Details of reduction in force at Belvidere Assembly

579 Belvidere assembly plant workers expected to be given WARN notices

• Andrew Carrigan
• Mar 30, 2022 Updated 26 min ago
• <?XML:NAMESPACE PREFIX = "[default] https://www.w3.org/2000/svg" NS = "https://www.w3.org/2000/svg" /> 0

12… 6 seek to 10%, 20% … 60%

BELVIDERE (WREX) — We now know how many people may be losing their jobs at the Stellantis plant in Belvidere.

On Tuesday, Stellantis confirmed with 13 WREX the plant is "making additional staffing reductions to operate the plant in a more sustainable manner."

A spokesperson says the reductions will be me done through a combination of offering retirement packages to employees who are eligible as well as laying off both hourly and salaried employees.

13 News asked for an exact number of people who will be getting laid off, but the company declined since they are not confirming the number of retirement packages being offered to eligible employees.

However, 13 WREX has since obtained documents saying 579 employees were given a WARN (Worker Adjustment and Restraining Notification) notice.

The document says Stellantis plans to cut the plant down to 603 non-skilled employees and 199 skilled trade employees.

According to the document, employees in multiple departments are expected to be given a WARN notice. A determination for who will be given a notice will be done by seniority.

For instance, someone who works in the body shop at the plant will be given a notice if they started after June 6, 1994, according to the document.

Here's a full breakdown:

• Body shop: 06/06/1994 or less will be given a notice
• Paint: 06/05/1996 or less will be given a notice
• Trim: 10/05/1998 or less will be given a notice
• Chassis: 10/05/1998 or less will be given a notice
• Material: 01/23/1995 or less will be given a notice
• Final: 05/02/1994 or less will be given a notice 
• Stamping: 07/21/1999 or less will be given a notice

Anyone with more seniority than Oct. 5, 1998 will have the opportunity to bump back into the plant, according to the document.

Employees who receive a WARN notice does not guarantee they're getting fired, but a requirement by law to inform workers of a pending layoff.

The company did say the layoffs could begin as soon as May 27, 2022 with retirements taking effect on May 31st.

It's the 5th time in the past 13 months the plant will be laying off employees.

Timeline of Events

The struggles for the plant started in January 2021 when a global microchip shortage impacted carmakers across the globe.

The shortage caused the first temporary closure of the plant in February. Later in February, the company announced it was laying off 150 employees to "meet global demand for the Jeep Cherokee."

In the spring, the plant was shut down multiple times because of the microchip shortage, including more than two months straight from Mar. 29 through June 1.

During the shut down in May, a spokesperson from the company told 13 WREX the company was reducing the number of shifts at the plant from two to one, a move which could've laid off 1,641 employees from the plant.

The summer saw the more temporary closures due to the microchip shortage.

In the fall, 13 WREX learned and later confirmed with Stellantis that about 1,100 laid off employees were offered a letter from the company with three options: relocate, quit, or be fired.

Employees were being given an option to relocate to Stellantis' Toledo Assembly Complex and several Mopar locations. If an employee declined the placement, they were placed with no company-provided income or benefits, but maintained their eligibility for other job opportunities. If an employee failed to respond to the letter, they were terminated.

In November, the company sent a WARN notice to employees, anticipating an additional 400 lay offs. The company said the notices were sent as the company continued to balance its global sales with the production of the Jeep Cherokee produced in Belvidere, which sales were further exacerbated by the microchip shortage.

In December, the Chicago Tribune reported the plant is being eyes to become an electric vehicle manufacturing facility as soon as 2024.

Last month, Stellantis announced it had reached "record sales" for 2021 as a whole, despite the struggles at the Belvidere Assembly Plant.

So far this year, the plant has been shut down five times; three weeks due to the chip shortage and two to align production with sales.

Above is from:  https://www.wrex.com/news/top-stories/579-belvidere-assembly-plant-workers-expected-to-be-given-warn-notices/article_c553dbb2-b04b-11ec-80c8-ab73abeb5dc7.html

Second Booster on the way

FDA authorizes second booster of Pfizer/BioNTech COVID shot

Tue, March 29, 2022, 9:39 AM

In this article:

• PFE

  +0.74%

  Watchlist

  <?XML:NAMESPACE PREFIX = "[default] http://www.w3.org/2000/svg" NS = "http://www.w3.org/2000/svg" />Watchlist

  Fair Value Estimate

  Near Fair ValueSee why

• BNTX

  +3.88%

March 29 (Reuters) - U.S. regulators authorized a second booster dose of Pfizer Inc and BioNTech SE's COVID-19 vaccine for people 50 and older due to concerns about waning immunity in the age group, the drugmakers said on Tuesday.

The U.S. Food and Drug Administration also authorized the second booster dose of the vaccine for people aged 12 and older with compromised immune systems.

The new boosters - a fourth round of shots - to be administered at least four months after the third dose are intended to offer more protection against severe disease and hospitalization, the companies said.

The authorization comes as some scientists have raised concerns about the highly contagious BA.2 Omicron subvariant, which has driven new spikes in COVID-19 cases in other countries.

COVID-19 cases in the United States have dropped sharply since a record surge in January, but have seen a small uptick over the past week, according to data from the U.S. Centers for Disease Control and Prevention.

"While this EUA (emergency use authorization) will help address a current need for some, we're working diligently to develop an updated vaccine that not only protects against current COVID-19 strains, but also provides more durable responses," Pfizer Chief Executive Albert Bourla said in a statement.

Pfizer and BioNTech originally asked for the next booster doses to be authorized for people 65 and older in a submission citing data collected in Israel, where a second booster is already authorized for many people over age 18. The companies did not explain why the age range had been expanded.

Scientists and officials have debated whether young, healthy people will need a fourth shot. A study of Israeli healthcare workers suggested that the fourth dose added little additional protection in the age group.

Biden administration officials have said that the U.S. government currently has enough doses of the vaccines to meet the demand for another round of booster shots in older Americans, even as funding for the U.S. pandemic response has all but run out.

