More Voices Against Masks & Restrictions

Concern about the Delta variant is causing many governments to keep COVID restrictions in place, while experts are saying that there’s nothing for vaccinated people to fear about the Delta variant. LA is reinstating a mask mandate. In the UK, they’re already talking about vaccine booster shots.

A study shows Germany was able to reopen schools without increasing cases, and Australia is still trying to balance their reaction to COVID.

In other news:

  • Paul Collits writes about Australia’s overzealous COVID restrictions at Conservative Woman
  • John Mandrola, MD, weights in on the risk of vaccinating young people at MedScape
  • Going back to masks isn’t good science, it’s fear mongering, Marty Makary writes for The Washington Post
  • Vinay Prasad, MD, MPH, et al. speak out against 2 doses for kids in MedPage Today

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COVID News

Delta Variant’s Spread Hobbles Global Efforts to Lift Covid-19 Restrictions

https://www.wsj.com/articles/delta-variants-spread-hobbles-global-efforts-to-lift-covid-19-restrictions-11625131968

The fast spread of the Delta variant of the coronavirus in much of the world is thwarting plans in many countries to lift lockdowns and reopen economies, a major setback to efforts to contain the global Covid-19 pandemic.

The variant’s spread has heightened a likely feature of an extended global pandemic: the contrast between poorer unvaccinated countries where hospitalizations and death rates are surging and highly vaccinated populations where the link between rising case rates and serious illness has been largely broken.

Delta, which swept through India in May, is estimated to be at least twice as contagious as the original version of the virus. It is now present in 85 countries and is the most common variant in the U.S. Only in South America, where another highly contagious version of the virus is prevalent, does Delta not seem to be making inroads.

In parts of Asia, Australia and Europe, governments are reintroducing travel restrictions and delaying the lifting of lockdowns as health authorities find that restrictive measures that kept earlier lineages of the virus in check aren’t curbing Delta.

U.K. Plans to Introduce Covid-19 Booster Shots in September

https://www.wsj.com/articles/u-k-plans-to-introduce-covid-19-booster-shots-in-september-11625137154

LONDON—The U.K. government said it is preparing to deliver booster Covid-19 vaccine shots from September, in case extra protection is needed to deal with waning immunity from initial doses and to bolster protection against new variants of the coronavirus.

The U.K. is among the first governments to set out provisional plans for booster shots, following advice from specialists who are concerned that possible further Covid-19 outbreaks over the winter could coincide with a wave of influenza and put pressure on the country’s health system.

The government said the actual rollout would depend on further advice from an expert group known as the Joint Committee on Vaccination and Immunization, based on a host of new data, including whether protection from the vaccines weakens after six months.

Experts say those in Mass. should respect but not fear the Delta variant

https://www.bostonglobe.com/2021/06/30/metro/respect-dont-fear-delta-variant/

Just as people are happily resuming life without face masks, alarms are sounding over the Delta variant, a highly contagious form of the coronavirus raging across the globe.

The World Health Organization last week urged even vaccinated people to wear masks indoors, and Los Angeles County health officials on Monday followed suit.

But health experts in Massachusetts and elsewhere are adamant that the Delta variant should not ruin our Fourth of July or require vaccinated people to dig out that box of paper masks. If you’re fully immunized, they say, you’re safe.

“There is no scientific reason why a vaccinated person should wear a mask anywhere, except for their own comfort,” said Dr. Shira I. Doron, hospital epidemiologist at Tufts Medical Center.

Los Angeles urges everyone to mask up because of delta variant — even the vaccinated

https://www.washingtonpost.com/health/2021/06/30/los-angeles-indoor-masks-vaccinated/

Los Angeles County public health authorities are urging unvaccinated and vaccinated people alike to don masks again inside restaurants, stores and other public indoor spaces because of the growing threat posed by the more contagious delta variant of the novel coronavirus.

The high-profile move by the county of 10 million marks an abrupt shift in tone after states and localities have dropped most mask mandates and social distancing requirements in recent weeks. The Centers for Disease Control and Prevention in mid-May rescinded almost all masking recommendations for fully vaccinated people.

Commentary/Analysis

Two Covid deaths this summer and Australia turns into North Korea

AS THE Australian’s Adam Creighton recently noted, Australasia’s ill-deserved global reputation for ‘gold standard’ Covid management has had more to do with Australia and New Zealand being islands than anything much else. Not only this. We were in a good part of the world (the end of it) and in a good season (late summer) when the virus hit.  We missed the ‘first wave’ entirely.

A good analogy is Australia’s ‘selective high schools’ for the very bright kids. We make a fuss when these schools routinely produce top results. This isn’t an achievement. It would be the absence of excellent results that would need to be explained.

Understanding this would spoil the narrative of Australia’s multiple Covid governments entirely. Government policy drives Covid outcomes, right?

Australia has done what distant islands can fairly safely do. We cut ourselves off from the rest of the world. The wisdom of the latter is far from established, to put it at its most polite. Especially for economies reliant on exports of minerals, agricultural produce and tourism, and imports of people, especially tertiary students, and manufactured goods, such as, er, vaccines. We halted all but rarely permitted overseas travel, placing us in the company of Cuba and North Korea.  We set up dodgy quarantine systems which were totalitarian and incompetent at the same time. These apply to internal borders between states as well as external borders.

