Celebrating Safely This Holiday Season

Preparation and prevention strategies can help keep you safe and healthy 

OLYMPIA – With the cooler weather comes traditional holiday gatherings with friends and family. Amid a strained hospital system, an early and more severe respiratory virus season, and people gathering to celebrate, the Washington State Department of Health (DOH) would like to remind everyone how to stay safe and healthy this holiday season. 

Respiratory viruses are more common this time of year and medical facilities, especially pediatric emergency departments, are seeing a higher-than-usual number of patients for respiratory syncytial virus (RSV). Hospitals were already operating at higher capacity, and it has become even more important to utilize preventive measures to ensure there is space for those with critical health needs. 

“Connecting is important during the holiday season but it can be challenging when we are concerned about our own health and that of those around us,” said Umair A. Shah, MD, MPH, Washington State Secretary of Health. “A little prevention can go a long way in helping us enjoy our social circle and stay healthy at the same time.”  

Tips to help lower the risk of contracting viruses, spreading illness, or needing hospital care in the coming months: 

  • Although masks are no longer required for the public except in healthcare settings and correctional facilities, DOH recommends you consider wearing a mask in crowded or poorly ventilated settings to reduce the chance of getting sick or spreading viruses. 
    • Note – DOH had planned to update current masking requirements by mid-November. It is continuing its review and plans to issue an update in the coming weeks.   
  • DOH recommends everyone 6 months and older be vaccinated for influenza and COVID-19 to lower risk of transmission and serious illness. If you have already been vaccinated against COVID-19, make an appointment now to receive your booster. People ages 5 years and older who had their last COVID-19 shot at least two months ago can get the updated booster. Influenza and COVID-19 vaccines can be safely given at the same time. There is currently no approved vaccine for respiratory syncytial virus (RSV).  
  • If you or a member of your family are sick, stay home and use the appropriate level of care necessary. Call your healthcare provider or pediatrician for advice or to make an appointment. Consider going to an urgent care or check if telehealth is an option. For emergencies, call 9-1-1 or go to your nearest emergency room immediately.  
  • Wash your hands often and avoid touching your eyes, mouth, and nose, which are where viruses commonly enter the body.  
  • Consider taking a COVID-19 test prior to gathering, especially if you are getting together with people who are older, immunocompromised, or at risk for severe disease. 
  • Practice food safety by washing your hands, keeping foods at the correct temperature, preparing foods correctly, and disinfecting surfaces. 

Simple but important steps can help keep all of us healthy and safe this holiday season! 

COVID-19 Cases and Deaths, Vaccinations, and Treatments by Race/Ethnicity as of Fall 2022

As the United States enters its third holiday season navigating a potential increase in COVID-19 cases as well as other respiratory illnesses, federal data from the Centers for Disease Control and Prevention (CDC) show that as of November 9, 2022, 80% of the total population in the United States have received at least one dose of a COVID-19 vaccine and only 10% of eligible individuals have received the updated, bivalent booster that was authorized for use among individuals 5 years of age and older in early Fall 2022. Individuals who have not received any booster dose are at higher risk of infection from the virus, and people who remain unvaccinated continue to be at particularly high risk for severe illness and death.

Over the course of the pandemic, racial disparities in cases and deaths have widened and narrowed. However, overall, Black, Hispanic, and American Indian and Alaska Native (AIAN) people have borne the heaviest health impacts of the pandemic, particularly when adjusting data to account for differences in age by race and ethnicity. While Black and Hispanic people were less likely than their White counterparts to receive a vaccine during the initial phases of the vaccination rollout, these disparities have narrowed over time and reversed for Hispanic people. Despite this progress, a vaccination gap persists for Black people. COVID-19 outpatient treatments, which can mitigate hospitalization and death from COVID-19, are also available. However, early data suggest racial disparities in access to and receipt of these treatments.

This data note presents an update on the status of COVID-19 cases and deaths, vaccinations, and treatments by race/ethnicity as of Fall 2022, based on federal data reported by the Centers for Disease Control and Prevention (CDC).

What is the status of COVID-19 cases and deaths by race/ethnicity?

