August 31: Johns Hopkins COVID 19 Report

COVID-19 Situation Report

EPI UPDATE The WHO COVID-19 Dashboard reports 216.9 million cumulative cases and 4.5 million deaths worldwide as of August 31. Global weekly incidence decreased for the first time since mid-June, down 3.12% from the previous week. Weekly mortality also decreased, for the first time since late June*, falling 2.41% compared to the previous week.

*With the exception of the week of July 19, when Ecuador reported 8,786 deaths.

The global cumulative mortality surpassed 4.5 million deaths in today’s update:

1 death to 500k: 165 days

500k to 1 million: 86 days

1 to 1.5 million: 70 days

1.5 to 2 million: 44 days

2 to 2.5 million: 37 days

2.5 to 3 million: 52 days

3 to 3.5 million: 38 days

3.5 to 4 million: 51 days

4 to 4.5 million: 54 days

Global Vaccination

The WHO reported 5.02 billion cumulative doses of SARS-CoV-2 vaccines administered globally as of August 30. A total of 1.93 billion individuals have received at least 1 dose, and 1.16 billion are fully vaccinated. Analysis from Our World in Data indicates that global daily vaccinations increased sharply over the past several days, up to 41 million doses per day, which would be the third highest peak to date*. The global trend continues to closely follow the trend in Asia. Our World in Data estimates that there are 3.11 billion vaccinated individuals worldwide (1+ dose; 39.45% of the global population) and 2.12 billion who are fully vaccinated (26.9% of the global population)**.

*The average doses administered may exhibit a sharp decrease for the most recent data particularly over the weekend, which indicates effects of reporting delays. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent data.

**China reported 448 million new vaccinated individuals (1+ dose) and 112 million fully vaccinated individuals on August 26, its first report since June 10.

UNITED STATES

The US CDC reported 38.9 million cumulative COVID-19 cases and 636,015 deaths. Daily incidence continues to increase, but the trend is tapering off toward a peak or plateau. The current average of 149,334 new cases per day is the highest since January 29. Daily mortality also continues to increase, and the mortality trend may be starting to taper off as well. The current average of 970 deaths per day is the highest since March 13*.

*Changes in the frequency of state-level reporting may affect the accuracy of recently reported data, particularly over the weekend. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent dates.

Data from HHS indicate that more than 100,000 COVID-19 patients are currently hospitalized nationwide. This represents the second highest peak to date, and is still increasing. The CDC reports more than 84,000 COVID-19 patients currently hospitalized, 32% below the highest peak.

US Vaccination

The US has administered 369.6 million cumulative doses of SARS-CoV-2 vaccines, and daily vaccinations appear to have peaked over the past several days. The average briefly exceeded 798,000 doses per day on August 23 before falling to 787,000 on August 25*. Notably, we have not observed a marked increase in daily vaccinations since the US FDA issued full approval for the Pfizer-BioNTech vaccine. There are 204.5 million individuals who have received at least 1 dose, equivalent to 61.7% of the entire US population. Among adults, 74.1% have received at least 1 dose, as well as 13.4 million adolescents aged 12-17 years. A total of 173.8 million individuals are fully vaccinated, which corresponds to 52.4% of the total population. Approximately 63.4% of adults are fully vaccinated, as well as 10.2 million adolescents aged 12-17 years.

*Due to delays in reporting, estimates for the average daily doses administered are less accurate for the most recent 5 days. The most current average provided here corresponds to 5 days ago.

US CDC ACIP MEETING At a meeting on August 30, the US CDC's Advisory Committee on Immunization Practices (ACIP) expressed initial support for third doses of SARS-CoV-2 mRNA vaccines for vulnerable populations, such as long-term care facility residents, and healthcare workers but said there is not enough data yet to recommend so-called booster shots for the general population. In a presentation to the committee, Dr. Sara Oliver, Co-Lead for the COVID-19 Vaccines ACIP Work Group, said data through July show the vaccines appear to provide strong protection against severe disease and hospitalization. Vaccine effectiveness (VE) against hospitalization remains high, between 75% to 95%, while VE against infection spans a much broader range, between 39% to 84%, since the predominance of the Delta variant. Dr. Oliver noted the reasons for lower VE “likely include both waning over time and the Delta variant.” Instead of focusing on booster doses, ACIP members emphasized that improving overall vaccination coverage is a “top priority,” as a high percentage of hospitalizations are occurring among unvaccinated individuals. They also said any booster dose recommendation should take into account equitable access to vaccines, both domestically and globally. The committee did not vote on booster doses, noting it intends to do so after the US FDA authorizes their use. The committee expects to meet in a few weeks to discuss data covering August, although a date was not announced. While the administration of US President Joe Biden has endorsed booster shots, saying they will be available by September 20, the FDA and CDC must first make recommendations based on scientific evidence.

At the meeting, the ACIP backed the US FDA’s full approval of the Pfizer-BioNTech SARS-CoV-2 mRNA vaccine, voting 14-0 to recommend the vaccine for individuals aged 16 and older. CDC Director Dr. Rochelle Walensky endorsed the recommendation, 9 months after the committee made an interim recommendation supporting the vaccine’s use. The committee reiterated that though there are rare reports of heart inflammation after mRNA vaccination, especially among males under age 30, the benefits of the vaccine outweigh the risks because the condition can occur at higher rates in COVID-19 patients than among those who received an mRNA vaccination.

DELTA HOSPITALIZATION RISK A study published August 27 in The Lancet Infectious Diseases adds evidence to what many experts already suspected: people infected with the highly contagious SARS-CoV-2 Delta variant are twice as likely to be hospitalized as those infected with the Alpha variant. To compare hospitalization rates, researchers from Public Health England (PHE) and Cambridge University examined data on 43,338 sequencing-confirmed COVID-19 cases between March 29 and May 23, 2021, during which time the Delta variant was becoming the predominant variant in the UK. The majority of the cases were among unvaccinated individuals (74%), while 2% were fully vaccinated and 24% had received one dose. Of 34,656 Alpha cases, 764 (2.2%) were admitted to the hospital within 14 days of a positive SARS-CoV-2 test, while 196 of 8,682 (2.3%) Delta cases were hospitalized. Although the percentages of hospitalized cases were similar between both variants, the risk of being hospitalized more than doubled (adjusted hazard ratio [HR] 2.26, 95% confidence interval [CI] 1.32-3.89) for Delta cases compared with Alpha cases when the researchers adjusted the data to account for certain factors, including age and sex. Delta cases also were more likely to seek emergency medical care or be hospitalized within 14 days versus Alpha cases (adjusted HR 1.45, 95% CI 1.08-1.95).

