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June 15 California Reopening: ABC7 explores what’s changed since California COVID-19 restrictions lifted

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SAN FRANCISCO (KGO) – California’s coronavirus restrictions were lifted Tuesday, but what has actually changed? We sent several ABC7 news reporters to the Bay Area to find out.

MORE: June 15th is here – everything changes with the grand reopening of California

San Francisco

Reporter Luz Pena examined several shops in the city. When she stopped by the Nightingale Bar, they were preparing to fully reopen. For the first time in over a year, they took their cash register out of the warehouse.

Pena also swung past City Hall, where couples celebrated an even bigger milestone than the reopening on June 15: their wedding anniversaries.

She also visited the Ferry Building, where masks are still required. This is because the building is categorized as a “transit hub”.

East bay

Reporter Amy Hollyfield started her morning at Starbucks, where masks are now optional for vaccinated customers under the updated mask mandate.

This is what the reopening looks like! Masks are optional for those vaccinated at Starbucks. We can see each other’s smile again! pic.twitter.com/iKGchrVCyx

– Amy Hollyfield (@amyhollyfield) June 15, 2021

However, all drivers are required to wear a mask on BART. Hollyfield said she still saw everyone wearing masks when she was at Dublin / Pleasanton train station.

“Our latest data collection found that 96% of people were wearing masks. For the few who do not want to wear masks, they will be escorted out of the system. But that’s very rare, “said BART spokesman Jim Allison.

Reporter Cornell Barnard visited the Pacific Pinball Museum in Alameda, which has reopened for the first time in over a year. They still ask visitors to wear masks for the time being just to be safe.

“Reopening Day means less masking for me and more hope for California,” said Diane Deering of Alameda.

Barnard also stopped by the Oakland Zoo, which has been open for a while. They accept the looser adult mask restrictions but ask children under the age of 11 to continue to remain masked as they cannot be vaccinated yet.

South bay

Reporter Matt Boone checked a grocery store in San Jose Tuesday morning. The owner told him he did not trust the “honor system” so he continues to require that all customers continue to wear masks – not just those who are not vaccinated.

He also went to a gym that no longer required masks, but still found plenty of people wearing them.

Some thoughts so far on “reopening” California from my morning in San Jose. First, we went to a gym that no longer required masks. I noticed that about half of the people were still wearing them. One guy said he forgot the change (even though it was not vaccinated) pic.twitter.com/t2cUSdclDN

– Matt Boone (@MattBooneNews) June 15, 2021

Reporter Chris Nguyen found the same thing at the Westfield Valley Fair Mall. They removed social distancing marks and brought back certain community activities like ping pong tables. Again, there is no mask requirement for vaccinated people, but there were still plenty of masks to see.

Hello from the south bay! Masks are no longer required in the public areas at Westfield Valley Fair, but most of the people I saw there still wore them. Do you plan to be without a mask in public (indoors) or are you going to hang on yours a little longer? #SanJose pic.twitter.com/60lDW8U6d3

– Chris Nguyen (@ ChrisNguyenABC7) June 15, 2021

peninsula

Reporter Wayne Freedman ventured to the peninsula, where they celebrated the first day of California’s reopening with a party, complete with a vaccine clinic and a ribbon cut.

“Vaccinations work and that is celebrated,” said supervisor David Canepa.

“We haven’t seen each other in 15 months. We need this,” added UCSF epidemiologist Dr. Monica Gandhi added. She supported wearing masks during the pandemic, but with 90% of the county now at least partially vaccinated, Gandhi says masks are no longer required.

VACCINE TRACKER: How California is doing when you can get a coronavirus vaccine

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Covid-19 Breakthrough Infections in Vaccinated Health Care Workers

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Breakthrough infections

Of 11,453 fully vaccinated healthcare workers, 1,497 (13.1%) underwent RT-PCR testing during the study period. 39 breakthrough cases were found among the workers tested. For each positive case found, more than 38 people were tested for a test positive of 2.6%. Thus, this percentage was much lower than the test positive rate in Israel at the time, as the ratio between positive results and the extensive number of tests performed in our study was much lower than in the national population.

