Updated recommendations for opening schools in fall 2021

In updated guidance for the 2021-22 school year, the American Academy of Pediatrics strongly recommends in-person learning and urges all who are eligible to be vaccinated to protect against COVID-19.

In addition to vaccinations, the AAP recommends a layered approach to make school safe for all students, teachers and staff in the guidance here. That includes a recommendation that everyone older than age 2 wear masks, regardless of vaccination status. The AAP also amplifies the Centers for Disease Control and Prevention’s recommendations for building ventilation, testing, quarantining, cleaning and disinfection in the updated guidance.

“We need to prioritize getting children back into schools alongside their friends and their teachers — and we all play a role in making sure it happens safely,” said Sonja O’Leary, MD, FAAP, chair of the AAP Council on School Health. “The pandemic has taken a heartbreaking toll on children, and it’s not just their education that has suffered but their mental, emotional and physical health. Combining layers of protection that include vaccinations, masking and clean hands hygiene will make in-person learning safe and possible for everyone.”

AAP recommends universal masking because a significant portion of the student population is not yet eligible for vaccines, and masking is proven to reduce transmission of the virus and to protect those who are not vaccinated. Many schools will not have a system to monitor vaccine status of students, teachers and staff, and some communities overall have low vaccination uptake where the virus may be circulating more prominently.

Research has shown that opening schools generally does not significantly increase community transmission with masking and other safety measures in place. Recently, COVID-19 variants have emerged that may increase the risk of transmission and result in worsening illness. Given the effectiveness of safety precautions when used consistently, children are at higher risk of suffering mental health issues and developmental setbacks if they miss out on in-school learning, according to AAP.

Click here to read the full news release. 

Arizona numbers and testing sites

Updated as of Thursday, July 29, 2021, all 15 Arizona counties have confirmed cases with a combined total of 923,204 cases across the state and 18,200 deaths and 6,799,586 vaccinations administered*. In Pima County: 119,969 cases 2,458 deaths and 897,655 vaccinations administered*. For up-to-date numbers, click here. 

Click here for vaccine finder locations.

Arizonans are able to access COVID-19 testing at more than 600 various sites throughout the state. Click here to find information on where to find the COVID-19 testing sites, hours of operation and information about pre-registration. If you have a testing site you would like to be included on this list, please use this form to provide information about your site.

*Vaccination numbers are displayed by the county of vaccine administration. Vaccinations administered at State of Arizona vaccination sites (PODs) are included in the state totals but not the county totals. 

Dr. Cara Christ, longest-serving ADHS director, to leave position

Gov. Doug Ducey announced on Wednesday, July 28 that Arizona Department of Health Services Director Dr. Cara Christ, who has been instrumental in the state’s COVID-19 response, will leave her position on Aug. 27 for another leadership role as chief medical officer for Blue Cross® Blue Shield® of Arizona.

“When Cara Christ became a doctor, she did it to help others and save lives. That’s exactly what she’s done,” said Gov. Ducey. “She dedicated countless hours to protecting millions of Arizonans from the COVID-19 pandemic — and she’s done it with grace, stability and confidence. She implemented effective statewide testing and internationally-recognized mass vaccination sites, established the national model Arizona SurgeLine, worked hard to increase vaccinations for communities in need and so much more.

“By mid-August, Dr. Christ will be the longest-serving ADHS director. And she was a dedicated leader long before the pandemic hit — developing the Arizona Opioid Action Plan and the Zika Action Plan, expanding access to health care institutions and child care facilities, and always taking creative approaches to better protecting Arizonans. Through any and every challenge, Dr. Christ put the health and safety of Arizonans first. I am deeply grateful for her years of leadership and service to our state, and I wish her continued success at her new opportunity with Blue Cross® Blue Shield® of Arizona.”

Dr. Christ has led ADHS as director since May 2015 after serving as chief medical officer, licensing director and deputy director of public health for the department since 2008. She will be the longest-serving director in the history of the department as of Aug. 13, before her departure from the position.

Dr. Christ, an Infectious Disease Epidemiologist, earned a Bachelor and Master of Science in Microbiology from Arizona State University. She earned her Doctor of Medicine from the University of Arizona College of Medicine — Tucson.

Click here to read the full news release. 

Banner Health requiring employees to get COVID vaccine by Nov. 1

By Stephanie Innes
Arizona Republic

Phoenix-based Banner Health, which is Arizona's largest private employer, says its entire workforce must get a COVID-19 vaccine by Nov. 1.

Banner is the first health system or hospital in the state to publicly announce mandatory COVID-19 vaccines for employees. There will be "limited exceptions" to the requirement, officials said. The criteria for those exceptions is still being developed, according to Banner leadership.

The nonprofit health system, which has roughly 45,000 employees in Arizona, told staff members about the vaccine requirement via an e-mail announcement Tuesday (July 20) afternoon.

Banner officials said they decided to put the mandate in place "to protect patients, team members and the community."

Banner Health is the largest health care system in Arizona and operates in six states. The majority of its approximately 52,000 employees work in Arizona.

The announcement came a week after a national coalition of health care organizations called on hospitals and other health care systems to make the COVID vaccine a requirement.

“The COVID-19 vaccines in use in the United States have been shown to be safe and effective,” Dr. David Weber, a board member for the Society for Healthcare Epidemiology of America, said in a statement on behalf of the coalition.

