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‘It is likely that we will see a surge [of Covid-19] in the fall,’ Fauci says

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“I think we should expect, David, that over the next couple of weeks, we are going to see an uptick in cases — and hopefully there is enough background immunity so that we don’t wind up with a lot of hospitalizations,” Fauci said when asked by Bloomberg TV’s David Westin about the prospect of another wave of Covid-19 from BA.2 or another variant, given the level of immunity believed to exist in the US today.

Fauci reiterated that the US often follows other countries, offering the UK, which also has the BA.2 variant, as an example. He said that as well as a pullback on many mask mandates and restrictions for indoor settings, there has been a waning of immunity.

“Those conditions are also present in the United States,” he said. “So, I would not be surprised if we see an uptick in cases. Whether that uptick becomes a surge where there are a lot more cases is difficult to predict.”

Asked later whether it should be expected that this fall will look like the past two — and if people should be bracing for something around October — Fauci said that he thinks “it is likely that we will see a surge in the fall.”

He noted that “these are uncharted waters for us with this virus” and that with other viruses, such as flu — which people have decades of experience with — predictions about what might happen can be made with some degree of accuracy.

“I would think that we should expect that we are going to see some increase in cases as you get to the colder weather in the fall,” he said. “That’s the reason why the [Food and Drug Administration] and their advisory committee are meeting right now to plan a strategy, and we at the [National Institutes of Health] are doing studies now to determine what the best boost would be.”

CNN’s Virginia Langmaid contributed to this report.

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Potential for fourth Covid-19 vaccine dose is being ‘very carefully monitored in real time,’ Fauci says

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Now, the US Food and Drug Administration “is indeed continually looking at the emerging data on the pandemic and variants in the United States and overseas in order to evaluate the potential utility and composition of booster doses,” FDA spokesperson Alison Hunt wrote in an email to CNN on Friday.

She confirmed that although Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, has noted that there is still much uncertainty as to how the pandemic may further evolve, he also has said it is possible that a fourth dose might be recommended as we move into fall.

A fall timeline coincides with the administration of flu shots, which could be convenient for people and makes sense scientifically because respiratory viruses — like the coronavirus and influenza — tend to peak in the winter months that follow.

“As more data become available about the safety and effectiveness of COVID-19 vaccines, including the use of a booster dose, we will continue to evaluate the rapidly changing science and keep the public informed,” Hunt wrote. “Any determination that additional booster doses are needed will be based on data available to the agency.”

If or when the FDA authorizes a fourth dose for the public, the next step would be for the US Centers for Disease Control and Prevention to review the data before making a recommendation for use, as the agency has done for other coronavirus vaccine recommendations.

‘Vaccination and boosting will be critical’

The United States has seen significant improvements recently in Covid-19 cases, hospitalizations and deaths. As of Friday, cases were down 44% from the prior week, hospitalizations dropped 26%, and deaths were 13% lower, according to Johns Hopkins University data.

“Vaccination and boosting will be critical in maintaining that downward trajectory, particularly when you’re talking about the red curve of severe disease leading to hospitalization,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said during a White House Covid-19 Task Force briefing Wednesday.

The “potential future requirement” for an additional boost or a fourth shot of the Pfizer/BioNTech or Moderna mRNA vaccines or a third dose of the Johnson & Johnson vaccine “is being very carefully monitored in real time,” Fauci said. “And recommendations, if needed, will be updated according to the data as it evolves.”

The CDC has no recommendation of fourth doses of coronavirus vaccine for the general public, but the agency updated its guidelines in October to note that certain people who are moderately or severely immunocompromised may receive a fourth dose of the Moderna or Pfizer/BioNTech vaccines.

“For the immunocompetent people, a single booster shot continues to provide high levels of protection against severe disease caused by Omicron,” Fauci said Wednesday. “This should not be confused with the fact that for many immunocompromised people, already a second booster shot — namely a fourth dose of an mRNA — is recommended because of what we know about their poor response to the initial regimen.”

Meanwhile, vaccine makers continue to study fourth doses in broader populations.

‘We recognize the need to be prepared’

Pfizer announced in January that it has been studying the safety and efficacy of a fourth dose as part of its ongoing study of an Omicron-specific coronavirus vaccine among healthy adults ages 18 to 55.

For that study, participants have been separated into three cohorts. One includes 600 people who got three doses of the current Pfizer/BioNTech coronavirus vaccine before enrolling in the study. As part of the research, they will receive either a fourth dose of the current vaccine or a dose of the Omicron-based vaccine.

“While current research and real-world data show that boosters continue to provide a high level of protection against severe disease and hospitalization with Omicron, we recognize the need to be prepared in the event this protection wanes over time and to potentially help address Omicron and new variants in the future,” Kathrin Jansen, senior vice president and head of vaccine research and development at Pfizer, said in the company’s announcement of the study.

A study published by the CDC last week showed that protection against Covid-19 hospitalization and emergency department or urgent care visits is much higher after a third vaccine dose than a second dose but that protection wanes with time.

With the Omicron variant dominant in the United States, vaccine effectiveness was 87% against Covid-19 emergency department or urgent care visits and 91% against hospitalizations in the two months after a third dose. Effectiveness fell to 66% and 78%, respectively, by the fourth month, the data showed.

“Nonetheless, the level of 78 is still a good protective area,” Fauci said Wednesday.

Dr. Christopher Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation, told CNN on Friday that he thinks having a fourth dose “makes very little sense” right now — but possibly makes more sense this upcoming fall or winter.

