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Welcome to Overnight Health Care. Hawaii’s governor is encouraging tourists to rethink any upcoming trips to the state as it deals with rising COVID-19 cases, saying, “It is not a good time to travel to the islands.”

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Today:  A new study shows vaccine effectiveness may be waning, but hospitalizations are far more likely among unvaccinated. The American Medical Association endorsed vaccine mandates, and Oregon has reimplemented an outdoor mask mandate.

We’ll start with some numbers:

If you’re unvaccinated, a CDC study suggests you could be 29 times more likely to be hospitalized with COVID-19.

A CDC study found that unvaccinated people in Los Angeles County were 29 times more likely to be hospitalized with COVID-19 than those who are fully vaccinated.

The CDC’s Morbidity and Mortality Weekly Report released Tuesday also determined that unvaccinated people in the county were almost five times as likely to contract the coronavirus compared to their fully vaccinated counterparts. 

The study, spanning May 1 to July 25, documented more than 43,000 COVID-19 infections in the county among residents aged 16 and older. About a quarter of these cases occurred among the fully vaccinated, 3.3 percent among the partially vaccinated and 71.4 percent among the unvaccinated. 

Fully vaccinated people appeared to avoid severe illness at a greater rate, and fewer of them were hospitalized, admitted to an intensive care unit or needed mechanical ventilation, compared to those who were unvaccinated. 

Significance: The results back the justification that getting fully vaccinated can reduce the risk of COVID-19 infection and hospitalization, even as the delta variant dominates the U.S. 

“These data remind us that if you are not vaccinated, you are among those highest at risk,” CDC Director Rochelle WalenskyRochelle WalenskyThe perpetual pandemic: Politicians won’t let COVID end People who received J&J vaccine will likely need booster, surgeon general says The Hill’s Morning Report — Presented by AT&T — COVID-19 infects inoculated senators; Kabul evacuations drag MORE said during a Tuesday briefing. 

But: The vaccine’s effectiveness has also apparently slipped amid the delta variant. The data showed at the beginning of the study unvaccinated people were eight times as likely to contract COVID-19 than the fully vaccinated. That dropped to nearly five times as likely by July 25. 

Read more here.

American Medical Association calls for public, private sectors to mandate vaccines

The American Medical Association (AMA) on Tuesday urged the public and private sectors to mandate COVID-19 vaccinations, saying the move is key to getting control of the pandemic.

The call comes one day after the Food and Drug Administration (FDA) fully approved the Pfizer vaccine, a step that is expected to lead more companies to pull the trigger on mandating vaccination for their employees.

The AMA, the country’s leading doctors group, is seeking to speed that process along.

The AMA argued that other steps to simply incentivize vaccination, rather than mandates, have not resulted in the high vaccination rates needed to tame the highly transmissible delta variant.

​​The statement joins calls from President BidenJoe BidenHouse Democrats punt key vote on budget to Tuesday Biden envoy calls on North Korea to restart nuclear talks Biden to decide on Afghanistan troop withdrawal extension in next 24 hours: report MORE, who spoke after the FDA’s approval on Monday and called for employers to mandate vaccines for their workers as well.

Read more here.

LSU requiring fans at football games to be vaccinated or show negative test

Louisiana State University on Tuesday announced that it will require anyone age 12 and older to be vaccinated against coronavirus or to provide a negative COVID-19 test in order to attend a football game in Tiger Stadium.

LSU President William F. Tate IV said in a statement that the move comes as the university seeks to help curb the spread of the coronavirus in the state.

“As the flagship institution of the state of Louisiana, our foremost responsibility is to ensure the safety of our students, our supporters, and our community,” Tate said. “While we are aware of the diverse perspectives across the nation regarding masks and vaccinations, we must take all reasonable measures to protect our campus and community, not only on gamedays, but long after guests have left Tiger Stadium.”

According to the university, those attending football games will be asked to provide a hard copy vaccination card, verified digital proof of vaccination or a photocopy or photo of a vaccination card in order to prove their vaccination status.

Moving the needle: Louisiana has one of the lowest vaccination rates in the country, at less than 50 percent of its total population. Tiger Stadium holds more than 100,000 people, so the requirement has the potential to make a real difference.

Read more here.

Oregon implementing mask mandates outdoors regardless of vaccination status

Oregon announced Tuesday it is reimplementing an outdoor mask mandate regardless of vaccination status, a measure that is slated to take effect starting Friday.

“Effective Friday, August 27, masks will be required in most public outdoor settings, including large outdoor events, where physical distancing is not possible, and regardless of vaccination status,” a press release from the governor’s office stated.

Gov. Kate BrownKate BrownOregon becomes latest state to offer help in resettling Afghan refugees Oregon governor deploys up to 1,500 National Guard troops to support hospitals These states are requiring vaccines or testing for government workers MORE (D) said in a video the action is to “protect Oregonians and save lives.”

The move is likely to be highly controversial. The state’s directive goes beyond the Centers for Disease Control and Prevention (CDC) guidelines, that suggest fully vaccinated individuals wear a mask indoors in areas with high transmission rates.

Oregon is the first state to reimplement an outdoor mask mandate — all states dropped theirs after the CDC guidelines allowed them to do so. 

Read more here.

Officials, experts warn against using COVID-19 vaccine in kids under 12

Health experts and federal officials are advising physicians not to administer the newly-approved Pfizer coronavirus vaccine to children under the age of 12, despite pressure from parents clamoring for a way to vaccinate their young children.

While full approval of a drug generally allows for “off-label” use outside the prescribed population, the Food and Drug Administration and the Centers for Disease Control and Prevention said there’s still not enough data about the safety of the vaccines for children in that age group.

“That would be a great concern that people would vaccinate children, because we don’t have the proper dose, and we don’t have the safety data, nor do we have all the efficacy data,” Acting FDA Commissioner Janet Woodcock said during a media briefing Monday. 

“We need to get the information and data on uses in younger children. They are not just small adults, we’ve learned that time and time again,” Woodcock said.

The dosing amounts for children are likely to be less than the amount used for adults, and clinical trials for children are currently underway. 

Read more here.

What we’re reading

Sadness and death: Inside the VA’s state nursing-home disaster (Politico)

To boost Covid-19 vaccine uptake, one health system hunts for patients who fell through the cracks (Stat News)

Biden to receive report on Covid-19 origins, but challenges persist in how to deal with China (The Wall Street Journal)

State by state

Missouri AG sues to stop school mask mandates (The Associated Press)

Arkansas says no ICU beds available for coronavirus patients (The Associated Press)

Pritzker warns of ‘significantly greater mitigations’ if COVID metrics don’t decline (NBC Chicago)

Op-eds in The Hill

Here’s your decision: Get vaccinated first or be infected first

Is it safe to go back to school? We may find out the hard way

Are nonprofit hospitals holding up their end of the tax-free bargain?

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