“By requiring vaccination as a condition of employment we raise levels of vaccination for health care personnel, improve protection of our patients and aid in reaching community protection. As health care personnel, we’re committed to these goals.”

Banner Health, which already mandates the flu vaccine for employees, implemented the COVID-19 vaccine requirements for several reasons, including the rise of the Delta variant, the upcoming flu season and an expected lift of the emergency use authorization for the vaccines in use.

Click here to read the full story.

All civilian federal workers must be vaccinated or face testing

By Annie Karni and Michael D. Shear
(Rebecca Robbins and Dan Levin contributed reporting)
The New York Times

President Biden on Thursday, July 29 announced that all civilian federal employees must be vaccinated against the coronavirus or be forced to submit to regular testing, social distancing, mask requirements and restrictions on most travel.

“We all want our lives to get back to normal, and fully vaccinated workplaces will make that happen more quickly and more successfully,” Biden said, speaking in the East Room. “We all know that in our gut. With incentives and mandates, we can make a huge difference and save a lot of lives.”

The federal government employs more than 4 million Americans, all of whom will need to attest to being fully vaccinated in order to avoid wearing a mask on the job, regardless of where in the country they work, and comply with screening tests once or twice a week.

The president also directed the Defense Department to study how and when to add the coronavirus vaccine to the list of required vaccinations for all members of the military. The announcement marked the first time he has suggested that a mandate could come for active-duty members of the military before any of the three federally authorized vaccines receives full approval from the Food and Drug Administration. And he called on states, territories and local governments to pay $100 to Americans who remain unvaccinated to get their shots.

Biden’s announcement of new mandates in a pleading speech was part of an attempt to reset expectations on the health scourge that just weeks ago he thought he had under control. On July 4, the White House celebrated the national holiday as a day of “independence from COVID-19.”

Officials now expect vulnerable Americans to need booster shots

By Sharon LaFraniere
The New York Times

Biden administration health officials increasingly think that vulnerable populations will need booster shots even as research continues into how long the coronavirus vaccines remain effective.

Senior officials now say they expect that people who are 65 and older or who have compromised immune systems will most likely need a third shot from Pfizer-BioNTech or Moderna, two vaccines based on the same technology that have been used to inoculate the vast majority of Americans thus far. That is a sharp shift from just a few weeks ago, when the administration said it thought there was not enough evidence to back boosters yet.

On Thursday, July 22, a key official at the Centers for Disease Control and Prevention said the agency is exploring options to give patients with compromised immune systems third doses even before regulators broaden the emergency use authorization for coronavirus vaccines, a step that could come soon for the Pfizer vaccine.

Dr. Amanda Cohn, the chief medical officer of the CDC’s immunizations division, told an advisory committee to the agency that officials were “actively looking into ways” to provide certain people access to booster shots “earlier than any potential change in regulatory decisions.”

Mask guidelines changed based on new research on Delta variant

By Apoorva Mandavilli
The New York Times

The recommendation that vaccinated people in some parts of the country dust off their masks was based largely on one troublesome finding, according to Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention.

New research showed that vaccinated people infected with the Delta variant carry tremendous amounts of the virus in the nose and throat, she said in an e-mail responding to questions from The New York Times.

The finding contradicts what scientists had observed in vaccinated people infected with previous versions of the virus, who mostly seemed incapable of infecting others.

That conclusion dealt Americans a heavy blow: People with so-called breakthrough infections — cases that occur despite full vaccination — of the Delta variant may be just as contagious as unvaccinated people, even if they have no symptoms.

CDC reverses course on indoor masks in some part of U.S.

By Mike Stobbe
Associated Press

The Centers for Disease Control and Prevention reversed course Tuesday, July 27 on some masking guidelines, recommending that even vaccinated people return to wearing masks indoors in parts of the U.S. where the coronavirus is surging.

Citing new information about the ability of the Delta variant to spread among vaccinated people, the CDC also recommended indoor masks for all teachers, staff, students and visitors to schools, regardless of vaccination status.

The new guidance follows recent decisions in Los Angeles and St. Louis to revert to indoor mask mandates amid a spike in COVID-19 cases and hospitalizations that have been especially bad in the South. The country is averaging more than 57,000 cases a day and 24,000 COVID-19 hospitalizations.

Most new infections in the U.S. continue to be among unvaccinated people. But “breakthrough” infections, which generally cause milder illness, can occur in vaccinated people. When earlier strains of the virus predominated, infected vaccinated people were found to have low levels of virus and were deemed unlikely to spread the virus much, CDC Director Dr. Rochelle Walensky said.

But with the Delta variant, the level of virus in infected vaccinated people is “indistinguishable” from the level of virus in the noses and throats of unvaccinated people, Dr. Walensky said.

The data emerged over the past couple of days from 100 samples. It is unpublished, and the CDC has not released it. But “it is concerning enough that we feel like we have to act,” Dr. Walensky said.

Vaccinated people “have the potential to spread that virus to others,” she said.

For much of the pandemic, the CDC advised Americans to wear masks outdoors if they were within 6 feet of one another.

Then in April, as vaccination rates rose sharply, the agency eased its guidelines on the wearing of masks outdoors, saying that fully vaccinated Americans no longer needed to cover their faces unless they were in a big crowd of strangers. In May, the guidance was eased further for fully vaccinated people, allowing them to stop wearing masks outdoors in crowds and in most indoor settings.