They say that unless Congress approves more spending, the government will not be likely to be able to be pay for future inoculations, if they are needed, particularly if the vaccines need to be redesigned to target new variants.

(Reporting by Michael Erman Editing by Bill Berkrot)

Above is from:  https://finance.yahoo.com/news/fda-authorizes-second-booster-pfizer-143907886.html

Staff Reductions at Belvidere Assembly Plant

Stellantis announces staff reductions, retirement packages

WIFR Newsroom - Yesterday 5:09 PM

<?XML:NAMESPACE PREFIX = "[default] http://www.w3.org/2000/svg" NS = "http://www.w3.org/2000/svg" />FollowView Profile

ReactComments

Listen to this article

BELVIDERE, Ill. (WIFR) - Car manufacturer Stellantis sent notices on Monday to employees, the state of Illinois, the city of Belvidere and the United Auto Workers union stating the company’s staff reduction plans at the Belvidere Assembly plant.

© Provided by Rockford WIFR-LDThe company notified affected employees, that layoffs could begin as early as May 27, 2022, with retirements taking effect on May 31, 2022.

The company says that in a move towards sustainability, its making additional staffing reductions at the plant.

A spokesperson from the manufacturing and labor communications team says staffing reductions will come through a combination of retirement packages offered to eligible UAW-represented employees as well as layoffs of both hourly and salaried staff.

The spokesperson says that layoffs could begin as early as May 27, 2022, with retirements taking effect on May 31, 2022.

Above is from:  Stellantis announces staff reductions, retirement packages (msn.com)

A sober view of Ukrainian and other wars around the World

Why the U.S.'s double standards on Russia-Ukraine matter

Self-sanitizing propaganda distorts the reality and makes war more likely.

Left: A man reacts after seeing his house in ruins after Russian shelling in Kyiv, Ukraine, on March 21. Right: Another man inspects the damage following overnight airstrikes by the Saudi-led coalition targeting the Huthi rebel-held capital, Sanaa, Yemen, on Jan. 18.MSNBC / AP; Getty Images file

March 28, 2022, 5:43 AM CDT

By Zeeshan Aleem, MSNBC Opinion Columnist

Throughout their coverage of Russia’s invasion of Ukraine, mainstream media and political commentators in America have framed the conflict as an earth-shattering violation of international norms in our modern era. “The Russia-Ukraine crisis is about whether the world will operate according to rules or whether anarchy will prevail,” Richard Haass, the president of the Council on Foreign Relations, tweeted the day of the invasion. “World order is the oxygen for all else, for whether and how we live.” Reporters and commentators have described Russia’s invasion as a moral atrocity without any kind of recent precedent: “medieval”; comparable to Adolf Hitler; marking the “first” test of the post-1945 "rules-based" global order; or triggering the advent of a new one entirely.

For those of us who closely observe U.S. conduct on the world stage, the self-sanitizing and ahistorical nature of many of these narratives has been head-spinning. Not too long ago the U.S. knowingly deceived the global community before entering a war of choice and a neocolonial nation-building project in Iraq that killed hundreds of thousands of civilians. President Joe Biden and much of our commentariat claim standing up to “bullies” is “who we are.” Yet the U.S. has actively aided Saudi Arabia in its brutal, ongoing war and blockade against Yemen, which human rights watchdogs say has involved Saudi Arabia taking actions that are similar to or worse than Russia's in Ukraine and created one of the world’s worst humanitarian crises. (Notably this has not deterred Biden from trying to cozy up to the country for help in dealing with the Russia crisis.) This is just to list two of countless examples of the U.S. being a bully, or siding with bullies, after World War II and disregarding a rules-based order.

A truthful account of the world is a precondition for understanding it.

Pointing out this inconsistency and self-flattering omission of history is often to enter a conversational minefield. But the value of this exercise is not to play some abstract game of whose hands are dirtier. It’s about combating imperial blindness — American society’s endless capacity for self-delusion about how and why it conducts itself as a hegemon in the global arena. By cloaking its geopolitical goals in the language of moralism and sweeping contradictions beneath the rug, the U.S. is able to behave recklessly and brutally without taking accountability for its behavior or learning lessons from it. And refusing to understand that only sows the seeds for further misbehavior and poor decision-making.

A truthful account of the world is a precondition for understanding it. And understanding the real world, rather than living in a world of idealized self-image or visceral feeling, is a precondition for behaving morally and effectively. The myth of Russia’s actions as entirely singular — as a kind of satanic force that has caused a rupture in the progress of human civilization — increases the odds that American society develops a mandate for a rash intervention such as a no-fly zone that could spark a war with Russia. (Stopping evil incarnate would seem to be a worthy reason to risk World War III.) But a more accurately contextualized account of what’s happening and recently happened in the world can act as a source of humility and restraint. At a time when belligerence surrounding the Russia-Ukraine crisis is intensifying, it couldn’t be more urgent.

Russia’s military operation in Ukraine — an act of aggression and a war of choice — is heinous. Russian President Vladimir Putin is not just conducting an unjustifiable war, he's waging it brutally. Human rights watchdogs say that Russia has used indiscriminate cluster bombs, and it’s clear that Russia is targeting areas that are densely populated with civilians. Aiding Ukraine’s suffering population and surprisingly well-performing military is a moral and, as far as I can tell, strategically sound thing to do.

But the Biden administration’s aid to Ukraine was not fueled by moral imperatives. The U.S. is not a country that gazes upon the world with an altruistic eye, but a state which, like any other, pursues its own interests. Moreover, in its quest to be the world’s sole superpower, it has acted ruthlessly for decades. Which is why the U.S. painting its involvement on behalf of Ukraine as a pure extension of defend-the-underdog principles is nonsense.

