For WaterISAC's Coronavirus Pandemic Member Crowdsourcing webpage (Members Only), click here.

This portal page is being updated regularly and is organized as follows:

• Situation Updates (updated regularly)
• CISA/FEMA Broad Stakeholder Call Information
• Resources
  • COVID-19 Cases (numbers of cases in WaterISAC member countries and worldwide)
  • Return to Work Planning
  • Water and Wastewater Utility COVID-19 Impacts and Responses
  • Personal Protective Equipment (PPE)
  • General Workplace  and Community Safety and Security
  • Cybersecurity
  • Business Continuity 
• Government Declarations   

Situation Update

November 9, 2023

Challenges and Lessons Learned from COVID-19 Response: Emergency Services Sector

CISA has released an after action review (AAR) discussing the emergency services sector’s response to the COVID-19 pandemic. It outlines major challenges during the response, challenges that continue to persist today, and lessons learned for topics like logistics and supply chain and staffing and capacity needs, among others. Although the AAR focuses on the emergency services sector, many of its findings are applicable to other critical infrastructure sectors, including the water and wastewater sector.

The full list of topic areas covered in the AAR are: General COVID-19 Response; Logistics and Supply Chain; Staffing and Capacity Needs; Mental and Physical Health Impacts; Communication, Collaboration, and Coordination; Crosscutting Effects; and Preparedness and Guidance. Many of the challenges and lessons learned discussed in these topic areas were experienced in the water and wastewater sector, such as the greater use of equipment or provisions relied upon less before COVID-19 (e.g., IT gear and sleeping quarters) and the continuing challenge of acquiring vehicles. Under the staffing and capacity needs topic, the AAR notes cross-training of operations staff with administrative staff resulted in significant benefits. In addition to its sections focused on challenges and lessons learned, the report also provides a references section with links to key resources assembled by CISA’s ES SMT.

CISA developed the AAR in its role as the Sector Risk Management Agency (SRMA) of the emergency services sector. Its Emergency Services Sector Management Team (ES SMT) established a working group of emergency services sector government and private sector partners to examine the sector’s response to the pandemic and develop lessons learned from its experiences.

Access the report at DHS and below (the report is posted as resource # 49).

September 19, 2023

COVID-19 Levels Near 2020’s Initial Peak, according to Wastewater Surveillance and Modeling

Two measures of COVID-19 activity reflect increasing numbers of infections, pointing to upwards of 720,000 new cases occurring every day. These numbers put the level of activity near the peak in 2020 and signal the virus is still here even though the official pandemic state is over.

Numerous wastewater utilities across the U.S. are involved in the National Wastewater Surveillance System (NWSS), through which they submit testing data to the U.S. Centers for Disease Control and Prevention (CDC). The CDC shares information from the utilities involved in the program on a public website, where charts and maps help researchers and the public understand COVID-19’s spread in the community. Additionally, Biobot Analytics monitors the data for the federal government and provides updates. According to recent analysis of the data, there are 720,000 new COVID-19 infections occurring every day and 1 in every 46 people are infected. Jay Weiland, a leading COVID-19 modeler, reached similar conclusions in data he recently shared. He estimated 650,000 Americans are becoming infected daily, with 1 in 51 people currently infected. Fortunately, both the Biobot data and Weiland’s model show U.S. cases beginning to recede. But they may not fall much more, if any, before the anticipated fall and winter surge. Given concerning COVID-19 trends around the world, World Health Organization (WHO) officials encouraged people to get vaccinations, especially those that are at high risk for poor outcomes from the virus. Vaccinating and boosting with any available version “remains vitally important to saving people’s lives now,” officials said. This messaging comes on the heels of the new vaccines having been made available last week from Pfizer and Moderna, which the CDC encouraged everyone 6 months and older to receive. Read more at Yahoo News.

September 14, 2023

CDC Recommends Updated COVID-19 Vaccine for Everyone Six Months and Older

Earlier this week, the U.S. Centers for Disease Control and Prevention (CDC) issued a formal recommendation that everyone 6 months and older get an updated COVID-19 vaccine to protect against illness this fall and winter. It added updated vaccines from Pfizer-BioNTech and Moderna will be available later this week.

As the CDC noted in its announcement, the virus that causes COVID-19 is always changing, and protection from COVID-19 vaccines declines over time. Receiving an updated COVID-19 vaccine can restore protection and provide enhanced protection against the variants currently responsible for most infections and hospitalizations in the United States. This is also especially important with the fall and winter seasons quickly approaching, when COVID-19 activity is expected to rise along with illnesses from flu and RSV. Despite the recommendation, there will be challenges to widespread adoption of the vaccines. For one, this this is the first time the federal government is not buying all the coronavirus shots, meaning doctors, hospitals and pharmacies must order them directly. Most Americans can still get a COVID-19 vaccine for free. For people with health insurance, most plans will cover COVID-19 vaccine at no cost to you. Additionally, if the experience last year is any guide, only 17 percent of the population got a vaccine. Read more at the CDC and a related article at the Washington Post.

August 24, 2023

COVID-19 Activity on the Rise as Information about New Variants Emerges

COVID-19 cases are again on the rise in the U.S., based on hospitalization data from the U.S. Centers for Disease Control and Prevention (CDC), which also forecasts more cases in the coming month. Yesterday, the CDC provided a risk assessment of a new COVID-19 variant, BA.2.86 (nicknamed “Pirola” by some), which it reports may be more capable of causing infection in people who have previously had COVID-19 or who have received COVID-19 vaccines. Meanwhile, the recently emerged EG.5 (also referred to as “Eris”) is the dominant variant in the U.S., infecting more people than any other single strain.

According to CDC data, weekly new hospitalizations jumped 21.6% this past week, marking a fifth straight week of increasing admissions. The CDC also forecasts an acceleration in new COVID-19 hospitalizations over the coming month, with 1,100 to 7,500 daily COVID-19 hospital admissions likely on September 18. This replaces a previous projection that admissions would "remain stable or have an uncertain trend.” The CDC also reports it has detected the new COVID-19 variant BA.2.86, for which it released a risk assessment yesterday. Only two cases have been identified in the U.S. so far, but the variant is notable because it has multiple genetic differences from previous variants, potentially posing new challenges for immunity from prior infections and vaccinations. The CDC notes scientists are evaluating the effectiveness of the forthcoming, updated COVID-19 vaccine (expected to be released next month) but that its current assessment is the vaccine will be effective at reducing severe disease and hospitalization. Right now, the EG.5 variant, a descendent of the Omicron strain, is dominant in the U.S. It isn’t setting off any alarms as far as disease severity, although early reports show it may be more transmissible.

With these developments, the question is what precautions need to be taken. While far from previous peaks seen of the virus, the worsening trends translates to nearly 10 million Americans now living in areas the CDC deems to be at "medium" COVID-19 levels. For these places the CDC recommends people who are at high risk of severe disease wear a high quality mask when indoors in public. For the general public, it says Americans should consider self-testing and masking for contact with others who are at high risk. And of course, the CDC continues to urge people to get updated COVID-19 shots and stay home if they are sick. In some places, schools and businesses are responding by reinstating mask mandates, typically in situations where cases have been reported among students and employees.

Read more at CBS News (articles one and two) and Yale Medicine.

May 3, 2023

New Research Sheds Light on COVID-19 Variant Dynamics

COVID-19 variants showed high diversity in their spread based on factors like vaccination rates, the number of co-circulating variants, and immunity from previous infections, according to new research recently published by a team from the Los Alamos National Laboratory. With COVID-19 still with us and the real risk of future pandemics, the researchers’ work can help to inform modeling approaches that forecast how future variants and viruses may behave.

The team looked at 16 COVID-19 variant transitions for 230 countries and regions from October 2020 to January 2023. They found variant transition dynamics differed substantially between locations and were associated with vaccination rates, prior infection rates, the time since the last COVID-19 peak, population demographics, and the number of co-circulating variants in competition with the emergent variant. Their research further demonstrated the effect vaccines had on the virus, noting they helped slow the speed of new variant transitions prior to the emergence of the Delta variant. However, continuing viral evolution contributed to new waves of disease spread, with viral variants that became progressively more infectious and resistant to protective antibodies, such as Omicron. The team also found stronger immunity acquired from prior infection, due to higher prior infection rates and a shorter time since the last COVID-19 peak, was associated with later and lower peak-prevalence variant transitions. This suggests that new variant transitions may be slower in locations with a large recent disease outbreak. There have been over 660 million confirmed cases of COVID-19 globally, leading to 6.7 million deaths. The virus continues to evolve, and global transitions to new variants can generate waves of disease spread, adding to the importance of the researchers’ efforts. Read more at the Los Alamos National Laboratory.

February 2, 2023

White Houses Says COVID-19 Emergency Declarations Will End in May

Earlier this week the White House announced it will end public health and national emergencies for COVID-19 on May 11 and noted the implications this will have on the nation’s health system and government operations.

The public health emergency (PHE) was set to expire on April 11 and the national emergency was scheduled to expire on March 1. The White House extended both to May 11, at which time both will end. It explained doing so is consistent with its plan of giving at least a 60-day notice before ending the PHE given the implications doing so will have. Given the emergency declarations provided additional funding to Medicaid and Medicare and the states, when they end access and costs associated with vaccines, tests, and treatments will be affected. For many, these services will continue to be provided through Medicaid and Medicare and private insurance, although there may now be costs involved. The White House’s announcement comes at a transition time as the U.S. and the world move from a more acute phase of the pandemic to a more endemic spread pattern. On the same day as the White House’s announcement, the World Health Organization (WHO) stated the situation still warrants a public health emergency of international concern, although it acknowledged the pandemic is at an "inflection point." Additionally, Dr. Ashish Jha, White House COVID-19 response coordinator, said there are other reasons for ending the two emergencies. He said the nation is in a better place with managing the virus and is getting through the winter without a big surge or a run on hospitals. He also said the nation has the tools for managing the virus. Read more at the University of Minnesota Center for Infectious Disease Research and Policy and Time.

January 5, 2023

Experts Tracking New COVID Variants That Could Drive Next U.S. Surge

Scientists are investigating strains descended from COVID’s Omicron variant to predict the shape of the next wave. Currently the variant families BQ and XBB are the most cause for concern, with XBB1.5 in particular spiking in number of infections at the start of 2023. This trend is due to two factors researchers believe could make the XBB family particularly resilient: high immune evasion and better ability to penetrate cells. XBB1.5 was found to be “49 times less likely to be neutralized” by antibodies compared to the most infectious COVID variants of summer 2022.  A unique mutation also allows XBB1.5 to better enter cells, making it easier to transmit. However, while experts are concerned about XBB1.5’s overall infectiousness, it does not appear to be any more severe than other COVID strains. Read more at CNN.

November 10, 2022

Wastewater Surveillance for Diseases Effective but Not Widespread, and Other COVID-19 Lessons Learned

The RAND Corporation has published a report reflecting on lessons that can be learned from the COVID-19 pandemic so that the U.S. and nations worldwide can be better prepared for future scenarios.

The report contains a collection of essays that explore topics of critical importance and identify actions that can be taken. In its second essay, regarding the role (and potential role) of government agencies in detecting and warning about an impending health crisis, the report comments on the advantage of using wastewater surveillance systems to get a near-real-time picture of disease spread. According to the report, public health officials in Houston and New York City used this technology to detect the Omicron variant 11 days before anyone in the U.S. tested positive for it. This system contrasts with the lagging indicators provided by looking at hospitalizations and deaths but unfortunately is not widespread throughout the U.S. Other essays in the report discuss lessons learned from Wuhan, China, where the coronavirus was first detected; reforming global pandemic preparedness and response institutions; meeting medical supply needs for future pandemics; and more. Read the report at the RAND Corporation.

September 8, 2022

Updated COVID-19 Boosters Now Available; U.S. Plans to Shift to Annual Shots

Following the CDC’s and FDA’s approvals of the updated COVID-19 booster shots last week, the federal government has been rolling out the new vaccines to locations around the country. When discussing the boosters earlier this week, White House coronavirus coordinator Ashish Jha said the expected cadence of delivering them in upcoming years would be similar to that of the annual flu shot, which could be administered at the same time.

The updated booster shots, one by Moderna and another from Pfizer, are called “bivalent” and tailored to combat the two most prevalent omicron subvariants, BA.4 and BA.5, as well as the original strain. The previously approved vaccines were developed just for the original strain and demonstrated an inability to prevent reinfections and to trigger long-term protective immunity, prompting the need for the reformulated vaccines. In announcing the federal government’s intent for annual COVID-19 boosters, Jha said staying up to date on vaccinations can get the country back “to a more normal set of rules,” allowing businesses and schools to stay open. Heading into the third fall of the pandemic, Jha and other Biden administration health officials urged eligible Americans to get an updated booster. CDC Director Dr. Rochelle Walensky cited modeling projections that were presented last week to the agency’s vaccine advisory committee showing that if the public embraces the boosters early this fall at a rate similar to that of annual flu shots, about 100,000 hospitalizations and 9,000 deaths could be prevented. Read more at PBS and the Washington Post.

August 25, 2022

Government Planning for Fall COVID-19 Booster Campaign with Updated Vaccines

The Biden administration has signaled it will offer updated boosters to people ages 12 and older soon after Labor Day, according to media reporting. Updated shots from Pfizer and Moderna will target the BA.4 and BA.5 omicron subvariants, in addition to the original coronavirus strain, in a single shot.

BA.5 is still the dominant subvariant, accounting for nearly 90 percent of all new COVID-19 cases in the U.S. according to data from the Centers for Disease Control and Prevention. Since the currently authorized vaccines only targeted the original strain of the virus, U.S. health officials are looking toward more finely-tuned boosters as a way to blunt possible surges in the fall as schools resume and as more people gather indoors. Both the Food and Drug Administration (FDA) and the CDC must authorize the updated boosters before they can be administered, but both authorizations are expected to be granted very quickly. If the authorizations happen based on the timeline discussed, vaccinations with the updated shots could begin as early as the day after the national holiday. Both Pfizer and Moderna noted they have rapidly scaled up manufacturing to be ready, if authorized, to deliver doses. Read more at NBC News and the University of Minnesota Center for Infectious Disease Research and Policy.

August 16, 2022

CDC Streamlines COVID-19 Guidance

Late last week the CDC released simplified COVID-19 guidance, detailing measures the public should take in terms of getting vaccinations and boosters and quarantining and self-isolating for positive cases and potential exposures.

With this updated guidance, the CDC emphasizes the pandemic is not over but that the country is in a different place than before, with tools for reducing the severity of the disease and cutting the number of hospitalizations and deaths that translate into it not needing to severely disrupt daily lives. It promotes the importance of staying up to date with vaccinations, noting that the protection provided diminishes over time. One of the biggest changes is quarantine guidance for people exposed to the virus. Instead of quarantining, the CDC recommends wearing a high-quality mask, watching for symptoms for 10 days, and getting tested on the fifth day. People who are mildly sick with COVID-19 should still isolate for at least 5 days while wearing a high-quality mask. After isolating, people who are recovering should avoid contact with vulnerable people for 11 days. The CDC recommends longer isolation periods for people with moderate and severe illness. Another major change is that the CDC no longer recommends screening asymptomatic people who don't have known exposures. It urges people to consider their risks in particular settings, keeping in mind community transmission levels and ventilation, when gauging needed distancing measures. Read more at the CDC and the University of Minnesota Center for Infectious Disease Research and Policy.

May 3, 2022

With Abundant Evolutionary Space to Explore, Coronavirus Threatens to Become More Contagious and Evade Vaccines

The coronavirus, SARS-CoV-2, has had billions of chances to reconfigure itself over the past 2 plus years, and it continues to evolve, changing its structure and chemistry in ways that confound efforts to bring it fully under control.

In the early days of the pandemic, scientists were optimistic the virus would mutate slowly and that mutations would be inconsequential. In such a scenario, vaccines might not need regular updating. Not only did that prove to be overly optimist, but scientists now say the virus still has abundant evolutionary space to explore. This could enable the virus to evade vaccines as well as to become even more contagious than some of its subvariants already are. “This virus has probably got tricks we haven’t seen yet,” virologist Robert F. Garry of Tulane University said. “We know it’s probably not quite as infectious as measles yet, but it’s creeping up there, for sure.” Case in point, preliminary research suggests the latest strain, BA.2.12.1, is 25 percent more transmissible than the BA.2 subvariant that is currently dominant nationally. Both emerged from the highly transmissible Omicron variant. The Omicron subvariants keep coming: scientists in South Africa have identified BA.4 and BA.5, which have mutations that were seen in earlier variants and are associated with immune evasion. In newly published research, the authors concluded these strains have the “potential to result in a new infection wave.” Read more at the Washington Post.

March 29, 2022

FDA Authorizes Second Booster for People 50 and Older and Immunocompromised Individuals; Omicron Subvariant BA.2 Becomes Dominant in the U.S.

Today the Food and Drug Administration (FDA) authorized a second booster shot of the Pfizer and Moderna COVID-19 vaccines for people 50 and older and immunocompromised individuals. The announcement comes as “BA.2,” a more transmissible version of the Omicron variant, has become the dominant strain in the U.S.

The second booster can be given at least four months after a first booster dose and is expected to become available immediately after the Centers for Disease Control and Prevention (CDC) reaches a decision on who should get it. The CDC is expected to say people may get a fourth shot, instead of explicitly recommending they do so, a reflection of the ongoing debate about the benefits of additional doses and uncertainties about the future of the pandemic. But so far the federal government has emphasized the importance of older and immunocompromised persons getting the booster. "Current evidence suggests some waning of protection over time against serious outcomes from COVID-19 in older and immunocompromised individuals. Based on an analysis of emerging data, a second booster dose of either the Pfizer-BioNTech or Moderna COVID-19 vaccine could help increase protection levels for these higher-risk individuals," said Dr. Peter Marks, director of the FDA's Center for Biologics Evaluation and Research. Evidence in support of a second booster is limited and mixed, based largely on data from Israel — where people 60 and older have been able to receive a second booster. Israeli studies have supported the idea that an additional shot could be lifesaving for people older than 60 but have also suggested the shots will have marginal benefits for young, healthy people and offer only short-term and modest protection against getting infected. Read more at The Washington Post and NPR.

The BA.2 strain now accounts for nearly 55 percent of new cases, based on CDC data for the week ending March 26. That is up from about 27 percent two weeks earlier. BA.2 is thought to be about 30 percent more transmissible than the original Omicron strain, BA.1, which itself was already more contagious than earlier versions of the virus. Experts say there is no evidence that BA.2 causes more severe disease than the original Omicron strain or that it evades the protection from vaccines to a greater degree. “I can be pretty confident in saying that vaccines will continue to work really well at keeping people away from the hospital if they are boosted,” said Dr. Peter Chin-Hong, an infectious-disease specialist at the University of California, San Francisco. When fully vaccinated and boosted, a person’s cells adopt memory and are able to detect similar variants, preventing extreme illness if infected, he added. Read more at The Hill and The Wall Street Journal.

March 8, 2022

COVID-19 Test to Treat Initiative Fact Sheet

Today the Department of Health and Human Services published a fact sheet about the “Test to Treat” initiative that is included in the Biden Administration’s National COVID-19 Preparedness Plan that was announced last week. In this program, people will be able to get tested, and – if they are positive and treatments are appropriate for them – receive a prescription from a qualified health care provider, and have their prescription filled all in one location.

These “One-Stop Test to Treat” locations will be available at hundreds of locations nationwide, including pharmacy-based clinics, federally qualified community health centers (FQHCs), and long-term care facilities. People will also continue to be able to be tested and treated by their own health care providers who can appropriately prescribe these oral antivirals at locations where they are being distributed. The antiviral pills include Pfizer’s Paxlovid and Merck’s Molnupiravir, which can help prevent severe illness and hospitalization when taken soon after symptom onset. HHS has already been distributing COVID-19 treatments, including oral antivirals, to states and territories for free on a weekly basis. Beginning yesterday (March 7), HHS also began distributing oral antiviral pills directly to participating Test to Treat pharmacy-based clinics, making more treatments available to more people in more locations. The fact sheet also includes a list of frequently asked questions about the initiative, such as where to find Test to Treat sites. It notes a federal Test to Treat website is in development with anticipated launch in mid-March. Access the fact sheet at HHS.

March 3, 2022

White House Unveils New COVID-19 Plan Aimed at Returning Life to Normal

Yesterday the White House  unveiled a new road map for the COVID-19 pandemic, one that envisions life going back to normal while staying vigilant for new variants and outbreaks.

There are four main goals in the 96-page plan: 1) protect and treat COVID-19, 2) prepare for new variants, 3) prevent business and school shutdowns, and 4) help vaccinate the rest of the world and save lives. The newest feature of the plan, which is covered in the first goal, is to offer a one-stop "test to treat" system at hundreds of pharmacies, community health centers and other sites starting in March — places where people can confirm whether they have COVID-19 and, if they're at high risk, get treated with antivirals on the spot, at no cost. As part of the second goal, the White House aims to give businesses guidance, tests, and supplies to stay open, including tools to improve ventilation and air filtration. It also notes the Occupational Safety and Health Administration (OSHA) will update workplace guidance to better equip employers with the tools they need to ensure safe workplaces. The White House’s plan also notes the Centers for Disease Control and Prevention (CDC) has updated its framework for recommendations on preventive measures like masking, so masks are recommended when and where they matter the most and Americans will be wearing masks less often. Read the plan at the White House and a relevant article at NPR.

January 25, 2022

WHO Director General Warns Conditions Conducive for More COVID-19 Variants; Workers Share Attitudes about Workplace Safety

Yesterday the World Health Organization (WHO) Director General warned conditions around the world remain conducive for the emergence of new COVID-19 variants, potentially tempering some of the optimism about the future of the pandemic as cases in some areas of the U.S. and other parts of the world have recently declined. Meanwhile, a new survey sheds light onto workers’ attitudes about the safety of their workplaces, offering potential helpful information to leaders given that COVID-19, in some fashion, is expected to remain with us for some time.

“It is dangerous to assume that Omicron will be the last variant, or that we are in the endgame,” WHO Director General Tedros Adhanom Ghebreyesus said at an executive board meeting. “On the contrary, globally the conditions are ideal for more variants to emerge.” Striking an optimistic tone, he said it's possible to end the emergency phase of the pandemic this year if countries use tools and strategies known to drive down cases, including vaccination, increasing testing and sequencing, using targeted public health measures when needed, and using new solutions as they surface. In the U.S., one of the new solutions employed during the pandemic that has involved the sector is the testing of wastewater as an early indicator of COVID-19 prevalence in a community. Samples from wastewater taken from 83 US cities suggests the latest surge of COVID-19 cases caused by the Omicron variant may have already peaked in major urban areas. New York, Boston, Denver, Minneapolis and St. Paul, and San Diego have all likely peaked, according to the level of virus detected in sewage samples. Of all the measures, however, Tedros emphasized bridging the vaccine access gap across countries as a key step for ending the emergency phase.

Read more at the University of Minnesota Center for Infectious Disease Research and Policy (article one, article two, and article three) and the Washington Post.

Given the likelihood that COVID-19 will remain with us for some time, even if the world ends the emergency phase, organizations must continue to factor in the virus for their workplace safety and resilience plans. One aspect of this is managing risks at the workplace for employees. To help inform discussions and decisions on this topic, Honeywell recently released the results of a comprehensive study on workers' perceptions and feelings on the health and safety of their workplace. The study surveyed 2,000 workers that typically work in buildings with 500 or more employees across the U.S., U.K., Germany, and the Middle East. The findings show that a staggering majority of the global workforce (68 percent) does not feel completely safe working in their employer's buildings. This number is even higher for those working remotely (75 percent), who are especially skeptical about the safety of work sites. In fact, nearly 1 in 4 remote workers (23 percent) would look for a new job rather than return to a site that did not implement necessary safety measures.

Read more at Honeywell.

January 18, 2022

Supreme Court Ruling Blocks OSHA Vaccine Mandate; Program for Ordering Free, Rapid COVID-19 Tests Begins

Last week the U.S. Supreme Court blocked the Occupational Safety and Health Administration’s (OSHA’s) vaccine-or-test mandate that would have applied to many American workplaces. This week, Americans can begin ordering free rapid COVID-19 tests online through a program recently announced by the Biden administration.

The Supreme Court ruled 6-3 against the OSHA employer mandate, blocking it from taking effect while other legal challenges play out. Meanwhile, it allowed the Centers for Medicare & Medicaid Services vaccine mandate for health care workers to go into effect, by a 5-4 opinion. The cases now return to the courts of appeals for further proceedings, where it is very unlikely there will be a conclusion different than the Supreme Court’s. Given a statement released following the Supreme Court’s decision, it seems the White House recognizes the attempt to finalize the OSHA vaccine-or-test mandate is effectively blocked, noting “it is now up to States and individual employers” to institute vaccination requirements. The White House statement observed nearly one third of Fortune 100 companies had implemented such requirements. A limited number of places have adopted the equivalent of the federal rule for companies within their borders, such as Illinois and New York City. Outside of these places, requirements for workers at private companies from local and state officials are few and far between. And even states with plans to adopt the vaccine-or-test standard announced they would not move forward with the rule at this time. Meanwhile, almost a dozen states have adopted rules to prevent workplace vaccine mandates – from seeking to ban the mandates entirely or imposing specific restrictions on specific programs.

Read more at the American Hospital Association, The Hill, The Washington Post, U.S. News and World Report, and Littler.

Officially beginning tomorrow, January 19, Americans can order free rapid COVID-19 tests online through COVIDTests.gov, part of a new program announced by the Biden administration in which the federal government is purchasing one billion tests. Each residential address is limited to four tests. Tests will usually ship within 7-12 days of ordering. Additionally, the White House announced a series of other steps intended to expand access to free testing, including by requiring private insurance companies to cover at-home COVID-19 tests, making more tests available at schools, standing up new federal testing sites, increasing the number of tests authorized in the U.S., and more. Read more at the White House.

January 11, 2022

U.S. COVID-19 Hospitalizations Hit Record High, Hospitals Experience Critical Staffing Shortages, CDC Weighs Recommending Better Masks against Omicron

The U.S. has surpassed its record for COVID-19 hospitalizations and nearly a quarter of hospitals are reporting critical staffing shortages due to workers being sick or off for quarantine. Meanwhile, the CDC is said to be weighing updating its mask guidance to recommend that people opt for the highly protective N95 or KN95 masks.

Tuesday’s total of 145,982 people in U.S. hospitals with COVID-19 passed the record of 142,273 set on January 14, 2021, during the previous peak of the pandemic in this country. More troubling still, those numbers are expected to continue to rise. Disease modelers are predicting total hospitalizations in the 275,000 to 300,000 range when the peak is reached, expected for later this month. The sheer number of cases has put pressure on hospitals, which are also contending with workers having to take off due to illnesses or quarantine requirements. Some facilities are leaving some beds empty, because they don't have enough staff to safety fill them with patients. Currently, about 24 percent of hospitals report critical staffing shortages, the highest of the pandemic, and many facilities are starting to limit elective surgeries and consider crisis standards of care.

Read more at the Washington Post and the University of Minnesota Center for Infectious Disease Research and Policy.

With the highly transmissible Omicron variant spurring the current surge, the CDC is said to be weighing updating its mask guidance to recommend that people opt for the highly protective N95 or KN95 masks worn by health-care personnel, if they can do so consistently. Experts have recommended these masks vs. cloth coverings and have emphasized the importance of masking in general. The updated guidance is expected to say the best mask is one worn consistently and correctly and that if people can “tolerate wearing a KN95 or N95 mask all day, you should.”

Read more at the Washington Post.

January 6, 2022

“Flurona” Co-infections of COVID-19 and Flu Reported in the U.S.; Supreme Court to Hear Arguments about OSHA Vaccine Mandate Tomorrow

In COVID-19 pandemic updates, recent cases of “flurona” – when a person has both COVID-19 and the flu – have been reported in the U.S., and the U.S. Supreme Court is scheduled to hear oral arguments tomorrow on whether to allow OSHA’s workplace vaccine mandate to go into effect.

Some of the recent flurona cases in the U.S. have been reported in Houston and California, in cases involving children. Cases of flurona are actually not new, although the term was recently coined following infections in Israel. Instances of co-infection were reported in the U.S. almost two years ago. Additionally, flurona is not a distinct disease. But more cases of flurona could occur this winter as the highly contagious Omicron variant surges in the U.S., and around the world. According to Reuters reporting, the U.S. reported nearly 1 million new COVID-19 infections on Monday, the highest daily tally of any country in the world and nearly double the previous U.S. peak set a week ago. So what are the symptoms of flurona? Both COVID-19 and flu are respiratory infections, which can cause similar symptoms such as fever, coughing, fatigue, runny nose, sore throat and diarrhea, along with muscle and body aches. Both infections can be fatal, although the severity of each diagnosis depends largely on an individual’s immune system. And for both, health experts and doctors stress that vaccines remain the best way to protect against severe infections. Given the emergence of the cases, as well as because it’s flu season anyways, it’s a good time to check the CDC’s information and guidance on the flu.

Read more at the Washington Post and Reuters.

The Supreme Court’s decision following tomorrow’s arguments may effectively decide whether OSHA’s vaccine mandate, as well as the one from the Centers for Medicare & Medicaid Services that applies to health care facilities, go into effect at all. The outcome will have implications for private and non-profit water and wastewater systems, as well as for public systems in some states. The challengers for the OSHA mandate argue that nothing in the Occupational Safety and Health Act expressly gives OSHA the power to require vaccination or weekly testing of many American workers and that the mandate will lead to economic and political consequences, including for individual organizations. The federal government, by contrast, points to the Occupational Safety and Health Act’s requirement that the agency regulate “agents” and that are “physically harmful” and argues that SARS-CoV-2 fits that definition. The challengers also attack OSHA issuing its mandate through its “emergency temporary standard” authority without notice and comment. The federal government responds that an emergency standard is appropriate any time there is a “new” hazard and that SARS-CoV-2’s recent emergence meets that standard. It’s unclear how quickly the Supreme Court will rule following the arguments. The public can listen to the arguments on the Supreme Court’s homepage: https://www.supremecourt.gov/.

Read more at the American Hospital Association.

January 4, 2022

New Data on Omicron Variant

New daily reported cases of COVID-19 are continuing to increase in the U.S., fueled by the Omicron variant that recently became dominant. Recent analyses and research have helped shed additional light on the relatively new strain, in some cases bringing encouraging news.

For one, Dr. Anthony S. Fauci observed that hospitalizations, which are not rising as fast, were a more important barometer than reported cases for the severity of the Omicron wave, a sharp distinction after nearly two years of tallying daily case counts. “As you get further on and the infections become less severe, it is much more relevant to focus on the hospitalizations as opposed to the total number of cases,” Dr. Fauci said. Relatedly, a large British study has determined people who contract COVID-19 due to Omicron are far less likely to be hospitalized than those infected with the Delta variant. Other studies found that Omicron may not spread as easily to the lungs, a possible explanation of why its effects appear less severe. The British study also underlined the risk of hospitalization was significantly lower for people who had received two or three vaccine doses, compared with unvaccinated people. Among COVID-19 cases who developed symptoms, people who had three doses were 88 percent less likely to be hospitalized than those who had not had any shots.

The number of cases is still staggering and in many places is expected to continue to grow. A tool some public health authorities have for projecting upcoming cases is testing wastewater for traces of the virus that causes COVID-19. In Boston, Massachusetts, for example, levels of the virus detected in wastewater have reached new highs, with the seven-day average for last week more than tripling the previous period. According to the company that tests the wastewater coming into the treatment plant, the amount of virus is correlated with newly diagnosed COVID-19 cases four to ten days later.

Read more at the New York Times and the Boston Globe.

December 21, 2021

President Biden to Deliver Address and Announce New Steps for Now Dominant Omicron Variant

Today President Biden is announcing new actions intended to address Omicron, building on the plan he released earlier this month when the variant’s presence had just been detected in the U.S. In data released yesterday, the CDC noted Omicron now accounts for 73 percent of all COVID-19 cases, a nearly six-fold increase in its share of infections in only one week.

Although President Biden will make the announcement later today, some details of the actions have already been shared in a statement released by the White House. The actions include expanding access to free testing, including at-home tests; increasing capacity for vaccinations and boosters; and providing increased support for hospitals, including with mobilizations of military personnel. Reflecting language already in the statement, Biden is expected to emphasize the benefits of vaccinations and the risks posed to unvaccinated individuals. In its updated Omicron webpage, the CDC notes while breakthrough infections in people who are fully vaccinated are likely to occur, vaccines have remained effective at preventing severe illness, hospitalizations, and death. It adds the emergence of Omicron further emphasizes the importance of vaccination and boosters. Public health officials and experts have added to the calls for more people to get vaccinated and boosted given Omicron’s arrival. “All of us have a date with Omicron,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “If you’re going to interact with society, if you’re going to have any type of life, Omicron will be something you encounter, and the best way you can encounter this is to be fully vaccinated.”

Omicron’s arrival and surge comes at an unfortunate time, during the holidays when many are expected to travel and interact with others. It has already altered some travelers’ plans, and it has also led to the cancelation of numerous events, such as in the sports and entertainment world, and to the reimposition or extension of mask mandates. Eight states, the District of Columbia, and Puerto Rico require most people to wear masks in an indoor public setting, coinciding with current CDC guidance. The federal government has extended its mask mandate to March 18. It was originally set to expire on January 18 and includes public transportation settings, such as on buses, trains, and airplanes.

Read more at NPR, the Associated Press, the Washington Post, and CNET.

December 16, 2021

Omicron Continues to Spread, Could Bring a Wave of Infections as soon as January

The Omicron variant has quickly gained a foothold in most of the country, with cases now detected in 36 states. During a CDC briefing with governors and health officials earlier this week, data was presented that showed a wave of infections, caused by both the Omicron and Delta variants, could hit the U.S. as soon as next month.

This time last week, Omicron was in just 21 states. Delta is still the dominant strain, with just three percent of all national cases caused by Omicron. But there are hotspots in parts of the country, such as in parts of New York and New Jersey where the percentage jumps to 13 percent. In Ithaca, New York, Cornell University reported 903 COVID-19 cases among students from December 7 through 13, and a high percentage are Omicron. The outbreak led school officials to shut down its campus. The CDC expects Omicron to become more prevalent in the coming weeks, assisted in part by it seeming to be more transmissible based on early data. Omicron’s spread and the greater impacts it could soon have on the nation were highlighted during a CDC briefing on Tuesday, when two scenarios for how Omicron may spread through the country were presented. The worst-case scenario is a winter surge that arrives in January, at the same time as flu activity increases. In the second scenario, a small wave of Omicron cases occurs in the spring.

Omicron has begun to influence the nation's mood: 36 percent of Americans say they are worried or extremely worried about themselves or a family member being infected with COVID-19, up from 25 percent in October. Despite the worry, respondents report taking fewer precautions than they did in the spring and are planning a return to normal activities. Roughly half of those polled say they currently stay away from large groups, wear a face mask, and avoid nonessential travel, down from 70 percent in February.

Read more at the University of Minnesota Center for Infectious Disease Research and Policy and the Washington Post.

December 9, 2021

CDC Provides Need-to-Know Information on Omicron Variant

The CDC has posted a webpage with need-to-know information on Omicron, updating the resource as more is learned on the variant by its own scientists and other researchers. While information on Omicron is still being developed, CDC provides what is known or expected in terms of transmission, illness severity, vaccine effectiveness, and more.

In terms of transmission, the CDC notes Omicron likely spreads more easily than the original COVID-19 virus but that how it compares to the Delta variant remains unknown. The CDC notes more data is needed to know if Omicron infections result in more severe illness or death as compared to other variants but adds that it expects current vaccines protect against these situations (while acknowledging breakthrough infections are likely to occur). The CDC also emphasizes vaccines are the best public health measure to protect people from COVID-19, slow transmission, and reduce the likelihood of new variants emerging. With research on Omicron still being conducted, the CDC also stresses the importance of using all tools to protect yourself and others, including by using face masks, getting tested when appropriate, and frequently washing hands. The CDC webpage also provides a map showing the U.S. states where Omicron cases have been confirmed, which now includes 21 states.

Access the webpage at the CDC.

December 2, 2021

Biden Administration Announces New Actions to Address Omicron, Variant Confirmed Present in the U.S.

Today President Biden will announce new actions to address the COVID-19 pandemic given the recent emergence of the Omicron variant, which has been confirmed in cases in California and Minnesota, as well as the continuing prevalence of the Delta variant and the onset of winter.