The guidance still called for wearing masks in crowded indoor settings, like buses, planes, hospitals, prisons and homeless shelters, but it cleared the way for reopening workplaces and other venues.

Subsequent CDC guidance said fully vaccinated people no longer needed to wear masks at summer camps or at schools, either.

For months COVID cases, deaths and hospitalizations were falling steadily, but those trends began to change at the beginning of the summer as the Delta variant, a mutated and more transmissible version of the virus, began to spread widely, especially in areas with lower vaccination rates.

Click here to read the full story. 

CDC urges Americans to get vaccinated amid virus surge

By Sheryl Gay Stolberg
The New York Times

The director of the Centers for Disease Control and Prevention struck a new tone of urgency on Thursday, July 22 about the coronavirus pandemic, warning that the United States is “not out of the woods yet” and is once again at “another pivotal point in this pandemic” as the highly infectious Delta variant rips through communities with low rates of vaccination.

The warning from the director, Dr. Rochelle Walensky, during a briefing by members of the White House COVID-19 response team, was a marked shift from just weeks ago, when President Biden threw a big Fourth of July party on the South Lawn of the White House to declare independence from the virus.

It reflects a growing concern among administration officials that the gains they appeared to have made are being erased — and that the current surge in cases will overwhelm health systems in parts of the country where vaccination rates are low and hospitalizations are high.

Still, new cases, hospitalizations and deaths remain at a fraction of their previous devastating peaks. Vaccines remain effective against the worst outcomes of COVID-19, including from the Delta variant. Experts say breakthrough infections in vaccinated people are so far still relatively uncommon. The Delta variant is estimated to account for 83 percent of new cases in the United States, the CDC said the week of July 19.

Slightly fewer than half of the country was fully vaccinated, as were just under 60 percent of eligible people, according to data from the CDC. (This story was originally published on Thursday, July 22.)

Dr. Walensky pleaded with unvaccinated people to “please take the Delta variant seriously,” adding, “This virus has no incentive to let up, and it remains in search of the next vulnerable person to infect. Please consider getting vaccinated and take precautions until you do.”

Click here to read the full story. 

Mayor Romero orders masks be worn in all Tucson city buildings

By Dylan Smith
TucsonSentinel.com

Anyone entering a city facility must wear a face mask, Tucson Mayor Regina Romero said Wednesday, July 28, following CDC guidance that everyone in areas where COVID-19 cases have spiked should cover their faces in public buildings.

The measure takes effect immediately, city officials said.

Romero directed City Manager Mike Ortega to "require all members of the public, including those who are fully vaccinated, to wear a mask in city of Tucson facilities."

Masks will be made available to anyone who does not have one at the entrances to city buildings, officials said.

The move follows an announcement by the federal Centers for Disease Control and Prevention that even vaccinated individuals should "wear a mask indoors in public if you are in an area of substantial or high transmission." The CDC has designated Pima County as an area with "substantial" transmission because of the increasing number of new reported COVID-19 infections in recent days.

The city's action only applied to municipal facilities and the mandate does not apply to private businesses, which continue to be able to require mask wearing if they choose to do so, city officials said.

Click here to read the full story.

Arizona will not change mask mandate despite CDC updates

Gov. Doug Ducey declared that Arizona will continue to not allow mask mandates on Tuesday, July 27 in light of the Centers for Disease Control Prevention's recent reversal of its guidelines for indoor mask use in response to the rising COVID-19 cases across the country.

Back in March, Ducey pulled back all of Arizona's COVID-19 mitigation measures as COVID-19 cases began to drop and vaccination rates in the state steadily increased. These efforts included an executive order that phased out all mask mandates implemented by local governments, including the ones put in place by both the City of Tucson and Pima County in June.

The governor also signed House Bill 2770 into law allowing businesses in Arizona to not be required to enforce any mask mandates. In addition, he issued an Executive Order that banned mask mandates for all staff and students, and blocked several school policies, which required COVID-19 vaccinations, regular COVID-19 testing or mask wearing for students and staff.

During this timeframe, the CDC initially recommended that people who were fully vaccinated do not have to wear masks or stay 6 feet away from others in most settings. However, on Tuesday, July 27, the Associated Press reported that because of a drastic rise in COVID-19 cases and "new information obtained about the ability of the Delta variant to spread among vaccinated people," the CDC changed course and said all people, including those who are vaccinated, should return to wearing masks indoors, especially in areas where the virus is seeing a resurgence.

"The CDC today (July 27) is recommending that we wear masks in school and indoors, regardless of our vaccination status," Ducey said in a press release on Tuesday, July 27. "This is just another example of the Biden-Harris administration’s inability to effectively confront the COVID-19 pandemic."

Here in Arizona, state health officials have been reporting a significant climb in virus cases over the last few weeks, seeing 1,475 new COVID-19 cases and 12 more deaths on Tuesday (July 27) alone.

This overall state totals as of Thursday, July 29 are 923,204 cases and 18,200 deaths, according to ADHS.

"Arizona does not allow mask mandates, vaccine mandates, vaccine passports or discrimination in schools based on who is or isn’t vaccinated," the governor said. "We’ve passed all of this into law, and it will not change."

Click here to read the full story. 

