“A lot has changed since early 2020, when countries around the world first realized the potential threat of a highly contagious, and still mysterious, flulike virus.
In the early days of the coronavirus pandemic, no one knew for sure how the virus spread. People were scrubbing their groceries. Governments urged people to stay home, to wash their hands frequently and to avoid touching their faces.
Masks quickly emerged as a point of confusion, as public health officials at first discouraged people from wearing them, citing shortages, and then endorsed them. Mask mandates became a flash point in the culture wars as states, counties and cities across the country adopted a patchwork of policies.
On Tuesday, the Centers for Disease Control and Prevention said that it was no longer necessary for fully vaccinated people to wear masks in small groups outdoors, bringing the public guidance in line with a growing body of research indicating that the risk of spreading the coronavirus is much greater indoors.
Here is how the public health guidance on masking in the United States has shifted since the start of the pandemic.
FEBRUARY 2020
‘Stop buying masks,’ surgeon general pleads
“Seriously people — STOP BUYING MASKS!” the surgeon general at the time, Dr. Jerome M. Adams, wrote on Twitter in February 2020. “They are NOT effective in preventing general public from catching #Coronavirus, but if health care providers can’t get them to care for sick patients, it puts them and our communities at risk!”
APRIL 2020
A change in policy, with more mixed messaging
In April, officials reversed course, with the C.D.C. urging all Americans to wear a mask outside their homes to supplement other public health measures, such as social distancing and hand washing.
SEPTEMBER 2020
Health officials speak out for masks
Many officials have emphasized the public health benefits of masks. In September, Dr. Robert R. Redfield, then the C.D.C.’s director, told a Senate committee that masks were “the most important, powerful public health tool we have” for fighting the pandemic, adding that the universal use of face coverings could bring the pandemic under control in months.
JANUARY 2021
President Biden imposes some masking rules
President Biden in January used his executive authority to impose mask requirements where he could — including on federal property and in interstate travel.
MARCH 2021
The C.D.C. issues its first guidelines for vaccinated people
In March, almost exactly a year since the pandemic first gripped Americans in fear, the C.D.C. said that people who had been fully vaccinated against the coronavirus could gather in small groups indoors without masks or social distancing. Vaccinated adults could begin to plan mask-free dinners with vaccinated friends, the agency said.
MARCH 2021
States begin lifting mask mandates
With vaccinations on the rise, some states began lifting mask mandates. Others, including Florida and South Dakota, never had one.
Gov. Greg Abbott of Texas, a Republican, lifted the mask mandate and capacity limits on all businesses starting March 10. The order ensured that “all businesses and families in Texas have the freedom to determine their own destiny,” Mr. Abbott said.
APRIL 2021
C.D.C. relaxes masking advice for people who gather outdoors
On April 27, the C.D.C. said that fully vaccinated people generally no longer needed to wear masks outdoors, but should continue to wear them at indoor gatherings or at crowded outdoor events. People who haven’t gotten their shots can also go without a mask in small gatherings held outside as long as they are with fully vaccinated friends and family, the agency said.
Vaccinated adults should continue to wear masks and stay at least six feet from others in large public spaces — such as at outdoor performances or sporting events, or in shopping malls and movie theaters — where the vaccination and health status of others would be unknown, the agency said. And they should still avoid medium-size and large gatherings, crowds and poorly ventilated spaces, officials said.
A growing body of research indicates that the risk of spreading the virus is far lower outdoors than indoors. Viral particles quickly disperse outdoors, public health officials have said, so the transmission risk is far lower, though not impossible.
“I think it’s pretty common sense now that outdoor risk is really, really quite low,” Dr. Fauci said Sunday on “This Week” on ABC. Particularly “if you are a vaccinated person, wearing a mask outdoors — I mean, obviously, the risk is minuscule.” “ (A)
“The Centers for Disease Control and Prevention says people who are fully vaccinated do not need to wear a mask when they’re outdoors unless they’re in a crowd, such as attending a live performance, sporting event or parade. People are considered fully vaccinated two weeks after receiving the second dose of the Pfizer or Moderna vaccines, or two weeks after the single dose of the Johnson & Johnson shot.
“If you are vaccinated, things are much safer for you,” CDC Director Rochelle Walensky said Tuesday at a White House briefing. “If you are fully vaccinated and want to attend a small outdoor gathering — with people who are vaccinated and unvaccinated — or dine at an outdoor restaurant with friends from multiple households, the science shows you can do so safely, unmasked.”
As part of the new guidance, the agency spelled out settings in which it’s OK for fully vaccinated people to be unmasked, including:
Walking, running, hiking or biking outdoors alone or with members of your household;
Attending a small outdoor gathering with fully vaccinated family and friends;
Attending a small outdoor gathering with a mixture of fully vaccinated and unvaccinated people;
Dining at an outdoor restaurant with friends from multiple households.
And, the risk is low enough that even unvaccinated people can exercise, bike and hike outside and attend small outdoor gatherings with fully vaccinated friends and family without wearing a mask.
“We continue to recommend masking in crowded outdoor settings and venues such as packed stadiums and concerts where there is decreased ability to maintain physical distance and where many unvaccinated people may also be present,” Walensky said. “We will continue to recommend this until widespread vaccination is achieved.”…
The agency lists a range of settings where masking is still recommended for people who are fully vaccinated:
Attending a crowded outdoor event such as a live performance, parade or sporting event;
Visiting a barber or hair salon;
Visiting an indoor shopping mall or museum;
Riding public transport;
Attending a small indoor gathering with a mixture of fully vaccinated and unvaccinated people;
Going to an indoor movie theater;
Attending a full capacity service at a house of worship. (B)
Three reasons public masking is still important — no matter your vaccination status
A handful of states have lifted their mask mandates — and plenty of them never introduced them in the first place. But that doesn’t mean people shouldn’t still wear masks in public, according to infectious disease experts. Especially now, when most people are still unvaccinated and some places are seeing surging case numbers.
