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• CDC issues new guidance to reopen schools
• Nationwide pharmacy vaccination program has begun
• Batch of homegrown coronavirus mutations seen in US
• How Covid-19 death data honors lives lost

CDC issues new guidance to reopen schools

The US Centers for Disease Control and Prevention last week released guidelines for reopening schools that focus on five key Covid-19 mitigation strategies: the universal and correct wearing of masks; physical distancing; washing hands; cleaning facilities and improving ventilation; and contact tracing, isolation and quarantine.

Vaccines and testing are not among the "key" strategies the agency laid out, calling them "additional layers" of Covid-19 prevention.

"I want to be clear, with this operational strategy, CDC is not mandating that schools reopen. These recommendations simply provide schools a long-needed roadmap for how to do so safely under different levels of disease in the community," CDC Director Dr. Rochelle Walensky said in a news briefing on Friday.

Walensky added that while each strategy is important, CDC recommends "prioritizing the first two" -- wearing masks and physical distancing.

The new guidelines also recommend virtual learning for middle schools and high schools, and hybrid learning or reduced attendance for elementary schools in what the CDC calls high transmission zones or “red” zones.

Currently, a CNN analysis of federal data shows that about 89% of children in the US live in a county considered a “red” zone.

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Nationwide pharmacy vaccination program has begun

A few weeks ago, the Biden administration announced the federal government would begin direct shipments of vaccines to retail pharmacies, with a total of 1 million doses going to about 6,500 stores, before eventually expanding. The coordinated effort is expected to help expand vaccine uptake. The program last week was met with fanfare, a few technical glitches and plenty of sore arms.

Twenty-one pharmacy chains are included in this ambitious first-time rollout, including CVS, Walgreens, Rite Aid and Walmart.

Many experts say turning to retail pharmacies to increase vaccine uptake makes sense as a way to minimize the logistical challenges in state and local health departments. And with clinics and hospitals struggling to provide care for patients sick with Covid-19 -- especially in small rural communities -- taking vaccines elsewhere makes sense.

Steven Anderson, president and CEO of the National Association of Chain Drug Stores, says he's confident the 1-million goal can be met, as long as enough vaccine ends up in pharmacies.

"Ultimately NACDS member pharmacies can meet and exceed the 100 million vaccinations in a month threshold, yet it's important to understand that the supply of vaccines remains the rate-limiting factor in the vaccination effort," he said.

About two months have passed since the Pfizer/BioNTech and Moderna Covid-19 vaccines were authorized for emergency use in the United States and states began to administer doses, vaccinating health care workers and long-term care facility residents first.

Since then, many states have moved on to vaccinate the next prioritized groups, such as other essential workers, older adults and -- most recently -- people with comorbidities or underlying medical conditions that put them at an increased risk, such as diabetes.

But access to the vaccine for people with these underlying conditions will vary from state to state.

Batch of homegrown coronavirus mutations seen in US

Researchers said Sunday they have identified a batch of similar troubling mutations in coronavirus samples circulating in the United States. They've not only drawn attention to them; they've come up with a better shorthand for referring to them. They've named them after birds using labels such as Robin, Pelican and Bluebird.

The mutations all affect the same stretch of the spike protein -- the knob-like extension on the outside of the virus that it uses to dock onto the cells it infects, the researchers wrote in a pre-print report. It's not peer reviewed yet, but researchers are rushing such findings online to share them quickly with other experts.

The genetic stretch that is mutated, or changed, is called 677. The various changes are so similar that the researchers think evolution favors these particular variants. And it's in a troubling place, said Vaughn Cooper, director of the Center for Evolutionary Biology and Medicine at the University of Pittsburgh School of Medicine, who worked on the study.

"This stretch of Spike is important because of its proximity to a region key for virulence," Cooper told CNN via email.

"We actually think these mutations are relatively rare (compared to other types of mutation), but they are disproportionately selected when they occur," he added.