During the Cold War, the U.S. didn’t just casually ignore sovereignty but actively snubbed it, with indiscriminate bombing campaigns and the backing of dozens of coups and brutal authoritarians that killed or helped cause the death of millions. More recently, the U.S. occupied Afghanistan for nearly two decades even after the Taliban surrendered, where it used brutal and unmonitored airstrikes, targeted civilians with its double-tap drone strike policy, and is currently subjecting the country to an economic suffocation campaign that has laid the groundwork for a horrific humanitarian crisis that has resulted in the death of some 13,000 infants since January. While commentators in the West describe Putin’s use of blockades as belonging to the Middle Ages and condemn his use of cluster munitions, the U.S. is backing Saudi Arabia, which has used cluster munitions from the U.S. against Yemen and is starving its population. All the while, the U.S. has declined to intervene in many genocides the world over.

The chief reason that U.S. policymakers are so attentive to Ukraine’s welfare and need for aid is because Russia is a huge, nuclear-armed and powerful adversary of the U.S., and they're concerned about the instability and precedent set by the invasion, particularly in immediate proximity to NATO countries. Because of this invasion’s geopolitical significance — and the racialized assumption that Europe is not a place where war belongs, in contrast to the Middle East or Central Asia — the media has focused on this with extraordinary intensity, and in the process reshaped our national consciousness.

It makes sense that a war that matters a lot to the U.S.’s core geopolitical interests would be huge news. What doesn’t follow is that that war in and of itself elevates the U.S.’s moral sensibilities.

Stephen Wertheim, a senior fellow in the American Statecraft Program at the Carnegie Endowment for International Peace, told me the U.S. seems to be seizing an opportunity to reclaim a moral high ground. “In this moment there is a real danger that American leaders will use this moment to reclaim a sense of moral purity that the U.S. has lost domestically and internationally as a result of the war on terror and post- 9/11 military operations,” he told me. “This attempt seems to take the form of ‘Russia is a terrible actor’ — which is true, and ‘Therefore the U.S. is more virtuous than it was a month ago’ — which is false.”

The U.S. cannot cleanse itself using Putin’s unconscionable actions.

The U.S. cannot cleanse itself using Putin’s unconscionable actions. And the more it tries to do that, and the more it tries to erase every other conflict in recent world history in order to single him out in the process, the easier it becomes to go to war. The urge to enter war will increase if the entire country buys into its own propagandistic moralizing and is convinced that Russia's actions constitute an entirely unique threat to humanity. Growing pressure from the public, Congress, and our hawkish press could put pressure on the Biden administration, which has generally been very clear about wanting to avoid military intervention against Russia, to act imprudently if Russia does something like uses chemical weapons or accidentally hits a NATO target.

Consistency in describing the world creates a foundation for more careful behavior: If people remember that Russia is one of many actors that are doing horrific things internationally then people will breathe before deciding what kind of action should be taken. (Note that one does not have to ignore the political and moral differences between Russia and other countries to note the fact that some of Russia's actions are not unique.) Considering that the stakes are a possible confrontation between the world's two biggest nuclear powers, thinking about the civilizational long game in this situation is rather important.

And consistency in describing the world is a prerequisite for any agenda to try to behave consistently in the world — and reckon with how radical of a task it is. Seeking a consistently morally upstanding foreign policy would require confronting and clashing with some longtime allies, thawing tensions with some adversaries and making all kinds of decisions on whether to intervene in every armed conflict in the world. Naturally any serious exercise of this kind raises questions of constraints on national resources and practical concerns about international stability and access to trade routes and energy. And if it truly is serious, it would require confronting the reality that much of the global economy and security are not based on noble and democratic principles but shaped by power structures led by the West and capital.

Calling for consistency is a demand for honesty about what’s really driving the events of the world. It prevents the public from fooling itself with self-flattering illusions. And it's a critical part of any agenda to truly better the world.

Above is from:  https://www.msnbc.com/opinion/msnbc-opinion/why-u-s-s-double-standards-russia-ukraine-war-matter-n1293171?cid=eml_mda_20220328&user_email=982db1251d051374650c5b955ad9021ff10338eb5df4b61b37a899251cd30a75

March 24, 2022: Johns Hopkins COVID 19 Report

COVID-19 Situation Report

Editor: Alyson Browett, MPH

Contributors: Clint Haines, MS; Natasha Kaushal, MSPH; Amanda Kobokovich, MPH; Christina Potter, MSPH; Matthew Shearer, MPH; Marc Trotochaud, MSPH; and, Rachel A. Vahey, MHS.

NON-PUBLISHING NOTICE The Situation Report is taking a short break and will not publish next week, Tuesday, March 29, and Thursday, March 31. We will resume publication on Tuesday, April 5.

CALL FOR PAPERS, DEADLINE EXTENDED The Center’s Health Security journal will devote a special feature to climate change and its impact on national and global health security. Those interested are encouraged to submit original research articles, case studies, and commentaries on topics including climate change-related public health emergencies, public health emergency management and climate change, displacement of populations and the health impact of climate change, and more. Please submit all manuscripts for consideration by April 4, 2022: https://home.liebertpub.com/cfp/special-feature-on-climate-change-and-health-security/378/

EPI UPDATE The WHO COVID-19 Dashboard reports 473 million cumulative cases and 6.1 million deaths worldwide as of March 23. The global weekly incidence increased for a second week, up nearly 9% from the previous week. The increase appears to be driven principally by trends in Europe and the Western Pacific region. Notably, the Western Pacific continues to set new records for weekly incidence, with more than 6 million new cases last week (+21% over the previous week). The trend in weekly incidence also continues to tick upward in Europe but not at such a steep pace (+5% over the previous week). All other regions reported decreasing weekly incidence last week, although the rate of decline is slowing. Global weekly mortality decreased for the fourth consecutive week, down 25% from the previous week.