“Because Omicron is going away,” he said, “third dose immunity wanes, and so fourth dose will probably wane as well. So we would want to time a fourth-dose push for when either there’s a new variant or for next winter. So I think right now, unless you’re immunocompromised or you’re older, unless you have some personal risk, it doesn’t make a lot of sense.”

The research showing some waning immunity after a third dose has led to more discussion around if or when fourth doses could be needed.

“Just like with everything else, the health departments look at this data that’s coming out and wait for guidance from the CDC and from the drug manufacturers. The drug manufacturers have been monitoring vaccine effectiveness,” Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials, told CNN on Friday.

The timing for fourth doses not only depends on waning immunity “but also depends on whether we see any more variants emerge and what we discover in terms of additional vaccine effectiveness for any emerging new infections,” Freeman said.

If fourth doses are needed, “health departments would go into the mode of preparing to administer the fourth dose in the way they have done previous doses,” Freeman said. However, of greater concern among local public health officers is the slow — and declining — pace of people completing their third doses, she said.

About 65% of the US population is fully vaccinated with at least their initial series, and about 28% of the population has received a booster dose, according to the CDC, as of Friday. But the pace of booster doses being administered has dropped to one of the slowest rates yet.

“As time goes on, if there is the necessity of a fourth dose, we’re already behind with people getting the third dose,” Freeman said. “So all of a sudden, we could have a fairly large segment of the population that is not up to date on vaccines because they’re behind by two doses, potentially, and more people could get sick.”

CNN’s Katherine Dillinger contributed to this report.

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Covid Thanksgiving: Fully vaccinated family members can celebrate the holidays without masks, Fauci says

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“That’s what I’m going to do with my family,” Fauci, the director of the National Institute of Allergy and Infectious Diseases, told CNN’s Dana Bash on “State of the Union.”

However, the nation’s top infectious disease expert also noted that if you’re traveling or are unaware of the vaccination status of the people around you, then you should wear a mask in those situations.

“Get vaccinated and you can enjoy the holidays very easily. And if you’re not, please be careful,” Fauci said. “Get tested if you need to get tested when you’re getting together, but that’s not a substitute for getting vaccinated. Get yourself vaccinated and you can continue to enjoy interactions with your family and others.”

Fauci’s comments come as the US faces the second holiday season of the pandemic, but the first with safe and effective vaccines now available to people ages 5 and older. Still, a significant part of the eligible population remains unvaccinated.

According to data published Friday by the US Centers for Disease Control and Prevention, nearly 196 million people, or 59% of the total US population is fully vaccinated. But about 26.6% of the eligible population, or 83 million people, have yet to receive a first dose.

The seven-day average of vaccinations has increased — about 36% compared to last week — due in large part to vaccinations among newly eligible children.

Definition of ‘fully vaccinated’ remains the same

Another factor here is vaccine booster doses: As of Friday, the CDC and the US Food and Drug Administration have approved boosters for every adult who received Moderna or Pfizer/BioNTech’s Covid-19 vaccine six months ago or longer.

The agencies had already said everyone who got Johnson & Johnson’s Janssen vaccine two months ago or more should get a booster.

For now, Fauci said the US definition of “fully vaccinated” remains the same — two doses given within a certain timeframe — but those guidelines could potentially change with more data.

“Two shots for a time frame means you are fully vaccinated, but the thing you want to get the people and the viewers to understand, it isn’t the effectiveness of the vaccine — it’s quite effective — it’s how long it lasts,” he said.

“We’re going to take a look right now at what the durability is of the booster. We’re going to follow people who get boosted,” Fauci told Bash. “It will be guided by the science — and people should not be put off by the fact that as time goes by and we learn more and more about the protection that we might modify the guidelines.”

Fauci underscored the importance of vaccines and boosters going into the next few months, as he noted an uptick in cases is “not unexpected” in the winter.

Those who are eligible for vaccines but remain unvaccinated pose a risk not just to themselves and other people who are unvaccinated, he said, “but it also spills over into the vaccinated people, because no vaccine is 100% effective.”

“We have a lot of virus circulating around. We know that there are breakthrough infections and that’s how you get the uptick in cases,” Fauci said. “The bottom line, common denominator of all of this data, is we should get vaccinated if you’re not vaccinated, and boosted if you have been vaccinated.”

CNN’s Maggie Fox contributed to this report.

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US coronavirus: ‘It’s going to be within our capability’ to prevent another coronavirus surge, Fauci says

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“If we don’t do very well in that regard, there’s always the danger that there will be enough circulating virus that you can have a stalling of the diminishing of the number of cases, and when that happens, as we’ve seen in the past with other waves that we’ve been through, there’s the danger of resurgence,” said Fauci, the director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to President Joe Biden, on Fox News Sunday.

Although cases still remain high, with an average of about 85,000 new infections a day as of Sunday, they are down by more than 8,000 from a week prior, according to data from Johns Hopkins University. Deaths are down an average of more than 200 a day from the start of the month.
Progress in the numbers is still threatened, however, by the low rates of vaccination. As of Sunday, 57% of the total population was fully vaccinated against the virus, according to the US Centers for Disease Control and Prevention.

And though health experts do not know exactly what proportion of the population needs to be protected to control the spread of the virus, Fauci has said a vast majority will need to be vaccinated.

The good news is, Fauci does not think another spike in cases is inevitable.

“It’s going to be within our capability to prevent that from happening,” said Fauci. “The degree to which we continue to come down in that slope will depend on how well we do about getting more people vaccinated.”

Vaccine mandates are counterproductive, governor says

Health experts have pointed to vaccine mandates as a key tool to keeping cases down and relieving hospital strain, but some officials stand staunchly against the measures.

