The COVID Wave Continues: KP.3.1.1 Expands, Novavax Approved, Back to School Impact on Transmission
KP.3.1.1 Impact on Pemivibart
The COVID wave continues, with over 1 million new infections daily. Approximately, 25% of the U.S. population has been infected since May 2, 2024, and currently, 1 in 41 people are infectious, according to Michael Hoerger, PHD, MSCR, MBA posting on X. Cases are increasing in the upper mid-west and the Northeast while much of the rest of the U.S. is decreasing. The Upper Midwest and Northeast will likely see overall prevalence start to decline within the next two weeks.
Wastewater Prevalence from CDC NWSS.
We're observing a worrisome trend in regional COVID-19 data. While the West is seeing a decline from its recent peak, cases in the Northeast continue to climb. The Midwest and South, which showed initial signs of improvement last week, have now reversed course and are experiencing an uptick in infections. If this trend persists, it would mark the fastest turnaround we've witnessed throughout the pandemic.
The most likely culprit behind this surge appears to be the rapid spread of the highly infectious KP.3.1.1 variant. This variant is particularly adept at exploiting the close contact environment of schools and households, leading to an increase in cases.
Unfortunately, this situation is further exacerbated by the recently updated guidance from the CDC. It is extremely negligent guidance that is not based on the science. This guidance, which is being echoed by many doctors on news networks, advises parents that it's safe to send children back to school after just 24 hours without fever, even if they haven't tested negative. This approach disregards the fact that people remain contagious well after a fever has resolved and that as many as 80% of people don’t have a fever. It also ignores asymptomatic spread. This has already resulted in multiple school closures within weeks of reopening. (1,2,3,4)
Why did the South and West decrease while the Northeast continued to increase?
Most kids end their camps and other activities about two weeks before schools reopen after summer break. This breaks the chain of transmission, stopping the exponential growth and allowing the overall prevalence to decline. However, once schools reopen, the exponential growth begins again, generally taking 6 to 8 weeks to see this growth in the overall data.
From TACT’S July 21st update, “U.S. COVID Forecast”
“There will likely be a leveling-off and decline coming within the next week or two that will last for 6 to 8 weeks in the South and much of the West before the exponential growth between schools and homes drives overall prevalence back up. This will occur almost a month later in much of the Midwest and Northeast U.S.”
While prevalence is increasing again in children where schools open, the overall prevalence can decline. Historically, it would take 6 to 8 weeks for the exponential growth between schools and homes to translate into a broader increase in overall prevalence. However, if the current trends in wastewater data for the South and Midwest hold, we're facing an unprecedented rate of transmission. We’ll have to watch the West to see if there is a similar turnaround. This rapid spread underscores the interconnectedness of schools and the wider community. The transmission that begins within schools quickly ripples outward, impacting families, workplaces, and the entire fabric of society.
The decision to reopen schools without implementing crucial safety measures like upgraded ventilation and air filtration systems is deeply troubling. The KP.3.1.1 variant, with its high immune evasion and suppression capabilities, poses a significant risk of persistent infection and long-term health complications.
Repeatedly exposing children, teachers, parents, and caregivers to this systemic virus, which has been linked to heart dysfunction, brain damage, and a range of other serious health issues, is simply unacceptable. We must demand better for our communities and prioritize the health and well-being of all.
A Predictable Crisis and the Urgent Need for Action
The current surge in COVID-19 cases, while alarming, is unfortunately not surprising. As early as May 6, 2024, TACT's summer forecast predicted this very scenario:
“In the U.S., it will likely begin increasing by mid-June, possibly a little earlier, particularly in the Southern states. The prevalence will start increasing at a faster pace into July and August, and peak in the first couple weeks of September. The peak is likely to go quite a bit higher than last summer.”
And indeed, the peak has surpassed last summer's levels, with hospitalizations also reaching concerning heights.
While we're seeing a decline in the West, and a partial decline in the South, the Northeast and Upper Midwest are likely to peak around the first week of September. The Walgreens national test positivity rate, though still alarmingly high, is showing signs of decreasing. However, this respite may be short-lived. If the wastewater data holds true, we could see a resurgence in cases much earlier than in previous years.
.The positivity map, below, also shows a similar trend to what the wastewater data is showing.
These overall trends don't show the increasing transmission between schools and homes wherever schools have reopened. As we will show further down, the hospitalization data does give us insight into the increasing spread among children. This predictable crisis underscores the urgent need for proactive measures to mitigate the spread of the virus. The reopening of schools without adequate safety protocols, combined with the negligent CDC guidance and the highly infectious nature of the KP.3.1.1 variant, has created a perfect storm for transmission.
U.S. Variant Proportions
KP.3.1.1 is dominant in all regions.
KP.3.1.1 is Dominant Globally
Mike Honey posted the graphs above and below. In referencing the graph below he posted on X. “Here are the leading countries reporting DeFLuQE. Growth looks to have stalled in northern Europe and the UK, probably due to the emergence of the new XEC recombinant. XEC is not yet classified by the Nextclade engine, so those samples are being reported as FLuQE KP.3.3”
If you would like more info on the new XEC variant, check out TACT’s post from August 9, 2024. “New XEC Variant (KS.1.1 and KP.3.3 Recombinant): An Emerging Threat” “Will the XEC Variant Be The Next Dominant COVID Strain?”
Link: https://tactnowinfo.substack.com/p/preliminary-overview-of-the-ks11
COVID Emergency Department Visits in the U.S.
