Hot Topics in Infection Prevention and Control: Week of Dec 15, 2022

Saskia v. Popescu, PhD, MPH, MA, CIC

Rising COVID-19 Cases–This Is No Longer a Pandemic of the Unvaccinated

In a Groundhog Day-like scenario, we see a rise in cases across the United States. I know—not particularly surprising, eh? In the last 2 weeks, cases have increased by 55%, with 66,000 new cases per day. Test positivity is around 12%, which is an increase of 23%, and hospitalizations are also up by 21%, with a daily average of 38,000. Deaths are also up by 65%, with a daily average of 460. Some states are seeing significant rises—like Oklahoma, where cases are up 211%, Indiana 95%, Nevada 119%, South Carolina 114%, Texas 101%, and Georgia 145%.

Early on, there were narratives that COVID-19 would transition into a pandemic of unvaccinated people. This idea is fundamentally no longer valid—as a majority of the US citizenry has been vaccinated, so many cases are in those vaccinated individuals. McKenzie Beard mentioned that “Fifty-eight percent of [COVID-19] deaths in August were people who were vaccinated or boosted, according to an analysis conducted for The Health 202 by Cynthia Cox, vice president at the Kaiser Family Foundation. “It’s a continuation of a troubling trend that has emerged over the past year. As vaccination rates have increased and new variants appeared, the share of deaths of people who were vaccinated has been steadily rising. In September 2021, vaccinated people made up just 23 percent of coronavirus fatalities. In January and February [2022], it was up to 42 percent, per our colleagues Fenit Nirappil and Dan Keating.”

While Paxlovid has been linked to a 44% drop in COVID-19 hospitalizations and deaths in older adults, we are still clearly struggling against the virus. In this winter where we are seeing surges of respiratory syncytial virus (RSV), influenza, and COVID-19, now more than ever, we need to be vigilant in terms of vaccines, masks, visitor restrictions, hand hygiene, cleaning/disinfection, and ventilation.

Update on Ebola Disease Outbreak in Uganda

According to the World Health Organization (WHO), as of 5 December 2022, Uganda has had 142 confirmed cases, 22 probable cases of deaths, 55 deaths among confirmed cases, and 80 days since the first case was confirmed. The case fatality rate (CFR) for this outbreak of Sudan Ebola is 39%. The WHO reported that “On 2 December, Uganda health authorities announced that all patients have been discharged from Ebola treatment units and that no more cases are currently hospitalized. As of 5 December, there are no active cases. As of 5 December 2022, out of 2564 contacts listed, 2167 (84.5%) have completed the 21-day follow-up period. Currently, 36 contacts are actively followed up in 4 districts, with a follow-up rate of 100%.”

Cholera Outbreak in Haiti

Haiti is experiencing quite a significant outbreak of cholera as the WHO works to provide oral vaccines to address the 13,000 cases. The International Coordinating Group on Vaccine Provision provided roughly 1.17 million doses of oral cholera vaccines to the country to help ensure an adequate response to the growing outbreak. Something to consider for travel-related illness in patients!