Fauci has been a proponent of mandates, saying the data shows that they work in getting more people vaccinated. And though it would be preferable to convince people to choose to get vaccinated, that is not always feasible, he said.

“I think when you’re in a public health crisis, sometimes unusual situations require unusual actions,” Fauci told Fox News.

But Arkansas Governor Asa Hutchinson said Sunday that he believes both federal and state mandates are counterproductive to increasing vaccination rates.

Hutchinson told NBC News he believes muddled messaging at the highest levels of government has “slowed down acceptance of the vaccine and increased resistance.”

“I’d like to see us get to, without the mandate battle, let’s just encourage the vaccine acceptance, build confidence in it, and that’s the direction we need to go,” the governor said.

Asked specifically about the success of Tyson Foods and Walmart’s vaccine mandates in the state of Arkansas, the governor said it is “absolutely” proof mandates work.

“So yes, there is an effectiveness there. And so, let me make it clear that when I say I don’t believe we ought to be engaged in mandates, I’m speaking of the government mandates, whether it’s a federal government mandate or a state government mandate,” he said.

Hutchinson pointed out that employers must navigate a nuanced, on-the-ground reality of some employees wanting a vaccine mandated work environment to feel safe while others do not. Hutchinson said based on that predicament, the choice of whether to mandate should be left in the hands of employers.

Minnesota Emergency and Urgent Care services suspended over nurses strike

In many places, the brunt of the hospital strain from Covid-19 has fallen on nurses, and a strike in Minnesota has impacted services.

Emergency and Urgent Care services have been temporarily suspended at Abbott Northwestern WestHealth in Plymouth, Minnesota, due to about 50 nurses from the Minnesota Nurses Association (MNA) choosing to strike, according to a statement from Allina Health.

The nurses are striking to seek “a contract that provides fair pay and benefits to nurses on the frontlines of the Covid-19 pandemic,” the MNA said in a statement Thursday.

“MNA nurses have been negotiating a new contract for months, but Allina has refused to agree to fair pay for holiday work or adequate benefits,” the MNA said in the statement. “Compensating nurses fairly for holiday work is especially critical because understaffing by Allina and other hospital systems has required nurses to work more days and longer hours, including overtime and holidays, as they continue on the frontlines of the COVID-19 pandemic.”

The closure began Sunday morning and will last until 7:00 a.m. local time Wednesday, according to the statement.

“Allina Health and Abbott Northwestern WestHealth have negotiated 7 times with MNA. A contract settlement was previously reached and unanimously recommended by the union’s bargaining team. Unfortunately, the MNA could not finalize that agreement,” Allina Health’s statement says. “Throughout negotiations, we have consistently offered proposals that demonstrate our commitment to our employees, including an immediate wage increase to align wages with other metro hospitals and agreeing to some of the union’s other priority issues.”

CNN’s Gregory Lemos, Jen Christensen and Jennifer Henderson contributed to this report.

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US coronavirus: People in the Northeast could prevent a Covid-19 surge like the one in the South by following these measures, Fauci says

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“It is within our power, and within our grasp, to prevent that from occurring,” Fauci, the director of the National Institute of Allergy and Infectious Diseases, told CNN’s Wolf Blitzer Monday.

The way to do it, he said, is by utilizing mitigation measures like wearing masks indoors and in schools, as well as increasing vaccination rates.

The idea of vaccine mandates for schools and businesses has sparked debate through much of the country, but with the spread of the Delta variant, more leaders are adopting such methods.

And the evidence shows that vaccine mandates do get more people vaccinated, and the more vaccinated people there are in a community, the more protected the community is, US Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky told ABC News Monday.

Those mandates have been implemented by the federal government for its employees, and President Joe Biden stressed the importance of people getting vaccinated Monday while receiving his booster shot.

“This is a pandemic of the unvaccinated. That’s why I’m moving forward with vaccination requirements wherever I can,” he said.

Former US Food and Drug Administration (FDA) commissioner, Dr. Scott Gottlieb estimated that the Delta wave of the pandemic could run its course by Thanksgiving, and Covid-19 could eventually become more of a seasonal nuisance than a devastating pandemic. But Fauci said that is dependent on getting a lot more people vaccinated.

Currently 55.4% of the country is fully vaccinated, according to the CDC — still far below the “vast majority” Fauci has said needs to be vaccinated to control the spread of the virus. And the daily pace of new vaccinations is the lowest it has been since the CDC started tracking it in mid-January, according to data from the agency.

And many places are still impacted by the spread.

North Carolina has received 25 Advanced Life Support (ALS) ambulances as the state experiences “greatly increased” calls for service during the Covid-19 pandemic.

The ambulances each have a two-person crew of EMS providers, according to a Monday news release from the North Carolina Department of Public Safety. The ambulances were provided in response to a request the state submitted to the Federal Emergency Management Agency (FEMA).

“These ambulances and crews will provide necessary relief to our extremely busy EMS systems,” North Carolina Emergency Management Director Will Ray said. “While it’s not the full complement we requested, we know medical resources are extremely limited across the nation right now, and we are grateful for this assistance from our federal partners.”

Vaccine mandates argued in court

Both mask and vaccine mandates have drawn intense debates.

In Arizona, a state ban on mask mandates in public and charter schools was scheduled to become a law on Wednesday, according to an earlier report from CNN.

But, a Maricopa County judge ruled the ban unconstitutional Monday in a move Gov. Doug Ducey called “an example of judicial overreach.”

The ruling was made because the Covid-19 measures were inserted into the state budget bill, and legislators are precluded from “combining unrelated provisions into one bill to garner votes,” according to the court filing.