1) Lots of people remain vulnerable to infection who can’t get a vaccine yet — including babies and kids. Some of them also can’t wear masks…
2) New variants could put us all at higher risk…
3) When the majority still isn’t vaccinated, masks help others feel safer… (C)
Where masks are extra important, and where we might be able to ease up
As people graduate to full vaccination status — two weeks after their final dose — they can finally restart many activities, such as close gatherings with small groups of vaccinated friends. But they also don’t yet have carte blanche to do everything mask-free. “Nobody loves wearing masks, but they give us that added level of protection and you can do activities that we all want to be doing,” Guthrie says.
The types of places where it’s highest-priority for everyone to continue masking include mass transit, airports, and other venues where people from different areas are mixing; locations with vulnerable individuals such as hospitals and long-term care facilities; gyms; and stores where distancing is difficult.
The new CDC guidance notes that even with a mask on, certain indoor venues — including movie theaters, high-intensity exercise classes, and full-capacity religious services — remain among the “least safe” places for people who are unvaccinated.
In general, “indoor, crowded, unventilated spaces have always been the most unsafe,” Gandhi says — and are the most important venues to keep a mask on. “The longer people share the same air indoors, the more chance there is of spread,” Smith adds.
In areas where cases and hospitalizations are high, such as Michigan, Colorado, New Jersey, and Pennsylvania, masking indoors is especially crucial.
And, of course, public places — especially indoors — where people will not always be wearing masks remain chancy, particularly for those who are unvaccinated. These include indoor restaurants and bars, which have long been known to be frequent loci of Covid-19 transmission.” (D)
“More than a month has passed since Gov. Greg Abbott ended virtually all statewide restrictions related to the coronavirus pandemic. Nationwide, new coronavirus cases are on the rise as new variants of the virus spread. And about four-fifths of Texans are not yet fully vaccinated.
But at least for now, the most dire predictions of a new major wave of cases in Texas have not come true, prompting a mix of theories from public health experts.
Those experts caution that a major increase in cases could still come and it may still be too early to tell whether Abbott’s decisions to lift the statewide mask mandate and allow businesses to fully reopen could prompt a new wave of infections. Still, daily new cases and the positivity rate have leveled off over the past month, while deaths and hospitalization have gone down substantially.
Experts point out that vaccination is ramping up, many businesses are still requiring masks and there are unique factors impacting individual metrics — like a drop in demand for testing that is driving down raw case numbers.
They also emphasize that, especially at this point in the pandemic, a stabilization of such metrics, or even a modest decline, is not exactly cause for celebration.
“I think we could’ve been even lower at this point in time,” if not for Abbott’s latest decisions, said Dr. Luis Ostrosky, an infectious disease specialist at UTHealth’s McGovern Medical School in Houston. “The fact that we’re sort of stable is not necessarily good news — because we’re stable at a very high level. It’s like everybody saying you’re at a stable cruising speed — but at 100 miles per hour.”..
The nation’s top infectious disease expert, Dr. Anthony Fauci, was asked in a TV interview last week about Texas’ numbers and gave an uncertain response about what was driving them at the moment. Speaking with MSNBC, he said “it can be confusing because you may see a lag and a delay because often you have to wait a few weeks before you see the effect of what you’re doing right now.”
“We’ve been fooled before by situations where people begin to open up, nothing happens and then all of a sudden, several weeks later, things start exploding on you,” Fauci said. “So we’ve got to be careful we don’t prematurely judge that.”
Until recently, Abbott has been restrained in openly touting the Texas trend lines, instead focusing much of his celebratory public messaging on vaccination progress.
“We absolutely are not declaring victory at this time,” Abbott told Fox News on Sunday. “We remain very vigilant and guarded and proactive in our response, but there’s simple math behind the reason why we continue to have success,” he added, citing the combination of increasing vaccinations and the “acquired immunity” among Texans who have already had the virus and recovered from it.
E.Texas coronavirus cases haven’t surged since Gov. Greg Abbott lifted the mask order. Experts warn it’s too soon to celebrate., Daily new cases and the positivity rate have leveled off over the past month, while deaths and hospitalization have gone down substantially., BY PATRICK SVITEK, https://www.texastribune.org/2021/04/14/texas-coronavirus-mask-order-abbott/
CDC – Interim Public Health Recommendations for Fully Vaccinated People
Underscores that immunocompromised people need to consult their healthcare provider about these recommendations, even if fully vaccinated.
Fully vaccinated people no longer need to wear a mask outdoors, except in certain crowded settings and venues.
Clarification that fully vaccinated workers no longer need to be restricted from work following an exposure as long as they are asymptomatic.
Fully vaccinated residents of non-healthcare congregate settings no longer need to quarantine following a known exposure.
Fully vaccinated asymptomatic people without an exposure may be exempted from routine screening testing, if feasible.
Key Points
This set of public health recommendations for fully vaccinated people will be updated and expanded based on the level of community spread of SARS-CoV-2, the proportion of the population that is fully vaccinated, and the rapidly evolving science on COVID-19 vaccines.
For the purposes of this guidance, people are considered fully vaccinated for COVID-19 ≥2 weeks after they have received the second dose in a 2-dose series (Pfizer-BioNTech or Moderna), or ≥2 weeks after they have received a single-dose vaccine (Johnson and Johnson (J&J)/Janssen).±
± This guidance applies to COVID-19 vaccines currently authorized for emergency use by the U.S. Food and Drug Administration: Pfizer-BioNTech, Moderna, and Johnson and Johnson (J&J)/Janssen COVID-19 vaccines. This guidance can also be applied to COVID-19 vaccines that have been authorized for emergency use by the World Health Organization (e.g. AstraZeneca/Oxford).