Of the 39 breakthrough patients, 18 (46%) were nurses, 10 (26%) were administrative or maintenance personnel, 6 (15%) were related health professionals, and 5 (13%) were physicians. The mean age of the 39 workers infected was 42 years and the majority were women (64%). The median interval from the second vaccination dose to the detection of SARS-CoV-2 was 39 days (range 11 to 102). Only one infected person (3%) had immunosuppression. Other comorbidities are listed in Table S1.

For all 37 case patients for whom data on the source of infection were available, the suspected source was an unvaccinated person; in 21 patients (57%) that person was a member of the household. These case patients included two married couples where both spouses worked at Sheba Medical Center and had an unvaccinated child who had tested positive for Covid-19 and was suspected to be a source. In 11 of 37 case patients (30%), the suspected source was an unvaccinated health care worker or patient; in 7 of the 11 case patients the infection was caused by a nosocomial outbreak of variant B.1.1.7 (alpha). These 7 patients, who worked in different hospital sectors and wards, were found to be all related to the same suspected unvaccinated index patient who had received non-invasive positive pressure ventilation prior to being infected.

Of the 39 cases of infection, 27 occurred in workers who were tested solely for exposure to a person with a known SARS-CoV-2 infection. Of all workers with breakthrough infection, 26 (67%) had mild symptoms at some point and none had to be hospitalized. The remaining 13 workers (33% of all cases) were asymptomatic for the duration of the infection; 6 of these workers were defined as borderline cases because they had an N-Gen-Ct value of more than 35 when tested again.

The most commonly reported symptom was upper airway congestion (36% of all cases), followed by myalgia (28%) and loss of smell or taste (28%). Fever or chills were reported in 21% (Table S1). In the follow-up survey, 31% of all infected workers stated that they still had residual symptoms 14 days after diagnosis. 6 weeks after their diagnosis, 19% said they had “long-term Covid-19” symptoms, including persistent loss of smell, persistent cough, fatigue, weakness, dyspnoea, or myalgia. Nine workers (23%) were taken off work beyond the 10 days of required quarantine; of these workers, 4 returned to work within 2 weeks. One worker had not returned after 6 weeks.

Verification tests and secondary infections

Repeated RT-PCR assays were performed on specimens collected from most infected workers and for all patients with an initial N-Gen Ct greater than 30 to ensure that the first test was not performed too early before the worker became infectious. A total of 29 case patients (74%) had a Ct value below 30 at some point during their infection. Of these workers, however, only 17 (59%) had positive results with simultaneous Ag-RDT. Ten workers (26%) had an N-Gen-Ct value of over 30 over the entire period; 6 of these workers had values ​​over 35 and were probably never contagious.

Of the 33 isolates tested for a variant of concern, 28 (85%) were identified as a B.1.1.7 variant by either multiplex PCR assay or genome sequencing. At the time of this study, variant B.1.1.7 was the most widespread variant in Israel and accounted for up to 94.5% of the SARS-CoV-2 isolates.1,16 Since the end of the study, the country has had a flood of cases caused by the delta variant, like many other countries worldwide.

Thorough epidemiological investigations of the data on contact tracing in the hospital revealed no transmission by infected nursing staff (secondary infections) in the 39 primary infections. No secondary infections were detected among the 31 cases for which household transmission data (including symptoms and RT-PCR results) were available, including 10 case patients and their 27 household members where the healthcare professional was the only index case patient.

Data on N-specific IgG antibodies after infection were available for 22 of 39 case patients (56%) on days 8 to 72 after the first positive result in the RT-PCR test. Of these workers, 4 (18%) had no immune response, as evidenced by negative results in N-specific IgG antibody tests. Of these 4 workers, 2 were asymptomatic (Ct values ​​32 and 35), 1 was not examined serologically until day 10 after diagnosis and 1 had immunosuppression.

Case-control analysis

The results of periinfection-neutralizing antibody tests were available for 22 groundbreaking cases. This group included 3 health care workers who participated in the serological study and who had a test in the week prior to the discovery; In 19 other workers, neutralizing and S-specific IgG antibodies were determined on the detection day. Of these 19 case patients, 12 were asymptomatic at the time of discovery. For each case, 4 to 5 controls were matched as described (Fig. S1). A total of 22 breakthrough cases and their 104 matching controls were included in the case-control analysis.

