflect the full picture because testing for the variant requires additional genomic sequencing beyond COVID-19 tests. 

The Oregon State Public Health Laboratory, part of the health authority, has announced it will start to perform genomic sequencing for specimens of public health significance starting Monday. Local public health agencies can submit a request for sequencing in cases that meet certain criteria, such as an individual who traveled, a person who tested positive in a “break through” case after receiving the vaccine and clusters of unusual size or severity. 

Labs at Oregon Health & Science University, Oregon State University and the University of Oregon are also performing the sequencing on samples.

Washington state has 152 cases of the B.1.1.7 variant, federal data show. Nationwide, there are nearly 11,000 cases with the variant, with most hard-hit states in the East Coast and in the Midwest. However, the Northwest region could be just a month beyond those parts of the nation, Osterholm said.

Study Shows Vaccines 90% Effective

Even as the variant spreads, more evidence emerged Monday that the vaccines are effective. Oregon health care professionals, first responders and frontline workers participated in a federal study that found that the Pfizer and Moderna vaccines are 90% effective in preventing COVID-19 infections and illnesses.  

The Centers for Disease Control and Prevention study tested nearly 4,000 people who took the vaccine every week for a 13-week period. Nearly 12 percent of the participants were Oregonians. The other participants were in Arizona, Florida, Minnesota, Texas and Utah.

“This study demonstrated that in real-world use, the mRNA vaccines are marvelously effective – 90% – in preventing SARS-CoV-2 infection as well as COVID-19 illness in frontline workers,” said Dr. Paul Cieslak, a senior health advisor, with the health authority.  “These vaccines will keep people out of the hospital and also reduce spread of the virus. ”

COVID-19 Cases Increase Slightly 

In Oregon, the rolling seven-day average of new COVID-19 cases increased slightly last week. Oregon had 349 new daily cases last week, up from 281 the prior week. Hospitalizations also increased, said Dr. Dean Sidelinger, state epidemiologist, adding that it’s too soon to know whether this is the start of a new trend.Sidelinger said Oregon schools are offering on-site testing for students and staff who develop symptoms or who are exposed to the virus. Sidelinger called school staff a key partner in curtailing infections because they  have closer relationships with families and students than public health officials.

Besides addressing elementary schools, Brown’s March 12 executive order  calls for secondary schools to offer in-person instruction starting the week of April 19. The order requires schools to offer online instruction to families who want it through the end of the school year. 

Colt Gill, director of the Oregon Department of Education, said the state changed protocols to require only three feet of distancing at the elementary school level instead of six feet due following CDC guidance.

During the hearing, Rep. Cedric Hayden, R-Roseburg, asked whether vaccines will be added to the vaccination list required by schools  in the fall. 

Sidelinger said he “would not anticipate a quick process” of adding the vaccine to the required school schedules  because they first need to be tested in clinical trials that are now underway.  

House Floor Session Canceled 

The Oregon House canceled its Monday floor session because a second person tied to that chamber tested positive for COVID-19, one week after a positive case shut down proceedings.

The Legislature’s human resources office notified lawmakers about the positive case. In a memo, Lindsey O’Brien, chief of staff for House Speaker Tina Kotek, D-Portland, wrote that the floor session was canceled “out of an abundance of caution” as some people get tested. The House plans to have its next floor session Tuesday, unless additional cases emerge. 

“We haven’t received notice of any positive tests so far,” Danny Moran, spokesman for Kotek, said Monday in an email. 

Due to medical privacy rules, officials did not say whether the person was a lawmaker, staffer or other individual. House lawmakers spent last week in quarantine, the time needed to self isolate after potential exposure to the first person, who was on the House floor March 15 and 16.

House legislative committees continued to meet virtually, as they have done throughout the session to prevent the virus’ spread. 

You can reach Ben Botkin at [email protected] or via Twitter @BenBotkin1.


 

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