One of Tennessee’s largest school districts plans to implement a mandatory mask mandate Tuesday ordered by a federal judge, and the school district is preparing for potential protests.

“Students who refuse to wear a mask will be allowed in the school building, but please know they will not be in their regular classroom,” Superintendent for Knox County Schools, Bob Thomas, said. Parents will be allowed to take their child home for refusing to wear a mask, but the student’s absence will be counted as unexcused, a message to families said.

Employees of New York City’s public schools initially had until Monday to get vaccinated, but enforcement of the mandate was temporarily blocked by a judge ahead of the weekend.

The injunction was then dissolved by a federal appeals court Monday, allowing the city’s schools to enforce vaccine mandates among educators once again. The cohort of teachers and paraprofessionals who requested the injunction lost their appeal, their attorneys said.

“With thousands of teachers not vaccinated, the City may regret what it wished for,” attorney for the teachers and paraprofessionals who asked for the injunction, Mark Fonte, said in a statement to CNN. “Our children will be left with no teachers and no security in the schools.”

The vaccine deadline for school employees has been extended to Friday, the city’s Department of Education said after the ruling.

“Vaccinations are our strongest tool in the fight against COVID-19 — this ruling is on the right side of the law and will protect our students and staff,” city education department spokeswoman Danielle Filson told CNN in a statement.

And in Massachusetts, vaccine mandates have motivated dozens of state troopers to submit resignation paperwork, State Police Association of Massachusetts’ (SPAM) President Michael Cherven said in a statement.

SPAM had also filed a motion requesting to put the requirement on hold while the union negotiated terms of their member’s employment, but Judge Jackie Corwin said the importance of protecting the citizens and officers outweighs the Union’s right to bargain the terms and conditions of the employment of its members.

Access to boosters will likely expand, but for most people there is no rush, experts say

Health experts have been discussing vaccine boosters as another way to increase protection against the virus, but they are not currently accessible to everyone.

Booster doses of Pfizer’s Covid-19 vaccine are now available to people 65 and older and some adults with underlying medical conditions or those at increased risk for a breakthrough infection.

While boosters will likely become available to more people in the United States, not everyone will need one right away, Fauci said Monday.

Fauci told CNN’s Wolf Blitzer that many people are still well protected from their initial Covid-19 vaccination, while certain categories of people, such as the elderly and those in long-term care facilities, may be ready for a boost six months after their initial vaccination.

“If you’re a person who ultimately might get a booster that will make you optimally protected, you don’t necessarily need to get it tomorrow,” Fauci said.

And boosters for people who got a Moderna or Johnson & Johnson vaccine will be addressed with urgency, Walensky told ABC.

“I want to reiterate that this is a very slow wane. There is no urgency here to go and get your booster immediately. You know, walk don’t run to your booster appointment,” she said. “We will come and look at the data for Moderna and J&J in very short order.”

CNN’s Lauren Mascarenhas, Naomi Thomas, Jason Hoffman, Deidre McPhillips, Rebekah Riess, Devon Sayers, Amy Simonson and Jennifer Henderson contributed to this report.

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US coronavirus: It may take many, many more vaccine mandates to end the Covid-19 pandemic, Fauci says

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Fauci, the director of the National Institute of Allergy and Infectious Diseases, said if more people aren’t persuaded to get vaccinated by messaging from health officials and “trusted political messengers,” additional mandates from schools and businesses may be necessary.

“I believe that’s going to turn this around because I don’t think people are going to want to not go to work or not go to college … They’re going to do it,” Fauci told CNN’s Jen Christensen during an interview at the NLGJA, the Association of LGBTQ Journalists, convention Sunday. “You’d like to have them do it on a totally voluntary basis, but if that doesn’t work, you’ve got to go to the alternatives.”

The combination of the highly contagious Delta variant and the vaccine holdouts has put the United States in a “very difficult period” of the Covid-19 pandemic, Fauci said.

Of the eligible population in the US, which is currently limited to people 12 and older, 63% are fully vaccinated, according to data from the US Centers for Disease Control and Prevention. Health experts and officials are aiming for the vast majority of the population to be inoculated to control the spread.

Last week, President Joe Biden announced new vaccine requirements, which include a mandate for businesses with more than 100 employees to require vaccination or regular testing for employees. The plan was met with praise and criticism.

Businesses that want employees to return to work and stay at work will benefit from vaccine requirements, US Surgeon General Dr. Vivek Murthy said. The mandate will benefit employees as well, he added.

“I believe that will not only improve public health, but it will give people some more peace of mind,” Murthy told CNN Sunday.

But Arkansas Gov. Asa Hutchinson argued that the requirements may backfire.

“We have to overcome resistance,” Hutchinson said Sunday on NBC’s “Meet the Press.” “This is a very serious, deadly virus and we’re all together in trying to get an increased level of vaccination out in the population. The problem is that I’m trying to overcome resistance but the President’s actions in a mandate hardens the resistance.”

As the debate over mandates continues, some hospitals are feeling the impact of lagging vaccination rates.

Colorado Gov. Jared Polis sounded the alarm Friday, saying, “We actually have the lowest ICU available rate that we’ve had since the start of this crisis, in part due to the unvaccinated with Covid and just other types of trauma that goes up seasonally this time of year.”

Polis said some hospitals in his state “reaching very close to their capacity limits. And that wouldn’t be happening if people were vaccinated.”

Children could get access to vaccines by Halloween

Parents concerned about protecting their young children from the virus could have access to vaccinations for them by for Halloween, said the former commissioner of the US Food and Drug Administration (FDA).

