COVID-19 Impact: -The Roundup - This meeting will be recorded and will be available at www.fmda.org/journalclub.php
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COVID-19 Impact:
-The Roundup
This meeting will be recorded and will be available at www.fmda.org/journalclub.php
FMDA Journal Club April 14, 2021 Diane Sanders-Cepeda, DO, CMD – Presenter
• State of the State
• Clinical Updates – Vaccinations & Variants
Agenda • Research updates
• Open Discussion
US 7 Day trend - ICU Capacity
US 7 Day trend – Inpatient capacity
• As of 4/12 positivity rate – 8.16%
• As of 4/12 new cases – 9,130
Florida Trends • Positivity rates amongst LTC residents – 0.22%
• Positivity rates amongst LTC staff - 0/19%
Florida 7 Day Trend – Inpatient Capacity
Florida 7 Day Trend – ICU Capacity
Vaccination Updates
COVID Vaccinations
Pfizer/BionNtech Moderana Johnson & Johnson Oxford/AstraZeneca Novavax
BNT162b1 RNA-based mRNA-1237 Ad26.COV2-S AZD1222 NVX-CoV2373
Type mRNA mRNA Adenovirus-based Adenovirus-based Protein-based
vaccine
Dose(s) 2 doses, 21 days apart 2 doses, 28 days Single dose and 2 doses (57 days 2 doses, 28 days apart 2 doses; 21 days
apart apart) are being studied apart
EUA Approved Approved Approved Not approved Not approved
Efficiacy 95% 95% 66% at preventing mod to severe 70% 89.3%
COVID; 85% overall vaccine efficacy –
in preventing severe disease Single
dose
Availability Approved in the US Dec 2020 Approved in the Approved in the US – Feb 2021 Pending approval in US; Feb. or March 2021
US Dec 2020 Authorized in Europe, and in in UK
other countries – **distribution Q1/Q2 in the US
on hold in several countriesCerebral Venous Sinus
Thrombosis In combination with
Thrombocytopenia
6 cases in women,
ages 18 – 48
Symptoms occurred 6
to 13 days post
vaccinationThe n e w e ng l a n d j o u r na l of m e dic i n e
Original Article
Thrombotic Thrombocytopenia
after ChAdOx1 nCov-19 Vaccination
Andreas Greinacher, M.D., Thomas Thiele, M.D., Theodore E. Warkentin, M.D.,
Karin Weisser, Ph.D., Paul A. Kyrle, M.D., and Sabine Eichinger, M.D.
A BS T R AC T
BACKGROUND
Several cases of unusual thrombotic events and thrombocytopenia have developed From Institut für ImWhat is the Impact on Vaccine
Confidence?The n e w e ng l a n d j o u r na l of m e dic i n e
Medicine a nd So cie t y
Debra Malina, Ph.D., Editor
Escaping Catch-22 — Overcoming Covid Vaccine Hesitancy
Lisa Rosenbaum, M.D.
On September 8, 2020, AstraZeneca announced reluctant.1 The behavioral obstacles to wide-
that it was pausing its late-phase SARS-CoV-2 spread vaccination are thus as important to
vaccine trial because of a serious adverse event understand as the scientific and logistic hurdles.
in a U.K. participant. The next day, my hair- Accordingly, since September, I have beenThe n e w e ng l a n d j o u r na l of m e dic i n e
C or r e sp ondence
Antibody Persistence through 6 Months after the
Second Dose of mRNA-1273 Vaccine for Covid-19
To the Editor: Interim results from a phase 3 (95% CI, 46 to 58) calculated with the use of an
trial of the Moderna mRNA-1273 severe acute exponential decay model, which assumes a steady
respiratory syndrome coronavirus 2 (SARS-CoV-2) decay rate over time, and 109 days (95% CI, 92 to
vaccine indicated 94% efficacy in preventing 136) calculated with the use of a power-law model
coronavirus disease 2019 (Covid-19).1 The dura- (at day 119), which assumes that decay rates de-COVID VARIANTS
Variants of Concern
Variants of Interest
Florida COVID Variant Proportions UK variant - B.1.1.7 = 52.5% South Africa B.1.351 = 0.3% US California variants B.1.427/B.1.429 = 7.5% Brazil/Japan P.1 = 2.4% All other lineages = 37.6%
Research Letter | Infectious Diseases
Genome Analysis for Sequence Variants in SARS-CoV-2 Among Asymptomatic
Individuals in a Long-term Care Facility
Baha Abdalhamid, MD, PhD; Peter C. Iwen, PhD; Michael R. Wiley, PhD; Catherine B. Pratt, MS; Steven H. Hinrichs, MD
Introduction Author affiliations and article information are
listed at the end of this article.