Table 1. Table 1. Population characteristics and results in the case-control study. Figure 2. Figure 2. Neutralizing antibody and IgG titers in cases and controls, depending on the point in time.

Among the 39 fully vaccinated health care workers who had a breakthrough infection with SARS-CoV-2, the neutralizing antibody titers are during the peri-infection phase (within a week before SARS-CoV-2 detection) (Panel A) and the peak Titer within 1 month after the second dose (panel B) compared to the corresponding controls. Also shown are IgG titers during the peri-infection period (Panel C) and peak titers (Panel D) in the two groups. Each breakthrough infection was compared with 4 to 5 controls according to gender, age, immunosuppression status and time of serological testing after the second vaccine dose. In each panel, the horizontal bars show the geometric mean titers and the bars show 95% confidence intervals. Symptomatic cases, all of which were mild and did not require hospitalization, are highlighted in red.

Figure 3. Figure 3. Correlation between neutralizing antibody titer and N-gene cycle threshold as an indication of infectivity.

The results of the antigen-detecting (Ag) rapid diagnostic tests for the presence of SARS-CoV-2 are shown along with neutralizing antibody titers and N-gene cycle thresholds (Ct) in 22 fully vaccinated healthcare workers with breakthrough infection for whom data were available ( Slope of the regression line, 171.2; 95% CI, 62.9 to 279.4).

The predicted GMT of the periinfection neutralizing antibody titre was 192.8 (95% confidence interval [CI], 67.6 to 549.8) for cases and 533.7 (95% CI, 408.1 to 698.0) for controls, for a predicted case-to-control ratio of neutralizing antibody titers of 0.361 (95% – KI, 0.165 to 0.787) (Table 1 and Figure 2A). In a subgroup analysis in which the borderline cases were excluded, the ratio was 0.353 (95% CI, 0.185 to 0.674). Periinfection-neutralizing antibody titers in the breakthrough cases were associated with higher N-gene Ct values ​​(i.e., lower viral RNA copy number) (slope of the regression line, 171.2; 95% CI, 62.9 to 279.4)Figure 3).

A peak in neutralizing antibody titer within the first month after the second dose of vaccine was only available for 12 of the breakthrough cases; the maximum neutralizing antibody titre predicted by GEE was 152.2 (95% CI, 30.5 to 759.3) in 12 cases and 1027.5 (95% CI, 761.6 to 1386.2) in 56 controls, for one Ratio of 0.148 (95% CI, 0.040 to 0.548) (Figure 2B). In the subgroup analysis, in which borderline cases were excluded, the ratio was 0.114 (95% CI, 0.042 to 0.309).

The observed and predicted GMTs of peri-infection S-specific IgG antibody levels in breakthrough infection cases were lower than controls, with a predicted ratio of 0.514 (95% CI, 0.282-0.937) (Figure 2C). The observed and predicted IgG GMT peak values ​​were also slightly lower in the cases than in the controls (0.507; 95% CI, 0.260 to 0.989) (Figure 2D).

In order to assess whether our approach to measuring antibodies on the day of diagnosis led to biases due to the recording of anamnestic reactions to the current infection, we examined 13 patients in whom both values ​​were present. In all cases, the periinfection titers were lower than the previous peak titers, suggesting that the titers obtained on the day of diagnosis were likely representative of the periinfection titers (Fig. S2).

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A Situation Update On Covid-19 Variants And Vaccines

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Orange, CA – July 21: Jamie McDonough, RN, left, and Nursing Assistant Vanessa Gutierrez, check a … [+] COVID-19 patient in the COVID-19 intensive care unit at St. Joseph Hospital in Orange, CA on Wednesday, July 21, 2021. COVID-19 cases have increased in recent weeks partly due to the Delta variant. (Photo by Paul Bersebach / MediaNews Group / Orange County Register via Getty Images)

MediaNews Group via Getty Images

The following article is complex, so I’ll summarize the main points first. The basic advice I need to start with is that if you are not vaccinated you should get vaccinated as it will likely prevent your hospitalization or death.

Second, some vaccines are much better than others. The mRNA vaccines have proven to be much better than the others, including the adenovirus and inactivated whole virus vaccines.