Global Vaccination

The WHO reported 10.9 billion cumulative doses administered globally as of March 18. A total of 5 billion individuals have received at least 1 dose, and 4.45 billion are fully vaccinated. Analysis from Our World in Data indicates that the overall trend in global daily vaccinations continues to decline, down from nearly 40 million doses per day in late December 2021 to 16.14 million on March 23, a decrease of 60% over that period.* The trend continues to closely follow that in Asia. Our World in Data estimates that there are 5.05 billion vaccinated individuals worldwide (1+ dose; 64.1% of the global population) and 4.51 billion who are fully vaccinated (57.3% of the global population). A total of 1.6 billion booster doses have been administered globally.

*The average daily 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.

UNITED STATES

The US CDC is currently reporting 79.65 million cumulative cases of COVID-19 and 971,212 deaths. The decline in daily incidence is tapering off, with the current average at 27,545 new cases per day. Daily mortality continues to decline, down to 787 deaths per day on March 22.* Notably, the average daily mortality is at its lowest level since late-November 2021, prior to the start of the Omicron surge.

*Changes in state-level reporting may affect the accuracy of recently reported data, particularly over weekends. 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 559 million cumulative doses of SARS-CoV-2 vaccines. Daily vaccinations have stalled, down from the most recent peak of 1.79 million doses per day on December 6 to approximately 169,000 on March 17*. Data are relatively unchanged since last week. A total of 255 million individuals have received at least 1 vaccine dose, which corresponds to 76.8% of the entire US population. Among adults, 88.2% have received at least 1 dose, as well as 27.1 million children under the age of 18. A total of 217.2 million individuals are fully vaccinated**, which corresponds to 65.4% of the total population. Approximately 75.3% of adults are fully vaccinated, as well as 22.6 million children under the age of 18. Since August 2021, 96.87 million individuals have received an additional or booster dose. This corresponds to 44.6% of fully vaccinated individuals, including 67.1% of fully vaccinated adults aged 65 years or older.

*Due to delays in reporting, estimates for the average daily doses administered are less accurate for the most recent several days.

**Full original course of the vaccine, not including additional or booster doses.

US FUNDING During a press briefing on March 23, several members of the White House COVID-19 Response Team repeatedly reiterated the need for the US Congress to authorize additional funding for the national COVID-19 pandemic response and future pandemic preparedness. Without the funds, the administration of US President Joe Biden will not be able to purchase additional supplies of monoclonal antibody treatments and SARS-CoV-2 vaccines, or maintain vital surveillance activities. Currently, the administration does not have enough money to buy fourth vaccine doses for the general population, if they are deemed necessary, and it will cut back on shipments of antibody treatments to states. Additionally, the White House is ending a federal program that reimburses healthcare providers for COVID-related care—such as testing, treatment, and vaccination—for people without health insurance at the end of April due to a lack of funds. If uninsured people hesitate to get tested or seek treatment because of the cost, the nation could see more COVID-19 cases and increased inequity. The calls for additional resources come as the US CDC released data showing that the highly transmissible BA.2 subvariant of Omicron accounts for about 35% of new COVID-19 cases, and some states and regions are showing an uptick in case numbers, hospitalizations, and virus levels in wastewater.

The Biden administration has asked Congress for US$22.5 billion in emergency spending for COVID-19, primarily to purchase more vaccines and treatments. An omnibus spending bill signed by President Biden earlier this month originally contained US$15.6 billion for pandemic response efforts, but the funds were removed over concerns from US House Democrats over one of the funding mechanisms. Republican lawmakers insist that funds can be diverted from other programs and are demanding an accounting of how previous emergency funds have been spent. There are signs that negotiations are making progress. On March 23, US Senator Mitt Romney of Utah indicated he expects to receive a new proposal from Democrats soon. After weeks of decline, new COVID-19 cases are beginning to plateau in the US, making clear that the unpredictability of SARS-CoV-2 necessitates a sustained response.

MODERNA VACCINE IN CHILDREN Moderna is plans to submit its data from Phase 2/3 trials in children aged 6 months to under-6 years to the FDA and other global regulators this month. The trials met the company’s primary endpoint in recent weeks, demonstrating robust neutralizing antibody titers and good tolerability and safety profiles. Around 11,700 children ages 6 months to under-6 years from the US and Canada were enrolled in the trials. The dose for this age group would be only 25% of the adult dose. Similar to data seen in adults, the vaccine was not as effective in preventing infection in the younger age group; efficacy against Omicron infection was around 44% for children 6 months to 2 years old and 37.5% for children ages 2 to 5 years. Still, like in adults, the vaccine appeared effective in preventing severe disease and hospitalization. Some parents have commented that even a low amount of protection is better than no protection for their children, particularly those with underlying conditions. Pfizer and BioNTech are expected to submit their data for this youngest age group by early April. Currently, the Pfizer-BioNTech vaccine is the only authorized vaccine for children aged 5-17. Moderna’s vaccine for this age group is still under review over concerns of myocarditis and other side effects due to the much larger dose compared with the Pfizer-BioNTech vaccine. For Moderna’s vaccine, 30-40% efficacy is much lower than hoped for from a pediatric vaccine, but with under-5-year-olds remaining the only ineligible age group, there remains strong demand to further protect our youngest.

ANTIBODIES IN CHILDREN A new study published in JCI Insight found that antibody responses were stronger in children than in adults following recovery from COVID-19. The study involved 682 serum samples from various households in Maryland, including 28 children whose samples contained receptor-binding domain (RBD) antibodies against SARS-CoV-2. Children aged between 0-4 years had RBD antibody titers 13 times higher than adults; children aged between 5-17 years had RBD antibody titers 9 times higher than adults. It has long been observed that children appear to be at lower risk of severe illness and hospitalization on average than adults due to COVID-19. Although this study is relatively small, it joins other evidence showing that children exhibit robust initial immune responses to SARS-CoV-2 infection. However, the evidence for why children appear to fare better with COVID-19 is still conflicted; other studies have found that children actually had lower levels of antibodies compared to adults, while their innate immune response cells responded at higher levels than those in adults. Regardless of the root cause, the US CDC has reported fewer deaths in children compared to adults when adjusted for several factors. Recent data adjustments reduced the reported death rate in US children by 24%. Children have accounted for 19% of total COVID-19 infections in the US, but only 0.26% of deaths. Still, many are hopeful that a vaccine will soon be authorized to further protect children under age 5 who are currently ineligible for vaccination.

