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Cases down. FDA panel recommends boosters. What to know about COVID this week in NC.

The (Raleigh) News & Observer logo The (Raleigh) News & Observer 10/18/2021 Ben Sessoms, The News & Observer (Raleigh, N.C.)

Oct. 16—New COVID-19 cases, following a weeks-long trend, are down over the past seven days in North Carolina, as the highly transmissible delta variant continues to wane.

Over the past week, there have been 21,819 new cases of COVID, data from the N.C. Department of Health and Human Services show.

In the week prior, there were 24,846 new cases, and the week before that, 31,474.

During the first week of September, when cases were peaking due to the delta variant, the state reported nearly 49,000 cases.

Delta is a mutation of the coronavirus that's more than twice as contagious as the original strain, according to the Centers for Disease Control and Prevention.

Reported deaths due to COVID-19 have decreased as well.

In the past week of available data — the week prior to Wednesday — 189 people statewide died due to the virus. That's down from the first week in September when 474 died.

But deaths spiked during the delta surge compared to months prior.

Since Aug. 1, 3,598 people have died to COVID-19. In all of May, June and July combined, 737 died.

Vaccines are the best protection against severe COVID.

A DHHS study from late August found that those unvaccinated are more than four times as likely to contract COVID-19 and 15 times more likely to die due to the disease, The News & Observer reported.

And even as delta has waned, public health experts warn of another surge in the weeks after Thanksgiving.

Over the week prior to Wednesday, the latest available data, 6.6% of tests have returned positive per day. That rate has decreased from 10.9% a month ago.

State health officials want it at 5% or lower.

Hospitalizations decrease

DHHS reported Friday that 2,074 people were hospitalized with COVID-19, down from the 2,449 reported a week ago.

Of those, 564 are being treated in intensive care units. A week ago, 668 were in ICUs.

Hospitalizations hit a delta peak of 3,815 in mid-September. ICU patients hit a pandemic peak of 955 in late August.

Among UNC Health hospitals in the Triangle — the UNC Medical Center in Chapel Hill, UNC Rex in Raleigh and Johnston Health — there are 95 COVID-19 patients, including 35 in ICUs, as of Friday.

Of those hospitalized at UNC Health hospitals in the Triangle, 85% are unvaccinated. For those in ICUs, it's 90%.

Among COVID-related deaths at UNC Health, 98% were unvaccinated. The vaccinated deaths were among those with underlying conditions that weakened their immune systems.

At Duke Health hospitals — Duke University Hospital, Duke Regional Hospital and Duke Raleigh Hospital — there are 92 COVID patients, with 34 in ICUs.

Among their COVID patients, 82% are unvaccinated.

Duke Health did not provide specific vaccination rates for ICU patients or for those who have died due to the virus at their hospitals.

With hospitalizations going down, both health systems are accepting new patients from other hospitals as long as capacity remains available.

Hospital capacity reported is a snapshot of one moment in time. Capacity changes from day to day and even from hour to hour.

COVID-19 metrics reported by DHHS each day are preliminary and subject to change as more information becomes available.

FDA panel recommends boosters

A Food and Drug Administration panel recommended boosters of the COVID-19 vaccines from Moderna and Johnson & Johnson this week, The New York Times reported.

The boosters have not been officially authorized, but the FDA typically follows the panel's recommendation. The agency could authorize early next week.

If it does, then the CDC can recommend the boosters to those eligible

The FDA panel recommended authorizing boosters for people age 65 and older, health care workers and those with compromised immune systems.

When the CDC followed the FDA recommendation for the Pfizer booster, they added front-line essential workers to that group.

The J&J booster recommendation came with caveats, as the panel was concerned about problems with the testing.

The sample size of those tested, from the data the company presented to the FDA, was small — just 17 people.

And the single dose J&J vaccine has shown, from the beginning, to not be as effective as the two-dose mRNA vaccines from Pfizer and Moderna.

Dr. David Wohl, infectious disease specialist at UNC Chapel Hill, told The N&O that unless a single-dose vaccine is strongly preferred, he recommends the mRNA vaccines.

"For most of us, I think Pfizer, Moderna. And a little bit of a tip more towards Moderna," Wohl said.

Public health experts have found in recent months that Moderna has a slight edge in terms of effectiveness, The New York Times reported.

But if someone has already received doses of Pfizer, Moderna or J&J vaccines, they can't mix and match with boosters, per CDC recommendations.

But that could change soon as the panel may consider a booster of either Pfizer or Moderna for J&J recipients, Dr. Peter Marks said when the J&J booster recommendation was announced. He's the head of the FDA vaccine division.

A preliminary study from the National Institute of Health found that those with a first dose of J&J saw a 76-fold increase when they received a booster from Pfizer or Moderna. Those who got a second dose of J&J saw a 35-fold increase.

"People who got J&J and then got Moderna particularly, or Pfizer, but especially Moderna, really made great antibody responses. That's hard to ignore," Wohl said.

But he said if boosters are recommended, you shouldn't wait that long for the mRNA mix and match.

"What we're talking about here is not as effective. It's a question of how effective," Wohl said. " The people who got the booster with J&J, their antibody levels went much higher ... but you got a much greater increase with these other vaccines. It's not like the J&J second vaccine didn't work. It did work. We're just talking about making things even better."

He said he thinks mix and match for boosters is coming though.

"As we move further, we're going to see mix and match. More data is going to support this. The signals are so strong. It's just a matter of time," Wohl said.

Comparisons over the last week

Here's COVID-19 case data over the last week at the local, statewide and national levels.

Vaccine rates are since they've been offered and among those currently eligible, ages 12 and up.

Deaths are over the whole pandemic.

North Carolina

Weekly cases: 21,819

Per 100,000: 206

Full vaccination rate (12+): 63%

Total deaths: 17,456

Wake County

Weekly cases: 1,542

Per 100,000: 139

Full vaccination rate (12+): 77%

Total deaths: 875

Durham County

Weekly cases: 296

Per 100,000: 92

Full vaccination rate (12+): 74%

Total deaths: 257

Orange County

Weekly cases: 130

Per 100,000: 88

Full vaccination rate (12+): 79%

Total deaths: 109

Chatham County

Weekly cases: 83

Per 100,000: 111

Full vaccination rate (12+): 60%

Total deaths: 91

Johnston County

Weekly cases: 324

Per 100,000: 155

Full vaccination rate (12+): 56%

Total deaths: 316

Nationwide

Weekly cases: 576,282

Per 100,000: 174

Full vaccination rate (12+): 67%

Total deaths: 720,228

This story was originally published October 16, 2021 7:00 AM.

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