Vaccine-Induced Myocarditis Concerns Demand Respect, Not Absolutism

https://www.medscape.com/viewarticle/954038

For the first half of 2021, the mRNA vaccines looked to be near perfect. The trials reported more than 90% efficacy for the Pfizer and Moderna vaccines. Both provided near 100% prevention of severe COVID-19 and after hundreds of millions of adults received the shots, no signal of harm emerged.

I, like any rational person, see a positive benefit-harm ratio from the vaccines for adults.

Younger People?

After a “positive” trial in which just over 1100 kids aged 12 to 15 years received an mRNA vaccine, a movement arose to vaccinate young and old alike. I put “positive” in quotes for two reasons:  The first is that this trial measured noninferiority of the immune response, not clinical outcomes. That was necessary because so few kids get sick with COVID-19. The other reason is that the authors claimed a favorable safety profile, but 1100 kids is not enough to inform the safety of a vaccine that will be given to many millions.

Then came a signal of myocarditis in young people, then another, and another, and now one in slightly older (median age, 25 years) military recruits. These reports complicate matters because young people have the lowest risk from COVID-19.

Opinion: Los Angeles’s masking guidance is not only excessive. It undermines vaccination efforts.

https://www.washingtonpost.com/opinions/2021/07/01/la-mask-guidance-excessive/

The latest guidance from Los Angeles County officials that fully vaccinated residents should once again wear masks to stop the spread of the delta variant is not just excessive; it also undermines vaccination efforts and perpetuates fearmongering.

As the United States has reopened, too many public health officials have held the fear of the unknown over people’s head. It’s a line of argument no one can overcome. Rarely can we ever guarantee that something bad won’t happen in the future — even in medical science. But we as practicing physicians routinely need to make decisions based on the best available information. We can’t just sit around in decision-paralysis based on uncertainty. In fact, doing so can cause harm.

CDC’s All-or-Nothing Approach to Teen COVID Vaccination Is All Wrong

https://www.medpagetoday.com/opinion/second-opinions/93340

Last week, the CDC’s Advisory Committee on Immunization Practices (ACIP) met to discuss the safety signal of myocarditis among young people who receive mRNA vaccination against COVID-19. This dialogue has been months in the making. Ultimately, the panel continued to endorse a two-dose mRNA strategy for all ages. We are concerned with this recommendation and offer five alternative considerations. But first, let’s review how we got to this moment in order to make sense of vaccine-induced myocarditis.

A Recent History of Vaccine-Induced Myocarditis

The potential risk for vaccine-induced myocarditis was first raised on February 1 in the Jerusalem Post, which reported the hospitalization and intensive-care admission of a healthy 19-year old male 5 days after receiving his second dose of the Pfizer vaccine. This was followed by a nationwide report in the Times of Israel on April 23, later picked up by Reuters on April 25. These news reports suggested that Israel had seen elevated rates of this event after young men were vaccinated with the Pfizer vaccine, almost always after the second dose (56 out of 62 cases or 90%).

Research

Does re-opening schools contribute to the spread of SARS-CoV-2? Evidence from staggered summer breaks in Germany

https://www.sciencedirect.com/science/article/abs/pii/S0047272721000621

Abstract

This paper studies the effect of the end of school summer breaks on SARS-CoV-2 cases in Germany. The staggered timing of summer breaks across federal states allows us to implement an event study design. We base our analysis on official daily counts of confirmed coronavirus infections by age groups across all 401 German counties. We consider an event window of two weeks before and four weeks after the end of summer breaks. We do not find evidence of a positive effect of school re-openings on case numbers. For individuals aged between 5 and 59 years, comprising school-aged children and their parents, our preferred specification indicates that the end of summer breaks had a negative but insignificant effect on the number of new confirmed cases. Our results are not explained by changes in mobility patterns around school re-openings arising from travel returnees. Analyses of Google Trends data suggest that behavioral changes of parents may have contributed to contain larger outbreaks after school re-openings. We conclude that school re-openings in Germany under strict hygiene measures combined with quarantine and containment measures have not increased the number of newly confirmed SARS-CoV-2 infections.

Charts and Graphics

International News

Australia Plots Covid-19 Exit Strategy

https://www.wsj.com/articles/australia-plots-covid-19-exit-strategy-11625222789

SYDNEY—Australia plans to experiment with shorter isolation periods for vaccinated travelers and the gradual return of foreign students, Prime Minister Scott Morrison said in laying out a four-stage strategy to return life in the country to normal.

Still, some health experts worry that the government’s push to reopen is premature as Australia has fully vaccinated around 6% of its population and the Delta variant is spreading in ways that scientists don’t fully understand. Australia doesn’t have enough doses of the Pfizer Inc.-BioNTech SE vaccine to meet current demand, raising concerns that the government won’t be able to meet a target of inoculating every adult that wants to be vaccinated by the end of the year.

Mr. Morrison said Friday that increased risks from the Delta variant necessitated a 50% cut to the number of people allowed to arrive in Australia on commercial flights. Thousands of the country’s citizens remain stranded overseas.

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