The Farmers’ Almanac tells us that today, August 11, marks the official end of the “Dog Days of Summer,” a stretch that began on July 3. Technically speaking, the dog days have nothing to do with your steadfast and loyal pooch and everything to do with the alignment of the sun with the Dog Star Sirius in the constellation Canis Major.

In ancient days, people believed that Sirius enhanced the sun’s warmth, thus producing a few weeks of sweltering and unwelcome heat. In 2021, the dog days bring a sweltering and unwelcome surge in COVID-19, which comes and stays but will not sit. Nor, despite our fond wishes and feeble commands, will it roll over and play dead.

Fueled by the Delta variant of the SARS-CoV-2 virus, with more variants waiting their turn in the wings, new COVID-19 cases have surged past the mark of 100,000 a day in the United States. The daily count had dipped to 11,000 in late June after peaking at more than 250,000 in January.

In certain parts of the country, especially those with low vaccination rates, hospital beds and ICUs are filling up as they did in the throes of 2020, a year not fondly remembered. Both literally and figuratively, hospitals are looking for some oxygen.

The vaccination campaign had its own healthy surge in the first quarter of the year and then downshifted into low gear after the willing and eager had rolled up their sleeves. Now the pace is picking up again, energized by fear of Delta and boosted by government and business policies designed to nudge the shotless to the nearest immunization site.

In some cases, that push will be an order. The Pentagon will require COVID-19 vaccination of active-duty military by mid-September, or sooner if any of the vaccines receives formal approval from the Food and Drug Administration.

Delta-driven hot spots are also flaring around the world, notably in Southeast Asia and Down Under. Australia’s’ three most populous cities—Sydney, Melbourne and Brisbane, all past or future Olympic sites—are in lockdown in a country where just 20% of adults are fully vaccinated, the AP reports.

August, as it happens, is National Immunization Awareness Month, traditionally a time for the Centers for Disease Control and Prevention to start talking up flu vaccines. Things, you might say, are just a bit different this year.

Normally, mid-August would be a time for laid-back, late summer vacationing. The saga of this global pandemic is by no means beach reading, but it does offer a number of page-turning story lines:

Vaccines versus variants. This is the main event, an epic battle fit for Olympians, in which time is of the essence. The more successful we are in vaccinating the population, and the sooner we do so, the better the odds of stifling the emergence of new and potentially vaccine-resistant variants.

Persuasion versus push. Will young people listen to the army of YouTubers, TikTokers and other influencers recruited by the White House to promote COVID-19 vaccination? In PRWeek, Aleda Stam poses that question to key players in the comms industry. Ketchum EVP Courtney Nally suggests not relying on influencers alone but teaming up with organizations such as the American Academy of Pediatrics, which has more sway with parents, who in turn have at least some sway with their kids.

When it comes to getting vaccinated, Gen Z is influenced more by family and friends than by branded ads and influencers, Sabrina Sanchez reports in Campaign. In a global survey by discount platform Unidays, the vast majority (88%) of those who were vaccinated and had seen a branded ad promoting vaccination said it did not influence their decision. Overall, more than half (55%) of those surveyed said they were excited to get the vaccine while 15% said they’d never agree to it.

A White House push to vaccinate children and adolescents calls for incorporating COVID-19 vaccinations into sports physicals (a step endorsed by the AAP and 11 other organizations), sending pediatricians to back-to-school nights and helping schools and colleges set up pop-up vaccination clinics as students return to class.

The Public Health Communications Collaborative offers six ways schools can promote COVID-19 vaccination, from hosting vaccination clinics to making COVID-19 and the history of pandemics a teachable moment in the classroom.

Push is coming to shove in messaging—get vaccinated or get tested—directed to healthcare workers, public employees and others. The growing list of states adopting such measures includes Hawaii, Massachusetts, Virginia, Maryland, California, New Jersey, New York, and Washington (the state and DC).