Dr. Scott Gottlieb, who is a board member at Pfizer, told CBS’ “Face the Nation” Sunday the company is expected to have data on vaccinations for children ages 5-11 ready for the FDA by the end of September.

“The FDA says it will be a matter of weeks, not months, to make a determination if they’re going to authorize vaccines for kids between 5 to 11. I interpret that to be perhaps four weeks, maybe six weeks,” said Gottlieb.

While hopeful that vaccines for young children will soon be available, the FDA cautioned parents not to race to vaccinate their children before approval from the agency.

“Children are not small adults — and issues that may be addressed in pediatric vaccine trials can include whether there is a need for different doses or different strength formulations of vaccines already used for adults,” the FDA said in a statement Friday.

Until it is safe to vaccinate that age group, Dr. James Versalovic, pathologist-in-chief at Texas Children’s Hospital, told CBS that prevention is crucial.

“In addition to prevention … we need to continue to emphasize to all parents and families the importance of timely diagnosing through testing,” Versalovic said. “And then triage the care appropriately. Decide whether that child needs hospital-based care. We know how to treat children at this point in the pandemic.”

NYC to welcome back 100% of students

The concern over children’s risk of becoming infected has increased as many return to their classrooms for a new school year.

Monday is the first time New York City public schools are anticipating 100% of students back since last year.

“We’ve been working for 18 months to get ready for this day,” New York Education Chancellor Meisha Ross Porter told CNN in an interview Friday.

As for safety concerns, all students and teachers returning to school on Monday will be required to wear masks and the city previously announced a vaccine mandate for all public school employees with no testing opt out.

Last week, New York Mayor Bill De Blasio announced 72% of teachers are vaccinated and 65% of students 12-17 years old have had at least one dose of the Covid-19 vaccine.

On Friday, the United Federation of Teachers said in a statement, that an independent arbitrator decided teachers who have documented or religious exemptions must be offered a non-classroom assignment.

In some parts of the country, a return to campus has coincided with a surge in pediatric cases.

At Texas Children’s Hospital, Versalovic said, “We continue to be on a high plateau. The reality is we may be headed to another peak — or another valley if we all pull together.”

Gottlieb said even though Covid-19 case rates may be declining in some older age groups, “the one age category where it’s continuing to increase is in school-aged children.”

Putting students in “pods” in schools and routine asymptomatic testing can help reduce transmission, Gottlieb said.

“Rather than quarantine that whole classroom, you just test them in a serial fashion to make sure that you didn’t have an exposure that led to a downstream case and so you can actually use testing to prevent quarantines.” Gottlieb said during an Axios event Friday.

CNN’s Jen Christensen, Jessica Firger, Elizabeth Stuart, Dakin Andone, Aya Elamroussi and Holly Yan contributed to this report.

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US coronavirus: Schools don’t need to see a big uptick in cases if they follow these measures, Fauci says

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But Dr. Anthony Fauci said there shouldn’t be a big uptick “if we do it right.”

There are certain simple things that are essential, he told CNN on Tuesday. “We’ve gotta get the school system masked in addition to surrounding the children with vaccinated people,” the director of the National Institute for Allergy and Infectious Disease said. “That’s the solution.”

Fauci stressed that masks and vaccines in schools are crucial, even though some local leaders are pushing back against such measures.

Officials believe that the federal government is limited on broadly mandating vaccines, but President Joe Biden is expected to deliver a major address later this week on the next phase of the pandemic, which will include components related to schools, private companies and requirements for federal employees, two sources familiar with the speech told CNN.

Ahead of the speech, poll data from Gallup on Tuesday showed that more Americans now disagree than agree that Biden and the US Centers for Disease Control and Prevention have communicated a clear plan of action in response to Covid-19.

The speech also comes as the impact of the pandemic on schools becomes clearer.

Children now represent 26.8% of the weekly Covid-19 cases, according to new data released Tuesday. Over two weeks, from August 19 to September 2, there was a 10% increase in the cumulated number of Covid-19 cases in children since the beginning of the pandemic, according to the American Academy of Pediatrics.

In Miami-Dade County Public Schools, 13 school employees have died from Covid-19 since August 16, the school district and local teacher union told CNN. All 13 — three teachers, one security monitor, one cafeteria worker, and seven school bus drivers — were unvaccinated, they said.

“I think this underscores the big tragedy that we see occurring across America,” Miami-Dade County Public Schools Superintendent Alberto Carvalho told CNN’s Erin Burnett. “Even though in my community, 98% of individuals have gotten at least one dose of the vaccine, there is still a lag specific to individuals that represent ethnic minorities in Miami-Dade.”

Carvalho said the 13 individuals who died were African Americans and were unvaccinated, according to their families.

Since vaccine mandates are illegal in Florida, Carvalho said the best thing he can do is offer incentives to teachers to get fully vaccinated, including a $275 stipend to any employee who shows proof of vaccination.

Reinforcements going to hospitals

The lagging vaccination rates and climbing case numbers are keeping the pressure on the health care systems in many states.

In Kentucky, hospitals are facing critical staffing shortages and getting pushed to the brink for ICU beds, Gov. Andy Beshear said Tuesday, forcing the closure of some surgery rooms to create ICU centers and more beds to address the influx of Covid-19 patients.

The state has stepped in to help by providing Covid-19 testing via third-party vendors that set up outside of hospitals, freeing up hospital emergency room staff and clinicians to prioritize other healthcare needs for the community, Beshear said.

The governor said he also requested FEMA strike teams and has had a nurse strike team deployed up at St. Claire Regional Medical Center, which has been overwhelmed in treating the influx of Covid-19 patients.

Less than half of Kentucky’s population is fully vaccinated against the virus, according to CDC data.