The following recommendations apply to non-healthcare settings. For related information for healthcare settings, visit Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination.
Fully vaccinated people can:
Visit with other fully vaccinated people indoors without wearing masks or physical distancing
Visit with unvaccinated people (including children) from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing
Participate in outdoor activities and recreation without a mask, except in certain crowded settings and venues
Resume domestic travel and refrain from testing before or after travel or self-quarantine after travel
Refrain from testing before leaving the United States for international travel (unless required by the destination) and refrain from self-quarantine after arriving back in the United States
Refrain from testing following a known exposure, if asymptomatic, with some exceptions for specific settings
Refrain from quarantine following a known exposure if asymptomatic
Refrain from routine screening testing if asymptomatic and feasible
For now, fully vaccinated people should continue to:
Take precautions in indoor public settings like wearing a well-fitted mask
Wear well-fitted masks when visiting indoors with unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease
Wear well-fitted masks when visiting indoors with unvaccinated people from multiple households
Avoid indoor large-sized in-person gatherings
Get tested if experiencing COVID-19 symptoms
Follow guidance issued by individual employers
Follow CDC and health department travel requirements and recommendations (F)
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
POST 96. December 26, 2020. CORONAVIRUS. “Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci…”…”..he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….”
POST 97. December 27, 2020. “A new variant of the coronavirus that has been spreading through the UK and other countries has not yet been detected in the United States..”.. . But if new-wave medicines like antivirals and antibody therapy contributed to the development of viral variants, it will be “a reminder for all the medical community that we need to use these treatment options carefully.”
POST 99. December 29, 2020. CORONAVIRUS. “ICUs are being overwhelmed across many parts of California. Statewide aggregate ICU availability has been at 0% since Christmas Eve…. a surge on top of a surge on top of a surge.”… “hospitals are getting close to the point where they would begin putting COVID-positive patients under the care of COVID-positive staff who are asymptomatic.”
POST 100. December 29, 2020. CORONAVIRUS. Front line hospital workers – in the ER, ICUs, EMS, acute medical care, behavioral health – are amongst the most courageous, heroic and dedicated colleagues you will ever meet.
POST 101. December 30, 2020.CORONAVIRUS. Is there a point where the increasing Coronavirus trajectory so far exceeds the slow growth of the vaccination rate that reaching herd immunity through vaccinations becomes less likely?
POST 102. January 2, 2020. CORONAVIRUS. “We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination — which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, the dean of Brown University’s School of Public Health. “Ultimately, the buck seems to stop with no one,”…
POST 103. January 4, 2021. CORONAVIRUS. Dr. Fauci said “that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses…Dr. Moore – ”British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”
POST 104. January 6, 2021. CORONAVIRUS. “Paramedics in Southern California are being told to conserve oxygen and not to bring patients to the hospital who have little chance of survival…”
POST 105. January 8, 2021. CORONAVIRUS. POST 105. January 8, 2021. CORONAVIRUS. “Facing a shortage of vaccinators, the Association of Immunization Managers… recommends relaxing regulation or adjusting licensing requirements. At least two states, Massachusetts and New York, have changed their laws in recent weeks to expand those who are eligible to give shots.”
POST 106. January 9, 2021. CORONAVIRUS. The riots at the Capitol could have been a superspreader event. “From what I saw… you had a large congregation of individuals who were in close contact for an extended period of time and almost universally unmasked…. many coming and going on buses as well, also unmasked, and hanging out in hotel lobbies.”
POST 107. January 8, 2021. CORONAVIRUS. “Our job is to make sure the vaccine isn’t politicized the way masks were politicized,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said after getting her vaccine. South Carolina Rep.-elect Nancy Mace, a Republican, wrote that “Congress shouldn’t be putting themselves first in line for the COVID-19 vaccination when the average American can’t get it.”
POST 108. January 9, 2021. CORONAVIRUS. (vaccination)”Line-cutters will be named and shamed. It’s inevitable, as will be the congressional hearings and front-page investigative stories ferreting out who saved their own skin at the expense of others.”
POST 109.January 9, 2021. CORONAVIRUS. “President-elect Joe Biden will aim to release nearly every available dose of the coronavirus vaccine when he takes office, a break with the Trump administration’s strategy of holding back half of US vaccine production to ensure second doses are available.
POST 110. January 13, 2021. CORONAVIRUS. ““The (federal) government is changing the way it allocates Covid vaccine doses, now basing it on how quickly states can administer shots and the size of their elderly population.”… “New York State sent a letter to hospitals saying if they don’t use their vaccine allocations by the end of this week, they won’t receive any further allocations.”
POST 111. January 14, 2021. CORONAVIRUS. “Visitors from Toronto to New York to Buenos Aires have long flocked to Florida for sun, surf and shopping. Now they are coming for the Covid-19 vaccine….
POST 112. January 14, 2021. CORONAVIRUS. CHINA – “Eleven million people are under lockdown in Hebei province after a new cluster of coronavirus infections.
PART 113. January 17, 2021. CORONAVIRUS. The Next President Actually Has a Covid Plan… New York City and other places in the state expect to exhaust their supply of doses as early as next week… Charles Barkley said during the “NBA on TNT” broadcast that pro athletes should get the first round of the vaccine…..
POST 114. January 18, 2021. CORONAVIRUS. “When government programs that have been unattended, underfunded and bogged down by red tape suddenly have to meet a huge demand in a crisis, they can’t cope and people suffer….”