Racial disparities in COVID-19 cases and deaths have widened and narrowed over the course of the pandemic, but when data are adjusted to account for differences in age by race/ethnicity, they show that AIAN, Black, and Hispanic people have had higher rates of infection and death than White people over most of the course of the pandemic. Early in the pandemic, there were large racial disparities in COVID-19 cases. Disparities narrowed when overall infection rates fell. However, during the surge associated with the Omicron variant in Winter 2022, disparities in cases once again widened with Hispanic (4,341 per 100,000), AIAN (3,818 per 100,000), Black (2,937 per 100,000), and Asian (2,755 per 100,000) people having higher age-adjusted infection rates than White people (2,693 per 100,000) as of January 2022 (Figure 1). Following that surge, infection rates fell in Spring 2022 and disparities have once again narrowed. However, as of September 2022, the age-adjusted COVID-19 infection rates were still highest for Black and Hispanic people (192 per 100,000 for each group), followed by AIAN people at 188 per 100,000. White and Asian people had the lowest infection rates at 164 per 100,000 and 153 per 100,000, respectively. While death rates for most groups of color were substantially higher compared with White people early on in the pandemic, since late Summer 2020, there have been some periods when death rates for White people have been higher than or similar to some groups of color. However, age-adjusted data show that AIAN, Black, and Hispanic people have had higher rates of death compared with White people over most of the pandemic and particularly during surges. For example, as of January 2022, amid the Omicron surge, age-adjusted death rates were higher for Black (37.4 per 100,000), AIAN (34.7 per 100,000), and Hispanic people (29.9 per 100,000) compared with White people (23.5 per 100,000) (Figure 1). Following that surge, disparities narrowed when death rates fell. As of August 2022, age-adjusted death rates were similar for AIAN (4.9 per 100,000), Black (4.4 per 100,000), and White people (4.2 per 100,000) and lower for Hispanic (3.6 per 100,000) and Asian (2.7 per 100,000) people. Despite these fluctuations over time, total cumulative age-adjusted data continue to show that Black, Hispanic, and AIAN people have been at higher risk for COVID-19 cases, hospitalizations, and deaths compared with White people.

Read the full article from KFF here.

People With Long Covid Face Barriers to Government Disability Benefits

When Josephine Cabrera Taveras was infected with covid-19 in spring 2020, she didn’t anticipate that the virus would knock her out of work for two years and put her family at risk for eviction.

Taveras, a mother of two in Brooklyn, New York, said her bout with long covid has meant dealing with debilitating symptoms, ranging from breathing difficulties to arthritis, that have prevented her from returning to her job as a nanny. Unable to work — and without access to Social Security Disability Insurance or other government help — Taveras and her family face a looming pile of bills.

“We are in the midst of possibly losing our apartment because we’re behind on rent,” said Taveras, 32. Her application for Social Security disability assistance, submitted last fall, was rejected, but she is appealing.

Like many others with long covid, Taveras has fallen through the cracks of a system that was time-consuming and difficult to navigate even before the covid pandemic. People are facing years-long wait times, insufficient legal support, and a lack of clear guidance on how to prove they are disabled — compounded by the challenges of a medical system that does not have a uniform process for diagnosing long covid, according to health experts and disability attorneys.

The Biden administration promised support to people with long covid, but patient advocates say many are struggling to get government help.

The Centers for Disease Control and Prevention defines long covid broadly, as a “range of ongoing health problems” that can last “weeks, months, or longer.” This description includes people, like Taveras, who cannot work, as well as people with less severe symptoms, such as a long-term loss of smell.

Read the full article from KHN.

Updated COVID-19 booster eligibility expanded to people ages 5 and older

The Washington State Department of Health (DOH) and other healthcare providers will soon begin offering Omicron variant-targeted bivalent booster doses of COVID-19 vaccines to people ages 5 and older, following guidance and recommendations from the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the Western States Scientific Safety Review Workgroup.

“This is another step forward to a healthier tomorrow for everyone in Washington state,” said Umair A. Shah, MD, MPH, Secretary of Health. “The more people who are eligible for COVID-19 boosters, the better protection we can provide to our communities.

