Week CXXIII: Vaccines evolve to cope with highly transmissible new variants

— Graph from NYS Comptroller’s Office

Economic toll of the pandemic: One in eight residential customers had unpaid utility bills as of March 2022, according to a report by State Comptroller Thomas DiNapoli.

ALBANY COUNTY — Governor Kathy Hochul has extended the state’s disaster emergency until Aug. 13, citing new COVID-19 hospital admissions remaining at over 100 a day.

The pandemic’s economic effects continue to be felt as the state comptroller issued a report showing one in eight residential customers have unpaid utility bills.

Also this week, Hochul announced $234 million more in food assistance for July.

The governor’s office announced, on July 13 and on July 19, the COVID-related deaths of two more Albany County residents, which would bring the county’s death toll to 572 although the county’s website on July 19 still listed 571 deaths.

This week, the Centers for Disease Control and Prevention continue to label Albany County — along with 16 other New York counties — as having a “medium” community level of COVID-19. Long Island and the counties in and around New York City are now labeled “high” while the rest of the state — unlike many places nationwide — is still designated “low.”

Fewer than a quarter of the counties in the United States are designated by the CDC as having a “low” community level of COVID-19.

Currently, according to the state’s dashboard, Albany County has 20.4 cases per 100,000 of population as a seven-day average while statewide that number is 35.43. However, there is no longer a government system to track cases and many people who test at home for COVID-19 don’t report positive results while many others don’t test at all.

Wastewater analysis for Albany County shows conflicting trends.

Scientific studies have demonstrated that the genetic material of the virus causing the disease can be detected in the feces of up to 40 percent of people who are infected. So wastewater is tracked to predict COVID trends.

The state website reporting wastewater metrics said on Tuesday that the most recent samples, taken on July 11, show a “decreasing” trend for the county’s South Plant and an “increasing” trend for the county’s North Plant.

At Albany County’s North Plant, which serves an estimated 109,426 people, there has been a 17-percent increase over two weeks, the site says. At the county’s South Plant, which serves an estimated 80,922 people, there has been a 2-percent decrease over the same two weeks.

Both sites are labeled as having “substantial to high levels.” The county has a population of about 317,000.

Wastewater samples collected and analyzed on April 4 in Albany had shown a 32 percent spike in COVID-19 intensity over a two-week period, which presaged the surge in COVID cases caused by Omicron subvariants.

The CDC reports that for Region 2 (New York and New Jersey as well as Puerto Rico and the Virgin Islands) the Omicron subvariant BA.5 now makes up 80 percent of the cases while BA.4 makes up 11 percent and the original BA.2.12.1 now makes up 9 percent of the new cases.


Evolving vaccines

Omicron subvariants BA.4 and BA.5 are four times more resistant to COVID-19 vaccines than was BA.2.12.1, meaning breakthrough infections are more likely, according to a new study.

“These novel subvariants carrying additional mutations in their spike proteins raise concerns that they may further evade neutralizing antibodies, thereby further compromising the efficacy of COVID-19 vaccines and therapeutic monoclonals,” say the researchers from Columbia University and the University of Hong Kong in the study published in Nature, not yet in its final form.

Vaccines, expected out in the fall, have been updated to target BA.4 and BA.5. 

Over a quarter of Albany County residents still have not completed a vaccine series, and just 62 percent of the eligible county population have gotten booster shots.

“Vaccines remain our single-most important tool to protect people against serious illness, hospitalizations, and death. And staying up to date is essential as we see BA.5 rise across the country,” said Ashish Jha, the COVID-19 Response Coordinator for the White House, at a July 12 press briefing.

He also recommended testing before attending a large, indoor gathering or visiting indoors with a high-risk immunocompromised person as well as wearing masks and improving ventilation.

“We are experiencing about 300 to 350 deaths a day. That is unacceptable. It’s too high,” he said.

At the same briefing, CDC Director Rochelle Walensky said, “We do not know yet about the clinical severity of BA.4 and BA.5 in comparison to our other Omicron subvariants, but we do know it to be more transmissible and more immune evading. People with prior infection, even with BA.1 or BA.2, are likely still at risk for BA.4 or BA.5.”

