By Richard L. Gaw

Staff Writer

When held up against the now persistent battering ram known as the Delta variant, the Commonwealth of Pennsylvania can best be categorized in Dickensian terms.

It is the best of times. It is the worst of times.

The latest statistics from the Centers for Disease Control (CDC) indicate that Pennsylvania ranks fifth among all 50 states for total COVID-19 doses administered – 67 percent of those age 18 and older are fully vaccinated – and eighth in the U.S. in the number of first doses administered. In total, vaccine providers have administered 12,442,131 total vaccine doses to 6.06 million residents, including 55,421 additional doses authorized for people who are immunocompromised.

The CDC also reported that an additional 49,277 vaccinations have been administered in the state since Sept. 10 for an average rate of 14,500 vaccinations a day.

While the numbers are impressive, their impact seems futile in the wake of a tidal wave of new COVID-19 cases reported throughout the state. Between Sept. 11 and Sept. 13, the Pennsylvania Department of Health confirmed that there were 12,406 additional positive cases of COVID-19, bringing the statewide total to 1,350,719 – with 2,183 individuals currently hospitalized with COVID-19. Of that number, 535 patients are in intensive care units.

The upward trend shows no sign of subsiding. The state's health department said that the state's positivity rate for COVID-19 stood at 9.1 percent during the week of Sept. 3 – Sept. 9 and worse still, there were 33 new deaths identified by the Pennsylvania death registry between Sept. 10 and Sept. 12, bringing the statewide totals to 28,568 deaths attributed to COVID-19.

High numbers could have been easily prevented

The Chester County Health Department's latest monitoring report reflects the rest of the state. While 67 percent of those from 12 to 18 years of age have been fully vaccinated in Chester County – and 72 of the population over 18 have also been fully vaccinated – positive COVID-19 test results continue to rise. During the period of Sept. 3-9, 492 residents tested positive, adding to the mark of 2,181 positive tests recorded over the past 30 days. During the last month, 9 Chester County residents died from the virus, bringing the total death count in the county to 837.

According to the state's health department, the variant is more contagious than the original strain of the virus, accounting for more than 92 percent of current COVID-19 cases in Pennsylvania. Since July when schools first began discussing health and safety plans, Pennsylvania’s COVID-19 caseload has increased from less than 300 a day to more than 3,000 a day – with cases among school aged children increasing by more than 11,000 in the last month, and by more than 79,000 from January 2021 to August 2021.

Additionally, new cases of COVID-19 among children enrolled in licensed child care facilities in Pennsylvania have increased significantly in recent months, according to data reported to the Department of Health and Safety by child care providers. On June 4, for example, child care providers reported eight cases of COVID-19 among children in the previous week, but on Aug. 27, the number of new COVID-19 cases among children in child care the previous week was 162.

Debra L. Powell, M.D., chief of the Division of Infectious Diseases at Tower Health, said she has seen the continuing impact of the Delta variant reflected in higher positivity rates, and more patients on ventilators at Tower Health. In looking at current modeling for the virus, she projects that these rates will continue to rise and then begin to plateau over the next three to four weeks.

These rising numbers could have been easily prevented, she said.

“I do believe we would have seen less impact if people had gotten more vaccinations, and that is clearly showing,” she said. “We also have to realize that this is a global pandemic, so across the world there are populations who aren't getting vaccinations. As we continue to see more variants emerge, we need to get more vaccines out to the world – both the first and second doses.”

The spread of COVID-19 has also begun its assault on Pennsylvania's schoolchildren. A comparison of cases among the 5-18 age group for the first week in September 2021 and 2020 shows the number of cases in the age group this year is nearly 10 times greater the same timeframe in 2020. Between Sept. 4 and Sept. 10, 2020, there were a total of 574 COVID-19 cases in the age group compared to Sept. 2 and Sept. 8, 2021, when there were 5,371 cases in the same age group.

'The science is clear'

In an effort to protect students, Pennsylvania Gov. Tom Wolf initiated an order that requires masks to be worn inside all K-12 school buildings, early learning programs and child care centers that went into effect on Sept. 7.

“My office has received an outpouring of messages from parents asking the administration to protect all children by requiring masks in schools,” said Gov. Wolf. “The science is clear. The Delta variant is highly transmissible and dangerous to the unvaccinated, many of whom are children too young to receive the vaccine. Requiring masks in schools will keep our students safer and in the classroom, where we all want them to be.

“The reality we are living in now is much different than it was just a month ago,” said Acting Health Secretary Alison Beam. “With case counts increasing, the situation has reached the point that we need to take this action to protect our children, teachers and staff. The science is clear. If we want to keep our schools open, maintain classroom learning and allow sports and other activities to continue, masking significantly increases our chances of doing so.”

Wolf's proclamation echoed the refrain of the letter he sent to the state's General Assembly on July 29, when he asked lawmakers to “use every tool at your disposal, starting now, to encourage your constituents to be vaccinated.”

