Volume 2 No. S3: Second Quarter Editorial https://doi.org/10.47488/dhrp.v2iS3.68 DHR Proceedings ǀ http://dhrproceedings.org 10 2022, Vol. 2 No. S3 10-15 EDITORIAL The Rising Incidence of SARS-CoV-2 Infection in the Greater Rio Grande Valley: Is the COVID-19 Pandemic Over? Sohail Rao, MD, MA, DPhil,1 and Manish Singh, MD, FACS, FASMBS2 1Executive Vice President for Research & Leadership Development, DHR Health, 5501 S. McColl Road, Edinburg, Texas 78539, and Founding President & Chief Executive Officer, DHR Health Institute for Research & Development, 5323 S. McColl Road, Edinburg, Texas 78539. ORCID: https://orcid.org/0000-0001-5027-9992 2DHR Health Bariatric and Metabolic Institute and Chief Executive Officer, DHR Health, 5501 S. McColl Road, Edinburg, Texas 78539 and DHR Health Bariatric & Metabolic Institute, 5500 Raphael Drive, Edinburg, TX 79539 ORCID: https://orcid.org/0000-0003-4146-3282 Correspondence should be addressed to: Sohail Rao, MD, MA, DPhil., DHR Health Institute for Research & Development, 5323 S. McColl Road, Edinburg, Texas 78539. E-mail: s.rao@dhr-rgv.com. Keywords: COVID-19; SARS-CoV-2; BA.4; BA.5; Omicron; CDC: Centers for Disease Control and Prevention; FDA: U.S. Food and Drug Administration; WHO: World Health Organization The first case of SARS-CoV-2 infection was reported in 2019 by the World Health Organization for a patient in Wuhan, China (1). In the United States, the first case was reported in January 2020 of a patient who had travelled from Wuhan China to Snohomish County, Washington (2). In the Hidalgo County, Rio Grande Valley, Texas the first confirmed patient with COVID-19 was treated on March 21, 2020. Globally since the identification of the first case in Wuhan China and as of July 28, 2022, over 574 million (approximately 7.2% of the world population) people have been diagnosed with COVID-19 and over 6.3 million people have died because of SARS-CoV-2 infection (Table 1). During the same period, over 91 million (approximately 27% of the population) people in United States were diagnosed as COVOD-19 positive and over one (1) million people have died (Table 1). In Texas with a population of over 29 million people, over 7.5 million (approximately 26% of the population) residents acquired SARS-CoV-2 infection and over 300,000 have died due to COVID- 19 (Table 1). The Greater Rio Grande Valley (G-RGV) in South Texas is comprised of eight counties (Hidalgo, Cameron, Webb, Starr, Willacy, Zapata, Jim Hogg, and Brooks) and according to the 2020 United States Census, it has a total population of over 1.6 million people (3). It is one of the most rapidly growing regions in the United States and enjoys the uniqueness of having over 90% of the population who are of Hispanic ethnicity (3). Since the identification of the first case of SARS-CoV-2 infection in March 2020 (Table 2), over 488,000 (approximately 29% of the https://orcid.org/0000-0001-5027-9992 https://orcid.org/0000-0003-4146-3282 mailto:s.rao@dhr-rgv.com Rao, et al Rising Incidence of SARS-CoV-2 Infection https://doi.org/10.47488/dhrp.v2iS3.68 DHR Proceedings ǀ http://dhrproceedings.org 11 2022, Vol. 2 No. S3 10-15 population) people in the G-RGV have been diagnosed positive with COVID-19 and over 7,600 people have died as a consequence of this infection (Table 2; 4). The advent of COVID-19 mRNA vaccines in December 2020 positively impacted the outcome of SARS-CoV-2 infection both globally as well as in the United States (5, 6). As of July 27, 2022, over 229 million (approximately 67.2% of the population) people in the United States have been fully vaccinated, whereas during the same period over 50 million (approximately 91.8% of the population) people over the age of 65 years have been fully vaccinated (Figure 1). As of July 28, 2022, in Texas, over 17.8 million people have been fully vaccinated and over 7 million people have received at least one booster. Unfortunately, in the United States, only approximately 48% (over 107 million) people who qualify have received the first booster and only over 19 million (approximately 30.9%) people >50 years and over 13 million (approximately 37.8%) people >65 years who qualify have received the second booster (7). These observations are alarming considering the results of a recent study that was published in the journal Science which suggested that COVID-19 vaccine boosters provided adequate protection against Omicron sub-lineages (8). This gradual decline in compliance with CDC recommendations for receiving primary and booster vaccinations and the concomitant lackadaisical approach to maintaining appropriate safety precautions are converging factors that are leading to an observed increase in