Although President Biden will make the announcement later today, some details of the actions have already been shared in a statement released by the White House. The actions include efforts to increase vaccinations, including for boosters and initial doses; expanding access to testing resources; implementing new protocols for international travel; extending the requirement to wear a mask on airplanes, rail travel, and public transportation; and supplying treatment pills to help prevent hospitalizations and deaths, among other steps.

Officials in California and the U.S. Centers for Disease Control and Prevention (CDC) confirmed the first U.S. Omicron case yesterday, in an individual who recently returned from South Africa. And today, the Minnesota Department of Health (MDH) confirmed an Omicron case, the second in the U.S. The individual in that case recently returned from travel to New York City, where they attended a convention. In both cases, the individuals had been vaccinated and were reported to have mild symptoms, with the symptoms for the Minnesota case having already resolved. Echoing the messaging of other public health authorities, the MDH acknowledged scientists are still working to determine how Omicron compares with the Delta variant in terms of transmissibility and disease severity and the degree to which existing vaccines and therapies protect against the newest variant. They also emphasize the importance of getting vaccinated (and a booster shot, when applicable) given Omicron’s emergence, as the CDC did in a statement earlier this week.

November 30, 2021

CDC Emphasizes Booster Shots for “Omicron,” Variant of Concern Recently Detected in North America

Yesterday the U.S. Centers for Disease Control and Prevention (CDC) announced it was strengthening its recommendation on COVID-19 vaccine boosters given the recent emergence of “Omicron,” noting early data for the newly classified “variant of concern” suggests it has increased transmissibility. No cases in the U.S. attributed to Omicron have been confirmed yet, but Canada announced it had detected two cases on Sunday.

In its statement, the CDC encourages everyone in the U.S. 18 and older to get a booster shot six months after their initial Pfizer or Moderna series or two months after their initial Johnson & Johnson vaccine. It also encouraged those not yet vaccinated to get vaccinated as soon as possible and to vaccinate children and teens. The CDC also said it is examining the effectiveness of current vaccines on Omicron. According to a White House statement, Dr. Anthony Fauci has said while it will take approximately two more weeks to have more information on the transmissibility, severity, and other characteristics of the variant, he believes existing vaccines are likely to provide a degree of protection against severe cases of COVID-19. During an interview with the media, Dr. Fauci also noted that while the Omicron variant has not yet been confirmed in the U.S. it could be here already and that it’s inevitable there will be cases at some point. Meanwhile, Omicron is spreading to other parts of the world, including Australia.

Read more at NPR.

November 18, 2021

Some States Authorizing COVID-19 Boosters for All Adults ahead of FDA Authorization; OSHA Suspends Enforcement of Business Vaccine Mandate while Health Associations Urge Compliance

Several states have expanded access to COVID-19 vaccine boosters for all adults ahead of a formal authorization from the Food and Drug Administration (FDA) that could come as soon as this week. Additionally, the Occupational Safety and Health Administration (OSHA) announced it is suspending enforcement of the Biden administration’s vaccine mandate for large private businesses, while numerous health care associations called on employers to voluntarily implement the mandate.

Yesterday, Kansas, Kentucky, Maine, and Vermont joined several other states, including Arkansas, California, Colorado, and New Mexico (as well as New York City), in announcing they had expanded COVID-19 vaccine booster access to all adults. Currently, federal regulators say people who received two doses of the Pfizer or Moderna vaccines and are 65 or older, or adults who are considered to be at special risk because of their medical conditions, jobs, or living environments are eligible for boosters. Anyone who received the single-dose Johnson & Johnson shot can already get a booster. Eligible people can select from any of three vaccine brands as a booster. State leaders have used various justifications for choosing not to wait for federal decisions on boosters, ranging from concerns about holiday season gatherings and winter temperatures pushing people indoors to rising cases and confusion among residents about eligibility. The Centers for Disease Control and Prevention's (CDC’s) advisory committee is scheduled to meet Friday afternoon to discuss Pfizer's booster shot. The committee typically makes a formal recommendation after FDA authorization, and then the CDC director signs off on the decision. In its filing last week, Pfizer said new data from a large clinical trial of more than 10,000 fully vaccinated people found that a booster dose was over 95 percent effective against COVID-19 compared to individuals who were fully vaccinated but had not received a booster dose. A press release issued by Pfizer said that during the study period, "there were 5 cases of COVID-19 in the booster group, and 109 cases in the non-boosted group."

Read more at The New York Times, CBS News, and NBC News.

OSHA recently announced it was suspending its activities related to the Biden administration’s vaccine mandate for private businesses, which applied to those with 100 or more employees, given pending litigation. “The court ordered that OSHA 'take no steps to implement or enforce' the ETS [Emergency Temporary Standard] 'until further court order.' While OSHA remains confident in its authority to protect workers in emergencies, OSHA has suspended activities related to the implementation and enforcement of the ETS pending future developments in the litigation,” OSHA said. In a 22-page ruling last week, the 5th U.S. Circuit Court of Appeals wrote that the administration’s COVID-19 vaccine and testing mandate was “fatally flawed” and ordered that OSHA not enforce the requirement “pending adequate judicial review” of a motion for a permanent injunction. Meanwhile, the American Medical Association and more than 60 other health care associations today called on employers to voluntarily implement the mandate, saying businesses had no time to waste ahead of the busy holiday season. “We — physicians, nurses and advanced practice clinicians, health experts, and health care professional societies — fully support the requirement that workers at companies with over 100 workers be vaccinated or tested,” the organizations wrote in a joint statement. “From the first day of this pandemic, businesses have wanted to vanquish this virus. Now is their chance to step up and show they are serious.”

Read more at The Hill and The Washington Post.

November 9, 20210

Biden Administration Announces Details of Workplace Vaccination Policies
Late last week the Biden administration released details of its plan to require full COVID-19 vaccination or weekly testing for two-thirds of the nation’s workforce by January 4. Included in the vaccination or weekly testing mandate are companies that have 100 or more employees, a program that is administered by the Occupational Safety and Health Administration (OSHA). OSHA has posted the Emergency Temporary Standard (ETS) that addresses the requirement, which notes businesses do not need to pay for testing or face masks, the latter also a requirement in most circumstances under the policy. Additionally, OSHA has released a video, frequently asked questions webpage, and other compliance materials to help guide businesses through the transition. The plan is facing legal challenges, however, including the U.S. Court of Appeals for the 5th Circuit halted the requirements on Saturday pending review, writing that “the petitions give cause to believe there are grave statutory and constitutional issues with the Mandate.” It’s unclear which court (perhaps even the U.S. Supreme Court) will ultimately decide the case, and when. In the meantime, the White House said businesses should move forward. Read more at the White House, the University of Minnesota Center for Infectious Disease Research and Policy, CNBC, and Homeland Security Today.

October 26, 2021

Boosters Approved for All COVID-19 Vaccines in the U.S.
There are now booster recommendations for all three COVID-19 vaccines authorized for use in the U.S. following CDC Director Dr. Rochelle Walensky’s endorsement late last week of recommendations from the agency's outside advisory panel. More than 50 million Americans are now eligible to get a booster from Moderna and Johnson & Johnson. Combined with Pfizer recipients, there are now nearly 100 million Americans who are over the age of 65, or otherwise at risk of severe disease, who are eligible for a booster shot. Currently anyone who received a Johnson & Johnson vaccine more than 2 months ago can be boosted. People over 65 who completed an mRNA series (either the Pfizer or Moderna vaccine) more than 6 months ago, or are 18 and older with an underlying medical condition or working or living in an environment that puts them at high risk for infection, can also get a booster. Additionally, eligible Americans can choose any booster they want, either sticking with the vaccine used in their primary series or mixing and matching. Read more at The Hill and the University of Minnesota Center for Infectious Disease Research and Policy.

October 12, 2021

Compendium of U.S. Wastewater Surveillance to Support COVID-19 Public Health Response
EPA has released A Compendium of U.S. Wastewater Surveillance to Support COVID-19 Public Health Response, which details various COVID-19 wastewater surveillance programs across the nation from 2020 to early 2021, led by federal, state, local, and tribal agencies and associations, universities, and the private sector. It explores federal and other funding sources, developing and implementing wastewater surveillance programs for the virus that causes COVID-19, and uses case studies to provide implementation insight and lessons learned. The document additionally guides those interested in implementing wastewater surveillance in the future by elaborating on funding, project management, results, and potential actions to prevent the continued spread of COVID-19. Access the report at EPA and below (the report is posted as resource # 48).

Public Health Authorities Bracing for Potential “Twindemic” of Flu and COVID-19
Some public health authorities are worried the flu will come roaring back this season after not materializing last year when most of society was shut down. Combined with the ongoing COVID-19 pandemic, the flu could contribute to a “twindemic” and create challenges for workplace manning as well as put more strain on hospitals. Part of authorities’ concerns stem from low rates of flu vaccinations, with recent survey data showing slightly more than half of American adults plan to get vaccinated against the flu. That’s not much of a change from pre-pandemic surveys. But experts say Americans have built up less natural immunity against influenza because so few were infected in 2020. Flu viruses may also roar back with more opportunities to spread this fall and winter in reopened schools, workplaces and businesses, especially where masks are not mandated. Read more at the Washington Post.

October 5, 2021

The Cybersecurity and Infrastructure Security Agency has updated its COVID-91 Vaccination Hesitancy within the Critical Infrastructure Workforce “Insights” document with information from the July 2021 iteration of the Kaiser Family Foundation (KFF) COVID-19 Monitor, which compares participants’ changes in vaccine attitudes from January to June 2021 and the reasons for these changes and other COVID-19 vaccination news from the summer of 2021.

As CISA observes, the recent iteration of the Monitor found that people who changed their attitude and received their first vaccine shot did so because they saw family and friends safely receive the vaccine and heard pro vaccine messages from people they trust. By hearing about the safety of the vaccine rather than the dangers of getting COVID-19, these personalized community-based efforts proved to be most effective in convincing the hesitant KFF poll participants to receive the COVID-19 vaccine. This finding reinforces a message CISA included in the first version of this document, published in March 2021, that employers of frontline essential workers have an opportunity to encourage and lead their critical infrastructure workforce in COVID-19 vaccine acceptance. CISA also observed that building and sustaining public trust and confidence in immunization systems is essential and the critical infrastructure workforce can play a vital role.

September 28, 2021

In the past week, the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) endorsed providing some COVID-19 vaccine booster shots, giving the Biden administration the authority to start administering doses. The administration had originally said all Americans would receive a third shot. But for now the booster plan is more narrow, focused on the populations most likely to develop severe symptoms from COVID-19 and those who face more exposure because of their work. The extra dose is available only to Pfizer vaccine recipients who are people 65 and older, long-term care facility residents, and individuals aged 18-64 who either have underlying medical conditions or are at an increased risk for COVID-19 because of occupational or institutional setting. The latter group includes first responders, education staff and workers in the agriculture, manufacturing, grocery store and public transit industries and Postal Service. The federal health agencies did not endorse a “mix-and-match” approach to vaccine boosters, citing a lack of evidence on the potential effects of using two different shots. Those who were immunized with Moderna’s or Johnson & Johnson’s vaccines will have to wait. Read more at Vox and the Washington Post.

September 23, 2021

The surge of COVID-19 cases associated with the Delta variant appears to be peaking nationally, and cases and deaths will likely decline steadily now through the spring without a significant winter surge, according to a new analysis by a consortium of researchers advising the Centers for Disease Control and Prevention. For its latest update, the COVID-19 Scenario Modeling Hub combined nine different mathematical models from different research groups to get an outlook for the pandemic for the next six months. The modelers developed four potential scenarios, taking into account whether or not childhood vaccinations take off and whether a more infectious new variant should emerge. The most likely scenario is that children do get vaccinated and no super-spreading variant emerges. In that case, the model forecasts that new infections would slowly, but fairly continuously, drop from about 140,000 today now to about 9,000 a day by March. "Any of us who have been following this closely, given what happened with delta, are going to be really cautious about too much optimism," says Justin Lessler at the University of North Carolina, who helps run the hub. "But I do think that the trajectory is towards improvement for most of the country," he says. Read more at NPR.

September 14, 2021

President Biden’s announcement last week that companies with 100 employees or more must require them to be vaccinated or tested regularly as part of his administration’s COVID-19 action plan has been criticized by some government leaders, including numerous state governors, as well as by some in industry. Some of the opponents of the new mandate have threatened to challenge it in court, prompting questions of whether it will stand. The mandate has not yet been written by the Occupational Safety and Health Administration (OSHA), but several legal experts anticipated the focus of lawsuits. According to one expert, OSHA making a new rule when accommodations for unvaccinated employees have already been made presents an issue, but the Delta variant’s spread could address that question. Experts also point out the Supreme Court has ruled in favor of vaccine mandates before, while acknowledging the current justices may view this case differently. There’s also the question of what happens in states where vaccine mandates are banned. As another expert observed, in such cases the federal rule would preempt the state rule. Read more at CBS News and the Washington Post (article one and article two).

September 7, 2021

An article recently published in the journal Disaster Medicine and Public Health Preparedness documents California’s efforts to address oxygen supply issues that emerged because of high numbers of COVID-19 patients needing ventilator support. While some rationing and troubleshooting did occur, the state was largely able to create a centralized request and allocation system, which included regional oxygen depots, procurement contracts, and tip sheets on oxygen safety and conservation. While the findings and recommendations are tailored to mass patient care situations, they also speak to efforts that can be taken state-wide and by individual end-users to address oxygen shortage issues. "Oxygen plans are required at every level of disaster and pandemic response, from logisticians to end-users," said Dr. Asha Deveraux, one of the researchers. "Assumptions that oxygen is an endless supply are erroneous, and oxygen conservation and supply should be part of every current and future planning efforts,” she added. Other states have also contended with oxygen shortages brought on by the COVID-19 pandemic, sometimes resulting in impacts to water utilities. As WaterISAC noted in its August 26 Security & Resilience Update, the Orlando Utilities Commission has been asking customers to limit their water use due to a regional shortage of liquid oxygen that is impacting treated water supplies. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.

• mRNA COVID-19 vaccines, which include those produced by Pfizer and Moderna, were not associated with significantly higher rates of 23 serious adverse events 1 to 21 days (risk interval) after receiving one or two doses than after 22 to 42 days (comparison interval), finds an interim analysis of surveillance safety data involving millions of people in the Journal of the American Medical Association (JAMA). Researchers from Kaiser Permanente Vaccine Study Center led the study, which consisted of analyzing vaccine surveillance data from the Vaccine Safety Datalink (VSD) on 6.2 million vaccinated members of eight US health plans from Dec 14, 2020, to Jun 26, 2021. Of 6.2 million participants, 57 percent received the Pfizer/BioNTech COVID-19 vaccine, and the remainder received Moderna. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• Most firms are now planning on having COVID-19 vaccine mandates for their workforce, according to data released last week by Willis Towers Watson, a multinational advisory and insurance firm. Over half of the employers surveyed (52 percent) said that by the fourth quarter of 2021, they could have one or more vaccine mandate requirements in the workplace. This ranges from requiring vaccinations for employees to access common areas (such as cafeterias) to requiring the jab for a subset of specific employees to requiring it for all employees. This is a major hike from the current 21 percent of firms that have some type of vaccine mandate in place for employees. The survey was conducted between August 18 and 25, in the wake of the spread of the more contagious Delta variant. Respondents included nearly 1,000 U.S. employers that together employ nearly 10 million workers. Read more at ABC News.
• On Thursday, President Biden is expected to present a six-pronged strategy aimed at fighting the spread of the highly contagious coronavirus Delta variant and increasing U.S. COVID-19 vaccinations. A White House official, speaking on condition of anonymity, said Biden’s strategy will work “across the public and private sectors." Read more at Reuters.

August 31, 2021

A new study published in the U.K.’s Lancet Infectious Diseases journal compared the hospitalization rate between individuals infected with the Delta variant versus the Alpha variant. The authors determined that “patients with the Delta variant had more than two times the risk of hospital admission compared with patients with the Alpha variant.” The study observed that vaccinated patients infected with the Delta variant had a lower risk of hospital admission. The scientists examined more than 40,000 COVID patients in the U.K. between March and May of this year. The results also found that “emergency care attendance combined with hospital admission was also higher for patients with the Delta variant, showing increased use of emergency care services as well as inpatient hospitalization.” With deaths from COVID up 355 percent since early July, this study illustrates the significance of vaccines in helping to combat the persisting pandemic. Access the study and read a relevant article at CBS News.

In other updates:

• For only the second time during the 18 months the U.S. has been battling COVID-19, the country reached 100,000 daily hospitalizations due to infection with the virus, matching the previous record seen last winter. In several states, the fourth wave, or summer surge caused by the Delta variant, has led to hospital bed and healthcare worker shortages. Intensive care units (ICUs) have reached capacity in places such as Georgia, Mississippi and Florida. In those states, elective surgeries have been put on hold. During a meeting yesterday of the Advisory Committee on Immunization Practices, which advises the Centers for Disease Control and Prevention (CDC), committee members heard that 23 states are reporting over 80 percent of ICU capacity is being used by COVID-19 patients. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• The percentage of Americans who say they will never get vaccinated against COVID-19 has dropped to a new low, according to a new poll. The Axios-Ipsos poll published today found 20 percent of Americans said they either are not very likely or not likely at all to receive a vaccine. That represents a new low in the survey and is down from a combined 34 percent in March and 23 percent two weeks ago. The factors driving down vaccine hesitancy, the survey found, were a surge in delta variant cases, the return of children to schools in recent days and the Food and Drug Administration's granting of full approval for the Pfizer-BioNTech vaccine earlier this month. Read more at The Hill.
• Companies unwilling to require employees to get vaccinations are increasingly considering penalties and other more aggressive measures, including healthcare-benefit surcharges, to make their workplaces safer from COVID-19, employment and benefit experts say. Delta Air recently became one of the first high-profile companies to impose a health-insurance surcharge for unvaccinated employees, charging them $200 a month starting in November. Delta also requires newly hired employees to be vaccinated, but not existing workers. Such tactics are generally legal, according to experts, but they do carry risks for companies. Employees upset about the changes could quit, and businesses need to be mindful of laws such as the Affordable Care Act that set strict limits on rewards and penalties under wellness programs. Read more at the Wall Street Journal.

August 26, 2021

Since late last week, the Orlando Utilities Commission (OUC) has been asking customers to limit their water use, especially for irrigating their lawns (noting it accounts for 40 percent of use), due to a regional shortage of liquid oxygen that is impacting treated water supplies. The shortage is due to a surge of COVID-19 inpatients, resulting in liquid oxygen that ordinarily goes to water treatment being diverted to hospitals. The utility typically goes through ten trucks of liquid oxygen a week but its supplier recently said that it would be cut back to five to seven trucks a week to accommodate hospitals, according to Linda Ferrone, OUC’s chief customer and marketing officer. In its advisory to customers, OUC notes that if liquid oxygen supplies continue to be depleted and water usage isn’t reduced, water quality may be impacted. It added that it believes this will not happen if everyone does their part to conserve water, and in its latest update noted there has been a moderate reduction in water demand. OUC also advises residents to be prepared to follow the conservation measures for at least two weeks and lists other water conservation measures, which include limiting car washes, taking short showers, and repairing leaking faucets and toilets, among others. Read more at OUC and the Associated Press.

August 24, 2021

Yesterday the Food and Drug Administration (FDA) granted full approval to the Pfizer COVID-19 vaccine, a move that is expected to increase vaccination rates by prompting some previously vaccine hesitant individuals to get the shot and motivating more employers to issue vaccine mandates. Unlike an emergency use authorization, a full approval lasts indefinitely, unless an unexpected side effect develops. To get a product approved, a company must provide vastly more data and details on the manufacturing process and relevant facilities and is subject to in-depth inspections by the FDA. The FDA redoubled its efforts to expedite the approval process, increasing staff and computer resources dedicated to the review. In the end, the vaccine approval was the fastest in the agency’s history, coming less than four months after Pfizer filed for approval on May 7. Meanwhile, Moderna, the second most widely used vaccine in the U.S., filed for full approval June 1. Johnson & Johnson, the maker of the third COVID-19 vaccine authorized for emergency use, has said it plans to apply for approval later this year. Read more at the Washington Post.

In other updates:

• A group of energy companies are among the latest employers to have issued vaccine mandates. The second-largest U.S. oil producer, Chevron, and refiner Valero Energy will require vaccinations for certain field workers or new workers, while Pioneer Natural Resources is requiring newly hired employees to be fully vaccinated before their first day of work. Oil producer Hess said it will require workers at U.S. Gulf of Mexico operations to be fully vaccinated by November 1. In a statement, the company pointed to the "highly infectious nature" of the Delta variant and rising number of COVID-19 cases in the U.S. Meanwhile, the U.S. Department of Defense is moving forward with a vaccine mandate for all service members, a move it recently indicated it planned to do. Defense Secretary Lloyd Austin is “prepared to issue updated guidance requiring all service members to be vaccinated,” Pentagon press secretary John Kirby told reporters yesterday. Read more at Reuters and The Hill.
• On September 23, the Association of Metropolitan Water Agencies and Carollo Engineers will host a free webinar on pandemic-related construction costs and delays. The webinar will bring together a diverse panel of utility leaders, a construction executive, and a chief estimator. The panel will explore the challenges the water sector is experiencing in completing construction projects due to commodity pricing strains and supply chain issues related to delays and cost escalation. Read more and register at AMWA.
• The Environmental Finance Center at the University of North Carolina at Chapel Hill recently published a compilation of the federal pandemic programs from which water utilities may find financial relief. The report discusses programs and funds provided through the Coronavirus Aid, Relief, and Economic Security (CARES) Act; the Consolidated Appropriations Act, 2021; and the American Rescue Plan Act (ARPA). Access the report at the UNC Environmental Finance Center.

August 19, 2021

Yesterday the Biden administration unveiled plans to begin offering COVID-19 booster shots on September 20 for American adults who received the Pfizer or Moderna vaccines. Under the plan a third shot will be provided to Americans who received their second vaccine dose at least eight months ago, pending authorization from the U.S. Food and Drug Administration. In a joint statement, federal public health and medical experts explained mRNA vaccines like Pfizer and Moderna continue to be effective in reducing risk of hospitalization and death but that new data shows the vaccines' effectiveness decreases over time. They said people who received the single-dose Johnson & Johnson vaccine probably will also need an extra shot but that they're still collecting data because the federal rollout of the vaccine did not begin in the U.S. until March. The initial doses will go to those who were fully vaccinated earliest in the vaccine rollout, including health care providers, nursing home residents and other older Americans. Read more at USA Today.

In other updates:

• The Occupational Safety and Health Administration (OSHA) has updated its guidance on mitigating and preventing the spread of COVID-19 in the workplace, most notably to reflect the U.S. Centers for Disease Control and Prevention’s (CDC’s) recommendations for mask use and testing for fully vaccinated people. Read the guidance at OSHA.
• The Transportation Security Administration (TSA) is expected to to extend requirements for travelers to wear masks on airplanes, trains and buses and at airports and train stations through Jan. 18 to address ongoing COVID-19 risks. The current TSA transportation mask order runs through Sept 13. The extension reflects the impact of the highly transmissible Delta variant and is an acknowledgement that transit remains potentially risky, especially for unvaccinated people. In some U.S. states, transportation hubs are among the only places where masks are still required. Read more at Reuters.
• The U.S. Centers for Disease Control and Prevention (CDC) said yesterday it is creating a new disease forecasting center to improve the ability to use data to predict and gauge emerging health threats. The Center for Forecasting and Outbreak Analytics will help in sharing information in real time to activate governmental, private sector, and public actions in anticipation of threats both domestically and abroad, CDC Director Dr. Rochelle Walensky said in a statement. Read more at Reuters.

August 12, 2021

Two-thirds of Americans in highly vaccinated counties now live in COVID-19 hot spots, according to an analysis by The Washington Post. The analysis illustrates how the latest surges of activity, which until recently was concentrated in areas with local vaccination numbers, has quickly developed into a nationwide problem. According to the analysis, on July 4th just four percent of residents of highly vaccinated communities lived in hot spots, compared with 13 percent of people in low-vaccination areas. The gap narrowed in recent weeks as cases surged in major West Coast cities, South Florida urban centers, and the New York-to-Boston corridor. By August, it closed. Public health leaders have attributed these outbreaks to several reasons. Even urban areas that can boast high vaccination rates have susceptible unvaccinated residents who are at greater risk of contracting the virus than during earlier spikes because businesses have reopened, masks are often not required in public, and the Delta variant spreads more easily. Additionally, breakthrough infections do not appear to be as extremely rare as hoped, accounting for more than a fifth of new recent infections in Los Angeles; New Haven, Connecticut.; and Oregon. Read more at the Washington Post.

In other updates:

• How do breakthrough infections for fully-vaccinated people occur? For a start, none of the vaccines in use are 100 percent effective at preventing infection. The U.S. Centers for Disease Control and Prevention has said that breakthrough cases are “expected” and that “there will be a small percentage of fully vaccinated people who still get sick, are hospitalized, or die from COVID-19.” In addition, new COVID-19 strains, such as the highly infectious Delta variant, have complicated the efficacy picture. There is also incomplete data into how long immunity lasts following vaccination. It must be emphasized that studies show that fully vaccinated people are much less likely to suffer from a COVID-19 infection — or to contract the virus in the first place. Read more at CNBC.
• The Food and Drug Administration (FDA) is expected to amend the emergency use authorizations for the Pfizer and the Moderna COVID-19 vaccines today to allow people with compromised immune systems to get a third dose. An estimated 2.7 percent of adults in the United States are immunocompromised, according to the CDC, which includes organ transplant recipients, people undergoing cancer treatment, and people with HIV, among others. Doctors say it is increasingly clear that many such patients are still vulnerable to Covid following vaccination because they may not mount an effective immune response to the shots. Following the FDA’s action, a CDC advisory group is scheduled to meet and may vote on whether to officially recommend a third shot for immunocompromised people. The panel’s signoff is needed before doctors can start prescribing extra doses. Read more at NBC News.
• The head of the World Health Organization (WHO) warned yesterday that unless the situation drastically changes for the better, the world will pass 300 million COVID-19 cases by early next year. WHO Director-General Tedros Adhanom Ghebreyesus said the number of recorded COVID-19 infections surpassed 200 million last week, just six months after passing 100 million. He added that the numbers are almost certainly an undercount. "At the current trajectory, we could pass 300 million reported cases early next year, but we can change that," Tedros said. Tedros noted that while there are no vaccines for Marburg, a deadly hemorrhagic fever similar to Ebola, "we have several effective vaccines for COVID-19, and yet cases and deaths continue to rise." Read more at The Hill.

August 10, 2021

The U.S. is now averaging 100,000 new COVID-19 cases a day, the highest numbers since February, before vaccines became widely available. The spike in Infections, which began just after July 4, has been fueled by the highly-transmissible Delta variant. Especially in areas with large numbers of unvaccinated persons, it has spread quickly and in many cases has stressed or exceeded the capabilities of local healthcare infrastructure. Much of the focus is on the southern U.S., where states like Florida and Louisiana have emerged as epicenters of activity, with each setting new seven-day records of infections as hospitals fill up. Tennessee is also reporting hospital strain, and in Mississippi the state's top health official said yesterday there are no beds available in intensive care units. The U.S. Centers for Disease Control and Prevention (CDC) has emphasized that the spike in cases and hospitalizations is occurring largely among the unvaccinated. "In places that are well vaccinated, we have quite good protection and we don't have a lot of surge. In places that are less well vaccinated, this virus is an opportunist and it has taken hold in those places in particular," said CDC Director Dr. Rochelle Walensky. Read more at NPR, the University of Minnesota Center for Infectious Disease Research and Policy, and The Hill.

In other updates:

• Full approval of the COVID-19 vaccines currently authorized in the U.S. under emergency use authorizations could be weeks away, according to Dr. Anthony Fauci. “No one wants to get ahead of the FDA because they’re an independent group that makes their own decisions,” Fauci said." “But I hope, I don’t predict, but I hope that it’s in the next few weeks. I hope that it’s in the month of August,” he added. Full approval could spur new vaccine mandates in private businesses. A fully approved vaccine would lead to “the empowerment of local enterprises” to institute vaccine mandates, Fauci predicted. Over the past several weeks, an increasing number of private businesses and institutions have begun mandating vaccines as a condition of employment or enrollment in educational programs. Read more at USA Today.
• Members of the U.S. military will be required to get the COVID-19 vaccine beginning next month under a plan laid out by the Pentagon yesterday and endorsed by President Joe Biden. The Pentagon plan provides time for the FDA to give final approval to the Pfizer vaccine. Without that formal approval, Defense Secretary Lloyd Austin needs a waiver from Biden to make the shots mandatory, and Biden has already made clear he supports it. Austin warned that if infection rates rise and potentially affect military readiness, “I will not hesitate to act sooner or recommend a different course to the President if l feel the need to do so. To defend this Nation, we need a healthy and ready force.” Read more at the Associated Press.
• Yesterday Canada lifted its prohibition on non-essential travel by Americans into the country, which had been put in place in March 2020. U.S. citizens and legal residents must be both fully vaccinated and test negative for COVID-19 within three days to enter. Travelers also must fill out a detailed application on the arriveCAN app before crossing. The U.S. has said it will extend its closure to all Canadians making nonessential trips until at least August 21, which also applies to the Mexican border. But the Biden administration is beginning to make plans for a phased reopening. The main requirement would be that nearly all foreign visitors to the U.S. will have to be vaccinated against the coronavirus. Read more at the Washington Post.

August 3, 2021

Given increasing COVID-19 activity and revised public health guidance, a growing number of organizations are adjusting their policies to help reduce the risk of transmission among their workforces, including by mandating vaccines. On Thursday, the White House announced that all federal workers will have to be vaccinated (or undergo weekly testing), and a growing number of cities and states that had not already taken that step followed suit. This included San Diego County, which announced a vaccine requirement for its public workforce, and North Carolina, where the governor issued an executive order for state workers to get vaccinated and called on businesses to also demand that workers receive the vaccine. Businesses across the country have been increasingly mandating vaccines, including Disney and Google. Many of the companies that are requiring shots have mostly office workers who are already largely vaccinated and are reluctant to work alongside those who aren't. In contrast, major companies that rely on blue-collar workers, such as Walmart and Amazon, are shying away from mandates for fear of driving away employees and worsening labor shortages. Read more at the Washington Post and the Star Tribune.

In other updates:

• For organizations considering vaccine requirements a question is whether doing so is legal. Though there are certain limitations, the short answer is likely yes. The Justice Department recently released an opinion stating that federal law does not prohibit businesses from requiring vaccines even if the vaccines have only been granted emergency use authorization by the Food and Drug Administration (FDA) and have not received full regulatory approval. Earlier guidance from the federal Equal Employment Opportunity Commission said that federal laws prohibiting discrimination in the workplace "do not prevent an employer from requiring all employees physically entering the workplace to be vaccinated for COVID-19." But a full approval from the FDA could prompt more businesses to feel comfortable issuing vaccine mandates. Enforcement mechanisms for these types of policies, however, are not yet clear. Some businesses might require employees to simply pledge that they are vaccinated while others could require proof. Read more at U.S. News & World Report.
• When will the COVID-19 vaccines currently approved in the U.S. under emergency use authorizations gain full approval? Pfizer began that process by submitting an application to the FDA in May, and the agency granted it a priority review. Moderna kicked off its process in June. The FDA said late last week it was taking an “all-hands-on-deck approach” to complete the review, while ensuring that “any vaccine that is authorized or approved meets our rigorous standards for safety, effectiveness and quality.” For now, it’s unclear when to expect full approval, with one expert’s projection for sometime this fall. Read more at Bloomberg.
• How can an individual prove their vaccination status? There are a variety of options, which include not carrying the white card from the U.S. Centers for Disease Control and Prevention everywhere. States including California, Colorado, Louisiana, New Jersey, New York, and Utah offer portals or apps to download fully authenticated vaccination information, and more are on the way. And millions across the U.S. have access to digital records directly from Walmart, CVS, Walgreens, and others. But there can be downsides to going digital, making it important to look into aspects like application security and terms that eventually require payments. Read more at the Washington Post.
• Yesterday the U.S. reached the milestone of 70 percent of adults having received at least one shot of a COVID-19 vaccine, about a month behind President Biden’s July 4 goal. The goal set by Biden in May is seen by federal health officials as a crucial step toward reaching so-called herd immunity. While the milestone is a significant achievement, it should be seen as a floor, rather than a ceiling, especially as the highly contagious delta variant spreads, health experts say. “We need to have at least 80 percent of the population vaccinated to truly have some form of herd immunity,” Dr. Paul Offit, a voting member of the Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee, said in a recent interview. Read more at CNBC.

July 29, 2021

How do you know if you’re located in an area of “substantial” or “high” levels of COVID-19 transmission referred to by the U.S. Centers for Disease Control and Prevention (CDC) in its recently revised guidance regarding face mask use by vaccinated persons? The CDC has provided an online tool to help, which prompts visitors to select a state and then a county or metropolitan area. It then presents a transmission rating, as well as numerous other statistics regarding COVID-19 activity and vaccination status. The CDC's guidelines make it clear it is ultimately up to state and local officials to determine when and if mask use is appropriate. So far, several states have signaled they will follow the agency's recommendations. The CDC’s revised guidance also recommends wearing a face mask in other cases. These include: if you or a member of your household has a weakened immune system or are at increased risk for severe disease; if you’ve been around someone who has COVID-19; and all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status. Read more at NPR and the University of Minnesota Center for Infectious Disease Research and Policy.

In other updates:

• A new report by the Institute for Strategic Dialogue explores how vaccine skepticism is being fed by misinformation, including a growing number of conspiracy theories. They note some of the authors of the misinformation include right-wing extremists and hard-core conspiracists, who are sowing seeds of discord and take advantage of pre-existing fears. The report focuses on Germany, but misinformation regarding the COVID-19 pandemic and vaccines are being experienced worldwide, including in WaterISAC member countries. Earlier this month, U.S. Surgeon General Dr. Vivek Murthy highlighted the “urgent threat” posed by “health misinformation” regarding the COVID-19 pandemic in the first advisory of his tenure (as WaterISAC reported on in its July 15 Security & Resilience Update). The report is posted below as resource # 47.
• Yesterday Pfizer predicted that vaccine boosters would soon be needed, a declaration that came on the same day the company published data showing that its shots remained robustly protective six months after vaccination, providing nearly complete protection against severe disease. Company officials also presented data showing that a third shot could boost disease-fighting antibodies many times higher than the level achieved by the standard two-dose regimen. They said they planned to seek authorization for a booster by mid-August, reiterating the company’s belief that a third dose would be needed to enhance immunity within a year of vaccination. Read more at the Washington Post.
• Australia’s New South Wales state saw its highest daily caseload today as 239 new infections were reported. State Premier Gladys Berejiklian, who extended an already strict lockdown, said the outbreak has forced her to impose “the harshest restrictions Australia has ever seen.” Most of the new restrictions affect people living in the Sydney area. For example, from 12:01am tomorrow, people in designated areas of the city must not travel more than 5 kilometers from their home and must wear face masks while outside their residences. If they live in one of the areas of concern they must not travel to another area for work unless they are classified as an authorized worker. Read more at ABC News Australia.

July 27, 2021

The Centers for Disease Control and Prevention (CDC) recommended today that vaccinated Americans who live in high-transmission areas wear masks in indoors public spaces to help prevent COVID-19 transmission, altering its May 13 recommendation that vaccinated people did not have to wear masks indoors or outside because of the protection afforded by vaccines. At the time, cases were dropping sharply, and the more transmissible Delta variant had not gained significant traction in the U.S. However, the U.S. has been experiencing a new surge of COVID-19 activity in recent weeks fueled by the Delta variant, with hotspots emerging in places across the country. Due to this, some places in the U.S. have already reinstituted or are considering reinstituting public health mandates and guidance, including regarding face masks. But the game-changer for the CDC's decision is said to be new data showing that vaccinated people infected by the Delta variant carry the same viral load as unvaccinated people who are infected. Vaccinated people are unlikely to become severely ill, but the new data raises questions about how easily they might transmit the disease. Such transmission did not happen in any significant way with earlier strains. Read more at the Washington Post and the University of Minnesota Center for Infectious Disease Research and Policy.

