'Breakthrough' COVID-19 cases will happen but remain rare, Duke medical expert says

RALEIGH, N.C. (WTVD) -- North Carolina, like many other states across the country, is seeing an uptick in COVID-19 cases.

Q&A: With the Delta variant spreading, can vaccinated people feel safe without a mask?
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Dr. Lisa Pickett with Duke Health answers questions about COVID-19 and the vaccines.



9:30 p.m.
Experts agree that breakthrough cases are going to happen. They're expected. But, still very rare.

More than 156 million Americans are now fully vaccinated, nationwide, according to the Centers for Disease Control. Of those people, approximately 153,000 of them have contracted symptomatic breakthrough cases of COVID-19. Breakthrough cases represent 0.098% of those fully vaccinated, according to an unpublished internal CDC document obtained by ABC News.

Duke University's Hospital Chief Medical Officer, Dr. Lisa Pickett, spoke to ABC11 on Monday, about the breakthrough cases that physicians are seeing at the medical campus in Durham.

"We are aware of some breakthrough cases. The very good news is that very few of those are severe. Generally speaking, we're only seeing (breakthrough cases) in those who are immuno-compromised -- cancer patients, transplant patients. But it's very rare that patients have significant disease after full vaccination," Pickett said.

The evidence of the data bolsters the case that the vast majority of those becoming severely ill are unvaccinated people and the risk to vaccinated people is dramatically less.

The big takeaway from experts is that no vaccine can provide 100% protection. But they are still very effective at preventing severe illness and death.

Reporting by ABC11's Joel Brown

4:15 p.m.
Dr. Nerissa Price, a psychiatrist with WakeMed, said the shifting recommendations around COVID-19 safety measures have caused anxiety in her patients and she is concerned about what new mask guidance could mean.

"It feels for a lot of individuals like it's two steps forward and three steps back," said Price. "Going back to wearing masks feels like maybe we're losing the battle. I think for others it offers them support because they're concerned about the virulent nature of this Delta variant and having that mask adds extra protection."

Price urged health officials they would need to be clear, consistent, and transparent in their messaging around why it's important to mask up once again.

For people who are struggling with anxiety, Price reminds them that wearing a mask is within their control.

"A lot of times with anxiety the issue is that people feel like they don't have control," she said. "But this is something in our control. This is something we can do for ourselves and for other people."

Concerned about the mental health crisis coinciding with the ongoing pandemic, Price is also worried about suicide and overdose rates as well as random violence that happens if people who need help don't have access to mental health services.

"I would hope that part of what our leaders do in addition to asking for things from the community to wear masks-- that we provide access to mental health resources as well so that people can really manage these types of massive changes," Price said.

4:10 p.m.
The Downtown Raleigh Food Truck Rodeo is canceled for Aug 1.

"We are not able to do temperature checks at this open event, so we have to assume that there could be highly contagious individuals in the crowd with the new Delta variant," organizers said on Facebook. "Because of the rapid surge of the Delta Variant, we will be looking to Sept 26th event date as the first event. This will ensure that we have time to take into account the new challenges. Please let others know of the cancellation and to keep an eye out for Sept 26th. We are working on a limited budget which prevents paid promotion efforts."

3:30 p.m.
The Department of Veterans Affairs on Monday became the first major federal agency to require health care workers to get COVID-19 vaccines, as the aggressive delta variant spreads and some communities report troubling increases in hospitalizations among unvaccinated people.

The VA's move came on a day when nearly 60 leading medical and health care organizations issued a call for health care facilities to require their workers to get vaccinated.

1:54 p.m.
On Thursday, the Moore County Health Department will be offering COVID-19 vaccinations at West End Presbyterian Church at 275 Knox Lane in West End at the Crawford Center.

The event is open to the public and runs from 3 p.m. to 6 p.m. with no appointment required.

Anyone age 12-17 seeking a COVID-19 vaccination must be accompanied by a parent or guardian who can provide consent.

The Moore County Health Department at 705 Pinehurst Avenue in Carthage, continues to offer weekly COVID-19 vaccine clinics. Appointments can be made by calling (910) 947-SHOT (7468) Monday-Friday from 8 a.m. to 5 p.m. and walk-ins will also be accepted on vaccine clinic days, which are held each Thursday from 8:30 a.m. to 11:15 a.m.and from 1 p.m. to 4:15 p.m

12:40 p.m.
North Carolina's latest County Alert System map shows viral spread is increasing rapidly in the state. There is one red county, 12 orange counties, 41 yellow counties, 41 light yellow counties, and 5 green counties. 40 counties have moved up a tier since July 8.