Reinforcements are also on the way for health care workers treating Covid-19 patients in Idaho, Arkansas and Alabama.

Each state will get a 20-person US Army North (ARNORTH) team that includes nurses, respiratory therapists, and medical doctors. Six teams are already deployed, with three teams in Louisiana, two in Mississippi, and one in Alabama.

“This is the first time Department of Defense medical assets have deployed to support both Idaho and Arkansas during the pandemic,” ARNORTH commander Lt. Gen. Laura J. Richardson said in the statement. “We are proud to be called upon to support our local, state, and federal partners there, and in Alabama, Louisiana and Mississippi, in this whole-of-government response.”

Rollout of booster shots may be in late September

The best protection against hospitalizations, experts have emphasized, is vaccination.

Data from local health departments in Utah, Virginia and Seattle’s King County suggests that unvaccinated people are at least four times — and up to nine times — more likely than vaccinated people to test positive for Covid-19, and that gap has grown in recent weeks.

About 62.5% of the total US population has received at least one dose of the Covid-19 vaccine and 53.2% is fully vaccinated, according to CDC data. Those numbers are not yet where experts say they need to be to protect the majority of Americans.

In August, the FDA authorized an additional Covid-19 vaccine dose for certain immunocompromised people. And while the effort to vaccinate the entire population continues, officials are now preparing for the rollout of booster doses for a larger population.

The White House is expected to kick off its booster plan the week of September 20, and at that time up to 5.2 million people may be eligible to receive their third dose.

The schedule envisions residents getting the third dose eight months after receiving their second of either the two-dose Pfizer-BioNTech or Moderna mRNA vaccines, although the timing could fluctuate.

On Sunday, for example, Fauci predicted that Moderna may be rolling out its booster dose later than Pfizer.

The boosters do not indicate that something is wrong with the first two doses, Fauci said Tuesday. Rather, the third dose may just be part of a full vaccine regimen.

In addition, it’s not clear what the timing will be for a second dose of the single-dose J&J vaccine, which was received by more than 14 million people, according to the CDC.

“That might be two doses for a J&J, but for the mRNA, we know from studies that are already ongoing in Israel now, that when the degree of protection against infection and even severe disease goes down to a certain precarious level, when you give the person that third boost, you dramatically increase the level of protection. Even more so than before the boost, it goes up to and beyond the level of protection,” Fauci said.

CNN’s Jacqueline Howard, Virginia Langmaid, Kaitlan Collins, Elizabeth Stuart, Carma Hassan and Leslie Perrot and Deidre McPhillips contributed to this report.

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US Coronavirus: Three doses of Covid-19 vaccine are likely needed for full protection, Fauci says

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He cited two Israeli-based studies that showed a decrease in infections among people who got a third or booster shot.

There was good reason to believe that a third dose “will actually be durable, and if it is durable, then you’re going to have very likely a three-dose regimen being the routine regimen,” Fauci, the director of the National Institute of Allergy and Infectious Diseases, said at a briefing Thursday.

It’s ultimately up to the US Food and Drug Administration to decide whether Americans should get three doses of the Covid-19 vaccine, Fauci said. The agency is considering the question later this month after Moderna and Pfizer both applied for FDA authorization for a third dose either six months or eight months after getting the second dose.
The recommendation for the booster doses will likely lead to availability for a broad portion of the population, and doses could begin rolling out as early as the week of September 20, US Surgeon General Dr. Vivek Murthy said Thursday.

“At some point down the line, we may have a way of telling who needs an extra shot, and who doesn’t,” Murthy said on a call hosted by US Health and Human Services’ Covid-19 Community Corps.

“Right now, we don’t have that indicator, which is why we’re recommending that not only people get vaccinated across the board — regardless of whether they were infected in the past or not — but also when it comes to getting these extra doses to sustain and extend your protection, that we do that broadly,” he said.

Additional doses were granted emergency use authorization by the FDA this month for those who are immunocompromised.

Even though the doses are not yet available to the public, local health departments nationwide have seen a recent surge in calls from people wanting to make appointments, according to the National Association of County and City Health Departments.

But the emphasis remains on increasing vaccination rates among the US population to help overcome the pandemic. Approximately 52.7% of the total US population are fully vaccinated. But of the 10 states with the worst Covid-19 case rates over the past week, seven of them also had among the 10 best vaccination rates, according to data from the US Centers for Disease Control and Prevention.

Schools and universities enact safety measures

The risk of Covid-19 spread at schools and campuses remains critical, and recent research demonstrates how unmasked behavior among the unvaccinated can lead to outbreaks.

A study published Thursday described a Covid-19 outbreak among more than 150 students at a Chicago university after many unvaccinated students traveled during spring break, despite university policies that advised against it.

To prevent similar outbreaks, some universities have instituted mandates to attend classes in-person.

Virginia Tech disenrolled 134 students for failing to comply with the university’s requirement that students be fully vaccinated against Covid-19, and “did not submit vaccination documentation or receive a medical or religious exemption,” according to a statement on Monday.

The University of Virginia has also disenrolled more than 200 students for failing to comply with their vaccine mandate, according to a statement last month.
Vaccinations in teens and adults can not only stave off infections at schools but can also protect children under 12 who are ineligible for the vaccine.

“Communities with high vaccination coverage are seeing lower pediatric cases and hospitalizations,” CDC director Dr. Rochelle Walensky said.

Along with vaccinations, mask-wearing is also beneficial to curbing Covid-19 spread, evidence shows.

The state of New York will require weekly Covid-19 testing for teachers and other school employees, with an opt-out for those who are vaccinated, and will continue their mask mandate for everybody in a school building, Gov. Kathy Hochul announced Thursday.