Arizona's ban on school mask mandates criticized by health experts

By Rithwik Kalale
Cronkite News

Health experts are concerned that Arizona’s recently approved budget, which bans public schools and universities from enforcing mask mandates and COVID-19 testing for unvaccinated students, is endangering public health across the state. (This story was originally published Friday, July 9.)

In a virtual panel assembled by the Committee to Protect Health Care, a national advocacy organization that aims to “fight for quality, affordable health care that protects patients over profits,” experts weighed in on how the legislation, as well as Gov. Doug Ducey’s June 15 Executive Order banning masks at schools, could prolong the pandemic in Arizona.

“Students are being linked to community outbreaks, including in Arizona, and they accounted for 72 percent of all school-related cases in Maricopa (County) at one point in the past spring,” said Dr. Elizabeth Jacobs, a professor of epidemiology at the University of Arizona. “Banning schools from adopting a simple, cost-effective and scientifically proven safety measure like mask wearing while we are still in the midst of a pandemic makes absolutely no scientific or public health sense.”

Daily COVID-19 cases in Arizona have declined since March, according to the Arizona Department of Health Services, with only several hundred new cases per day now compared with the thousands of daily new cases earlier this year. However, in recent weeks, that number has ticked up slightly.

The state’s low vaccination rate also was a major concern for the experts on the panel.

“Only 23.5 percent of Arizona youth, aged between 12 and 17, have been vaccinated,” said Dr. Ricardo Correa, program director for endocrinology at the University of Arizona. “Policymakers and politicians must do better for Arizona and for children in our state, who deserve elected leaders who will use science and other resources to keep them safe during a pandemic.”

The department of health services says 51.9 percent of Arizona’s eligible population has received a COVID-19 vaccination since shots became available in January. The state has reported 923,204 COVID-19 cases and 18,200 deaths since January 2020 (updated as of Thursday, July 29).

Ducey’s executive order stated that students could not “be mandated to take the COVID-19 vaccine or submit COVID-19 vaccination documents.” Under the order, students also cannot be required to be tested or wear masks to participate in learning.

Click here to read the full story. 

Deadly Delta variant is spreading rapidly in Arizona

By Jerod MacDonald-Evoy
Arizona Mirror

Although COVID-19 hospitalizations are down, genetic sequencing and a recent outbreak in Maricopa County has shown the highly transmissible Delta variant of the virus is beginning to take hold in the Grand Canyon state, making up more than one in every five infections in June and accelerating rapidly.

Arizona was among the early leaders in vaccination rates, but efforts to inoculate the state’s residents has plateaued since May. Now, with Arizona lagging the nation in vaccinations, the state is currently averaging approximately 500 new cases of COVID-19 a day, several times greater than more populated states like New York and Massachusetts, which are averaging between 80 to 130 cases per day. (This story was originally published on Friday, July 9.)

As of Thursday, July 29 the average daily cases toll for the past seven days is about 1,500 new cases a day, according to Arizona Department of Health Services. 

Among the cases of COVID that are appearing in the state is a new variant of the virus known as B.1.617.2, also known as the Delta variant, which is believed to have originated in India. 

Genetic sequencing data done by Arizona-based TGen shows that the Delta variant made up about 3 percent of the Arizona samples that were genetically sequenced in May. By the end of June, that number had shot up to 21 percent. 

The Delta variant is currently spreading across the nation, and has caused major spikes in cases in India and the United Kingdom. 

Click here to read the full story.

India's pandemic death toll could be in the millions

By Sheikh Saaliq and Krutika Pathi
Associated Press

India’s excess deaths during the pandemic could be a staggering 10 times the official COVID-19 toll, likely making it modern India’s worst human tragedy, according to the most comprehensive research yet on the ravages of the virus in the South Asian country.

Most experts believe India’s official toll of more than 414,000 dead is a vast undercount, but the government has dismissed those concerns as exaggerated and misleading.

The report released Tuesday, July 20 estimated excess deaths — the gap between those recorded and those that would have been expected — to be 3 million to 4.7 million between January 2020 and June 2021. It said an accurate figure may “prove elusive” but the true death toll “is likely to be an order of magnitude greater than the official count.”

The report was published by Arvind Subramanian, the Indian government’s former chief economic adviser, and two other researchers at the Center for Global Development, a nonprofit think tank based in Washington, and Harvard University.

It said the count could have missed deaths that occurred in overwhelmed hospitals or while health care was disrupted, particularly during the devastating virus surge earlier this year.

“True deaths are likely to be in the several millions not hundreds of thousands, making this arguably India’s worst human tragedy since Partition and independence,” the report said.

Click here to read the full story.

Coronavirus in the United States

Coronavirus in the United States: The latest map and case count can be found by clicking here.  

Click here to see reopening plans and mask mandates for all 50 states.

OPINION: It's time to require COVID vaccination in the workplace

By Lao-Tzu Allan-Blitz, MD and Jeffrey D. Klausner, MD, MPH 
MedPage Today

Ethics taught to medical students include the right of the individual to self-determine treatment and the role of the physician do whatever is necessary for the benefit of the individual patient in the absence of doing harm. Ethics taught to public health students include doing the greatest good for the most people while balancing the need for coercion or laws to promote public health.