The team has been reviewing genomic sequences deposited into GISAID, a global database that researchers are using to share genetic information about the virus. It's where scientists first noticed the rise of troubling new variants such as B.1.1.7, first seen in the United Kingdom, and B.1.351, first seen in South Africa.

How Covid-19 death data honors lives lost

As more and more Americans lose loved ones to Covid-19 or fall ill themselves, summarizing very human experiences of fear and grief into statistics may feel cold.

"Numbers can be a bit sterile," said Bob Anderson, the CDC's chief mortality statistician. "But these numbers are people -- mothers, fathers, brothers and sisters. I have to constantly remind myself of that."

Anderson has worked through the HIV epidemic, the opioid epidemic and more over the 24 years he's been in this role. But the Covid-19 pandemic is different, he said.

"Those were concerning, of course, and the numbers were relatively large, but not on the scale that we're seeing the Covid deaths," he said. "This is not something we've had to deal with."

Mortality data are widely used to help prevent disease, by ensuring resources are allocated properly and programs are assessed comprehensively. And it's uniquely personal.

"As far as health data go, mortality data is really the only dataset in which we have a record for each person," Anderson said.

Amid the pandemic, West Virginia Gov. Jim Justice has found a way to respect both the anonymity required of the data and the individual life behind each Covid-19 death record.

At the start of his press briefings each Monday, Wednesday and Friday -- before moving into the graphs and trends -- Justice reads through each new death, identifying the West Virginians who have recently lost their lives to Covid-19 with these data points: age, gender and home county.

Even without knowing their names, Justice said the connection is personal to him.

"As you're moving through the age and the gender and the county, you're thinking across West Virginia and the close-knit, loving people that live here. Oftentimes, my mind drifts to situations where I've been in someone's home in a specific county or I've been on a trout stream in a specific county," Justice said.

"In my mind I'm seeing families in these communities at a dinner table or on a picnic or on a trout stream. It's overwhelming at times."

But wait, there's more!

• Double masking can block 92% of infectious particles, CDC says
• Vitamin C, zinc don’t lessen Covid-19 symptoms, study says
• Rheumatoid arthritis drug reduces risk of death for severely ill hospitalized Covid-19 patients, researchers say
• WHO Wuhan mission finds possible signs of wider original outbreak in 2019
• 'Revenge bedtime procrastination' could be robbing you of precious sleep time

From the desk of Dr. Gupta

After reporting on the novel coronavirus for a little over a year, and having spoken to many of the prominent players involved in every aspect of research and public health, I think it's pretty safe to say that most people in the scientific community did not think it was likely that we would have a vaccine authorized by the end of 2020. Even people who are who are optimistic thought it would probably be 18 months to get to that point.

Yet the country now has two authorized vaccines, one from Pfizer/BioNTech and another from Moderna, and a third one -- made by Johnson & Johnson subsidiary Janssen Biotech -- appears to be on the cusp of also getting a green light.

By all accounts, that's pretty remarkable.

As a result of the two authorized vaccines, there are now at least 39.6 million people in this country who have received their first dose, and more than 15.0 million who are fully vaccinated with both doses -- and all of these people are significantly less likely to become severely ill, require hospitalization or die of Covid-19.

And that would also be the case if the Johnson & Johnson vaccine is authorized. While the overall efficacy is 66%, remember I told you that the most important number is 85% because that is how effective it is at doing what we care about most: preventing hospitalizations and deaths.

Still, now is not the time to let our guard down. While we are getting mostly positive news about vaccines, and the number of Covid-19 cases is going down, we're still very much in this pandemic and things can change rapidly, especially when it comes to the effect the variants will have on both vaccine efficacy and the number of new infections.

So until we know more, including whether vaccines reduce transmission in addition to reducing severe disease, we have to keep doing the things we know will keep us safe: wear a mask, keep our physical distance, stay in well-ventilated areas -- and if you get the chance, get your shot.

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