POST 219. December 9, 2021. CORONAVIRUS. “Entering uncharted territory, the U.S. counts 500,000 Covid-related deaths.”… “So yes, I am furious at the unvaccinated, and I am not ashamed of disclosing that. I am no longer trying to understand them or educate them.”

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“The United States reached a staggering milestone on Monday, surpassing 500,000 known coronavirus-related deaths in a pandemic that has lasted almost a year. The nation’s total virus toll is higher than in any other country in the world. It has far surpassed early predictions of loss by some federal experts. And it means that more Americans have died from Covid-19 than did on the battlefields of World War I, World War II and the Vietnam War combined.

“The magnitude of it is just horrifying,” said Jeffrey Shaman, a professor of environmental health sciences at Columbia University who has modeled the virus’s spread and says that the scale of loss was not inevitable, but a result of the failure to control the virus’s spread in the United States.

The United States accounts for about 20 percent of the world’s known coronavirus-related deaths, but makes up just 4.25 percent of the global population.

About one in 670 Americans has died of Covid-19, which has become a leading cause of death in the country, along with heart disease and cancer, and has driven down life expectancy more sharply than in decades. The losses have been searingly personal for the relatives and friends of the 500,000.” (A)

“Geisinger, one of Pennsylvania’s largest health systems has run out of beds due to the COVID surge, causing patients to wait 10 to 20 hours in the emergency department, officials said Wednesday.

Officials said doctors and nurses are having to perform “waiting room medicine” on waiting patients.

Geisinger is operating at 110 percent capacity in its nine hospitals located in central and northeastern Pennsylvania. A quarter to over half of admissions are unvaccinated COVID patients, Dr. Jaewon Ryu, Geisinger’s president and chief executive officer, said. Citing the increasing number of cases and percentage of positive tests, he expects the situation to worsen. (B)

“Citing a temporary federal injunction, Bayhealth and Beebe Healthcare will no longer require employees to get their COVID-19 vaccine as a condition of employment.

A federal judge on Tuesday blocked President Joe Biden’s mandate that all health care workers must receive the vaccine, which was set to go into place next week. The original requirement would have forced workers to get the first dose by Dec. 6 and the second dose by Jan. 4.

In a Dec. 1 email to employees, Shana Ross, vice president of human resources, wrote that Bayhealth will no longer fire employees who have not received their first COVID-19 vaccine dose by Dec. 6, according to an email obtained by Delaware Online/The News Journal.

Bayhealth will continue to “strongly urge all employees to get vaccinated consistent with our commitment to maintaining a safe environment for all patients, employees, physicians and visitors,” according to the email.

The health system will still follow Delaware’s directive of health workers either receiving the vaccine or undergoing regular testing, according to the email. A spokesperson could not be reached for comment.” (C)

“Moderna CEO Stephane Bancel on Monday said it will take months to develop and ship a vaccine that specifically targets the omicron variant of the virus that causes Covid-19.

However, a higher 100-microgram dose of the company’s booster shot could be ready much sooner.

“The higher dose could be done right away but it will be months before the omicron specific variant is ready to ship in massive quantities,” Bancel told CNBC’s “Squawk Box.”

Bancel said Moderna believes the omicron variant is highly infectious, but it will take at least two weeks to determine how much the mutations have impacted the efficacy of the vaccines currently on the market.

“Depending on how much it dropped, we might decide on the one hand to give a higher dose of the current vaccine around the world to protect people, maybe people at very high risk, the immunocompromised, and the elderly should need a fourth dose” he said.” (D)

“Because the Delta variant of coronavirus spreads easier than the original virus, the proportion of the population that needs to be vaccinated to reach “herd immunity” protection could be upwards of 80% or more, experts say.

Also, it could be time to consider wearing an N95 mask in public indoor spaces, regardless of vaccination status, according to a media briefing today sponsored by the Infectious Diseases Society of America.

Furthermore, getting booster shots to the fully vaccinated is not the top public health priority now. Instead, third immunizations should be reserved for more vulnerable populations – and efforts should focus on getting first vaccinations to unvaccinated people in the U.S. and around the world.

“The problem here is that the Delta variant is … more transmissible than the original virus. That pushes the overall population herd immunity threshold much higher,” Ricardo Franco, MD, assistant professor of medicine at the University of Alabama at Birmingham, said during the briefing.