PANDEMIC-RELATED WORKPLACE VIOLENCE A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health supports previous evidence that public health workers and officials experience various forms of pandemic-related workplace violence. Researchers used media content and a national survey of local health departments (LHDs) to characterize public health officials’ experiences between March 2020 and January 2021. The study, published online in the American Journal of Public Health, identified at least 1,499 harassment experiences, representing 57% of LHDs that responded to the survey. Nearly one quarter of those faced backlash on social media, 6% received personally targeted messages over social media, 6% received threats of physical harm directed toward them or their families, and 2% said their personal information was publicly shared online. Additionally, at least 222 public health officials in 42 states left their jobs during that time, either due to resignation, retirement, termination, or other action, and another 34 threatened to leave but did not. Of those 222 departures, 36% involved officials who experienced some form of harassment.

The researchers identified 5 common themes of public health officials’ experiences: feeling underappreciated, undermined, villainized, politicized, and disillusioned. Many of the affected workers remain in their positions. To help reduce and respond to acts of harassment, the researchers recommend training public health leaders about how to respond to political and societal conflict; improving professional support networks; providing trauma-informed employee support; making long-term investments in public health staffing and infrastructure; and establishing workplace violence reporting systems and legal protections. Additionally, they suggest stronger policies to protect public health workers, noting that the problem likely will not go away once the COVID-19 emergency ends. 

COLLATERAL IMPACTS The COVID-19 pandemic has disrupted the treatment and prevention of many health conditions, including infectious diseases and mental health. Worldwide, 6.1 million people have died from COVID-19, and researchers are now working to understand the pandemic’s collateral impacts on human health. In a letter published online in JAMA, researchers from the US NIH National Institute on Alcohol Abuse and Alcoholism (NIAAA) report that, based on a review of death certificates, the number of deaths involving alcohol increased from 78,927 in 2019 to 99,017 in 2020, the first year of the pandemic. The 25.5% relative change in the number of alcohol-associated deaths is enormous, outpacing the increase for all-cause mortality, which was 16.6%. Notably, the mean annual percent increase in alcohol-associated deaths between 1999 and 2017 was only 2.2%. Only a small proportion of the alcohol-related deaths reported in 2020 also involved COVID-19 (1.5%). The rates increased for all racial/ethnic and age groups, with those aged 25 to 34 years (37%) and 35 to 44 years (39.7%) seeing the greatest increases, and the rate increases were similar for females (27.3%) and males (25.1%). The number of drug overdose deaths in which alcohol played a role also increased significantly. The researchers said possible factors contributing to the increase in alcohol-related deaths could include pandemic-related stressors, shifting alcohol policies, and disrupted treatment access. Provisional data from 2021 show alcohol-associated deaths remain high.

In another research letter published in JAMA Network Open, a study led by Kaiser Permanente researchers found that death rates associated with heart disease and stroke rose significantly during the first year of the pandemic. After declining between 2011 and 2019, the estimated age-adjusted mortality rate from heart disease increased 4.3% and 6.4% from stroke between 2019 and 2020. Additionally, greater increases were observed for racial and ethnic minority populations, with risk-associated increases of heart disease and stroke greatest among non-Hispanic Black individuals. The researchers speculate the pandemic is associated with several factors that contributed to these increases, including overcrowded hospitals that resulted in fewer hospitalizations for cardiovascular concerns, fewer medical visits, poorer adherence to medications, and disruptions in healthy lifestyle behaviors.

A separate study, published in the journal Pediatrics by researchers from Boston Children’s Hospital, suggests there was an increase in referrals for intimate partner violence (IPV) after the start of the pandemic. Even as face-to-face visits became less common, dropping 28% to 2% from the 11 months prior to the pandemic’s beginning to April 2020 through February 2021, IPV consults—primarily for emotional abuse—and psychoeducation referrals rose significantly. The researchers said increased isolation, school closures, and pandemic-related economic impacts likely led to an increase in IPV. An accompanying commentary highlighted the importance of pediatric healthcare settings in helping to recognize and support families experiencing IPV.

In some good news, there was a 52% decrease in reported gastrointestinal (GI) outbreaks—including those caused by food poisoning, hemolytic uremic syndrome, and infectious bloody diarrhea—in England during the first 6 months of the pandemic (February to July 2020) compared with the 5-year average from 2015-2019, according to a study published in BMJ Open. Overall, there was a 94% drop in suspected and confirmed parasitic outbreaks, a 62% drop in viral outbreaks, and a 47% decline in bacterial outbreaks. Additionally, the number of laboratory confirmed cases fell by 34%. GI indicators rose after the first lockdown eased, but all remained lower than historical averages. Some of the behavior changes associated with the pandemic, including greater isolation and improved hand hygiene, likely influenced the drop in GI outbreaks. The researchers said that strict and sustained handwashing could significantly decrease the incidence of GI-related illnesses in the future.

AIR TRAVEL RESTRICTIONS The US Travel Association (USTA), the International Air Transport Association, and some Republican lawmakers are urging the US CDC and the administration of US President Joe Biden to lift transportation-related mask mandates and end all other pandemic-related travel restrictions, including pre-departure testing and “avoid travel” guidance for vaccinated individuals. Supporters of dropping the mask mandate say that air filtration systems and vaccination requirements are sufficient to keep people safe enough. Last week, a group of 16 Republican lawmakers sued the CDC to force an end to the requirement that face masks be worn for air travel. That mandate was recently extended through April 18 and will be reviewed again over the coming weeks. While repealing mask mandates for air travel may be rationalized by currently declining COVID-19 incidence, public health experts say it is too soon to make a change, especially with rising concerns over the global spread of the BA.2 subvariant of Omicron. Additionally, repealing the mandate now could make reinstating the requirement much more difficult in the future. Other proponents of the mandate say universal mask-wearing helps to protect people who are immunocompromised, those who are unable to be vaccinated, and younger children who remain ineligible for vaccination. Even when the federal mask mandate for air travel is dropped, individual airports or airlines could continue to require mask-wearing in terminals or on certain flights. Several British airlines are relaxing mask mandates on some routes, and many Danish airports recently lifted their mask mandates, one of the few remaining restrictions after most public health mitigation requirements were dropped in February.