In other updates:

• The current COVID-19 surge in the U.S. fueled by the Delta variant will steadily accelerate through the summer and fall, peaking in mid-October, with daily deaths more than triple what they are now, according to a model’s new projections. The projections were released last week from the COVID-19 Scenario Modeling Hub, a consortium of researchers working in consultation with the Centers for Disease Control and Prevention to help the agency track the course of the pandemic. In the most likely scenario, at the peak in mid-October, there would be around 60,000 cases and around 850 deaths each day. Commenting about the projections, experts said the impacts of the ongoing activity will depend on the level of vaccinations and should lead states and local governments to rethink mask mandates and other public health measures. Read more at NPR.
• The U.S. Department of Justice and the U.S. Department of Health and Human Services have jointly publishing guidance on how “long COVID” can be a disability under the Americans with Disabilities Act. Read more at the Department of Justice.
• Today New South Wales, the most populous state in Australia (a WaterISAC member country) reported its biggest daily increase of locally acquired cases of COVID-19 for the year. A total of 172 new local cases were detected, up from 145 a day earlier. Australia has been contending with an outbreak of new cases in recent weeks largely attributed to the more transmissible Delta variant, with New South Wales experiencing much of the activity. Nearly half of Australia’s population of roughly 25 million is under some form of lockdown as Delta-fueled outbreaks have hit cities and communities that until recently were largely spared the worst of the pandemic. Although Australia’s infection and fatality rates remain far below global hot spots such, authorities worry that the country’s slow vaccine rollout will make this wave harder to control. Less than 13 percent of Australians have been fully inoculated since the country’s vaccine program began in February. Read more at Reuters and the Washington Post.

July 20, 2021

New COVID-19 cases have increased 140 percent in the past two weeks, according to an analysis. Additionally, hospitalizations and deaths have increased by 34 and 33 percent, respectively. And just today, the U.S. Centers for Disease Control and Prevention announced the Delta variant now makes up 83 percent of all sequenced cases in the U.S., a dramatic increase from 50 percent the week of July 3. With the increase in activity and continued spread of the highly transmissible variant, there are concerns the U.S. could be on the cusp of a fourth wave, and some places are reimposing public health mandates and guidance that had been lifted not long ago. In California, Los Angeles County officials recently reimposed a mask mandate. In the Bay Area, health officers on Friday recommended that residents of seven counties and the city of Berkeley resume wearing masks indoors. Mask mandates are being discussed, too, in COVID-19 hot spots, such as Arkansas and Missouri. While public health officials and experts debate and consider next steps at this juncture of the pandemic, they are unequivocal in their messaging that vaccines are the best protection against severe illness and hospitalization. Read more at the University of Minnesota Center for Infectious Disease Research and Policy, the Washington Post, TIME, and CNBC.

July 15, 2021

Today the U.S. surgeon general, Dr. Vivek Murthy, will release the first advisory of his tenure highlighting the “urgent threat” posed by “health misinformation” regarding the COVID-19 pandemic. Much of this misinformation relates to the safety and efficacy of vaccines, which have been a powerful contributor to vaccine hesitancy. In an interview ahead of the advisory’s release, Dr. Murthy commented, "Every life that is lost to COVID-19 when we have vaccines available, is a preventable tragedy.” He emphasized the importance of every American doing their part to fight misinformation, such as by not sharing with others something questionable found online and having simple one-on-one conversations with friends and family who are reluctant to get the vaccine. The surgeon general’s advisory comes at a time when COVID-19 cases are rising again after months of decline. The number of new cases per day has doubled over the past three weeks, driven by the fast-spreading Delta variant that the U.S. Centers for Disease Control and Prevention says now accounts for 58 percent of infections. Read more at NPR, the Associated Press, and ABC News.

July 13, 2021

The U.S. Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are maintaining their position that a booster shot is not presently needed for fully vaccinated Americans, following a meeting yesterday with representatives of Pfizer. The CDC and FDA made their assertion in a joint statement last week, noting that the boosters aren’t needed at this time because the current vaccines are highly effective. Their statement was a response to comments made by Pfizer earlier in the week in which it said the efficacy of its vaccine was waning and boosters would be needed within six months to a year. The CDC and FDA have not ruled out the need for booster eventually, however, noting they will continue to review new data and will be prepared for the doses if and when the science demonstrates they are needed. Meanwhile, World Health Organization (WHO) Director-General Tedros Ghebreyesus criticized the push for boosters when many countries have had little access to vaccines thus far. Read more at the University of Minnesota Center for Infectious Disease Research and Policy, CNN, and STAT.

July 8, 2021

World Health Organization (WHO) Director-General Tedros Ghebreyesus warned that the world is at a perilous point in the pandemic during a briefing yesterday, adding that variants are winning the race against vaccines. While his comments were directed mostly towards countries where vaccines have yet to be made widely available, he pointed out the dilemma of other countries dropping public health measures despite ongoing the ongoing activity with fast moving variants. In the U.S., although new cases have decreased significantly from previous levels, there have been recent upticks in some places, with many of the new infections attributed to the Delta variant. Many public health officials and experts are concerned about the vulnerability of unvaccinated people, especially in places where there are significant clusters of such individuals. Officials and experts also fear the possibility these places could become breeding grounds for potentially more transmissible and deadly variants, some of which might be less susceptible to current vaccines. Read more at the University of Minnesota Center for Infectious Disease Research and Policy and CNN.

July 6, 2021

Twenty states, the District of Columbia, Puerto Rico, and Guam met President Joe Biden's goal of vaccinating 70 percent or more of adults with at least one dose of a COVID-19 vaccine by July 4th, according to an analysis. Fourteen states have vaccinated 60 to 65 percent of adults, and 16 states are below 60 percent. Meanwhile, there’s been a slight increase in the number of new COVID-19 cases, which have been largely attributed to the highly transmissible Delta variant that now accounts for 25 to 50 percent of cases in U.S. communities. In two places that have seen recent increases, California and Arkansas, officials say most new cases are in unvaccinated residents. In promising news concerning the Delta variant and vaccines, Johnson & Johnson released data that showed its one-dose shot is protective against the strain and provides immunity for at least 8 months. Approximately 11 million Americans have received the Johnson & Johnson vaccine thus far. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.

June 29, 2021

The rapid spread of the delta coronavirus variant has forced a growing number of countries to reimpose lockdowns and other public health restrictions. In Australia, officials have said it’s a “critical time” for the nation given recent outbreaks attributed to the Delta variant. By yesterday, the country’s most populous city, Sydney, and its smallest capital, Darwin, were in lockdown. Mask mandates were introduced in the federal capital, Canberra; in Queensland; and in Perth. Victoria imposed restrictions along its borders with several states. In the U.S., where the Delta variant now accounts for about one in every five new COVID-19 cases, it’s forcing officials to rethink public health measures. In Los Angeles County, for example, the variant's spread has motivated officials to reinstate mask guidance for public indoor spaces, regardless of vaccination status. Experts have said that evidence points to vaccines like those from Moderna and Pfizer providing high amounts of protection against the variant, but LA Public Health Director Barbara Ferrer said it is not clear what the future of the variant will be as it becomes more prevalent. Read more at the Washington Post and CNN.

In other updates:

• Nearly all COVID-19 deaths in the U.S. now are in people who weren’t vaccinated, according to an analysis by the Associated Press. Its review of available government data from May shows that “breakthrough” infections in fully vaccinated people accounted for fewer than 1,200 of more than 853,000 COVID-19 hospitalizations (about 0.1 percent). And only about 150 of the more than 18,000 COVID-19 deaths in May were in fully vaccinated people. That translates to about 0.8 percent, or five deaths per day on average. Earlier this month, Andy Slavitt, a former adviser to the Biden administration on COVID-19, suggested that 98 to 99 percent of the Americans dying from the disease are unvaccinated. And CDC Director Dr. Rochelle Walensky said on Tuesday that the vaccine is so effective that “nearly every death, especially among adults, due to COVID-19, is, at this point, entirely preventable.” Read more at the Associated Press.
• Over the weekend, the White House launched a week-long blitz to encourage vaccination against COVID-19. The administration had hoped 70 percent of Americans over age 18 would have received at least one dose of COVID-19 vaccine by July 4, but last week officials said they expect to miss that mark. Now, top officials from the administration and even celebrities are being used to court what the Associated Press calls the "moveable middle," roughly 55 million unvaccinated American adults, many under age 30. These people are considered persuadable and open to the idea of vaccination but have not made it a priority. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• Many vaccine-hesitant Americans have said they will be more trusting of the vaccines once they gain full FDA approval, leading to a growing call for the approval process to be expedited. Until formal approval is gained, some fear the vaccines will always be thought of as risky or experimental. Pfizer began submitting data for full approval May 7, but it is unclear when the FDA will act. Moderna applied later, on June 1. Gigi Gronvall, a senior scholar at the Johns Hopkins Center for Health Security, said that while there should not be “political pressure” on the FDA, “I would be interested in knowing what the holdup is.” “It could have a big impact on people getting [vaccinated] if it is FDA approved,” she said. “I think it’s worth asking why it hasn't happened yet.” Read more at The Hill.
• The COVID-19 vaccines from Pfizer and Moderna could provide long-term protection, including for “years,” according to a study published in the journal Nature yesterday. The study found the Pfizer and Moderna vaccines produce a "persistent" immune response and give a sign of long-lasting protection. The study centers on what are known as germinal centers, what Ali Ellebedy, the study's senior author and an associate professor at Washington University in St. Louis, describes as "boot camps for immune cells” and the “the key to a persistent, protective immune response.” He explained, “The longer we have a germinal center, the stronger and more durable our immunity will be,” and he noted the study “found that germinal centers were still going strong 15 weeks after the vaccine’s first dose." He added, "We’re still monitoring the germinal centers, and they’re not declining; in some people, they’re still ongoing. Read more at The Hill.

June 24, 2021

An article in the online journal STAT discusses how cities sampled their wastewater for evidence of the SARS-CoV-2, the virus that causes COVID-19, and argues this approach should be increasingly used by public health officials to help prevent and manage future pandemics. It notes that unlike individual testing, wastewater testing captures virus shed by symptomatic and asymptomatic people alike, and can test en masse the 80 percent of households connected to a sewer system. Such testing can detect exactly when dangerous viral variants enter a community and provide an early warning to public officials. It can even predict new outbreaks with a lead time of one to two weeks. The articles cites the CDC’s partnership with other federal agencies, states, and utilities to develop a National Wastewater Surveillance System (previously discussed by WaterISAC on its COVID-19 general webpage). To support the development of a fuller system, it proposes a three-pronged plan that involves deploying wastewater sampling at strategic sentinel sites, identifying or setting up reliable testing labs near the sampling sites, and moving wastewater testing from an academic enterprise to an operational policy tool. To help accomplish this, it proposes federal funding to help upgrade the sector’s physical infrastructure. Read more at STAT.

June 22, 2021

Young Americans are less likely to get vaccinated against COVID-19 than their elders, the U.S. Centers for Disease Control and Prevention (CDC) reported in research it published yesterday. In one study, the CDC found 80 percent of adults older than 65 had been immunized compared with less than 40 percent of 18- to 29-year-olds. The study also noted weekly vaccination rates among 18- to 29-year-olds are declining, going from 3.6 to 1.9 percent a week from April 19 to May 22. In the second study, the CDC found that nearly 25 percent of 18 to 39-year-olds reported they probably or definitely would not get vaccinated while 23 percent were probably going to get vaccinated or were unsure. Overall, the CDC reported adults aged 18–39 years with lower incomes, with lower educational attainment, without health insurance, who were non-Hispanic Black, and who lived outside of metropolitan areas had the lowest reported vaccination coverage and intent to get vaccinated. Concerns about vaccine safety and effectiveness were the primary reported reasons for not getting vaccinated. Read more at the Washington Post and USA Today.

In other updates:

• The White House acknowledged on Tuesday that the U.S. is expected to fall short of President Biden’s stated goal of vaccinating 70 percent of American adults with at least one dose of COVID-19 vaccine by July 4. However, White House coronavirus response coordinator Jeff Zients said during a briefing that the U.S. has vaccinated 70 percent of those 30 years old and up with at least one dose and is on track to meet the 70 percent goal among those 27 and older by July 4. Read more at The Hill.
• The Delta variant is spreading so quickly in the U.S. that it's likely to become the predominant strain within weeks, according to a new analysis. Delta has been reported to be the most contagious variant yet and accounts for at least 14 percent of all new infections, responsible for more than 242,000 cases nationwide over the last six months. All the vaccines authorized for use in the U.S. appear, in general, to provide powerful protection against all the variants, including Delta. But given Delta’s rapid spread and the large number of people who remain unvaccinated, there are concerns it could trigger yet another moderate surge of infections through many parts of the U.S. Read more at NPR.

June 17, 2021

The U.S. Centers for Disease Control and Prevention (CDC) reports the COVID-19 Delta variant, which is highly transmissible and currently sweeping through the U.K., now makes up at least 10 percent of all domestic cases. On May 22, the variant had made up only 2.7 percent of cases. The CDC also now designated Delta as a variant of concern, which means it officially recognizes the variant may carry a risk of more severe illness and transmissibility. The rapid rise of the variant in the U.K. – where it now accounts for 90 percent of cases – has slowed that nation’s reopening efforts by 4 or 5 weeks. The risk posed by Delta has public health officials stressing the benefits of vaccines, which have been shown to be highly effective against the variant. In one recent study, researchers in the U.K. found that a two-dose regimen of the Pfizer vaccine was 88 percent effective against symptomatic disease from Delta. "If you are vaccinated, you're going to be protected, which is another very good reason to encourage people strongly to get vaccinated," said Dr. Anthony Fauci. "If you are not vaccinated, you are at risk of getting infected with the virus that now spreads more rapidly and gives more serious disease." Read more at the University of Minnesota Center for Infectious Disease Research and Policy and NPR.

June 14, 2021

Demand for the COVID-19 vaccine has slowed down so much in some states they have stopped requesting shipments and even given millions of doses back to the federal government, even though significant portions of their total populations are not vaccinated. In some cases the returned shipments are sent to other states where demand remains high. The U.S. averaged about 870,000 new injections per day earlier this month, down sharply from a high of about 3.3 million a day on average in mid-April, according to the CDC. President Joe Biden wants to have 70 percent of the adult U.S. population at least partially vaccinated by July 4. But the U.S. could well fail to meet that target. As of last Friday, 64 percent of Americans 18 and older had had at least one dose, by the CDC’s count. Amid the glut, the White House has announced plans to share 80 million doses globally by the end of June and also buy 500 million more doses of the Pfizer vaccine and donate them to lower-income countries. Read more at the Associated Press.

In other updates:

• As part of his announcement for the U.S. to join with other countries to provide COVID-19 vaccines for the world, President Biden also discussed efforts that would be undertaken to prevent the next pandemic. One of the efforts supports the establishment of a coordinated global surveillance network to improve disease forecasting and surveillance, enable swift detection of pathogens, and translate early detection into action. Another aims to work with other countries and private sector partners to reach agreement by the 2021 UN General Assembly on the creation of a catalytic global health security financing mechanism and for its sustainable funding. Read more at the White House.
• A new study recently published in the journal Nature suggests the current crop of approved COVID-19 vaccines prevents new and more infectious variants from causing actual disease. Scientists took blood from volunteers who had received the Johnson & Johnson vaccine and looked at the levels of neutralizing antibodies, the kind that prevent a virus from entering cells. "What we showed is that the neutralizing antibodies are reduced about fivefold to the [Beta] variant," said Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston. "That's very similar to what other investigators have shown with other vaccines," he says. "But what we also showed is that there's many other types of immune responses other than neutralizing antibodies, including binding antibodies, FC functional antibodies and T-cell responses." And it's that last immune response, the T-cell response, that Barouch says is critically important. Because T cells, play a crucial role in preventing illness. Read more at NPR.
• As the number of COVID-19 cases remains low, more governors are weighing decisions on ending emergency orders. Already, governors, lawmakers or judges have ended emergency declarations in more than a half-dozen states. More could join that list soon. About half the states had emergency orders set to expire before the Fourth of July. And over a dozen additional states have open-ended emergency orders, which could be canceled at any time by governors. Nationally, the public health emergency declared by Health and Human Services Secretary Xavier Becerra is scheduled to run until July 20, though another 90-day extension is possible. Read more at the Associated Press.

June 9, 2021

The highly transmissible “Delta” coronavirus variant, which was first identified in India, accounts for six percent of new infections in the U.S., the Biden administration said this week. Fortunately vaccines appear to be highly effective against the variant, with Dr. Anthony Fauci pointing to data from the U.K. that shows two doses of the vaccine made by Pfizer are 88 percent effective in preventing symptomatic disease caused by the new variant. He said in an interview that the Pfizer data would be similar for Moderna’s product, which also is an mRNA vaccine. The Delta variant quickly spread in the U.K., which Dr. Fauci referenced to emphasize the importance of getting vaccinated. “It’s essentially taking over [in the U.K.],” Dr. Fauci said at a briefing for reporters. “We cannot let that happen in the United States, which is such a powerful argument” for vaccination, he added. Read more at the Washington Post.

June 7, 2021

The U.S.’s COVID-19 vaccination rate is averaging fewer than 1 million shots per day, a decline of more than two-thirds from the peak of 3.4 million in April. The slowdown is national, with every state down at least two-thirds from its high. But overall levels of vaccination vary considerably across states. Thirteen mostly East and West Coast states have already vaccinated 70 percent of adult residents, and an additional 15 states and Washington, D.C. are over 60 percent. Where vaccination levels are lagging, such as in many states in the South, experts are concerned there could be a case surge over the summer. If there is a surge, experts believe it won’t be as serious as last summer’s because at least some people are vaccinated and treatments have improved. Another worry is testing, for which a similar decline would make it difficult to contain outbreaks ahead of a potential surge. Read more at the Washington Post and the New York Times.

June 1, 2021

On Friday, the U.S. Equal Employment Opportunity Commission (EEOC) issued updated “technical assistance” guidance related to the COVID-19 pandemic, explaining how companies can issue vaccine mandates for employees and the incentives they can offer to promote vaccinations (read the press release here). Based on the guidance, companies can require vaccines of employees returning to the workplace. Companies must give the same legally required considerations that company-wide vaccine requirements entail, like making accommodations under the Americans with Disabilities Act for employees who can’t receive the vaccine. The EEOC acknowledged in its guidance that other laws, such as state laws, may offer opposing views. Employers can offer vaccine incentives, as long as they are not coercive. Incentives can include paid time off to get vaccinated, rewards for employees who show proof of inoculation, and the opportunity to go mask-free at the office as a type of inducement. Read more at the New York Times.

In other updates:

• The latest poll from the Kaiser Family Foundation (KFF) shows steady progress in vaccine uptake, with 62 percent of U.S. adults saying they've gotten at least one shot, up from 56 percent in April. The share of people saying they will "wait and see" fell from 15 percent to 12 percent. The KFF also observes one potential avenue for further increasing vaccine uptake is full FDA approval of one of the vaccines currently authorized for emergency use, with about one-third (32 percent) of unvaccinated adults saying such approval would make them more likely to get vaccinated. Read more at the KFF.
• The CDC’s latest models predict the number of newly reported COVID-19 cases will likely decrease over the next 4 weeks, with 38,000 to 241,000 new cases likely reported in the week ending June 19, 2021. Read more at the CDC.
• The WHO has unveiled a new naming system for COVID-19 variants, one that uses letters from the Greek alphabet instead of their countries of origin. For example, the “Indian,” “South African,” and “British” variants are now the  Delta, Beta, and Alpha variants. The WHO intends the labels to be “non-stigmatizing” and to be easier to pronounce and “more practical to be discussed by non-scientific audiences. Read more at the Washington Post.

May 18, 2021

FEMA has published the COVID-19 Pandemic Operational Guidance: All-Hazards Incident Response and Recovery (also posted below as resource # focused on helping state and local officials and emergency managers prepare for disasters while continuing to respond to and recover from the COVID-19 pandemic. FEMA adds the guidance can be used by private sector and non-governmental organizations to gain an understanding of the government’s posture, planning and readiness efforts. It also explains the updated document takes an all-hazards approach and builds on guidance provided in last year’s COVID-19 Pandemic Operational Guidance for the 2020 Hurricane Season (also posted below as resource #32). Read more at FEMA.

Additionally, FEMA is offering a series of webinars throughout June to further educate people on the pandemic operational guidance.

In other updates:

• Following the CDC’s relaxation of masking guidance for fully vaccinated persons last week, 18 states announced plans to drop public mask mandates immediately or in the weeks to come. Other states, such as California, New York, and New Jersey, are moving forward with caution. To be clear, what the CDC released are just guidelines on mask wearing – leaving it up to states, stores, and other venues to decide if masks are required. Read more at CBS News.
• A growing number of businesses, including Delta Airlines, have announced new workplace requirements surrounding COVID-19 vaccines. Delta Airline mandated that all new hires in the U.S. be vaccinated, unless they qualify for an accommodation. The company said it will not be putting in place a company-wide requirement that current employees to be vaccinated, but noted that more than 60 percent of its employees have already been vaccinated. In its most-recent guidance updated last December, the Equal Employment Opportunity Commission said employers can legally require workers to be vaccinated against COVID-19, with exceptions for those who have a medical or religious accommodation. Read more at ABC News.
• Despite the CDC’s latest guidance and declining COVID-19 cases, down 18.2 percent over the past week by one account, some vaccinated people aren’t ready to give up their masks. People have myriad reasons for continuing to wear a mask. For some, they are still worried about new virus variants and the off-chance they might contract the virus and pass it along to others, though the risks of both are greatly reduced for those who are fully vaccinated. Read more at the Associated Press.

May 13, 2021

Today the U.S. Centers for Disease Control and Prevention (CDC) updated its "When You've Been Fully Vaccinated" guidance, indicating that those who are fully vaccinated can go without masks or physical distancing in most cases, even when they are indoors or in large groups. The CDC noted that some settings may still require masks, including due to federal, state, local, tribal, or territorial laws, rules, and regulations, as well as local business and workplace guidance. For example, the relaxation of restrictions does not apply to airplanes or health-care settings. And the CDC urges those who are immune-compromised to speak with their doctors before giving up their masks. CDC officials cited a growing body of real-world evidence demonstrating the efficacy of the COVID-19 vaccines and noted the shots offer protection even against more contagious variants circulating in the U.S. They said they also factored in the country’s declining cases, and the rarity of breakthrough infections in people who are fully vaccinated. Nonetheless, officials cautioned the guidelines could change again if the pandemic worsens. Read more at the Washington Post.

May 11, 2021

The nation's leading social media companies have engaged in efforts aimed at stopping the spread of falsehoods, conspiracy theories, and hoaxes that are fueling vaccine COVID-19 hesitancy. But according to a new report from research organization Advance Democracy, with the exception of Facebook, nearly all of them are losing the war against COVID-19 mis/disinformation. As the pace of the nation’s immunizations slows, the report found that debunked claims sowing unfounded fears about the vaccines are circulating largely unfettered on Twitter and TikTok. Twitter began labeling tweets that include misleading or false information about COVID-19 vaccines in March. It also started using a “strike system” to eventually remove accounts that repeatedly violate its rules. Yet none of the top tweets on Twitter using popular anti-vaccine hashtags like #vaccineskill, #novaccine, #depopulation and #plandemic had labels as of May 3. On TikTok, anti-vaccine lies and conspiracies are still surging despite a company crackdown. TikTok says it prohibits content that's false or misleading, including misinformation related to COVID-19 and vaccines. It has also banned the hashtags #VaccinesKill and #plandemic. Yet, as of May 3, TikTok failed to consistently apply labels to anti-vaccination hashtags used in videos with millions of views. In recent months, Facebook has moved more aggressively to combat misinformation. The company said in March that it would add labels to posts about vaccines. As of May 3, all of the top 10 posts discussing COVID-19 vaccines that used the #vaccineskill hashtag were labeled, compared to only two of the top 10 on March 28. Read more at USA Today.

In other updates:

• Despite the progress in falling COVID-19 cases and growing numbers of Americans becoming vaccinated, White House Chief Medical Advisor Dr. Anthony Fauci warned this weekend that indoor masking may be required until daily case counts fall well below the average 43,000 currently seen across the country. "As you get more people vaccinated, the number of cases per day will absolutely go down. We're averaging about 43,000 a day. We’ve got to get it much, much lower than that. When that gets lower, the risk of any infection indoor or outdoor diminishes dramatically," Dr. Fauci said. Twenty-two states still require masks indoors, according to reporting by the New York Times. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• The White House will announce a new partnership with ride-sharing companies Uber and Lyft to make all rides to and from vaccination sites free until July 4. The effort is expected to be detailed in a call today between White House COVID-19 Coordinator Jeff Zients and state governors. The feature will launch in the next two weeks and run until July 4, when President Biden set a target of 70 percent of the U.S. adult population getting at least one vaccine dose. While the companies were already providing free or discounted rides in some circumstances, the rides will now be free to anyone in the U.S. who is going to a vaccination site to get the shot, and Lyft and Uber will promote the rides to and from tens of thousands of vaccination sites through their apps. Read more at the Wall Street Journal.
• Yesterday the Food and Drug Administration authorized use of the Pfizer COVID-19 vaccine for 12- to 15-year-olds in the U.S., seen as a crucial step in the nation’s recovery from the pandemic and a boon to tens of millions of American families eager for a return to normalcy. It removes obstacles for school reopenings by reducing the threat of transmission in classrooms and for parents who have been grappling with how to conduct their lives when only the adults in a household are immunized. However, the F.D.A.’s go-ahead is not the final hurdle. An advisory committee of the Centers for Disease Control and Prevention is expected to meet shortly to review the data and make recommendations for the vaccine’s use in 12- to 15-year-olds. If the committee endorses the vaccine for that age group, as expected, immunizations in theory could begin immediately. Clinical trials have shown that these children may safely receive the dose already available for adults. Read more at the New York Times.

May 6, 2021

President Joe Biden set a new vaccination goal to deliver at least one shot to 70 percent of adult Americans by July 4th as he seeks to address vaccine hesitancy and others otherwise unmotivated to get inoculated. Biden announced his goal during remarks on Tuesday, when he acknowledged “the pace of vaccination is slowing” and predicted the vaccination effort is “going to be harder” when it comes to convincing “doubters” of the need to get shots. Biden’s push comes as his administration has shifted away from setting a target for the U.S. to reach “herd immunity,” instead focusing on delivering as many shots into arms as possible. To that end, the Biden administration is shifting the government’s focus toward expanding smaller and mobile vaccination clinics to deliver doses to harder-to-reach communities. It is also spending hundreds of millions of dollars to try to boost interest in vaccines through education campaigns and greater access to shots through community organizations that can help bring people to clinics. Read more at the Associated Press.

In other updates:

• COVID-19 infections could be driven to low levels and the pandemic at least temporarily throttled in the U.S. by July if the vast majority of people get vaccinated and continue with precautions against transmission, according to a Centers for Disease Control and Prevention (CDC) report released yesterday. The CDC report is not a prediction or forecast. Rather, it is a set of four scenarios based on modeling of the pandemic, using different assumptions about vaccination rates, vaccine efficacy and precautions against transmission. Each scenario shows an epidemic curve in which the national increase in cases that began in early March hits a peak and then plummets in late spring, leading to a dramatically improved viral landscape this summer. Under the most optimistic scenario, deaths from COVID-19 could drop into the low 100s per week in August and into the “tens” per week in September. In the less optimistic scenarios, hospitalization numbers will vary significantly from state to state. Read more at the Washington Post.
• Several new studies released yesterday offered encouraging news about the ability of widely used vaccines to protect against severe COVID-19 cases, including illness caused by some dangerous variants. Two published studies found that the Pfizer vaccine was extraordinarily effective against severe disease caused by two variants, including B.1.1.7 that was first identified in the U.K. and B.1.351 that was first identified in South Africa. And the results of an early-stage trial of the Moderna vaccine — though not published or vetted by scientists — suggested that a single dose given as a booster was effective against B.1.351 and P.1, which was first identified in Brazil. Read more at the New York Times.
• Canada became first country to authorize use of the Pfizer vaccine for children of ages 12 to 15 yesterday. The announcement was welcome news for the many parents and children whose lives have been upended by the pandemic. Several provinces and territories began the school year with in-person learning. But as cases in many provinces surged, schools have on multiple occasions reverted to online learning, severing children from their social networks, keeping them out of extracurricular activities and putting stress on parents. Pfizer has sought authorization for similar use in the U.S., which the Food and Drug Administration is expected to do by early next week. Read more at the Washington Post.

May 4, 2021

The rolling average for daily vaccinations in the U.S. has fallen to its lowest point in more than seven weeks. The nation is administering about 2.3 million shots per day, the lowest since March 11. Daily vaccinations peaked in mid-April at nearly 3.4 million per day. One of the contributing factors to the slowdown appears to be that a significant number of people who received their first doses of the two dose vaccines – the Pfizer and Moderna vaccines – haven’t returned to get their second shot. The U.S. Centers for Disease Control and Prevention (CDC) recently reported this applies to almost 8 percent of those who received their first shot. The CDC said the number of people missing doses – 5 million – may not be exact. If a person got the two doses from different reporting entities — for example, first from a state-run clinic and then from a local health clinic — the two doses may not have been linked by databases. But some people are certainly missing their second dose. Fear of the side effects of the second dose – which are reportedly more severe than after the first dose for some people – along with trouble getting an appointment and finding the time for it are among the reasons people have given for missing second doses. Read more at the Washington Post and CNN.

In other updates:

• With the nation’s mass immunization campaign appearing to slow despite every American now being eligible for the shots, President Biden is set to deliver remarks later today on his administration’s pandemic response. Read more at the Washington Post.
• Many public health experts now believe the U.S. is unlikely to reach “herd immunity” given persistent vaccine hesitancy and widely circulating coronavirus variants. The term signifies  the point when enough Americans would be protected to be rid of the pathogen. Early on, the target herd immunity threshold was estimated to be about 60 to 70 percent of the population. Most experts, including Dr. Anthony Fauci, expected that the U.S. would be able to reach it once vaccines were available. But given the contagiousness of new variants, experts now calculate the herd immunity threshold to be at least 80 percent. If even more contagious variants develop, or if scientists find that immunized people can still transmit the virus, the calculation will have to be revised upward again. More than half of adults in the U.S. have been inoculated with at least one dose of a vaccine. But daily vaccination rates are slipping, and polls show that about 30 percent of the U.S. population is still reluctant to be vaccinated. That number is expected to improve but probably not enough. Read more at the New York Times.
• The Food and Drug Administration is expected to expand emergency authorization to allow children as young as 12 to receive the Pfizer vaccine by next week. The vaccine is currently authorized for use in people 16 and older. Families and pediatricians have been eager for a vaccine to become available for children, particularly in advance of the next school year. Follow-on trials testing the Pfizer vaccine in younger children are ongoing. Moderna is conducting a similar trial of its vaccine in teens, with results expected in the summer. Moderna is also testing its vaccine in younger children. Johnson & Johnson is planning pediatric trials of its single-shot vaccine. Read more at the Washington Post.

April 29, 2021

After worrisome increases in COVID-19 cases in the U.S. in recent weeks, there are encouraging signs the situation is beginning to stabilize, according to Centers for Disease Control and Prevention Director (CDC) Dr. Rochelle Walensky earlier this week. During a briefing on Tuesday, she noted new reported cases fell by 21 percent over the past week, with the most recent seven-day average coming in at just over 54,400 cases per day. Walensky called the figure "a really hopeful decline." Hospitalizations also fell by 9 percent, with an average of more than 5,100 hospital admissions per day over the past seven days. Walensky partly attributed the recent trends to the ongoing nationwide vaccination campaign. "Each day more and more Americans are rolling up their sleeves and getting vaccinated, and likely contributing to these very positive trends," she said. The CDC director's optimism stands in stark contrast to her remarks one month ago, when she warned of "impending doom" and pleaded for continued vigilance as COVID-19 cases rose steadily in the U.S., as WaterISAC reported on in the March 30 Security & Resilience Update. Still, Dr. Walenksy warned that “the virus is an opportunist” and could strike in communities with low vaccination rates. Read more at NBC News and the New York Times.

In other updates:

• Despite declines in COVID-19 activity in nationwide numbers, some states have seen significant jumps, especially in western states like Washington, Oregon, and Colorado. In Oregon, cases have risen 54 percent and hospitalizations are up 39 percent during the past two weeks. In Washington and Colorado, cases have doubled since March. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• A new European Union (EU) report says Russia and China have been trying to sow distrust in western COVID-19 vaccines by publishing fake news about them online between December and April. According to the report, the countries sensationalized vaccine safety concerns, publicized unfounded links between vaccines and deaths, and promoted their own vaccines as superior. Written by the EU's disinformation unit, the report said Russian and Chinese vaccine diplomacy "follows a zero-sum game logic and is combined with disinformation and manipulation efforts to undermine trust in Western-made vaccines.” It added, “Both Russia and China are using state-controlled media, networks of proxy media outlets and social media, including official diplomatic social media accounts, to achieve these goals." Read more at Sky News.
• In spot checks across the country, people seeking vaccines and officials dispensing them appear eager to resume using the Johnson & Johnson vaccine, which requires just one dose and is also easier to store and transport. On Tuesday, for example, 1,355 people chose Johnson & Johnson at the clinic run by Indiana University Health, while 407 took the Pfizer vaccine. A recent poll suggested that fewer than one in four unvaccinated people would be willing to get the Johnson & Johnson vaccine. But the survey was taken during the pause, while health authorities were reviewing the safety data. Read more at the Washington Post.

April 27, 2021

Today the U.S. Centers for Disease Control and Prevention (CDC) unveiled updated guidance saying that fully vaccinated Americans can go without masks outdoors when engaged in certain activities, such as walking, running, or biking; attending small gatherings; and dining at restaurants. The CDC stopped short of telling those people they could shed their masks altogether in outdoor settings, citing the risk that remains for transmitting the coronavirus, unknown vaccination levels among people in crowds, and the still high-caseloads in some regions of the country. The guidance includes a color-coded chart that shows activities that fully vaccinated and unvaccinated people can do indoors and outdoors, and which ones can be done without masks. For activities that involve crowded outdoor settings, such as sporting events, live performances, and parades, the guidance indicates that both vaccinated and unvaccinated individuals should wear masks. The guidelines address growing calls from infectious-disease and other public health experts to relax mask mandates for the outdoors because of the dispersion of virus particles in the air, distancing is easier, and humidity and sunlight render the coronavirus less viable. Read more at the Washington Post and the New York Times.

In other updates:

• The risk of being exposed to COVID-19 indoors can be as great at 60 feet as it is at 6 feet in a room where the air is mixed and even when wearing a mask, according to a new study by Massachusetts Institute of Technology (MIT) researchers. The study’s findings challenge the CDC guidelines that recommend 6 feet of distance between people, pointing out that staying 6 feet away from another person may not be enough when people are inside for prolonged periods of time. “We argue there really isn’t much of a benefit to the 6-foot rule, especially when people are wearing masks” since everyone in the room is breathing the same air, said MIT professor Martin Z. Bazant, who teaches chemical engineering and applied mathematics. “It really has almost no physical basis because the air a person is breathing while wearing a mask tends to rise and comes down elsewhere in the room so you’re more exposed to the average background than you are to a person at a distance,” he explained. Read more at CNBC.
• Two recently-published independent studies suggest both the Pfizer and Moderna vaccines effectively prevent serious illness and death from a coronavirus variant that originated in New York, adding to a growing body of research that indicates the two main vaccines in the U.S. are protective against all of the variants identified so far. Antibodies stimulated by those vaccines are only slightly less potent at controlling the variant than the original form of the virus, both studies found. “The take-home message is that the vaccines are going to work against the New York variant and the South African variant and the U.K. variant,” said Nathan Landau, a virologist at N.Y.U.’s Grossman School of Medicine who led one of the studies. Read more at the New York Times.
• On Friday, the Food and Drug Administration (FDA) once again authorized the Johnson & Johnson vaccine for emergency use, with a special warning for women ages 18 to 49, explaining the low risk of the clots. Since then, some states have started distributing the vaccine again. The development comes as case counts and deaths from COVID-19 are dropping throughout the U.S.. While the COVID-19 activity is still high in some parts of the country, such as the Upper Midwest and Northeast, recent declines show improvements as more and more of the most vulnerable Americans are fully vaccinated. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.

April 22, 2021

Daily COVID-19 vaccinations have slowed significantly for the first time since February, a sign that demand is slipping even though every adult in the U.S. is now eligible for the shots. About 3 million Americans are getting vaccinated daily, an 11 percent decrease in the seven-day average of daily shots administered over the past week. The drop is rivaled only by a brief falloff that occurred in February, when winter storms forced the closure of vaccination sites and delayed shipments nationwide. Vaccine hesitancy, vaccinating hard-to-reach groups, and other barriers appear to be hampering efforts. Yesterday President Biden sought to remove one potential barrier, promising tax credits for employers that give their workers paid time off to receive and recover from inoculations. “The time is now to open up a new phase of this historic vaccination effort,” President Biden said. “To put it simply, if you’ve been waiting for your turn, wait no longer.” Read more at the Washington Post.