“For Delta, those threshold estimates go well over 80% and may be approaching 90%,” he said.

To put that figure in context, the original coronavirus required an estimated 67% of the population to be vaccinated to achieve herd immunity. Also, measles has one of the highest herd immunity thresholds at 95%, Franco added.” (E)

“New Jersey’s COVID-19 hospitalizations have more than doubled in a month and are expected to continue to rise due to Thanksgiving gatherings, a busy travel season and more indoor holiday celebrations as Christmas and New Year’s Eve approach, health officials said Wednesday.

The 1,409 COVID patients in New Jersey hospital beds on Tuesday was the highest since May 2 and higher than any day during the summer, when the highly contagious delta variant propelled an unexpected surge. About 75% to 80% are unvaccinated.

The rising numbers, along with news of the omicron variant circulating in the U.S., have caused a surge in demand for booster shots. Many providers are no longer allowing walk-ins, and appointments are sometimes weeks away at some of the largest pharmacy chains.” (F)

“As new COVID infections, hospitalizations and the rate of transmission (r/t) continues to rise in New Jersey, there are growing concerns about staffing shortages at hospitals across the Garden State.

During Wednesday’s virtual coronavirus response press conference, New Jersey Department of Health Commissioner Judith Persichilli said she has been speaking to a number of hospital CEOs about the shortages they face, adding that there are multiple factors responsible for the shortages, including exhaustion.

Why are hospitals short-staffed?

Burnout is one challenge facing health care workers amid the pandemic.

“Those that have worked over the past 22 months taking care of patients that are suffering from COVID, the nurses are tired and they’re burned out,” Persichilli said.

She said besides burnout, another factor is “age out,” where many nurses who were near retirement have now decided it’s time to pack things in and stop working.

Persichilli said there is also the issue of “buyout,” where nurses are being offered “very attractive packages from staffing agencies, for individuals to leave and work as an agency nurse or sometimes a traveling nurse.”

She noted, “In some cases they’re not only bought out, they’re then sold back to the hospitals that they had just left.” (G)

“The first cases of influenza have been detected in Marin County pointing to the start of flu season which typically kills thousands of people each year.

On average influenza kills between 20,000 – 50,000 Americans each year, and now experts are concerned we might be entering a “twindemic” with cases of the COVID-19 variant omicron likely to rise.

“We don’t know whether Omicron will add substantially to that or not. But, Delta is enough of a problem as it is. We don’t want people ending up at the hospital with Delta and people winding in the hospital with the influenza and hospital beds getting filled and the ICU beds getting with both of these patients,” said Dr. John Swartzberg, UC Berkeley Clinical Professor Emeritus & Infectious Disease Expert.

Dr. Swartzberg says we are about two weeks from seeing how fast influenza will spread this year.

That’s about the same time scientists say we’ll have more data on omicron’s transmission rate. Based on this data, experts says the flu shot is necessary.” (H)

“The Senate voted Wednesday to block President Joe Biden’s vaccine mandate on private employers in the latest blow to his push to flex federal power to boost vaccinations in the U.S.

The measure to block the mandate heads to the Democratic-held House. It faces a tougher path to passage in the House, and the Biden administration has threatened a veto if it reaches the president’s desk.

Because the mandate itself has a slim chance of becoming law, the measure to overturn it will have little practical effect. A federal court has already halted the administration’s Covid vaccination and testing requirements for private businesses with 100 or more employees.

Even so, the vote underscores resistance to the Biden policy even among Democrats who represent red states. It reflects the White House’s struggle to increase U.S. vaccinations and booster shots as the highly mutated omicron variant — which has shown the potential to evade protection offered by a two-dose vaccine regimen — starts to gain a foothold around the country.

The Senate approved the measure in a 52-48 vote. Sens. Joe Manchin, D-W.V., and Jon Tester, D-Mont., joined every Republican in supporting it. It needed only a simple majority to pass under the Congressional Review Act, a process that allows Congress to overturn rules made by federal agencies.

Republicans who introduced the plan to overturn the mandate argued it would damage small businesses as they try to navigate the pandemic.

“That is the heavy hand of government, that is overreach,” Sen. Mike Braun, R-Ind., said on Wednesday.” (I)

“Nearly two years into the Covid-19 pandemic, the world remains “dangerously unprepared” for the next major outbreak, according to a new report.