Although the researchers examined differences between vaccinated and unvaccinated groups for hospitalizations and emergency care or hospitalization, the results were non-significant due to low numbers of cases who were fully vaccinated. Therefore, the results only apply to people who are unvaccinated. In a statement, Dr. Anne Presanis, Senior Statistician at the University of Cambridge and a lead author of the study, emphasized the importance of getting fully vaccinated to reduce the risk of symptomatic infection with Delta, as well as reduce the risk of severe disease and hospitalization. The researchers noted that a previous study conducted in Scotland and published in The Lancet in June showed a similar increase in hospitalization risk among people infected with the Delta variant. While the UK study is the largest to date examining hospitalization risk for the Delta versus Alpha variants based on whole-genome sequenced cases, the researchers called for further assessments into how hospitalization risks differ for vaccinated individuals after infection with either variant.

SCHOOL TRANSMISSION A case study published August 27 in the US CDC’s Morbidity and Mortality Weekly Report (MMWR) shows how quickly the highly contagious SARS-CoV-2 Delta variant can spread within a classroom of children too young to be vaccinated. The outbreak involved an unvaccinated Marin County, California (US), elementary school teacher who began showing COVID-19 symptoms on May 19, but who came to work the next 2 days, attributing the symptoms to allergies. During that time, the teacher read aloud to the class without wearing a mask, even though masks were required for staff and students while indoors. The teacher received a positive SARS-CoV-2 test on May 21 and informed the school on May 23. Several students became symptomatic on May 22, and the Marin County Department of Public Health (MCPH) initiated an investigation on May 26 to characterize the outbreak. Overall, 27 COVID-19 cases were identified, including the teacher. Among the teacher’s 24 students—all of whom were too young to be eligible for vaccination—12 of 22 who were tested received positive results between May 23-26. Notably, 8 out of 10 students who sat in the 2 front rows closest to the teacher became infected, representing an extremely high attack rate of 80%.

In another classroom, located across an outdoor courtyard from the source classroom, 6 of 18 students in a different grade—also too young for vaccine eligibility—tested positive between May 24 and June 1. Additionally, 8 other cases were identified among parents and siblings of the students in the 2 classes, 3 of whom were fully vaccinated. An additional infected adult was unvaccinated. Of the 18 cases sequenced, all were identified as the Delta variant. The report’s authors underlined the importance of vaccination and other preventive measures, “including masking, routine testing, facility ventilation, and staying home when symptomatic” to ensure safe in-person learning in schools. Notably, all of the children were seated 6 feet apart and the classrooms had portable high-efficiency particulate air filters with open doors and windows, raising a question about whether consistent masking could have helped contain transmission in this outbreak.

A separate MMWR report published the same day concluded that in Los Angeles County, California, schools with transmission mitigation and containment protocols in place, “case rates in children and adolescents were 3.4 times lower during the winter peak compared with rates in the community,” showing multi-pronged prevention strategies are critical in helping to prevent new cases as children return to classrooms. However, the authors cautioned the data were collected prior to the predominance of the Delta variant (September 1, 2020-March 31, 2021).

SARS-CoV-2 ORIGIN: US REPORT As expected, the US Office of the Director of National Intelligence on August 27 released an unclassified summary of a report stating that the US Intelligence Community “remains divided on the most likely origin of COVID-19. All agencies assess that two hypotheses are plausible: natural exposure to an infected animal and a laboratory-associated incident." Just over 3 months ago, US President Joe Biden ordered the Intelligence Community to undertake a systematic, detailed review of any evidence that could elucidate the origins of the COVID-19 pandemic. The only strong conclusion expressed in the summary is that SARS-CoV-2 was not developed as a biological weapon. Most agencies also agreed, with low confidence, that the virus probably was not genetically engineered, although 2 agencies believed there was insufficient evidence to make an assessment either way. In a statement following the summary’s release, President Biden said the US will continue to search for answers, adding, “I will not rest until we get them.” In order to do so, however, investigators will need cooperation from China, which continues to deflect blame and resist sharing information, according to the summary.

HURRICANE IDA Southern Louisiana (US) hospitals, already inundated with COVID-19 patients, are now dealing with damage from Hurricane Ida. The Category 4 storm made landfall in Lafourche Parish on August 29, battering the area for 16 hours with heavy rainfall and strong winds that caused widespread power outages, levee failures, flooding, collapsed buildings, and the need for rescues. At least 2 hospitals in Lafourche Parish reported significant damage, including extensive roof damage and partial generator failure. Residents of the parish were ordered to evacuate, but evacuating hospital patients was not an option because no other hospitals had the capacity to take additional patients due to an overwhelming number of COVID-19 patients and staff shortages.

Louisiana Governor John Bel Edwards said that with more than 2,400 COVID-19 patients hospitalized in the state, many in serious or critical condition, the focus is on ensuring there is enough generator power and clean water at hospitals to meet patients’ needs, including providing oxygen and ventilator support, both of which require electricity. Nearly 1 million people within the New Orleans power grid were without power due to the storm’s “catastrophic intensity,” with the Entergy Corporation working to get lines back in operation. Hurricane Ida hit on the 16th anniversary of Hurricane Katrina and, with sustained winds of 150 mph, tied a record for the most intense hurricane on record to hit Louisiana. Notably, lessons learned after Katrina, including the relocation of hospital generators to higher floors, likely helped save lives during this storm.

COURT-ORDERED VACCINATION As the rate of SARS-CoV-2 vaccination slowly creeps up in the US, a significant portion of the population continues to resist getting the shots. In what appears to be efforts to persuade the reluctant, several judges have ordered defendants to be vaccinated as part of their orders. In New York, a Bronx County criminal court judge ordered a man pleading guilty to drug possession and shoplifting to get a SARS-CoV-2 vaccine as part of his plea deal, an action that the judge said would be viewed as rehabilitative. In another case in New York, a federal judge in Manhattan granted bail for a defendant charged with conspiracy to distribute fentanyl on the condition that she be vaccinated so she posed less of a danger to the community. Neither defendant appeared to object.

In a similar case, a Cook County, Illinois, judge on August 10 revoked a woman’s right to visit her 11-year-old son until she is vaccinated for SARS-CoV-2. The 39-year-old woman shares custody of the boy with her divorced husband, who did not seek such an order. The woman’s lawyer said she believes the judge exceeded his authority and hopes an appellate court, which is expected to hear the case this week, reverses the decision. While some legal experts say these judges might have overstepped their authority, others argue that the orders fall within their jurisdiction, highlighting the legal and ethical questions surrounding the interpretation of the line between civil responsibility and civil liberty.