POST 115. January 21, 2020. CORONAVIRUS. A year ago today an unnumbered POST was headlined “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.” The CORONAVIRUS CONTENT TRACKING PROJECT started with HISTORIOGRAPHY and over time moved to LESSONS LEARNED, RAPID RESPONSE, and THE VACCINATION PROGRAM. Now 115 POSTS later – the BIDEN CORONAVIRUS PLAN.
POST 116. January 22, 2021. President Biden – “We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation.”
POST 117. January 23, 2021. CORONAVIRUS. 1.Dr. Fauci:“The idea that you can get up here….”and.. let the science speak”… “It is somewhat of a liberating feeling.” 2.updated CDC guidance:”.. providers could give the second dose up to six weeks after the first dose..” 3.Dr. Fauci: people would be “taking a chance” if they follow the CDC’s updated guidance.
POST 118. January 24, 2021. CORONAVIRUS. “Unfortunately, we’ve let this virus spread extensively and are launching the vaccination campaign at the height of the threat,” Dr. Meyers said. “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.”
POST 119. January 27, 2010. CORONAVIRUS. Amazon is offering its help to President Joe Biden with the rollout of COVID-19 vaccines. Washington’s governor, Jay Inslee, included the help of companies like Starbucks, Costco and Microsoft in a plan to vaccinate 45,000 residents a day.
POST 120. January 28, 2021. CORONAVIRUS. “The fact that four vaccines backed by the federal government seem to be less effective against the (South African) B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.”
POST 121. January 30, 2021. CORONVIRUS. Will our communities become stratified by which vaccine is distributed? 95%ters v. 72%ters? Will the easier distribution of the J&J vaccine drive its inequitable distribution to” hard-hit, marginalized, and medically underserved communities.” (thanx! to XJ/LA)
POST 123. February 4, 2021. CORONAVIRUS. “Nursing homes across the country are facing the same struggle, as workers have been more reluctant than residents to be vaccinated…
POST 124. February 5, 2021. CORONAVIRUS. Dr. Osterholm ” …it may be time to..go with a ‘first-dose only’ approach, so more people over the age of 65 can have at least some protection right away. He said that would require delaying second doses until this summer.” Dr.Fauci “warned against this practice, and cautioned people about “the danger” that could come with focusing only on the first dose.”
POST 125. June 9, 2021. CORONAVIRUS. “States are rolling back Covid-19 restrictions as new cases trend down from record highs across the country. But experts warn it might be too much too soon as variants pose an increased risk and the pandemic… is far from over.”
POST 126. February 11, 2021. CORONAVIRUS. “There will be more coronavirus outbreaks in the future. Bats and other mammals are rife with strains and species of this abundant family of viruses. Some of these pathogens will inevitably spill over the species barrier and cause new pandemics. It’s only a matter of time.” (A)
POST 127. February 12, 2021. CORONAVIRUS. “… Trump only agreed to be hospitalized when aides told him that he could walk to Marine One or he could wait until his case progressed and he would be carried out.”
POST 128. February 14, 2021. CORONAVIRUS. “The Centers for Disease Control and Prevention released new research on Wednesday that found wearing a cloth mask over a surgical mask offers more protection against the coronavirus, as does tying knots on the ear loops of surgical masks…
POST 129. February 15, 2021, CORONAVIRUS. “ “The CDC released its much-anticipated, updated guidance to help school leaders decide how to safely bring students back into classrooms, or keep them there.”…” For politicians, parents and school leaders looking for a clear green light to reopen schools, this is not it.”
POST 130. February 16, 2021. CORONAVIRUS. “A second person who had contracted the Ebola virus died this week in the Democratic Republic of Congo, marking another outbreak just three months after the nation outlasted the virus’s second-worst outbreak in history…”
POST 131. February 17, 2021. CORONAVIRUS. “It really is right now – a race between how quickly new variants, particularly the U.K. variant, can spread in the United States and how quickly we can get people vaccinated”
POST 132. February 20, 2021. CORONAVIRUS. “In Texas, where over 2.5 million people are still without power, the state health department said this week’s vaccine shipments wouldn’t arrive until Wednesday at the earliest.”
POST 133. February 23, 2021. CORONAVIRUS. “Going off your meds is a surefire way to aggravate your doctor. What if a whole country did it?” The United Kingdom has veered into uncharted territory by changing tack and introducing a revised COVID-19 vaccination protocol, one that involves distributing the second dose at 12 weeks, rather than the prescribed 21 days.”
POST 134. February 24, 2021. CORONAVIRUS. The first tranche of the J&J (single dose) vaccine must go to K-12 teachers, so schools can open safely in the first 100 days of the Biden Administration. The federal government…”can set up its own vaccination centers in regions with eligible populations it’s trying to target.” We owe our front-line teachers nothing less!
POST 135. February 27, 2021. CORONAVIRUS. “As Chief Executive Officers of New York’s major health care systems, we would like to provide facts to clear up confusion in the public and the media regarding decisions to discharge patients to nursing homes during New York’s spring coronavirus surge.”
POST 136. March 2, 2021. CORONAVIRUS. ““The governors of Texas and Mississippi both announced on Tuesday they would be lifting their states’ mask mandates and rolling back many of their Covid-19 health mandates..”…while “The US could experience a “fourth surge” of coronavirus before the majority of the country is vaccinated.”
POST 137. March 4, 2021. CORONAVIRUS. “The clamor for hard-to-get Covid-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system. They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow? Some pharmacists have even given them a nickname: vaccine lurkers.” (H)
POST 138. March 6, 2021. CORONAVIRUS. “New cases are decreasing in the third wave because we are past the holidays, not because of vaccinations. It is a common misconception that the decrease we are seeing in new cases, hospitalizations, and deaths in the U.S. is due to vaccinations. The two aren’t related; at least yet.”