In other updates:

• The pause of the Johnson & Johnson vaccine has not substantially deflated overall confidence in COVID-19 immunizations, a new poll reveals. In fact, 76 percent of 1,000 registered voters surveyed nationwide said the pause didn't decrease the likelihood that they would get vaccinated. In addition, among those already vaccinated, 87 percent said they would "definitely" get vaccinated again if they had to do it all over. However, 32 percent indicated they would never get a Johnson & Johnson vaccine specifically. "These results do not surprise me," said Dr. James McDeavitt, senior vice president and dean of clinical affairs at Baylor College of Medicine. "There appears to be a relatively small portion of the population that is hard-core opposed to vaccines and are unlikely to change their minds." Pollsters also inquired about how people perceived the decision to pause the Johnson & Johnson vaccine. Fifty-three percent believed it was a good example of the rigorous safety monitoring of the COVID-19 vaccines in place to protect Americans. Another 29 percent felt this was a good example of why the COVID-19 vaccines are possibly unsafe, untested, and should not be taken unless you absolutely have to. Read more at WebMD.
• A new report from the Kaiser Family Foundation (KFF) estimates the U.S. will likely reach a tipping point on vaccine enthusiasm in the next two to four weeks, when supply will outstrip demand. To make this conclusion, KFF used the results of a March poll that found that 61 percent of U.S. adults either received one vaccine dose or want to get vaccinated as soon as they can has continually increased. It identifies this number as representing a current “outer edge” of vaccine enthusiasm, translating to about 157 million adults. Using the latest data from the CDC indicating that almost 131 million adults (or 50.7 percent of all adults), had received at least one vaccine dose as of April 19, that leaves an additional 27 million adults to go before we hit up against the “enthusiasm limit.” At the current rate of first doses administered per day, the U.S. will reach the tipping point in about 15 days. Read more at KFF.

April 20, 2021

Yesterday, anyone over the age of 16 in the U.S. became eligible for the COVID-19 vaccine, following President Biden’s announcement earlier this month of April 19 as the deadline for states to expand eligibility to all adults. The U.S. continues to make progress in its nationwide vaccination campaign, with daily vaccinations reaching about 3 million on average and 50 percent of American adults (over 130 million) having received at least one dose of a vaccine so far. The challenge ahead is vaccinating the remaining 50 percent of the population, and addressing the hesitancy and other factors that might undermine efforts. As part of addressing hesitancy, the White House conducted a targeted media blitz yesterday, which involved announcements and social media engagements by the President himself as well as top officials. Another factor that is getting increasing attention is the difficulty of vaccinating older Americans. As it stands, older adults are the most vaccinated age group in the country. Yet about a fifth of those 65 and older have not received even one shot. There are many reasons that eligible people may not be vaccinated, limited access to vaccination sites and confusing procedures for booking appointments. Read more at the University of Minnesota Center for Infectious Disease Research and Policy, Axios, and the New York Times.

In other updates:

• The CEOs of Moderna and Pfizer are now acknowledging that their two-dose vaccines likely will require a third shot, with Moderna CEO Stephane Bancel saying Saturday that the company's two-shot vaccine will probably require a third "booster shot," but that it's not clear how long after the first two shots that will be, and that '"the variant is going to be the big question in terms of boosting.” On Thursday, Pfizer CEO Albert Bourla said, "There will be likely a need for a third dose, somewhere between six and 12 months. And then from there, there will be an annual revaccination. But all of that needs to be confirmed." Read more at Fox News and CBS News.
• Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Sunday that he expects a decision to be made about the Johnson & Johnson Covid-19 vaccine by Friday, predicting the vaccine would come back on the market with restrictions or warnings. "I don't want to get ahead of the CDC and the FDA and the advisory committee, but I would imagine that what we will say is: that it would come back and it would come back in some sort of either warning or restriction," he said. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) is scheduled to meet on Friday to discuss recommendations for the J&J vaccine. The CDC and the Food and Drug Administration recommended pausing the use of the J&J Covid-19 vaccine last week over six reported blood clot cases. Read more at CNN.
• Health providers are starting to see the consequences of a year of pandemic-delayed preventive and emergency care as they find more advanced cancer and rotting and damaged teeth, among other ailments. One cardiologist was confused in the early days of the pandemic. Why the sudden drop in heart attack patients at the clinic? And why did some who did come arrive hours after first feeling chest pains? Two patients, both of whom suffered greater heart damage by delaying care, provided what came to be typical answers. One said he was afraid of contracting COVID-19 by going to the hospital. The other patient went to the emergency room in the morning, left after finding it too crowded, then returned that night when he thought there would be fewer patients – and a lower risk of catching COVID-19. Along with exacerbating existing health problems, the pandemic has caused a host of new medical concerns in patients. The American population will be coming out of the pandemic with teeth worn down from grinding, back problems from slouching at makeshift homework stations and mental health problems from a combination of isolation and being too close to family. Read more at the Washington Post.

April 15, 2021

Federal officials’ calls for a pause in the use of the Johnson & Johnson COVID-19 vaccine on Tuesday have triggered a spreading of false and misleading information that some experts fear could grow into a deluge of misinformation and that will cause greater vaccine hesitancy. When most Americans went to bed Monday evening, the news about vaccinations in the was overwhelming positive: the average number of shots administered per day was well over three million, leading to predictions that pandemic restrictions could ease in the coming months and some semblance of normalcy could return. But the story began to shift the following day when a vast online network that feeds vaccine skepticism with bad information and conspiracy theories went into action. Millions of Americans were already skeptical of the vaccines before the Johnson & Johnson news, a challenge the federal government, state and local governments, private sector organizations, and others have been trying to address with their own messaging campaigns. "As it plays out, this is the sort of thing that increases the possibility of vaccine hesitancy across the board," said Dr. Steve Schrantz, an assistant professor of medicine at the University of Chicago, who specializes in infectious diseases. "It's a very hard thing to message, and it can put further doubt in people's minds." Read more at NPR and NBC News.

In other updates:

• During an emergency meeting yesterday, the Advisory Committee on Immunization Practices (ACIP), an independent a committee within the Centers for Disease Control and Prevention that provides advice and guidance on vaccines, called for the Johnson & Johnson COVID-19 vaccine to stay "on pause" as the group gathers more data on the potential link between the vaccine and blood clots. Members said they needed to reconvene as quickly as possible after some risk-benefit and risk refinement has been completed. They said they will announced within 2 days when they plan to next meet, but it will likely be in the next 7 to 10 days. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• Jeff Zients, the White House pandemic coordinator, said during a briefing yesterday the U.S. vaccine supply will not be significantly impacted by a pause in Johnson & Johnson distribution. In an accompanying announcement, he explained the Johnson & Johnson vaccine makes up less than 5 percent of the recorded shots in the U.S. to date. He added the U.S. secured enough Pfizer and Moderna doses for 300 million Americans and that there is more than enough supply to continue the current pace of vaccinations of 3 million shots per day, and meet the President’s goal of 200 million shots by his 100th day in office, in late April. Read the announcement at the White House.
• Scientists generally agree that there is no evidence that the known COVID-19 variants of concern are causing tests to fail completely but are encouraging manufacturers and regulators to remain vigilant to ensure they keep pace with a constantly changing virus. If variants begin to evade detection, that could be consequential not only for individual patients, who may not receive the treatment they need, but also for the broader population. If a test misses someone who is infected by a variant, then that person may not realize they need to isolate and could unknowingly spread that variant to others, said Gary Schoolnik, a physician and infectious disease expert at Stanford University. “And that’s how a diagnostic test, if it’s missing variants, can actually promote the spread of that variant,” he explained. Read more at the New York Times.

April 13, 2021

During the White House COVID-19 briefing yesterday, U.S. Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky said that current hotspots, such as those in the Upper Midwest and East, need to focus on basic measures, such as masking and physical distancing, to end the latest surge in COVID-19 activity. Dr. Walensky also noted the important role vaccines play in reducing COVID-19 cases and other activity, but she added that it takes time for vaccinations to have an effect on transmission levels, 2 to 6 weeks or more. "If we tried to vaccinate our way out of what is happening…we would be disappointed that it took so long for the vaccine to work to actually have the impact." In the past week new daily COVID-19 cases across the U.S. rose by 6.7 percent, and hospitalizations rose by 3.8 percent. Deaths, however, fell by 6 percent. Read more at the University of Minnesota Center for Infectious Disease Research and Policy and the Washington Post.

In other updates:

• Today the CDC and the FDA called for an immediate pause in use of Johnson & Johnson’s single-dose coronavirus vaccine after six recipients in the U.S. developed a rare disorder involving blood clots within about two weeks of vaccination. While the move was framed as a recommendation to health practitioners in the states, the federal government is expected to pause administration of the vaccine at all federally run vaccination sites. Federal officials expect that state health officials will take that as a strong signal to do the same. CDC and FDA scientists will jointly examine possible links between the vaccine and the disorder and determine whether to continue to authorize use of the vaccine for all adults or limit the authorization. The move could substantially complicate the nation’s vaccination efforts at a time when many states are confronting a surge in new cases and seeking to address vaccine hesitancy. Nearly seven million people in the U.S. have received Johnson & Johnson shots so far, and roughly nine million more doses have been shipped out to the states. Read more at the New York Times.
• More colleges are saying they’ll require students to have COVID-19 vaccines in the fall, an effort to prevent and control outbreaks on their campuses that can also contribute to cases in surrounding communities. Colleges have long required vaccinations for infectious diseases, backed up by laws and even some judicial cases. In a survey of about 100 four-year institutions representing all 50 states and Washington, D.C., nearly all required at least one vaccine for enrollment. But current COVID-19 vaccines have been authorized by the FDA under an emergency use authorization, or EUA, which introduces a "new situation.” “We've never had the vaccine for the entire population authorized under EUA before," explained Dorit Reiss, a law professor at the UC Hastings College of the Law in San Francisco. So legal arguments have a little asterisk, she says, until vaccines are officially approved by the FDA, which could come as early as this summer. Read more at NPR.
• For the first time, the P.1 variant that originated in Brazil has taken the number 2 spot in CDC data on emerging COVID-19 variants. According to the data, nearly 500 people in the U.S. have been infected with the variant, which has devastated Brazil, with the largest number of cases found in Massachusetts, Illinois and Florida. Previous reporting indicated this variant demonstrated the ability to infect some people who had immunity from previous bouts of COVID-19. Read more at the Washington Post.

April 8, 2021

B.1.1.7, the coronavirus variant first detected in the U.K., is now the most common variant in the U.S., Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky announced during the White House press briefing on the pandemic yesterday. She said the variant was behind the recent spike in cases, which has the U.S. seeing an average of 63,000 new cases each day. Young adults, kids in youth sports, and people associated with daycare centers are among the new cases, Walensky added. These populations are not likely to have been vaccinated yet. The CDC has also noted B.1.1.7 is most prevalent in California, Colorado, Florida, Massachusetts, Michigan, and Minnesota. As WaterISAC noted in its Tuesday Security & Resilience Update, one of these states – Michigan – has recently emerged as one of the U.S.’s COVID-19 hotspots. But analysis of recent COVID-19 data has revealed other hotspot states, including New York, Florida, Pennsylvania, and New Jersey. Researchers have found these four states and Michigan account for 44 percent of the nation's new COVID-19 infections in the latest available 7-day period. Read more at the University of Minnesota Center for Infectious Disease Research and Policy and the New York Times.

In other updates:

• The CDC is recommending Americans not travel to Canada at this time, noting that even fully vaccinated travelers are at risk of getting and spreading the virus variants. The U.S.-Canada border remains closed to non-essential travel. Essential travel includes commercial travel and work-related commuting. The CDC recommends that for those who must travel to Canada should be fully vaccinated, wear masks and stay socially distant. The CDC also recommends getting tested 3-5 days after traveling to Canada. The current restrictions are in place through April 21, although that deadline is expected to be extended. Read more at the CDC and the News Tribune.
• Ontario, Canada’s most populous province, declared a one-month stay-at-home order yesterday and announced plans for mobile vaccine teams to target high-risk workers as it battles a surge of COVID-19 cases. The Ontario premier, Doug Ford, pleaded with residents to remain at home. “The risks are greater and the stakes are higher,” he Ford. Thanks in part to the B.1.1.7 variant, new cases in Ontario have tripled throughout March. The surge has overwhelmed the province’s intensive care units, breaking records previously set during the previous second wave of the virus. Other Canadian provinces are grappling with their own outbreaks that are hitting a younger demographic. British Columbia, the country’s westernmost province, is currently battling an outbreak of the P1 variant, first documented in Brazil. Neighboring Alberta announced new restrictions earlier this week, cancelling in-person dining and limiting retail as the P1 variant threatened to overwhelm the province’s healthcare system. Read more at the Guardian.

April 6, 2021

Over the weekend, four million COVID-19 vaccinations were administered in the U.S. on a single day, a new record. On average, about three million shots are being given per day. These vaccination numbers have inspired some optimism, but the situation is being overshadowed by increasing new case counts and the spread of variants. The new weekly average is 64,000 cases per day, up seven percent from the prior seven-day period. And the highly contagious B.1.1.7 variant, which was first identified in the U.K., has now been reported in every state in the U.S. Public health officials and experts are attributing many of the new cases to younger groups of Americans who have not yet been vaccinated and to the more transmissible variants. "Cases are increasing in younger adults, we know this is due to more highly transmissible variants," said U.S. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky. Until more of the population is vaccinated and COVID-19 activity subsides more, many officials and experts are asking the public to hold onto precautions for just a little while longer. Read more at the University of Minnesota Center for Infectious Disease Research and Policy and CNN.

In other updates:

• Today President Biden plans to announce that he is speeding up the deadline for states to make all adults eligible for a coronavirus vaccine – to April 19. The President’s newest target comes almost a month after he set an original deadline of May 1 for every state. A White House official said last week that Mr. Biden revised the timeline because states, encouraged by increases in shipments, were ramping up their vaccination programs more rapidly than expected. Many governors already moved up eligibility timelines on their own weeks ahead of Mr. Biden’s original May 1 marker. Read more at the New York Times.
• Michigan has become one of the nation’s COVID-19 hotspots, and epidemiologists partially attribute the rapid surge there to the spread of the variant first identified in the U.K. The state has witnessed a 30 percent rise in new cases in the past week and hospitalizations up 29 percent. More than 6,700 new cases are being diagnosed in Michigan every day, levels nearing what it saw during last year’s holiday season. The situation in Michigan is further demonstrating how the newest cases are disproportionately impacting younger adults who have yet to be vaccinated. Moreover, many of them are showing up in emergency departments, a perhaps unsurprising development given that the spreading variants are believed to cause more severe cases and be more deadly. Read more at the Washington Post.

April 1, 2021

Today the Biden administration announced an advertising campaign intended to encourage as many Americans as possible to get COVID-19 vaccines, an effort to further facilitate the nationwide effort and address vaccine hesitancy in the population. The campaign, with ads in English and Spanish, will air throughout April on network TV and cable channels nationwide, as well as online. Two hundred and seventy-five organizations will participate in the administration’s new public awareness push, with participating organizations including health professionals, scientists, community organizations, faith leaders, businesses, rural stakeholders, civil rights organizations, sports leagues, and athletes. It comes as the administration and the states are rapidly expanding access to vaccines but with some communities continuing to express skepticism about safety and the need to get the shots. Government officials expect to soon face the possibility of supply exceeding demand if many Americans remain reluctant to be vaccinated. With cases rising in some parts of the country again and variants spreading, the challenge is getting as many people as possible vaccinated to contain the pandemic and facilitate a return to a more normal way of life. Read more at the New York Times.

In other updates:

• In the past week, new daily reported cases in the U.S. have risen more than 12 percent, and an increasing number of these cases are impacting younger adults who are unvaccinated. For the first time, the majority of new hospitalizations have been younger adults, with cases among people ages 50-65 increasing more than those older than 65, who are more likely to have been vaccinated. And in some states, like Michigan and Massachusetts, the number of cases among older children, teenagers and young adults have also increased. At the same time recent data showed a 96% decline in COVID-19 cases in nursing homes since the vaccine rollout began in December, indicating high vaccination rates are helping protect older populations. Read more at the Washington Post and ABC News.
• The FBI has issued a public service announcement (PSA) stating that anyone who makes or fakes a COVID-19 vaccination card is endangering themselves and those around them and is breaking the law. The FBI advises that individuals are selling fake COVID-19 vaccination record cards and encouraging others to print fake cards at home. Because of this phenomenon, it strongly encourages businesses and government agencies to follow CDC guidance and continue to maintain social distancing and use personal protective equipment. Finally, it recommends vaccine recipients not post photos of their vaccine card to social media websites, observing that personal information could be stolen to commit fraud. Read the PSA at the FBI.
• The U.S. and thirteen other countries issued a rare joint statement questioning the validity of the World Health Organization (WHO) report regarding the origins of the coronavirus that was released on Tuesday. “We support a transparent and independent analysis and evaluation, free from interference and undue influence, of the origins of the COVID-19 pandemic. In this regard, we join in expressing shared concerns regarding the recent WHO-convened study in China,” reads the statement, which was issued by the U.S. State Department in coordination with Australia, Canada, the U.K., and other countries. The statement included strong support for the WHO and did not directly blame China for interfering with the scientific probe. But it said health experts were delayed in studying the origins of the virus and that even when granted access, they were denied “complete, original data and samples.” Read more at USA Today.

March 30, 2021

U.S. Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky pleaded with Americans to maintain their vigilance against the COVID-19 pandemic during the White House COVID-19 press briefing yesterday. "I'm speaking today not necessarily as your CDC director and not only as your CDC director, but as a wife, as a mother, as a daughter, to ask you to just please hold on a little while longer," Dr. Walensky said. She explained that after weeks of going down or remaining stable, COVID-19 cases across the country have jumped again, as has happened at least twice in the past year before the nation experienced a major surge in virus activity. Walensky explained that these jumps were likely fueled by states relaxing restrictions and abandoning mask mandates too soon, and by the heightened transmissibility of variants – including B117, the variant first identified in the U.K. – which now account for 26 percent of all COVID-19 cases sequenced in the U.S. According to the Washington Post, in the past week new daily reported COVID-19 cases rose 12.3 percent, deaths rose 1.1 percent, and hospitalizations rose 2.5 percent. Read more at the University of Minnesota Center for Infectious Disease Research and Policy and the Washington Post.

In other updates, which are described in further detail on WaterISAC’s COVID-19 general webpage:

• The World Health Organization is expected to officially release a report today that says the COVID-19 virus was likely transmitted to humans from animals, such as bats, with a lab leak unlikely. The report was completed by a 10-person mission that arrived in China in January and conducted a nearly four-week probe. The mission issued an initial assessment in early February as it completed its visit. Following that assessment, some groups questioned China's transparency and whether it shared full data with the WHO. Also, the source of the virus has become embroiled in political tensions between some western nations and China, with some suggesting that outbreak source involved a leak from the Wuhan Institute of Virology. According to a review of a leaked copy of the report, it lays out the different theories on how the virus may have spread to humans and provides rationales behind the group's conclusions for each possibility. They proposed further research into all of the possibilities, except for the lab-leak theory. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• Dr. Robert Redfield, who served as director of the CDC from March 2018 to January 2021, said during a recent interview that he believes the COVID-19 virus was accidentally released from a lab in Wuhan, China. He emphasized he was expressing his personal opinion, not as a public official. Noting his virologist background, Dr. Redfield explained he came to the belief because of the speed at which the virus spread. He also contended that after being manipulated in a research laboratory it could have been accidently released by a worker in September or October 2019, a few months before coming to public attention. Several scientists have expressed skepticism at Dr. Redfield’s theory. Dr. Anthony Fauci said the former CDC director’s belief is his opinion, and not one shared by a majority of public health care experts. Read more at USA Today and Voice of America.
• Moderna and Pfizer’s COVID-19 vaccines are highly effective at preventing symptomatic and asymptomatic infections under real-world conditions, according to findings released by the CDC yesterday. Consistent with clinical trial data, a two-dose regimen prevented 90 percent of infections by two weeks after the second shot. One dose prevented 80 percent of infections by two weeks after vaccination. Scientists have debated whether vaccinated people may still get asymptomatic infections and transmit the virus to others. The study suggested that since infections were so rare, transmission was likely rare, too. Read more at the New York Times.

March 23, 2021

According to a press release published yesterday by AstraZeneca, its COVID-19 vaccine demonstrated 79 percent efficacy at preventing symptomatic COVID-19 and 100 percent efficacy at preventing severe disease and hospitalization. But within a matter of hours federal health officials announced that the encouraging results may have been based on outdated and incomplete information. In a statement released shortly after midnight, the National Institute of Allergy and Infectious Diseases said that an independent panel of medical experts that has been helping to oversee the trial had “expressed concern that AstraZeneca may have included outdated information from that trial, which may have provided an incomplete view of the efficacy data.” AstraZeneca unveiled the results without conducting a full analysis requested by this panel, which was surprised about the pharmaceutical company’s announcement. Companies typically wait for the monitoring board to review analyses and conclude that the study has yielded an answer before they announce trial results. These events will likely trigger additional scrutiny of AstraZeneca’s vaccine when it seeks emergency use authorization, something it stated it was preparing to do in its press release. In an updated press release, the company defended the data it released on Monday and said it would immediately share its latest efficacy data with the monitoring board. It also stated it would reissue fuller results within 48 hours. Read more at the New York Times.

In other updates:

• Health experts are encouraging vaccine recipients to hold onto their proof of vaccination cards, with one calling it a “ticket back to normalcy.” In the "new normal" as we emerge from the pandemic, the vaccine card might just be your "ticket back to normalcy,” said John Brownstein, Ph.D., an epidemiologist at Boston Children's Hospital. He added, "A vaccination card is a tool that people can use to declare that they have some level of protection against COVID. Being able to assess immunity to COVID is a critical part of trying to resume our daily lives." The cards also have the potential to make something like international travel easier, although the logistics of a “vaccine passport” are still up for discussion. Read more at ABC News.
• Cybersecurity company Avast shares ways to share and celebrate that you’ve been vaccinated without getting your identity stolen. As one Avast representative points out, taking a picture of your actual card and posting it increases your risk for identity theft, especially considering in the U.S. the CDC vaccination card has your full name, date of birth, vaccine maker and lot number, date of vaccination, and the healthcare professional or clinic site that administered it. Some of the other options Avast proposes include sharing a photo of your “I was vaccinated” sticker or simply using just text. Read more at Avast.
• Researchers report they have seen sharp increases in COVID-19 vaccine related advertisements on the dark web, with offers of COVID-19 vaccines and vaccine passports, as well as fake negative test papers. Prices range between $500 and $750 for doses of some vaccines, while fake vaccination certificates are being sold by anonymous traders for as little as $150. Attempting to purchase vaccines via these channels is extremely dangerous as, even if they are legitimate, they may have been stored incorrectly and could be hazardous. Fake vaccine certificates are also damaging to public health as they could allow individuals still exposed to the virus and potentially infectious to claim they’re protected. Read more at the BBC and Info Security.

March 18, 2021

The Cybersecurity and Infrastructure Security Agency (CISA) has just released the “Insights” document COVID-19 Vaccination Hesitancy within the Critical Infrastructure. This document provides an overview of COVID-19 vaccination hesitancy (defined by the World Health Organization as a “delay in acceptance or refusal of vaccines despite availability of vaccination services”) and steps that critical infrastructure owners and operators can take to reduce the risk and encourage vaccine acceptance across their workforce. CISA emphasizes that COVID-19 vaccination hesitancy within the critical infrastructure workforce represents a risk to National Critical Functions and critical infrastructure companies and operations. According to CISA, recent reports show a high percentage of critical infrastructure workforces are hesitant or outright refuse to receive a COVID-19 vaccine. Moreover, CISA recognizes that critical infrastructure workforce can serve as a key stakeholder in encouraging the rest of the population to get vaccinated and help the return to everyday life. Building and sustaining public trust and confidence in immunization systems is essential and the critical infrastructure workforce can play a leading role. This document is also posted below as resource #45.

CISA also reminds its partners of the U.S. Centers for Disease Control and Prevention’s Essential Workers COVID-19 Vaccine Toolkit. This resource provides multiple communications templates and promotional products to help employers effectively communicate clear and credible information to their workforce about the vaccine.

Additionally, CISA is continuing to host calls every Thursday at 3 PM ET for Emergency Support Function (ESF) #14, which supports the coordination of cross-sector operations including the stabilization of community lifelines (includes water and wastewater services). The teleconference will include an overview of the situation, updates from available federal and private sector partners, and an open forum for questions and information sharing. The dial information is as follows:

Dial-In #: 1-800-619-3427
Passcode/PIN: 2725748

In other updates:

• The CDC has classified two COVID-19 variants first detected in California, B.1427 and B.1429, as variants of concern. The CDC said the variants may be 20 percent more transmissible. In comparison, the variant B117, first identified in the U.K., is considered 50 percent more transmissible than the original COVID-19 virus. Neither of the new variants of concern are thought to escape the effectiveness of currently approved vaccines, but therapeutics, including monoclonal antibody treatments, may be slightly less effective. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• After weeks of declining COVID-19 cases, deaths, and hospitalizations, new hot spots of infection have emerged in parts of the Upper Midwest, Northeast, and Mid-Atlantic. Michigan has seen a rise in hospitalizations and positive test results. Minnesota’s numbers are creeping up, as are Maryland’s and New Jersey’s. Many places, including New York City and surrounding counties, are no longer seeing steady declines in cases, despite intensive vaccination efforts. Variants, especially B117, may be behind the emergence of these hot spots. Read more at the Washington Post.
• Health experts in the U.S. say COVID-19 surges happening in Europe should serve as a cautionary tale for the U.S., warning against ignoring social distancing or dropping other safeguards too early. The pandemic’s diverging paths on the two continents can be linked in part to the much more successful vaccine rollout in the U.S. and the spread of more contagious variants in Europe. But while the U.S.’s vaccination campaign continues to expand, so too does the prevalence of variants. “Each of these countries has had nadirs like we are having now, and each took an upward trend after they disregarded known mitigation strategies,” said CDC Director Dr. Rochelle Walensky. “They simply took their eye off the ball.” According to Josh Michaud, associate director of global health policy with the Kaiser Family Foundation in Washington, the lesson for the U.S. is to keep vaccinating those at risk as fast as possible, keep an eye on variants, and “keep slow and steady with the easing of social distancing requirements.” Read more at the Associated Press.

March 16, 2021

Yesterday U.S. Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky said the highly contagious B.1.1.7 COVID-19 variant, which was first identified in the UK, is projected to become the dominant variant in the U.S. by the end of this month or early April. Cases of the B.1.1.7 have so far been found in 48 states, Puerto Rico and Washington, DC, according to CDC data. Meanwhile, another study supports suggests the variant brings a higher risk of death. The study published yesterday in Nature says the variant may pose a 61 percent higher risk of 28-day mortality. The finding is in line with a study published last week (WaterISAC reported on this study in its Thursday Security & Resilience Update) that noted B.1.1.7 had a 64 percent higher 28-day risk of death among people older than 30. The projected increased prevalence of B.1.1.7 and other COVID-19 variants have led many officials and public health experts, including Dr. Walensky, to warn Americans about letting down their guard too early, potentially because of dropping case counts and increasing vaccinations. Michael Osterholm, the director of the University of Minnesota’s Center for Infectious Disease Research and Policy (which WaterISAC often looks to for information), said the country is in a "whole new ballgame" in terms of dealing with the virus, given the new variants of COVID-19 that have cropped up in recent months. "We are, I think for the moment, in the eye of a hurricane with regard to the good news, the vaccine's coming, but the big challenge [is] with this new variant that has arrived here from Europe.” Read more at CNN, the University of Minnesota’s Center for Infectious Disease Research and Policy, and CBS News.

In other updates:

• The COVID-19 response and economic stimulus legislation signed into law last week includes billions of dollars that could be used to benefit local water and wastewater systems and ratepayers. For example, the final legislation includes $350 billion in aid for state, local, tribal, and territorial governments. Within this sum, $45.57 billion is reserved for U.S. cities with populations above 50,000 people, and communities would be free to pass funds on to their respective water systems to cover qualifying expenses. Each community receiving funds may use them for costs incurred before December 31, 2024, related to COVID-19 emergency response, including economic assistance to households or small businesses and premium pay to essential municipal workers; the replacement of lost revenue necessary to provide government services; and necessary investments in water, sewer, or broadband infrastructure. Read more at the Association of Metropolitan Water Agencies.
• During an address to the nation on Thursday night, President Joe Biden announced he was ordering all governors to make all U.S. adults eligible for COVID-19 vaccination by May 1 and once again maintained that all adults should be able to be vaccinated by the end of May. To that end, Jeff Zients, coordinator of the White House's COVID-19 response, said the following day during a White House briefing that 20,000 U.S. pharmacies will now be able to distribute the vaccine by May, and 700 community health centers will join the COVID-19 vaccine program, bringing the total number of participating health centers to 950. Read more at the University of Minnesota’s Center for Infectious Disease Research and Policy.
• Data updated by the CDC on Monday shows the country hit a seven-day average of about 2.4 million Covid-19 vaccine doses administered per day, a new record. That comes as more states expanded their eligibility requirements for vaccinations. So far, more than 71 million Americans have received at least one dose of a Covid-19 vaccine, according to CDC data. More than 38 million have been fully vaccinated – roughly 11.5 percent of the US population. Read more at CNN.
• Public health officials in Idaho have been using a wastewater testing dashboard to track the amount of COVID-19 present in sewage coming from Boise, Garden City and Eagle. As large percentages of patients with confirmed infections can shed their virus in their feces, wastewater testing systems have been used to track and even forecast COVID-19 spread in communities during the pandemic. A recent wastewater testing update indicated "concerning" increases of virus detection. But Central District Health officials say it's much too soon to tell whether the Boise area could see another big surge before more of the public gets vaccinated. Read more at Government Technology.

March 11, 2021

As vaccine production and deliveries and inoculations ramp up, a growing number of states are allowing ever more people to get vaccinated. Anyone age 16 and older who lives or works in Alaska became eligible on Tuesday after the state became the first in the country to allow the maximum possible number of residents access to a vaccine. Next week, Texans age 50 and older will be eligible, the state’s health department announced yesterday, the same day Georgia Governor Brian Kemp said that people in that state over 55 would be able to get a shot next week. New Yorkers age 60 and older became eligible on Wednesday, with Governor Andrew Cuomo citing increased supply from the federal government. The governors of Minnesota and Ohio also said this week that they would open eligibility to larger groups of residents. And at least 37 states, as well as Washington, D.C., are now allowing some residents with certain health problems to receive vaccines. The pace of vaccinations has picked up to the point where the daily average of individual shots has reached about 2.17 million a day. Should the pace hold or even increase, the adult American population of about 260 million could be fully vaccinated within months by any of the currently approved vaccines. About 62.5 million Americans have received at least one dose and about 32.9 million of that number have been fully vaccinated, according to the U.S. Centers for Disease Control and Prevention. Read more at the New York Times.

In other updates:

• One year ago today, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic. Also on March 11, 2020, then-President Donald Trump gave a prime-time address from the Oval Office, announcing a travel ban from Europe while the first confirmed case of COVID-19 was reported on Capitol Hill. The Dow Jones Industrial Average dropped more than 1,400 points amid fears of a shutdown. President Joe Biden will give his first prime-time address tonight marking the milestone. Read more at Bloomberg and CBS News.
• The 28-day risk of death for B117, the COVID-19 variant that originated in the UK, was 64 percent higher than for previously circulating strains in people older than 30 years, according to a study published yesterday. Those diagnosed as having B117 infections had higher viral loads at diagnosis than those infected with other variants, which the authors said could be attributed to a variant trait or to the tendency of these participants to seek care when they were most contagious. The researchers cautioned that their results may not apply to other settings and age-groups, because their study included only about 8 percent of COVID-19 deaths in England over the study period. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• Brazil is struggling with a second wave of COVID-19, spurred by a more contagious variant that emerged in the country and that has been observed in the U.S. Due to this latest wave, Brazil has overtaken the U.S. as the country with the most daily COVID-19 cases and deaths in the world. Public health specialists lay part of the blame on the rapid spread of the P.1 strain, which studies have shown to be more contagious and better able to reinfect people than previous versions of the disease. Researchers have also said Brazil is now home to hundreds of new Covid-19 variants, warning that other more dangerous versions could emerge the longer the disease is left to fester and mutate, threatening to undermine the progress of other countries against the pandemic. Read more at CNN and the Wall Street Journal.

March 9, 2021

Yesterday the U.S. Centers for Disease Control and Prevention (CDC) released guidelines for persons who are fully vaccinated against COVID-19, representing a first step in providing guidance about safely returning to everyday activities in communities. The CDC said people who are fully vaccinated against COVID-19 – meaning it has been 14 days since receiving the second dose of the Pfizer or Moderna vaccine or 14 days since receiving the Johnson & Johnson injection – can now freely socialize with small groups of fully vaccinated people indoors. The CDC says they should continue to take COVID-19 precautions when in public, such as wearing a well-fitted mask. It emphasized that the vast majority of people still need to be fully vaccinated and that, until then, it is important everyone continues to adhere to public health mitigation measures to protect the large number of people who remain unvaccinated.

According to the new guidelines, fully vaccinated people may also visit with unvaccinated people from one other household indoors without wearing masks or staying 6 feet apart if everyone in the other household is at low risk for severe disease, which CDC Director Dr. Rochelle Walensky described as younger than age 65 with no underlying health conditions. Additionally, fully vaccinated people can refrain from quarantine and testing following a known exposure to COVID-19, if they remain asymptomatic. The CDC also announced that it will update its recommendations as more people are vaccinated, rates of COVID-19 in the community change, and additional scientific evidence becomes available. Read more at the CDC and the University of Minnesota Center for Infectious Disease Research and Policy.

March 2, 2021

President Joe Biden is expected to announce today that Merck will help manufacture Johnson & Johnson’s vaccine, a move intended to substantially increase the supply of the newly approved vaccine as concerning new variants of the virus have been found in the U.S. The unusual deal between the competing pharmaceutical companies was brokered by the White House, which had been scouring the manufacturing landscape for weeks ever since it became evident that Johnson & Johnson’s was running behind on its mass production. Merck’s own attempt at making a COVID-19 vaccine was unsuccessful, but it is an experienced vaccine manufacturer. Under the agreement, Merck will dedicate two of its facilities to production of the Johnson & Johnson vaccine, which unlike the other two approved vaccines requires only one shot. How quickly Merck will be able to ramp up is unclear. It will take time, possibly as long as two months or more, for the company to be able to convert its facilities to manufacture and package a vaccine that it did not invent. Read more at the New York Times.

In other updates:

• CDC Director Dr. Rochelle Walensky has warned of a possible fourth wave of COVID-19 activity given that recent declines in COVID-19 case counts have stalled and as new variants are spreading. "The most recent 7-day average of cases, approximately 67,200, represents an increase of a little over 2 percent compared to the prior 7 days," said Walensky. "Please hear me clearly – at this level of cases with variants spreading, we stand to completely lose the hard-earned ground we have gained. These variants are a very real threat to our people and our progress. " She also said if states lift mitigation mandates, like mask-wearing, too quickly, the nation could see a fourth wave of virus activity before enough Americans are vaccinated. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• Many states and cities are easing COVID-19 restrictions despite warnings from health experts that moving too quickly could prove detrimental. Yesterday, Massachusetts made it much easier to grab dinner and a show. In Missouri, where individual communities get to make the rules, the two biggest metropolitan areas – St. Louis and Kansas City – are relaxing some measures. Iowa’s governor recently lifted mask requirements and limits on the number of people allowed in bars and restaurants, while the town of Lawrence, home to the University of Kansas, now lets establishments stay open until midnight. The push to reopen comes as COVID-19 vaccine shipments to the states are ramping up and as cases and hospitalizations have plunged since January. Read more at the Associated Press.
• Researchers have reported the variant that emerged in Brazil, referred to as “P.1.” demonstrated the ability to infect some people who had immunity from previous bouts of Covid-19. The researchers’ studies have yet to be published in scientific journals. Their authors caution that findings on cells in laboratories do not always translate to the real world and that they’ve only begun to understand P.1’s behavior. But even with the mysteries that remain around P.1, experts say that it is a variant to take seriously. “It’s right to be worried about P.1, and this data gives us the reason why,” said William Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health. In the U.S., the Centers for Disease Control and Prevention (CDC) has recorded six cases in five states: Alaska, Florida, Maryland, Minnesota and Oklahoma. Read more at the New York Times.
• Yesterday Twitter announced account holders who spread misinformation about the COVID-19 vaccines five times will get banned permanently. Initially, human moderators will do this work, and the data will be used to train the company’s machine learning algorithms. Eventually, Twitter wants to use a combination of human and automated moderators. It’s the social media company’s latest measure to address COVID-19-related misinformation. In December, Twitter said it would start removing tweets with harmful misinformation related to the coronavirus vaccines; the company announced yesterday it has deleted 8,400 such posts to date. Read more at the Next Web.

