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Rochelle Walensky, MD, MPH, director of the Centers for Disease Control and Prevention (CDC), walked through a multi-agency attack plan on Wednesday to halt the spread of three COVID-19 variants.
Dr. Rochelle Walensky. AP
As part of the Journal of the American Medical Association (JAMAs) Questions and answers with JAMA Editor-in-Chief Howard Bauchner, Walensky refers to the blueprint she shared with Anthony Fauci, MD, the country’s leading expert in infectious diseases, and Henry T. Walke, MDH, MPH, of the CDC, who JAMA Network.
In the opinion piece, they explain that the Department of Health and Human Services established the SARS-CoV-2 Interagency Group to coordinate between the CDC, the National Institutes of Health, the US Food and Drug Administration (FDA), and the Biomedical. improve. Advanced Research and Development Authority, US Department of Agriculture and US Department of Defense.
Walensky said the first goal is to increase vigilance regarding the mitigation of public health strategies to reduce the amount of virus circulating.
As part of the strategy, she said, the CDC strongly insists on non-important travel.
In addition, public health leaders are working on a monitoring system to better understand the SARS-CoV-2 variant. This will increase the genome sequence of the SARS-CoV-2 virus and ensure that sampling is geographically representative.
According to her, the CDC works with state health laboratories to obtain approximately 750 samples each week and works with commercial laboratories and academic centers to achieve an interim target of 6000 samples per week.
She acknowledged that the United States “is not where we need to be” in order, but has come a long way since January. At that time, they sequenced 250 samples each week; they currently follow thousands every week.
Data analysis is another concern: “We need to be able to understand at the basic scientific level what the information means,” Walensky said.
Researchers are not sure how the variants could affect the use of recovery plasma or monoclonal antibody treatments. It is estimated that 5% of those vaccinated against COVID-19 will nevertheless contract the disease. Sequence will help to answer whether such people who have been vaccinated and who contract the virus are below 5% and whether they have been infected by a variant that evades the vaccine.
Walensky said that the administration of vaccines should be accelerated worldwide and in the United States.
As of Wednesday, 56 million doses have been administered in the United States.
Top three threats
She updated the figures on the three biggest variant threats.
Regarding B.1.1.7, which originated in the UK, she said: “So far we have had more than 1200 cases in 41 states.” She noted that the variant is likely to be about 50% more transmissible and 30% to 50% more virulent.
“So far, the strain does not appear to have any real decrease in susceptibility to our vaccines,” she said.
The tribe of South Africa (B.1.351) was found in 19 cases in the United States.
The P.1. variant, which originated in Brazil, has been identified in two cases in two states.
Outlook for March and April
Bauchner asked Walensky what she intends for March and April. He noted that public optimism is high given the continuing decline in the number of COVID-19 cases, hospitalizations and deaths and the fact that warmer weather is approaching and that more vaccinations are imminent.
“Although I’m really hopeful about what could happen in March and April,” Walensky said, “I really know it can go so fast. We saw it in November. We saw it in December.”
CDC models predicted that the more transmissible B.1.1.7 voltage by March is likely to be the dominant strain, she repeated.
“I’m worried it would be spring, and we would all have had enough,” Walensky said. She noted that some states are already loosening mask mandates.
“Around that time, life will look and feel a little better, and the motivation for those who may be hesitant about vaccination may be reduced,” she said.
Bauchner also asked her to look into whether a third Johnson & Johnson (J&J) vaccine may soon be authorized for the FDA emergency – and whether the lower expected efficacy rate could lead to a lower system of vaccinations, with higher risk populations. receive the more effective vaccines.
Walensky said more information is needed before the question can be answered.
“It is quite possible that the data shows us the best populations to use this vaccine,” she said.
Phase 3 data showed that the J&J vaccine is 72% effective in the United States for moderate to severe diseases.
Walensky said it is important to remember that the projected efficacy for the vaccine is higher than that for the flu shot, as well as many other vaccines currently being used for other diseases.
She said it also has several benefits.
The vaccine has less stringent storage requirements, requires only one dose and protects against hospitalization and death, although it is less effective in contracting the disease.
“I think a lot of people would choose to get this one if they could get it sooner,” she said.
Marcia Frellick is a freelance journalist in Chicago. She previously wrote for the Chicago Tribune and Nurse.com and has been editor of the Chicago Sun-Times, the Cincinnati Enquirer and the St. Cloud (Minnesota) Times. Follow her on Twitter @mfrellick.
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