POST 139. March 8, 2021. CORONAVIRUS. CDC Issues First Set of Guidelines on How Fully Vaccinated People Can Visit Safely with Others…” In practice, that means fully vaccinated grandparents may visit unvaccinated healthy adult children and healthy grandchildren of the same household without masks or physical distancing.” (C)
POST 140. March 9, 2021. CORONAVIRUS. “In West Virginia, they are bracing for the second wave….. Not coronavirus but opioid overdoses, with one scourge driving a resurgence of the other.
POST 141. March 11, 2021. CORONAVIRUS. Today is the first anniversary of the WHO declaration that the novel coronavirus was a Public Health Emergency of International Concern… “To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like.”
POST 142. March 15, 2021. CORONAVIRUS. “Candida auris is a superbug, a pathogen that can evade drugs made to kill it—and early signs suggest the COVID-19 pandemic may be propelling infections of the highly dangerous yeast. That’s because C. auris is particularly prominent in hospital settings, which have been flooded with people this year due to the coronavirus.”
POST 143. March 17, 2021. CORONAVIRUS. “The Trump administration sought to suppress Covid-19 testing in the United States last year by softening guidance from the Centers for Disease Control and Prevention on who needed to be tested, a House panel said Monday.”
POST 144. March 20, 2021. CORONAVIRUS. ““The vaccine hesitancy we are seeing isn’t just about Covid vaccines,”… “It is a general reflection of Americans’ lack of trust in science, the pharmaceutical industry, and large health care institutions. We need a full court press on science and vaccine education right now to prevent more aggressive Covid-19 variants from developing and taking hold.”
POST 145. March 25, 2021. CORONAVIRUS. “Efforts to disseminate Covid-19 vaccines as widely as possible are hitting an unexpected obstacle: health-care workers who decline the shots.
POST 146. March 30, 2021. CORONAVIRUS. Dr. Osterholm told Becker’s: “This is the perfect storm,”…”Here is Europe locking down and having problems containing B.1.1.7, even with vaccinations and previous infection histories. Here we are opening up as wide as we can. We are literally just walking into the mouth of the virus saying, ‘Don’t worry.’” (M)
POST 147. April 5, 2021. CORONAVIRUS. “The pandemic helped cement the shift to “a philosophy of really focusing on the role of the physician in reasoning through ambiguous and unknown problems as the focus of education, rather than teaching students that the role of physician was to memorize a body of knowledge that was already in existence and good enough for what usually happens.”
POST 148. April 7, 2021. CORONAVIRUS. While the Biden administration accelerates vaccinations to ward off numerous variants and as more young people are being hospitalized, states, even with increasing case rates are on paths to fully reopen. Politics v. public health!
POST 149. April 10, 2021. CORONAVIRIUS. “From Michigan to Massachusetts, COVID-19 cases and hospitalizations are on the rise again. Deaths will soon follow. “ ”.. the Biden administration is facing renewed calls to delay second vaccine doses and blanket more of the U.S. population with an initial shot.”
POST 150. April 10, 2021. CORONAVIRUS. “The use of so-called COVID-19 “vaccine passports” is quickly becoming a divisive issue across the US – with several states, including New York, embracing the idea, while others have already moved to ban them.”
POST 151. April 14, 2021. CORONAVIRUS. the J&J vaccination pause. “ Federal officials are concerned that doctors may not be trained to spot or treat the rare disorder if recipients of the vaccine develop symptoms of it…” “…a standard treatment for blood clots — use of an anticoagulant drug — could be dangerous or even fatal in such cases…”
POST 152. April 15, 2021. CORONAVIRUS. “The Chinese Center for Disease Control and Prevention’s director said Saturday authorities are considering mixing COVID-19 vaccines because the country’s domestically made doses “don’t have very high protection rates,”
POST 153. April 18, 2021. CORONAVIRUS. “At least 35 hospitals across Michigan were listed Thursday as nearing capacity and three were at full capacity for COVID-19 patients..”.. We can manufacture beds. We can open up beds. We can create entire wings of the hospital if we have to, but if we don’t have staff for those beds, we’ve got nothing.”..
POST 154. April 19, 2021. CORONAVIRUS. “Breakthrough infections, which occur when fully vaccinated people are infected by the pathogen that their shots were designed to protect against, are an entirely expected part of any vaccination process.” “Pfizer’s chief executive said that a third dose of the company’s Covid-19 vaccine was “likely” to be needed within a year of the initial two-dose inoculation — followed by annual vaccinations.”
POST 155. April 24, 2021. CORONAVIRUS. As the J&J vaccine pause is ended Senator Johnson said “The science tells us that vaccines are 95% effective. So if you have a vaccine, quite honestly, what do you care if your neighbor has one or not? I mean, what is it to you?”
POST 156. April 28, 2021. CORONAVIRUS. As CDC revises guidance on outdoor masking, Texas Governor Abbott says “the state is “very close” to herd immunity… despite acknowledging that he does not know what the herd immunity threshold is for the virus, an uncertainty echoed by the public health community.”
“People in the United States will once again be able to receive the one-shot Johnson & Johnson coronavirus vaccine after a review by the Centers for Disease Control and Prevention and the Food and Drug Administration. Federal health officials decided to end the pause on the vaccine, ultimately determining that its benefits far outweigh the rare risks of a severe blood clot. Officials said 15 vaccine recipients had developed the blood clot out of 8 million shots that were given. Overall, there were three deaths. State and local officials can now immediately resume giving out any of the vaccine they still have available.
In lifting the pause, the FDA decided against putting any limits on the use of the vaccine by age or gender. But Information about the rare possibility of blood clots will be made available at vaccination sites and the FDA and Johnson & Johnson will update the vaccine’s label so that it mentions the rare risk of blood clots. The label specifies that “most cases” have occurred in women between 18 and 49 years old. European regulators earlier in the week had come to the same decision that the risk was rare enough to allow the vaccine to be administered.” (G)
“Johnson & Johnson’s COVID vaccine will be made available to the public again, ending an 11-day pause initiated after a rare blood clotting disorder was associated with the shot.