Before the onslaught of the original Omicron variant, only about a third of United States residents had had COVID-19 but afterwards, almost 60 percent had.

At the July 12 briefing, Anthony Fauci said of BA.5, “It substantially evades neutralizing antibodies induced in people by vaccination and infection.” But he also said, “It doesn’t appear to be associated with greater disease severity or hospitalizations compared to the most recent subvariants.”

“We have put in one order so far with Pfizer for 105 million doses,” said Jha of the bivalent vaccine that would help combat BA.4 and BA.5. “Obviously, that will not be enough for all Americans. We are continuing to think about other orders, talking to other companies. But that order has been placed to get the next generation of bivalent vaccines, as directed by FDA.”

At the same time, the FDA on July 13 issued an emergency use authorization for another vaccine for COVID-19, this one developed by Novavax.

The Novavax vaccine was assessed in an ongoing randomized, blinded, placebo-controlled study conducted in the United States and Mexico, the FDA said. About 17,200 people received the vaccine and approximately 8,300 people received saline placebo.

Overall, the vaccine was 90.4 percent effective in preventing mild, moderate, or severe COVID-19, with 17 cases of COVID-19 occurring in the vaccine group and 79 cases in the placebo group.

The Novavax vaccine is a more traditional vaccine unlike the messenger RNA vaccines developed by Moderna and PfizerBioNTech.

“The Novavax vaccine contains a very small amount of the SARS-CoV-2 spike protein, which elicits an immune response, in combination with an adjuvant, which boosts the immune system response to vaccine,” according to a release from the federal Department of Health and Human Services. “FDA-approved protein-based vaccines have been used widely for decades,” it says, such as for shingles and Hepatitis B.

“While more than two-thirds of the American public are already fully vaccinated,” said Jason Roos in the release, “we must maintain a sense of urgency to ensure all eligible individuals get vaccinated, particularly heading into the fall. This latest vaccine would offer people another choice to help protect themselves from severe disease or hospitalization caused by COVID-19.”


Utility bills

One in eight residential customers had unpaid utility bills as of March 2022, according to a report by State Comptroller Thomas DiNapoli. Over the course of the pandemic, the report says, the amount in arrears increased significantly for all utilities and more than doubled on a statewide basis. 

 More than 1.2 million customers statewide owed $1.8 billion, and 60 percent of these customers were from New York City and Long Island.

“The pandemic’s effects continue to be felt in multiple aspects of life, including the elevated number of New Yorkers who continue to have trouble paying their utility bills,” DiNapoli said in a statement, releasing the report. “Failure to pay these bills may result in service shutoffs, which increases economic stress on families and can damage local economies by reducing household spending, leading to job losses.

“State lawmakers and the Public Service Commission have acted to provide meaningful relief to low-income customers through the Utility Arrears Relief Program and the Phase 1 Arrears Reduction Program, and should continue to consider mechanisms to help utility customers that cannot pay their bills,” DiNapoli urged.


Food assistance

All New Yorkers enrolled in the Supplemental Nutrition Assistance Program, formerly known as food stamps and now known as SNAP, will receive the maximum allowable level of food benefits for July.

All households participating in SNAP — including those already at the maximum level of benefits — will receive a supplemental allotment this month, resulting in a roughly $234 million infusion of federal funding into the New York State economy.

“Far too many New Yorkers are still struggling with food insecurity as a result of the economic toll from COVID-19,” said Houchul in a statement. “These additional food benefits will help hundreds of thousands of households make ends meet each month, while also providing a welcome economic boost to food retailers still recovering from the effects of the pandemic.”

Households already near or at the maximum benefit level — $835 for a household of four — will receive a supplemental payment of at least $95.

Every federal dollar invested by SNAP generates up to $1.54 in economic activity, according to a federal study quantifying the impact of SNAP on the United States economy.   

About 14 percent of New York State’s population relied on SNAP benefits last year according to a recent study. More than half of recipient households were families with children and about 48 percent included an adult over the age of 55 or a person with a disability.

New Yorkers continued to rely heavily on SNAP this spring, with more than 1.6 million households, including more than 2.8 million New Yorkers, throughout the state enrolled in the program in May, the governor’s office said.

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