February 25, 2021

Yesterday Food and Drug Administration (FDA) staff released a report in which they endorsed Johnson & Johnson’s COVID-19 vaccine for emergency use, a critical step in bringing a third shot into the U.S.’s vaccination campaign. The FDA does not need to follow the report’s recommendations in formally issuing an emergency use authorization (EUA) for the Johnson & Johnson candidate, but it often does, and it did when Pfizer and Moderna submitted their vaccines for EUAs in December. FDA’s Vaccines and Related Biological Products Advisory Committee will meet Friday to review the EUA request. Also yesterday, leaders of the White House COVID-19 response team said they are ready to distribute Johnson & Johnson's vaccine when and if the FDA issues an EUA. Johnson & Johnson has a deal with the federal government to supply 100 million doses of its vaccine by the end of June. A key difference between the Johnson & Johnson vaccine and the two that have already been granted EUAs is that it requires only one dose. Johnson & Johnson’s vaccine has also been rated at less effective overall, at 66 percent. But infectious disease experts pointed out that Johnson & Johnson’s numbers can’t be used as a direct comparison to the other two vaccines because of the single dose and the company’s trial was conducted when there were more infections as well as new, more contagious variants. Read more at the University of Minnesota Center for Infectious Disease Research and Policy and CNBC.

In other updates:

• The U.S. Centers for Disease Control and Prevention (CDC) is supporting a recently revamped website called “VaccineFinder” as a venue where the public can search for nearby vaccination locations with does on hand. The website is run by Boston Children’s Hospital, with the help of several other collaborators. It grew out of the H1N1 flu pandemic of 2009 and has been used for years to coordinate the distribution of flu and childhood vaccines. It expanded on yesterday to include the availability of coronavirus vaccines at more than 20,000 locations, concentrated in several states. If the program goes well, the website’s developers plan to expand it nationwide in coming weeks to include nearly all vaccine providers that agree to be featured. That would make the website far more comprehensive than anything that exists now. Read more at the New York Times.
• At the White House COVID-19 briefing yesterday, CDC Director Dr. Rochelle Walensky said the nation is continuing to move in the right direction, with an average of 64,000 cases per day. Though still high, the daily average is now slightly below the summer peak of 67,000 cases per day as seen in July. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• February is usually the peak of flu season, but flu has virtually disappeared in the U.S. this year, with reports coming in at far lower levels than anything seen in decades. Flu death data for the whole U.S. population is hard to compile quickly, but CDC officials keep a running count of deaths of children. One pediatric flu death has been reported so far this season, compared with 92 reported at the same point in last year’s flu season. Experts say that measures put in place to fend off the coronavirus – mask wearing, social distancing and virtual schooling – were a big factor in preventing a "twindemic" of flu and COVID-19. A push to get more people vaccinated against flu probably helped, too, as did fewer people traveling, they say. Read more at Fox News.

February 23, 2021

Water Online has published an article discussing the efforts of water and wastewater utility employees and state sector associations to make the case to officials that sector workers should be given greater priority for receiving COVID-19 vaccinations. In Maine, for example, the state moved water and wastewater workers from a “1B” priority for vaccines to “1C” to first accommodate residents who are age 70 and older. “The water districts and sewer districts are the first line of defense for health,” said Scott Abbattoni, a water director in Maine who is advocating for his fellow employees to be put on a higher vaccine priority list. The situation is similar in Iowa, where state sector associations have advocated that officials include sector water and wastewater workers in a higher priority grouping. “We have limited resources, we have limited staff and so, should we have a large number of our staff become affected with COVID and have to be off for a while, we would really need to start calling in employees from other utilities who could be struggling with the same things we are dealing with,” explained William O’Brien, Dubuque’s Water and Resource Recovery Center manager. Read the article at Water One.

National sector associations and organizations, including the Water Sector Coordinating Council (WSCC) and WaterISAC, have encouraged utilities to collaborate with their state and local health departments to ensure their staff members are considered as plans are developed for the distribution of COVID-19 vaccines. The WSCC’s full statement is has been posted below as resource #43. The statement echoes WaterISAC's previous guidance to its members, with an initial recommendation in the September 17 Security & Resilience Update and the latest in the December 10 Security & Resilience Update.

In other updates:

• The U.S. death toll from the COVID-19 pandemic has topped 500,000, a milestone that underscores the grave threat the virus still poses even as more people are vaccinated. Worldwide, nearly 2.5 million people have died, meaning more than a fifth of all deaths have occurred in the U.S., which has less than five percent of the global population. President Joe Biden released “A Proclamation on Remembering the 500,000 Americans Lost to COVID-19,” which notes that the death toll exceeds the number of Americans who dies in World War I, World War II, and the Vietnam War combined.
• The delivery of about 6 million COVID-19 vaccine doses, representing about three days’ worth of shipments, was delayed last week by the winter storms. White House senior advisor for COVID-19 response Andy Slavitt said yesterday that the White House anticipates catching up on the delivery backlog by mid-week. He added, though, that “it will take time” for vaccination sites to catch up on administering those backlogged shots. Read more at CNBC.
• The U.S. Centers for Disease Control and Prevention (CDC) has released a report on safety monitoring from the first month of the COVID-19 vaccines being administered in the country. The report states that monitoring indicates reassuring safety profiles for COVID-19 vaccines. Local and systemic reactions were common; rare reports of anaphylaxis were received. No unusual or unexpected reporting patterns were detected. It adds that health care providers and vaccine recipients can be reassured about the safety of Pfizer and Moderna vaccines. Read the report at the CDC.
• Tomorrow at 9:30 am ET, the U.S. House Committee on Homeland Security will host a virtual hearing, “Confronting the Coronavirus: Perspectives on the COVID-19 Pandemic One Year Later.” Access more details at the U.S. House Committee on Homeland Security website.

February 18, 2021

The two COVID-19 vaccines developed by Pfizer and Moderna  showed a decreased ability to neutralize the strain that originated in South Africa, according to newly published studies in the New England Journal of Medicine. Both companies subsequently announced they were taking steps to develop booster shots or updated vaccines, plans corroborating by White House senior advisor on the COVID-19 response Andy Slavitt. “Each of the vaccine companies – and I’ve talked to all of them, both the ones approved and the candidates – have plans to continue to update their vaccines, and if need be, create boosters down the road if there continue to be additional mutants, as there likely will be,” he said. Meanwhile, the studies showed the vaccines to be highly effective against the variant of the virus first detected in the U.K. Read more at the Washington Post.

In other updates, which are described in further detail on WaterISAC’s COVID-19 general webpage:

• Life expectancy in the U.S. fell by a full year during the first half of 2020, a staggering decline that reflects the toll of the pandemic as well as a rise in deaths from drug overdoses, heart attacks and diseases that accompanied the outbreak, according to government data. Read more at the Washington Post.
• While COVID-19 cases and deaths drop around the world, including in the U.S., more countries have reported their first variant cases, and many are reporting local variant transmission. Eight more reported B117 cases (which emerged in the U.K.), raising the total to 94, with local spread under way in at least 47 nations. Two more countries reported B1351 detections (which emerged in South Africa), pushing the number to 46, including at least 12 in which the variant is spreading locally. And for P1 (which emerged in Brazil), 6 more countries confirmed their first cases, raising the number to 21. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• Risk intelligence company Flashpoint has provided WaterISAC with a TLP:AMBER COVID-19 Vaccine Fraud and Threats to Vaccine Supply Chain intelligence report. Read the report at WaterISAC. FOR MEMBERS ONLY.

February 16, 2021

While much attention has been focused in recent weeks on COVID-19 variants that emerged in foreign countries, especially the U.K., South Africa, and Brazil, scientists are finding a number of new variants that seem to have originated in the U.S. And they have expressed concern that many of these variants may pose the same kind of extra-contagious threat as their overseas counterparts. In a study posted over the weekend, a team of researchers reported seven growing lineages of the coronavirus, spotted in states across the country. All have gained a mutation at the exact same spot in their genes. It’s not clear yet whether this shared mutation makes the variants more contagious, but because it appears in a gene that influences how the virus enters human cells, the scientists are highly suspicious. It’s difficult to answer even basic questions about how prevalent the new variants are in the U.S. The researchers found examples scattered across much of the country. It’s also hard to say whether the variants are spreading now because they are more contagious, or for some other reason, like holiday travel. Read the article at the New York Times.

In other updates:

• The U.S. Centers for Disease Control and Prevention (CDC) operates a variant tracker, which now shows 1,173 cases of variant B117, 17 cases of variant B.1.351, and 3 cases of variant P.1, which emerged in the U.K., South Africa, and Brazil, respectively.
• Daily new COVID-19 cases in the U.S. continue to drop, with the 7-day average now at about 85,000 cases, down from a peak of about 250,000 in January. The decreases have been treated as a welcome sign that post-holiday surges are on the decline. The nation’s public health officials continue to encourage vigilance in adhering to mitigation strategies, including face mask wearing and social distancing, emphasizing their importance as variants become more prevalent. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• The COVID-19 vaccine is in high demand across the U.S. and states are expanding vaccination criteria and opening mass vaccination sites, but few states claim they have enough vaccine supply to meet demand. On average, 1.7 million Americans are getting vaccinated each day, and the federal government is sending 11 million doses to the states each week. Though this is a substantial increase since vaccines first became available in December, most governors say they go through allotted supply quickly. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• The winter storm stretching across much of the country is disrupting the distribution of COVID-19 vaccines. Vaccination sites have closed and shipments have been delayed due to impacts to transportation systems. The interruptions appear likely to grow as the storm continues on its path, with more closures are being announced. Read more at the New York Times.

February 11, 2021

Many public health experts have suggested doubling up on face masks to prevent the transmission of COVID-19, a measure now backed up by a new study from the U.S. Centers for Disease Control and Prevention (CDC). Adding a cloth mask over a surgical mask on a rubbery dummy head more than doubled particle blocking when the dummy simulated coughing. Specifically, a surgical mask or a cloth mask alone blocked about 42 to 44 percent of particles, respectively, coming out of the coughing dummy. The combo of a cloth mask over a surgical mask blocked 92.5 percent of the risky particles. The CDC researchers also tested out tucking and knotting a surgical mask on either the receiver or the source head. The tuck-and-knot reduces side gaps that let unfiltered-breath escape. This alone reduced the receiver’s exposure by 64.5 percent and 63 percent when it was used by the receiver or the source, respectively. When both heads had tucked-and-knotted masks, exposure dropped again by 96 percent. Read the article at Ars Technica.

In other updates:

• People who have been fully vaccinated against COVID-19 (having had both shots of either the Pfizer or Moderna vaccine and with at least two weeks having passed since the second shot) can skip quarantine if they are exposed to someone infected with the virus, the U.S. Centers for Disease Control and Prevention said yesterday. That doesn't mean they should stop taking precautions, the CDC noted in updated guidance. It's just not necessary for them to quarantine. Read the article at CNN.
• COVID-19 is now linked to a new set of symptoms, including chills, loss of appetite, headache, and muscle aches, according to findings from a new study. The Imperial College London conducted the study, which involved swab tests and questionnaires taken from June up until last month of over one million people. This is in addition to the "classic" symptoms of COVID-19, which are fever, new persistent cough, and loss of smell and/or taste. Read the article at Sky News.
• Yesterday the World Health Organization vaccine advisory group today recommended the AstraZeneca-Oxford vaccine for emergency use, seen as a key development that clears the way for lower- and middle-income countries to receive their first deliveries from the COVAX program. Earlier this week, the disappointing early results from the South African trial of the AstraZeneca-Oxford vaccine against mild-to-moderate disease led to officials there which paused the rollout of the vaccine to health workers (it has since announced a temporarily switch to the unapproved Johnson & Johnson vaccine). Read the article at the University of Minnesota Center for Infectious Disease Research and Policy.

February 9, 2021

During yesterday’s White House COVID-19 Response Team press briefing, officials observed that the U.S. is continuing to experience declining numbers of new COVID-19 cases. U.S. Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky noted that cases have continued to decline over the last four weeks, with an average of 119,900 new cases being reported between January 31 and February 6. This represents a drop of nearly 20 percent from the prior week. However, she also observed that case numbers are still dramatically higher than last summer’s peak and encouraged the nation to continue to keep up its guard to combat the pandemic, implementing measures like wearing masks, avoiding travel, crowds, and poorly ventilated spaces, and getting vaccinated when it’s made available. Access the press briefing transcript at the White House.

As a reminder, the CDC will convene a webinar on COVID-19 vaccination for the water sector tomorrow, February 10 at 1:00 PM ET. This event is part of a series of webinars on COVID-19 vaccination for essential workers, with the intended audience for this webinar being the drinking water and wastewater treatment workforce, including engineers, sanitation workers, plumbing specialists, and other administrative and professional staff. Register at the CDC.

In other updates:

• Johnson & Johnson has applied to the U.S. Food and Drug Administration (FDA) for emergency use authorization of its COVID-19 vaccine candidate. On February 26, an FDA advisory committee will hold a public meeting to make a recommendation about whether or not the vaccine should be approved. Johnson & Johnson previously announced its vaccine is 85 percent effective at preventing severe cases of Covid-19, and 66 percent effective overall at preventing moderate cases of the disease. The Johnson & Johnson vaccine has a few key differences from the other vaccines approved for use in the U.S., those from Moderna and Pfizer. For one thing, Moderna and Pfizer’s vaccines each require two shots, given three or four weeks apart, but Johnson & Johnson’s vaccine is just one shot. While the other vaccines need to be stored at super-cold temperatures, the Johnson & Johnson vaccine just needs a standard refrigerator for storage up to three months. Read more at the Smithsonian Magazine.
• Health officials in South Africa paused their rollout of the AstraZeneca-Oxford COVID-19 vaccine following early findings that it offered little protection against mild-to-moderate disease caused by the variant that's dominant in the country. South Africa recently received 1 million doses of the vaccine and was poised to start vaccinating healthcare workers, but the country decided to halt administering the vaccine while further investigations are underway. The chief investigator of the Oxford vaccine trial said the findings confirms that the virus will find ways to continue to spread in vaccinated populations, as expected, but promising results from other vaccine trials in South Africa using a similar virus vector suggest vaccines will still help ease the burden on health systems by preventing severe disease. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• Given their finding that the COVID-19 variant that originated in the UK will likely dominate other strains in the coming weeks, scientists are encouraging the U.S. to immediately increase its surveillance and mitigation effort. Otherwise the spread of the UK variant could trigger major COVID-19 surges like those seen in other countries. The scientists’ finding is based off a study led by the Scripps Research Institute. Study coauthor Mark Zeller, PhD, of Scripps Research Institute, told CIDRAP News that US vaccination efforts will have very limited effectiveness in slowing the spread of B117 in the coming weeks. "It will still take many months before enough people are vaccinated to slow down transmission significantly," he said. In the meantime, he described the best strategy as one that involves physical distancing and wearing face coverings, as well as increased testing and vaccination to lower the variant’s spread to buy some time for before it becomes dominant. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• The Federal Trade Commission (FTC) is imploring vaccine recipients to not post photos of their vaccination cards on social media, as doing so could invite identity theft. Read more at the FTC.

February 4, 2021

The U.S. Centers for Disease Control and Prevention (CDC) will host a webinar on Wednesday, February 10 at 1:00 PM ET on COVID-19 vaccination for the water and wastewater sector. This event is part of a series of webinars on COVID-19 vaccination for essential workers, with the intended audience for this webinar being drinking water and wastewater treatment workforce, including engineers, sanitation workers, plumbing specialists, and other administrative and professional staff. Presenters will provide an overview of vaccine distribution and implementation and briefly cover safety and efficacy. Participants are encouraged to submit any questions they have when they register so the presenter can address any FAQs. Register at the CDC.

Participation is also available via an H.323/SIP room system, using the following information:

H.323: 161.199.138.10 (US West) or 161.199.136.10 (US East)
Meeting ID: 161 172 1632
Passcode: 14483787
SIP: [email protected]
Passcode: 14483787

In other updates:

• FEMA has made vaccine support information available via a page on its website. The webpage includes information on how you can get vaccinated, FEMA’s support for vaccine distribution, accelerated state vaccine efforts, identifying and filling resource gaps, and supporting and establishing vaccine sites. In coordination with the White House COVID-19 Response Plan, FEMA is working with federal, state, local, tribal and territorial partners to deliver vaccinations across the country. Access the webpage at FEMA.
• After two months of record-setting COVID-19 case counts, hospitalizations, and deaths, the director of the Centers for Disease Control and Prevention (CDC) said yesterday the U.S. has finally returned to pre-Thanksgiving levels of COVID-19 transmission. "We are now averaging 144,000 cases per day, and though deaths continue to increase, a recent decline in hospitalizations gives us hope those will also soon fall," said Dr. Rochelle Walensky, during the White House COVID-19 press briefing. Though the US numbers have come down, Walensky warned they were overall still very high. She also said the early efforts at contact tracing with variant cases in the U.S. showed people were contracting the virus when not wearing masks and when attending in-person social events with people outside their households. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• Both Dr. Walenksy also asked Americans to be mindful of this information for the Super Bowl this coming Sunday, discouraging parties that are not virtual or take place with people from other households. Dr. Anthony Fauci seconded this recommendation, stating, “You don’t want parties with people that you haven’t had much contact with.” He explained, “You just don’t know if they’re infected, so, as difficult as that is, at least this time around, just lay low and cool it.” Read more at the Associated Press.

February 2, 2021

The Occupational Safety and Health Administration (OSHA) has issued new guidance for employers and employees on implementing a program to mitigate and prevent the spread of COVID-19 in the workplace. President Biden directed OSHA to release this guidance, which is intended to help workplaces identify risks of being exposed to and/or contracting COVID-19 and determine appropriate control measures to implement. The guidance recommends several essential elements in a prevention program, including conducting a hazard assessment, adopting policies for employee absences that don’t punish workers as a way to encourage potentially infected workers to remain home, and ensuring policies and procedures are communicated to both English and non-English speaking workers, among others. OSHA emphasizes the guidance is not a standard or regulation, and it creates no new legal obligations. It does contain descriptions of existing mandatory safety and health standards. Read more about the guidance at Facility Executive.

In other updates:

• The U.S. Centers for Disease Control and Prevention (CDC) issued an order requiring the use of face masks on nearly all forms of public transportation. The order, which took effect late Monday night, requires face masks be worn by all travelers on airplanes, ships, trains, subways, buses, taxis, and ride-shares and at transportation hubs like airports, bus or ferry terminals, train and subway stations, and seaports. President Biden had previously ordered government agencies to “immediately take action” to require masks in all public transportation modes and hubs. The order says passengers must wear a mask in transit except for brief periods, such as to eat, drink or take medication. The CDC said people violating the order could potentially face criminal penalties but suggested civil penalties would be more likely if needed. The order will be enforced by the Transportation Security Administration and federal, state, and local agencies. Read more about the order at Reuters.
• Acting Secretary of Homeland Security David Pekoske ordered the Transportation Security Administration to support the CDC in the enforcement of any orders for protecting the transportation system and mitigating the spread of COVID-19. Pekoske’s order also cites President Biden’s Executive Order on Promoting COVID-19 Safety in Domestic and International Travel, the same one cited by the CDC in issuing its public transportation mask mandate.
• Although there have been reports of people testing positive for COVID-19 even though they already received a vaccine, experts say cases like these are not surprising and do not indicate that there was something wrong with the vaccines or how they were administered. Some of the reasons for how these infections can still happen include that vaccines don’t work instantly (it takes a few weeks for the body to build immunity after receiving a dose), nor do they work retroactively (a person may have already been infected); the vaccines prevent illness, but maybe not infection (vaccines are authorized based on how well they keep people from getting sick); and even the best vaccines aren’t perfect (the Pfizer and Moderna vaccine efficacy rates are high, but not 100 percent). Read more at the New York Times.

January 28, 2021

Today South Carolina health officials announced they had diagnosed two cases associated with the COVID-19 variant that originated in South Africa, marking the first time this variant has been detected in the U.S. The two cases don’t appear to be connected, nor do the people have a history of recent travel. “That’s frightening,” because it means there could be more undetected cases within the state, said Dr. Krutika Kuppalli, an infectious diseases physician at the Medical University of South Carolina in Charleston. “It’s probably more widespread,” she observed. Like the other two notable variants, those originating in the U.K. and Brazil, this variant is believed to be significantly more transmissible than the original strain. As WaterISAC reported on in the Tuesday Security and Resilience Update, the other variants have already been detected in the U.S., with the U.K. variant having been first observed in a case in Colorado in late December and the first U.S. case of the Brazil variant having been identified on Monday in Minnesota. In addition to concerns about the effectiveness of existing vaccines against these and potential future variants, health officials also worry that mutations of the virus mean people might get COVID-19 a second time. South African studies have documented dozens of instances of people who contracted earlier strains of the coronavirus being infected with the new variant, suggesting that those who had contracted mild cases or otherwise had low antibody counts might be prone to reinfection. Read more at the Associated Press and the Washington Post.

In other COVID-19 update:

• Pfizer has issued a statement showing its vaccine was slightly less effective against the variant from South Africa, based on a yet-to-be-peer-reviewed study. The statement emphasized that the small differences in viral neutralization are unlikely to lead to a significant reduction in the effectiveness of the vaccine. It also added that Pfizer will continue to monitor emerging COVID-19 strains and conduct studies on the vaccine’s real-world effectiveness. Additionally, Pfizer believes the flexibility of the mRNA vaccine platform is well suited to develop new vaccine variants if required.
• President Biden announced the U.S. is ramping up deliveries to hard-pressed states over the next three weeks and expects to provide enough doses to vaccinate 300 million Americans by the end of the summer or early fall. Biden called the push a “wartime effort” and said his administration was working to buy an additional 100 million doses of each of the two approved vaccines. Governors and top health officials have been increasingly raising the alarm about inadequate supplies and the need for earlier and more reliable estimates of how much vaccine is on the way so that they can plan. Read more at the Associated Press.

January 26, 2021

Yesterday the Biden administration issued a proclamation banning non-citizen entry into the U.S. by travelers from countries where COVID-19 variants have been recently discovered, including the U.K., Brazil, and South Africa (among other countries). This measure is intended to prevent or limit the spread of the variants in the U.S., given that they are all believed to be more transmissible and have been associated with outbreaks in their countries of origin, as well as in other countries. Two out of the three variants, those from the U.K. and from Brazil, have already been detected in the U.S. The U.K. variant was first detected in the U.S. in late December, in a case in Colorado. Since then it has spread to other states, with Virginia announcing its first case associated with the variant yesterday afternoon. Meanwhile, the first documented U.S. case of the variant that originated in Brazil was confirmed in yesterday, in Minnesota. The South Africa variant has not yet been detected in the U.S., although it has been documented in Canada.

In addition to their transmissibility, there are also concerns about these variants’ lethality and susceptibility to existing vaccines. Late last week, British Prime Minister Boris Johnson said the U.K. variant "may be associated with a higher degree of mortality," referring to preliminary data from new studies. Johnson and U.K. Chief Scientific Adviser Patrick Vallance repeated assertions that existing vaccines remain effective against the variant. Pfizer and Moderna have said their vaccines appear to work against this variant. For the other variants, those originating in Brazil and South Africa, there is no evidence that they are more lethal, but there are greater concerns about vaccine effectiveness. For the Brazil variant, there’s no strong evidence that suggests that vaccines won’t work. However, scientists have raised the possibility that this variant can evade antibodies, which would impact vaccines effectiveness. And for the South Africa variant, Dr. Anthony Fauci said the vaccines may have a diminished impact, but they probably will still be effective. Yesterday Moderna announced its vaccine protects against the South Africa variant (as well as the U.K. variant), with the caveat that vaccine-elicited antibodies were also less effective at neutralizing this mutation in a laboratory dish.

Read more at the University of Minnesota Center for Infectious Disease Research and Policy and the Washington Post.

In other COVID-19 updates, which are described in further detail on WaterISAC’s COVID-19 general webpage:

• The Biden Administration released its full, 200-page national strategy to combat the COVID-19 pandemic, which WaterISAC initially discussed in last Thursday’s Security & Resilience Update. The strategy is organized around seven goals. Access the strategy at the White House.
• The U.S. Centers for Disease Control and Prevention (CDC) released updated guidance allowing the second dose of Pfizer and Moderna COVID-19 vaccines to be scheduled for administration up to 6 weeks after the first dose. In “exceptional circumstances,” patients may switch from one of the authorized vaccines to the other between the first and second doses. Read the guidance at the CDC.
• Yesterday Google announced it will begin to make vaccination locations available on Google Maps and Search in the coming weeks. The feature will roll out initially in Arizona, Louisiana, Mississippi, and Texas, “with more states and countries to come.” The feature will display information like whether you’ll need an appointment or referral to get vaccinated, if the vaccine is limited to certain population groups, or if the vaccine is available at a drive-through location.

January 21, 2021

The Biden administration is rolling out a new strategy to combat the COVID-19 pandemic, one that is organized around seven goals (read a preview of the strategy here). Some of these goals involve bolstering production of vaccines and medical supplies, implementing measures to help prevent and mitigate the disease’s spread, addressing disparities across demographic groups, and preparing the nation for future threats, among other types of measures. As expected, and as reported on in the Tuesday Security and Resilience Update, the Biden administration aims to expedite the COVID-19 vaccination campaign through a variety of steps, including by leveraging the Defense Production Act to ensure the availability of glass vials, syringes, and other supplies needed to administer vaccines. The strategy includes encouragement for all Americans to wear face masks, a measure also addressed in an executive order released yesterday (and that requires face masks be worn in all federal buildings, among other stipulations). President Biden has also said he will issue a separate order to federal agencies to require masks on airplanes, trains, and other public transportation. The strategy specifies establishing an equity task force to address disparities in rates of infection, illness and death across lines of race, ethnicity and geography. And as part of preparing for future threats, the U.S. will rejoin the World Health Organization. Read more at the University of Minnesota Center for Infectious Disease Research and Policy, the Associated Press, and the New York Times.

January 19, 2021

On Friday, President-elect Joe Biden presented a five-point plan aimed at expediting the COVID-19 vaccination campaign. The five points include:

• Working with states to clearly identify priority groups for the vaccine, the first of which will be adults 65 and older and “frontline” essential workers (those who regularly interact with and are exposed to the public as part of their duties, such as first responders and grocery store clerks).
• FEMA establishing 100 federally supported vaccination centers across the country by the end of February. Biden also said he would oversee the creation of thousands of community immunization sites, such as school gyms and community centers, as well as mobile vaccination units that would travel to hard-to-reach communities to deliver the vaccines.
• “Fully activating” pharmacies to act as vaccination sites, building on the Trump administration’s reliance on commercial pharmacies to distribute the vaccine.
• Using the full force of the Defense Production Act to make the supplies needed to administer vaccines, including syringes and personal protective equipment.
• Committing to transparency and introducing a massive public information campaign to combat disinformation.

Read more at the University of Minnesota Center for Infectious Disease Research and Policy and Ars Technica.

The money to pay for some of the points would come from a $1.9 trillion stimulus plan Biden announced the day before, on Thursday. The plan includes a request for $160 billion in funding for a national vaccination program, expanded testing, and other steps. The plan also entails billions in grants and loan programs for small businesses, and $350 billion in emergency funding for state, local, and territorial governments. Read more at the New York Times.

In other COVID-19 updates:

• Recently three distinct versions of the coronavirus seem to have independently converged on some of the same mutations, despite being thousands of miles apart in the UK, South Africa, and Brazil. All three variants seem to be becoming more common. And all three are potentially more transmissible. What’s been observed with the recent variants demonstrates coronavirus is in a constant arms race against our immune system and should serve as a reminder that it will keep evolving. Although vaccines are believed to still be effective against the current variants, eventually they may need to evolve with new mutations. Read more at the Atlantic.
• A coronavirus variant first identified in Denmark has been linked to several large outbreaks in California, prompting state and local officials to investigate whether it may be more transmissible. State officials disclosed the rise of the variant Sunday night after genetic monitoring linked it to a fast-growing share of new cases. Experts stress that they need to look more closely at the circumstances of the outbreaks, as well as at the latest variant before declaring it more contagious or more dangerous than the virus already broadly circulating. Read more at the Washington Post.

January 14, 2021

Yesterday the U.S. Centers for Disease Control and Prevention (CDC) announced a new order requiring all air travelers arriving in the U.S. to have tested negative for COVID-19 within three days of their departure. Documentation of the negative test result, or proof of having recovered from COVID-19, is required before passengers are allowed to board the aircraft. This order goes into effect on January 26. The announcement comes as the U.S. continues to experience a critical level of COVID-19 activity, with more than 200,000 new cases reported on Tuesday alone, and given concerns of new variants of the virus, including those that show evidence of being more transmissible, emerging in countries around the world. Much attention has been paid to the variant that originated in the UK and that is known to be circulating in the U.S., but there are now also reports of two more variants of concern linked to Brazil, both which have a mutation or mutations that may affect transmissibility and host immunity. And yesterday researchers based in Ohio said they have spotted a new variant, native to the state, and likely behind rapid spread of the virus in Columbus. Like the strain that originated in the UK, the variant seems to spread more easily than the original virus, but vaccines should still be able to offer protection. Read more in two articles from the University of Minnesota Center for Infectious Disease Research and Policy (article one and article two).

January 12, 2021

Today the U.S. Department of Health and Human Services announced new guidelines that recommend COVID-19 vaccines be given to everyone over 65 in the country. The move is intended to expand eligibility for the vaccine and accelerate a nationwide effort that has fallen short of its initial targets. Decisions for vaccine allocations are ultimately left to state and local governments, but the federal government has been issuing recommendations for priority groups that have been adopted to varying degrees. Currently, the vaccines are largely being distributed to people in the highest-risk categories, including frontline health care workers and older people in nursing homes. HHS will also no longer hold back vaccine doses to ensure that those who receive a first dose will have a second dose in reserve. Instead, all existing doses will be sent to states to provide initial inoculations. Second doses are to be provided by new waves of manufacturing. Both vaccines authorized in the U.S. so far require two doses: 21 days apart for the one developed by Pfizer and BioNTech, and 28 days apart for the one from Moderna. Read more at the New York Times.

In other COVID-19 updates

• From Rhode Island to California, all regions of the U.S. are seeing an uptick in COVID-19 cases in what is likely the post-holiday surge of the virus that experts feared. California, Arizona, Oklahoma, South Carolina, and Rhode Island are reporting the highest rates of new daily cases per person. Read more at the University of Minnesota Center for Infectious Disease and Research Policy.
• The new, more transmissible variant of the virus, first found in the UK, continues to spread in the U.S., with Minnesota reporting its first case associated with the strain over the weekend. Read more at the Minneapolis Star Tribune.
• President-elect Joe Biden said he would be announcing his plan to "get the entire COVID operation up and running," including the necessary costs, on Thursday. Biden said he was confident in his team would be able to administer vaccines to 50 million Americans in his first 100 days. The announcement came as Biden received his second dose of the COVID-19 vaccine, as part of an effort to reassure the country of the safety of the vaccines. Read more at CNN.
• A podcast from the New York Times offers helpful insights into the latest on the COVID-19 pandemic, providing information on the new variant of the coronavirus (and why it’s more transmissible) and why the vaccine rollout has been taking longer than expected (due in part to holiday staffing and saving doses for nursing homes). Access the podcast at the New York Times.
• The Cybersecurity and Infrastructure Security Agency (CISA) has published the COVID-19 Vaccine Distribution Physical Security Measures infographic, which highlights resources within the Department of Homeland Security and other agencies to enhance relevant stakeholder knowledge of physical security. This infographic is intended to assist facility owners, operators, and vaccine recipients to increase their understanding of potential physical threats and relevant mitigation measures. While there are elements of cyber vulnerabilities across the distribution process as well, this product focuses on physical protective measures to safely administer the vaccine. These resources and others are intended to help reduce the chance of a successful attack occurring and the impact should one occur. Access the infographic at CISA.

January 7, 2021

In a news conference yesterday, Health and Human Services Secretary Alex Azar encouraged states to focus on administering COVID-19 vaccines to as many people as possible as quickly as possible, and not let "perfection be the enemy of the good" as far as adhering to the federal government’s vaccine priority guidelines. "We need to not be overly prescriptive," Azar explained, adding that if people in top priority groups had been offered the vaccine and doses were left over, states should quickly start offering the vaccine to other groups. As of Wednesday, only 28 percent of vaccine doses distributed to hospitals and 13 percent of those allocated to nursing homes have been delivered into arms, according to U.S. Centers for Disease Control and Prevention data. Azar also announced that a “federally arranged pharmacy partnership” will launch soon. He said it will involve more than 40,000 pharmacy locations across the country, to which states can allocate vaccines for administration, including to those “over a certain age or in certain occupations” and eventually to the general public. Read more at the University of Minnesota Center for Infectious Disease Research and Policy, USA Today, and CNBC Television (via YouTube).

As WaterISAC reported on in its December 22 Security & Resilience Update, a CDC advisory committee recommended that water and wastewater sector workers be included in phase 1c for COVID-19 vaccine allocations as part of the “other essential workers” group. Phase 1c also includes people aged 65 to 74 and 16 to 64 with underlying health conditions. Phase 1a consists of healthcare personnel and long-term care facility comprise phase 1a, and phase 1b is for individuals 75 and older and “frontline” essential workers (those who regularly interact with and are exposed to the public, which include police and firefighters, public transit workers, and grocery store workers, among others). Although the federal government is issuing recommendations for vaccine allocations, ultimately these decisions are left to state and local governments.

January 5, 2021

Public health officials are warning of the likelihood of a post-holiday spike in COVID-19 cases and other activity in the days and weeks ahead. “It’s terrible, it’s unfortunate, but it was predictable,” said Dr. Anthony S. Fauci on Sunday. Although air travel is down markedly from years past, American airports had their busiest day of the pandemic on Saturday, with nearly 1.2 million passengers passing through security checkpoints, according to the Transportation Security Administration. And tens of millions more people were expected to travel by car.

Further complicating the situation, the new, more transmissible variant of the virus, first found in the UK, is now known to be circulating in the U.S. The variant was first detected in Colorado last week, and since then there have also been cases associated with the strain in California, Florida, and New York. Additionally, the nationwide vaccination effort has not rolled out as quickly as anticipated. Operation Warp Speed had said it would inoculate 20 million Americans by the end of 2020, but so far about 4.5 million people have received the first of two injections, according to the Centers for Disease Control and Prevention data. Surgeon General Dr. Jerome Adams explained the vaccine rollout has gone slower than anticipated because healthcare facilities are still dealing with an onslaught of new cases and increased demand for testing. "I want everyone to know that over the next week or two is when we should be paying attention closely and making sure we continue to see this ramp up," he said.

Read more at the New York Times and the University of Minnesota Center for Infectious Disease and Research Policy.

In other COVID-19 updates:

• The FBI has issued a press release warning of emerging fraud schemes related to COVID-19 vaccines. In one scheme, the perpetrators offer early access to a vaccine upon payment of a fee. The press release describes other variations of this activity and offers tips to avoid vaccine-related fraud. Read the press release at the FBI.
• The peer-reviewed data on both the Moderna and Pfizer/BioNTech COVID-19 vaccines are in, which note that they demonstrate 94 to 95 percent protection from the disease. When compared with placebos, Moderna's vaccine showed 94.1 percent efficacy and Pfizer's had 95.0 percent efficacy. Both rates are for patients who received the two intended doses. Adverse events were uncommon in both studies. Read more at the University of Minnesota Center for Infectious Disease and Research Policy.
• The idea is being floated of halving the dose of each shot of the Moderna vaccine to expedite the administration of vaccines to more people. Data from Moderna’s clinical trials demonstrated that people between the ages of 18 and 55 who received two 50-microgram doses showed an “identical immune response” to the standard of two 100-microgram doses said Dr. Moncef Slaoui, an official with the federal government’s Operation Warp Speed. While some experts agreed this could be an approach, some also voiced hesitancy, with one noting “this is not something I would want to see done unless it were absolutely necessary.” Read more at the New York Times.

December 30, 2020

Yesterday public health officials in Colorado confirmed a COVID-19 case attributed to the variant that’s been seen in the United Kingdom, the first such case in the U.S. The case involves a man who has no travel history, meaning the variant is likely spreading in the U.S. after having been brought by travelers from the UK in recent months.