infection from Omicron BA.4 and BA.5 sub-lineages. As depicted in Table 1 and 2, in the last 28 days, there is a marked increase in both the frequency of infection as well death from COVID-19. In the last 28 days, in United States, over 27 million people have been infected with SARS-CoV-2 virus and during the same period over 55,000 people have died (Table 1). In Texas during the same period, over 300,000 people have been diagnosed as COVID-19 positive and 385 people have died (Table 1). Additionally, in the last 28 days in the G-RGV, over 22,000 people have been diagnosed with SARS-CoV-2 infection and 34 people have died because of COVID-19 (Table 2). It is noteworthy that positive home tests are not reported to the central registry thus it is highly likely that these numbers are not reflective of the actual incidence of SARS-CoV-2 infection in the community. From the evidence presented above, we conclude that the COVID-19 is still a pandemic and has the potential to cause more fatality if adequate measures are not taken promptly. We recommend that people seriously consider getting vaccinated and observe safety precautions to abate the incidence of SARS-CoV-2 infection, reduce the frequency of mutations, and minimize the attendant lethality. Funding: The project was funded by a Seed Grant from the DHR Health Institute for Research & Development and the DHR Health Conflict of Interest: The authors have reported no conflict of interest Rao, et al Rising Incidence of SARS-CoV-2 Infection https://doi.org/10.47488/dhrp.v2iS3.68 DHR Proceedings ǀ http://dhrproceedings.org 12 2022, Vol. 2 No. S3 10-15 References 1. COVID-19 – China. World Health Organization. January 5, 2020. https://www.who.int/emergencies/disease- outbreak-news/item/2020-DON229 2. Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, Spitters C, Ericson K, Wilkerson S, Tural A, Diaz G, Cohn A, Fox L, Patel A, Gerber SI, Kim L, Tong S, Lu X, Lindstrom S, Pallansch MA, Weldon WC, Biggs HM, Uyeki TM, Pillai SK; Washington State 2019-nCoV Case Investigation Team. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med. 2020 Mar 5;382(10):929-936. doi: 10.1056/NEJMoa2001191. Epub 2020 Jan 31. PMID: 32004427; PMCID: PMC7092802. 3. Our Changing Population – Texas. USA Facts. https://usafacts.org/data/topics/people- society/population-and-demographics/our- changing- population/state/texas?utm_source=google& utm_medium=cpc&utm_campaign=&msclk id=17d027689f6f128bad6d458fa7f6ef24 4. Johns Hopkins University & Medicine. COVID-19 Resource Center. https://coronavirus.jhu.edu/map.html 5. Thanh Le T, Andreadakis Z, Kumar A, et. al. The COVID-19 Vaccine Landscape. May 2020. Nature Reviews. Drug Discovery. 19 (5): 305-306. doi: https://doi.org/10.1038/d41573-020-00073-5 6. Le TT, Cramer JP, Chen R, Mayhew S (October 2020). "Evolution of the COVID-19 vaccine development landscape". Nature Reviews. Drug Discovery. 19 (10): 667–668. doi:10.1038/d41573-020-00151-8. PMID 32887942. S2CID 221503034 7. COVID-19 Vaccination Data – United States. CDC. https://covid.cdc.gov/covid- data-tracker/#vaccinations_vacc-people- additional-dose-totalpop (Data accessed as of July 27, 2022 @ 06;00 hrs EST). 8. Bowen JE, Addetia A, Dang HV, et.al. Omicron spike function and neutralizing activity elicited by a comprehensive panel of vaccines. Science. 2022 Jul 19:eabq0203. doi: 10.1126/science.abq0203. Epub ahead of print. PMID: 35857529. Rao, et al Rising Incidence of SARS-CoV-2 Infection https://doi.org/10.47488/dhrp.v2iS3.68 DHR Proceedings ǀ http://dhrproceedings.org 13 2022, Vol. 2 No. S3 10-15 TABLE 1: NUMBER OF COVID-19 POSITIVE CASES AND DEATHS AS OF THE START OF THE PANDEMIC AND IN THE LAST 28 DAYS* *as of July 28, 2022 @ 16:00 hours Rao, et al Rising Incidence of SARS-CoV-2 Infection https://doi.org/10.47488/dhrp.v2iS3.68 DHR Proceedings ǀ http://dhrproceedings.org 14 2022, Vol. 2 No. S3 10-15 TABLE 2: NUMBER OF COVID-19 POSITIVE CASES AND DEATHS IN THE GREATER RIO GRANDE VALLEY, SOUTH TEXAS AS OF THE START OF THE PANDEMIC AND IN THE LAST 28 DAYS* *as of July 28, 2022 @ 16:00 hours Rao, et al Rising Incidence of SARS-CoV-2 Infection https://doi.org/10.47488/dhrp.v2iS3.68 DHR Proceedings ǀ http://dhrproceedings.org 15 2022, Vol. 2 No. S3 10-15 FIGURE 1: COVID-19 VACCINATION IN THE UNITED STATES* (Adopted from: https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-people-additional-dose- totalpop) *as of July 27, 2022 @ 06:00 hours EST **Fully Vaccinated: Having received two doses of primary vaccination of mRNA vaccine https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-people-additional-dose-totalpop https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-people-additional-dose-totalpop