EU TRAVEL RESTRICTIONS The EU on August 30 recommended that member states halt all non-essential travel from the US due to the rising number of COVID-19 cases throughout the country. The EU also recommended the removal of Israel, Kosovo, Lebanon, Montenegro, and North Macedonia from the bloc’s “white list” of places whose tourists could be permitted entry without certain restrictions. In order to be included on the white list, countries have to have no more than 75 new daily COVID-19 cases per 100,000 residents over the last 14 days, and these 6 countries no longer meet that criterion. The decision is non-binding, as each EU member state is able to set its own tourism policies and restrictions. Possible restrictions include testing requirements, quarantine upon arrival, a ban on non-vaccinated travelers, and a ban on all non-essential travelers from the stated countries. The white list now includes 18 countries.

Removal of the US from the white list follows a previous decision in June that recommended lifting restrictions on non-essential travelers from the US and 14 other nations. A majority of countries in the EU lifted non-essential travel restrictions after the decision in hopes of retaining income from the summer tourism season. New travel restrictions are anticipated to cost billions in lost tourism income.

AUSTRALIA Australian Prime Minister Scott Morrison announced that the country is moving past its “COVID zero” goal, arguing that the current level of restrictions “is not a sustainable way to live,” particularly in light of the emergence of the Delta variant. Throughout the pandemic, Australia has responded to local outbreaks with highly restrictive “lockdown” measures, while facing relatively few restrictions in the periods between outbreaks. This plan aimed to interrupt chains of transmission and prevent localized outbreaks from spreading to a regional- or national-level epidemic in order to reach and maintain essentially zero domestic transmission. The policy change appears to be tied to vaccination coverage, and the government could begin easing restrictions once national coverage reaches 70% among eligible individuals. Australia is currently reporting full vaccination coverage of 35% for individuals ages 16 and older, and officials reportedly believe Australia can double this rate by the end of 2021. Notably, Prime Minister Morrison also announced children aged 12-17 years are now be eligible for vaccination.

MEDIGEN VACCINE Taiwan on August 23 launched an island-wide rollout of its domestically produced Medigen SARS-CoV-2 vaccine, produced by Taipei-based Medigen Vaccine Biologics Corporation, with Taiwan President Tsai Ing-wen publicly receiving the first shot. But the rollout quickly hit speed bumps, with experts criticizing the launch of the vaccine without the completion of Phase 3 clinical trial and no efficacy data. Then, over the next 3 days, 4 people died after receiving the vaccine, raising questions about its safety among some experts. Taiwan’s Central Epidemic Command Center (CECC) said it does not plan to halt the campaign, as there is no indication that the deaths are associated with the vaccine. The CECC will continue to investigate whether there is a causal relationship, indicating the news has not affected vaccine uptake among the Taiwanese population. Throughout the pandemic, Taiwan has been successful at curbing dramatic surges in COVID-19 cases and reports fewer than 16,000 total confirmed cases to date.

SPUTNIK V Russia’s Sputnik V SARS-CoV-2 vaccine, officially known as Gam-COVID-Vac, appears to reduce the risk of hospitalization and prevent severe lung damage among COVID-19 patients, according to a preprint paper posted to medRxiv. The analysis, which has not yet been peer-reviewed, includes data from 13,894 patients, 9.3% of whom were fully vaccinated, having completed their second shot at least 2 weeks prior. Among those fully vaccinated, the adjusted vaccine effectiveness (VE) against hospital referral was 81% (95% confidence interval [CI], 68-88). The VE against hospital referral was slightly better among women (84%, 95% CI, 66-92) compared with men (76%, 95% CI, 51-88). The data also show that Sputnik V was 76% effective at protecting against severe lung injury, defined as more than 50% lung involvement. Although the data do not include genetic sequencing for viral variants, Russian health officials say 95% of new infections in July and August, when the study was conducted, were attributable to the Delta variant. The Sputnik V vaccine is authorized for use in 69 countries, but the European Medicines Agency (EMA) and the WHO continue to review the vaccine for authorization.

C.1.2 VARIANT A preprint article posted on medRxiv from a group of South African researchers describes a potential SARS-CoV-2 variant of interest assigned to the PANGO lineage C.1.2. According to the paper, which is not yet peer-reviewed, the variant was first identified in May 2021 and likely originated from the C.1 viral lineage, one of the lineages that dominated the first wave of SARS-CoV-2 infections in South Africa. The C.1.2 variant is believed to have between 44-59 mutations in regions such as the spike protein, receptor binding motif, and furin cleavage site, representing more mutations than previous variants of interest and variants of concern. The mutations described in the article are associated with increased neutralizing antibody evasion, increased transmissibility, and potentially increased viral reproduction.

By August 13, 2021, the variant had been detected in a majority of South African provinces, as well as in the Democratic Republic of the Congo, Mauritius, New Zealand, Portugal, and Switzerland. Despite the wide geographic spread, prevalence of C.1.2 in tested samples remains low. However, monthly increases in prevalence are similar to those seen in the early stages of the Beta and Delta variants. Researchers are currently assessing the effectiveness of vaccines against this lineage and more information is expected soon. Notably, though the researchers say they are “concerned” about C.1.2, it has not yet been named a variant of interest or concern, as more data are necessary to make that determination.

COMPARING mRNA VACCINE IMMUNE RESPONSE A research letter published in the Journal of the American Medical Association (JAMA) describes results from a prospective study comparing antibody responses to the Pfizer-BioNTech and Moderna SARS-CoV-2 vaccines among a cohort of Belgian healthcare workers. For the study, antibodies against the SARS-CoV-2 nucleocapsid protein were measured after vaccination. Among the 1,647 healthcare workers included in the evaluation, 2 doses of Moderna produced higher antibody titers than 2 doses of Pfizer-BioNTech; participants who were previously infected with SARS-CoV-2 had higher antibody titers than participants who were never infected; and higher antibody titers were correlated with younger age groups. The limitations of the study include a lack of information on cellular immunity and neutralizing antibody titers. Neutralizing antibodies can stop a virus from entering a cell and initiating infection while binding antibodies alert white blood cells to the presence of a pathogen and mark them for destruction. Neutralizing antibodies serve a different purpose from binding antibodies and they can result in long-term immunity to certain infections.

