January 4 coronavirus pandemic and Omicron variant news

The US Centers for Disease Control and Prevention released some of the data backing up its decision to shorten recommended isolation and quarantine periods for people who test positive for the coronavirus or who are exposed to someone who has it.

In updates to its recommendations released Tuesday, the CDC said that if people have access to a Covid-19 test and want to take one, the best approach is to use a rapid test toward the end of their five-day isolation period.

It cites a few sources in explaining the recommendations. 

“Data, including a review of 113 studies from 17 countries, show that most SARS-CoV-2 transmission occurs early in the course of infection,” the CDC says. “Infectiousness peaks around one day before symptom onset and declines within a week of symptom onset, with an average period of infectiousness and risk of transmission between 2-3 days before and 8 days after symptom onset,” the agency adds, linking to two sources.

One analysis the CDC cites, published in the Annals of Internal Medicine, dates to September 2020 and looks at what was detailed in other studies.

The second source, a review of 113 studies, published in the Lancet medical journal on Dec. 20, 2021, says that review that showed genetic material from the virus can be detected up to six days before people develop symptoms and as long as two weeks afterwards. 

“Studies using viral cultures show that, although patients can remain RNA-positive for weeks after symptom onset, live virus cannot be cultured from specimens collected later than 9 days after symptom onset, suggesting that the mean period of infectiousness and risk of transmission could be restricted to the period between 2 and 3 days before and 8 days after symptom onset,” says the Lancet study, conducted by Rosanna Peeling of the London School of Hygiene and Tropical Medicine and colleagues.

The CDC notes that the data comes from studies done before the Omicron variant was circulating. “The science is evolving, particularly for the Omicron variant, and some reports suggest that compared with previous variants, Omicron has a shorter incubation period (2-4 days), defined as the time between becoming infected and symptom onset.” It links to those studies, as well.

“Hospitalization and death rates are much lower for vaccinated people for all SARS-CoV-2 variants; preliminary data from South Africa suggest that hospitalization and death rates are lower for people infected with Omicron compared with other variants,” the CDC adds, citing a study from a private South African hospital group published in the Journal of the American Medical Association.

“Early estimates of lower vaccine effectiveness against symptomatic infection due to Omicron after the Pfizer-BioNTech primary series suggest that booster doses are important to improve protection from hospitalization and death due to infection with the Omicron variant,” the CDC adds, referring to a Dec. 14 pre-print of work led by the UK Health Security agency.

Everyone wants to find a way to keep children in school, but it must be done safely and responsibly, Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, said on Tuesday.

“Nobody has suffered, I think, the social isolation from not being in school more than children,” Offit told CNN’s Jake Tapper. “For many, it’s the only decent meal they get during the day, and ‘distance learning’ is in many ways a contradiction in terms. I think we want kids to be in school. But if we want them to be in school, then we have to do everything we can to keep them in school.”

Offit acknowledged that many Americans are still having problems finding Covid-19 tests.

“I think what we have to do is make use of the fact or understand the fact that we just don’t have testing that’s available. So the best thing to do then, if a child obviously has Covid, they should stay home until they’re completely asymptomatic and then come back to school with masks. And for anybody who’s been exposed, they need to mask for 10 days. With masking and social distancing and vaccination, I think we can really get on top of it,” he said. 

“If the teachers have to be vaccinated, the bus drivers have to be vaccinated and the children over 5 should be vaccinated, and then we can have the thing we all want, the precious thing we all want, which is to have our children back in school. But we should do it in a responsible way," he added.

Offit also emphasized the importance of vaccines for kids, noting that although the coronavirus tends to affect children less severely than adults, it can still be dangerous. “About 1,000 children less than 18 years of age have died from this infection. We have vaccines in place for diseases that cause far fewer deaths than that,” he said.

According to the US Centers for Disease Control and Prevention, 1,045 children under 18 have died from Covid-19. 

It’s especially hard to watch children struggle with Covid-19 now that kids over 5 are eligible to be vaccinated, he said.

“You’re watching these parents suffer the fact that their children are brought up to the ICU, sedated, put on a ventilator, and you’re watching the parents cry, and you’re thinking, ‘this was all preventable. You could have vaccinated your child; you could have vaccinated yourself,’ and it’s just really heartbreaking. This was heartbreaking enough before we had a vaccine. Now that you have a vaccine to prevent all of this, it’s doubly heartbreaking," he told CNN.

The Omicron variant of the coronavirus is up to three times more infectious than the Delta variant, the US Centers for Disease Control and Prevention said Tuesday.

The CDC included the estimate as part of an update to its guidelines on isolating after testing positive for the virus or quarantining after exposure to it.

“With the recommended shorter isolation and quarantine periods, it is critical that people continue to wear well-fitting masks and take additional precautions for 5 days after leaving isolation or quarantine,” it adds.

“Modeling data from the United Kingdom reinforce the importance of mask use; after the 5th day after a positive test, an estimated 31% of persons remain infectious,” the CDC said. It cites a pre-print study posted online on Dec. 24.

