By Lily H-A
From PHN Issue 47, Fall 2021
A newer variant of the COVID-19 virus called the delta variant, which is more than twice as contagious as earlier variants of the virus, is now the most common coronavirus variant in the US. Earlier in the summer, US cases had dropped to some of their lowest levels since the beginning of the pandemic, but now the delta variant is driving new surges. In the US, Southern states are currently most affected. Hospitals in some heavy-hit areas have reached their capacity. Many states, after rolling back COVID-19 restrictions earlier in the summer, are putting some restrictions back in place. There have also been new lockdowns in some jails and prisons after outbreaks.
Based on data coming out so far, it seems like the currently available vaccines are still very good at preventing serious illness, hospitalizations and deaths from the delta variant. The large majority of hospitalizations and deaths from COVID-19 are people who were not vaccinated, and spread of COVID-19 seems to be worse in communities with low vaccination rates. But, vaccines do seem to offer less protection from people getting milder cases of COVID-19 with the delta variant, and spreading it to others, than with earlier variants.
On August 23, 2021, the FDA fully approved the Pfizer vaccine for people ages 16 and up. It was previously approved under an abbreviated process called an Emergency Use Authorization (EUA). The Moderna and Johnson & Johnson vaccines are still approved under an EUA, but are expected to receive full approval soon as well. Children from 12 to 15 are also approved for the Pfizer vaccine under an EUA, and younger children may be approved soon too.
Vaccination rates in the US have slowed down since the vaccines first became available to everyone, but are starting to pick up again slightly during the latest surge. As of September 15, 65% of US adults were fully vaccinated, and 76% had at least one dose of a COVID-19 vaccine. With millions of people now vaccinated, the vaccines still seem to be extremely safe.
The federal government and some state and local governments as well as employers have begun to issue policies that require vaccination for certain people, such as government employees, health care workers, and teachers, by a certain date. In some cases people can continue to work if not vaccinated, but must get regular COVID-19 testing or comply with other requirements. Some of these policies requiring vaccination cover health care workers caring for incarcerated people, and some cover other prison and jail staff as well. Currently, prison and jail staff in the US are vaccinated at significantly lower rates than incarcerated people and the surrounding community.
Many experts are now saying it is unlikely that COVID-19 will be completely controlled or eliminated through vaccination, like it had been hoped. They think it is more likely that COVID-19 will continue to exist for a long time, but that vaccination will make it a much less dangerous disease for people who are vaccinated.
Third dose of vaccine recommended for immunocompromised people
Because of data suggesting that people with weaker or suppressed immune systems may get more protection from an extra dose of the Pfizer or Moderna vaccines, the CDC is now recommending a third dose of the vaccine for people who have:
- Been receiving active cancer treatment for tumors or cancers of the blood
- Received an organ transplant and are taking medicine to suppress the immune system
- Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
- Moderate or severe primary immunodeficiency
- Advanced or untreated HIV infection
- Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response
Right now, in mid-September, the CDC says they do not have enough data about immunocompromised people who received the Johnson & Johnson (J&J) vaccine to recommend a second J&J dose. This may change in the future.
There has also been discussion about offering a third vaccine dose to people who are not immunocompromised, but as of mid-September, the CDC is not recommending this.
As we wrote in the last issue, many people have reported that even after recovering from COVID-19, they have symptoms that outlast their infection. This has become known as “long COVID” or “long-haul COVID.” People with long COVID have described a wide range of symptoms like fatigue, “brain fog” (trouble with concentration and memory), shortness of breath, cough, joint pain, and chest pain.
These symptoms have been recognized by the National Institutes of Health, CDC, and World Health Organization, and many research studies about them are underway.
Unfortunately, scientists and doctors still do not know much about what might be causing these symptoms, or how best to treat or prevent them. Since many people with long COVID seem to have similar symptoms to those found in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), they may benefit from similar approaches as ME/CFS. ME/CFS patient advocates have developed an approach called “Stop. Rest. Pace.” which involves taking a cautious approach to increasing activity, resting often, and respecting your limits, since pushing yourself too hard can worsen symptoms. For other long COVID patients, who are dealing primarily with reduced lung capacity or muscle weakness, gradually increasing exercise might help. As with many health conditions, what works may be different for different people, and listening to your body is very important.
If you think you might have long COVID, it is important to share your symptoms with a healthcare provider, especially since the symptoms of long COVID can also be caused by other health conditions that need to be ruled out. Unfortunately, many people with long COVID report they have had a difficult time getting their doctors to take their symptoms seriously. You may have to be persistent and advocate for yourself. For a tipsheet on how to best advocate for your healthcare in prison, please write to us. We can also send you articles and other written materials about long COVID.
We would like to hear from you if you are experiencing long COVID. Please write to us about your experiences, and if you have found anything that helps. We would like to include more information and tips about dealing with long COVID inside in our next issue.
COVID-19 prison lawsuits
Since the pandemic started, hundreds of lawsuits have been filed across the country at the local, state and federal level about the treatment of prisoners during the COVID-19 crisis. Many court orders and settlements have been issued requiring prisons and jails to implement better safety measures, improve conditions, and release medically vulnerable prisoners. Many other cases are still working their way through the courts. A few examples of recent victories:
- In December 2020, a California Superior Court judge ordered that the Orange County jail population must be cut in half, which would result in the release of around 1,800 people.
- In February 2021, North Carolina reached a settlement requiring them to release 3,500 prisoners to supervised release over the next six months.
- In March 2021, Illinois reached a settlement requiring them to release prisoners nearing the end of their sentences meeting certain conditions; advocates said this would likely affect 1,000 prisoners.
The Prison Policy Initiative, however, reports that after dropping in 2020 (mostly from reduced admissions rather than releases), prison populations are starting to increase again in many states.