In Florida, districts will be able to institute mask mandates following a judge signing a written order Thursday that ruled against Gov. Ron DeSantis’ ban on such mandates in schools. DeSantis said he will appeal.

New Mu variant is under observation

A new coronavirus variant designated as Mu by the World Health Organization is being monitored as a “variant of interest,” but federal health officials say they don’t consider it immediately dangerous.

On Tuesday, WHO designated the B.1.621 variant as a “variant of interest” because it carries mutations that could help it partially evade vaccines and treatments such as monoclonal antibodies. WHO named it Mu under its system to designate important variants using the Greek alphabet.

“This variant has a constellation of mutations that suggests that it would evade certain antibodies,” Fauci said Thursday of Mu. “Not only monoclonal antibodies, but vaccine and convalescent serum-induced antibodies. But there isn’t a lot of clinical data to suggest that — it is mostly laboratory, in vitro, data.

“Not to downplay it — we take it very seriously. But remember, even when you have variants that do diminish somewhat the efficacy of vaccines, the vaccines still are quite effective against variants of that type. Bottom line, we’re paying attention to it. We take everything like that seriously. But we don’t consider it an immediate threat right now,” he said.

The Delta variant still accounts for more than 99% of Covid-19 cases diagnosed and sequenced in the US, Walensky said Thursday, while Mu is rare.

“We are watching it carefully,” she said.

CNN’s Maggie Fox, Lauren Mascarenhas, Jacqueline Howard, Deidre McPhillips, Naomi Thomas, Elizabeth Stuart, Rob Frehse, Hannah Sarisohn, Sara Weisfeldt and Leyla Santiago contributed to this report.

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US coronavirus: Covid-19 variants that evade protection could emerge in the US if more people don’t get vaccinated, Fauci says

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“Then all of us who are protected against delta may not be protected against zaida (zeta),” the director of the National Institute of Allergy and Infectious Diseases said in a Q&A with USA Today published Sunday.

If an overwhelming majority of the population is vaccinated, the virus will disappear in the country, Fauci said. But having only a partially vaccinated population means that smoldering levels of infection will carry into the fall, be confused as the flu in the winter and pick back up in the spring, Fauci told USA Today.

And if the rest of the world isn’t vaccinated over the next couple of years, more circulation could mean more variants, Fauci warned.

Already, states are struggling to fend off the Delta variant, a strain believed to be significantly more transmissible than others. In 47 states, the seven-day average of new cases is surging by at least 10% more than the previous week, according to data from Johns Hopkins University. And the US is averaging more than 100,000 new Covid-19 cases every day — the highest in almost six months, according to data from Johns Hopkins University.

In many parts of the country, particularly the South, hospitalizations are surging. Louisiana set a new record for Covid-19 hospitalizations last week, Florida’s hospitalizations jumped 13% over the previous peak in 2020, and a hospital in Houston said Sunday morning there are no more beds left in the facility.

“Over the last 12 hours, we have lost more patients than … in the last five to six weeks,” Houston’s United Memorial Medical Center Chief of Staff Dr. Joseph Varon said.

And though the impacts of the pandemic are worsening once again, some continue to engage in activities that health experts worry are high risk for spread, like the 10-day motorcycle rally in Sturgis, South Dakota, that began over the weekend. Fauci told NBC’s Meet the Press he worries the event could cause a rapid surge in cases.

“There comes a time when you’re dealing with the public health crisis that could involve you, your family and everyone else, that something supersedes that need to do what you need to do,” Fauci said. “You’re going to be able to do that in the future, but let’s get this pandemic under control before we start acting like nothing is going on. Something bad is going on. We’ve got to realize that.”

The answer to stopping or slowing the virus could be vaccine mandates, which Fauci told NBC he would support once the vaccines get full approval from the Food and Drug Administration.

Fauci added that while he can’t predict when a Covid-19 vaccine will receive full FDA approval, he hopes it will be “within the next few weeks.”

Experts not worried about vaccine protection yet

The good news, experts say, is that data shows that vaccines do protect against the strains the US is currently grappling against.

Some concerns have risen with the emerging Lambda (C.37) variant, first identified in Peru. But the teams that study emerging variants vigorously don’t yet have anxieties about vaccines not working against Delta or Lambda, Dr. Francis Collins, director of the National Institutes of Health told George Stephanopoulos on ABC on Sunday.

“We all worry about the day when a variant arrives that the vaccines stop working as well,” Collins said. “The best way to reduce that from happening is to reduce the number of infections. That’s how variants happen.

“All the more reason why we should be doing everything possible to cut back the wild spread of Delta so we don’t get something even more dangerous.”

But public health officials are watching vaccine protection closely, Fauci told CNN’s Fareed Zakaria, including how protection may wane over time.

When data shows protection goes below a certain threshold, health officials will recommend boosters for the general population, Fauci said.

Pfizer has said that protection of its Covid-19 vaccine appears to drop to 84% after six months. Moderna said last week that its Covid-19 vaccine showed 93% efficacy against symptomatic disease through six months, CNN has previously reported.

Boosters could come too late for immunocompromised people

Concerns over vaccine protection are different for people who are immunocompromised, have had a transplant or are undergoing cancer therapy.

“We know for sure that they never did get an adequate response — most of them, not all of them, but most of them,” Fauci said. “We need to look at them in a different light than the durability for a normal person, which means that we will almost certainly be boosting those people before we boost the general population that’s been vaccinated.”

Research published in JAMA Network Open estimates that 6 million people in the US are taking immunosuppressants that could interfere with the vaccine — a number the researchers say is likely an under-estimate.