“Mask use and layered prevention strategies, such as receiving all recommended vaccination and booster doses, physical distancing, screening testing, and improved ventilation, are key to preventing COVID-19 and decreasing transmission," the CDC continued.

For the estimate of transmissibility, the CDC cites a study published in the Journal of Medical Virology. Kimihito Ito of Japan’s Hokkaido University and colleagues used data including 758 cases of Omicron variant infection confirmed in Denmark. They developed a method to calculate the infectiousness of a variant based on how many times it is detected over a certain period of time.

“We have estimated the effective (instantaneous) reproduction number of Omicron as 3.19 times greater than that of Delta under the same epidemiological conditions,” they wrote in the report.

“Theoretically, the enormous advantage of transmission can stem from two independent factors, (i) intrinsically greater transmissibility of Omicron compared to that of Delta, and (ii) substantial capacity of Omicron variant to escape from existing population-level immunity conferred either naturally or by vaccination," they added.

The UK study, posted on the online server MedRxiv, was done by the UK Health Security Agency and was a modeling study done to support earlier release from isolation.

One table in that paper shows estimates that 31% of people would still be infectious on day five after a test. By day six it’s 22% and by day seven it’s 16%. “The current 10-day isolation period results in the release of 5% of the infected population being released from isolation whilst still being infectious,” the researchers wrote. They advocated for a seven day isolation period.

 

The number of people in New York state hospitalized for Covid-19 topped 10,000 on Tuesday, marking the first time the state’s Covid-19 hospitalization rate was over 10,000 since May 1, 2020, according to state data.

At least 10,411 New Yorkers were hospitalized Tuesday, with at least 1,302 of those patients in the intensive care unit. On May 1, 2020, 10,350 people were hospitalized. At its peak in mid-April 2020, Covid-19 hospitalizations reached nearly 19,000 statewide, data shows.

Most of the New York’s new Covid-19 cases remain in New York City or in adjacent counties.

Of the 236,904 tests reported on Tuesday, 53,276 were positive for Covid-19. Nearly 31,000 of the new cases are located in the city, with another 12,035 of the new cases in surrounding Westchester, Rockland, Suffolk, and Nassau counties.

At least 99 more New Yorkers have died due to Covid-19, bringing the state’s pandemic death toll to 48,798, the data shows, and 69.9% of all New Yorkers are fully-vaccinated and 78.2% have at least one vaccine dose, according to Gov. Kathy Hochul’s office.

Cloth masks are still OK to use to protect against the Omicron variant of the coronavirus, so long as they are well-fitted and filter the air properly, the US Centers for Disease Control and Prevention says. 

The CDC referred to its existing guidance on mask use in updated recommendations for isolation after a positive Covid-19 test and quarantine after exposure.

It says people should wear masks after testing positive and isolating for five days to protect others, because people may remain infectious for up to 14 days after a positive test.

“Masks are designed to contain your respiratory droplets and particles. They also provide you some protection from particles expelled by others,” the CDC notes in Tuesday’s update.

In a question and answer, the CDC provides links to its guidance suggesting what types of masks work best. Although several medical experts have said in recent days that cloth masks do not provide good protection, the CDC says they can.

“Can I remove my mask in public places after the end of isolation/quarantine? No. After your 5 days of quarantine or isolation end, you should continue to wear a well-fitting mask when around others at home and in public for 5 days. Refer to current CDC guidance for mask wear to determine what to do after the 10-day period is complete. In areas of substantial or high community transmission, masks should continue to be worn in public indoor settings,” the new guidance reads.

All masks should fit snugly so air does not escape around the edges of the mask but is filtered through the material, the CDC said. All masks should have wire to fit the mask tightly across the bridge of the nose. Cloth masks should have multiple layers of fabric, the CDC said.

Using a cloth mask over a disposable surgical style mask can provide good protection, the CDC said. The CDC recommends holding cloth masks up to the light and says that if light shines through, it’s too thin.

 

The US Centers for Disease Control and Prevention on Tuesday updated its guidance on the recommended Covid-19 isolation period, telling people that if they have access to a Covid-19 test and want to take it, the best approach is to use a rapid test toward the end of their five-day isolation period.

The agency has faced pressure over the past week from outside medical experts to include a testing component in its new shortened isolation period.

The updated recommendations do not advise a test for isolated people, but they offer guidance on how those people should respond to a test result if they choose to take one:

• If the test is positive, isolated people are advised to continue their isolation until 10 days after their symptoms started. If the test is negative, isolated people can end their isolation but are advised to wear a mask around other people until day 10.
• The recommendations advise people who are isolating to avoid places where they can’t wear a mask, such as restaurants and gyms, and to avoid eating around others until day 10.
• People who are isolating are now urged to wait to travel until at least 10 days after the start of symptoms. Those who must travel on days six to 10 should wear a mask for their entire trip.

The CDC says the changes aim to “focus on the period when a person is most infectious. … These updated recommendations also facilitate individual social and well-being needs, return to work, and maintenance of critical infrastructure.”

CDC Director Dr. Rochelle Walensky foreshadowed the updated guidance Monday night on CBS’ “The Late Show.”

