February 24 coronavirus news

Two studies published Wednesday by the US Centers for Disease Control and Prevention linked Covid-19 outbreaks over the summer in Chicago and Hawaii to exercise facilities. The reports suggest that mask use may be a key mitigation strategy in these settings.

In Chicago, 60% of people who attended in-person fitness classes between August 24 and September 1 tested positive for Covid-19. Another 7% of attendees reported symptoms consistent with the disease.

While some mitigation measures were in place at the facility – including required temperature checks and symptom screenings upon entry – removal of masks was permitted during exercise, according to the report by researchers from Chicago and the CDC.

In Hawaii, 21 cases were linked to a fitness instructor who tested positive for Covid-19 on July 1, said the report by researchers from Hawaii and the CDC. About two days before experiencing symptoms, the fitness instructor led a yoga class for 27 people while wearing a mask. There were no reported cases among these participants. A few hours before symptom onset, the same instructor led a stationary cycling class for 10 people, none of whom wore a mask. All participants later tested positive for Covid-19, including a second fitness instructor linked to additional cases.

According to the first report, “the increased respiratory exertion that occurs in the enclosed spaces of indoor exercise facilities facilitates transmission” of the virus. 

Even when spaced 6 feet apart, the CDC recommends the use of a mask to reduce transmission in fitness facilities. They also say that facilities should improve ventilation and encourage patrons and staff to follow proper quarantine and isolation protocol after potential exposure to Covid-19 or the onset of symptoms. 

The Johnson & Johnson vaccine might prevent Covid-19 infection without symptoms starting at about four weeks, according to the US Food and Drug Administration’s briefing document on the vaccine released Wednesday.

Earlier studies from the US Centers for Disease Control and Prevention have shown that most coronavirus cases are spread by people without symptoms. If a vaccine prevented asymptomatic infection, it might help reduce opportunities to transmit the disease – not just keep the vaccinated from getting sick.

The clinical trial looked for asymptomatic infections among the volunteers at several points after they had been vaccinated. The trial found that the vaccine had “modest” protection against asymptomatic infection from day one through day 29, but after that, it seemed to offer protection. 

When the volunteers were checked at 71 days after they had gotten the vaccine, it seemed about 74% effective against asymptomatic infections. 

The document says these findings should be “interpreted with caution” and additional research is needed, since the follow-up time is limited and the number of volunteers in this sample was comparatively small, so “definitive conclusions cannot be drawn at this time.”

An ensemble forecast published Wednesday by the US Centers for Disease Control and Prevention now projects there will be 526,000 to 548,000 coronavirus deaths in the United States by March 20.

Notably, this forecast extends a week beyond the previous forecast, but the projected number of deaths has dropped. Normally, each new CDC forecast projects a greater number of total deaths over a longer period of time.

The previous ensemble forecast, published February 17, projected up to 559,000 coronavirus deaths by March 13. 

At least 502,698 people have already died from Covid-19 in the United States, according to data compiled by Johns Hopkins University.

CNN's John King reviews the latest US Covid-19 numbers: 

Another sign of stiff Republican opposition to Biden’s Covid-19 relief plan: at a closed-door meeting today, one House GOP member after another railed against the measure, according to Reps. Doug Lamborn and Tom Reed. No one spoke in favor of it.

Reed, a member of the bipartisan Problem Solvers Caucus, told me that he will vote against the plan. 

“There's so many issues with the bill that the popularity of it is gonna wear off,” Reed said.

Republican leaders see opposition to the bill as key to unifying their party after a divisive few months of intra-party squabbling. 

Johnson & Johnson's single-shot coronavirus vaccine appears to be safe, according to a 62-page briefing document released by the US Food and Drug Administration on Wednesday.

An analysis of safety data through January – which included more than 40,000 adults – "supported a favorable safety profile with no specific safety concerns identified that would preclude issuance of an EUA," the FDA noted in the document.

The FDA advisory committee noted in the briefing document that the most common side effects associated with the vaccine were pain at the injection site, headache, fatigue and muscle pain.

There appeared to be more incidents related to blood clotting and ringing in the ears among those who received the vaccine compared with those who didn't, but the FDA notes, "Data at this time are insufficient to determine a causal relationship between these events and the vaccine."

Overall, non-fatal serious adverse events were infrequent, according to the briefing document, and there were no reported cases of anaphylaxis following vaccination.

As of Feb. 5, there were seven Covid-19-related deaths in the placebo group and no Covid-19-related deaths in the vaccine group. Nineteen deaths total had been reported as of Jan. 22 – three among those who received the vaccine and 16 among those who received a placebo. Then from Jan. 22 to Feb. 5, according to the document, an additional six deaths occurred – two in the vaccine group and four in the placebo group. 