BLOOD CLOTTING RISKS The risk of blood clotting events after infection with SARS-CoV-2 is much higher than the risk posed by vaccination with either the Pfizer-BioNTech or AstraZeneca-Oxford vaccines, according to a large UK study published August 27 in the British Medical Journal (BMJ). A team led by researchers from the University of Oxford examined the health records of more than 29 million people who received a first dose of either vaccine between December 2020 and April 2021, as well as nearly 1.8 million who were infected with the virus, looking for complications up to 28 days post-vaccination or infection.

The researchers found that people who received the Pfizer-BioNTech vaccine had an increased risk of ischemic stroke and blood clots in arteries, while those who received the AstraZeneca-Oxford vaccine had an increased risk of low platelets (thrombocytopenia) and blood clots in veins. While the researchers said that people should be aware of the increased risk, they stressed that the risks of the same complications among people infected with SARS-CoV-2 are much higher. For example, the risk of thrombocytopenia is almost 9 times higher with infection than vaccination with the AstraZeneca-Oxford vaccine, and the risk of stroke is nearly 12 times higher after COVID-19 than with the Pfizer-BioNTech vaccine. The risk of blood clotting events also remained elevated for a longer period of time after infection compared with vaccination. Experts continue to stress that the short- and long-term complications of COVID-19 are much more severe than the risks associated with vaccination, and they urge those eligible to get vaccinated.

Your chaplain is an atheist?

Harvard's new chaplain is an atheist. Is that a contradiction?

Samuel Goldman, Contributing Writer

Fri, August 27, 2021, 4:43 AM

In this article:

• Greg Epstein

  Chaplain, Havard university

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Greg Epstein. Illustrated | Getty Images, iStock

The motto of Harvard University, which might as well be tattooed on aspirants to the American upper class, is "veritas." For those who never learned the Latin that was once part of the standard curriculum, that means "truth." It seems like an obvious fit for the nation's most prominent institution of higher learning. Isn't pursuing truth what a university is all about?

But the motto's history isn't so simple. Although it appeared in several versions following Harvard's establishment in 1643, most stressed the theological character of the truth to which the college was devoted. "Veritas Christo et Ecclesiae" — truth for Christ and Church — read one version. "In Christam Gloriam" — to the glory of Christ — went another. The one word version was adopted in the late 19th century, partly at the urging of poet Oliver Wendell Holmes Sr.

A surprising announcement on Thursday revived tensions between Harvard's original mission and its more recent secular orientation. The association of more than 30 Harvard chaplains representing a wide range of religious communities elected Greg Epstein as their new leader. The surprise isn't that Epstein is not a Christian, an element of Harvard's heritage that the university hasn't stressed for decades. It's that he doesn't believe in God at all.

An atheist chaplain seems like a contradiction in terms. Epstein's life work is to convince people that it's not. An ordained "humanist rabbi," Epstein doesn't oppose religious texts, ideas, or practices. But he argues that people who doubt the existence of supernatural forces need their own ways of inculcating virtues, exploring the meaning of life, and sustaining communities that can extend through generations.

In his 2009 book Good Without God, Epstein contrasts this approach to two rival forms of non-belief. One is "antagonistic atheism" associated with figures like Marx, Nietzsche, and the so-called New Atheists of the early 2000s. The antagonistic project tries to expose religious teachings as primitive myths at best and, at worst, intentional lies used to justify exploitation. Its goal is the liberation of humanity from superstition.

One problem with this approach is that it hasn't delivered on the promise to replace ignorance with truth. Modern natural science undermined, or at least complicated, many traditional religious beliefs. Yet it doesn't answer questions about the origin of the material world, the basis of human consciousness, or the meaning of "uncanny" experiences that gave rise to those beliefs in the first place.

Another issue is that antagonistic atheism can be counterproductive. Rather than persuading believers, polemics against religion are most effective in polarizing the whole subject. In the 19th century, antagonistic atheism helped legitimize the public expression of non-belief. But it also encouraged fundamentalist reactions that was more hostile to ideals of reason and freedom than the orthodoxies that the skeptics attacked.

Finally, antagonistic atheists have a way of swapping one dogma for another. The most dramatic example is Marxism, which rejected any appeal to divine redemption while promulgating a philosophy of history leading to the ultimate triumph of justice on earth. Scholars dispute whether such movements are properly described as "political religions," a term coined in the 1930s by the German political theorist Eric Voegelin, but there is at least an analogy between religious movements and modern ideologies.

For these reasons, antagonistic atheism is probably a dead end. The main alternative is more subtle. What Epstein calls "reconstructionism" doesn't try to refute religion. Rather, it seeks to reinterpret religious sources and doctrines in ways that dispense with appeals to miraculous events or supernatural beings.

Epstein has some respect for reconstructionism, which can be traced back to ancient philosophy. Yet he sees it as dishonest, at least in recent versions. Unlike antagonistic atheists, religious reconstructionists continue to talk about God and may even identify with traditional creeds and communities. What they mean by God, though, is so different from the personal deity of Biblical monotheism that it's a kind of pious fraud to suggest they're the same thing.

Epstein's humanism avoids this deception. As the book's title proclaims, he wants to be good without God. Even as he rejects theology, though, Epstein argues that religious practices such as ritual, meditation, or textual study meet irreducible human needs that conventional atheists neglect. At Harvard and in his previous position as leader of the Humanist Community Project, Epstein organized interfaith dialogues, weekly services including sermons, musical performances and other activities that resemble traditional worship without appealing to a personal deity. He also provides counseling to students facing personal or ethical problems, much like a rabbi, minister, or imam.

It's an intriguing proposal at a time when the unaffiliated are the fastest growing religious group. The trend is even more pronounced among the highly educated. At Harvard, nearly 50 percent of the class of 2019 described themselves as "atheist," "agnostic," or "other." In 2005, Epstein was hired as the university's first chaplain devoted specifically to this group. By all reports, he's had some success, both as a mentor to other humanists and as a participant in Harvard's broader religious community.

Yet the prospects for Epstein's humanism are dimmer than he might admit. One reason is that it seems most appealing to people who were brought up in demanding religious communities but no longer accept all of their teachings or lifestyle prescriptions. The New York Times reports that many of the students who seek Epstein's counsel are such "religious refugees."

Individuals in this position may find genuine comfort in humanism, but will they pass on that disposition to their children, who will lack the same rigorous formation? Given the difficulty even conventionally devout parents have in transmitting their beliefs, they probably won't be successful. Yet one of the central goals of organized humanism is creating communities that can be sustained across generations.