"So, if you have access to a test, and if you want to do a test at day five, and if your symptoms are gone and you're feeling well, then go ahead and do that test. But here's how I would interpret that test. If it's positive, stay home for another five days. If it's negative, I would say you still really need to wear a mask. You still may have some transmissibility ahead of you. You still should probably not visit grandma. You shouldn't get on an airplane. And you should still be pretty careful when you're with other people by wearing a mask all the time," Walensky said.

More context on the CDC guidance: The updated guidance advising people to stay isolated until day 10 if they have a positive rapid test after five days in isolation appears to contradict Walensky’s claim to CNN last week that “we wouldn’t change our guidance based on the result of the rapid test.”

Walensky had steadfastly defended the agency's decision not to include recommending a rapid test in the new guidance, telling CNN last week, “We opted not to have the rapid test for isolation because we actually don’t know how our rapid tests perform and how well they predict whether you’re transmissible during the end of disease." 

On CNN on Sunday, Dr. Anthony Fauci said the “likelihood of transmissibility is considerably lower” in the second half of the 10-day period following a positive result.

Walensky has also maintained that the CDC’s decision to not include a testing recommendation had nothing to do with the nationwide shortage of rapid tests. 

“This decision really, from an isolation standpoint, had everything to do with the fact that we wouldn’t change our guidance based on the result of that rapid test. And you know that it didn’t have anything to do with any shortage at all, because we recommend rapid tests for those in quarantine,” Walensky said. 

Despite that, there has been deep frustration inside the Biden administration in the days since the CDC announced that it was shortening the isolation period for those who test positive for Covid-19 from 10 days to five with no testing component, according to multiple officials.

French President Emmanuel Macron said he “really wants to piss off” the unvaccinated, in an exclusive interview with Le Parisien newspaper on Tuesday.

"I'm not for pissing off the French. I rant all day at the administration when it blocks them,” Macron said, referring to his disdain for how bureaucracy often gets in the way of the French people.

“Now the unvaccinated, I really want to piss them off. And so, we're going to keep doing it, until the end. This is the strategy,” Macron added.

Macron went on to say there will be no severe punishment – such as jail time – for the unvaccinated, but their status could limit their lifestyle and access to restaurants, travel and more from mid-January, if a bill currently being debated in parliament is approved.  

“I'm not going to put them in jail, I'm not going to forcibly vaccinate them, and so, you have to tell them: from January 15, you will no longer be able to go to the restaurant, you will no longer be able to have a drink, go for a coffee, to the theatre, you will no longer go to the movies,” Macron said.

The proposed legislation would replace France’s health pass with a vaccine pass, making proof of vaccination necessary for access to a range of everyday activities, from entering restaurants and bars to traveling inside the country.

First introduced last July, the health pass is a pillar of President Macron’s Covid-19 strategy, aimed at pushing people in France to get vaccinated.

Macron described those opposed to vaccination as “irresponsible” adding that "they undermined the strength of a nation.”

 “When my freedom threatens that of others, I become irresponsible,” he said, “an irresponsible person is no longer a citizen."

Here’s a look at the latest data on vaccination efforts in the United States, published Tuesday by the US Centers for Disease Control and Prevention:

• Fully vaccinated: 62.2% of the total US population (all ages), about 207 million people
• Not vaccinated: at least 21.6% of the eligible population (age 5+) have not received any dose of Covid-19 vaccine, at least 67.5 million people
• Current pace of vaccinations (seven-day average): 1,093,005 doses are being administered each day 
• That’s nearly half of what it was a month ago. 
• Most doses being administered – about 623,000 – are booster doses.
• Only about 305,000 people are initiating vaccination each day.
• About 71.6 million people have received a booster dose
• About 22% of the total US population is now fully vaccinated and boosted.
• The pace of booster dose administration ticked up amid the early spread of the Omicron variant but has since trailed off.

Note: CDC data on Covid-19 vaccinations is an estimate. The agency notes that data on people who are fully vaccinated and those with a booster dose may be underestimated, while data on people with at least one dose may be overestimated. 

Here's how the seven-day average of new administered vaccine doses compares over time, according to CDC data.

Additional details are coming “soon” on a plan to allow Americans to request free test kits online from the federal government, the White House said Tuesday.

The Departments of Defense and Health and Human Services are already working on an "accelerated contracting timeline,” White House press secretary Jen Psaki told reporters in an afternoon press briefing.

She said the request for proposal, or RFP, which “allows us to best understand logistics timing and manufacturing considerations,” is closed as of Tuesday.

“We are currently evaluating the responses to it, which means we are finalizing the contracts,” Psaki said.

“We're on track to start seeing movement on some of the awards through the RFP this week. So the first deliver delivery for manufacturers will start later this month. That's our expectation,” she continued. Once the tests are in hand, she said, the website will come online.  

In remarks earlier in the day, President Biden admitted he was frustrated on the status of testing in the country, adding that “we should see waiting lines shorter, more appointments freed up.”

“I know this remains frustrating. Believe me it's frustrating to me. But we're making improvements in the last two weeks,” he said, claiming that drugstores an online websites are “restocking,” and pointing to a previously-announced federal initiative to have tests shipped to Americans who request them for free.