We are seeing that emergency department visits are increasing at a faster pace in school-age children, while adults are declining. This again shows that the transmission between schools and homes is moving swiftly and that the decline shown in adults will likely be short-lived.
COVID U.S. Hospitalizations Year Over Year
Hospitalizations were lower than in previous years until KP.3.1.1 emerged. Now, they're higher than in 2022/2023, and after surpassing 2020/2021 levels in June and July, they're just below that mark, but still increasing.
Men and women have equal chances of COVID hospitalization, but those over 65 are significantly more likely to be hospitalized as shown in the second graph below.
Novavax JN.1 Targeted Vaccine Approved
The Emergency Use Authorization of the Novavax JN.1 targeted vaccine was approved on August 30, 2024. The earlier authorized Moderna and Pfizer KP.2 targeted vaccines are already available in many locations. The rapid evolution of the virus, with the near extinction of the KP.2 variant, underscores the challenges of vaccine development in the face of COVID’s increasing pace of evolution.
Why are they still using the EUA when it's supposedly no longer an emergency?
While the emergency phase may be officially over, the continued use of Emergency Use Authorizations (EUAs) raises questions.
Currently, the KP.3.1.1 variant accounts for nearly half of all cases, reducing the vaccines' effectiveness, but if you haven't been infected in the past 6 to 10 months, it's advisable to get an updated vaccine to boost protection against the latest variants.
The recent approval of the Novavax JN.1 targeted vaccine offers another option, particularly for those hesitant about mRNA vaccines. If you previously took an mRNA vaccine and didn't have any issues then that's the better option however if you are hesitant about the mRNA vaccines, Novavax will still boost the immune response helping to protect from severe disease and death.
The rapid evolution of the virus, driven by the removal of mitigation measures, demands a shift in our approach. To slow COVID’s evolution, we have to reduce transmission. We must prioritize upgrading ventilation and air filtration in schools, hospitals, and other enclosed spaces to curb transmission and protect public health. The path we're on is unsustainable; it's time for change.
KP.3.1.1 Impact on Pemivibart
In a study published on August 13, 2024, they looked at Pemivibarts efficacy against newer variants including KP.3.1.1. COVID-19 vaccines don't work as well for many people with weak immune systems so monoclonal antibodies have been a huge help, however, COVID keeps evolving to evade these important treatments. In March 2024, the FDA approved pemivibart, a lab-made antibody, for these individuals. However, the virus has continued to evolve, with new variants like KP.3.1.1 emerging. The study shows pemivibart is less effective against the latest variants, especially KP.3.1.1. This means we need to keep an eye on its effectiveness and develop more treatments to protect those who can't rely on vaccines.
We must demand better for our communities. This means advocating for improved ventilation and filtration in schools and science-based guidance from the CDC. The guidance should say that children (and adults) can only return to school after testing negative two times, 24 hours apart. Most people remain contagious for 8 to 12 days, so in order to save money on tests, people could start checking if their children are negative 7 days after symptoms started. Schools should independently test children and adults upon return to school to ensure they are no longer infectious.
The health and well-being of our children, teachers, families, and all of society are at stake. We cannot afford to be complacent in the face of this ongoing threat. It's time to take decisive action to protect our communities and build a safer future for all.
References:
“JAG High School goes to remote classes due to COVID outbreak” WSFA 12 August 13. 2024 https://www.wsfa.com/video/2024/08/13/jag-high-school-goes-remote-classes-due-covid-outbreak/
“Tennessee school closed for 1 day due to positive COVID tests” “the closure was a result of a number of students and staff testing positive for COVID as well as others presenting with symptoms.” WSMV 4, August 14,2024: https://www.wsmv.com/2024/08/14/tennessee-school-closed-1-day-due-positive-covid-tests/
CALVERT, Texas (KBTX) - “Just two weeks into the new school year, Calvert ISD closed its doors Wednesday due to rising COVID-19 numbers.”
“The district issued a special notice Tuesday that the school would be closed Aug. 21 for deep cleaning “due to a number of individuals” coming down with the virus.” KBTX, August 21, 2024 link: https://www.kbtx.com/2024/08/21/calvert-isd-closes-campus-due-covid-19-cases/
SAN PERLITA, Texas (ValleyCentral) — “The San Perlita Independent School District is cancelling classes for the rest of the week due to students and staff testing positive for COVID-19.”
“Due to “numerous” individuals testing positive for COVID-19, all after school and extracurricular activities are also canceled through this weekend.” KVEO-TV, August 20, 2024 link: https://www.google.com/amp/s/www.valleycentral.com/news/local-news/san-perlita-isd-cancels-classes-due-to-covid-19-cases/amp/
“Pemivibart is less active against recent SARS-CoV-2 JN.1 sublineages”
https://www.biorxiv.org/content/10.1101/2024.08.12.607496v2 (Published: Aug 13, 2024)
Walgreens Test PositivityRate link: https://www.walgreens.com/healthcare-solutions/covid-19-index
Hi TACT...Have you heard about the "unexplained" tuberculosis cases ramping up in Kansas schools?
Expect more of this.
https://www.kake.com/home/kansas-covid-19-spike-coincides-with-unexplained-tuberculosis-infections/article_20f4ff08-6708-11ef-b146-6b676f5dde6f.html
If the insurance companies would allow Doctors to run immune subpanels (expensive) on these kids, the "unexplained" would become 'explained'. I'm not holding my breath.
I came across a comment that the White House is very much aware of our current situation, but does not want to actively address it for fear of influencing the upcoming election.
Perhaps this country deserves the political leaders that it gets.
Thanks for doing what you do.