As the late Kenny Rogers sang, “You need to know when to hold them and when to fold them.” The FEHBlog tried to revive his Covid charts, but alas, it was infeasible because the FEHBlog could not show the stats in seven-day weeks as FEHBlog had been doing.

In any event, the Centers for Disease Control continues to issue weekly interpretations of Covid statistics so here we go:

New Reported Cases

As of October 26, 2022, the current 21-day average of weekly new cases (37,683) decreased 25.1% compared with the previous 21-day average (50,328). A total of 97,329,787 COVID-19 cases have been reported in the United States as of October 26, 2022.

CDC Nowcast projections* for the week ending October 29, 2022, estimate that the combined national proportion of lineages designated as Omicron will continue to be 100%. There are eight lineages designated as Omicron with estimates above 1%: BA.5—and four of its sublineages (BQ.1, BQ.1.1, BF.7, and BA.5.2.6)—BA.4.6, BA.2.75, and BA.2.75.2. The predominant Omicron lineage is BA.5, projected to be 49.6% (95% PI 45.3-53.9%).

The New York Times report on a study finding that Covid rebounds can happen to people have not taken Paxlovid.

“Symptom return is common,” said Dr. Davey Smith, the chief of infectious diseases and global public health at the University of California, San Diego School of Medicine, who led the study. “It doesn’t mean that things are going south. It’s just the natural way the disease goes.” What is surprising, however, is how many people may experience a rebound, he said. * * *

“The good news is that nobody who had their symptoms return needed to go to the hospital or died or even got severe symptoms,” Dr. Smith said. Eighty-five percent of those who had a rebound reported that their symptoms were mild; 15 percent had at least one moderate symptom. * * *

Concerns about rebound symptoms when taking Paxlovid — and another antiviral drug called molnupiravir — appear to have reduced people’s interest in using treatments for Covid. But the new study shows that you can have a rebound with untreated Covid as well. “I hope this can help people to be less afraid of a potential rebound,” Dr. Smith said.

If you do experience a rebound after treatment, there is no evidence that you need to start another course of Paxlovid. Isolate a while longer in case you are contagious to others. And try to manage symptoms with pain and fever-reducing medicines, home remedies and time, Dr. Smith said. “I recommend staying hydrated, watching ‘The Golden Girls’ and eating chicken soup.”

New Covid Hospitalizations

The current 7-day daily average for October 19–25, 2022, was 3,249. This is a 1.0% increase from the prior 7-day average (3,217) from October 12–18, 2022.

New Reported Deaths

The current 21-day average of new deaths (373) decreased 13.7% compared with the previous 21-day average (432). As of October 26, 2022, a total of 1,066,351 COVID-19 deaths have been reported in the United States.

Covid Vaccinations

As of October 26, 2022, 636.9 million vaccine doses have been administered in the United States. Overall, about 266.0 million people, or 80.1% of the total U.S. population, have received at least one dose of vaccine. About 226.9 million people, or 68.4% of the total U.S. population, have completed a primary series.

Of those who have completed a primary series, about 111.8 million people have received a booster dose,* and more than 22.88 million people have received an updated (bivalent) booster dose. But 49.3% of the total booster-eligible population has not yet received a booster dose. Booster dose eligibility varies by age and health condition.

CDC Community Levels

As of October 27, 2022, there are 73 (2.3%) counties, districts, or territories with a high COVID-19 Community Level, 705 (21.9%) counties with a medium Community Level, and 2,439 (75.8%) counties with a low Community Level. Compared with last week, this represents a minor increase (+0.8 percentage points) in the number of high-level counties, a minor increase (+4.4 percentage points) in the number of medium-level counties, and a minor decrease (-5.2 percentage points) in the number of low-level counties. Overall, 46 out of 52 jurisdictions** had high- or medium-level counties this week. California, Delaware, the District of Columbia, Hawaii, North Carolina, and South Carolina are the only jurisdictions to have all counties at low Community Levels.