The FDA is moving quickly to make a decision on Covid-19 vaccine boosters for people with compromised immune systems, and a decision could come sometime before early September, a Biden administration official told CNN.

Even if the decision comes soon, it may not be soon enough for people who are immunocompromised amid the spread of the Delta variant, according to Dr. Scott Gottlieb, former commissioner of the FDA.

“Because by the time you actually make that decision … and you start operationalizing a booster campaign, you’re talking about maybe late October if the decision comes in September, that you can start getting a sizeable number of people boosted,” Gottlieb told CBS Sunday.

“It takes time to get that stood up and get people into the doctors’ offices to get injections. And it will take a couple of weeks for the immunity to mature.”

CNN’s Jessica Firger, Holly Yan, Aya Elamroussi and Lauren Mascarenhas contributed to this report.

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US coronavirus: The UK identified variant ‘might become dominant’ in the US, Fauci says

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“It seems to be very efficient in spreading from person to person,” the director of the National Institute for Allergy and Infectious Disease told CNN’s Chris Cuomo, adding that recent studies show that it could be more deadly and cause more severe illness.

The emergence of these virus mutations — first detected in the United Kingdom (B.1.1.7), South Africa (B.1.351) and Brazil (P.1), respectively — could mean another surge in cases, according to Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

The UK variant is already on track to becoming dominant in hotspots like Florida and Southern California “within a few weeks,” according to a testing company called Helix that has helped identify the largest share of US cases.

The only way to prevent the variants from becoming dominant is to prevent them from spreading from person to person by following public health measures and getting as many people vaccinated as quickly as possible, Fauci said.

Fauci tweeted Thursday his hopes that data will support coronavirus vaccinations for older children by late spring or early summer.

And the US Food and Drug Administration said Thursday it plans to use the process for updating flu vaccines as a template for authorizing any changes to coronavirus shots to address the emergence of new variants.

“We have a possibility, and the capability, of trying to stop them from becoming dominant,” Fauci said.

New vaccines hope to ease the burden if approved

How quickly the variants spread versus the speed of vaccinations will be a key factor in the amount of coronavirus deaths over the coming months, according to the latest forecast from the Institute for Health Metrics and Evaluation at the University of Washington.

Depending on the balance, up to another 190,000 people could die between now and June 1, bringing the death toll total from 455,733 on Thursday to more than 630,000.

New coronavirus vaccines added to the market could help speed up the inoculation process.

The biotechnology company Novavax announced on Thursday that the “rolling review” process for authorization of its Covid-19 vaccine is underway in multiple countries.

The vaccine maker announced that it has started the process with several regulatory agencies, including the US FDA, the European Medicines Agency, UK Medicines and Healthcare products Regulatory Agency and Health Canada. Rolling review means that the company will submit some completed sections of its application for authorization instead of waiting until the entire application is finished.

And Johnson & Johnson officially asked the FDA for an emergency use authorization of its Covid-19 vaccine Thursday.

The company has been developing a single-shot vaccine it says could help reduce “the burden of disease for people globally and putting an end to the pandemic,” Dr. Paul Stoffels, Chief Scientific Officer at Johnson & Johnson, said in a statement.

The FDA will schedule a public meeting, and if the agency decides to authorize the vaccine, the CDC Committee on Immunization Practices will meet to discuss whether the vaccine should be given to Americans and if so, who should get it first.

The push to vaccinate teachers and return to the classroom

As some students approach nearly a year since they have stepped foot in their classrooms, officials have been eager to see a return to in-person learning.

CDC director Rochelle Walensky has said that with the proper distancing, masking and testing in place, schools can safely resume on campus even before teachers are vaccinated. But many states are making the inoculation of teachers a priority.

So far, 24 states and Washington, DC are now allowing some teachers or school staff to receive the vaccine.

In West Virginia, all teachers over 50-years-old who expressed that they wanted the vaccine already have received it, according to Gov. Jim Justice. In Ohio, Gov. Mike DeWine has set a plan to have all teachers vaccinated by the end of February, with the goal of all students returning to classrooms by March 1.

Alabama and Colorado will include teachers among those who can be vaccinated starting on Monday.

But the availability of doses still poses an issue in many states as officials have complained that their allotment of doses is not meeting the demand.

In some cities, like Chicago and Minneapolis, officials are at odds with teachers unions and schools as their push to reopen is met with a concern for the safety of staff, students and families. In some cases, the tensions have boiled over into lawsuits and threats of strikes.

Fauci promotes two vaccine doses for those previously infected

Separately, Fauci said Thursday that even those who have already had Covid-19 should still be vaccinated.

“If you had Covid-19, you should still get vaccinated. Because re-infection is uncommon 90 days after initial infection, you can delay vaccination until the end of that 90-day period, if desired. But vaccination is still safe after you’ve recovered from Covid-19,” he said in a tweet.

Though a study earlier in the week suggested that people who were previously infected with coronavirus may only need one shot of Covid-19 vaccines, Fauci pushed back.

The authors of this preprint study, which has not been peer reviewed, argued that changing policy to give these individuals only one dose would “spare them from unnecessary pain and free up many urgently needed vaccine doses.”

A previous infection may help boot vaccination, Fauci tweeted, but there is not enough evidence yet to show it is sufficient to compare to two doses for most people.

“People who had COVID-19 should still follow the current @FDA guidance,” he said.

CNN’s Michael Nedelman, Maggie Fox, Andrea Diaz, Jacqueline Howard, Yon Pomrenze, Evan Simko-Bednarski, Elizabeth Stuart and Naomi Thomas contributed to this report.

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