As the COVID-19 pandemic has swept across the world, the practice of medicine and public health have sometimes come into conflict. Patients are isolated and hospitalized, separated from their loved ones at critical moments of sickness and death, subjugating the personal need for comfort and the ethical tenet of respect for persons with the community need to protect others and prevent the spread of infection. Similarly, autonomy gives way to public good in the collection and sharing of personal information among those infected with SARS-CoV-2 in order to notify persons potentially exposed and initiate quarantine.

The marriage between public health and medical practice, when the world is at equilibrium, is one of reciprocity, where public health policies support medical work, and advances in medical technologies and innovations provide new tools for public health activities. In equilibrium, the ethics of public health and medicine are complementary. But since the COVID-19 pandemic began, the world has not been at equilibrium. And the ethics of public health have to be understood as different from that of a medical doctor when treating a patient with COVID-19.

Given the status of the COVID-19 crisis — with continued spread and emerging variants — it's time to take the next critical step for public health: government-mandated vaccination in workplaces. A brief look back in history shows us this wouldn't be the first time society has needed to place public health above individual rights.

Click here to read the full opinion piece. 

The real toll from prison COVID cases may be higher than reported

By Maura Turcotte, Rachel Sherman, Rebecca Griesbach and Ann Hinga Klein
The New York Times

Richard Williamson, 86, was rushed from a Florida jail to a hospital last July. Within two weeks, he had died of COVID-19.

Hours after Cameron Melius, 26, was released from a Virginia jail in October, he was taken by ambulance to a hospital, where he died. The coronavirus, the authorities said, was a contributing factor.

And in New York City, Juan Cruz, 57, who fell ill with COVID-19 while in jail, was moved from a hospital’s jail ward into its regular unit before dying.

None of these deaths have been included in official COVID-19 mortality tolls of the jails where the men had been detained. And these cases are not unique. The New York Times identified dozens of people around the country who died under similar circumstances but were not included in official counts.

More than 2,700 people are reported to have died of COVID-19 in connection to U.S. prisons, jails and immigration detention centers, but the additional cases raise the prospect that the known toll on incarcerated people falls far short of providing the full picture. (This story was originally published on Wednesday, July 7.)

Click here to read the full story.

This is a round up of COVID news,
which has occurred over the past couple of weeks. 

FDA attaches warning of rare nerve syndrome to Johnson & Johnson vaccine

The Food and Drug Administration warned on Monday, July 12 that Johnson & Johnson’s coronavirus vaccine can lead to an increased risk of a rare neurological condition known as Guillain–Barré syndrome, another setback for a vaccine that has largely been sidelined in the United States.

Although regulators have found that the chances of developing the condition are low, they appear to be three to five times higher among recipients of the Johnson & Johnson vaccine than among the general population in the United States, according to people familiar with the decision. The warning was attached to fact sheets about the vaccine for providers and patients.

Federal officials have identified 100 suspected cases of Guillain-Barré among recipients of Johnson & Johnson’s one-dose shot through a federal monitoring system that relies on patients and health care providers to report adverse effects of vaccines. Ninety-five percent of those cases were considered serious and required hospitalization, the FDA said. The reports are preliminary.

Click here to read the full story.

~The New York Times~

The CDC must rethink its mask guidance, former U.S. Surgeon General says

With the highly contagious Delta variant fueling a rise in COVID-19 cases, Dr. Jerome Adams — the surgeon general under former President Donald Trump who once advised against mask-wearing — now says even the vaccinated may need to mask up. (This story was originally published on Tuesday, July 20 before the CDC reversed course on indoor masks in some part of U.S. on Tuesday, July 27. Click here to read story above.)

Dr. Adams is part of a growing chorus of criticism of the CDC guidance, issued in May, that people who are fully vaccinated can resume activities indoors and outdoors without masks. The messaging, Dr. Adams told NPR's Morning Edition, "has just absolutely, unequivocally failed."

"More people than ever — vaccinated and unvaccinated — are going maskless," he said. "It doesn't seem to have convinced anyone to get vaccinated."

Dr. Adams said the CDC needs to change guidance on masking requirements again in light of new virus outbreaks and the more contagious Delta variant.

Click here to read the full story.

~NPR~

Citing new data, Pfizer outlines case for booster shots

Pfizer reported on Wednesday, July 28 that the power of its two-dose COVID vaccine wanes slightly over time, but nonetheless offers lasting and robust protection against serious disease. The company suggested that a third shot could improve immunity, but whether boosters will be widely needed is far from settled, the subject of heated debate among scientists.

So far, federal health officials have said boosters for the general population are unnecessary. And experts questioned whether vaccinated people should get more doses when so many people have yet to be immunized at all.

“There’s not enough evidence right now to support that that is somehow the best use of resources,” said Natalie Dean, PhD, a biostatistician at Emory University in Atlanta.

Still, the findings raise questions about how well the Pfizer vaccine will prevent infection in the months to come. And with coronavirus cases surging again in many states, the data may influence the Biden administration’s deliberations about delivering boosters for older people.

Click here to read the full story.

~The New York Times~

Delta variant widens gulf between 'Two Americas':
vaccinated and unvaccinated

By Apoorva Mandavilli and Benjamin Mueller
The New York Times

Even as many Americans celebrate the apparent waning of the pandemic, the thrum of concern over the so-called Delta variant grows steadily louder.

The variant, the most contagious version yet of the coronavirus, accounts for more than half of new infections in the United States, federal health officials reported this month. The spread of the variant has prompted a vigorous new vaccination push from the Biden administration, and federal officials are planning to send medical teams to communities facing outbreaks that now seem inevitable. (This story was originally published on Wednesday, July 14.)