Third, all currently approved vaccines become less effective over time, more so in some populations than others. Those who are 65 and older, along with other high-risk groups, can expect less robust and more rapidly declining immune protection. Boosters will most likely be needed within six months of the last injection, first for older adults, then for the general population.

Finally, it is very likely that new and even more dangerous viruses than the Delta will emerge, and it is unclear how well existing vaccines protect against hospitalization and death from such new variants. I will address all of these considerations and more in the following paragraphs.

With Covid-19 nearing the end of another month, the outlook for the rest of the year is decidedly unclear. Although around a quarter of the world’s population has received at least one dose of a Covid-19 vaccine, the virus is still circulating at worrying, if not downright alarming, rates in many countries. Even in countries with high vaccination rates, like the UK and Israel, new variants of SARS-CoV-2 – each seem more contagious than the other – have contributed to a surge in new cases, some of which are groundbreaking infections.

How can this paradoxical state of affairs be explained? It depends on where you go for answers. Public Health England published a study in June that found that two doses of the Pfizer or AstraZeneca vaccine were more than 90 percent effective in preventing serious illness and hospitalization from the Delta variant. But last month, the number of daily new Covid-19 cases in the UK still peaked, rivaling the record highs in the country last winter. While new infections now seem to be on the decline, hospital admissions rose more than 30 percent in the past week, sending National Health Services executives and health workers into another downward spiral.

Recent data released by the Israeli Ministry of Health on July 23 tell a slightly different story about the effectiveness of the vaccine against the Delta variant. According to their study, which has not yet been fully published, the Pfizer vaccine is 88 percent effective in preventing hospitalizations and 91 percent in preventing critical illness from the Delta variant, but only 39 percent effective against infection – one significant decrease from previous estimates of 64 percent effectiveness. The report came when hospital admissions rose more than 50 percent nationwide in a week.

With the rise of Covid-19 not only in Israel and the UK but around the world, the issue of immune protection has re-emerged in the discussions about pandemic control with new and increasing urgency. Research on Pfizer and Moderna’s mRNA vaccines has repeatedly confirmed that they elicit the most robust immune response against SARS-CoV-2. But how long vaccine-mediated immune protection will last remains uncertain, especially for their less potent counterparts: the adenovirus vaccines from AstraZeneca and Johnson & Johnson, China’s Sinopharm vaccine, India’s Covaxin vaccine, and so on.

Comparison of efficacy losses over time based on data from the modeling study

“Neutralizing antibody levels are highly predictive of immune protection against symptomatic SARS-CoV-2 infection” https://www.nature.com/articles/s41591-021-01377-8

It turns out that not all vaccines are created equal. In May 2021, a study published in Nature Medicine made this claim based on the aggregated clinical trial results of seven different Covid-19 vaccines. Using predictive modeling techniques to record the strength and duration of their immune protection over a theoretical 250 day period, the study’s authors showed that some vaccines fell to 50 percent effectiveness much earlier than others. At the forefront were the Pfizer and Moderna mRNA vaccines, which were initially 95 percent effective and took a full 250 days to drop to 50 percent. The AstraZeneca vaccine rounded off the bottom with 62 percent initial effectiveness and a half-life of 48 days, although the Sinopharm vaccine, initially only 50 percent effective, was even worse.

Relationship between degree of neutralization and protection against SARS-CoV-2 infection

“Neutralizing antibody levels are highly predictive of immune protection against symptomatic SARS-CoV-2 infection” https://www.nature.com/articles/s41591-021-01377-8

The authors of the Nature Medicine study, like many researchers before them, use antibody titers as a selected measure of immune protection and not the number of T cells or B memory cells. While all of the above factors ultimately represent inaccurate correlates to protection, based on vaccine data and previous encounters with viruses like influenza, antibodies are most likely the best we have. And until a standardized immunological assay for SARS-CoV-2 is created, they are the best we will get.

Early studies with Covid-19 patients found that antibody levels generated by natural infections drop quickly. Today studies on vaccinated people are emerging that give similar results. According to a study conducted across the UK in June and published in the Lancet on July 15, antibody levels in adults fully immunized with either the Pfizer (BNT162b2) or AstraZeneca (ChAdOx1 nCoV-19) vaccines dropped significantly over the course of 70 days . In participants who received two doses of Pfizer, the decrease was two-fold; for those who received AstraZeneca, fivefold.