Given this development and possible concerns of its implications for their utilities and communities, WaterISAC is sharing with members recently published or updated resources from the U.S. Centers for Disease Control and Prevention (CDC). These include "New COVID-19 Variants," "Emerging SARS-CoV-2 Variants," and "Implications of the Emerging SARS-CoV-2 Variant VOC 202012/01." Some of the most significant observations from these resources include:

• Transmissibility: The variant seems to spread more easily and quickly than others.
• Severity of illness and lethality: There is no evidence the variant causes more severe illness or increased risk of death.
• Vaccine efficacy: There is no evidence to suggest the variant has any impact on vaccine efficacy.

December 29, 2020

Canada and Australia are now among a growing list of countries to have confirmed their first cases of COVID-19 due to the variant recently observed in the United Kingdom, which is now the dominant strain there. Although the U.S. has yet to confirm any cases due to this variant, many government officials and health experts have indicated it is likely already in the country. Yesterday, Health and Human Services Assistant Secretary Brett Giroir said, "We don't have proof that it's here, but we do suspect that it is likely here, given the global interconnectedness.” Researchers are rushing to understand more about how the UK variant behaves, but preliminary information has suggested its transmissibility may be as high as 70 percent greater than that of other strains. These developments have led to many countries to implement or increase their travel restrictions in an effort to slow the spread. In the U.S., travelers arriving from the U.K. are now required to show proof of a negative COVID-19 test under new rules issued by U.S. Centers for Disease Control and Prevention (CDC). Even without the presence of the new variant, officials and experts are already expecting more spikes in cases due to increased travel and family gatherings during the holidays. "As we get into the next few weeks, it might actually get worse," said Dr. Anthony Fauci. Nearly 1.3 million people traveled through U.S. airports Sunday, setting a pandemic travel record  – despite warnings from the CDC to stay at home to quell coronavirus cases. Read the articles at the University of Minnesota Center for Infectious Disease Research and Policy, The Hill, NPR, and USA Today.

In other COVID-19 updates:

• Experts are optimistic that the COVID-19 vaccines will still be effective against the variant observed in the UK, as well as other strains. And even if the virus were to mutate further, the vaccines could be rapidly reprogrammed to remain effective against new variants. While a tweaking of vaccines could be done quickly, actually rolling out a recalibrated vaccine would take some time, perhaps a couple of months, due to manufacturing and regulatory requirements. Read more at the Washington Post.
• Novavax’s COVID-19 vaccine candidate entered final-stage testing in the U.S. yesterday. If testing goes well and the vaccine is eventually approved, it would be added to the U.S.’s vaccination campaign, adding to an effort that is need of more supplies. “If you want to have enough vaccine to vaccinate all the people in the U.S. who you’d like to vaccinate — up to 85 percent or more of the population — you’re going to need more than two companies,” said Dr. Anthony Fauci. Read more at the Associated Press.
• World Health Organization (WHO) experts have warned that the world will have to learn to live with the COVID-19 and that despite the severity of the current pandemic it is “not necessarily the big one.” The “destiny” of the virus is to become endemic, even as vaccines begin to be rolled out, says Professor David Heymann, the chair of the WHO’s strategic and technical advisory group for infectious hazards. And Dr. Mark Ryan, the head of the WHO emergencies program, warned that the next pandemic may be worse. “This pandemic has been very severe … it has affected every corner of this planet. But this is not necessarily the big one,” he said. “This is a wake-up call. We are learning, now, how to do things better: science, logistics, training and governance, how to communicate better. But the planet is fragile,” he added. Read more at The Guardian.
• Adding to the knowledge scientists and public health experts have learned about the COVID-19 virus is that all the scrubbing and disinfecting of surfaces previously advocated might not be necessary. Back in January and February, surface contamination was thought to be a problem, with early studies suggesting the virus could live on surfaces for days. Since then scientists have found that even in hospital settings, no infectious virus could be identified on surfaces near COVID-19 patients. What's found is viral RNA, which is like the “corpse of the virus” and is not infectious. In retrospect, extensive actions to disinfect surfaces seem like overkill. Today, the evidence points toward breathing in the virus from the air as being the most important route of transmission, and the one deserving of the most attention for reducing cases. Read more at NPR.

December 22, 2020

Over the weekend, a CDC advisory committee recommended that water and wastewater sector workers be included in phase 1c for COVID-19 vaccine allocations, not in phase 1b as had been anticipated up until recently. Essential workers are included in phase 1b, but only those considered to be “frontline,” meaning those who regularly interact with and are exposed to the public as part of their duties. Examples of frontline essential workers include police and firefighters, public transit workers, and grocery store workers. Phase 1c includes “other essential workers,” which in addition to those in the water and wastewater sector also captures workers in the IT and communications, energy, and finance sectors, among others. Both phases also include seniors, with individuals 75 and older in phase 1b and individuals 65 to 74 in phase 1c. Phase 1c also includes people aged 16 to 64 with underlying health conditions. As WaterISAC has previously noted, although the federal government is issuing recommendations for vaccine allocations, ultimately these decisions are left to state and local governments. WaterISAC reiterates its recommendation (including that from the December 10 Security & Resilience Update), as well as that of the Water Sector Coordinating Council (whose letter on the matter has been posted below as resource #43), that water and wastewater utilities discuss the vaccine prioritization status of their workers with their respective state and local health departments.

In other COVID-19 updates:

• The CDC advisory committee decided to recommend specific groups for vaccine allocation, to include creating a distinction between “frontline” and “other” essential workers, because of the limited supply of vaccines. Given the limitations, "difficult choices have to be made," said Dr. Kathleen Dooling, a committee member. "Front-line workers in particular are unable to work from home and have a high level of interaction with the public or others in the workplace," she added. Read the article at NBC News.
• Doses of the Moderna vaccine began being administered across the U.S. yesterday, after having been authorized by the federal government in the preceding days. The authorization of a second vaccine should vastly expand the reach of COVID-19 vaccines. Additionally, the Moderna vaccine should be available in more locations than the previously-authorized Pfizer vaccine because it doesn’t require super-cold freezer storage. Read the article at the University of Minnesota Center for Infectious Disease Research and Policy.
• In the UK, public health officials are responding to a newly identified variant of the coronavirus that appears to be more contagious than more established variants. The officials say models suggest the variant may be up to 70 percent more transmissible and may be responsible for a rapid increase in COVID-19 cases in parts of the country in recent weeks. There is no strong evidence that the variant causes more severe cases, at least not yet. And experts have said the current COVID-19 vaccines should be effective against the variant. Still, the situation in the UK raised alarm around the world, with many nations barring or imposing restrictions on travelers from the country. Speaking about the development, Dr. Anthony Fauci said the new variant is likely in the U.S. "We have to make that assumption [that it has arrived in the U.S.]" said Fauci. "When you see something that is pretty prevalent in a place like the U.K…I would not be surprised if it's already here. When we start to look for it we're gonna find it," he explained. Read the articles at the University of Minnesota Center for Infectious Disease Research and Policy, the New York Times (articles one and two), and Newsweek.
• Despite repeated pleas of public health officials for people to stay home over the holidays and avoid travel, Transportation Security Administration data show that more than 2 million people have passed through security checkpoints over the last two days. Travel volume is down 60 percent from last year but is still much higher than in earlier pandemic months. Read the article at NPR.

December 17, 2020

The Cybersecurity and Infrastructure Security Agency (CISA) has written a letter to critical infrastructure partners and colleagues re-promoting its Essential Critical Infrastructure Workforce Guidance as a tool to assist COVID-19 response. CISA notes it is working with states and local officials to help inform their vaccine prioritization decisions, which includes by encouraging them to use the guidance document. WaterISAC previously reported on CISA’s outreach to state and local governments about factoring in essential workers, including those at water and wastewater utilities, in its December 10 Security and Resilience Update. WaterISAC has also consistently referred to CISA’s guidance when recommending members reach out to their state and local health departments about the status of workers for vaccine allocation. The Water Sector Coordinating Council also referred to this guidance when recommending utilities collaborate with their state and local departments, which WaterISAC reported on in a special advisory on Monday. CISA’s full letter has been posted below as resource #44 (scroll to the list of documents near the bottom of this page).

In other COVID-19 updates:

• Today, independent vaccine advisors for the Food and Drug Administration (FDA) meet to discuss emergency use authorization (EUA) for Moderna's vaccine, which if approved would clear the way for a second vaccine to be distributed. A separate vaccine advisory group for the Centers for Disease Control and Prevention (CDC) will have an emergency meeting on Dec 19 to discuss a recommendation for Moderna's vaccine, plus an emergency session on Dec 20 to discuss on vote on the next groups that should be prioritized the receive the vaccine. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• The New York Times has set up an online vaccine distribution tracker, depicting the amount of doses allocated to states, territories, and other jurisdictions.
• The Associated Press has created an online “pandemic atlas,” which provides overviews of how COVID-19 has impacted countries around the world. It includes numbers on total deaths and cases, as well as summaries of how the countries have responded and fared from the pandemic.

December 15, 2020

U.S. COVID-19 Vaccination Campaign Begins

Pfizer’s COVID-19 vaccine began being administered across the U.S. yesterday, with the first doses going to a priority group consisting of healthcare personnel and residents of long-term care facilities. The U.S. vaccine distribution network kicked into high gear following the federal government’s final approval of the vaccine for emergency over the weekend, with shipments of the vaccine arriving at 145 distribution centers yesterday, with 425 sites expected to receive their deliveries today and the remaining 66 tomorrow. U.S. Health and Human Services Secretary Alex Azar said he believes 20 million people will be vaccinated by the end of the month, with additional doses of Pfizer's vaccine coming in and 12.5 million doses of Moderna's vaccine, which is awaiting authorization, also ready to be shipped. Pending the Moderna vaccine's authorization, Azar said, "we have enough vaccines already purchased to ensure we can meet our goal of vaccinating every American who wants it by the end of the second quarter of 2021."

In other COVID-19 updates:

• The Trump Administration is rushing to roll out a $250 million public education campaign to encourage Americans to be vaccinated against COVID-19, according to the New York Times. It said the U.S. Department of Health and Human Services is overseeing the campaign, which will include ads in print, social media, and radio formats.
• According to a Kaiser Family Foundation survey, about a quarter (27 percent) of the public remains vaccine hesitant about a COVID-19 vaccine, saying they probably or definitely would not get it even if it were available for free and deemed safe by scientists. Among those who are hesitant to get a COVID-19 vaccine, the main reasons are worries about possible side effects (59 percent cite this as a major reason), lack of trust in the government to ensure the vaccines’ safety and effectiveness (55 percent), concerns that the vaccine is too new (53 percent), and concerns over the role of politics in the development process (51 percent). Still, the share of the public willing to get vaccinated has increased, with about 71 percent now saying they would definitely or probably get the vaccine, an improvement from September when that number stood at 63 percent.
• State leaders quoted in the Wall Street Journal said they are billions short in funding needed to roll out the COVID-19 vaccine to Americans who want to be immunized by June. They said additional funding is needed to hire medical workers, do community outreach, set up vaccination clinics, and ensure proper storage for the vaccines.
• Have questions about the COVID-19 vaccine and/or getting vaccinated? The U.S. Centers for Disease Control and Prevention has posted and updated numerous webpages to help, including:
  • What to Expect after Getting a COVID-19 Vaccine, 
  • What to Expect at Your Appointment to Get Vaccinated for COVID-19,
  • When Vaccine is Limited, Who Gets Vaccinated First?, and
  • General COVID-19 vaccine information

December 14, 2020

Today, the Water Sector Coordinating Council (WSCC), a body of water and wastewater utility representatives that advises the federal government on security and resilience issues relevant to the sector, released a statement urging utilities to collaborate with their state and local health departments to ensure their staff members are considered as plans are developed for the distribution of COVID-19 vaccines. The full statement from the WSCC has been posted below as resource #43 (scroll to the list of documents near the bottom of this page).

The WSCC's statement echoes WaterISAC's previous guidance to its members, with an initial recommendation in the September 17 Security & Resilience Update and the latest in the December 10 Security & Resilience Update. In its messaging, WaterISAC has pointed to federal government planning and guidance documents that support the prioritization of the water and wastewater sector for vaccine allocation, including the Centers for Disease Control and Prevention's COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations and the Cybersecurity and Infrastructure Security Agency's Guidance on the Essential Critical Infrastructure Workforce.

However, final distribution strategies are left to state and local governments, and WaterISAC once again encourages its members to contact their health departments to ensure the water and wastewater sector is included in their plans. The documents referenced above and other materials posted to this webpage can assist utilities in preparing for these conversations.

December 10, 2020

A Food and Drug Administration (FDA) advisory panel is expected to vote today on whether Pfizer’s COVID-19 vaccine candidate should be approved. If it votes in favor of approval, it will likely lead the FDA to authorize the vaccine within days and the first doses to be administered in the U.S. next week. Health care personnel and long-term care facility residents are likely to get these first doses, as was recommended by a U.S. Centers for Disease Control and Prevention (CDC) advisory panel last week. Although the panel has yet to vote on the vaccine prioritizations for other groups, it is likely that it will recommend essential workers (including those at “utilities”) for phase two.

While the federal government can make recommendations about vaccine prioritization, these decisions are ultimately up to the states. And when it comes to workers and who among them are “essential” and should be prioritized for vaccines, there are some differences in interpretation among the states, as some companies and industry groups are reported to have found. The Cybersecurity and Infrastructure Security Agency (CISA), which worked with partner groups across all critical infrastructure sectors to create the Guidance on the Essential Critical Infrastructure Workforce (now in version four), has indicated it is working with states to help inform their vaccine prioritization decisions. To further inform these decisions and help ensure water and wastewater workers are given the appropriate status, WaterISAC encourages it members to contact their state and local health departments on this issue. WaterISAC initially recommended this in its September 17 Security & Resilience Update, when it pointed to CISA’s guidance as a reference for helping to inform these discussions.

• The National Governors Association (NGA) has published a report to help support an equitable distribution of COVID-19 vaccines, presenting key themes, strategies, and challenges across state and territorial plans. As part of preparing this report, the NGA worked with the Duke-Margolis Center for Health Policy and the COVID Collaborative to conduct a qualitative analysis of all publicly available state and territorial COVID-19 vaccination plans. The analysis aims to support identification of key issues and promote sharing of promising practices across the country.
• USA Today published an article discussing the federal government’s COVID-19 vaccine distribution process, based on a discussion with the lead of supply, production, and distribution for Operation Warp Speed. Among other details, the vaccine will be shipped to all 50 states and outlying U.S. territories within 24 hours following the FDA’s authorization. Additionally, the federal government plans to only ship half of all vaccine available each week. The other half will be held in storage and be released just before the second dose is due for those vaccinated the first time.
• President Trump signed an Executive Order (EO) on Tuesday stating that Americans should have priority access to vaccines developed in the U.S. or procured by the U.S. government. The EO goes on to say that once the country’s vaccination needs have been met, the U.S. will facilitate international access to its vaccines. Nations Security Advisor Robert O’Brien issued a statement following the EO providing further explanation and background.
• A new surge of COVID-19 activity related to Thanksgiving gatherings may be starting to show, with a record 104,600 people in the hospital for COVID-19 infections reported earlier this week. Additionally, more than 200,000 Americans are now testing positive for COVID-19 each day, on average.

December 8, 2020

CDC Recommends Indoor Mask-Wearing When Not at Home, and Other COVID-19 Updates

The U.S. Centers for Disease Control and Prevention (CDC) is now recommending “universal use of face masks,” which for the first time includes in all indoors settings, with the exception of when people are in their homes (excepting when a member of the household is infected or had a recent potential COVID-19 exposure). The CDC had already recommended mask-wearing in outdoors settings and public spaces. The CDC explained it issued the updated guidance given that the U.S. has entered a high-level transmission phase, with the onset of colder weather, more time spent indoors, and the ongoing holiday season. In the same updated guidance, the CDC addressed other measures for reducing COVID-19 transmission, which include postponing travel plans. Despite the recommendation, experts are anticipating a holiday travel rush. The Sunday after Thanksgiving was the busiest day of air travel in 2020, with more than 1.1 million Americans flying. Read more at the University of Minnesota Center for Infectious Disease Research and Policy and the Washington Post.

In other COVID-19 updates:

• What are employers entitled to know about their employees’ holiday travel plans, and what measures can they legally take to protect the safety of the workplace? According to an article in the Wall Street Journal, employers generally have wide latitude during a pandemic in what they can ask and do, although the situation varies by state. Permissible actions can include asking workers to take a pledge to refrain from any risky behavior – as some companies did right before Thanksgiving – and cautioning employees against any conduct that would violate federal or local health guidelines. Employers can also discipline workers for what they do during off hours. That could include if workers don’t disclose potential exposure to the virus and return to the workplace without quarantining after personal travel or after attending large celebrations. Read more at the Wall Street Journal.
• The National Institutes of Health (NIH) has released a tool designed to help businesses and other organizations plan COVID-19 testing. The COVID-19 Testing Impact Calculator is free, available online, and can be used within organizations to model the costs and benefits of COVID-19 testing strategies. The tool also shows how other CDC-recommended countermeasures, such as masks, contact tracing, and social distancing, can work in concert with testing to keep people safe. Users enter which of these measures are in place in their organization and the tool integrates this information to produce testing recommendations. NIH developed the tool with other organizations, including a team at the Massachusetts General Hospital in Boston and researchers at the Massachusetts Institute of Technology. Read more and access the tool at NIH.
• The U.S. Department of Health and Human Services (HHS) has released a Preservation Planning Toolkit, which is intended for any PPE-using organization to plan and implement preservation strategies. With the tool, users enter data on their current or prospective PPE use practices. The tool then assists users with understanding types of preservation strategies and provides estimates of positive impacts of those measures in increasing the duration of PPE supplies. Access the toolkit at HHS.
• The United Kingdom (U.K.) began delivering the first does of COVID-19 vaccine to its citizens today, using the Pfizer vaccine that was approved for use in the country last week. The U.K. is the first Western country to start a mass vaccination program, with other nations expected to approve vaccines in coming days or weeks, part of a global immunization effort. In the U.S., The Food and Drug Administration will consider Emergency Use Authorizations (EUAs) for Pfizer’s COVID-19 vaccine candidate on Thursday and Moderna’s vaccine candidate on December 17. HHS Secretary Alex Azar expressed optimism Sunday that the vaccine could be authorized “within days.” Read the articles at the Associated Press and Fox Business.
• Pfizer has told the U.S. government it cannot provide substantial additional doses of its COVID-19 vaccine until late June or July because other countries have rushed to buy up most of its supply, according to media reporting. That means the U.S. government may not be able to ramp up as rapidly as it had expected from the 100 million doses of the Pfizer vaccine that it purchased earlier this year, raising questions about whether it can keep to its aggressive schedule to vaccinate most Americans by late spring or early summer. Government officials denied there would be availability issues in the second quarter, citing other vaccines in the pipeline, such as Moderna’s, also expected to be approved in coming weeks. Both vaccines are two-dose regimens, so the 100 million doses purchased of each would cover 50 million people each. Read more at the Washington Post.

December 3, 2020

As discussed in the Tuesday Security and Resilience Update, that same day the U.S. Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) was meeting to vote on which among a series of priority groups should be the first to receive a COVID-19 vaccine (link to the presentations made during the meeting at CDC). As expected, the group voted that when a COVID-19 vaccine is authorized by the Food and Drug Administration (FDA) and recommended by ACIP, healthcare workers and people in long-term care facilities should be the first to receive vaccinations, as part of phase “1a”. Before the vote, members also discussed those considered in phases “1b” (“essential workers,” which includes those at “Utilities”) and “1c” (adults with high-risk medical conditions and who are 65 and older) but decided to take no action until after an upcoming FDA meeting. During that meeting, scheduled for December 10, the FDA will discuss the emergency use authorization request for Pfizer’s COVID-19 vaccine candidate. For this past Tuesday’s meeting, ACIP also discussed gating criteria for moving to the next phase. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.

In other COVID-19 updates:

• Vaccination cards will be issued to everyone getting the COVID-19 vaccine, health officials say. Additionally, vaccination clinics will report to their state immunization registries what vaccine was given, so that, for example, an entity could run a query if it didn't know where a patient got a first dose. The card will be provided in a vaccine kit that also includes a needle and syringe, alcohol wipes, and a mask. Read more at CNN.
• IBM has released a report on cyber actors targeting the COVID-19 vaccine supply chain. According to the report, impersonating a biomedical company, cyber actors are sending phishing and spearphishing emails to executives and global organizations involved in vaccine storage and transport to harvest account credentials. The emails have been posed as requests for quotations for participation in a vaccine program. Read more and access the report via CISA.
• Yesterday, the CDC said though the 14-day quarantine period after exposure to COVID-19 is still ideal, it now recommends two acceptable periods: 10 days without a test if the person in quarantine has no symptoms and 7 days with a negative test if the individual has no symptoms. In both instances, the CDC urges people to continue to monitor their symptoms for the full 14 days following exposure. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• Also yesterday, the CDC issued updated travel guidance during the COVID-19 pandemic. The CDC begins by emphasizing “travel can increase your chance of spreading and getting COVID-19,” adding “postponing travel and staying home is the best way to protect yourself and others from COVID-19.” If people decide to travel, the CDC recommends they get tested 1 to 3 days before travel, with testing repeated 3 to 5 days after travel. For returning travelers, the CDC recommends they avoid nonessential activities for 7 days after travel for people who were tested, extending the period to 10 days for those who weren't tested.
• The World Health Organization has released a new resource with tips for staying safe during the winter holidays. The resource consists of a calendar with tips for each day this month, such as a recommendation to stay home if you’re feeling unwell and on ways to celebrate without gathering with family and friends.
• With predictions of tough months ahead and public health officials encouraging the public to maintain its vigilance, now’s a good time to review COVID-19 symptoms. Fever, cough, and shortness of breath are the highest-frequency symptoms of COVID-19. But other symptoms can include fatigue or muscle aches, headaches, loss or distorted sense of smell or taste, sore throat, congestion, runny nose, and stomach issues. Read more at the Washington Post and CDC.

December 1, 2020

CDC Advisory Committee Holds Meeting on Priority Vaccine Allocation Today, States Continue Efforts to Prepare for Distribution, and Other COVID-19 Updates

Today at 2 pm ET, the U.S. Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) will meet to vote on which among a series of priority groups should be the first to receive the COVID-19 vaccine. During a meeting last week, ACIP members indicated that healthcare workers and people in long-term care facilities (phase 1a) should be the first to be vaccinated, followed by essential workers (phase 1b, which includes those at “utilities”) and adults with high-risk medical conditions and those over 65 (phase 1c). But the committee did not vote on those recommendations. The ACIP expected to recommend that those in phase 1a be first in line, and then to make recommendations at later meetings for priority groups in the next phases. Recommendations from the advisory group are sent to CDC Director Dr. Robert Redfield, who also informs Health and Human Services Secretary Alex Azar. If the recommendations are approved, they will become official CDC recommendations on immunization in the U.S.

The ACIP typically votes on who should get a vaccine after the Food and Drug Administration (FDA) has approved it. The advisory group is meeting today because states want priority group guidance before Friday, when they must submit final details to the federal government on where they want vaccine to be delivered once one is authorized. Ultimately state officials will decide how the doses are distributed, but many have said they plan to follow the federal recommendations.

Read more at the University of Minnesota Center for Infectious Disease Research and Policy and the Washington Post.

In other COVID-19 updates:

• The initial doses of vaccine will only be enough to cover a fraction of the entire phase 1 population. There are an estimated 21 million healthcare workers, 3 million people in nursing homes, 87 million essential workers, 53 million adults over age 65, and more than 100 million people with high-risk conditions. U.S. officials anticipate that by the end of this year they’ll have 40 million doses of vaccines from Pfizer and Moderna, which have both submitted for emergency use authorizations (EUAs) from the Food and Drug Administration (FDA) for their two-dose vaccine candidates, enough to immunize 20 million people. Read more at the University of Minnesota Center for Infectious Disease Research and Policy and the Washington Post.
• With the Thanksgiving holiday now in the rearview mirror, a time when air travel was at its highest point since the COVID-19 pandemic began, health officials are bracing for another spike in infections. Dr. Deborah Birx, who coordinates the White House’s COVID-19 task force, said over the weekend that the post-Thanksgiving spike could be worse than what the nation experienced after Memorial Day. She added that people who gathered for Thanksgiving should assume they've been infected and get tested in the next 5 to 10 days. She also urged those who attended gatherings to limit their social contacts, especially with older family members. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• Yesterday the Government Accountability Office (GAO) published the report COVID-19: Urgent Actions Needed to Better Ensure an Effective Federal Response, which examines the federal government’s continued efforts to respond to and recover from the COVID-19 pandemic. It makes 12 new recommendations to federal agencies and for congressional consideration on topics including medical supply shortages, COVID-19 testing, COVID-19 vaccines and therapeutics, assistance to individuals and businesses, and program integrity.

November 24, 2020

The CDC is strongly urging Americans to avoid traveling for the Thanksgiving holiday, observing that postponing travel and staying home is the best way to protect yourself and others this year. Its “Celebrating Thanksgiving” webpage offers a series of questions for those considering travel, recommendations for those who do travel, and general tips for mitigating risks during the holiday. Despite the urging, as well as similar pleas from state and local health officials and others, more than 3 million Americans passed through airport security checkpoints on Friday, Saturday, and Sunday. The daily travel numbers are among the highest recorded at U.S. airports since the pandemic began in March. National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci expressed concern that a surge of Thanksgiving travelers could translate to a surge in cases. “The travel, the congregate setting, not wearing masks, the chances are that you will see a surge superimposed upon a surge. What we're doing now is going to be reflected two, three weeks from now," he stated.

In other COVID-19 updates:

• This dim outlook comes as the U.S. is already experiencing spiking case numbers in most places, which have led to warnings about full hospitals, exhausted health care workers, and expanded lockdowns. Over the past week, there has been an average of 173,165 cases per day in the U.S., an increase of 49 percent from the average two weeks earlier. On one day last week, there were nearly 200,000 new cases of COVID-19.
• The Food and Drug Administration (FDA) announced it has scheduled a meeting on December 10 to discuss Pfizer’s request for an Emergency Use Authorization (EUA) of its COVID-19 vaccine. The FDA has also published new information about the vaccine development and review process. These include:
  • Vaccine Development 101
  • Emergency Use Authorization for Vaccines Explained
  • The Path for a COVID-19 Vaccine from Research to Emergency Use Authorization
• AstraZeneca announced yesterday that early analysis of some of its late-stage clinical trials, conducted in the United Kingdom and Brazil, showed that its COVID-19 vaccine was about 70 percent effective in preventing cases of COVID-19. The drug maker and the University of Oxford, with whom the company partnered developed the vaccine, said they would submit their data to regulators in Britain, Europe, and Brazil and seek emergency authorization.
• People are most likely to pass on COVID-19 within the first five days of having symptoms, a British study suggests. The research indicates patients had the highest levels of virus early on in their illness and "live" virus, capable of replicating, was found up to nine days after symptoms began. "People really need to be supported to make sure they isolate as soon as they get symptoms, however mild. By the time some people get the results of swabs, they may be past their most infectious phase,” said Dr Muge Cevik, who was involved in the study.

November 19, 2020

Vaccine Announcements Continue to Inspire Optimism, but Distribution Questions Remain

Yesterday, Pfizer announced that its COVID-19 vaccine has 95 percent efficacy, better than the 90 percent noted in its initial announcement last week, and that it will apply for emergency use authorization (EUA) from the Food and Drug Administration (FDA) in the coming days. It also reported the vaccine demonstrated high efficacy in older adults and helps protect against severe cases, data that had been eagerly awaited by the scientific and public health communities. Commenting on this development, Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy (which WaterISAC often looks to for information and analysis of COVID-19 and other public health issues), said he believes Pfizer is likely to receive the EUA. He added that he has complete confidence in the FDA's review and the input of its science advisors and looks forward to guidance on where and how to use the vaccine to come from the Center for Disease Control and Prevention's, following recommendations it received from its Advisory Committee on Immunization Practices. Osterholm observed that the next task will be to actually deliver the vaccine to the public. "The number one challenge is no longer research and development; it's how to convert a vaccine into a vaccination."

In other COVID-19 updates, which are described in further detail on WaterISAC’s COVID-19 general webpage:

• The U.S. Government Accountability Office (GAO) released a report (posted below as resource #41) saying supply chain issues could interfere with a smooth rollout of a COVID-19 vaccine. The report details the challenges of scaling up mass production of COVID-19 vaccines and drugs, including needing to add new manufacturing capacity—or shift capacity from other products—because most was already in use before the pandemic. Even when large quantities of vaccines and drugs are manufactured, they must be sealed in sterile containers in finish-fill facilities, the current scarcity of which could lead to production backlogs. Supplies of products needed for this process, including glass vials and syringes, are also limited. The report cautions that manufacturing supply chains may struggle to keep up with demand because of coronavirus-related disruptions such as changes in worker availability, fluctuating demands for certain products, and some countries' export restrictions. Read the article at the University of Minnesota’s Center for Infectious Disease Research and Policy.
• Can employers mandate employees get the vaccine? Yes, according to the legal experts interviewed for one article. Whether they should is a different matter, given that federal protections could allow for some exceptions and the possibility of workers’ compensation claims and public relations problems. Some of the other suggested approaches include allowing workers to get the vaccine on company time, having senior leadership promote that they got the vaccine, and engaging the union (if applicable) to promote the shot. Read the article at CNN.
• The American Enterprise Institute, a public policy think tank, has published a report (posted below as resource #42) on building a resilient workforce in the post-COVID-19 world. As the report describes, before the pandemic remote work was reserved for just seven percent of the workforce. In a matter of weeks, COVID-19 forced virtually every industry, employer, and worker to transform their approach to work. This report seeks to outline the positive and negative trade-offs of remote work for employers and employees. It also intends to improve the collective understanding of the existing research on remote work and some of the immediate impacts of COVID-19.
• COVID-19 has led to a movement among architects and building standards professionals over how to promote healthy conditions indoors, where viruses could thrive and threaten occupants. Months into the pandemic, designers are tracking changes in how people interact with buildings and trying to see how they can help make the indoors healthier. Design tweaks could start with a user's entry into a building, through vestibules and queuing areas to facilitate temperature checks or social distancing. Architects are also incorporating one-way doors and hallways, spreading workstations farther apart, deploying touchless technologies, and upgrading air-filtration systems. Read the article at Thomson Reuters Foundation.

November 17, 2020

CDC Clarifies Guidance on Reintegrating Exposed Workers into Operations, and other COVID-19 Updates

Yesterday CDC issued updated guidance stating that reintegrating into onsite operations critical infrastructure workers who had been exposed to COVID-19 but who are not experiencing any symptoms and have not tested positive should be used as a last resort and only in limited circumstances. The CDC added that these cases could include when cessation of operation of a facility may cause serious harm or danger to public health or safety. This guidance as posted to CDC’s updated “COVID-19 Critical Infrastructure Sector Response Planning” webpage, which also notes that all workers should wear a mask in accordance with guidance from CDC, OSHA, and state and local authorities.

In other COVID-19 updates:

• With significant increases in COVID-19 cases across the nation, many states and cities are reimposing or instituting new measures to slow the spread of the disease. Some states are halting phased reopening plans or imposing new coronavirus-related restrictions. Several are putting limits on social gatherings, adding states to travel quarantine lists, mandating face masks and encouraging residents to stay home, as many did in the spring. Others are restricting business hours of operation and limiting restaurant capacity. Thirty-five states – plus the District of Columbia and Puerto Rico – now require people to wear face coverings in public statewide. Read more at the University of Minnesota Center for Infectious Disease Research and Policy and USA Today.
• The U.S. added more than 180,000 new COVID-19 cases on Friday, a new record. Over the past week, there has been an average of 155,442 cases per day, an increase of 82 percent from the average two weeks earlier. According to the Johns Hopkins University tracker, as of today there are 11,207,088 confirmed cases of COVID-19 in the U.S. (+785,410 since the Thursday Security and Resilience Update). In WaterISAC’s other member countries, Canada and Australia, there are 305,449 (+24,984) and 27,760 (+85) cases, respectively. Read more at the New York Times and NPR.
• In more good news from the vaccine front, yesterday Moderna Inc. announced that early data from a phase 3 clinical trial indicate its vaccine candidate showed 94.5 percent efficacy. The news comes a week after Pfizer announced its vaccine demonstrated 90 percent efficacy in a phase 3 trial involving more than 44,000 volunteers. Like the Pfizer-BioNtech vaccine, the Moderna vaccine will also require cold storage, which experts have noted could pose problems for distribution. But while the Pfizer vaccine needs to be stored at –94°F, the Moderna vaccine needs to be stored at –4°F and is stable for 30 days at refrigerator temperatures (36°F to 46°F). Even with the positive news about both vaccine candidates, it's likely to be several months before large segments of the population can get vaccinated. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.

November 12, 2020

CDC Says Masks Protect Wearers, and other COVID-19 Updates

The U.S. Centers for Disease Control and Prevention (CDC) posted updated guidance stating that cloth face masks offer protection from SARS-CoV-2, the virus that causes COVID-19, for both the person wearing them and those around them. In previous guidance, the CDC noted the main benefit of mask wearing was to help prevent infected people from spreading the virus to others. "You protect others, their mask protects you, and your mask also protects you," said National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci, speaking about the new guidance. The CDC cites a number of studies that support the updated guidance and discusses the efficacy of different materials for cloth face masks. It emphasizes that those composed of multiple layers of cloth with higher thread counts demonstrated superior performance.

In other COVID-19 updates:

• State governments’ COVID-19 vaccine distribution plans show many are not ready to deliver the shots when they’re available, according to a review by ProPublica. As reported on in the Tuesday Security and Resilience Update, Pfizer revealed that its vaccine may be 90 percent effective, making it a leading candidate. However, the Pfizer vaccine is unusually difficult to ship and store. It is administered in two doses given 28 days apart, has to be stored at temperatures of about minus 100 degrees Fahrenheit, and will be delivered in dry ice-packed boxes holding 1,000 to 5,000 doses. ProPublica found health officials haven’t figured out how to get the ultracold doses to critical populations living far from cities. And needing to use 1,000 doses within a few days may be fine for large hospital systems or mass vaccination centers. But it could rule out sending the vaccine to providers who don’t treat that many people, even doctors’ offices in cities. Read more at ProPublica.
• The number of Americans hospitalized for COVID-19 is hitting new highs as coronavirus infections continue to spike across the country. The COVID Tracking Project reports that 61,964 Americans were hospitalized with COVID-19 as of Nov 10. That's the most hospitalizations recorded since the beginning of the pandemic in March. And with hospitalizations lagging a few weeks behind new cases, that number will continue to climb. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.
• There were more than 142,000 new cases of COVID-19 in the U.S. yesterday, according to the New York Times. According to the Johns Hopkins University tracker, as of today there are 10,421,678 confirmed cases of COVID-19 in the U.S. (+311,126 since the Tuesday Security and Resilience Update). In WaterISAC’s other member countries, Canada and Australia, there are 280,465 (+8,431) and 27,675 (+6) cases, respectively.
• More than half of people who recover from COVID-19 still report fatigue 10 weeks later, regardless of the seriousness of their initial infection, an observational study found. Sixty-seven of 128 participants (52.3 percent) reported fatigue, a common symptom of acute COVID-19 infection, a median of 10 weeks after recovery, while 54 (42.2 percent) said they had recovered their full health. Additionally, nearly a third of the participants hadn’t returned to work. Before their illness, 105 participants (82 percent) had worked outside the home, but 33 (31 percent) of them still had not returned to employment by the time of study participation. "This is of particular concern, given that it is recommended that post-viral infection return to work should take place after four weeks to prevent deconditioning," the researchers wrote. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.

November 10, 2020

New resources and information:

• Occupational Safety and Health Administration (OSHA) guidance and an accompanying one-pager (also posted below as items #39 and 40) to help employers understand which standards are most frequently cited during coronavirus-related inspections. OSHA based these documents on data from citations issued, many of which were the result of complaints, referrals, and fatalities in industries. In the guidance document, OSHA also notes that if offers no-cost, on-site consultation services to small and medium-sized businesses. These services are confidential and separate from enforcement, meaning they don’t result in penalties or citations.
• National Institute of Standards and Technology (NIST) research findings that show masks with exhalation valves do not slow the spread of the disease. NIST conducted the research by taking special videos that depict airflow patterns through masks with and without the valves.