This new demographic of booster eligibility expansion follows last month’s rollout of the updated (bivalent) COVID-19 vaccine, which specifically targets the BA.4 and BA.5 subvariants that currently make up the majority of COVID-19 cases across the country. The Department of Health urges all individuals 5 and older to prioritize receiving the updated booster as we enter the beginning of cold and flu season. Additionally, flu vaccines are now available at many provider offices and pharmacies across the state and are safe to receive concurrently with the COVID-19 bivalent booster.

“It’s also time to get your flu shot,” Dr. Shah added. “We are entering respiratory illness seasons and it is a critical time to protect yourself and those around you from influenza.”

DOH’s updated COVID-19 booster dose recommendations are as follows:

  • People ages 5 and older who have completed a primary vaccine can receive the Pfizer-BioNTech bivalent booster at least two months after their most recent dose. These doses are scheduled to begin arriving in provider offices the week of October 17th.
  • People ages 6 and older who have completed a primary vaccine series can receive the Moderna bivalent booster at least two months after their most recent dose. Providers who already have an inventory of Moderna can begin administering these doses immediately.
  • Children ages 6 months to 4 years remain eligible for the primary, monovalent COVID-19 vaccine series from both Pfizer-BioNTech and Moderna and are not currently authorized for any COVID-19 booster doses.

As with previous vaccine and booster rollouts, the CDC will provide states with weekly allocations, building each state’s inventory levels over time. DOH urges the public to remain patient as we expect initial demand to exceed availability, resolving in the following weeks.

To make a vaccine or booster appointment, visit VaccinateWA.org, or call the COVID-19 Information Hotline at 833-VAX-HELP. Language assistance is available. Those individuals with further questions are encouraged to visit DOH’s COVID-19 Vaccine Frequently Asked Questions webpage or talk to their trusted healthcare provider.

Will Covid Spike Again This Fall? 6 Tips to Help You Stay Safe

Last year, the emergence of the highly transmissible omicron variant of the covid-19 virus caught many people by surprise and led to a surge in cases that overwhelmed hospitals and drove up fatalities. Now we’re learning that omicron is mutating to better evade the immune system.

Omicron-specific vaccines were authorized by the FDA in August and are recommended by U.S. health officials for anyone 5 or older. Yet only half of adults in the United States have heard much about these booster shots, according to a recent KFF poll, and only a third say they’ve gotten one or plan to get one as soon as possible. In 2020 and 2021, covid cases spiked in the U.S. between November and February.

Although we don’t know for sure that we’ll see another surge this winter, here’s what you should know about covid and the updated boosters to prepare.

1. Do I need a covid booster shot this fall?

If you’ve completed a primary vaccination series and are 50 or older, or if your immune system is compromised, get a covid booster shot as soon as possible. Forty percent of deaths are occurring among people 85 and older and almost 90% among people 65 and over. Although people of all ages are being hospitalized from covid, those hospitalizations are also skewing older.

Unvaccinated people, while in the minority in the U.S., are still at the highest risk of dying from covid. It’s not too late to get vaccinated ahead of this winter season. The United Kingdom, whose covid waves have presaged those in the United States by about a month, is beginning to see another increase in cases.

If you’ve already received three or more covid shots, you’re 12 to 49 years old, and you’re not immunocompromised, your risk of hospitalization and death from the disease is significantly reduced and additional boosters are not likely to add much protection.

However, getting a booster shot provides a “honeymoon” period for a couple of months after vaccination, during which you’re less likely to get infected and thus less likely to transmit the virus to others. If you’ll be seeing older, immunocompromised, or otherwise vulnerable family and friends over the winter holidays, you might want to get a booster two to four weeks in advance to better shield them against covid.

You may have other reasons for wanting to avoid infection, like not wanting to have to stay home from work because you or your child is sick with covid. Even if you aren’t hospitalized from covid, it can be costly to lose wages or arrange for backup child care.

One major caveat to these recommendations: You should wait four to six months after your last covid infection or vaccination before getting another shot. A dose administered too soon will be less effective because antibodies from the previous infection or vaccination will still be circulating in your blood and will prevent your immune cells from seeing and responding to vaccination.