Total antibody count after second doses of BNT162b2 (Pfizer) and ChAdOx1 nCoV-19 (AstraZeneca) … [+] Vaccinations

“Spike antibodies disappear after a second dose of BNT162b2 or ChAdOx1” https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01642-1/fulltext#coronavirus-linkback-header

But just as the strength and duration of immune protection varies from vaccine to vaccine, the Lancet study suggests that it also varies from individual to individual. The supplementary figures below show that in adults aged 65 and over, antibody levels are generally lower and fall faster. Notably, the lower limit of antibody levels in older adults who received the AstraZeneca vaccine approached zero at the end of the 70-day period. The same applied to people who were classified as “clinically extremely at risk” due to certain comorbidities such as chronic respiratory diseases, obesity, diabetes and certain types of cancer. In other words, the populations at greatest risk of developing serious illness if infected were supposedly the least protected.

Total antibody count after second doses of BNT162b2 (Pfizer) and ChAdOx1 nCoV-19 (AstraZeneca) … [+] Vaccines, stratified by age (left) and vulnerability (right)

“Spike antibodies disappear after a second dose of BNT162b2 or ChAdOx1” https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01642-1/fulltext#coronavirus-linkback-header

Not to mention the variants. In a virtual presentation for the Zuckerman Institute at Columbia University, infection analysis expert Miles P. Davenport added another addition to the previously discussed prediction model – the CUREVAC vaccine. Like Pfizer and Moderna vaccines, CUREVAC was developed using mRNA, which increases expectations of its success. However, in phase 3 clinical trials, it only showed 47 percent effectiveness. One interpretation of the lackluster performance is that previously approved vaccine candidates did not struggle with variants in their respective clinical trials. What if more variants emerge that are even more contagious than what we are seeing now?

Performance of the CUREVAC vaccine

“Relation in vitro Neutralization Level and Protection in the CVnCoV (CUREVAC) study” https://www.medrxiv.org/content/10.1101/2021.06.29.21259504v1

I cannot stress enough that any Covid-19 vaccine – that is, of course, those that are believed to be safe and effective – is better than no vaccine. Indeed, both hospitalization rates and the incidence of serious illnesses have declined from their respective highs in the past year. But the combination of a rapidly developing virus and, if the antibody counts are to be believed, a rapidly fading immunity is too unfortunate for my taste.

While the global adoption of vaccines remains uneven and unfair, booster vaccinations are inevitable, especially for the elderly and other high-risk populations. When booster syringes are finally made available, everyone over 65 or a similar risk level should look for them. The rest of us should monitor our antibody counts and take action when we see a significant drop. After all, it’s always better to play it safe.

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Here Are The Republicans Most Likely To Refuse The Covid-19 Vaccine, Poll Finds

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Top line

Almost 40% of Republicans are still reluctant to get the Covid-19 vaccine or refuse to get it, according to a new survey by the Public Religion Research Institute (PRRI) / Interfaith Youth Core (IFYC), despite certain subsets of the GOP seem significantly more likely to accept or reject the shot based on their religion, media consumption, and whether or not they believe in the QAnon conspiracy theory.

A protester holds an anti-vaccination sign in support of President Donald Trump’s rally on Jan. … [+] 2020 in Woodland Hills, California.

Getty Images

Important facts

The survey, conducted June 7-23 of 5,123 adults in the United States, found that 64% of Republican respondents are Covid-19 “vaccine acceptance” who have been or are planning to vaccinate – up from 45% in March – while 18% are reluctant to get vaccinated and 19% refuse to shoot (compared to 32% and 23% respectively in March).

The most likely group to oppose the Covid-19 vaccine are Republicans who consume far-right television news (46% versus 31% in March), while 8% of those viewers are reluctant to shoot (versus 37% in March). ) and 45% accept it (up from 32% in March).

The Republicans most likely to get vaccinated are those who oppose the QAnon conspiracy theory and those who consume mainstream news, with 79% and 77% of those groups calling themselves “vaccine acceptors”, respectively.

Republicans who are white evangelical Protestants were more likely to be against the vaccine than those of other religions, with 55% accepting the vaccine compared to 67% of other religions, while 24% of evangelicals opposed the vaccination and 21% were reluctant, 16% and 17 respectively % for other religions).