Studies have suggested that sequence variants in the genome of SARS-CoV-2 may affect infectivity,
transmission, and pathogenicity of the virus.1-3 In this study, genome analysis was performed on
SARS-CoV-2 RNA recovered from 7 individuals in a long-term care facility who were asymptomatic atAll 7
NE-007-17 17.2 17.72 EPI_ISL_732826 20C
Nex
Figure. Sequence Alignment Between the 7 SARS-CoV-2 Strains and Wuhan Strain With Amino Acid Changes
Nonstructural Structural
ORF1a ORF1b S EM N
5’ UTR 3’ UTR
3a/b 6-8 9b 9c 10
Accessory
854 57
265 3606 314 614 900 223 39 36
Wuhan-Hu-1 (NC045512) T L P D K M Q T Q N
USA/NE-001-17/2020
USA/NE-002-17/2020
USA/NE-003-17/2020
USA/NE-004-17/2020
USA/NE-005-17/2020
USA/NE-006-17/2020
USA/NE-007-17/2020
I F L G N I H I L Y
Spike N
ORF3a ORF9b
Open Access. This is an open access article distributed under the terms of the CC-BY License.The n e w e ng l a n d j o u r na l of m e dic i n e
C or r e sp ondence
Neutralization of SARS-CoV-2 Variants B.1.429 and B.1.351
To the Editor: The severe acute respiratory E484K, N501Y, and A701V). Neutralization assays
syndrome coronavirus 2 (SARS-CoV-2) variant were performed with the use of a validated len-
B.1.429 (also called CAL.20C or 452R.V1), first tivirus-based spike-pseudotyped virus assay in
identified in California,1 is spreading rapidly in 293T cells that were stably transduced to over-
the United States and has been found in at least express angiotensin-converting enzyme 2.4 The
25 other countries (see updates at https://www variant B.1.429 was neutralized by convalescentThe n e w e ng l a n d j o u r na l of m e dic i n e
C or r e sp ondence
Neutralizing Response against Variants
after SARS-CoV-2 Infection and One Dose of BNT162b2
To the Editor: The BNT162b2 vaccine was however, administration of a single dose is now
shown to have 95% efficacy against coronavirus being considered.
disease 2019 (Covid-19).1 To date, the two-dose In addition to the original virus first identi-
vaccine protocol has not been approved in Israel fied in Wuhan, China, SARS-CoV-2 variants firstfor persons previously infected with severe acute identified in the United Kingdom (B.1.1.7), South
respiratory syndrome coronavirus 2 (SARS-CoV-2); Africa (B.1.351), and Brazil (P.1) have been de-
Patients: 1 2 3 4 5 6
A Original Virus B B.1.1.7 Variant
9195 8192
16,384 16,384
456.1
4096 4096
Neutralizing Antibody
Neutralizing Antibody
256.0
1024 1024
80.63
Titer (Log2)
Titer (Log2)
256 256 40.32
64 64
16 16
4 4
1 1
After Before After After Before After
Infection Vaccination Vaccination Infection Vaccination Vaccination
C B.1.351 Variant D P.1 Variant
2896
16,384 16,384
1625
4096 4096
Neutralizing Antibody
Neutralizing Antibody
1024 1024 71.46
Titer (Log2)
Titer (Log2)
256 256
35.92
64 8.00 64
7.127
16 16
4 4
1 1
After Before After After Before After
Infection Vaccination Vaccination Infection Vaccination Vaccination
Figure 1. Neutralizing Response against the Original Virus and Variants after SARS-CoV-2 Infection and One Dose
of the BNT162b2 Vaccine.
Serum samples from six patients previously infected with severe acute respiratory syndrome coronavirus 2 (SARS-Revisiting Monoclonal Antibody Treatment….
Research Updates
JAMDA xxx (2021) 1e6
JAMDA
journal homepage: www.jamda.com
Original Study - Brief Report
Characteristics of Nursing Homes by COVID-19 Cases among Staff:
March to August 2020
Kira L. Ryskina MD, MSHP a, b, Hyunkyung Yun MSW c, Hannah Wang BS a,
Angela T. Chen MA b, d, Hye-Young Jung PhD c, *
a
Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA
b
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
c
Department of Population Health Sciences, Weill Cornell Medical College, Cornell University, New York, NY, USA
d
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
a b s t r a c tLooking Beyond COVID… Reimaging PALTC Environment
Open Discussion
400 Executive Center Drive, Suite 208
West Palm Beach, FL 33401
www.fmda.org; www.bestcarepractices.org
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