In the senior care industry, one of the bigger dominos to fall in line with mandates is Brookdale Senior Living, with 685 communities in 41 states. Kimberly Bonvissuto has details in McKnight’s Senior Living.

Connecticut has decided that a nudge is not enough. As Bonvissuto reports, Governor Ned Lamont announced that long-term care facilities face civil penalties of $20,000 a day if employees do not receive their first vaccine dose by September 7. More than half (55%) of Connecticut nursing homes have staff vaccination rates below 75%.

United Airlines is requiring its 67,000 US employees to roll up their sleeves. Hawaiian Airlines followed suit and Frontier Airlines adopted a get-vaccinated-or-get tested policy. Gilead Sciences is on board with a mandate as well.

Cruise ships embarking from Florida can require passengers and crew to be vaccinated, a federal judge has ruled. The first sailing for Norwegian Cruise Lines out of Miami is Sunday.

Source: Getty Images.

Boosters versus no boosters. White House chief medical adviser Dr. Anthony Fauci sees boosters for the immunocompromised in the near future, Alicia Lasek notes in McKnight’s Long-Term Care News. That could lead to boosters for others considered vulnerable, including seniors and people with chronic medical conditions.

The CDC’s Advisory Committee on Immunization Practices will meet virtually on Friday to discuss the need for additional vaccine doses in immunocompromised individuals and boosters in general.

The World Health Organization maintains that the rush to boosters is premature, not to mention unfair to countries begging for vaccines.

Communication versus confusion. Public health messaging has taken a beating of late. MM+M’s Lecia Bushak speaks with health policy expert Dr. Leana Wen, who says the CDC “keeps getting the science right but the policy interpretation and communication totally wrong.” Shifting advice on masks is one example, discussion of breakthrough infections another.

In a New York Times op-ed, University of North Carolina professor Zeynep Tufekci calls on the CDC to “stop confusing the public” and start following its own mantra to be first, be right and be credible, and avoid mixed messaging.

In defense of the CDC, a report issued last Friday clearly states how effective the vaccines are in keeping older folks out of the hospital. For fully vaccinated seniors ages 65 to 74, the scorecard reads 96% for Pfizer/BioNTech and Moderna and 84% for Johnson & Johnson. For fully vaccinated folks 75 and older, the numbers are 91% for Pfizer/BioNTech, 96% for Moderna and 85% for J&J.

Credibility and trust are not just issues in the U.S. The majority (52%) of citizens in a U.K. survey feel that the national government’s pandemic communications lack honesty and credibility, Jonathan Owen reports in Campaign. Local government sources received higher marks on “truthiness” and empathy.

Remote versus in-person. Publicis Groupe is delaying a return to the office at least until Q4, Alison Weissbrot reports in Campaign. The agency is not alone. Amazon has postponed its return to bricks and mortar until January 2022. As PRWeek’s Steve Barrett notes, companies that were planning to revive office-based activity right after Labor Day have hastily convened to map out Plan B.

PRWeek’s Betsy Kim reviews what 20 national businesses are doing to reshape and fine-tune their vaccination and masking policies for employees and customers.

Source: Getty Images.

To gather or to disperse. Unlike the summer of 2020, when cancellations were (mostly) the rule, large gatherings are taking place. Among others, there was the Lollapalooza concert in Chicago at the end of July and the Sturgis motorcycle rally in South Dakota, rolling on as we speak. Sturgis, one of the few mega-events not to shut down last year, expects crowds of up to 700,000.

At the HIMSS (Healthcare Information and Management Systems Society) Global Health Conference and Exhibition this week in Las Vegas, one of the biggest health IT meetings in the world, proof of COVID-19 vaccination plus a mask is the ticket to admission for all attendees, exhibitors and staff. No exceptions.

Nearly 500 visitors to the Deer District, the area outside the Milwaukee Bucks arena where tens of thousands of jubilant fans gathered during the NBA finals, have tested positive for COVID-19.