COVID-19 SURVEILLANCE The number of confirmed COVID-19 cases globally increased for the second week in a row, up nearly 9% in the last week. The increase is being driven by the BA.2 subvariant of Omicron, particularly in the Western Pacific region, but the WHO warned that with many countries dropping large-scale testing programs, many cases are likely going unrecorded. Furthermore, the widespread availability of at-home rapid tests could lead to positive tests going unreported or false-negative results, further hindering early-warning systems. And while deaths from COVID-19 continue to decline globally, experts agree that the numbers are far greater than those officially recorded, in part due to overwhelmed, antiquated, and decentralized systems for reporting deaths. Data on COVID-19 deaths continue to be poorly sourced and documented, although researchers are working to close this knowledge gap. Pandemic data collection is vital for public education and policymaking, as it can help individuals make decisions about behavior and increase public trust through transparency. Some experts fear that gains made in data collection and visualization through various online dashboards could be lost even before the pandemic ends. Already, government surveillance efforts to collect real-time data are slowing in several countries. These cutbacks are happening just as cases caused by the highly infectious BA.2 subvariant are rising globally, underlining the need to reinforce, not dismantle, surveillance systems.

VACCINE INEQUITY Entering the third year of the COVID-19 pandemic, shipments of SARS-CoV-2 vaccines and treatments to wealthy nations continue to outpace those to low- and middle-income countries (LMICs). More than one-third of the global population has not yet received a vaccine dose. This persistence of inequity between rich and poor nations is dangerous, leaving open the possibility that a more virulent variant of the virus could emerge. Even the COVAX initiative, established to facilitate the purchase of vaccine supplies for LMICs, is essentially out of funding and has fallen short of its goals. The initiative’s failure—due to supply chain issues, manufacturing and export constraints, queue-jumping by wealthy nations, and other issues—shows that future efforts to equitably and responsibly distribute public health resources will need leadership from at least one powerful country that can influence others and, importantly, must engage LMIC governments from the start. Instead of cooperation, vaccine nationalism overtook efforts to equitably distribute vaccines.

A global plan to achieve vaccine equity remains an urgent priority to reduce the risk of new variants and to set in place a system that can be employed during future health crises. In recent articles, one published in NEJM and the other in The BMJ, experts outline several potential paths to reaching this goal—including increasing local manufacturing capacity, accelerating pledged donations, and licensing and technology transfer arrangements. Until the world gets closer to vaccine equity, LMICs will continue to face healthcare system strain, excess morbidity and mortality, and economic disruption, and the entire world will remain under the threat of future variants.

March 22, 2022: Johns Hopkins COVID 19 Report

COVID-19 Situation Report

Editor: Alyson Browett, MPH

Contributors: Clint Haines, MS; Natasha Kaushal, MSPH; Amanda Kobokovich, MPH; Christina Potter, MSPH; Matthew Shearer, MPH; Marc Trotochaud, MSPH; and, Rachel A. Vahey, MHS.

WEBINAR Reliable and affordable access to rapid at-home and laboratory-based diagnostic testing across the US is a key component of a sustainable COVID-19 recovery plan. However, it is a challenge to ensure long-term public access to testing capacity, even during times when demand wanes. Please join us for a webinar, Enabling Population-Scale Diagnostic Testing for COVID-19 and Future Infectious Disease Outbreaks, on Wednesday, March 30, at 11am (ET) that explores how policymakers can sustain diagnostic testing capacity for COVID-19 and expand applying this technology to other health security threats. Register online here.

FELLOWSHIP OPPORTUNITY Applications are now open for the Johns Hopkins Center for Health Security’s Emerging Leaders in Biosecurity (ELBI) Fellowship Class of 2022. ELBI inspires and connects the next generation of biosecurity leaders and innovators. This highly competitive, part-time program is an opportunity for talented career professionals to deepen their expertise, expand their network, and build their leadership skills through a series of sponsored events. Applications can be submitted through 11:59PM (EST) March 31, 2022. Learn more about eligibility requirements and application materials.

US PREPAREDNESS FOR BA.2 Public health professionals are warning state and federal government officials of a potential uptick in COVID-19 cases and hospitalizations due to the increasing prevalence of the Omicron subvariant BA.2. During a briefing this week, White House Chief Medical Advisor Dr. Anthony Fauci shared that current evidence suggests BA.2 is 50%-60% more transmissible than the original Omicron variant (BA.1), with similar clinical presentations. The US CDC estimates that 35% of new cases are caused by the BA.2 subvariant, and officials predict that it likely will become the predominant variant over the coming weeks.

US health officials are watching the situation in other countries, including the UK and France, for clues about how the BA.2 subvariant might impact the US. In the UK, new COVID-19 case numbers have doubled in the past 3 weeks, and hospitalizations also are rising. Case numbers also are rising in France, where most COVID-related mitigation protocols were recently lifted. There is some hope that the increased proportion of individuals with immune protection from vaccination, natural infection, or a combination could help blunt a new wave of infections in the US, leading to a less stark surge in new cases. However, many states and jurisdictions are dropping mitigation measures, reporting COVID-19 data less frequently, and closing testing sites, leaving many experts to worry these changes will create blindspots that could lead to delayed responses. Others warn the country is letting its guard down too early. Additionally, the administration of US President Joe Biden said it is quickly running out of funding to address the pandemic. All of these developments have left many, especially vulnerable populations, worried about the weeks to come.