Infections, hospitalizations and deaths are rising swiftly in some states with low vaccination rates like Arkansas, Missouri, Texas and Nevada, and are beginning to show small upticks in all of the others. The curves have also begun shifting upward in New York City, and the percentage of positive tests in the city has doubled in the past few weeks to just over 1 percent.

Nationwide, the numbers remain at some of the lowest levels since the beginning of the pandemic, but are once again slowly trending upward, prompting a debate about when booster shots might be needed to protect Americans.

The virus has also set off large outbreaks across the globe, from Japan and Australia to Indonesia and South Africa, forcing many countries to reimpose stringent restrictions on social activity. Even in places like Britain, where wide swaths of the population are immunized, the Delta variant has outpaced vaccination efforts, pushing the goal of herd immunity further out of reach and postponing an end to the pandemic.

If Britain’s experience is a harbinger of what’s to come, the overall number of infections may rise as the Delta variant spreads through the United States. But hospitalizations and deaths are likely to be much lower than they were following the arrival of previous variants, because the average age of those infected has shifted downward and young people tend to have mild symptoms.

As important, vaccines are effective against the Delta variant and already provide a bulwark against its spread.

“I think the United States has vaccinated itself out of a national coordinated surge, even though we do expect cases pretty much everywhere,” said Dr. Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health.

“Delta is creating a huge amount of noise, but I don’t think that it’s right to be ringing a huge alarm bell.”

Still, there are likely to be isolated outbreaks in pockets of low vaccination, he and other scientists predicted. The reason is simple: The pattern of the protection against the coronavirus in the United States is wildly uneven.

Click here to read the full story.

At FDA's urging, Pfizer and Moderna are expanding
their studies of children 5 to 11

By Sheryl Gay Stolberg, Sharon LaFraniere and Noah Weiland
The New York Times

At the urging of federal regulators, two coronavirus vaccine makers are expanding the size of their studies in children ages 5 to 11 — a precautionary measure designed to detect rare side effects including heart inflammation problems that turned up in vaccinated people younger than 30.

Appearing at a televised town-hall-style meeting in Ohio on Wednesday, July 21, President Biden said that emergency clearance for pediatric vaccines would come “soon.” The White House has declined to be more specific on the timeline, and it was unclear whether expanding the studies will have any impact on when vaccines could be authorized for children.

Multiple people familiar with the trials said the Food and Drug Administration has indicated to Pfizer-BioNTech and Moderna that the size and scope of their pediatric studies, as initially envisioned, were inadequate to detect the rare side effects, including myocarditis, an inflammation of the heart muscle, and pericarditis, inflammation of the lining around the heart. Members of a CDC advisory committee have said that the benefits of shots for people older than 12 greatly outweigh the risks, including of heart problems.

The FDA has asked the companies to include 3,000 children in the 5-to-11 year old age group, the group for whom results were expected first, according to people familiar with the situation. One of the people, granted anonymity to speak freely, described that as double the original number of study participants envisioned.

Click here to read the full story.

Medical groups back vaccine mandates for health care workers

By Molly Walker
MedPage Today

Medical groups' calls for COVID-19 vaccination mandates for health care workers reached a fever pitch on Monday, July 26 with the American Medical Association (AMA), American Nurses Association and 55 other organizations joining the chorus supporting mandatory vaccination.

"It is critical that all people in the health care workforce get vaccinated against COVID-19 for the safety of our patients and our colleagues," said Susan R. Bailey, MD, immediate past president of the AMA, in a statement. "Increased vaccinations among health care personnel will not only reduce the spread of COVID-19 but also reduce the harmful toll this virus is taking within the health care workforce and those we are striving to serve."

The joint statement was unequivocal: "We call for all health care and long-term care employers to require their employees to be vaccinated against COVID-19," it said in a single paragraph in bold and italicized font.

"Unfortunately, many health care and long-term personnel remain unvaccinated," the statement said, describing COVID-19 vaccination as an "ethical commitment of all health care workers to put patients as well as residents of long-term care facilities first and take all steps necessary to ensure their health and well-being."

Click here to read the full story.

Vaccine persuasion:
Many vaccine skeptics have changed their minds

By David Leonhardt
The New York Times

When the Kaiser Family Foundation conducted a poll at the start of the year and asked American adults whether they planned to get vaccinated, 23 percent said no.

But a significant portion of that group — about one quarter of it — has since decided to receive a shot. The Kaiser pollsters recently followed up and asked these converts what led them to change their minds. The answers are important, because they offer insight into how the millions of still unvaccinated Americans might be persuaded to get shots, too.

First, a little background: Recently, it seemed plausible that COVID-19 might be in permanent retreat, at least in communities with high vaccination rates. But the Delta variant has changed the situation. The number of cases is rising in all 50 states. (This story was originally published on July 19.)

Click here to read the full story.

KFF COVID-19 Vaccine Monitor

The KFF COVID-19 Vaccine Monitor is an ongoing research project tracking the public’s attitudes and experiences with COVID-19 vaccinations. Using a combination of surveys and qualitative research, this project tracks the dynamic nature of public opinion as vaccine development and distribution unfold, including vaccine confidence and hesitancy, trusted messengers and messages, as well as the public’s experiences with vaccination.