Cumberland, Hoke, Lee and Sampson counties are orange.

Richmond County is red.

Wake and Durham counties are yellow.

12 p.m.
The resurgence of COVID-19 continues in North Carolina.

On Saturday, the number of single-day new cases surpassed 2,000 -- with 2,133 new COVID-19 cases reported in the state. That's the highest since April 30.

1,910 new cases were reported Sunday and 1,401 new cases were reported Monday morning.

On Friday, NCDHHS said North Carolina had experienced a 66% increase in cases from the week prior.

The percent of positive tests is at 8.6%. That's the highest it has been since early April.

943 people are currently hospitalized in the state with COVID-19. One week ago, 612 people were hospitalized.

Hospitalizations have more than doubled since July 9 and are at the highest rate they have been since May.

60% of the adult population of North Carolina has at least one dose of the COVID-19 vaccine. 57% is fully vaccinated.

13,580 have died since the start of the pandemic.

Take a look at the metrics for yourself at this website.

10:40 a.m.
New York City will require all of its municipal workers - including teachers and police officers - to get coronavirus vaccines by mid-September or face weekly COVID-19 testing.

The rule is expected to affect about 340,000 city employees, making the city one of the largest employers in the U.S. to take such action.

While it isn't a vaccine mandate, officials hope the inconvenience and discomfort of weekly tests will persuade many to overcome a reluctance to get inoculated.

More on this story here.

10:25 a.m.
The American Medical Association and the American Nurses Association have joined up with over 50 other health care organizations to call for mandatory vaccinations for their industry, citing the rising case rates and the Delta variant as reasons.

"Due to the recent COVID-19 surge and the availability of safe and effective vaccines, our health care organizations and societies advocate that all health care and long-term care employers require their workers to receive the COVID-19 vaccine," the organizations wrote in a joint statement on Monday morning.

UNC Health, Duke Health and other North Carolina hospitals announced last week that they would be mandating vaccinations for healthcare workers.

10:20 a.m.
Orange County announced that it extended the local COVID-19 related State of Emergency declaration indefinitely, The extension went into effect Friday, July 23, at 5 p.m.

This comes as hospitalizations are increasing and the Delta variant is spreading.

Orange County officials said most of the new cases there are amongst unvaccinated individuals and are caused by the rapidly spreading Delta variant.

MONDAY MORNING HEADLINES

With soaring COVID-19 cases, the Center for Disease Control and Prevention is once again considering a change to its mask guidance.

Dr. Anthony Fauci said the CDC is discussing the possibility of renewing the call for a mask mandate.

The vast majority of new cases and serious complications from COVID-19 are among people who are not fully vaccinated.

With more than 156 million Americans fully vaccinated, nationwide, approximately 153,000 symptomatic breakthrough cases are estimated to have occurred as of last week, representing approximately 0.098% of those fully vaccinated, according to an unpublished internal Centers for Disease Control and Prevention document obtained by ABC News. These estimates reflect only the adult population and do not include asymptomatic breakthrough infections.

"While anecdotal cases and clusters can conjure concern around the vaccine, when put in the larger context of how many people have been vaccinated and the sheer volume of cases in the unvaccinated population, we recognize that the vaccines are working and how rare breakthroughs actually are," said Dr. John Brownstein, the chief innovation officer at Boston Children's Hospital and an ABC News contributor.

New research suggests the pandemic has thrown our sleep schedules off.

A recent survey by the American Academy of Sleep Medicine found that more than half of Americans have had a hard time sleeping since the pandemic began.

Dr. Shelby Harris said the following seven words can help improve your sleep: No screens, wind down, have a routine.

FRIDAY
6 p.m.
Wake County officials are making yet another push to increase the county's vaccination rate.

Health officials are expanding the county's vaccine outreach program by launching a door-to-door canvassing event.

"It was pretty surprising. I wasn't planning on getting it anytime soon. But my family they were telling me I had the opportunity right now, so I got it," said Kobin Flores Aguilar, a teenager who received his vaccine from the door-to-door canvassing.