Read the full article from KHN.

COVID-19 Boosters

The CDC recently recommended the following updated mRNA COVID-19 vaccine boosters to help restore protection that has waned since previous vaccination and target more transmissible and immune-evading variants:

  • The Moderna bivalent mRNA COVID-19 booster is authorized for people 18 and older.
  • The Pfizer bivalent mRNA COVID-19 booster is authorized for people 12 years and up.

These boosters are referred to as “bivalent” vaccines because they target both the original strain of COVID-19 and the Omicron BA.4 and BA.5 subvariants currently circulating in the United States. These updated boosters will help better protect us against these and future variants that might be closely related to Omicron.

Everyone who is eligible to receive the bivalent booster – including those who are moderately and severely immunocompromised – are recommended to receive ONE dose of the booster regardless of how many doses they have received previously. Those eligible may receive the updated booster if at least 2 months have passed since their last COVID-19 dose (either the final primary series dose or the last booster).

The original (monovalent) mRNA COVID-19 vaccine boosters are no longer authorized for people aged 12 years and older and can no longer be given to them, even if they had not previously received a monovalent booster dose. Children ages 5-11 should still receive the monovalent booster (at least 5 months after their second dose).

Routine Childhood Immunizations, Seasonal Influenza, & COVID-19 Vaccination can be co-administered

COVID-19 disrupted both in-person learning and routine well-child visits for many children. As a result, tens of thousands of children and adolescents have fallen behind on receiving recommended vaccines.

Timely vaccination is critical, as immunization schedules are designed to provide children with immunity early in life before they may be exposed to life-threatening diseases. Not only do delayed or missed vaccines leave children vulnerable to illness but when vaccination rates fall even just a little, vaccine-preventable diseases can spread easily.

We know from studies conducted throughout the pandemic that receiving a COVID-19 vaccine at the same time as routine immunizations is safe. If multiple vaccines are due, giving more than one vaccine at the same visit is important because it increases the probability that an individual will be up to date with vaccines.

In addition, with both influenza and COVID-19 viruses circulating, getting both the Flu and COVID-19 vaccines is important for prevention of severe disease, hospitalization, and death. CDC recommends health care providers offer influenza and COVID-19 vaccines at the same visit, with each dose administered in separate limbs.

Omicron COVID-19 vaccine boosters now authorized for certain individuals

The Washington State Department of Health (DOH) and other healthcare providers will soon begin offering Omicron variant-targeted bivalent booster doses of the Pfizer-BioNTech and Moderna COVID-19 vaccines following authorization by the U.S. Food and Drug Administration (FDA), and recommendations from the Centers for Disease Control and Prevention’s Advisory Committee on Immunizations Practices, and the Western States Scientific Safety Review Workgroup.  

The bivalent vaccines combine the companies’ original COVID-19 vaccine compositions with BA.4 and BA.5 spike protein components, providing additional protection by targeting variants that are more transmissible and immune-evading. The primary COVID-19 vaccine series will stay the same, given their proven efficacy in preventing serious illness, hospitalization, and death from COVID-19. DOH’s updated booster dose recommendations are as follows: 

  • People ages 12 – 17 who have completed a primary vaccine series can receive the Pfizer-BioNTech bivalent booster at least two months after their most recent dose. 
  • People 18 and older who have completed a primary vaccine series can receive either company’s bivalent booster at least two months after their most recent dose. 
  • Those ages 5 – 11 who have completed Pfizer-BioNTech’s primary vaccine series should continue to receive the company’s original monovalent booster at least 5 months after their most recent dose. 
  • Children ages 6 months – 4 years are currently not authorized for any COVID-19 booster doses. 
  • People ages 12 and over who currently have appointments to receive COVID-19 booster doses will need to contact their providers to ensure the bivalent booster is available; if not, those appointments will need to be rescheduled, as the former monovalent booster doses are no longer authorized for this age group. 

“We’re excited this updated bivalent booster will help increase protection against the Omicron variants as we head into the fall season,” said Tao Sheng Kwan-Gett, MD, MPH, Chief Science Officer. “As SARS-CoV-2 changes, so must the tools we use against it – this update helps ensure that vaccines and boosters will continue to be the most effective ways to reduce the risk of hospitalization and death, and keep those most at-risk healthy and safe.” 

