The Pause in Using the J&J Vaccine
This morning, April 13, the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) issued a joint statement recommending a pause in the use of the Johnson & Johnson vaccine out of an abundance of caution. The joint statement said more than 6.8 million doses of the J&J vaccine have been administered in the U.S. and that the CDC and the FDA are reviewing data involving six reported U.S. cases of a rare and severe type of blood clot in individuals after receiving the J&J vaccine. In these cases, a type of blood clot called cerebral venous sinus thrombosis was seen in combination with low levels of blood platelets (thrombocytopenia). All six cases occurred among women between the ages of 18 and 48, and symptoms occurred six to 13 days after vaccination, said the statement.
The CDC will convene a meeting of the Advisory Committee on Immunization Practices tomorrow, April 14, to further review these cases and assess their potential significance. The FDA will review that analysis as it also investigates these cases. The CDC and the FDA recommended the pause until that review is complete. “Right now, these adverse events appear to be extremely rare.”
The Illinois Department of Public Health (IDPH) said in accordance with the recommendation, it will pause the use of the J&J vaccine out of an abundance of caution. IDPH has notified all Illinois COVID-19 providers throughout the State to discontinue use of the J&J vaccine at this time.
“Per the federal health authorities, people who have received the J&J vaccine who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider,” said IDPH. “Patients with other clinical questions should contact their health care provider.”
The City of Evanston issued a statement this afternoon, saying it was pausing its use of the J&J vaccine. The City said, “The City of Evanston has not administered the J&J vaccine at its community point of dispensing (POD) events, and has administered fewer than two dozen doses of the J&J vaccine as part of its vaccination program for homebound individuals. The City will use the Moderna vaccine for future in-home vaccinations until the CDC and FDA have completed their review.”
Risk of Community Spread
The charts in the above chart box show that new cases are continuing to rise in suburban Cook County, Chicago, and Illinois.
For total cases in the last seven days per 100,000 people, IDPH says that more than 100 cases indicates a risk of “substantial spread.” CDC says that more than 100 cases indicates a risk of “high transmission.” [1, 2, 3, and 4]
For test positivity in the last seven days, IDPH uses a target of 5%. CDC says between 5% and 7.9% represents a “moderate” risk of transmission. [1, 2, and 3]
Evanston – COVID
The City reported 15 new COVID-19 cases of Evanston residents today, up from seven yesterday.
The average number of new cases per day in the last seven days is 12.3, down from the seven-day average of 16.4 on April 6.
In the last seven days, there was a total of 86 new COVID-19 cases of Evanstonians. The 86 new cases equate to about 116 new cases per 100,000 people in the seven-day period.
Evanston’s case positivity rate for the last seven days is 1.2%.
There has been a total of 4,353 COVID-19 cases of Evanston residents during the pandemic, 207 of which are active.
No Evanstonian has died due to COVID-19 since April 10. The total number of resident deaths due to COVID-19 is 116.
Impact of Northwestern University. Northwestern University has posted data on its website reporting that between April 5 and April 11, there were 44 new confirmed COVID-19 cases of NU faculty, staff, and students. If the faculty, staff or students reside in Evanston, they are included in the City’s numbers. The number reported by NU, though, includes people who live outside of Evanston. [5]
Illinois – COVID-19
In the State, there were 3,193 new COVID-19 cases reported today, up from 2,433 yesterday.
Statewide, the average number of new cases per day in the last seven days is 3,390. The seven-day average one week ago on April 6 was 2,811, so today’s number is up by 21%. The average number is up 39% in the last two weeks.
Today’s seven-day average is up from a low this year of 1,513 on March 15. Cases have almost doubled since then. An accompanying chart shows the trend.
In the seven days ending April 13, the number of new cases per 100,000 people in the State was 187, up from 155 one week ago.
The seven-day case positivity rate for the State today is 4.3% and the test positivity rate is 5.0%.
On a Statewide basis, the number of hospitalizations due to COVID-19 was 2,028 as of midnight on April 12. This is up from 1,112 on March 15.
The number of patients using ICU beds is 466, up from 227 on March 15. The number of patients on ventilators is 185, up from 95 on March 15.
On a Statewide basis, there were 17 deaths due to COVID-19 in the last 24 hours, which brings the total to 21,540.
For the last seven days, the numbers of deaths in the State are 28, 34, 21, 13, 16, 18, and 17 today. The seven-day average is 21.
Variants in Illinois
IDPH is reporting a total of 1,051 confirmed cases of COVID-19 variants in the State. Of those 794 are the variant first discovered in the U.K.