The implications of Epstein's selection as head chaplain are also dubious. On the one hand, there's nothing wrong with him occupying an administrative position for which he's demonstrated ability over many years of service. On the other, the decision implies that there's nothing special about theistic religion or appeals to transcendent authority that justify a distinctive status.

That may seem uncontroversial in the 21st century. But it raises uncomfortable questions about the very purpose of a university. Harvard's motto presumes that truth is important and worth pursuing. Yet its shortened modern version makes no argument about why that's the case. For Harvard's founders, truth was worth pursuing because it set man in the right relationship with God. Harvard's present leadership can only claim, like the administration of Faber College in Animal House, that "knowledge is good."

As with humanist practice, the absence of justification isn't a problem on the individual level. Some people are inclined toward inquiry and debate as a matter of temperament. They'll pursue the truth as they understand it without further encouragement. But it is a problem for justifying institutions. Why should students, their families, and taxpayers devote billions of dollars to what is, in essence, an unusual hobby? Too often, the answer is simply to acquire advantages in the scramble for social and economic advantage.

Epstein and humanism aren't to blame for the challenges of secularization in originally religious institutions. But they aren't the solution, either. Despite their apparent opposition, Harvard's Puritan founders and antagonistic atheists agreed that the truth will set you free. We can't replace that faith with a good-natured shrug.

Above is from:  https://www.yahoo.com/harvards-chaplain-atheist-contradiction-094309106.html

August 27: Johns Hopkins COVID 19 Report

COVID-19 Situation Report

Applications Now Open for Johns Hopkins Center for Health Security Educational Opportunities for 2022-2023 Academic Year

In a world of rapid innovation in the biological sciences, the emergence of new diseases, and changing environmental pressures, health security risks to the global community are a rising concern. The field of health security has a growing need for trained expertise that can provide science-based solutions and inform global policies to shape preparedness and response efforts. The Johns Hopkins Center for Health Security is pleased to announce it is now accepting applications for its educational opportunities for the 2022-2023 academic year. The Johns Hopkins Center for Health Security provides 2 Masters of Public Health scholarships and funds 2 PhD candidates for the Health Security PhD track at the Johns Hopkins Bloomberg School of Public Health.

Click here for more information and application details.

These funding opportunities are supported by Open Philanthropy and are targeted toward students with an interest in the field of health security, particularly in pandemics and global catastrophic biological risks.

EPI UPDATE The WHO COVID-19 Dashboard reports 214.5 million cumulative cases and 4.47 million deaths worldwide as of August 27. If global mortality continues on this trajectory, we expect to surpass 4.5 million cumulative deaths in the next 3-4 days.

Global Vaccination

The WHO reported 4.95 billion cumulative doses of SARS-CoV-2 vaccines administered globally as of August 25. A total of 1.90 billion individuals have received at least 1 dose, and 1.13 billion are fully vaccinated. Analysis from Our World in Data indicates that the global daily doses administered has held relatively steady over the past 2 weeks at approximately 36 million doses per day*. The global trend continues to closely follow the trend in Asia. Our World in Data estimates that there are 2.59 billion vaccinated individuals worldwide (1+ dose; 33.0% of the global population) and 1.96 billion who are fully vaccinated (24.9% of the global population). We expect to surpass one-third of the global population with 1+ dose and one-quarter with full vaccination by early next week.

*The average doses administered may exhibit a sharp decrease for the most recent data particularly over the weekend, which indicates effects of reporting delays. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent data.

As global vaccination efforts continue, enormous disparities remain in terms of access and coverage. African countries, in particular, are still struggling to secure sufficient vaccine supply, which is severely hindering vaccination efforts across the continent. In fact, just 10 countries account for nearly 75% of the 5 billion cumulative doses administered globally, including 6 that have each administered more doses than the entire continent of Africa. Africa represents approximately 17.5% of the global population but only 1.9% of the cumulative doses administered.

Daily vaccinations are increasing in Africa, but overall vaccination coverage remains low, with many African countries among the lowest globally. Notably, of the 52 countries reporting partial vaccination coverage (1+ dose) less than 10%, 40 are in Africa**. Additionally, the average across the continent is only 4.6%, the lowest among all continents by a factor of more than 7. Only Seychelles (75%) and Mauritius (62%) are reporting partial coverage greater than 50%, and only 3 others—Morocco (47%), Cabo Verde (38%), and Tunisia (30%)—are reporting more than 20%.

**Data are unavailable for Burundi and Eritrea.

Similarly, among 73 countries reporting fewer than 0.2 daily doses administered per 100 population, 41 are in Africa. The average for Africa as a whole is 0.11 doses per day per 100 population, the lowest among all continents by nearly a factor of 3. In terms of total daily vaccinations, Africa is beginning to approach North America—1.52 million doses per day, compared to 1.89 million. Africa’s current average daily vaccinations is more than 3.5 times its average on July 1 and more than double its average on August 1. The trend continues to increase exponentially, which is a positive sign.

A number of African countries are exhibiting substantial increases in their daily vaccinations. In total, 10 African countries reported increases in daily vaccinations of more than 500% since July 1, including 5 that increased more than 1,000%. Gambia’s average increased 2,539%; Rwanda’s increased 2,637%, and Malawi’s increased 2,882% over that period. While most African countries reported extremely low daily vaccinations as of July 1—on the order of 1,000 doses per day or fewer—this is not necessarily the case for all African countries. For example, Morocco averaged more than 100,000 doses per day on July 1, and its average increased to more than 350,000 doses per day (+243%) since then. And Egypt’s average increased from nearly 28,000 to nearly 170,000 (+510%).

The increasing trends in daily vaccinations across Africa are encouraging; however, supply volume remains a major constraint. This is particularly concerning in light of recent decisions by a number of higher-income countries, including the US, to begin administering additional booster doses to some or all fully vaccinated individuals. Existing global production capacity has still not caught up with demand, and any doses allocated as extra boosters inherently take away from doses that could be allocated to low- and middle-income countries (LMICs).

UNITED STATES

The US CDC reported 38.3 million cumulative COVID-19 cases and 631,440 deaths. Daily incidence continues to increase, up to 142,006 new cases per day, the highest average since January 30. Daily incidence continues to taper off, however, and if the trend continues on this trajectory, we expect the surge to peak in the next several weeks. Daily mortality continues to increase as well, up to 864 deaths per day, the highest average since March 16*.

*Changes in the frequency of state-level reporting may affect the accuracy of recently reported data, particularly over the weekend. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent dates.