The U.S. has recorded more than 100,000 new daily cases of COVID-19 on numerous days over the past week, rising to higher than 130,000 cases on some days according to some accounts. The U.S. also recently passed over 10 million total COVID-19 cases. Read more at the University of Minnesota Center for Infectious Disease Research and Policy.

According to the Johns Hopkins University tracker, as of today there are 10,110,552 9,309,298 confirmed cases of COVID-19 in the U.S. (+801,254 since last Tuesday’s Security and Resilience Update). In WaterISAC’s other member countries, Canada and Australia, there are 272,034 244,218 (+27,816) and 27,669 27,610 (+59) cases, respectively.

On an optimistic note, yesterday Pfizer said its COVID-19 vaccine may be a remarkable 90 percent effective, based on early and incomplete test results. Read more at the Associated Press.

October 29, 2020

The U.S. Centers for Disease Control and Prevention (CDC) has updated its “COVID-19 Employer Information for Utility Workers” webpage, providing its latest advice on how to protect staff and others. It provides guidance for creating a COVID-19 workplace health and safety plan, recommends actions to take if an employee is suspected or confirmed to have COVID-19, and describes controls utilities can implement to prevent infections among workers. Access the webpage at the CDC.

October 27, 2020

The U.S. Centers for Disease Control and Prevention (CDC) has published a series of webpages discussing the use of wastewater surveillance as a new public health tool to understand COVID-19 spread in communities. As described on the main “Wastewater Surveillance” webpage, the CDC has initiated the National Wastewater Surveillance System (NWSS) in collaboration with the U.S. Department of Health and Human Services and other agencies throughout the federal government. The CDC adds that it is currently developing a portal for state, tribal, local, and territorial health departments to submit wastewater testing data into a national database for use in summarizing and interpreting data for public health action. The webpage also includes a “How do I become engaged in NWSS?” section. Access the webpage at the CDC.

The main webpage also linkes to the following CDC webpages on this topic:

• Sampling Strategy: Where, How, and What to Sample
• Data Reporting and Analytics
• Public Health Interpretation and Use
• Testing Methods
• Targated Wastewater Surveillance at Facilities, Institutions, and Workplaces

WaterISAC has reported on the use of wastewater to measure the spread of COVID-19 in communities. As discussed in the June 23 Security and Resilience Update, the Water Research Foundation (WRF) published a report on recommendations of global experts on this topic. In the June 9 Security and Resilience Update, it described how some wastewater utilities in the U.S. have been participating in the early stages of efforts to track the levels of coronavirus in their areas. And in the April 16 Security and Resilience Update, it discussed Australia’s use of this technology.

October 22, 2020

Earlier this week, the Brookings Institution, a policy think tank, published an article on the role of water infrastructure in the response and recovery to the ongoing COVD-19 pandemic, noting its “importance to health, hygiene, and safety has never been more obvious.” However, it also describes some of the challenges facing water infrastructure and the communities it serves, and how these have been highlighted because of the pandemic. While emphasizing that state and local leaders mostly understand these challenges, it calls on more action to be taken at the federal level, with water being elevated to core issue as part of driving a lasting recovery. Some of the solutions proposed in the article include increased technical and financial support for customer assistance programs and embracing the digital transition of water systems, such as with advanced metering infrastructure. Read the article at the Brookings Institution.

Yesterday, the U.S. Centers for Disease Control and Prevention issued new guidance that expands the pool of people considered at risk of contracting the COVID-19 by changing the definition of who is a “close contact” of an infected individual. The CDC previously defined a close contact as someone who spent at least 15 consecutive minutes within six feet of a confirmed coronavirus case. It now defines a close contact as someone who was within six feet of an infected individual for a total of 15 minutes or more over a 24-hour period. The change is likely to have its biggest impact in schools, workplaces and other group settings where people are in contact with others for long periods of time. Read an article about the change at the Washington Post.

October 6, 2020

On Friday, the National Academies released the final Framework for Equitable Allocation of COVID-19 Vaccine, presenting its criteria for what it believes should be used to set priorities for equitable distribution among groups of potential vaccine recipients. The Framework identifies a four-phased approach to vaccine allocation, with high-risk health workers, first responders, and individuals who are at heightened risk for COVID-19 in the first phase. Water and wastewater utilities fall in the second phase, which includes “critical workers in high-risk settings – workers who are in industries essential to the functioning of society and at substantially higher risk of exposure.” See the top of page 3-30, which identifies “workers in the utilities sector” and specifically lists the water sector as an example. The intent with the final Framework is that it be provided to the U.S. Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) to assist with the creation and implementation of national and/or local guidelines for COVID-19 vaccine allocation. Access the report at The National Academies.

This is the second in a set of strategies requested or authored by the federal government regarding allocation of a COVID-19 vaccine. As WaterISAC reported on in its September 17 Security and Resilience Update, the U.S. Department of Health and Human Services released two documents outlining the federal government’s strategy for distributing a COVID-19 vaccine. The documents include an interim playbook that indicates critical infrastructure workers should be considered by jurisdictions when making decisions about vaccination priority.

September 17, 2020

Yesterday the U.S. Department of Health and Human Services released two documents outlining the federal government’s strategy for distributing a COVID-19 vaccine. The documents, developed in coordination with the U.S. Department of Defense and the Centers for Disease Control and Prevention (CDC), provide a strategic distribution overview along with an interim playbook for state, tribal, territorial, and local public health programs and their partners on how to plan and operationalize a vaccination response to COVID-19 within their respective jurisdictions.

In “Section 4: Critical Populations,” specifically on page 14, the playbook indicates that critical infrastructure workers should be considered by jurisdictions when making decisions about vaccination priority. It refers to the U.S. Department of Homeland Security Cybersecurity and Infrastructure Security Agency’s (CISA’s) Guidance on the Essential Critical Infrastructure Workforce, which includes workers in the water and wastewater sector. The playbook also references CDC’s Roadmap to Implementing Pandemic Influenza Vaccination of Critical Workforce, which provides additional information and tools for state and local planners on how to operationalize and implement specific plans for targeting critical workforce groups. Although this information is specific to an influenza pandemic, the playbook indicates that it may help to inform the COVID-19 vaccination planning for critical workforces.

Given the release of the strategy, WaterISAC recommends its members contact their appropriate health departments to discuss their COVID-19 vaccine priority status. Both CDC's Roadmap and CISA’s Guidance on the Essential Critical Infrastructure Workforce (also available here) may help to inform these discussions and ensure water and wastewater workers are given the appropriate status.

September 10, 2020

HHS Issues Guidance on COVID-19 Vaccine Access while CDC Announces End of Enhanced Screenings for International Travelers; Studies on COVID-19-related Impacts to Mental and Financial Health

HHS Guidance
Yesterday, the U.S. Department of Health and Human Services (HHS) issued guidance under the Public Readiness and Emergency Preparedness Act (PREP Act) to expand access to safe and effective COVID-19 vaccines when they are made available. This guidance authorizes state-licensed pharmacists to order and administer COVID-19 vaccinations to persons ages three or older, subject to certain requirements. "Allowing pharmacists to order and administer COVID-19 vaccines will greatly expand convenient access for the American people," said Assistant Secretary for Health Admiral Brett P. Giroir.

Vaccine Update: There are numerous candidate COVID-19 vaccines being developed in the U.S. and around the world. Both the World Health Organization (WHO) and STAT, an online health and medicine journal, are tracking the progress of these candidates. Yesterday STAT published an exclusive report on a recent decision by AstraZeneca to pause the phase three trials of its vaccine following the unexplained illness in a participant. The participant received the vaccine rather than the placebo, and  AstraZeneca said the pause and investigation are standard whenever there is an unexplained illness, which can happen by chance in large clinical trials.

CDC Announcement
Also yesterday, the U.S. Centers for Disease Control and Prevention (CDC) announced that beginning on September 14, the U.S. government will remove requirements for directing all flights carrying airline passengers arriving from, or recently had a presence in, certain countries to land at one of 15 designated airports and halt enhanced entry health screening for these passengers. Currently, enhanced entry health screening is conducted for those arriving from, or with recent presence in, China, Iran, the Schengen region of Europe, the United Kingdom, Ireland, and Brazil. The CDC explained symptom-based screening has limited effectiveness because people with COVID-19 may have no symptoms or fever at the time of screening, or only mild symptoms. It added that resources will instead be dedicated to more effective mitigation efforts that focus on the individual passenger, including, pre-departure, in-flight, and post-arrival health education, among other measures.

COVID-19’s Impacts on Mental and Financial Health
While much of the attention has been on COVID-19’s costs on human life, in terms of cases and deaths, two recently published reports reflect on the disease’s other impacts. A study recently published in the medical journal JAMA indicates that more than a quarter of American adults are experiencing COVID-19-related symptoms of depression. Financial pressures as a result of the pandemic are thought to be the main factor for the rise. And according to the results of a poll conducted by NPR, the Robert Wood Johnson Foundation, and Harvard’s T.H. Chan School of Public Health, at least half of households in four major U.S. cities reported serious financial problems triggered by the pandemic, and more than half report serious problems caring for their children. The results also showed these effects are falling heaviest on households with annual incomes below $100,000 and in Black and Latino families.

September 3, 2020

The U.S. Centers for Disease Control and Prevention (CDC) sent planning documents to public health agencies around the country last week discussing preparations for two COVID-19 vaccines. Although the CDC referred only to a “Vaccine A” and “Vaccine B,” the technical details it provided, including the time between doses and storage temperatures, match well with the two vaccines furthest along in U.S. clinical tests, made by Moderna and Pfizer. Both companies are currently testing their candidates in Phase 3 trials. Normally, vaccine makers would wait for clinical trials to yield definitive results before moving forward with manufacturing. This time, many manufacturers have begun preparing in advance for production, and the CDC told public health agencies last week that limited doses may be available beginning in late October or November. The CDC’s planning documents indicate the extraordinary complexity of distributing vaccines to hundreds of millions of people. In its documents, the CDC said certain groups would have priority, beginning with health care workers, essential workers, “national security populations,” and employees and residents of long-term care facilities. Read more at the New York Times.

Earlier this week, the National Academy of Science released a draft of its framework for vaccine distribution, providing an opportunity for public comments. The framework was commissioned by the National Institutes of Health and the CDC. The Advisory Committee on Immunization Practices (ACIP), an independent panel of the CDC, will take the recommendations developed through the framework into account as it formulate its own recommendations for the CDC. The period for public comment is open until 11:59 p.m. ET on Friday, September 4. The discussion draft and public comment form can be found here.

September 1, 2020

Two scientific studies published late last week provide further evidence for the airborne spread of COVID-19 and the importance of effective ventilation systems. One study found that patients can exhale millions of viral RNA particles per hour in the early stages of disease, and the second tied an outbreak affecting 81 percent of residents and 50 percent of healthcare workers at a Dutch nursing home to inadequate ventilation. For the second, a letter accompanying the research was written in support of a study published on July 6 warning of the hazards of airborne COVID-19 transmission in poorly ventilated environments. Read the article at the University of Minnesota’s Center for Infectious Disease Research and Policy.

As WaterISAC has previously described, both the Occupational Safety and Health Administration (OSHA) and the U.S. Centers for Disease Control and Prevention (CDC) encourage workplaces to implement measures regarding air filtration and circulation to reduce the risk of COVID-19 transmission. WaterISAC has posted these and other resources regarding this topic to this webpage. It has also reported on information provided by other organizations. The design and architecture firm Gensler is among them; it published a building air filtration primer in early May. Members may also be interested in an “HVAC and Reopening Buildings amid COVID-19” article recently published in Facility Executive.

August 20, 2020

The U.S. Department of Homeland Security Cybersecurity and Infrastructure Agency (CISA) has released version 4.0 of its Guidance on the Essential Critical Infrastructure Workforce. For this version, there are no changes to the “Water and Wastewater” section, which identifies the types of workers needed to operate and maintain the sector’s infrastructure. Central to the value of the guidance in the early months of the pandemic was the discrete problem it was intended to support solutions for – enabling essential workers to work during COVID-19-related community restrictions. CISA’s assessment is that, for the most part, essential workers are able to work, and it that what is now most important is that essential workers are able to work in a safe environment. To support this, it offers a series of worker risk mitigation strategies for consideration. These include creating a risk categorization methodology for worker safety and determining the allocation of scarce resources for workers, such as PPE, other protection, access to medical evaluation, testing, and vaccines, among other strategies. This section of the document also includes links to other resources that provide additional guidance on health, workplace, and worker safety issues related to the pandemic. Read the guidance at CISA.

In addition to the hyperlink embedded above, the latest version of the guidance has been posted to this webpage as resource #38.

August 18, 2020

Researchers at the University of Southern California (USC) say they've found the symptoms of COVID-19 tend to appear in a specific order: fever, cough and muscle pain, then nausea and/or vomiting, then diarrhea. Knowing the order of COVID-19’s symptoms may help patients seek care promptly or decide promptly to self-isolate, they researchers say. It also could help doctors rule out other illnesses or plan how to treat patients. The researchers’ findings may prove useful for the upcoming flu season, helping medical professionals differentiate between cases of that illness and COVID-19. “This order is especially important to know when we have overlapping cycles of illnesses like the flu that coincide with infections of COVID-19,” said USC Professor Peter Kuhn. “Doctors can determine what steps to take to care for the patient, and they may prevent the patient’s condition from worsening.” To discover the sequence, the USC researchers examined data from more than 55,000 confirmed cases in China, collected from February 16 to 24. And to compare the order of COVID-19 symptoms to flu, the researchers examined data from 2,470 cases in North America, Europe, and the Southern Hemisphere that were reported to health authorities from 1994 to 1998. Their findings were recently published in the journal Frontiers in Public Health. Read the press release at USC.

August 13, 2020

There were 1,470 confirmed COVID-19 related deaths in the U.S. yesterday, the highest single-day total yet in August.  With the exception of three days this summer, Wednesday’s death total was the country’s highest since late May. The figure was higher on each of those three days because of single states reporting large numbers of backlogged deaths from unspecified days. For the past two weeks, the U.S. has averaged more than 1,000 deaths per day, more than twice as many as in early July. Read more at the New York Times.

With the COVID-19 pandemic continuing to have serious impacts on the U.S., some organizations have recently released reports containing recommendations for new and revised approaches to addressing this unprecedented public health challenge.

• The first report is from the Johns Hopkins University (also posted below as resource #35), which offers policy actions at the federal, state, and local levels to gain control of the pandemic. The recommended actions in the report pertain to non-pharmaceutical interventions, PPE supply chains, and testing and contact tracing, among other topics. The report’s authors emphasize that leaders and stakeholders at all levels will need to contribute their commitment, technical expertise, insights, and funding to make these proposed actions possible.
• The Association of American Medical Colleges published the next report (also posted below as resource #36), presents a roadmap for containing the coronavirus and ending the pandemic with measures that include addressing critical shortages, reopening schools safely, and prioritizing the distribution of a vaccine. It also identifies longer-term actions to protect and strengthen public health, reduce health disparities, and improve the overall health of the nation.
• The third and final report was published by the National Governors’ Association (also posted below as resource #37). It doesn’t offer recommendations for how to end the pandemic, but it does provide insights and considerations for policy makers as they seek to make workforces resilient to the disruptions. The report was actually written before the pandemic began, but the authors observe the new context reinforces their findings and underscores the urgency of the transformations that should be implemented as part of a systemwide, resilient education and workforce development agenda.

In other COVID-19 news, the has updated its guidance on face masks, warning that those with valves or vents do not prevent the wearer from spreading the disease to others.

August 11, 2020

On Thursday, the U.S. Department of State and the Centers for Disease Control and Prevention (CDC) rescinded their global advisories recommending U.S. citizens avoid all international travel because of the COVID-19 pandemic. While the decision removed blanket recommendations to avoid all international travel, the Department of State and CDC still encourage citizens not engage in non-essential travel to much of the world through their respective systems that list threats and recommendations by country. For the U.S. Department of State, it advises all U.S. citizens to read the country-specific Travel Advisories and U.S. Embassy COVID pages for updates on the impact of COVID-19 worldwide. For the CDC, it has published a “COVID-19 Travel Recommendations by Destination” webpage, which depicts COVID-19 risk levels in each country. The webpage complements the CDC’s Travel Health Notices webpage, established to inform travelers about current health issues that impact travelers’ health, like disease outbreaks in specific international destinations. The CDC has also recently updated its “Travel during the COVID-19 Pandemic” webpage, which provides numerous recommendations and considerations when traveling. Here the CDC reminds the public that travel increases chances of getting and spreading COVID-19 and that staying home is the best way to protect oneself and others from COVID-19. It also recommends people avoid travel if they’re sick or if they’ve been around someone with COVID-19 in the past 14 days.

WaterISAC has become aware of the following COVID-19 resources that may be useful to members as they respond to the pandemic:

• The Government Accountability Office (GAO) has published a "Science & Tech Spotlight” on contact tracing apps, which may be helpful to members conducting or participating in contact tracing.
• The U.S. Centers for Disease Control and Prevention has updated its COVID-19 dashboard with the following new or revised toolkits:
  • Community Mitigation
  • Worker Safety and Support
  • HIV and COVID-19
  • Public Service Announcements

July 28, 2020

CDC Revises Guidance on Isolation Period for Most COVID-19 Cases
The U.S. Centers for Disease Control and Prevention (CDC) recently issued revised guidance based on its assessment that most people with COVID-19 are no longer infectious 10 days after they begin having symptoms. As a result, the CDC discourages people from getting tested a second time after they recover. “For most persons with COVID-19 illness, isolation and precautions can generally be discontinued 10 days after symptom onset and resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with improvement of other symptoms,” the CDC says. For people who have tested positive but don't have symptoms, "isolation and other precautions can be discontinued 10 days after the date of their first positive RT-PCR test for SARS-CoV-2 RNA.” There are exceptions for the 10-day guidance, including people with compromised immune systems who may be infectious for a longer period of time. Additionally, the recommendation of 10 days is specifically for those who test positive for the coronavirus and have been asked to self-isolate. It doesn’t apply to people who need to quarantine to keep from possibly spreading the virus. The incubation period for the virus is 14 days, health experts say, so anyone who has been exposed to the virus would need to quarantine to see if they become sick. Read the guidance at the CDC and an article about the guidance at NBC News.

Final Stage Testing of First U.S. Vaccine Candidate Begins
Yesterday, final-stage testing of a COVID-19 vaccine began. Also referred to as the phase 3 trial, this stage involves 30,000 volunteers at 89 sites across the country receiving shots of Moderna’s COVID-19 vaccine candidate (half of the volunteers will receive a placebo). After volunteers get two doses a month apart, scientists will closely track which group experiences more infections as they go about their daily routines, especially in areas where the virus is rapidly spreading. The answer probably won’t come until November or December, cautioned the National Institute of Health’s Dr. Anthony Fauci. Don’t expect a vaccine as strong as the measles vaccine, which prevents about 97 percent of measles infections, Dr. Fauci said, who added he would be happy with a COVID-19 vaccine that’s 60 percent effective. If Moderna's candidate is successful, it will mark the fastest vaccine development timeline in history. Modern's vaccine is the first U.S. vaccine to enter phase 3 trials, but at least three more are soon to follow. All are part of the U.S. government's Operation Warp Speed, which has set the goal of producing, manufacturing, and distributing an effective vaccine against the novel coronavirus by 2021. Read the articles at The University of Minnesota’s Center for Infectious Disease Research and Policy and The Associated Press.

For more on this topic, the New York Times is maintaining a Coronavirus Vaccine Tracker.

July 23, 2020

The U.S. Centers for Disease Control and Prevention (CDC) recently posted a webpage discussing COVID-19 in rural communities, which could be a useful resource for water and wastewater utilities in these areas. The webpage includes a section discussing why rural communities may be at higher risk for COVID-19, influenced by factors like the health of populations, the healthcare infrastructure, and the presence of agricultural and food processing industries in such places. On the webpage the CDC also describes the approaches that can be taken by businesses and workplaces and residents, among other groupings, to reduce the risk of COVID-19 transmission. Among its recommendations the CDC encourages the use of face coverings, as well as other COVID-19 prevention behaviors, to limit exposure to the virus. Access the webpage at the CDC.

Given the increasing number of confirmed COVID-19 cases around the country, there have been increasing calls for face coverings to be worn in public places. Some state and local government leaders have issued face covering mandates. And on Tuesday, President Trump encouraged Americans to wear face coverings, saying that “they have an impact,” adding that the COVID-19 situation “will probably unfortunately get worse before it gets better.”

On the topic of face coverings, WaterISAC has found two recent resources that may be helpful to members:

• Dr. Michael Osterholm, the Director of the University of Minnesota’s Center for Infectious Disease Research and Policy (a site regularly referenced by WaterISAC), published a commentary on face masks yesterday. He emphasized his support for wearing face masks while also advocating for other protective steps, like physical distancing.
• Additionally, an article from Security Informed addresses how organizations can enforce face covering requirements, such as by their employees and customers, without confrontation or bias. As noted in the article, there have been violent confrontations between individuals charged with enforcing these requirements and others.

WaterISAC has also posted numerous resources regarding face coverings and other protective measures to its COVID-19 general webpage. These include a link to CDC resources and information, including its main face covering webpage.

July 21, 2020

The U.S. Department of Homeland Security Cybersecurity and Infrastructure Security Agency (CISA) has just released the COVID-19 Recovery CISA Tabletop Exercise Package (CTEP), a compilation of instructions and templates to help organizations conduct their own exercise regarding COVID-19 recovery. The CTEP materials include an exercise planner handbook, an exercise brief slide deck, and an after-action report/improvement plan, among others. The intent of the CTEP is to assist critical infrastructure owners and operators in assessing their recovery and business continuity plans and addressing key questions.  The CTEP also provides organizations the opportunity to discuss how ongoing recovery efforts are impacted by a potential “second wave” of COVID-19 infections. Access the CTEP at CISA.

CISA has also advised its partners of another resource that may be helpful in their COVID-19 response and recovery efforts, the Communications Sector Coordinating Council’s Return to Normal: Guidance and Resources for Communications Providers (also posted below as resource #34). Although specifically tailored to the communications sector, the information and advice provided in this resource can be useful to other critical infrastructure, including water and wastewater utilities. It contains sections on key planning questions and considerations, employee testing protocols, workplace social distancing, use of PPE, and distancing and cleaning in common eating and break areas, among others.

This resource is similar to another COVID-19 resource WaterISAC has promoted in its Security and Resilience Updates and on its COVID-19 general webpage, the Electricity Subsector Coordinating Council’s Assessing and Mitigating the Novel Coronavirus (COVID-19) (posted below as resource #10).

CISA/FEMA Broad Stakeholder Call Information

The U.S. Department of Homeland Security's Cybersecurity and Infrastructure Security Agency (CISA) and the Federal Emergency Management Agency (FEMA) are continuing to convene Broad Stakeholder Calls, which are open to critical infrastructure operators and other stakeholders. They are being held every Tuesday 3:00 to 4:15 pm ET until futher notice. Beginning in July, the calls will only be held every-other Tuesdays - the next call is on August 4.

The call-in information is as follows:

Dial: 1-800-593-7177
Enter passcode: 7963614

Resources - COVID-19 Cases

For the latest information on the numbers and locations of cases in WaterISAC member countries (the U.S., Canada, and Australia) and around the world, visit the following websites:

• For the U.S., visit the U.S. Centers for Disease Control and Prevention (CDC).
• For Canada, visit the Public Health Agency of Canada (PHAC).
• For Australia, visit the Australian Department of Health.
• Johns Hopkins University is managing an online, GIS-based tracker, showing cases around the world.
  • Malicious COVID-19 Website – WaterISAC has learned there is a malicious website that looks very similar to and appears intended to mimic the Johns Hopkins University tracker. The malicious website infects visitors with the AZORult Trojan, an information stealing program that can exfiltrate sensitive data. Read more at Reason Blog.
• As individuals and organizations try to get a sense of the degree of COVID-19 spread in the communities, a series of new, online tools built by researchers and public health experts, including from the Harvard Global Health Institute, may be of assistance. The tools include a risk-assessment map that allows people to check the state or the county where they live and see a COVID-19 risk rating of green, yellow, orange or red. The risk levels are based upon the number of new daily cases per 100,000 people. There are other important metrics when it comes to tracking the spread and severity of COVID-19. But the group settled on tying the alert level to numbers of new cases per 100,000, noting it's a good indicator to show the current picture of outbreaks and compare them in a consistent way. "It allows you to compare a rural area in upstate New York compared to New York City and have an apples-to-apples comparison for relative impact and relative caseload," says Ellie Graeden of Talus Analytics and the Center for Global Health, Science and Security at Georgetown University, which is part of the group. Read an article about the new tools at NPR.

Resources - Return to Work Planning

• Planning Considerations for Organizations in Reconstituting Operations during the COVID-19 Pandemic (FEMA) - This resource provides lists of reconstitution planning considerations in general and for state, local, tribal, and territorial governments as well as for the private sector. It also provides a list of additional resources and lists of questions to consider when reconstituting operations, categorized by people, messaging/communications, facilities, and resources / logistics. This document is posted below as resource #27.
• Guidance on Returning to Work (OSHA) - This resource is intended to assist employers as they reopen businesses and employees return to work. It discusses general strategies businesses should implement during each phase of reopening and provides a series of guiding principles and examples of how to implement them. It also contains sections discussing its standards and required protections in workplaces and answering frequently asked questions. This resource is also posted below as resource #33.
• Exercise Starter Kit (FEMA) - This resource is intended for organizations to convene their own workshops on reconstitution, or the process of returning to full operations, during COVID-19. The kit includes a sample facilitator guide and conduct slides that present suggested discussion questions focused on four themes: people, facilities, messaging and communications, and resources and logistics. The suggested questions build upon the White House’s guidance for employers in the Guidelines for Opening Up America Again and FEMA’s Planning Considerations for Organizations in Reconstituting Operations during the COVID-19 Pandemic (in addition to the links included for each document, they are also posted below as resources #21 and 27). All of the kit’s materials, including the questions, are designed and intended to be adapted and customized to an organization’s own needs. The intended outcome from the workshop is a roadmap for a reconstitution plan tailored to an organization.
  • FEMA has also launched a series of four new COVID-19 training videos through its Center for Domestic Preparedness. While the content in most of these is tailored to healthcare professionals, some of it can be useful for a general audience and could be used by an organization providing employees with a baseline of information about COVID-19. The first video, for example, offers an overview of the virus and discusses symptoms, diagnosis, treatment, and prevention.
• All-Hazards Preparedness Exercise Starter Kit (FEMA) - The intent of this tool, as well as with the Exercise Starter Kit discussed above, is to facilitate discussions, validate planning, and identify and address gaps. With the release of this tool, FEMA Administrator Pete Gaynor encouraged his audience to review their plans, to include for emergency operations, continuity, resource management, mutual aid, logistics, public information, and recovery against the ongoing COVID-19 response.
• CDC Activities and Initiatives Supporting the COVID-19 Response and the President’s Plan for Opening American Up Again (CDC) - The U.S. Centers for Disease Control and Prevention (CDC) published a document containing information intended to be helpful for businesses as they consider and make reopening decisions and actions. The document  contains an “Interim Guidance for Employers with Workers at High Risk” section that encourages businesses to keep in mind as they gradually scale up their operations that some workers are at higher risk for severe illness from COVID-19. The CDC lays out a series of three steps that are intended to inform decisions and actions as organizations scale up their operations. It also identifies the actions it recommends organizations take as part of these steps, such as intensifying cleaning, disinfection, and ventilation; having a plan for when employees become sick; and being prepared to scale down operations based on state and local health department notices or if there are COVID-19 cases in the workplace. This resource is available at the CDC here. It has also been posted below as resource #31.
• Workplaces during the COVID-19 Pandemic (CDC) - This simple decision tree from the U.S. Centers for Disease Control and Prevention is intended to assist employers with walking through the process of making return to work decisions and bringing employees back into the workplace.
• Reopening Guidelines for Cleaning and Disinfecting Public Spaces, Workplaces, Businesses, Schools, and Homes (CDC) - This webpage provides a general framework for cleaning and disinfection practices. The associated Guidance for Cleaning and Disinfecting contains a decision flowchart.
• Errands and Going Out (CDC) - While utilities can do much to reduce the spread of COVID-19 at the workplace to promote safety and business continuity, there is also the risk that employees will contract the disease elsewhere in their communities. This is an increasingly important consideration given that reopening is underway across the U.S. and public life in many places is returning to a semblance of normalcy. Information and guidance provided via the CDC’s could be provided to employees to assist them in making risk-informed decisions. This resource links to other webpages that discuss topics like: 
  • Deciding to Go Out, which includes a series of questions individuals can ask themselves to help determine their risk, a list of frequently asked questions, and special considerations for certain settings (such as banks, restaurants, and gatherings); 
  • Using Transportation, which discusses general principles to adhere to for all modes, but also for specific settings (including public transportation); and 
  • Running Errands, which provides tips for safely engaging in activities like grocery shopping and getting gas.
  • The resource also links to webpages for Doctor Visits and Getting Medicines, Visiting Parks and Recreational Facilities, Social Distancing, Cloth Face Covers, and Wearing Gloves. A separate CDC webpage, Considerations of Events and Gatherings, offers considerations for enhancing protection at venues to prevent the spread of COVID-19.
• Information on Maintaining or Restoring Water Quality in Buildings with Low or No Use (EPA) - EPA has posted two documents regarding recommended actions to be taken by building owners and managers to address building water quality prior to reopening. The first document contains lists of actions for building owners and managers to take; it also includes steps for public water systems. The second document complements the first by providing a simple checklist of actions.
• Guidance for Building Water Systems (CDC) - The CDC published this guidance to help minimize the risk of Legionnaire’s disease and other diseases associated with water given that water has likely become stagnant in many buildings, such as those that have been vacated by businesses while social distancing measures are in place. The guidance recommends an eight step process before reopening a building, which includes flushing the water system and maintaining the water system (this step asks readers to consider contacting their local water utility to learn about any recent disruptions in the water supply).
• Safely Re-Opening Buildings: General Guidance for Water Utilities (Canadian Water and Wastewater Association) – Developed to be used by water and wastewater utilities, this resource is intended to provide advice on steps to take to prepare for increased flushing, recommendations for distributing information to building owners, and guidance on communicating with the public and media.
• Safely Reopening Buildings: A Fact Sheet for Building Owners/Operators (Canadian Water and Wastewater Association) – Developed to be used by building owners and operators, this resource provides general instruction for flushing and cleaning water systems and links to more detailed resources and guidance. CWWA notes the fact sheet can go out as is, but it encourages utilities to customize it before sending to building owners and operators, adding such details as utility name and logo, chlorine residual levels, and local contacts, among others.
• Coronavirus Building Flushing Guidance (The Environmental Science Policy & Research Institute [ESPRI]) - This guidance helps address the issue of building water quality degradation. As noted in the document, when buildings are shut down or used less frequently, as is happening during the current COVID-19 situation, water quality in the buildings can become a serious issue. In addition to discussing how water quality degrades in buildings in these circumstances, the guidance provides a general roadmap for how to flush contaminants from buildings and get plumbing system water quality back to pre-stagnation conditions. This document is posted below as resource #17.
• Assessing and Mitigating the Novel Coronavirus (ESCC) - The Electricity Subsector Coordinating Council’s (ESCC's) guide includes a “Responsible Re-entry and Return to the Workplace” section. In this section, the ESCC highlights four strategic priorities for returning to the workplace. Given similarities to the electricity sector, these priorities may also be relevant for water and wastewater utilities. This document is posted below as resource #10.
• Distribution of Infrared Thermometers (FEMA) - In late May, FEMA announced the federal government is distributing non-contact infrared thermometers (NCITs) to state, local, tribal, and territorial governments to support the reopening of the nation’s workplaces. The NCITs are being provided to these governments for further distribution to local authorities and businesses based on current conditions and their individual reopening plans and priorities. Although FEMA notes that these governments will be responsible for distributing NCITs and will have significant flexibility in making their decisions, it has identified considerations for establishing priority. These considerations include workplaces with essential critical workers (based on the DHS CISA’s Guidance on the Essential Critical Infrastructure Workforce), that are currently operating, and that support the reopening of other businesses. FEMA also emphasizes the thermometers should be used in accordance with CDC guidance for businesses and employers and OSHA guidance for preparing workplaces for identifying potentially ill individuals including employees, customers, vendors or other visitors. As FEMA reminds its partners, temperature checks are one important part of an assessment symptom screening process that includes checking for fever. Fever is one of many symptoms to reduce social exposure to individuals who may be exhibiting elevated temperature.
• Reopening Business Digital Resources Center (U.S. Chamber of Commerce) - The U.S. Chamber has made available an online portal that presents the latest state guidelines, guidance and advice for businesses, and other tools and resources to help employers and employees return to work safely and successfully. It offers a standardized employee screening questionnaire and a customizable workplace flyer for communicating to employees and customers the steps an organization is taking to keep them safe and prevent the spread of COVID-19. The U.S. Chamber notes it will regularly update the page as new information becomes available.
  • Reopening Guidance for General Office Settings (American Industrial Hygiene Association) - This is one of the resources the site links to, which discusses what employers should do to prepare their facilities for reopening, such as in general office spaces, conference rooms, lobbies and common areas, restrooms, and eating areas.
  • Path Forward Webinar Series - On the site the U.S. Chamber notes it is convening a weekly  webinar (Thursdays at 3:00 pm ET). Moderated by U.S. Chamber President Suzanne Clark, this series explores the complex issues that must be considered as part of a responsible reopening strategy. Each week a panel of experts discusses topics like barriers to reopening, big questions about immunity and liability, and ways employers can use innovative approaches to ensure safety into the workplace.
• Coronavirus and COVID-19 (Society for Human Resources Management [SHRM]) - SHRM has made available toolkits and tools, such as a coronavirus poster for business entrances, as well as forms and guides, including a return-to-work guide for employees. There are other COVID-19 FAQ pages and news articles that discuss a variety of topics germane to human resources professionals during the COVID-19 pandemic.
• There are numerous online resources that provide country-wide overviews as well as detailed information by state on the state of reopening, restrictions, and testing. Some include:
  • The National Governors Association is maintaining an online database of actions that have been taken by states, including stay-at-home orders, travel restrictions, and non-essential business closures, among others.
  • The New York Times is operating a tracker showing the status of reopening and COVID-19 restrictions by state.
  • MultiState Associates is maintaining a tracker that has an up-to-date list of executive orders and various travel restrictions.
  • A Kaiser Family Foundation website provides state-level information on social distancing measures, health policy actions, cases/deaths, and more.
  • A Politico website provides an overview of how states are responding to COVID-19 in seven maps, using data from the Kaiser Family Foundation.

