COVID-19 Alaska Clinical Update: Friday, March 26, 2021

COVID-19 Alaska Weekly Update

COVID-19 Alaska Clinical Update
Friday, March 26, 2021

COVID-19 Alaska Weekly Update

Alaska vaccinations

As of March 24, 235,412 Alaskans (over 40% of the population 16 years and older) have received at least one dose of vaccine and 157,816 Alaskans have received both doses of vaccine.

Vaccine news

  • People who are fully vaccinated may refrain from quarantine and testing following a known exposure, as long as they are asymptomatic, new CDC guidelines say. They also recommend that fully vaccinated people may socialize without masks or distancing indoors but should continue masking and distancing in public.
  • Alaskans age 16 and older as well as nonresidents working or living in Alaska are now eligible for vaccination.

Vaccine hesitancy

  • Vaccine hesitancy is a constant and growing problem but there are specific tools available to help healthcare providers communicate with their patients about getting vaccinated. In addition to resources from the CDC, a recent NEJM article explored multiple marketing strategies that may be helpful combatting vaccine hesitancy.
  • Healthcare providers play a key role in building public confidence in the COVID-19 vaccine. In addition to their roles as health advisers, protectors, and advocates, healthcare personnel were the first group offered COVID-19 vaccinations. Health workers are a trusted voice that can have a powerful influence on their families and communities when it comes to getting the COVID-19 vaccine.

Here are the CDC’s Six Ways to Help Build COVID-19 Vaccine Confidence:

  • Encourage leaders in your family, community, or organizations to be vaccine champions.
  • Have discussions about COVID-19 vaccines where people can openly discuss their views and ask questions.
  • Share key messages through multiple channels that people trust and that promote action.
  • Help educate people about COVID-19 vaccines, how they are developed and monitored for safety, and how individuals can talk to others about the vaccines.
  • Learn more about finding credible vaccine information. When you come across COVID-19 information, cross-check with CDC.gov and learn how to respond to misinformation you encounter.
  • When vaccine is offered to you, make visible your decision to get vaccinated and celebrate it!

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COVID-19 Alaska Weekly Update

Monoclonal Antibody Update

  • The available SARS CoV-2 Monoclonal antibody products have been found to have varying effectiveness to current variants of concern.  Bamlinivimab alone is unlikely effective against B.1.351 (S Africa), P.1 (Brazil), B.1.427/B.1.429 (CA), and B.1.526 (NY).  Given this resistance Eli Lilly has stopped the distribution bamlanivimab alone, etesevimab is available to pair with existing bamlanivimab doses as well the bamlanivimab/etesevimab combined packaging. The manufacturers have updated their package insert with the addition of a section on viral susceptibility. 
  • Modeling predicts Regeneron (casirivimab/indevimab) is maintaining is original activity against B.1.1.7, B.1.351, P.1, B.1.427/B.1.429, and B.1.526

COVID-19 Alaska Weekly Update

  • Modeling predicts Lilly (bamlanivimab) is maintaining is original activity against B.1.1.7.  However is unlikely to be effective against B.1.351, P.1, B.1.427/B.1.429, and B.1.526

COVID-19 Alaska Weekly Update

  • Modeling predicts Lilly (bamlanivimab/etesevimab) is maintaining is original activity against B.1.1.7, B.1.427/B.1.429, and B.1.526.  However, is unlikely to be effective against B.1.351 and P.1.

COVID-19 Alaska Weekly Update

Updates to EUA for MABs

Variant Tracking

  • The CDC added two new variants – B.1.427 and B.1.429 - to the list of Variants of Concern. A preprint, not yet peer reviewed serum study raises concern that both have approximately 20% increased transmissibility, are significantly less responsive to some of the monoclonal antibody therapies, and are moderately less responsive to convalescent and post-vaccination sera.
  • No new variants of concern were found this past week, however cases of B.1.1.7, P.1, and B.1.429 have all been identified in Alaska since December 2020.

COVID-19 Alaska Weekly Update

COVID-19 science news

  • The CDC updated school reopening guidelines to reflect new physical distancing guidelines calling for at least 3 feet between masked students. This came after publication of an observational study from Massachusetts that found no significant difference in K-12 student and staff COVID case rates in school districts that implemented ≥3 feet versus ≥6 feet of physical distancing between students.
  • Four MMWRs were published that all confirm the infection risk of in-person K-12 schools is less than the risk of community transmission so long as they use universal masking, social distancing, and increased ventilation – Link 1, Link 2, Link 3, Link 4
  • A preprint, not yet peer reviewed observational study of COVID vaccination in 66 patients with Long COVID found that those who received the vaccine reported a statistically significant overall improvement in Long COVID symptoms.
  • An MMWR found partial vaccination of SNF residents with Pfizer’s mRNA vaccine (one dose of vaccine or less than fourteen days after second vaccine) was 63% effective at preventing COVID infection.

Vaccine status

  • All Alaskans and people who work in Alaska are now eligible for vaccination. Appointments can be made at covidvax.alaska.gov. More appointments are added on a continuous basis, with many new appointments added each Thursday. Alaskans aged 18 and up are eligible for any of the available COVID-19 vaccines, while Alaskans aged 16 and 17 are eligible for the Pfizer mRNA vaccine, which is authorized for use in age 16 and older.
  • Alaska remains the most vaccinated state per capita; follow the DHSS dashboard here.
  • VSAFE: to use the free national reminder and safety test messaging system, anyone can text ENROLL to 1-833-VAX-TEXT when they get their vaccine and get text reminders about the second dose as well as texts asking about any side effects. Vaccine recipients can also go to the website provided on the information they get at the time of vaccination.

AK Clinical Reminders

COVID-19 testing guidelines and test site locator
Report any positive test to the state Section of Epidemiology using the COVID Reporting Hotline at 1-877-469-8067 or by faxing in the Infectious Disease report form. If you suspect COVID-19 in an outpatient who cannot isolate in their own home (for example they are unsheltered or from out of town) or for another urgent situation call SOE at 907-269-8000 or 800-478-0084 (after-hours).

Join us for the ECHO series for more information and discussion:
Use the links below to register beforehand for the online meeting
COVID-19 for Alaska Healthcare Providers: Every other Tuesday, 7-8:30PM
Science ECHO for the general public: Wednesdays, 12-1PM
Healthcare Specific COVID-19 Situational Awareness: Thursdays, 12-1PM
School Health ECHO: Mondays 3-4PM
Alaska Perinatal ECHO: Thursday, 6-7PM
Palliative Care in COVID-19 ECHO: Wednesday, 12-1PM
EMS ECHO: 2nd & 4th Friday, 10-11AM
Vaccine ECHO:Thursday, 2-3 PM
AK COVID-19 clinical hotline for physicians: 833-751-4212. Staffed 24/7.
8PM-8AM is for urgent/emergent questions only.
AK Responders Relief Line: 24/7 behavioral health for everyone working in healthcare
during the COVID-19 pandemic: 1-844-985-8275