US Vaccination

The US has administered 365.8 million cumulative doses of SARS-CoV-2 vaccines, and daily vaccinations continue to increase slowly, up to 783,239 doses per day*. There are 203.0 million individuals who have received at least 1 dose, equivalent to 61.1% of the entire US population. Among adults, 73.5% have received at least 1 dose, as well as 13.1 million adolescents aged 12-17 years. A total of 172.2 million individuals are fully vaccinated, which corresponds to 51.9% of the total population. Approximately 62.8% of adults are fully vaccinated, as well as 9.9 million adolescents aged 12-17 years.

*Due to delays in reporting, estimates for the average daily doses administered are less accurate for the most recent 5 days. The most current average provided here corresponds to 5 days ago.

J&J-JANSSEN SECOND DOSE On August 25, J&J-Janssen announced it has interim data showing a second shot of its SARS-CoV-2 vaccine administered 6 to 8 months after the initial dose generates “a rapid and robust increase in spike-binding antibodies,” up to 9-fold higher after 28 days than a single shot. The data—which have not been published in a scientific journal nor peer reviewed—come from 2 Phase 1/2a studies conducted in the US and Europe. The company plans to submit the data to the US FDA in the hopes of receiving authorization for a booster dose and indicated it is in talks with the FDA, US CDC, European Medicines Agency (EMA), and other health authorities regarding the need for second doses of its vaccine. The company also is testing a 2-dose regimen delivered 2 months apart, with data from that clinical trial expected in the next few weeks.

As we covered previously, US health officials have announced plans to begin providing third doses of the mRNA vaccines made by Moderna and Pfizer-BioNTech as soon as mid-September and have indicated boosters likely will be necessary for recipients of the J&J-Janssen vaccine. Initially, officials said the extra doses would be available for people who finished their regimen 8 months prior but now are looking at a 6-month gap instead, perhaps in part because of the J&J-Janssen data. Currently, only people with compromised immune systems are eligible for booster doses in the US.

Pfizer-BioNTech announced on August 25 that it plans to complete an application to the FDA for a third dose of its vaccine by the end of this week. The company received full approval of its vaccine, called Comirnaty, earlier this week. The CDC’s Advisory Committee on Immunization Practices is expected to meet next week and will discuss a framework for SARS-CoV-2 booster doses. While several studies show a higher level of antibody production in extra-dose recipients, it remains unclear whether this will translate to improved protection against SARS-CoV-2 infection or severe COVID-19 disease.

MODERNA FDA APPLICATION Moderna on August 25 completed its submission of a Biologics License Application to the US FDA for full approval of its SARS-CoV-2 vaccine to prevent COVID-19 in people aged 18 or older. The company requested priority review designation, meaning the FDA would have until the end of February to make a decision if it grants the designation. If approved, the vaccine would be the second for the prevention of COVID-19 after the FDA granted full approval to Pfizer-BioNTech on August 23. The agency’s review process for the Pfizer-BioNTech vaccine took 97 days, 40% of the normal time for such a submission, and it is expected regulators will take at least 3 months to review Moderna’s application. Moderna also has filed for emergency use authorization for its vaccine to be used in adolescents aged 12 and older.

VACCINE EFFECTIVENESS Researchers are collecting more proof that protection provided by SARS-CoV-2 vaccines is waning over time. In a study published this week in the US CDC’s Morbidity and Mortality Weekly Report (MMWR), researchers with the HEROES-RECOVER initiative—a US network of longitudinal cohorts including more than 4,000 healthcare workers, first responders, and other frontline workers—report that vaccine effectiveness (VE) fell from 91% in mid-December 2020, before the SARS-CoV-2 Delta variant was predominant, to 66% by mid-August following Delta’s spread. Among participants, 83% were vaccinated, with 65% having received the Pfizer-BioNTech vaccine, 33% Moderna, and 2% J&J-Janssen. The researchers cautioned that while Delta might be more capable of causing breakthrough infections, a reduction in VE could be due to detecting few infections among the cohorts, increasing time since vaccination, an easing of other preventive measures, or a combination of factors. Still, a “sustained two-thirds reduction in infection risk underscores the continued importance and benefits of COVID-19 vaccination,” they write.

In another analysis released on August 25 but not yet published, researchers from the UK’s ZOE COVID Study found a reduction in VE for both the Pfizer-BioNTech and AstraZeneca-Oxford vaccines. The data include more than 1 million self-reported test results among people who received full regimens of either vaccine, as well as test results from more than 75,000 people not yet vaccinated. Protection against infection 1 month after the second dose was 88% for Pfizer-BioNTech and 77% for AstraZeneca-Oxford, prior to the Delta variant’s predominance, but fell to 74% and 67%, respectively, after 4-5 months and after Delta spread throughout the UK. The researchers noted that more data on younger people are needed, as those who were vaccinated in the winter and spring were primarily older individuals.

In yet another study published this week in the MMWR, the CDC presented data from Los Angeles County, California (US), showing unvaccinated individuals were 5 times more likely to get COVID-19 than their vaccinated counterparts, and 29 times more likely to be hospitalized with the disease. These analyses add evidence that VE does appear to be waning over time and in the face of the highly transmissible Delta variant, but they also underscore the importance of vaccination in preventing infection, hospitalization, and serious disease. Still, more effort is needed to collect data on breakthrough infections among vaccinated people, with several officials familiar with the situation alleging the CDC is using “outdated and unreliable data,” Politico reports.

HEART INFLAMMATION The Pfizer-BioNTech SARS-CoV-2 vaccine is associated with an increased risk of myocarditis (inflammation of the heart muscle), but infection with the virus is associated with a much greater risk of the condition, according to a real-world case-control study published on August 25 in the New England Journal of Medicine. Researchers analyzed the health records of more than 2 million people who are members of the Clalit Health Services (CHS), the largest healthcare organization in Israel. Vaccination was associated with a 3-fold increase in the risk of myocarditis (risk ratio [RR], 3.24, 95% confidence interval [CI], 1.55-12.44), as well as several other conditions including swollen lymph nodes (RR, 2.43; 95% CI, 2.05 to 2.78), appendicitis (RR, 1.40; 95% CI, 1.02 to 2.01), and herpes zoster infection (RR, 1.43; 95% CI, 1.20 to 1.73). In a separate cohort, the researchers found SARS-CoV-2 infection is associated with an 18-fold increased risk of myocarditis (RR, 18.28; 95% CI, 3.95 to 25.12), as well as an increased risk of several other serious adverse events such as pericarditis (inflammation of tissue surrounding the heart), irregular heartbeat, blood clots, heart attack, bleeding in the brain, and kidney damage. Pfizer-BioNTech and the US CDC are conducting studies to examine the risks of myocarditis and pericarditis among people who receive the vaccine. 