The Food and Drug Administration and Centers for Disease Control and Prevention determined the benefits of the J&J vaccine outweighed the risks of keeping it off the market. Out of nearly 8 million who received the vaccine, 15 people have developed the condition and three have died.
The two agencies held a joint news conference Friday evening to announce their decision to allow distribution of the J&J vaccine to resume.
“Both agencies have full confidence that this vaccine’s known and potential benefits outweigh its known and potential risks in individuals 18 years and older,” said Dr. Janet Woodcock, the FDA’s acting commissioner.
The J&J vaccine should be available almost immediately, “by tomorrow morning even,” said Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research.
Everyone who receives the shot should receive an information sheet mentioning the rare clotting problem and the symptoms to look out for, officials said. Providers also will be given information about the condition and the appropriate treatment for managing it.
The rare condition involves a combination of blood clots, many in unusual locations such as the brain or abdomen, and low levels of platelets, which help wounds heal. It has been dubbed thrombosis with thrombocytopenia syndrome or TTS.
The unusual side effect, seen six to 14 days after receiving the J&J vaccine, seems to most often strike women under age 50.
The effect has not been seen with the two other vaccines authorized for use in the U.S., by Pfizer-BioNTech and Moderna, which have so far been given to about 130 million Americans.
Earlier Friday, a CDC advisory committee voted to resume distribution of the vaccine…
Resuming the use of the J&J vaccine in the United States would prevent 1,435 deaths from COVID-19 and 2,236 admissions to hospital intensive care units, according to a CDC analysis. It could cause approximately 24 cases of TTS, a CDC staffer said…
Women should be aware of this rare side effect, but if they’re unlikely to come back for a second dose, then they’re far better off getting the J&J than getting a single shot of Moderna or Pfizer-BioNTech, said Dr. Paul Offit, a pediatrician and head of the Vaccine Education Center at Children’s Hospital of Philadelphia.” (A)
“ACIP members heard from Tom Shimabukuro, MD, MPH, MBA, the deputy director of the Immunization Safety Office at the CDC, who shared that the agency had detected a total of 15 TTS cases, including 3 fatalities, up from 6 when the pause was first instated. The cases had been detected using the Vaccine Adverse Event Reporting System (VAERS).
“TTS is rare but clinically serious and potentially life threatening and a potentially life threatening adverse event that has been observed in association with the Janssen COVID-19 vaccine,” Shimabukuro said.
All 15 of the cases were women, and all but 2 were under the age of 50. Seven of the 16 cases were in women ages 30 to 39. As of Apr 21, Shimabukuro said the CDC was investigating less than 10 additional possible cases.
Seven of the 15 cases were in obese women, and two women were taking oral contraceptives. None had blood clotting disorders.
Of the 15 cases, 3 women died, 5 were recovered or recovering at home, and 7 remained hospitalized, including 4 in the intensive care unit. All women experienced symptom onset no sooner than 6 days post-vaccination, but no later than day 15, and all reported headache, fatigue, and abdominal pain.
Using the data that’s been collected, Shimabukuro said the risk of TTS from the J&J vaccine would be 7 TTS cases per 1 million doses administered to women ages 18 to 49. The risk for women older than 50 would be .9 per 1 million doses.
Shimabukuro said no TTS has been documented in recipients of the Moderna or Pfizer vaccines, the two mRNA vaccines authorized for COVID-19 in the United States…
Those who were in favor of lifting the pause said the 10-day window had allowed clinicians to understand the threat of TTS and improve clinical outcomes in patients. They also cautioned that most vaccination sites do not offer a choice of vaccines, but rather have one option for adult recipients.
In the end, the group decided to fully recommend the vaccine for use in all adults over the age of 18. Those who voted against lifting the pause argued the vaccine should contain patient warning language for women under the age of 50.
J&J said the company had agreed on warning language with the FDA, which will say the vaccine has, in rare instances, caused TSS in women under the age of 50.” (B)
“Specialists say the warning isn’t just a regulatory maneuver to please lawyers or to make clear the benefits outweigh the one-in-a-million risk. Instead, despite the disruption caused by the pause, there has been one clear public health benefit: Doctors are now aware of this rare complication, and how best to treat it.
“[The pause] has brought the condition to public and broader scientific attention,” said Dr. Laura Finn, director of hematology and bone marrow transplants at Ochsner Health.
The handful of initial cases were discovered when entered into the Department of Health and Human Services’ national Vaccine Adverse Event Reporting System database. They were investigated rapidly and revealed that if you get the J&J shot, you should be aware of the symptoms. Doctors will also be on alert for how to treat this uncommon disorder and, perhaps, just as importantly how not to treat it.
“This is a treatable condition if you recognize it right away,” Dr. Francis Collins, director of the National Institutes of Health, told “Good Morning America” Friday prior to the recommendation. “One of the reasons I think it’s been good to have this pause is to get everybody apprised of that so that all physicians know this is something to watch out for and can be prepared to treat it appropriately if it should happen again in the future.”
The pause will allow the CDC to offer recommendations and guidelines for doctors and patients, according to Dr. Simone Wildes, an infectious disease specialist at South Shore Health in Massachusetts.
Crucially, doctors have already been warned not to use a common blood thinner called heparin, which might accelerate the problem.
“Until we have a full grasp on this interplay of the vaccine, the blood system and anticoagulation, it’s best to avoid heparin when treating blood clots possibly related to a COVID-19 vaccine and treat with alternative anticoagulation medications and possibly IVIG (intravenous immunoglobulin) instead,” Finn told ABC News.