Here’s this week’s CDC FluView.

Key FluView Points for the week ended October 22:

• Influenza activity continues to increase. Regions 4 (southeast) and 6 (south-central) are reporting the highest levels of flu activity.
• The first influenza-associated pediatric death of the 2022-2023 season was reported this week.
• CDC estimates that, so far this season, there have been at least 880,000 flu illnesses, 6,900 hospitalizations, and 360 deaths from flu.
• The cumulative hospitalization rate in the FluSurv-NET system is higher than the rate observed in week 42 during previous seasons going back to 2010-2011.
• An annual flu vaccine is the best way to protect against flu. Vaccination helps prevent infection and can also prevent serious outcomes in people who get vaccinated but still get sick with flu.
• CDC recommends that everyone ages 6 months and older get a flu vaccine annually.
• There are also prescription flu antiviral drugs that can be used to treat flu illness; those need to be started as early as possible.

The Wall Street Journal adds

• An estimated 21% of adults have gotten a flu vaccine this year, similar to estimates from the same time last year, the CDC said, basing its estimates off an Ipsos survey conducted in early October. An estimated 22% of children have also gotten a flu shot, according to the CDC’s national immunization survey.
• It is too early to tell how effective this year’s vaccine will be, the CDC said. But the influenza virus that is being most often reported, a strain of influenza A called H3N2, matches well with the formation of this year’s shot, health experts said.

The CDC has an updated RSV page with prevention and symptom guidance. Yahoo News adds “U.S. officials are working on a respiratory syncytial virus (RSV) vaccine, but until one is available people should exercise caution, especially seniors and parents of young children, the nation’s top infectious disease official said.”

In other virus news, Prescision Vaccinations discusses the severe impact that monkeypox infections can have on immunocompromised people, such as those with HIV or AIDs.

Following up on yesterday’s note on the Kaiser Family Foundation’s 2022 Employer Health Benefit Survey

• Beckers Payer Issues calls four figures to our attention.

• Kaiser Family Foundation delves into the survey’s findings about employer sponsored mental health programs.

From the U.S. healthcare business front, BioPharma Dive reports on Gilead’s third quarter earnings report.

The results [which exceeded Wall Street expectations] were, in part, tied to growing sales from Gilead’s cell therapy business, which consists of the marketed cancer drugs Yescarta and Tecartus. Together, sales from the two drugs totaled $398 million in the third quarter, a nearly 80% increase from the same three-month period a year prior. * * *

Third quarter sales of Tecartus were up 72% year over year, reaching $81 million, while those for Yescarta rose 81% to $317 million. Gilead cited the approval of Yescarta as a “second-line” therapy for a type of hard-to-treat lymphoma, which happened in April, as a main reason for the uptick.

Other cell therapy developers have recorded larger sales from their products as well, though not to the same extent as Gilead.

From the Medicare front, the Centers for Medicare and Medicaid Services announced issuing a

final rule that updates Medicare enrollment and eligibility rules to expand coverage for people with Medicare and advance health equity. The final rule, which implements changes made by the Consolidated Appropriations Act, 2021 (CAA), makes it easier for people to enroll in Medicare and eliminates delays in coverage. Among these changes, individuals will now have Medicare coverage the month immediately after their enrollment, thereby reducing any delays in coverage. In addition, the rule expands access through Medicare special enrollment periods (SEPs) and allows certain eligible beneficiaries to receive Medicare Part B coverage without a late enrollment penalty.

To view a fact sheet on the final rule, visit: https://www.cms.gov/newsroom/fact- sheets/implementing-certain-provisions-consolidated-appropriations-act-2021-and- other-revisions-medicare-2

To view the final rule, visit: https://www.federalregister.gov/public-inspection

From the OPM front, Federal News Network offers insights into the recently released Federal Employee Viewpoint Survey.