September 10, 2020

September 10, 2020

Introduction – L.J Tan (IAC)
  • LaDora Woods – L.J took a moment to extend the Summit’s congratulations to LaDora Woods, who will be leaving her role with the Summit and moving to a new position with CDC. While we are sad to see LaDora leave the Summit, we are pleased to welcome Joanna Hill into this role.
  • Surveillance Reports – The Summit will be rotating surveillance reports for influenza and COVID-19 during upcoming weeks. This will allow partners to receive the most current updates for both illnesses.

COVID Surveillance Update – Shikha Garg (CDC)

Shikha provided a presentation on the latest information available through the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET). COVID-NET conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in all ages. Currently over 250 acute care hospitals in 99 counties in 14 states participate in the system, representing ~10% of the U.S. population. COVID-NET, which is similar to previously developed FluSurv-NET and RSV-NET, was established on March 1, 2020.

Shikkha reviewed the intense level of work required for case ascertainment. When a potential case is found, it is reviewed to assure the individual is a resident of the surveillance area and has received a positive SARS-CoV-2 within the 14 days prior to or during hospitalization. When a case is identified, a minimum set of data is sent to CDC each week. Information obtained from detailed chart reviews also is submitted to CDC, though this information typically lags behind the weekly data. Shikkha briefly described the various data elements that can be assessed using COVID-NET interactive, including hospitalization rates and patient characteristics.

From March 1 – September 5, 2020, 55,425 COVID-related hospitalizations had been identified in the COVID-NET catchment area. The overall hospitalization rate was 166.9/100,000. This varied greatly by age group, ranging from 113.8/100,000 for persons 18–49 years of age to 451.2/100,000 for persons older than 65 years of age. Males have slightly higher hospitalization rates than females. Rates of hospitalization are substantially higher in persons who are Hispanic or Latino, non-Hispanic Black, or non-Hispanic American Indian/Alaska Native.

There have been two peaks in COVID-related hospitalizations, with the first peak occurring in early April and the second in July. Hospitalization rates for persons older than 65 were much higher in the first peak than the second one. For all other age groups, the case counts were higher in the second peak. Unlike the other age groups, rates in school-aged children have remained relatively stable or have climbed slightly.

The most frequently reported underlying conditions in hospitalized adults are hypertension, obesity, diabetes, and cardiovascular disease. Nearly 90% of hospitalized adults have at least one or more underlying medical condition, and over 60% have three or more. A small number (~10%) have no underlying conditions. The prevalence of underlying conditions varies by age group, with obesity reported most frequently in persons age 18–45 and hypertension reported most frequently in persons 50–64. At over 77%, hypertension is also the most frequently reported underlying medical condition in persons age 65 and older. Risk factors for ICU admission included older age, male sex, obesity, diabetes, and immunosuppressive conditions. Increased risk of hospital death was reported for persons who were older or who had diabetes; chronic lung, cardiovascular, neurological, or renal disease; or immunosuppressive conditions. An additional study analyzing data from COVID-NET and BRFSS supported the concept that these underlying medical conditions were more prevalent in hospitalized cases. The magnitude of risk for COVID-19 associated hospitalization was greatest for adults with severe obesity, chronic kidney disease, and diabetes, as well as for persons with more than one underlying risk.

In response to a question, Shikka noted that CDC has been monitoring bacterial/viral coinfections with COVID, but this was found in only a handful of hospitalized people last spring. However, CDC will continue to collect this information this fall.

Influenza Communications Update – Erin Burns (CDC)

Erin gave a presentation on CDC’s communications plans for the upcoming influenza season. CDC’s social media campaign, which Erin discussed during last week’s Summit call, has now been released. The theme will continue to be #Fight Flu. Based on input from focus groups, the materials emphasize the importance of protecting your community. Static banners are available for a variety of groups, including essential workers. Animated materials for multiple high risk target groups also will be available. Additional materials emphasize that flu vaccine can protect both you and the people you love. The initial paid media effort will begin on September 14.

A new video, “Mask Up, Lather Up, Sleeve Up,” which incorporates some of the COVID-related messages to influenza prevention, is now available as part of the CDC Digital Media Toolkit. Additional materials are being developed that suggest “Roll up your sleeve to fight flu,” a social media “frame” in which persons can insert their own picture to show they have been vaccinated. One Summit member asked whether this concept might be an issue for persons who are missing an arm, and Erin said they would consider this comment. In addition, it was noted that this concept overlooks use of nasal spray influenza vaccine. Erin pointed out that other CDC materials include nasal spray as an option. After much consideration, CDC has determined that most persons see this as a flu “shot,” and this approach was chosen for this one campaign to try to be more in line with common perceptions. Consumer testing has shown that “shot” (as opposed to “immunization” or “vaccine”) reaches more people “where they are,” particularly among people who traditionally might not have listened to these messages. Carolyn asked whether discussions were occurring about combining getting a flu vaccine with other measures designed to prevent COVID-19. CDC is considering how to best address this issue.

Erin provided a timeline outlining when the various phases of the flu campaign will be released between mid-September and continuing through March 2021. This includes National Influenza Vaccination Week, which is scheduled for December 6–12.

Finally, Erin mentioned that CDC hopes to have all these pieces be unbranded. They are totally open to requests for specific images, and they are happy to take additional questions.

Announcements – Carolyn Bridges (IAC)
  • New IAC Website – IAC’s new website on Mass Vaccination Resources provides a listing of resources to assist persons who are planning mass vaccination clinics. Links are available for both CDC resources and information from multiple other sources. Suggestions are welcome for consideration on the website.
  • Developing COVID-19 Vaccines, Part 2 – Carolyn reported that Phyllis Arthur with BIO moderated this Summit-sponsored panel discussion on September 9. Speakers representing multiple vaccine manufacturers presented their latest clinical trial data. Watch for announcements about when the audio of this session will be available on the Summit website.


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