CAHFS Weekly Update: Increase in COVID-19 Cases among Middle and High School Students; Johnson & Johnson COVID-19 Vaccine to Resume; The COVID-19 Surge in India
Jan Mladonicky


Increase in COVID-19 Cases among Middle and High School Students

Great vaccination progress is being made within Minnesota with 55% of those 16 years of age and above having received one dose. Despite this, the state is experiencing increased community spread of COVID-19 particularly among middle and high schoolers. State health officials estimate that 60% of all cases are associated with the B.1.1.7 variant. This variant is thought to be more transmissible and may cause more severe disease among those infected. 

At this time, health officials are not planning to recommend the return of distance learning, but instead, will be ramping up in school testing to slow disease spread. Over 90% of Minnesota schools have some form of in person learning. The Minnesota Department of Health in partnership with the Minnesota Department of Education have updated their guidance urging COVID-19 testing to occur every two weeks among students and weekly testing to all students involved in organized sports. Saliva testing kits will be provided at no cost to middle and high schoolers on site at the schools.

While studies have shown children with COVID-19 as asymptomatic or with mild symptoms, state Health Commissioner, Jan Malcom, as reported in MPR, said some children can get very sick and warns long term health impacts are not fully understood. She insists continued  vigilance with public health practices in combination with increasing vaccination and testing are essential. With all these measures, health officials are hopeful in person learning experiences along with extracurricular activities can be preserved - including the graduation ceremony milestone, avoiding the social isolation that comes with keeping children at home. 

Minnesota Department of Health


Johnson & Johnson COVID-19 Vaccine to Resume 

After an 11 day pause, the Johnson & Johnson (J&J) COVID-19 vaccine has been approved by the Centers for Disease Control and Prevention (CDC) to resume distribution after a 10-4 panel vote. Out of a total of nearly eight million recipients who had received the vaccine, 15 experienced a blood clot, identified as thrombosis with thrombocytopenia syndrome. All affected recipients were women mostly under the age of 50 between the ages of 30-39. There were three deaths and seven remain hospitalized. 

Officials from the CDC said women, particularly those between the ages of 18-49, should be told there is a slight health risk for them to be aware of, evaluate, and manage prior to receiving the J&J vaccine. A warning label will be included in the vaccine’s fact sheet. Those who voted against restarting the J&J vaccine cite concern that this warning does not go far enough informing those in this particular demographic who are at the most risk of developing blood clots. 

Blood clot symptoms can occur within three weeks of receiving the vaccine and can include acute onset of headache, dizziness, shortness of breath, and leg and abdominal pain. Early treatment can be effective with the correct medical care. Ten million doses previously shipped from the Netherlands will now be administered across the US to those 18 years of age and older. The J&J vaccine uses a modified chimpanzee adenovirus as the delivery method, similar to the AstraZeneca vaccine, a vaccine that has also had issues with blood clots but has not yet been approved for use in the US. 

BBC News
The New Yorker


The COVID-19 Surge in India

India is in the midst of a second coronavirus wave, reporting more than 300,000 new infections each day, more than any other country, and contributing to almost half of all new cases around the globe. Over 2,000 people are dying every day, a number public health experts say is undercounted and the true number may be two to five times what is reported. 

Hospitals and crematoriums are overwhelmed. Oxygen supplies are insufficient and hospitals are turning patients away. International aid efforts are underway. The UK is sending ventilators and oxygen concentrator devices while the US is sending  vaccine raw materials, medical equipment, and protective gear. 
The recent surge likely stems from the premature laxing of public health guidelines after the country believed it had reached "the endgame" of the pandemic.” Further, less than 10% of the population has received one vaccine dose, despite serving as the major AstraZeneca exporter for more than 70 countries. Vaccine exports have since diminished to account for in country demand. The  circulating variant strain, B.1.617, commonly referred to as the “double mutant,” spreading across the country may also be playing a role. 

This variant strain really has 11 or more mutations but two of its mutations are being investigated for increased transmissibility and the ability to evade vaccine protection. As reported  in BBC, the World Health Organization said the situation in India was a “devastating reminder” of what this virus can do.

The New York Times
BBC News

Portrait of Jan Mladonicky

Jan Mladonicky

Jan Mladonicky is a veterinary public health resident at the University of Minnesota. She became interested in public health while working on basic science research at Michigan State University. Her focus shifted to Veterinary Public Health during an internship working with health surveillance programs at the Lincoln Park Zoo. While completing her DVM/MPH degree from Colorado State University, Dr. Mladonicky traveled to the rural villages of Uganda for an epidemiology field project, which solidified her career interest in One Health. Since graduation, she has been practicing small animal emergency and urgent care medicine.