Resources - Water and Wastewater Utility COVID-19 Impacts and Responses

• Food Grade CO2 Suppliers and Producers (EPA) - For water utilities that utilize carbon dioxide (CO2) in their treatment processes, the EPA has provided a document identifying food grade CO2 suppliers and producers in the event that water utilities need to find alternative companies. The CO2 used by water utilities is often produced as a byproduct of the ethanol manufacturing process, and with the demand for ethanol having decreased (largely due to the decrease in vehicle driving) some manufacturers have suspended or reduced their operations. At this time, it seems that the water utilities that learned of potential disruptions to their CO2 shipments from their primary vendors were able to switch to alternate companies. Access the resource document at EPA or below (posted as resource #28).
• Critical Infrastructure Operations Centers and Control Rooms Guide for Pandemic Response (DHS CISA) - This guide provides considerations and mitigation measures for operations centers and control rooms that are continuing to operate during a pandemic. The considerations and measures in the document are organized into sections for coordination with federal, state, and other authorities; communication and information sharing; protecting personnel; protecting equipment; and workforce planning. This document is posted below as resource #24.
• The Financial Impact of the COVID-19 Crisis on Drinking Water Utilities (Raftelis for AMWA and AWWA) - The financial impact of the COVID-19 crisis on U.S. water utilities is estimated to exceed $15 billion, according to a new report prepared by Raftelis for the Association of Metropolitan Water Agencies (AMWA) (read the press release at AMWA) and the American Water Works Association (AWWA). It estimates drinking water utilities in the U.S. will see revenues from customer payments drop by nearly $14 billion. The impacts result from the elimination of water shutoffs for non-payment, increased late payments due to high unemployment, reductions in non-residential water demands, and fewer new customers. These utilities may also experience additional future revenue losses estimated at approximately $1.6 billion in aggregate as a result of deferrals of planned water rate increases. The drop in revenue will require utilities to scale back projects by as much as $5 billion (annualized) to help manage cash flows due to the crisis. These reductions will have a cascade effect on communities, reducing economic activity by an estimated $32.7 billion and costing 75,000 to 90,000 private sector jobs. The financial impact of the COVID-19 crisis on drinking water and wastewater utilities combined is estimated to exceed $27 billion (the report has also been posted below as resource #20).
• Water Utility COVID-19 Financial Impact Tool (EPA) - This tool is intended to help drinking water and wastewater utilities assess how the COVID-19 pandemic has affected their financial health. The tool, an Excel spreadsheet that can be downloaded from EPA’s website, walks utilities through a series of questions in the categories of revenues, expenses, and cashflow. The spreadsheet automatically calculates the changes for a utility’s revenues and expenses by looking at current 2020 monthly financials versus the average monthly financials of the utility’s 2019 audited financial statement. Utilities can use the tool each month to keep a running total of their cashflow. EPA emphasizes that use of the tool is voluntary and results are provided for utilities’ information only. Additionally, EPA is not collecting the data entered by utilities or the results.
  • As noted in a news release announcing the tool, many utilities expect to experience revenue losses due to reduced commercial consumption, households that are unable to pay their bills, and deferred or cancelled rate increases. Utilities also anticipate incurring increased costs related to overtime wages, PPE purchases, and increased demand on customer assistance programs. Having an understanding of the extent of financial impacts can help utilities as they plan for ongoing operation and maintenance and capital infrastructure needs, including implementing plans to repair, replace, and modernize aging infrastructure. “It’s important for water utilities to understand – as early as possible – how to carry out their responsibilities and plan reinvestment for their communities as local economies start to recover from COVID-19,” said EPA Administrator Andrew Wheeler. Read the news release at EPA.
• Coronavirus Disease 2019 (COVID-19) (EPA) - One of the resources linked to on this webpage is "Coronavirus and Drinking Water and Wastewater," guidance that emphasizes the continued safety of tap water amid the COVID-19 pandemic. This guidance echoes previous statements by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), which are referenced in the next two materials below. It specifically states that consumers can continue to use tap water as usual, to include for drinking and hand washing, and that they do not need to boil their water to protect against COVID-19. Additionally, referencing a statement previously made by the WHO, it notes that “there is no evidence to date that COVID-19 virus has been transmitted via sewerage systems, with or without wastewater treatment.” And it adds that “standard treatment and disinfectant processes at wastewater treatment plants are expected to be effective” against the COVID-19 virus.
• Water Transmission and COVID-19 (CDC) - This webpage discusses the transmission of the COVID-19 virus in drinking water and wastewater as well as whether wastewater workers should take extra precautions.
• Incident Action Checklist - Pandemic Incidents (EPA) - This is the latest in EPA’s suite of incident action checklists and follows the same format as the others. It contains a brief discussion of the impacts water and wastewater utilities might experience in these incidents; provides links to resources with more information; has checklists of actions to take when preparing for, responding to, and recovering from a pandemic; and includes a contact list that can be filled out by a utility. In addition to the link above, this document is also posted below as resource #1.
  • Recording of Incident Action Checklist Webinar (EPA) – EPA has posted the recording from its April 7 webinar entitled “COVID-19 Planning and Response: Overview of EPA’s Pandemic Incident Action Checklist for Water Utilities."  The webinar provided an overview of EPA’s Pandemic Incident Action Checklist. It also included a case study from Todd Brown, the Town of Marbleton, Wyoming Public Works Director, who discussed the actions his small system has taken in response to COVID-19, as well as a Q&A session.
• COVID-19 Critical Infrastructure Sector Response Planning – On this webpage, the CDC encourages critical infrastructure workplaces to develop a COVID-19 response plan; it includes advice and links to resources to assist in this process. The CDC also discusses how to adapt a response plan based on the CDC’s guidance.
• Water, sanitation, hygiene and waste management for COVID-19 (WHO) - This technical brief from the World Health Organization discusses the persistence of the COVID-19 virus in drinking water and sewage and on surface. It states that “while persistence in drinking-water is possible, there is no current evidence that surrogate human coronaviruses are present in surface or ground water sources or transmitted through contaminated drinking-water.” For wastewater, it says, “While there is no evidence, to date, on the COVID-19 virus survival in water or sewage, the virus is likely to become inactivated significantly faster than non-enveloped human enteric viruses with known waterborne transmission.” In the “Keeping water supplies safe” section, the brief states that “based on current evidence the risk to water supplies is low.” The section also describes measures for keeping water supplies safe and for treating water, adding that “conventional, centralized water treatment methods which utilize filtration and disinfection should inactivate COVID-19 virus.” The “Safely managing wastewater and or/fecal waste” section states “there is no evidence to date that COVID-19 virus has been transmitted via sewerage system, with or without wastewater treatment.” Referencing findings from the 2003 outbreak of SARs, another type of coronavirus, the brief suggests there is low likelihood of wastewater treatment workers contracting COVID-19 in work environments. The brief also contains sections about cleaning practices for keeping surfaces disinfected. The technical brief is posted below as resource #2.
• Introductions to Coronaviruses (Stantec) - This white paper from Stantec states that utilities can continue using standard treatment measures for both water and wastewater for coronaviruses. The white paper is posted below as resource #3.
• COVID-19 (OSHA) -  On this webpage, the Occupational Safety and Health Administration indicates exposure risk may be elevated for wastewater management workers, among other types of workers. OSHA notes its existing standards apply to protecting workers from COVID-19, which are described on the webpage.
• Current Priority: Coronavirus (WEF)  - The Water Environment Federation’s webpage contains The Water Professional’s Guide to COVID-19, the recording from its February 25 “Updates on Novel Coronavirus for Water Professionals” webcast, and other information and resources regarding COVID-19.
• Coronavirus Disease 2019 (COVID-19): Water and Wastewater Sector Impacts and Needs - WaterISAC conducted a survey of its members asking about impacts and needs regarding COVID-19. Below WaterISAC has captured the two options that received the most responses from the 25 organizations that participated in the survey:
  • Primary Business Concerns – Absenteeism (84 percent) and Supply Chain Impacts (76 percent)
  • Specific Actions Already Being Taken – Reviewing Advisories (84 percent) and Reviewing or Completing Business Continuity Plans (64 percent)
  • Additional Actions that Might Need to Be Taken – Quarantining Essential Employees at Utility (48 percent) and Stockpiling Materials Needed for Operations (48 percent)
  • Priority Information Needs – Potential Supply Chain Impacts (88 percent) and Effectiveness of PPE and Disinfection Measures (84 percent)
• Pandemic Impacts to Lifeline Critical Infrastructure (DHS) - This Critical Infrastructure Security and Resilience Note examines the impact of a pandemic on the lifeline critical infrastructure, which includes the water and wastewater sector. The Note observes that the greatest risk to the water and wastewater sector comes from the loss of available operators and support staff due to illness and absenteeism, and it cities a previous report from AMWA and WaterISAC that found that the sector deemed roughly 41 percent of workers critical to maintaining systems.
• Key Considerations for Water and Wastewater Utilities Responding to the Coronavirus (Moonshot Missions) - This guide contains a compendium of best practices being implemented by water and wastewater utilities. Given that utilities are continuing to employ and experiment with new approaches, Moonshot Missions intends to routinely update this document. Moonshot Missions' founder is former DC Water CEO George Hawkins. This document is posted below as resource #15.

• "Cities are using sewer systems as COVID-19 early warning signs" (The Verge) - Some wastewater utilities in the U.S. have been participating in the early stages of efforts to track the levels of coronavirus in their areas. The utilities provide wastewater samples to research teams, such as one at Yale University, who analyze the contents for indicators of the virus and report their findings to local officials. “We’re expecting cases to pick up again because people are moving forward with their lives, interacting with the community, going to restaurants, and taking public transportation. Inevitably, there’s going to be an increased opportunity for exposure,” said Jordan Peccia, a Yale professor of chemical and environmental engineering working on the project. “This will give us an opportunity to kind of act a little quicker than depending on hospital data.”

  • The practice of testing wastewater to detect COVID-19 spread in communities is also being employed in Australia. As WaterISAC reported on in its April 16 Security and Resilience Update, Australian researchers completed a successful regional pilot in which they were able to detect coronavirus gene fragments in untreated wastewater. The technology used in the pilot is being integrated into an existing system under which crime agencies monitor wastewater, covering about 57 percent of the population, to detect the presence of illicit drugs.

Personal Protective Equipment (PPE)

• COVID-19 Pandemic: Personal Protective Equipment Preservation Best Practices (FEMA) - This document summarizes government guidance and best practices currently being implemented across the U.S. for COVID-19 response. This document lists actions and considerations that are grouped into the categories of reduce, reduce, and repurpose. This document is posted below as resource # 17.
• Interim Guidance for Conserving and Extending Filtering Facepiece Supply in Non-Healthcare Sectors (NIOSH) - The National Institute for Occupational Safety and Health (NIOSH) recently issued this document offering strategies to conserve, extend, and respond to shortages of NIOSH-approved filtering facepiece respirators (FFRs).
• Addressing PPE Needs in Non-Healthcare Setting (FEMA) - FEMA has published two documents providing guidance on how organizations in non-healthcare sectors should consider and manage their PPE needs during the COVID-19 pandemic response while ensuring the protection of workers. They focus on the prioritization of certain kinds of PPE (e.g., N95 face masks) for the healthcare sector, the expected continuation of PPE shortages, the importance of preserving PPE, and the careful consideration of what kinds of PPE workers should use, whether required by law or regulation for routine duties or for mitigating exposure to COVID-19.
  • The first document, a one page advisory (posted below as resource #22), summarizes the guidance and provides information for contacting FEMA about PPE allocations and orders.
  • The second document, a fact sheet (posted below as resource #23), states that if PPE is required by law or regulation for routine duties, organizations should take steps to preserve the PPE for reuse as well as to consider alternative types of PPE that are acceptable and that can support operations. In this section FEMA provides links to numerous resources, such as a CDC “Strategies to Optimize the Supply of PPE and Equipment” webpage and a PPE burn rate calculator. If PPE is not required by law or regulation, FEMA advises organizations not attempt to acquire medical of industrial use PPE given that it is likely unavailable and needs to be prioritized for the healthcare sector. Instead, FEMA recommends organizations and employees follow CDC guidance on simple cloth face coverings and implement exposure reduction measures, such as plexiglass barriers and improved ventilation systems. The fact sheet also provides information on acquiring PPE during shortages, if it’s deemed to be required, and lists a series of key questions to ask before making requests.
• COVID-19 Frequently Asked Questions (OSHA) - This webpage addresses a series of frequently asked questions regarding the use of masks in the workplace. It outlines the differences between cloth face coverings, surgical masks, and respirators. It further reminds employers not to use surgical masks or cloth face coverings when respirators are needed. In addition, it encourages social distancing measures and recommends also recommends reviewing the CDC’s guidance on cloth face coverings.
• Joint Advisory: Potential Availability of Cloth Masks for the Water Sector (WaterISAC) - On April 22, WaterISAC sent a joint advisory to members explaining a new program for distributing donated PPE to water and wastewater utilities nationwide (the text of the advisory is posted below as resource #25).
• (TLP:GREEN) Indicators of Fraudulent 3M Personal Protective Equipment (FBI) - The FBI has published a report providing indicators of fraudulent 3M PPE. The report indicates the signs of fraudulent PPE, which it reinforces with images. Given the TLP:GREEN marking, this report has been posted to WaterISAC’s members only COVID-19 crowdsourcing webpage.
• CDC calls on Americans to wear masks to prevent COVID-19 spread (CDC) - The CDC published this press release following an editorial by Director Dr. Robert Redfield in the Journal of the American Medical Association (JAMA) in which he called for the universal wearing of face coverings. "We are not defenseless against COVID-19," Redfield said in the press release. "Cloth face coverings are one of the most powerful weapons we have to slow and stop the spread of the virus – particularly when used universally within a community setting. All Americans have a responsibility to protect themselves, their families, and their communities."
• Use of Cloth Face Coverings to Help Slow the Spread of COVID-19 and Considerations for Wearing Cloth Face Coverings (CDC) - These webpages highlight CDC’s recommendations for cloth face coverings, which include that people wear cloth face coverings in public settings when around people outside of their household and especially when social distancing measures are difficult to maintain. It provides evidence on the effectiveness of cloth face coverings.

Resources - General Workplace and Community Safety and Security

• Interim Guidance for Businesses and Employers to Plan and Respond to 2019 Novel Coronavirus (CDC) - The U.S. Centers for Disease Control and Prevention has published interim guidance for businesses on how to prevent workplace exposures to acute respiratory illnesses, including the COVID-19. Some of the recommended measures in the guidance include actively encouraging sick employees to stay home, separating sick employees, and performing routine environmental cleaning, among others. The guidance also includes planning considerations if there are more widespread, community outbreaks of COVID-19.
• COVID-19 Dashboard ("What's New") (CDC) - The CDC continues to update its COVID-19 resources, posting new and revised information and guidelines for specific communities and sectors as well as for the general public. Some of the products that may be of interest to water and wastewater utilities include:
  • General Business Frequently Asked Questions
  • Discontinuation of Isolation for Persons with COVID-19 Not in Healthcare Settings
  • Preventing COVID-19 Spread in Communities
  • Preventing COVID-19 from Spreading
  • Steps to Prevent Illness
  • Social Distancing
  • Implementing Home Care
  • How COVID-19 Spreads
• COVID-19 One-Stop Shop Toolkits (CDC) - Here you can access and download videos, social media, public service announcements, checklists, FAQs, among other resources, for a variety of venues and settings.
• Coronavirus Emergency Management Best Practices (FEMA) – FEMA has created a new webpage where it has posted best practices and lessons learned across all levels of government, the private sector, professional associations, and other organizations. The content is organized around five themes: Helping People, which includes best practices on topics such as crisis counseling resources and anticipating and attending to civil rights; Government Operations, best practices such as public information and continuity of operations considerations; Private Sector and Infrastructure, which includes best practices for commercial trucking and food stores; Recovery Planning and Implementation, to include the newly released FEMA Disaster Financial Management Guide (discussed in the General Security and Resilience section below) and economic recovery considerations; and Medical Supplies and Equipment, including best practices for the preservation of personal protective equipment while ensuring workers are protected.
• Guidance on Preparing Workplaces for COVID-19 (OSHA) – The Occupational Safety and Health Administration (OSHA) has developed a guide to assist workplaces with implementing measures for infection prevention and industrial hygiene during COVID-19 outbreaks. It contains sections discussing steps all employers can take to reduce workers’ risk of exposure as well as for measures to implement to protect workers in low, medium, and high and very high exposure risk settings. The document is posted below as resource #4.
• List of Disinfectants to Use against COVID-19 (EPA) - The U.S. Environmental Protection Agency released a list of EPA-registered disinfectant products that have qualified for use against SARS-CoV-2, the novel coronavirus that causes COVID-19. Products appearing on EPA’s list registered disinfectant products have qualified for use against COVID-19 through the agency’s Emerging Viral Pathogen program. This program allows product manufacturers to provide EPA with data, even in advance of an outbreak, that shows their products are effective against harder-to-kill viruses than SARS-CoV-2. It also allows additional communications intended to inform the public about the utility of these products against the emerging pathogen in the most expeditious manner.
• Risk Management for Novel Coronavirus (COVID-19) (DHS CISA) - The U.S. Department of Homeland Security's Cybersecurity and Infrastructure Security Agency has published an Insights document to help organization executives think through physical, supply chain, and cybersecurity issues that may arise from the spread of Coronavirus Disease 2019 (COVID-19). CISA states it is sharing this readiness information to help organizations plan for potential organizational and workforce impacts from COVID-19. That includes taking steps like identifying mission essential functions, updating incident response plans, factoring in workforce changes in a distributed environment, the possibility of malicious cyber actors taking advantage of public concern by conducting phishing attacks and disinformation campaigns. The document is posted below as resource #5.
• FEMA Administrator April 15, 2020 letter to Emergency Managers (FEMA) - On April 15, FEMA Administrator Peter Gaynor released a letter intended for the nation’s emergency managers that discusses the agency’s lessons learned at this stage in the response and its priorities going forward. Some of the points he addresses are the preservation and prioritization of scarce resources, the use of data-driven decision making, mitigation efforts to flatten the curve, strengthening the supply chain, and the importance of busting myths. In his discussion of the first point, Administrator Gaynor encourages use of the guidance that has been disseminated to maximize supply inventories of PPE. These include the CDC’s Strategies to Optimize the Supply of PPE and Equipment and FEMA’s COVID-19 Pandemic: Personal Protective Equipment Preservation Best Practices (posted to this webpage as resource #19).
• FEMA Administrator June 1, 2020 letter to Emergency Managers (FEMA) - On June 1, FEMA Administrator Pete Gaynor addressed the nation’s emergency managers in a letter reflecting on the three-month mark of the U.S.’s response to COVID-19 pandemic and addressing what he and his agency perceive to be potential challenges to come. The letter was sent on the official first day of the Atlantic Hurricane season, and Gaynor took the opportunity to emphasize the importance of preparing for these events, noting that forecasters predicted above-normal activity for this year.
• COVID-19 Pandemic Operational Guidance for the 2020 Hurricane Season (FEMA) - This guide provides information to assist with preparations for response and recovery operations and encouraging personal preparedness. The document describes anticipated challenges to disaster operations posed by COVID-19; outlines how FEMA plans to adapt its response and recovery operations given these challenges; and provides guidance, checklists, and resources to help emergency managers adapt the response and recovery plans. FEMA notes that while the document focuses on hurricane season preparedness, most planning considerations can also be applied to any disaster operation in the COVID-19 environment, including floods and wildfires. This resource is available at FEMA here. This document is posted below as resource #32.
• Stay-at-home orders and other restrictions significantly limited the spread of the coronavirus, according to two separate research studies published in the journal Nature.
  • The effect of large-scale anti-contagion policies on the COVID-19 pandemic - According to this study, the measures prevented 60 million coronavirus infections in the U.S. (the study also looked at five other countries). “The disease was spreading at a really extraordinary rate that is rare even among very infectious diseases,” said Solomon Hsiang, director of the Global Policy Laboratory at the University of California at Berkeley and the leader of the research team. “Without these policies employed, we would have lived through a very different April and May,” he noted.
  • Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe - This study was conducted by epidemiologists in the United Kingdom, estimated the shutdown measures saved about 3.1 million lives in 11 European countries and dropped infection rates by an average of 82 percent.
• Hand Sanitizer Quiz (Food and Drug Administration) - The FDA encourages consumers to test their knowledge about the appropriate use of hand sanitizer. The quiz provides questions and answers to some of the most frequently asked questions related to hand sanitizer. This quiz can help consumers learn how to correctly use hand sanitizer.
• How Exactly Do You Catch Covid-19? There Is a Growing Consensus (The Wall Street Journal) - This article describes what scientists and other experts currently believe about how COVID-19 infections occur. As the article highlights, the virus spreads mainly through close-up, person-to-person interactions for extended periods of time. In these settings the virus doesn’t simply rely on being spread through sneezing and coughing. It can be transmitted through seemingly benign activities like speaking and breathing that produce respiratory bits of varying sizes that can disperse along air currents and potentially infect people nearby. Additionally, some researchers say the coronavirus can also be transmitted through aerosols, or minuscule droplets that float in the air longer than large droplets. Given what is known about how coronavirus spreads, crowded events, poorly ventilated areas, and places where people are talking loudly increase the risk of infections. The article also notes what the CDC recently acknowledged, that it’s not common to contract COVID-19 from a contaminated surface.

Resources - Cybersecurity

• ICT Supply Chain Risk Management (DHS CISA) -  To assist its partners with managing risks to their Information and Communications (ICT) supply chains, CISA has published several resources, to include a new ICT Supply Chain Essentials guide. Other resources include an ICT Supply Chain Risk Management Fact Sheet, an ICT SCRM Task Force Threat Scenarios Report, and an ICT Response Paper on Executive Order 13873. ICT systems include the hardware, software, and services critical to communicating, which support a broad range of critical infrastructure activities, including in the water and wastewater sector. Access the resources at CISA’s ICT Supply Chain Risk Management webpage.
• Defending against COVID-19 Cyber Scams (DHS CISA) - The U.S. Department of Homeland Security's Cybersecurity and Infrastructure Security Agency has published an advisory warning individuals to remain vigilant for scams related to COVID-19. In the advisory, CISA notes that cyber actors may send emails with malicious attachments or links to fraudulent websites to trick victims into revealing sensitive information or donating to fraudulent charities or causes. It encourages exercising caution in handling any email with a COVID-19-related subject line, attachment, or hyperlink, and be wary of social media pleas, texts, or calls related to COVID-19.
• COVID-19 Disinformation Activity (DHS CISA) - The U.S. Department of Homeland Security's Cybersecurity and Infrastructure Security Agency has published this resource discussing some of the false information and conspiracy theories related to COVID-19. As the document notes, some of this disinformation emanates or is being promoted by foreign governments. To counteract disinformation, it provides factual information and provides simple steps anyone can take to fact check information and minimize the risk of spreading false or misleading content. This resource has been posted to below as resource #30.
• COVID-19 Disinformation Toolkit (DHS CISA) - The U.S. Department of Homeland Security Cybersecurity and Infrastructure Agency has published a COVID-19 Disinformation Toolkit, which is intended to be used by state, local, tribal, and territorial officials to understand and bring awareness to misinformation, disinformation, and conspiracy theories related to COVID-19. To help address the overabundance of false information – what the World Health Organization referred to as an “infodemic” – the Toolkit provides “Core Messaging” and talking points organizations can use in their communications that encourage vigilance on the part of partners and individuals. CISA has also made available graphics and posters, including in Facebook, Instagram, and Twitter formats, that can be used to help spread awareness.
• COVID-19-Related Phone Scams and Phishing Attacks (CDC) – CDC has published a webpage raising awareness of phone calls that have been made and emails that have been sent purporting to come its personnel. Although they appear to originate from the CDC, they are in fact scams and phishing attempts. The CDC provides some tips for how to spot these and prevent yourself or your organization from falling victim.
• COVID-19 Consumer Warnings and Safety Tips (Federal Communications Commission [FCC]) - This webpage provides numerous examples of the scam and hoax emails, voicemails, and text messages. The webpage offers a list of tips to protect against scams.
• Enterprise VPN Security (DHS CISA) - DHS’s CISA has published a webpage encouraging organizations implement an enterprise virtual private network (VPN) as a means of adopting a heightened state of cybersecurity while employees participate in telework. It offers some considerations for implementing VPNs and a list of measures for mitigating cybersecurity concerns in alternate workplace situations.
• Public Service Announcement (PSA) (FBI IC3) - The FBI warns of an increase in fraud schemes related to COVID-19. The PSA discusses fake CDC emails, phishing emails, and counterfeit treatments and equipment. It offers links to legitimate websites that provide true and accurate information, such as those posted by the CDC and the EPA, and lists measures for good cyber hygiene and security.
• Web Conferencing Security (Australian Cyber Security Centre [ACSC]) - The ACSC published this document to provide guidance on how to select a web conferencing solution and how to use it securely. As noted in the document, web conferencing is increasingly in use as employees strive to remain connected with supervisors and with each other while working from home. However, these solutions oftentimes have vulnerabilities that, if left unaddressed, can introduce security threats. This document is posted below as resource #18.
• COVID-19 Phishing Resource Center (Cofense) - Visitors to this website can access a YARA rule consisting of major, actionable indicators for COVID-19 phishing emails and related malware; real examples of COVID-19 phishing emails that evaded security systems; and recommendations from Cofense’s anti-phishing professionals. Cofense is also hosting a webinar tomorrow, on March 26, at 11:00 am ET on the evolving coronavirus threats as well as useful tools and recommendations to combat the escalating volume of email attacks.
• Coronavirus Rumor Control (FEMA) - This webpage is intended to help the public distinguish between rumors and facts regarding the response to the COVID-19 pandemic. The webpage addresses rumors regarding a national lockdown and quarantine, FEMA's deployment of military assets, the stockpiling of groceriers and supplies, checks being sent to citizens by the government, and immunity to the COVID-19 virus by those below 60 years of age and who are not suffering from health problems. 
  • On about April 14, FEMA updated this webpage to address allegations that it is seizing or re-routing PPE and other medical supplies, both those that are being shipped to the U.S. from overseas and that are being distributed internally within the country. FEMA emphasizes that reports it is seizing or re-routing supplies are false.
• Criminals Exploiting COVID-19 Outbreak for Financial Gain through Procurement and
  Consumer Fraud (FBI’s Office of the Private Sector) -  This advisory discusses how criminals have seized upon the ever-growing demand for Personal Protective Equipment (PPE) to manufacture and sell counterfeit materials, such as N95 masks. The advisory provides a list of measures consumers and procurement personnel can take to help prevent financial loss and the purchase of potentially unsafe equipment. This advisory is posted below as resource #6.
• Threat Update: COVID-19 Malicious Cyber Activity and a Security Managers Guide: Working at Home (ACSC) - The Threat Update from the Australian Cyber Security Centre (ACSC) takes a look at some of the malicious cyber attacks and scams that seek to exploit the ongoing situation with COVID-19. As shown in one of the case studies, members of the public have received text messages that appeared to come from the government and that purported to offer authoritative information on COVID-19 testing. It concludes with a series of mitigation strategies for this and other COVID-19 malicious cyber activity, some of which focus on employees in remote work situations. This advisory is posted below as resource #7.
• Security Managers Guide - Working from Home (ASIO) - This guide from the Australian Security Intelligence Organisation (ASIO) describes security measures for remote work. It discusses the policies and procedures organizations should put in place when having employees work from home; provides lists of tips for conducting a risk assessment and maintaining physical security, among others; and includes a series of references for further reading. This advisory is posted below as resource #8.

Resources - Business Continuity

• Business Continuity Planning in the Event of an Influenza Pandemic: A Reference Guide (WaterISAC and the Association of Metropolitan Water Agencies)
• Business Continuity Planning for Water Utilities (Water Research Foundation, U.S. EPA, and the American Water Works Association)
• Business Continuity Planning Suite (FEMA)
• Pandemic Influenza Preparedness, Response, and Recovery Guide for Critical Infrastructure and Key Resources (DHS) - This guide is intended to serve as a reference for utility operators as they tailor emergency response plans to address the unique challenges of a pandemic event. It contains a list of primary actions to take, which are accompanied by series of supporting actions and questions to consider. The guide is posted below as resource #9.
• Assessing and Mitigating the Novel Coronavirus (COVID-19) Resource Guide, version 10 – The Electricity Subsector Coordinating Council (ESCC), a liaison body between the federal government and the electric power industry), has published a document that addresses steps to take at different stages of COVID-19 mitigation and response and offers lists of business continuity planning considerations. This guide has evolved significantly from its first version, which WaterISAC reported on in the March 19 Security and Resilience Update. Although this guide is specifically intended for electric utilities, many of the steps and considerations it discusses can be applied by water and wastewater utilities. For example, the “Sequestration Guidelines and Considerations” section is relevant to any utility implementing or considering a shelter-in-place programs. Some of the other areas of potential relevance and interest include the example Q&A sections (such as "Example Q&A for Using a Respirator for COVID-19 Mitigation" on page 13), "Scenario Development,” and "Social Distancing for Control Center Personnel,” to name just a few. The guide is posted below as resource #10.
• Guidance on the Essential Critical Infrastructure Workforce: Ensuring Community and National Resilience in COVID-19 Response (DHS CISA) - This memorandum is intended to promote a widespread understanding among state and local officials of the critical role workers in these industries play in sustaining and protecting their communities, including during emergencies. Water and wastewater utilities are specifically identified as one of the critical infrastructure sectors, and the memorandum goes on to identify types of workers for the sector (e.g., operational staff at community water systems and wastewater treatment facilities, workers repairing water and wastewater conveyances and performing required sampling or monitoring, staff and technical support for SCADA and digital systems, and chemical disinfectant suppliers for wastewater and personnel protection). As state and local communities consider COVID-19-related restrictions, this memorandum may assist in critical infrastructure workers being granted appropriate status to go about their duties, such as reporting for work or transiting between work locations. The memorandum is meant only as guidance, not as a federal directive, and it acknowledges that ultimately state and local officials are in charge of implementing and executing response activities in their jurisdictions. Additionally, the memorandum puts responsibility on critical infrastructure partners to use their judgement when balancing safety and the continued delivery of their services. In addition to the accessing the memorandum through the link provided above, it's also posted below as resource #14.
  • On May 19, DHS released version 3.1 of the guidance (posted below as resource #11). There are two significant changes for the “Water and Wastewater” section, which identifies the types of workers needed to operate and maintain the sector’s infrastructure.
    • One, “Laboratory staff performing water sampling and analysis” has been added.
    • And two, the bullet that previously read “Chemical equipment and personal protection suppliers to water and wastewater system” has been modified. It now states: “Suppliers and manufacturers of chemicals, equipment, personal protection equipment, and goods and services for water and wastewater systems.”

  • On April 17, DHS released version 3.0 of the guidance (posted below as resource #12). This iteration includes language focused on sustained access and freedom of movement; a reference to the CDC guidance on safety for critical infrastructure workers; and a statement saying sick employees should avoid the workplace and the workforce. In worker categories, all references to “employees” or “contractors” have been changed to “workers.” For the Water and Wastewater section, one small change has been made: "Chemical and equipment suppliers to water and wastewater systems and personnel protection" has been changed to "Chemical equipment and personal protection suppliers to water and wastewater system."

  • On March 28, DHS released version 2.0 of the guidance (posted below as resource #13). This iteration maintains many of the same descriptions of water and wastewater employees and support personnel as the first version, with some modificiations. Specifically:
    • "Workers repairing water and wastewater conveyances and performing required sampling and monitoring" now adds "including field staff."
    • "Chemical disinfectant suppliers for wastewater and personnel protection" has been revised to also include equipment suppliers, as well as suppliers for water systems. It now reads: "Chemical and equipment suppliers to water and wastewater systems and personnel protection."
• The EPA published a template for water utilities to use to provide documentation to state and local authorities that their workers that are considered essential (posted below as resource #16 and also available at EPA here). This template complements the letter that EPA Administrator Andrew Wheeler sent to governors on March 27 requesting that water and wastewater workers, as well as the manufacturers and suppliers who provide vital services and materials to the water sector, are considered essential workers and businesses by state authorities when enacting restrictions to curb the spread of COVID-19.
• Guidance on Essential Services and Functions in Canada during the COVID-19 Pandemic (Public Safety Canada) - Public Safety Canada has published its own guidance on critical infrastructure services and functions that are deemed essential to ensure the health, safety, and economic well-being of the population. The water sector is specifically identified in this document, as are types of workers in the sector (e.g., employees and others needed to operate and maintain drinking water and wastewater/drainage infrastructure). This guidance is very similar to the Memorandum on Identification of Essential Critical Infrastructure Workers during COVID-19 Response recently published by the U.S. Department of Homeland Security.
• Interim guidance for COVID-19 safety practices for critical infrastructure workers (CDC) - To ensure continuity of operations of essential functions, CDC advises that critical infrastructure workers may be permitted to continue work following potential exposure to COVID-19, provided they remain asymptomatic and additional precautions are implemented to protect them and the community. According to the CDC, in cases where workers have had an exposure but remain asymptomatic, they and their employers should engage in pre-screening, regular monitoring, wearing a face mask, social distancing, and workplace disinfecting and cleaning. As noted in its discussion of face masks, the CDC says employers can approve employees’ supplied face coverings in the event of shortages (its “Cloth Face Covers” webpage provides recommendations on how to make your own). The CDC states that an employee who becomes sick during their work shift should be sent home immediately and that the surfaces in their workplaces be cleaned and disinfected and a list of persons who had contact with the ill employee compiled. The CDC advises that this guidance should be implemented in conjunction with its previously published Interim Guidance for Businesses and Employers to Plan and Respond to Coronavirus Disease 2019.
• Commercial Routing Assistance (CRA) tool (DHS CISA) - ​​​The U.S. Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency (CISA) and Idaho National Laboratory provided this tool, which may be useful to utilities whose employees include truckers or commercial drivers. It is intended to help these workers to understand the restrictions they might encounter as they travel across the country. Commercial Routing Assistance (CRA) tool merges coordinated and vetted data streams, plots multiple automated or custom routing options, and visualizes the wide variety of state regulations and actions that a driver would encounter along a route. With this free tool, commercial operators can plan vehicle movements across multiple states quickly, particularly during emergencies (a fact sheet is posted below as resource #29).

Government Declarations

• On April 16, the White House released its Opening Up American Again Guidelines (posted below as resource #21). The new guidelines are aimed at clearing the way for an easing of restrictions in areas with low transmission of the coronavirus, while keeping them in place in harder-hit places. The ultimate decisions will remain with governors.
  • On April 28, the White House released the Blueprint for Testing Plans and Rapid Response Programs (posted below as resource #26), which includes recommendations for states to further develop and implement their testing plans. Also referred to as “The Blueprint,” its recommendations are intended to support state development and implementation of testing plans and rapid response plans that were called for in the Opening Up America Again Guidelines. As described on the U.S. Centers for Disease Control and Prevention’s “Testing for COVID-19” webpage, there are two kinds of tests available for COVID-19: diagnostic tests and antibody blood tests. Diagnostic tests check samples from your respiratory system (such as swabs of the inside of the nose) to tell you if you currently have an infection with the virus that causes COVID-19. Antibody blood tests check your blood for antibodies that would show if you have had a previous infection.
• On March 26, EPA announced a new policy to help address uncertainties regarding EPA enforcement amid the ongoing COVID-19 public health crisis. Public water systems are specifically singled out as "hav[ing] a heightened responsibility to protect public health because unsafe drinking water can lead to serious illnesses and access to clean water for drinking and handwashing is critical during the COVID-19 pandemic." Some water and wastewater associations believe that the current policy and how it relates to public water systems is unclear and have reached out to EPA's Office of Water to request further guidance and additional clarification. WaterISAC will keep its members updated as it learns more.
• On March 16, President Trump released COVID-19 guidelines, which emphasized the need for the public to listen to and follow the directions of state and local authorities in his administration released and highlighted best practices for reducing the spread of infections. The guidelines call for people to avoid gathering in groups of more than ten people and to work from home whenever possible. However, the guidelines notes that for those who work in critical infrastructure industry, which although not specifically stated in the document does include the water and wastewater sector, “you have a special responsibility to maintain your normal work schedule.”
• On March 26, EPA announced a new policy to help address uncertainties regarding EPA enforcement amid the ongoing COVID-19 public health crisis. Public water systems are specifically singled out as "hav[ing] a heightened responsibility to protect public health because unsafe drinking water can lead to serious illnesses and access to clean water for drinking and handwashing is critical during the COVID-19 pandemic." Some water and wastewater associations believe that the current policy and how it relates to public water systems is unclear and have reached out to EPA's Office of Water to request further guidance and additional clarification. WaterISAC will keep its members updated as it learns more.

• On March 13, President Trump declared the situation with Coronavirus Disease 2019 (COVID-19) to be a national emergency. This declaration relies on the National Emergency Act — the same law that former president Barack Obama used to bolster his administration’s response to the H1N1 influenza pandemic of 2009. The law grants the president and executive branch sweeping powers to act quickly and decisively to respond to an emergency. Trump said his declaration would free $50 billion in federal resources to combat the spread of the novel coronavirus and the respiratory disease it causes. The declaration also instructs state governments to set up emergency operations centers, directs hospitals nationwide to activate emergency preparedness contingency plans, and allows Department of Health and Human Services Secretary Alex Azar to waive regulations that could hinder health professionals’ response capabilities.

  • Also on March 13, Trump also issued an emergency declaration using the Stafford Act, which allows for the mobilization of the Federal Emergency Management Agency (FEMA) to assist with the response. As a result of the declaration, FEMA is directed to assist state, local, tribal, territorial governments and other eligible entities with the health and safety actions they take on behalf of the American public.

  • For more about the declarations, read this article at Stat.

• On March 11, President Donald Trump, in a televised address to the nation, announced a 30-day ban on travel from European countries to the U.S., beginning on March 13 at midnight, in a bid "to keep new cases" of COVID-19 "from entering our shores." Trump also announced economic measures that he said would help the country overcome "temporary economic disruptions" caused by the disease. One of the measures includes financial relief to people who need to stay home because they are sick, quarantined, or caring for others.
• On January 31, President Donald Trump announced via a Presidential proclamation the suspension of entry into the country of foreign nationals who had visited China in the past 14 days. Measures to detect this virus among those who are allowed entry into the U.S. (U.S. citizens, residents, and family) who have been in China within 14 days also are being implemented.
• On January 31, U.S. Health and Human Services Secretary Alex Azar declared a public health emergency for the ongoing situation with the COVID-19. The declaration provides aid to the nation’s healthcare community in responding to COVID-19.