The Garth Brooks national tour hesitated and then went ahead last Saturday with a sold-out show for 70,000 at Kansas City’s Arrowhead Stadium. But the New Orleans Jazz & Heritage Festival is canceled for the second year in a row, as is the New York International Automobile Show.

Masks versus no masks. Noting that “facts change,” Arkansas Governor Asa Hutchinson performed a 180 and said he erred when signing into law a ban on mask mandates in schools. The legislature won’t accommodate his request to undo the measure, but a state judge has put a temporary halt on the ban.

Battles over mask mandates in schools continue, notably in Florida, pitting state officials against local school districts. The return to school is fraught with concern, with COVID-19 cases and hospitalizations rising in the pediatric population and kids under 12 not yet eligible for vaccination.

The X-Factors

•  While vaccines and variants and masks and mandates gobble the headlines, it’s easy to lose track of the pivotal role of testing in curbing the spread of disease. The CDC now advises the fully vaccinated to get tested for SARS-CoV-2, whether or not they have any symptoms, three to five days after coming in contact with someone with suspected or confirmed COVID-19.

•  It’s also easy to lose track of the fact that the spread of disease is coming largely from the unvaccinated. Vanderbilt University’s Dr. William Schaffner, a leading voice in preventive medicine, describes the unvaccinated as “the big highway of transmission. The vaccinated, they’re little side streets. Let’s not get preoccupied with that. We need to get more people vaccinated.”

•  Here’s a cocktail with a twist: The FDA has granted emergency use authorization to the monoclonal antibody combination of casirivimab and imdevimab (Regeneron) for post-exposure prevention of COVID-19. As Diana Ernst reports in MPR, the combo is for people 12 and older who are at risk for severe disease and have been or are likely to be in close contact with an infected person, at home or in a group setting such as a nursing home. The treatment is not for the vaccinated and is not a substitute for vaccination.

Source: Getty Images.

The vaccine dashboard

•  The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine recommend that all pregnant individuals receive COVID-19 vaccination. The organizations note that COVID-19 poses a risk of severe complications in pregnancy, including death. Only 22% of pregnant individuals have received at least one dose of vaccine.

•  Do you need a COVID-19 vaccine if you’ve had the disease and developed some natural immunity? The CDC gathered data on Kentucky residents who were infected with COVID-19 in 2020 and experienced a new infection in May-June of 2021. Unvaccinated people were more than twice as likely as the fully vaccinated to get re-infected.

•  Moderna’s vaccine demonstrated durable 93% efficacy six months after the second dose, Brian Park reports in MPR. Moderna is also evaluating three booster candidates.

•  Novavax, a U.S. vaccine manufacturer largely out of the limelight, is seeking the first approvals for its COVID-19 vaccine in India, Indonesia and the Philippines. Application to U.S. authorities won’t come until later in the year.

Parting shot

We may be overlooking the influencer of all influencers: your grandma. In Montgomery County, Maryland, Abuelina puts her hands on her hips and reminds us to mask up, use hand sanitizer and get that vaccine.

Abuelina is a cartoon character working hard on behalf of the county’s Latin Health Initiative. Her inspiration is an elderly Dominican woman who attended focus group sessions and spoke with authenticity. Someone out there is listening: the vaccination rate for the county’s Hispanic and Latino population, after trailing the rate for non-Hispanic whites by 20 percentage points, is now nearly 10 points ahead, 74.2% to 65%.

…and some songs

Remember This, The Jonas Brothers (NBC Olympics Edition)

Who Let the Dogs Out, Baha Men

Right Back Where We Started From, Maxine Nightingale

It’s All in the Game, Tommy Edwards

One Way or Another, Blondie

Grandma’s Hands, Bill Withers

Thanks so much for joining us here today. We’ll be taking a summer break next week—catch you in a fortnight, same time, same place. Be well.