Mississippi may have arrived at the peak of the omicron wave, with cases and hospitalizations pausing a dizzying climb that began with the new year. But the ongoing surge, combined with significant lingering damage to the health-care system, continues to roil the state’s hospitals and intensive-care units.
On Wednesday, the Mississippi State Department of Health announced the 10th pediatric fatality from COVID-19. MSDH confirmed that this death, like all pediatric COVID deaths in Mississippi before it, occurred in an unvaccinated child.
Of Mississippi’s 10 deaths, six have occurred in children aged 11 to 17. Three children aged 5 or younger have died of COVID-19, potentially before their eligibility for the COVID-19 vaccine, which is available to all individuals aged 5 or older.
State Epidemiologist Paul Byers explained the urgency of the childhood vaccination campaign, a need that the fatality highlights.
“Currently we only have 7 percent of the 5-11 age group fully vaccinated and 37 percent of the 12-17 age group fully vaccinated,” Byers wrote in a statement. “Vaccination is the best protection for our children who are eligible to receive it. For those under 5 years of age, it is critically important that everyone around the infant or child are vaccinated.”
‘Still At Negative Capacity’
In a COVID-19 update, State Health Officer Thomas Dobbs explained the lasting stress on the hospital system in the days following omicron’s peak. “For the past week, there’s been a subtle decline (in new hospitalizations) along with our declining cases, but there is considerable stress on our health systems, and … very severe stress on our (intensive care units). We are at negative bed capacity at present in the state of Mississippi.”
Bed capacity in this instance refers to staffed, available beds, which may differ from a facility’s physical space availability. Burnout, resignations, deaths and transfers have drained a significant portion of the state’s health-care workforce, leaving less capacity for the expansive omicron surge than existed even for delta.
Dobbs urged Mississippians to get vaccinated, and for those Mississippians who are already vaccinated to get a booster shot.
“We know from recent data that a booster is about 90% effective in preventing hospitalizations from omicron,” Dobbs said. “And if you look at the number of people who have died from COVID in recent weeks, those who are fully vaccinated and have received a booster … do much better than those who have had a vaccine before and certainly much better than those who have never been vaccinated.”
Omicron’s mutations help it evade the immune protection that the vaccine provides, but studies show that even two shots of vaccine are highly effective at preventing the worst outcomes of the omicron variant, as the most significant evasion occurs for antibody resistance, the body’s first line of defense.
For Mississippians with serious immunocompromising positions, which may render their response to COVID-19 infectious less effective, state health leadership are encouraging more regular boosters. “If you haven’t got one, if you are immunocompromised, please remember that you need a fourth shot booster,” Dobbs pleaded. Currently, language on MSDH’s vaccine scheduling site suggests the booster is a third shot only, but immunocompromised individuals can still still schedule a fourth dose as long their last booster was five months ago or earlier.
Mississippi’s daily COVID-19 cases remain extremely high, with yesterday’s report clocking in at 6,535. Hospitalizations remain just below the delta peak in September, but severe hospitalizations, including ventilator usage, remain more comparable to last winter’s surge than delta, despite significantly more cases. These numbers show the comparative mildness of the new variant, as well as the protection of the vaccines, but also express how dangerous uncontrolled spread is in spite of the less lethal variant.
Currently, 1,447 individuals in Mississippi’s hospitals have COVID-19, down from the omicron peak of 1,531 last week.
The state health officer confirmed that virtually all detected coronavirus infections in the state are omicron, with the more infectious variant having out-competed delta into effective nonexistence.
As a result, the FDA has retracted approval for two of the monoclonal antibody treatments that proved so effective against delta and earlier variants. “FDA has removed their approval for the use of two COVID treatments—monoclonal antibodies—including RegenCoV and bamlanivimab/etesevimab, because they’re ineffective against Omicron. These are no longer recommended,” Dobbs said.
What is still useful against COVID-19, however, is the monoclonal antibody sotrovimab. Additionally, two new oral medicines—paxlovid and molnupiravir—have also shown significant effectiveness at reducing the severity of COVID-19 when administered after infection. As of Jan. 25, MSDH reported 152 doses of sotrovimab available across Mississippi, 1,220 doses of paxlovid and 4,798 doses of molnupiravir.
With such low availability of effective treatments, it is likely that these therapeutic options will be reserved for higher-risk cases, including older and immunocompromised adults.
UK Study Shows Booster Benefits
An extensive vaccine survey from the UK Health Security Agency found renewed protection against the omicron variant lasting for months after booster doses of either Pfizer or Moderna’s vaccine. Most promisingly, all vaccines—including AstraZeneca, which is relatively comparable to Johnson & Johnson’s single shot vaccine in the US—showed significant protection against mortality.
“High levels of protection (over 90%) are also seen against mortality with all 3 vaccines and against both the Alpha and Delta variants with relatively limited waning,” the study’s authors wrote.”
Notably, the study seems to show vaccine effectiveness at the prevention of symptomatic disease lasting longer after a booster dose, with 40% to 50% protection against all forms of symptomatic transmission even four to six months after the booster shot. Comparatively, unboosted protection against symptomatic disease in that time period is only 5% to 30%.