“Unfortunately, the rising tide of the Delta variant is lifting case numbers in all states, and Pennsylvania is no exception,” Wolf wrote. “Our statewide 7-day average daily caseload has nearly quadrupled in just three weeks. Low case counts and high rates of vaccination in eligible people are what keep all of us, including the immunocompromised and children under 12 safer as we return to our normal routines.

“We are all connected to our constituents on social media, through local events, newsletters, and more. We can talk to our constituents directly, we can elevate the voices of local trusted healthcare providers, we can discuss our own experiences, and talk about our shared goals: protecting ourselves and those we love. Please do this with care, with understanding, and with urgency.”

In recent weeks, Dr. Powell has given several interviews with the media as well as attended town halls in an effort to provide the right information about vaccinations to to the public.

“It is up to all of us to embrace public health and to realize that we are all a piece of this puzzle, and by not getting vaccinated, we forget the people around us,” she said. “That has been my personal message all along – that it is not about your personal liberties. It's about taking care of each other and being a community.”

To contact Staff Writer Richard L. Gaw, email [email protected].

What you should know

The following is a condensed list of commonly-asked questions regarding additional vaccination against COVID-19, as compiled by the Pennsylvania Health Department and the Chester County Health Department.

Who is eligible for a third dose?

People with medical conditions or people receiving care for moderate to severely weakened immune systems, such as those who:

• are actively receiving or have recently received treatment for solid tumor and hematologic malignancies

• have received solid-organ or recent hematopoietic stem cell transplants

• have severe primary immunodeficiency

• have advanced or untreated HIV infection

• are in active treatment with high-dose corticosteroids, alkylating agents, antimetabolites, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory, and

• those with chronic medical conditions such as asplenia and chronic renal disease may be associated with varying degrees of immune deficit

Why doesn't everyone need an additional dose?

The FDA has not recommended an additional dose for other individuals at this time. This recommendation helps to increase the likelihood this population is protected against COVID-19, especially as the more transmissible Delta variant spreads.

CDC and FDA continue to review available evidence and data on whether or when booster doses for other populations, including seniors, may be needed.  Available data right now show the vaccines continue to be strongly protective against severe illness and death caused by COVID-19.

If you are in close contact with immunocompromised people and are not yet fully vaccinated, you are encouraged to be vaccinated against COVID-19 now.

When will everyone be eligible for third doses?

At this time, the FDA is reviewing if an additional dose may be needed in the future.

Do I have to get the same product for my third dose?

For the third dose, people should get the same product (Pfizer or Moderna) as their first and second doses. If that’s not an option, people may receive an alternate product.

What’s the difference between a third dose and a booster?

The term “third dose” is used to describe an extra dose that provides increased protection for those who may have never reached full immunity. Some vaccines can wear off over time and at that point, a “booster” dose is needed to bring protection levels back up.

At this time, “booster” doses are not recommended. The “third dose” helps people with weakened immune systems build protection similar to what most people got with their original vaccination.

Does this mean my vaccine isn’t effective?

This update is not based on how well vaccines work. It is based on research showing people with weakened immune systems may not have reached full protection to prevent the more serious complications of COVID-19 compared to the general public.

My doctor isn’t offering the vaccine. What should I do?

Individuals who meet the eligibility criteria are able to schedule appointments using the Chester County Health Department's COVID-19 vaccination calendar available by visiting: www.chesco.org/4822/COVID19Vaccine

Are walk-in appointments available at the Chester County Health Department?

No. All individuals must make an appointment using the Chester County Health Department's calendar.

I received my original doses from a provider other than the Chester County Health Department. Can I make an appointment there?

Yes. Please make an appointment by visiting: www.chesco.org/4822/COVID19Vaccine

Where else can I get my additional dose?

Immunocompromised individuals who are fully vaccinated with Pfizer and Moderna and are looking to receive this additional dose of the respective vaccine, should consult their health care provider before scheduling a vaccine appointment. To find a vaccine provider near you, visit:  www.vaccines.gov.

How many people in Pennsylvania are eligible to get the additional dose?

Based on the CDC's estimate that 2.7 percent of the population may be immunocompromised, the eligible population would be approximately 250,000 to 300,000 people in Pennsylvania.

When can I get an additional dose of the COVID-19 vaccine?

Immunocompromised individuals who are fully vaccinated with Pfizer and Moderna and are looking to receive this additional dose of the respective vaccine, should consult their health care provider before scheduling a vaccine appointment.

How long do I have to wait after receiving the second dose to get the third dose?

The CDC recommends waiting at least 28 days after completion of your initial two-dose vaccination before seeking the additional dose.

For additional information, visit the Chester County's COVID-19 website at: www.chesco.org/4376/Coronavirus-COVID-19, or the Pennsylvania Health Department's COVID-19 website at: www.pa.gov/guides/responding-to-covid-19/, or call the Pennsylvania Department of Health hotline at  1-877-724-3258.