SARS-COV-2 ORIGINS The US Intelligence Community on August 24 delivered a classified report to US President Joe Biden that made no conclusions about the origins of the novel coronavirus, including whether the virus was transmitted to humans naturally through an animal vector or if human transmission was the result of a laboratory mishap. The report, some of which is expected to be declassified in the coming days, is the result of an order from President Biden given in late May for the Intelligence Community to provide another, more thorough assessment of the origins of SARS-CoV-2 within 90 days. The report’s lack of conclusions prompted calls from global health experts, scientists, and politicians for a more urgent international effort to find the source of the pandemic in order to inform future pandemic preparedness. According to The Wall Street Journal, 2 senior US officials said a lack of cooperation from China, where the virus is assumed to have originated, hampered the US investigation.

A lack of Chinese cooperation also challenged a WHO-convened joint WHO-China delegation’s investigation in early 2021, culminating in a March report that concluded a lab leak was “extremely unlikely.” However, WHO Director-General Dr. Tedros Adhanom Ghebreyesus later undercut the team's statement, saying there is not enough evidence to support any conclusion. WHO officials reiterated that stance this week, saying all of the origin hypotheses “are still on the table.” Then, on August 25, the independent international members of the WHO-China team published a detailed piece in the journal Nature, outlining their review process and calling for an expedited second phase of investigation, noting the search is “at a critical juncture.”

On the same day, Chinese officials urged any future investigations to be broadened, possibly to other countries; refused to take blame for stalled efforts; and said the country will continue to participate in “science-based origin tracing efforts.” Chinese officials also accused the US of politicizing the investigation and attempted to shift blame, once again suggesting without evidence that the virus possibly escaped an US Army research facility. The Chinese embassy in Washington, DC, and China’s envoy to the United Nations this week publicly called for investigations into US labs. While understanding the origins of the COVID-19 pandemic is a global priority, the likelihood of quickly finding evidence grounded in science is slim, especially without full and transparent cooperation from Chinese authorities.

GLOBAL VACCINE ACCESS The WHO this week again called for wealthier nations with higher SARS-CoV-2 vaccination rates to delay the deployment of booster doses for 2 months and instead donate those doses to countries with much lower coverage. WHO Director-General Dr. Tedros Adhanom Ghebreyesus expressed disappointment at the scope of vaccine donations worldwide, saying “vaccine injustice and vaccine nationalism” raise the likelihood of new, possibly more deadly SARS-CoV-2 variants emerging as the virus continues to circulate. Dr. Tedros noted that 75% of the 5 billion vaccine doses distributed globally have gone to only 10 countries. Overall, donations from wealthier nations have not reached the level required to provide the 11 billion doses needed to vaccinate 70% of the world’s population.

And now, several countries—including the US, Israel, France, Hungary, and others—have or are planning to implement booster dose programs. For its part, UK scientists are looking into using smaller, fractional doses for boosters, which, in theory, could help increase supplies for other parts of the world if the “extra” amounts were distributed internationally. But countries are running into another issue: a surplus of expiring doses. The 6-month shelf life provided to most SARS-CoV-2 vaccines under emergency authorizations is rapidly approaching and threatens to undermine donations of unused doses, as vaccines close to expiration raise suspicion in many countries, potentially increasing vaccine hesitancy. Some nations are publicly destroying expired vaccines to “stay accountable,” even though most experts agree the doses, if stored properly, could be viable for up to 2 years. While some countries have extended the shelf lives for authorized vaccines based on stability studies, others remain skeptical.

The US so far has donated more than 120 million doses to 80 countries and provided US$4 billion in funding and other resources to the COVAX facility, he noted. While the US has pledged to donate another approximately 500 million doses, as well as made efforts to expand manufacturing domestically and overseas, global health advocates and some members of the US Congress are calling on the US President Joe Biden to do more. An analysis from PrEP4All, an AIDS advocacy organization, criticizes the Biden administration for spending less than 1% of US$16 billion included in the American Rescue Plan meant for procuring and manufacturing COVID-19 treatments, vaccines, diagnostics, and other tools for distribution in other countries. The group, along with others, called on the US government to immediately scale up vaccine production to improve global supply.

In Africa, only 2.5% of the population is fully vaccinated. In an interview on CNBC this week, African Development Bank (ADB) President Akinwumi Adesina said the continent had been “shortchanged” in regard to vaccine access and that “Africa should not depend on the rest of the world for supplying it with critical vaccines and also therapeutics.” In an effort to improve self-sufficiency, Adesina said the ADB plans to invest at least US$3 billion in health care infrastructure and the pharmaceutical sector across the continent.

EVICTION MORATORIUM On August 26, the US Supreme Court granted a request to lift a US CDC moratorium on evictions, ending the measure meant to keep millions of people who owe back rent housed during the latest surge of the COVID-19 pandemic. In an unsigned, 8-page majority opinion, the court said the CDC exceeded its authority, relying “on a decades-old statute that authorizes it to implement measures like fumigation and pest extermination.” If a federal eviction moratorium is to continue, the US Congress must authorize it, the court said. However, Congress failed to do so when the last moratorium expired on July 31. Justices Stephen Breyer, Sonia Sotomayor, and Elena Kagan dissented from the majority opinion, saying the moratorium should remain in place in the midst of a public health crisis and calling on the court to hold a full briefing and arguments. In a statement, White House Spokesperson Jen Psaki said US President Joe Biden “is once again calling on all entities that can prevent evictions—from cities and states to local courts, landlords, Cabinet Agencies—to urgently act to prevent evictions.”

US MASK MANDATE BANS States across the country have begun the transition into a new, in-person school year. In last week’s COVID-19 briefing, we covered a number of states that were requiring masks and vaccinations for eligible students in an effort to minimize the spread and impact of COVID-19. This week, Illinois joined several states, ordering a mask mandate for students and vaccinations for students aged 16 and older. While many states have adopted this approach for the new school year, several states have gone in opposite directions, banning schools’ abilities to mandate mask wearing. In Florida, 10 school districts have fought back against a mask mandate ban from Florida Governor Ron DeSantis, facing potential backlash, including funding freezes, for violating the state-sanctioned ban. In South Carolina, the American Civil Liberties Union (ACLU) filed a new lawsuit challenging South Carolina’s ban on mask mandates in schools. The lawsuit was driven by a number of parents who have school-aged children with risk factors that could lead to more severe COVID-19 cases. The case for masks in schools has federal support, as many policymakers worry about the health and safety of children and the potential for school-based cases to drive up disease incidence. Although only 19 states have gone back to school these past few weeks, 90,000 children already have entered quarantine or isolation following contact with a COVID-19 case. It will be critical to monitor school-based COVID-19 outbreaks as more parts of the country return to the classroom.