Meanwhile, anyone suspected of having a rare blood clot can be given a blood test screen for PF4 enzyme-linked immunosorbent, and consult with a hematologist that specializes in these types of clotting events.
Patients who get the J&J vaccine now know that the symptoms to watch out for are different than typical post-vaccine discomfort like a sore arm or flu-like symptoms that come on within 48 hours after the injection and usually go away within days.
The more rare, but concerning clots seem to come on within six to 15 days after injection and may include a persistent headache, a full-body rash, swelling, abdominal pain, leg pain and or shortness of breath. These are the symptoms for which you should contact your doctor immediately.
This warning is meant to empower patients and health care workers alike, because although the risks from the vaccine are extremely rare, the risk of complications from COVID-19 are significant.
“The risk of thrombosis with COVID-19 infection far outweighs the risk with any of the vaccines,” said Dr. Carol Gonsalves, a thrombosis expert and associate professor of medicine at the University of Ottawa. “It is in our best interest for personal safety but also our civic duty to be vaccinated.”” (C)
“Blood clots are formed by platelets, which bind together to form a clot, and typically a lot of them are needed to do that. The clots seen with the Johnson & Johnson vaccine formed even in patients who had low platelet counts in their bloodstream. That combination is unusual. Typically, when you have really low platelet counts—a condition called thrombocytopenia—you actually have problems with being able to form clots, and you can develop ongoing bleeding that is hard to stop. Furthermore, we’re seeing this phenomenon of clots forming in serious places such as the brain, the lungs, the legs or the abdomen, despite the fact that platelet counts are really low. That’s a very unique phenomenon. The closest thing we’ve seen is a rare condition called heparin-induced thrombocytopenia (HIT)…
What are the symptoms of these blood clots in people who have had the Johnson & Johnson vaccine?
They are different than some of the symptoms people experience right after getting their vaccination, such as fatigue, soreness at the injection site or joint aches. These sorts of things are common, they appear shortly after the vaccination, and they usually go away after about three to five days. The symptoms related to the blood clots tend to appear about a week or two after the vaccination and then continue to worsen. A headache that won’t go away is one symptom. Now, if you’ve just exerted yourself by going for a run or gardening in the sun on a hot day, you might have a headache, fatigue, leg or abdomen pain, or shortness of breath, but if you sit in a cool spot and drink some water, these will probably go away. But if you are experiencing these symptoms, and they continue to get worse despite the fact that you’re doing things that would normally make you feel better, that would be more concerning.
We’re not precisely sure yet, but it sounds like it should not be heparin because of the risk of HIT. There are similar, more expensive blood-thinner medications that may be able to treat these blood clots. An April 12 study in the BMJ recommended the use of non-heparin anticoagulants along with immunoglobulins—antibodies produced by white blood cells—to treat vaccine-induced clotting.
We don’t know for sure. But our leading hypothesis is that they might be associated with this antibody against the protein platelet factor four, PF4 for short. That antibody seems to be implicated in the AstraZeneca clots and also is the mechanism for heparin-induced thrombotic thrombocytopenia, so the evidence all seems to be pointing in the same direction. HITT Is definitively linked to that antibody. And we have some evidence that it may be implicated in the AstraZeneca and Johnson & Johnson clotting cases. Hopefully, as we get more evidence, it will make us more confident in that mechanism.” (D)
“Lifting the pause will allow states to restart vaccination efforts among hard-to-reach populations like rural Americans, migrants and elderly people who have difficulty leaving their homes. Their access to the vaccine had been hampered by the suspension, which left roughly 10 million doses sitting on shelves.
In Wisconsin, officials said they intended to begin using their Johnson & Johnson doses as soon as possible.
“We have also heard from a number of vaccinators who say that there are lots of people who don’t like needles,” said Julie Willems Van Dijk, the deputy secretary of the state health department. “They just want to get the vaccine that requires them to have one shot versus two shots.”
Dr. Rochelle P. Walensky, the C.D.C. director, said governors in a number of states had expressed intense interest in resuming use of the shots.
“They wondered why we had paused, and they were anxious to have this back, have an opportunity for a single-dose vaccine, for a one-and-done possibility,” she said.
About 135.8 million people in the United States have received at least one shot of a coronavirus vaccine. But daily doses have fallen by almost 13 percent since last week, from a peak of 3.38 million daily doses on average to about 2.95 million.
It is difficult to say what is driving the decrease. Even before use of the Johnson & Johnson vaccine was paused, shipments had dipped because of a factory error that had ruined millions of doses…
Dr. Walensky said the federal government planned to emphasize the vaccine’s safety to Americans who might be hesitant to take it after the pause.
“We have to do extraordinary outreach to clinicians, as we have been doing this past week,” she said. “We already have plans to start that on Monday, to public health officials. And then we have to do extraordinary outreach to patients, to meet people where they’re at, to educate them.”…
“As we did this intensive scientific evaluation over recent days, I think we became more and more confident about the decision that was made today,” Dr. Janet Woodcock, the acting F.D.A. commissioner, said on Friday…
Top U.S. health officials have stressed that finding the small number of cases of a rare disorder and pausing use of the vaccine demonstrated that safeguards were in place to assess risks and to raise awareness among doctors and hospitals about the unusual symptoms.
“This pause was essential to our ability to inform the public,” Dr. José R. Romero, chairman of the expert panel, the Advisory Committee on Immunization Practices, said on Friday.
A poll released this week from Ipsos/Axios found that the pause itself boosted confidence in federal vaccine monitors, with 81 percent saying that the C.D.C. and the F.D.A. acted appropriately. The sentiment was unusually bipartisan, with 87 percent of Republicans and 91 percent of Democrats sharing that view.