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A vaccine outreach is underway in Wake County. Michael Perchick reports on the efforts.



He acknowledged hesitancy in getting his shot, which he did with his younger sister.

"Because they said (the vaccine) was new, I was worried about some bad side effects," said Flores Aguilar, who added that he planned on sharing his experience with friends.

His father, David Flores, was hospitalized with COVID-19 last year.

"Really, really bad. It's bad because you think that your life is gone. That's why I tell people to get the vaccine because it's very important," Flores said.

He's encouraging others to get vaccinated.

"I told my neighbor, we were talking yesterday about this. I was surprised (the canvassers were here) today. Ad she's coming. Maybe she'll get it today," said Flores.

Canvassers targeted underserved areas; while about 70% of the eligible population in Wake County has received at least one dose of the COVID-19 vaccine, there are some areas where rates are closer to 30%.

"I am concerned that this could be the starting of a road we don't want to go down again. And that's why it's so important to get the message out, to find solutions to barriers, and to get shots in arms," said Dr. Nerissa Price, the Medical Director of WakeMed's Behavioral Health Community Case Management Team.

Friday, there were nearly 2,000 new cases, about four times higher than two weeks ago. Over that time period, hospitalizations have nearly doubled, and the test positivity rate is more than twice as high.

The value of personal connections in convincing vaccine-hesitant individuals playing out, both in canvassing efforts and at a pop-up event at the Wilder's Grove Shopping Center in Raleigh. That's where Charles Lotson was early Friday afternoon, after speaking with two family members.

"I trust them. I trust their word. So if they say it's good, I'm still going to be scared, but I'm going to do it," Lotson said.

In North Carolina, disparities in vaccine demographics are evident. While 23% of the state's population is Black, the community comprises only about 17% of vaccinations. There's a smaller gap in the Hispanic community, which accounts for 10% of the state's population, but only 8% of vaccinations.

Price highlighted the importance of a diverse staff, working to bridge the gap.

"Having that instant credibility because they know that they speak the language or that they understand the concerns of the community, it's amazing how quickly change their attitude," Price said.

Reporting by ABC11's Michael Perchick

12:15 p.m.
North Carolina Department of Health and Human Services reported 1,998 new COVID-19 cases Friday, the highest single-day increase since April 30. 6.7% of tests are positive.

The number of North Carolinians hospitalized with COVID-19 rose for the 13th-straight day to 817, the highest in more than two months.

The spike in cases came with a stern warning in a press release from NCDHHS Secretary Dr. Mandy Cohen. "Unvaccinated North Carolinians are unnecessarily getting sick, being hospitalized and dying," she said. "Don't wait to vaccinate. And if you haven't gotten your shot, you need to wear a mask indoors at all times when you are in public spaces."

Cohen said more than 94% of recent North Carolina COVID-19 cases are in patients who are not fully vaccinated against the virus.

FRIDAY MORNING HEADLINES
Wake County officials are making yet another push to increase the county's vaccination rate.

Health officials are expanding the county's vaccine outreach program by launching a door-to-door canvassing event.

"It's important for us to reach everybody who may not have access to be able to come to us; whether it's transportation or time time or anything like that. So we try to make a very convenient for folks who are already out and about," nurse Laura Schiada said.

Wake County's eligible population has about a 70 percent vaccine rate--relatively high for the state and county. However, there are still areas in the county where the rate is much lower.

Canvassers will be out in those lower vaccination rate neighborhoods to pass out information and request forms. They will not be doing home vaccinations at this time.

In addition, a free vaccine event runs from 11 a.m. to 5 p.m. in front of Hamricks at the Wilders Grove Shopping Center.

"(The vaccine) is new and not knowing everything--but I figured it was safer to get it, because I actually caught COVID in April and I didn't like the way I felt. So I don't wanna go through that again," Dionne Oden said after getting vaccinated at the clinic.

Meanwhile, with cases increasing across the country, the Centers for Disease Control and Prevention is sticking to its mask guidance.

The CDC says only unvaccinated people need to wear a mask when out in public. Director Rochelle Walensky called it an "individual choice" for fully vaccinated people to still mask up.

A CDC advisory panel also issued new guidance on vaccine booster shots, saying a booster appears to help people with compromised immune systems who are more likely to get a breakthrough infection but are not necessary.
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