INSURANCE SURCHARGE Following the US FDA’s approval of the Pfizer-BioNTech SARS-CoV-2 vaccine, many employers implemented vaccination mandates, but one large US company is taking a different tack. Beginning November 1, Delta Air Lines will charge employees an additional $200 per month to remain enrolled in the company’s health plan if they refuse to be fully vaccinated for SARS-CoV-2. Additionally, unvaccinated employees are required to wear masks in all indoor company settings, will no longer qualify for pay protection if they are diagnosed with COVID-19, and will be required to take weekly tests beginning September 12. In a memo to staff, Delta CEO Ed Bastian noted that 75% of the company’s employees are fully vaccinated but expressed a desire to get “as close to 100% as possible.” Delta said the surcharge is necessary to cover the financial risk unvaccinated employees pose to the company, citing the average cost of a COVID-19-related hospital stay is $50,000. The airline is self-insured and sets its own premiums for its health plans, which are administered by UnitedHealthcare. Delta also requires new employees to be vaccinated.

United Airlines is the only major airline so far to require all of its employees to get vaccinated or risk termination, with religious or medical exemptions reviewed on a case-by-case basis.

STURGIS MOTORCYCLE RALLY Last summer, the Sturgis Motorcycle Rally—held annually in Sturgis, South Dakota (US)—was subsequently linked to more than 300 cases of COVID-19 across more than 20 states, including an outbreak in Minnesota that resulted in at least 77 cases linked directly to the event. Despite the ongoing pandemic, the rally was held again this year—August 6-15—largely without any COVID-19 restrictions or protective measures. Reportedly, the 2021 rally was one of the largest in the event’s history, drawing approximately 700,000 visitors. Even though the event ended only 11 days ago, there are already early indications of a major COVID-19 surge in the area. The experience following the 2020 event and the ongoing nationwide surge, driven largely by the highly transmissible Delta variant, should have been sufficient to inspire event and government officials to implement effective COVID-19 protections this year, but unfortunately, that did not happen.

Meade County, SD—where Sturgis is located—averaged fewer than 1 new case per day from late May through late July, before beginning to increase slightly. At the start of the 2021 rally, Meade County averaged 3 new cases per day, but daily incidence surged to 38 as of August 24, nearly a 13-fold increase and a new record for the county. The 86 cases reported in Meade County on August 23-24 accounted for 10% of the state’s total, despite the county only representing 3% of the state’s population. Analysis by The New York Times indicates that COVID-19 hospitalizations have more than tripled over the past 2 weeks. Test positivity surged past 40% (currently 34%), which indicates that testing may not be fully capturing the true scale of community transmission in the area. Considering that 700,000 visitors have returned to their homes across the US, the Sturgis Motorcycle Rally certainly has the potential to be another national-level superspreader event. While we are observing the early signs of a surge in and around Sturgis, it might be months before we could expect to have a clear idea of the extent to which this single event impacts state- and national-level epidemics.

CRUISE LINES Cruise lines are implementing more strict COVID-19 preventive measures, requiring passengers to be vaccinated, wear masks while in public areas aboard the ship, and show proof of a negative test within a few days of boarding, amid a current surge in cases and reports of breakthrough infections among vaccinated staff and passengers. Last week, Carnival Cruise Lines announced 27 COVID-19 cases aboard the Carnival Vista sailing out of Galveston, Texas (US). Most of the cases were among crew, but the one passenger case—a 77-year-old woman from Oklahoma—received medical care on the ship, was hospitalized in Belize, evacuated to her home state, and later died. In a statement, Carnival expressed condolences to the woman’s family and added that she “almost certainly” did not contract the virus onboard the ship.

On August 20, the US CDC updated its guidance for cruise ship travelers, recommending people who are at a higher risk for severe COVID-19 avoid cruises and asking passengers to have both a recent negative SARS-CoV-2 test and proof of vaccination. Additionally, some popular destinations, including the Bahamas, are requiring all cruise ship passengers aged 12 and older be vaccinated in order for ships to dock. This prompted Disney Cruise Line, Royal Caribbean, and Carnival to adopt vaccination requirements for their passengers. Norwegian Cruise Line already requires all eligible passengers to be vaccinated, after the company successfully challenged a Florida law banning companies from demanding proof of vaccination.

IVERMECTIN POISONINGS On August 26, the US CDC issued a Health Alert Network (HAN) advisory in response to a recent surge in poisonings in individuals who attempted to prevent or treat COVID-19 using ivermectin. As we covered previously, ivermectin is approved by the US FDA to treat parasitic infections in humans, but it is primarily used to treat animals, including livestock. The drug is not authorized for use to treat COVID-19, and currently available data do not indicate a treatment benefit for COVID-19. A study of prescriptions filled at retail pharmacies in the US found that the volume of ivermectin prescriptions in January 2021 was more than 10 times greater than the pre-pandemic baseline, and the volume in mid-August 2021 was more than 24 times greater than before the pandemic and still increasing. The CDC also reported that the volume of “veterinary formulations available over the counter but not intended for human use” increased as well.

The American Association of Poison Control Centers confirmed that poison control centers nationwide are fielding an elevated call volume related to the “misuse and overdose” of ivermectin, including veterinary formulations. The volume of poison control center calls related to ivermectin was 3 times higher than the pre-pandemic baseline in January 2021 and 5 times higher in July 2021. Available data also indicate an increase in associated visits to emergency departments and hospitals.

JAPAN The Japanese government recently halted a rollout of 1.6 million doses of the Moderna SARS-CoV-2 vaccine due to worries over contamination. The cause of the contamination has yet to be disclosed, but there were reports of 40 doses with unspecified contaminants found at 8 different vaccination sites across the country. These 40 doses led to the decision to pull the entire lot in addition to 2 other lots made at the same location in Spain. The Takeda Pharmaceutical Company, which is leading the sales and distribution of the vaccine in Japan, said the decision was made as safety precaution and has requested Moderna conduct an emergency investigation. Japan had a slow start to its vaccination campaign, but now 44% of the population is fully vaccinated.