Velandy Manohar, MD.,
Distinguished Life Fellow,
Am. Psychiatric Assoc.
Med Dir. Aware Recovery Care- CT.

09 09 21

A

These data points motivated me to dig deeper into the deadly quagmire we are sinking collectively as a nation. Especially hard hit is Tennessee. If it was an independent nation, it would have the THIRD Highest rate of Covid -19 infection in the WORLD

Please let me set the Concerning Context: We are in dire straits with a sliver of a silver lining [7-day av.-People Vaccinated per day]to menacing storm clouds enshrouding us. A matter of especial concern for our staff and patients in the 7plus states including the new venture of Aware Recovery Care- in the next two Quarters.

Covid Data:

1. Covid-19 US 648,474 Deaths 39,946,144 US Confirmed Cases - Bing

US Confirmed cases: 40,516,940,

US Total Deaths: 659,311

2. Home - Johns Hopkins Coronavirus Resource Center (jhu.edu)

US : Total doses administered:972,115

US:  Population fully Vaccinated: 54%, 176 million

US : 7-day average 1 million Vaccinations per day.

3. More Children Are Catching COVID-19, But It's Unclear If They're Getting Sicker : Coronavirus Updates : NPR

Nearly 94,000 Kids Got COVID-19 Last Week. They Were 15% Of All New Cases Updated August 10, 20213:01 PM ET, JOE HERNANDEZ

Coronavirus cases among children are rising at a time when the highly infectious delta variant is advancing across the United States at a rapid clip.

New state-level data analyzed by the American Academy of Pediatrics and the Children's Hospital Association shows that children accounted for roughly 15% of all newly reported COVID-19 cases across the nation for the week ending on Aug. 5.

Nearly 94,000 child cases of COVID-19 were recorded during that period, a 31% increase over the roughly 72,000 cases reported a week earlier. In the week before then, there were 39,000 new child cases.

4. Study shows COVID-19 vaccinated mothers pass antibodies to newborns – Harvard Gazette

Pregnant women show robust immune response to coronavirus vaccines, pass antibodies to newborns n the largest study of its kind to date, researchers at Massachusetts General Hospital (MGH), Brigham and Women’s Hospital and the Ragon Institute of MGH, MIT and Harvard have found the new mRNA COVID-19 vaccines to be highly effective in producing antibodies against the SARS-CoV-2 virus in pregnant and lactating women. The study also demonstrated the vaccines confer protective immunity to newborns through breast milk and the placenta.

The study, published in the American Journal of Obstetrics and Gynecology (AJOG), looked at 131 women of reproductive age (84 pregnant, 31 lactating and 16 non-pregnant), all of whom received one of the two new mRNA vaccines: Pfizer/BioNTech or Moderna. The vaccine-induced titers — or antibody levels — were equivalent in all three groups. Reassuringly, side effects after vaccination were rare and comparable across the study participants. 

V. A

All of the information that I am sharing on this attached excel spreadsheet, helped me to formulate my recommendations for developing and implementing a Mandatory Vaccination policy against COVID-19.[Attachment on left]  Of particular note are the 3 articles I have highlighted in my list. 

1. Guidance for Public Health Strategies to Address High Levels of Community Transmission of SARS-CoV-2 and Related Deaths, December 2020
2. Use of COVID-19 Vaccines After Reports of Adverse Events Among Adult Recipients 08 13 21
3. Largest real-world study of COVID-19 vaccine safety published 08 26 21

The first article defines the 10 public health strategies which we still need to implement to prevent community spread of Covid-19 for times to come. 

The second article documents the adverse responses to the vaccine against COVID 19 while the

third article shows the actual facts established by a carefully planned prospective study about the occurrence of severe medical disorders among the vaccinated and the unvaccinated.   It is of note that the unvaccinated show far more incidence of severe medical disorders following COVID-19 infection. 

Article 1 MMWR

 …the United States has entered a phase of high-level transmission where a multipronged approach to implementing all evidence-based public health strategies at both the individual and community levels is essential.

This summary guidance highlights critical evidence-based CDC recommendations and sustainable strategies to reduce COVID-19 transmission.

These strategies include

1) universal face mask use,

2) maintaining physical distance from other persons and limiting in-person contacts,

3) avoiding nonessential indoor spaces and crowded outdoor spaces,

4) increasing testing to rapidly identify and isolate infected persons,

5) promptly identifying, quarantining, and testing close contacts of persons with known COVID-19,

6) safeguarding persons most at risk for severe illness or death from infection with SARS-CoV-2, the virus that causes COVID-19,

7) protecting essential workers with provision of adequate personal protective equipment and safe work practices,

8) postponing travel,

9) increasing room air ventilation and enhancing hand hygiene and environmental disinfection, and

10) achieving widespread availability and high community coverage with effective COVID-19 vaccines.

In combination, these strategies can reduce SARS-CoV-2 transmission, long-term sequelae or disability, and death, and mitigate the pandemic’s economic impact.

Consistent implementation of these strategies improves

1. health equity, preserves health care capacity,
2. maintains the function of essential businesses, and
3. supports the availability of in-person instruction for kindergarten through grade 12 schools and preschool.

Individual persons, households, and communities should take these actions now to reduce SARS-CoV-2 transmission from its current high level. These actions will provide a bridge to a future with wide availability and high community coverage of effective vaccines, when safe return to more everyday activities in a range of settings will be possible.

5. B

The attachment on the right has these 4 key reports especially for us as we expand our reach into high prevalence states.

1. The Delta Surge Is "Peaking" in These 3 States, Virus Expert Says (bestlifeonline.com) Dr. Ashish Jha: FL, Louisiana and Arkansas
2. Your COVID Risk Is Highest in These 6 States This Labor Day Weekend  (bestlifeonline.com) They are in the South and West. GA, FL, WY, Mississippi, TN. If an independent nation will have the third rank for the incidence Covid Cases
3. The 5 Most Common Signs You Caught Delta If You're Vaccinated (bestlifeonline.com) Sneezing, Headache, Runny nose, Fatigue and Fever

Only 0.5 percent of partially vaccinated and 0.2 percent of fully vaccinated patients in the study tested positive for COVID, also finding that breakthrough infections were twice as likely to be asymptomatic in those who were fully vaccinated. In addition, those who had received both shots were also half as likely to develop lingering symptoms known as long COVID after such infections.

4. COVID After Vaccination May Be More Common With Johnson & Johnson (bestlifeonline.com)

Of those people, 0.32 percent of Johnson & Johnson recipients had breakthrough infections compared to only 0.2 percent and 0.13 percent of Pfizer and Moderna recipients, respectively.

A similar pattern occurred in Oklahoma. According to the Oklahoma State Department of Health, around 817,000 people had gotten Pfizer, 674,000 received Moderna, and 102,000 got Johnson & Johnson. When it came to breakthrough infections, 0.21 percent of Johnson & Johnson recipients tested positive for COVID after vaccination, while only 0.17 percent of Pfizer recipients and 0.12 percent of Moderna recipients tested positive.

Please Stay well, Stay safe and stay in touch. Please mask up and get vaccinated.

Velandy Manohar, M.D

Distinguished Life Fellow, Am. Psychiatric Association,
Chair, Community Engagement and Outreach Standing Committee of
Community Advisory Council of the Office of Health Strategy- CT