At the beginning of 2021 as vaccine distribution began in the U.S., KFF conducted interviews with a nationally representative sample of adults using open-ended questions to better understand public concerns around receiving a COVID-19 vaccine. Six months later, they contacted these individuals again to find out whether they chose to receive a COVID-19 vaccine, their reasoning behind their decisions and how they are feeling about their choice.

Click here to read more.

Standing vaccination PODs

The county has expanded COVID-19 vaccine eligibility to those 12 and older. (Pfizer is for ages 12 and older. Moderna and Johnson & Johnson are for those 18 and older.) 

While there are no more restrictions on eligibility other than age, only the Pfizer vaccine has been approved for 12 and older. Click here to access information on vaccination centers and mobile clinics. 

Those younger than 18 who are getting vaccinated need a parent or legal guardian with them to complete the consent forms. The only exception is if an accompanying adult brings a notarized letter stating that the parent allows the accompanying adult to complete the consent forms.

Pima County 'strongly recommends' indoor mask wearing

Pima County is changing its COVID-19 guidance to “strongly recommend” mask-wearing in indoor settings regardless of vaccination status amid new CDC guidance, Dr. Theresa Cullen, Director of the county health department, announced Wednesday, July 28.

The CDC changed its masking guidance Tuesday, July 27 as cases of the highly contagious Delta variant rise throughout the United States. The new recommendation is for fully vaccinated people to wear masks indoors in areas with moderate or substantial COVID-19 transmission, including Pima County.

The federal health agency said in May that fully vaccinated individuals no longer had to wear masks in most settings, causing both Pima County and the City of Tucson to rescind their mask mandates. Now, with cases of the Delta variant rising in the county, the health department is recommending everyone resume wearing masks indoors.

The health department released an updated public health advisory on Thursday, July 29, but Dr. Cullen said the mask mandate won’t be reinstated at this time.

About 52 percent of Pima County’s population has been fully vaccinated, according to CDC data, but Dr. Cullen says this is "not where we need to be."

Click here to read the full story. 

2 vaccinated people in Pima County have died of COVID-19

Two fully vaccinated people have died from COVID-19 in Pima County, according to the county’s health department. (This story was originally published on Saturday, July 10.)

This is an extremely small number compared to the number of fully vaccinated people countywide. The percentage of fully vaccinated people who have died from COVID-19 is about 0.00037 percent.

Local health experts are not alarmed at these two deaths and reiterate that vaccinations still provide an extremely high level of protection against COVID-19 hospitalizations and deaths.

“At the individual level it’s a tragedy because someone took the effort to protect themselves and it failed,” said Dr. Joe Gerald, an associate professor with the University of Arizona’s College of Public Health. “But at the population level it doesn’t represent a threat because these numbers are so small.”

The two vaccinated people who died from COVID-19 were considered high-risk, meaning they were 65 years or older, or had a chronic medical condition, such as diabetes, heart disease or chronic kidney disease.

About 550,115 people have been fully vaccinated in Pima County, according to data from the Centers for Disease Control and Prevention, as of Thursday, July 29.

The odds a fully vaccinated person has had of dying from COVID-19 in Pima County is similar to other small daily risks, like getting struck by lightning.

For comparison, there’s about a 1-in-500,000 chance of getting struck by lightning in a year, according to the CDC.

In total, the county is aware of 401 fully vaccinated people who contracted COVID-19, which are often called breakthrough cases. This is about 0.075 percent of the fully vaccinated population in Pima County.

And 16 fully vaccinated people have been hospitalized with COVID-19 countywide. This is about 0.0029 percent of the fully vaccinated population.

County health officials currently don’t know which variants infected the two vaccinated people who died of COVID-19.

Few breakthrough cases have been Delta cases. It takes a while for officials to get genetic sequencing results that identify variants, so it may be a couple of weeks before we know if the Delta variant is common among breakthrough cases in Pima County.

Meanwhile the Delta variant has become the dominant variant in the U.S., according to estimates from the CDC. And it will likely soon establish dominance in Arizona.

County health officials only know which variants caused two of the hospitalized breakthrough cases. One of these was an Alpha case, a variant that originated in the United Kingdom. The other variant was not on the CDC’s list of variants of concern.

Click here to read the full story.

Ducey threatens school districts over COVID protocols

Lawyers representing Catalina Foothills School District and Peoria Unified School District recently responded to a letter from Gov. Doug Ducey’s office that called their quarantine protocol “unlawful.”

In a July 14 letter, Kaitlin Harrier, education policy adviser for Gov. Ducey, told CFSD Superintendent Mary Kamerzell that the school’s isolation policy violated an Arizona statute, particularly the section on face coverings, signed by Gov. Ducey on June 30.

“Specifically, the practice of instituting a mandatory 14-day quarantine for unvaccinated students who have a COVID-19 exposure, but exempting vaccinated students, is contrary to Laws 2021, Chapter 404, Sec. 12, which states, “A school district or charter school may not require a student or teacher to receive a vaccine for COVID-19 or to wear a face covering to participate in in-person instruction,” Harrier wrote in her letter.

A similar letter was sent to the Peoria Unified School District. 

Harrier stated, under the Arizona Parents Bill of Rights, parents have the right to make health care decisions for their minor child, including vaccinations, and added that the policy would have detrimental effects on a child’s education, with students unable to meet attendance requirements to advance to the next grade level.