Republicans who don’t consume TV news at all are more likely to reject the Covid-19 vaccine than those who watch Fox News: only 53% of non-news viewers accept the vaccine and 24% oppose it (23% hesitate). , versus 63% of Fox viewers who accept the vaccine and 18% each who are reluctant to use it.

Believers in the QAnon conspiracy – that “the government, the media and the financial world in the US are controlled by a group of Satan’s worshiping pedophiles engaged in a global child trafficking operation” – were far more likely to oppose the vaccine than they would question or question the QAnon Reject: 37% of QAnon believers reject the Covid-19 vaccine (45% accept it), versus 15% of those who question QAnon and 5% of those who oppose the conspiracy.

Big number

71%. This is the overall percentage of respondents in the PRRI survey who said they were either vaccinated or were getting the vaccination as soon as possible, up from 58% in March. Another 15% are reluctant to accept and say that they “wait and see how” [it’s] work for others ”or only in an emergency (10% or 5%), while 13% of all respondents completely refuse the vaccination.

tangent

The poll found that Republicans were one of the largest overall demographics to be opposed to or reluctant to receive the vaccine, along with Americans under 50 and rural Americans. Women are also statistically slightly more likely to be against the vaccine than men, according to the survey. Across all religious groups, the PRRI survey found that most religious groups were broadly in favor of the Covid-19 vaccine – with sharp increases since the last poll in March – and the only religious groups to register less than 60% support for the vaccine are white Evangelical Protestants and Hispanic Protestants (both with 56% acceptance). In contrast, Jewish Americans are the most proponents of the vaccine, with 85% saying they were vaccinated or would be vaccinated ASAP.

Against

Although PRRI showed a sharp increase in Republican support for the vaccine – their vaccine adoption increased 18 percentage points between March and June, more than Democrats or Independents – other polls have shown no similar progress. A recent Morning Consult poll found that the percentage of Republicans who said they didn’t get vaccinated has remained unchanged since mid-March, with 28% opposing the vaccine then and now.

Key background

High vaccination reluctance among Republicans has become a bigger problem in recent weeks as the highly transmissible Delta variant has fueled new Covid-19 outbreaks across the country as surveys have consistently shown Republicans to be the most likely demographic who refuses the shot and has the right – lean states have largely lower vaccination rates. As a result, a growing number of senior Republicans have been vocal in advocating the shots over the past few days: Alabama Governor Kay Ivey said, “It is time to blame the unvaccinated people for the state’s Covid-19 surge and the moderators from Fox News ”. Sean Hannity and Steve Doocey encouraged viewers to get vaccinated while Florida Governor Ron DeSantis said the shots “saved lives” as his state records one in five of all Covid-19 cases nationwide. Other Republicans, including far-right MPs like MPs Marjorie Taylor Greene (R-Ga.) And Lauren Boebert (R-Colo.), Continue to oppose the shots.

What to look out for

The PRRI poll suggested that religion may play a role in encouraging more Americans who are opposed to the vaccination or are reluctant to get vaccinated. The survey found that 19% of those who refused to vaccinate believe that faith-based approaches would help to get vaccinated – such as appeals from trusted religious leaders or communities or the provision of vaccines to places of worship – as well as 32% of white evangelical Protestants who visit regular church services and hesitate to vaccinate. The recent flurry of appeals from Republican leaders to promote the vaccines, most of which came after the PRRI poll was conducted, could also have an effect. A recent study published in the Proceedings of the National Academy of Sciences of the United States of America found that vaccination recommendations from Republican Party “elites” – in this case former President Donald Trump – increased unvaccinated Republicans by 5.7% Signaling likelihood of signaling their intention to be vaccinated as if they had not seen confirmation or 7% more likely to signal their intention to vaccinate than if they had seen confirmation from President Joe Biden.

further reading

Here are the biggest groups still opposed to the Covid-19 vaccine, a poll found (Forbes)

Here are the groups that are still not getting the Covid vaccine – and why (Forbes)

Despite praise for Hannity and Doocy, Fox News still offers confused views on vaccines (Forbes)

More than 1 in 4 Republicans unwilling to take vaccines as the GOP steps up advocacy, polls (Forbes)

Full coverage and live updates on the coronavirus

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