Data on the vaccine will be discussed in a meeting of the FDA's Vaccines and Related Biological Products Advisory Committee on Friday. The committee will decide whether to recommend that the FDA issue an emergency use authorization, or EUA, for the Johnson & Johnson vaccine.

A combined flu and Covid-19 vaccination is a future possibility, a leading British virologist testified Wednesday. 

Wendy Barclay, head of the Department of Infectious Disease at Imperial College London, told UK lawmakers: “[The] most likely scenario is that a combination vaccine would be given going forwards in the future, which would combine influenza, with an updated SARS-CoV-2."

Johnson & Johnson says that it has four million doses of its Covid-19 vaccine ready to ship "immediately" once it receives emergency use authorization, which could happen this week.

In an analysis just released, the US Food and Drug Administration said the company's single-dose vaccine has met the requirements for emergency use authorization.

However, despite the excitement and anticipation, there are still several steps Johnson & Johnson has to go through before the vaccine will be available.

Here's what happens next:

The FDA's Vaccines and Related Biological Products Advisory Committee meets on Friday to review data on the vaccine and decide whether to recommend it for emergency use authorization in adults 18 and older.

Once the vaccine is authorized, the US Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, or ACIP, makes recommendations to the CDC on how the vaccine should be used, such as among what age groups and on what type of schedule. An emergency meeting of ACIP is scheduled for Feb. 28 and March 1.

Typically, the CDC director accepts the committee's recommendation. Shortly after that, the vaccine can be distributed, and can start going into arms.

What everyone wants to know is where the federal government will send those doses, and who they'll be steered toward.

"We're hoping that ACIP will provide some guidance on the most effective use of the J&J one dose vaccine," Claire Hannan, executive director of the Association of Immunization Managers, wrote in an email to CNN on Tuesday.

"States are looking for guidance for use of the vaccine in populations which might really benefit from the one dose series complete, such as transient populations," Hannan said. "We aren't hearing much on this."

You can read more about the Johnson & Johnson vaccine here.

In an analysis released Wednesday, the US Food and Drug Administration said Johnson & Johnson's single-dose Covid-19 vaccine has met the requirements for emergency use authorization.

The efficacy of the Johnson & Johnson vaccine against moderate to severe/critical Covid-19 across all geographic areas was 66.9% at least 14 days after the single dose vaccination, and 66.1% at least 28 days after vaccination, a new analysis meant to brief the FDA’s Vaccines and Related Biological Products Advisory Committee said. 

“There were no specific safety concerns identified in subgroup analyses by age, race, ethnicity, medical comorbidities, or prior SARS-CoV-2 infection,” the analysis said.

In a briefing document, the FDA said that it has reviewed the data for the vaccine and has determined that it is “consistent with the recommendations set forth in FDA’s guidance Emergency Use Authorization for Vaccines to Prevent COVID-19.”

An independent group of FDA advisers, the Vaccines and related Biological Products Advisory Committee, will consider the documents and make a recommendation about whether the Covid-19 vaccination should be authorized. 

The committee meets on Friday.

Watch more:

The National Institutes of Health announced a new initiative to study long Covid, and “to identify the causes and ultimately the means of prevention and treatment of individuals who have been sickened by Covid-19, but don’t recover fully over a period of a few weeks,” a statement from NIH Director Dr. Francis Collins said.

In December, NIH was provided with $1.5 billion over four years to support research into the long-term health consequences of coronavirus infection, and on Wednesday it announced the first research opportunities for the PASC Initiative.

About the initiative: The aim is to learn more about how the virus may lead to widespread and long-lasting symptoms and to develop ways to treat or prevent them. Initially, the initiative will look at areas including the spectrum of recovery across the population and what the underlying biological cause of prolonged symptoms. 

Initial research will support ongoing and new research studies, as well as the creation of core resources. 

“Through the PASC Initiative, we now ask the patient, medical, and scientific communities to come together to help us understand the long-term effects of SARS-CoV-2 infection, and how we may be able to prevent and treat these effects moving forward,” Collins said.

A study published Friday found that 30% of people with Covid-19 continue to have symptoms up to nine months after initial infection. The most commons symptoms were fatigue and loss of taste or smell, although some reported cough, trouble breathing, muscle aches and brain fog. Nearly a third reported worse quality of life compared to before getting sick, and some said they had trouble performing at least one usual activity, such as daily chores.