“This policy will lead to entire classrooms of students under 12 being kept at home for nearly two weeks at a time and potentially on multiple occasions with no way to make up for that lost learning time,” Harrier wrote. 

In a letter responding to Ducey’s office, John Richardson of the DeConcini, McDonald, Yetwin and Lacy law firm said the statutes referenced in Harrier’s letter do not apply to the school districts’ COVID-19 isolation policies, nor do they restrict districts from following guidance from federal, state and local public health authorities. 

“Parents and other community members have a right to expect that their local school district will do what it reasonably can to provide a safe educational environment for its students, and CFSD and PUSD are committed to providing such an environment,” wrote Richardson. “Students who are required to quarantine based on exposure to COVID-19 are not abandoned. Both school districts provide instruction and assistance to such students during their temporary absence from school.”

The dust-up between Ducey and the school districts comes as the Delta variant spreads across Arizona and COVID cases have begun a troubling rise across the state.

Click here to read the full story.

Masks will be 'optional' at TUSD in the fall

By Paul Ingram
TucsonSentinel.com

Masks will be optional in the Tucson Unified School District this fall, following a bill passed in June by GOP legislators blocking Arizona schools from requiring face coverings as a way to mitigate COVID-19 infections. The bill also bars schools from requiring vaccinations against coronavirus.

But officials will "highly recommend" that masks be worn. The number of new reported COVID-19 infections in Arizona over the past three days is nearly twice the rate of new cases of a month ago, state data shows, with the more infectious Delta variant spreading throughout the state.

In an e-mail to parents and staff sent Wednesday, July 14, TUSD's Superintendent Gabriel Trujillo quoted Arizona's HB 2898, which went into effect on July 1. 

The bill, Trujillo wrote "prohibits counties, cities, towns, schools and school districts from requiring students or staff to wear a face-covering during school hours and on school property." The bill also restricts schools from requiring vaccinations against COVID-19 for students and staff, and would fine school districts and charter schools if they tried to enforce mandates. 

"While this decision means students and staff no longer are required to wear a mask in Tucson Unified School District, our district along with federal, state and local health officials highly recommend a mask be worn by anyone who is not vaccinated," wrote Trujillo. "Thus, masks are optional." 

HB 2898 was one of a stack of bills signed by Arizona Gov. Doug Ducey at the tail end of the state's legislative session. In a news release touting several bills signed into law, Ducey said that the new law "requires district schools to maintain open enrollment processes that are truly open and fair so all Arizona families can easily access the school that best fits their learning needs — with minimal paperwork or hoops to jump through." 

"Educational freedom is essential," said Ducey. "In Arizona, parents are in the driver’s seat when it comes to choosing the best education for their child — not the government." 

"This legislation also prevents schools from requiring student and staff vaccinations, and makes it clear that wearing a face covering at school is an individual choice — not a mandate," Ducey said. Ducey also signed a similar bill, SB 1825, that keeps public colleges and universities from establishing their own mandates. 

Click here to read the full story.

Updated CDC schools guidance prioritizes in-person learning, even if all COVID-19 safety measure aren't in place

By Lauren Mascarenhas
CNN

The U.S. Centers for Disease Control and Prevention on Friday, July 9 updated its COVID-19 schools guidance to emphasize in-person schooling is a priority in the fall, regardless of whether all mitigation measures can be implemented.

As K-12 schools will have a mix of vaccinated and unvaccinated people, the agency says it's still necessary to layer strategies such as masking and physical distancing, and most importantly, vaccinations for everyone eligible — people age 12 and older.

Click here to read the full story.

Researchers find evidence of coronavirus epidemic 20,000 years ago

AZ HEROES research study awarded $15 million to continue, expand

University of Arizona Health Sciences

A University of Arizona Health Sciences study of COVID-19 vaccine effectiveness and immunity among front-line workers has received a $15 million award from the Centers for Disease Control and Prevention to continue the current research for another year and expand to include children and focus on underserved populations.

"This phase of the AZ HEROES study will build on what we have already learned, expand our knowledge of vaccine effectiveness as more youth receive the vaccine and provide vital knowledge as new COVID-19 variants with increased transmissibility expand globally,” said Dr. Jeff Burgess, a PCMS member who leads AZ HEROES and is the associate dean for research and a professor at the Mel and Enid Zuckerman College of Public Health.

AZ HEROES – the Arizona Healthcare, Emergency Response, and Other Essential Workers Surveillance study – is expanding participation to include children ages 4 months to 17 years and increasing its focus on underserved populations. The study initially sought to evaluate incidence of COVID-19 infection, reinfection and immunity among health care personnel, first responders and other essential workers.

Recent findings published in the New England Journal of Medicine showed that individuals who contract COVID-19 even after vaccination are likely to have a lower viral load, experience a shorter infection time and have milder symptoms than people who are unvaccinated.

Over the next year, researchers will continue to evaluate vaccine effectiveness, including different vaccine types and adherence to recommended vaccine doses and timing. They will also assess the duration of vaccine protection, the degree to which the vaccines prevent more severe illness in those cases when vaccinated individuals do become infected and the degree to which prior infection impacts vaccine effectiveness.

Click here to read the full story.

Information in Spanish

The University of Arizona Hispanic Center of Excellence is providing information and resources on COVID-19 in Spanish, including fliers to be distributed within communities. 

Click here for more information.