An initial allocation of 191,100 bivalent booster doses is currently en route to providers throughout the state and will be available beginning the week of September 5 after the Labor Day holiday. Subsequent weekly allocations will follow, building the state’s inventory levels over time. DOH urges the public to remain patient, as we expect initial demand to exceed available inventory before resolving in the coming weeks, and to visit Vaccine Locator or call the COVID-19 Information Hotline at 1-800-525-0127 to find available resources near them. 

Unraveling the Interplay of Omicron, Reinfections, and Long Covid

The latest covid-19 surge, caused by a shifting mix of quickly evolving omicron subvariants, appears to be waning, with cases and hospitalizations beginning to fall.

Like past covid waves, this one will leave a lingering imprint in the form of long covid, an ill-defined catchall term for a set of symptoms that can include debilitating fatigue, difficulty breathing, chest pain, and brain fog.

Although omicron infections are proving milder overall than those caused by last summer’s delta variant, omicron has also proved capable of triggering long-term symptoms and organ damage. But whether omicron causes long covid symptoms as often — and as severe — as previous variants is a matter of heated study.

Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, is among the researchers who say the far greater number of omicron infections compared with earlier variants signals the need to prepare for a significant boost in people with long covid. The U.S. has recorded nearly 38 million covid infections so far this year, as omicron has blanketed the nation. That’s about 40% of all infections reported since the start of the pandemic, according to the Johns Hopkins University Coronavirus Research Center.

Long covid “is a parallel pandemic that most people aren’t even thinking about,” said Akiko Iwasaki, a professor of immunobiology at Yale University. “I suspect there will be millions of people who acquire long covid after omicron infection.”

Read the full article from KHN.

Department of Health releases updated COVID-19 guidance for K-12 schools & child care

The Washington State Department of Health (DOH) has released its updated COVID-19 guidance for K-12 schools and child care. The guidance takes lessons learned from the first two and a half years of the pandemic, and outlines both required and recommended measures for the 2022-23 school year to help reduce COVID-19 transmission in school and child care settings. Schools, child care providers, and families can expect limited changes focused on clarifying and simplifying the guidance.

“We are entering a new stage of coexisting with COVID-19 in our communities, knowing that COVID-19 is here to stay for the foreseeable future,” said Umair A. Shah, MD, MPH, Secretary of Health. “DOH also recognizes the importance of being able to maintain in-person learning for children, and the fundamental links between education and long-term health outcomes.”

Clarified requirements and recommendations in this school year’s guidance include:

  • Students, children, and staff who test positive for COVID-19 are required to stay at home and isolate for 5 days. Repeating initial COVID-19 testing will not affect this requirement.
  • Students, children, and staff returning from 5 days of isolation should wear a well-fitted mask from days 6 to 10. Those returning are encouraged to test before doing so.
  • Schools and child care providers are no longer required to directly notify high risk individuals of exposure but must continue to have a process in place to inform students, staff, and families of cases and outbreaks.
  • Schools and child care providers continue to be required to report outbreaks (3 or more cases within a specified core group) to local health jurisdictions (LHJ) and to have a system in place to respond.

DOH continues to encourage schools and child care providers to consider their local context when selecting any additional measures to help reduce COVID-19 transmission in schools and child care settings and to coordinate with their LHJ, particularly during times of outbreak. Schools, child care providers, and the LHJ may choose to continue to implement more protective measures, depending upon their context, to help ensure students, children, and staff can continue in-person activities safely.

While the guidance is specific to COVID-19 prevention, it can also help to reduce transmission of other common respiratory viruses such as influenza. DOH has also developed a brief for schools and a brief for child care providers to provide a high-level overview on changes to the guidance.

COVID-19 vaccinations remain the best protection for everyone against hospitalization and severe disease from COVID-19. The COVID-19 vaccine is now available for children 6 months and older. Booster doses are also available for children 5 years and older. DOH encourages all families to vaccinate their children if they are eligible, in consultation with health care providers.