MODERNA VACCINE Late last week, Moderna submitted a request to the US FDA for Emergency Use Authorization (EUA) of a second booster dose of its SARS-CoV-2 vaccine for all adults. Moderna’s application extends beyond the scope of Pfizer-BioNTech’s recent EUA request for a second booster dose, as that submission was limited only to adults 65 years of age and older who have received an initial booster. In a press release, Moderna explained its rationale for including an extended population pool is to provide greater flexibility to the US CDC and other healthcare providers when determining future vaccination guidance for the people in the US. Like Pfizer-BioNTech, Moderna cited data from Israel showing increased immune resilience among populations who received a fourth dose during Omicron predominance. The FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) is scheduled to meet on April 6 to discuss considerations for future vaccine booster doses, as well as the process for selecting specific strains of SARS-CoV-2 for vaccines to address current and emerging variants. However, the committee will not be discussing specific applications and no vote is planned. Moderna also announced that Canada joined Australia and the EU in authorizing its SARS-CoV-2 vaccine for children aged 6-11 years.

VACCINE EFFECTIVENESS Once SARS-CoV-2 vaccines were developed, tested, and authorized for use, focus shifted toward evaluating their effectiveness in the broader population. Two of the principal concerns are the duration of protection and effectiveness against emerging SARS-CoV-2 variants. With the US past its Omicron peak, the US CDC has a wealth of data available for these analyses. The CDC’s COVID-19 Emergency Response Team published findings comparing vaccine effectiveness (VE) against hospitalization during the Omicron surge, based on data from 14 states collected from July 2021 to January 2022. At the peak of the Omicron surge, weekly per capita hospitalizations peaked at 38.4 per 100k population, compared to 15.5 during the Delta surge, and full vaccination with a booster reduced the risk of hospitalization by a factor of 12 compared to unvaccinated adults and a factor of 4 compared to adults with full vaccination and no booster. Additionally, hospitalizations during the Omicron surge were higher than during the Delta surge among both vaccinated and unvaccinated individuals. Hospitalization risk among non-Hispanic Black adults was the highest among all racial and ethnic groups and nearly 4 times the risk among non-Hispanic White adults. The researchers noted that non-Hispanic Black adults represented a larger proportion of unvaccinated adults during the Omicron surge than during the Delta surge, which likely factored into the higher hospitalization risk.

The COVID-19 Emergency Response Team also published findings from a study on mRNA SARS-CoV-2 vaccine effectiveness against invasive mechanical ventilation (IMV) and death. The researchers conducted a case-control study across 21 US medical centers from March 2021-January 2022, spanning both the Delta and Omicron surges. The study included more than 7,500 hospitalized COVID-19 patients—1,440 hospitalized adult COVID-19 patients who received IMV or died (case) and 6,104 hospitalized adult patients who tested negative for SARS-CoV-2 infection (control). Most of the vaccinated COVID-19 patients who received IMV or died “had complex underlying conditions, commonly immunosuppression.” The researchers estimated the overall VE against IMV or death to be 90%, including 88% for 2 doses and 94% for 3 doses (eg, including a booster). Specifically during the Omicron surge, the researchers estimated the effectiveness to be 79% for 2 doses and 94% for 3 doses. The overall VE among individuals who received their second dose more than 150 days prior was 84%, compared to 92% for those who received theirs 14-150 days prior. This study provides further evidence that mRNA vaccines provide substantial protection against severe COVID-19 disease and death—particularly with booster doses—including over prolonged periods and against emerging variants.

As the BA.2 subvariant begins to overtake the original Omicron subvariant (BA.1), experts have raised concerns about the continued effectiveness of SARS-CoV-2 vaccines against yet another variant. A study (preprint) of nearly 140,000 individuals conducted by researchers in Qatar found that the Pfizer-BioNTech and Moderna vaccines exhibited high effectiveness against symptomatic COVID-19 disease caused by BA.1 or BA.2 for 4-6 months after the second dose, but protection declined sharply after that point, down to approximately 10%. Booster doses restored some efficacy against both subvariants, back up to 30-60%. These data align closely with data from the UK, which show effectiveness less than 20% at 25 weeks or longer, but a third dose can increase effectiveness to approximately 70%.

A study by researchers in the UK evaluated VE for the Pfizer-BioNTech and Moderna vaccines against symptomatic disease after 1 dose among adolescents. The study utilized a case-control design and included data from children aged 12-17 years collected starting September 13, 2021, when vaccination was authorized for children aged 12-15 years. Because the UK recommends the 2 doses be administered 8-12 weeks apart, as opposed to 3, it provides the opportunity to evaluate 1-dose efficacy in this age group. The 1-dose effectiveness against the Delta variant among the 12-15 year age group peaked at 74.5% between 14 and 20 days after vaccination, before declining to 45.9% at 70-83 days. Against the Omicron variant, the 1-dose effectiveness peaked at 49.6% and declined to 16.1%. After the second dose, effectiveness peaked at 93.2% against the Omicron variant and 83.1% against the Delta variant. Similar results were observed among the 16-17 year age group, although the 2-dose effectiveness declined rapidly for the Omicron variant at Day 34 after the second dose. The vaccines exhibited 83.4% and 76.3% effectiveness against hospitalization for the Delta variant after 1 dose among the 12-15 year and 16-17 year age groups, respectively, but follow-up was not completed for 2 doses or the Omicron variant. This study provides further insight into the protection conferred against the Omicron variant, but the timing of the doses makes it difficult to compare against the efficacy estimates from clinical trials.

TYPE 2 DIABETES People who recover from acute SARS-CoV-2 infection, whether mild or severe, could experience myriad post-acute sequelae and long-term symptoms lasting weeks or months, including fatigue, shortness of breath, anxiety, depression, and cognitive impairments. The condition is known as post-acute sequelae of COVID-19 (PASC), or long COVID. Evidence is growing that people who recovered from COVID-19 within the past year have an increased risk of cardiometabolic conditions, including new onset diabetes. A study published online in The Lancet Diabetes & Endocrinology examined the post-acute risk and burden of incident diabetes in people who recovered from COVID-19. Researchers examined US Department of Veterans Health Administration (VHA) records of a cohort of 181,280 US Veterans who survived the first 30 days of SARS-CoV-2 infection between March 2020 and September 2021 and compared them with 2 large control groups—a contemporary cohort of more than 4.1 million non-infected participants who used VHA services during the same time period and a historical cohort of another 4.28 million non-infected participants who used VHA services during 2017.