Vaccinations in the State
A total of 9,343,775 doses of vaccine have been delivered to providers in Illinois, including Chicago and long-term care facilities. IDPH is currently reporting that a total of 7,344,112 doses of vaccines have been administered. The Illinois National Guard has administered more than 1 million doses of COVID-19 vaccines at State-supported vaccination sites around the State.
FOOTNOTES
1/ On Feb. 12, the CDC issued a K-12 School Operational Strategy. As part of that strategy, the report says, “CDC recommends the use of two measures of community burden to determine the level of risk of transmission: 1) the total number of new cases per 100,000 persons in the past 7 days; and 2) the percentage of nucleic acid amplification tests (NAATs), including RT-PCR tests that are positive during the last seven days. The two measures of community burden should be used to assess the incidence and spread of SARS-CoV-2 in the surrounding community (e.g., county) and not in the schools themselves.” The CDC provides a chart to assess whether the risk of transmission is low, moderate, substantial, or high. The CDC recommends different types of mitigations depending on the risk level. If the two indicators suggest different levels of risk, the mitigations recommended in the higher level of risk should be implemented, says CDC. The table below, reprinted from CDC’s report, provides CDC’s Indicators and Thresholds for Community Transmission of COVID-219.
CDC’s guidelines are available here: Operational Strategy for K-12 Schools through Phased Prevention | CDC
2/ Number of Cases per 100,000 Population. On July 1, a network of research, policy and public health experts convened by Harvard’s Global Health Institute and Edmond J. Safra Center published a Key Metrics for COVID Suppression framework that provides guidance to policy makers and the public on how to target and suppress COVID-19 more effectively across the nation. The targets for new COVID-19 cases per 100,000 people are as follows (these are converted from cases per day to cases per week): a) less than seven cases: “on track for containment;” b) seven to 63 cases: “community spread,” rigorous test and trace program advised; c) 70 to 168 cases: “accelerated spread,” stay-at-home orders and/or rigorous test and trace programs advised; and d) 169+: ”tipping point,” stay-at-home orders necessary. The article is available here: https://globalepidemics.org/key-metrics-for-covid-suppression/
IDPH provides these categories and ratings: 1) “minimal” – fewer than 50 cases per 100,000 in a week; 2) “moderate” – between 50 and 100 cases per week; and 3) “substantial” more than 100 cases per 100,000 in a week. In its Metrics for School Determination of Community Spread, IDPH says the “target” is 50 cases per week per 100,000 people.
3/ The Test Positivity Rate. In addition, on May 26, Johns Hopkins University & Medicine Coronavirus Resource Center said on its website that “the World Health Organization (WHO) advised governments [on May 15] that before reopening, rates of positivity in testing (i.e., out of all tests conducted, how many came back positive for COVID-19) should remain at 5% or lower for at least 14 days.” Link: https://coronavirus.jhu.edu/testing/testing-positivity
The Harvard Global Health Institute says, “A network of research, policy, and public health organizations convened by Harvard and MIT called the TTSI Collaborative has agreed on a 3% test positive rate or below as a key indicator of progress towards suppression level testing.”
IDPH says the test positivity target is 5% or less. IDPH provides these categories and ratings: 1) “Minimal” – test positivity rate is equal to or less than 5%: 2) “Moderate” – test positivity rate is between 5% and 8%; and 3) “Substantial” – test positivity rate is over 8%. In its Metrics for School Determination of Community Spread, IDPH says the target is 5%.
4/ Calculations. The RoundTable calculates the number of cases per 100,000 using case data provided by IDPH and assuming that the population of Suburban Cook County is 2.469 million, that the population of Chicago is 2.710 million, and that the population of Illinois is 12.671 million.
5/ Northwestern University COVID-19 Cases. Ike C. Ogbo, Director of Evanston’s Health & Human Services Department, told the RoundTable that the COVID-19 cases reported by the City include cases of faculty, staff, and students attending Northwestern University who live in Evanston. The RoundTable asked the City in an FOIA Request to provide the number of NU students who tested positive for COVID-19 and who live in Evanston. The City refused to provide the data. On Oct. 26, the RoundTable appealed the City’s decision to the Public Access Counselor of the Attorney General’s Office. On Nov. 13, the City filed a response claiming it does not have any records showing the number of NU students who tested positive for COVID-19 and who live in Evanston.
The RoundTable has asked Northwestern University on several occasions to provide information breaking out the number of new COVID-19 cases of its faculty, staff, and students by residency in Evanston. NU did not respond.
Operational Strategy for K-12 Schools through Phased Prevention | CDC