The 2021 Global Health Security Index, released on Wednesday, ranks 195 countries according to their capacity to respond to epidemics and pandemics. The inaugural version of the index, published just months before the first Covid-19 cases were detected, concluded that no nation was ready for such a crisis.

Overall, the world is not any better prepared today, according to the 2021 index, which was created by the Nuclear Threat Initiative, a global security nonprofit group, and the Johns Hopkins Center for Health Security at the Johns Hopkins University Bloomberg School of Public Health.

“I would call this a damning report,” said Dr. Rick Bright, the chief executive of the Rockefeller Foundation’s Pandemic Prevention Institute, who was not involved in creating the index. “The world is not ready.”” (J)

“I am disappointed, and I am angry, not just with my friend but with all the people who are choosing not to get vaccinated.

There was a point, earlier on in the pandemic, when vaccines were still scarce, when I tried to be tolerant with the holdouts, tried not to shame them, tried not to be angry with them, tried to allow them time to educate themselves about the benefits of getting vaccinated.

But that time has long since passed for me. Call me one of the intolerant. That’s what I am. I will not coddle willful ignorance anymore. I will not indulge the fool’s errand of “I’m still doing my own research” anymore, either.

This virus has already killed nearly 800,000 Americans and infected nearly 50 million. We are now averaging about 120,000 new cases a day.

This virus is deadly and unrelenting. The only way out of this situation, for our country and the world, is through the vaccines. We must dramatically shrink the number of people vulnerable to the virus — or else we risk allowing our population to act as a petri dish for the growth of variants.

I have heard all the reasons for resistance. There are the people who have politicized the virus and see getting vaccinated through a partisan lens. There are the people who view government pressure, and especially mandates, to put something in your body as overreach and anathema to the American ideal of independence and freedom. There are people who don’t trust the government, sometimes with good reason…

So yes, I am furious at the unvaccinated, and I am not ashamed of disclosing that. I am no longer trying to understand them or educate them. Barriers to access have fallen. The only reason for remaining unvaccinated that I now accept is from people who have medical conditions that prevent it.

All others have a choice to either be part of the solution or part of the problem. The unvaccinated are choosing to be part of the problem.” (K)

“The governors of Maine and New York deployed the National Guard in response to dangerously low capacity at statewide medical facilities due to the pandemic.

The New York National Guard announced Wednesday that it had deployed 120 medics and medical technicians to a dozen long-term care facilities statewide. The deployment came at the behest of Gov. Kathy Hochul, who issued the order last week in response to staffing shortages.

Service members deployed to facilities in Syracuse, Rochester, Albany, Buffalo, Utica, Plattsburgh, Uniondale, Liberty, Vestal, Olean, Lyons and Goshen, the Guard said in a statement.

Hochul has indicated that she may deploy the Guard to hospitals as well — as of last week, some 50 hospitals in northern New York had less than 10% bed capacity in large part due to lack of staff.

In Maine, Gov. Janet Mills activated the National Guard following a spike in Covid-19 cases.

“I do not take this action lightly, but we must take steps to alleviate the strain on our health care system and ensure care for all those who need it,” Mills said in a statement.

The state reported a record-high of 379 people hospitalized with Covid-19 as of Wednesday, 60 of whom were on ventilators.

Mills’ office said in a statement Wednesday that Maine had only 42 ICU beds available statewide.

Some 73% of Maine residents have received a full initial dose of Covid-19 vaccine, according to state data, with 16% of the population receiving a booster shot.

New Hampshire governor calls on FEMA and National Guard to prepare for winter Covid-19 surge

Epidemiologist Michael Osterholm said Wednesday he thinks the whole country will see Covid-19 case numbers go up in coming weeks. Already 23 states have had more than a 20% increase in case numbers in just the last two weeks.

There have been surges in the Northeast and the surges in the upper Midwest have been “dire,” said Osterholm.

“But we expect to see other areas of the country also light up in the next several weeks,” Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told CNN’s Erin Burnett.

The biggest problem are the unvaccinated. “We have tried everything from public relations to incentive offers, to just having people see what’s happening in our intensive care units and we still have that reluctant group of individuals that just won’t get vaccinated,” said Osterholm. (L)