Overall, COVID-19 was significantly associated with an increased risk of incident diabetes. Individuals who survived COVID-19 were 46% more likely than those with no history of COVID-19 to develop new onset diabetes (primarily Type 2) or be prescribed medication to control their blood sugar. In another calculation, the researchers found an excess burden of 1.8 per 100 people would develop diabetes or blood sugar control issues at 12 months. People older than 65 years and those with cardiovascular disease, high blood pressure, high cholesterol, or prediabetes had higher risks and burdens than younger individuals or those without underlying conditions. Additionally, Black participants had higher risks and burdens than White participants, although the researchers note that the cohort consisted primarily of White males, possibly limiting the generalizability of the findings. Notably, the risks and burdens increased according to the severity of the acute infection. Even those patients at low risk of diabetes prior to SARS-CoV-2 infection showed an increased risk of developing the condition compared to controls. The researchers concluded that diabetes and hyperglycemia should be considered in treating people recovered from COVID-19 and included in the definition of long COVID. They also warn the association between COVID-19 and incident diabetes could have significant global implications.

Another study, published recently in Diabetologia and based on records from a nationwide primary care database in Germany, found those recovered from COVID-19 had a 28% greater risk of developing Type 2 diabetes than people who never had COVID-19. Those researchers also encouraged blood sugar monitoring for all recovered COVID-19 patients. An international group of researchers have established the global CoviDIAB Registry to track COVID-19-related diabetes and severe metabolic disturbances and to examine the conditions’ pathogenesis, management, and outcomes.

US INDOOR AIR QUALITY As part of US President Joe Biden’s National COVID-19 Preparedness Plan, the US Environmental Protection Agency (EPA) last week launched the “Clean Air in Buildings Challenge” to reduce the risk of airborne viruses, including SARS-CoV-2, and other indoor contaminants. The Challenge includes a call to action for building owners and operators, schools, colleges and universities, and other organizations to assess indoor air quality and make improvements to ventilation and air filtration. Additionally, the EPA published a best practices guide, developed collaboratively with other federal agencies, that provides recommendations grouped into 4 categories: creating clean indoor air action plans, optimizing fresh air ventilation, enhancing air filtration and cleaning, and engaging those in the building community. The plan does not provide technical guidance nor discuss the cost of implementing air quality upgrades, although the EPA noted that funds from the American Rescue Plan and Bipartisan Infrastructure Law can be used to supplement investments in improving indoor air quality in public spaces.

The EPA has worked for many years to help schools improve their air quality, and the COVID-19 pandemic has brought renewed attention to the issue. Research shows that air quality improvements in schools can greatly impact health and learning, beyond reducing the risk of SARS-CoV-2 transmission. Improvements in ventilation and filtration are associated with lower rates of influenza, asthma, and absenteeism, as well as higher reading and math test scores. Advocates hope the Challenge will spur more schools and other buildings to make short- and long-term improvements as part of a layered mitigation approach to disease prevention.

PFIZER ANTIVIRAL The United Nations-backed Medicines Patent Pool (MPP) has signed agreements with 36 generic drug manufacturers in 13 countries to produce a generic version of Pfizer’s oral COVID-19 treatment for use in 95 low- and middle-income countries (LMICs) representing more than half of the world’s population. The oral treatment, known by the brand name Paxlovid, is a combination of the antiviral medications nirmatrelvir and ritonavir. The sublicense agreements are the direct result of a November 2021 voluntary licensing agreement between MPP and Pfizer. Under the agreements, the manufacturers will not need to pay royalties as long as the WHO continues to classify the COVID-19 pandemic as a public health emergency. When that designation ends, the companies can continue to sell the medication royalty-free to low-income countries but will be required to pay 5%-10% royalties on sales to certain middle-income nations. Not all of the manufacturers will fully produce the generic medication; 6 will produce ingredients, 9 will perform fill-and-finish operations, and the remaining will conduct both services. Most of the manufacturing companies—which are located in Asia, the Middle East, North and South America, Eastern Europe, and the Caribbean—indicated it will take them months to begin production. Merck and Ridgeback Biotherapeutics, which produce the oral antiviral molnupiravir, made a similar deal with the MPP in October 2021.

In a separate agreement, Pfizer will sell the United Nations Children’s Fund (UNICEF) up to 4 million courses of Paxlovid to distribute to the same 95 LMICs. Shipments of the pills will begin next month and are intended to bridge the gap in supplies until generic production is up and running. The company is providing a tiered pricing system, with low-income countries receiving the pills at lower pricing than more wealthy nations. The exact financial terms of the agreement were not disclosed.

500 MILLION DOSES US Secretary of State Antony Blinken announced last week that the US has donated more than 500 million doses of SARS-CoV-2 vaccines to more than 110 countries worldwide, bringing it closer to US President Joe Biden’s pledge to donate at least 1.2 billion doses. Notably, the US does not have data on how many of those doses have been administered and needs the US Congress to authorize additional funding for global vaccination efforts to continue. In marking the milestone, US Agency for International Development (USAID) Administrator Samantha Power said a lack of additional funding would “devastate” the agency’s efforts to help other nations deploy vaccines, as well as COVID-related diagnostics, treatments, and other supplies. Administrator Power called on the US Congress to urgently supply additional funding. Additionally, the White House has warned it will soon run out of money to purchase COVID-19 treatments and vaccines, and to maintain testing capacity domestically. A supplemental COVID-19 funding bill currently under consideration in the US Senate could provide up to US$15.6 billion, but with Republicans reluctant to approve the plan, it appears the US is set to continue its cycle of pandemic panic and neglect.