Measuring the impact of the Johnson & Johnson pause is tricky, said Liz Hamel, vice president of public opinion and research survey at the Kaiser Family Foundation. “You don’t know what the trajectory of the vaccine uptake would have been in the absence of this pause,” she said.
The biggest challenge ahead, she noted, will be the creation of vaccine-confidence messages that resonate with the public. “We don’t know whether it has increased hesitancy among women in particular,” she said.” (E)
“Sen. Ron Johnson on Thursday downplayed the urgency of vaccinating all Americans against Covid-19, putting the controversial Wisconsin Republican at odds with public health guidance aimed at easing the ongoing pandemic.
“The science tells us that vaccines are 95% effective. So if you have a vaccine, quite honestly, what do you care if your neighbor has one or not? I mean, what is it to you?” Johnson said in an interview with conservative radio host Vicki McKenna.
“You got a vaccine, and science is telling you it’s very, very effective. So why is this big push to make sure everybody gets a vaccine?” Johnson asked.
Johnson’s comments come as all states expanded their updated Covid-19 vaccine eligibility guidelines this week, opening up vaccinations to all Americans 16 years of age and older, and as the country’s leading medical experts urge all Americans to get a vaccine as soon as possible. Both President Joe Biden and Senate Minority Leader Mitch McConnell have stressed the importance of getting vaccinated and have encouraged Americans to do so.
In the McKenna interview, however, Johnson said he is skeptical of the “big push” to vaccinate all Americans.
“From my standpoint, because it’s not a fully approved vaccine, I think we probably should have limited the distribution to the vulnerable. To people that really aren’t, you know, for the very young, I see no reason to be pushing vaccines on people,” Johnson said.
Asked by CNN on Friday if he believed every American over the age of 16 should receive the vaccine, Johnson would not directly answer the question and instead insisted that he favored Americans making their own decisions about whether to get vaccinated.
“I believe government’s role (and therefore my role) is to help ensure transparency so that people have as much information as possible to make an informed decision for themselves,” Johnson said in a statement. “It is a legitimate question as to whether people at very low risk of suffering serious illness from Covid, particularly the young and healthy, should be encouraged to take a vaccine that is being administered under an Emergency Use Authorization — in other words, before it has been fully tested and fully approved.”
However, Johnson’s caution about the emergency use authorization is misleading. Both the Pfizer/BioNTech and Moderna vaccines — the two current US vaccination options — received emergency use authorization from the US Food and Drug Administration in December. For Pfizer/BioNTech, that includes everyone over the age of 16, and for Moderna, everyone who is 18 and older.” (F)
“After the Center for Disease Control signed off on the use of the Johnson & Johnson vaccine late Friday afternoon, Governor Andrew Cuomo said administration of the single-shot COVID vaccine will resume at all state-run sites ‘effective immediately.’
In a statement sent by the Governor Saturday morning, he said the following…
“World-renowned public health experts from the federal government and our own independent state task force have reviewed the data and reaffirmed that the use of the Johnson & Johnson vaccine can resume. The state of New York will resume administration of this vaccine at all of our state-run sites effective immediately. The vaccine is the weapon that will win the war against COVID and allow everyone to resume normalcy, and we have three proven vaccines at our disposal. I urge every New Yorker to take whichever one is available to them first. The sooner we all get vaccinated, the sooner we can put the long COVID nightmare behind us once and for all.” (H)
“R.I. Department of Health spokesperson Joseph Wendelken said Saturday the state will wait until next week to make a decision, adding Rhode Island has enough vaccine doses currently available that operations will not be disrupted without it.
“We only have a limited amount of Johnston & Johnson vaccine on-hand right now, and we would not expect another shipment for two or three weeks anyway,” Wendelken said. “On top of that, we have been getting more Moderna and Pfizer vaccine. For those reasons, this pause is not significantly impacting our current operations.”
The U.S. Centers for Disease Control and Prevention and the FDA ended a pause that began April 13 when federal health officials decided to investigate six out of nearly 7 million J&J vaccine recipients who reported severe and unusual blood clots. In an announcement Friday, federal regulators said use could resume with an updated label that warned of blood-clot risks.
Prior to the announcement, Rhode Island medical director Dr. James McDonald told 12 News the state would make an independent decision about whether to proceed with the vaccine regardless.
“Rhode Island is going to look at the data, look at the recommendations and make a customized recommendation for you, because we’re your doctor, Rhode Island, and we need to make sure what we have is good for you,” he said.
The decision to wait differs from Massachusetts and Connecticut, where state health officials almost immediately directed their vaccinating partners to resume use of the single-dose regimen.” (I)
“Friday’s vote by an advisory committee to the Centers for Disease and Control Prevention to resume administering the Johnson & Johnson coronavirus vaccine was the right decision, but with a serious mistake: There should be an explicit warning against the vaccine’s use in women under the age of 50.
I’m in this group. I’m also a participant in the Johnson & Johnson clinical trial who was told that I’d received the placebo. I then opted to get the Johnson & Johnson vaccine. If I knew then what I know now, I would have chosen the Pfizer or Moderna vaccines instead…
All of this more than justifies the decision to allow the Johnson & Johnson vaccine to be administered once again. In recognition of the risk of TTS, the FDA says that it will add information to the vaccine’s label that alerts people to its signs and symptoms. This is particularly important because the standard treatment for blood clots, administering the blood thinner heparin, is dangerous and can be fatal when there are low platelets.
But this is not enough for the highest-risk group of women under age 50. We are not talking about run-of-the-mill blood clots here. TTS is a severe, life-threatening illness afflicting otherwise healthy, young women. Of the 15 women with TTS after vaccination, seven remain hospitalized, four in critical condition. Three have died.
If there were no alternatives, the benefits of the Johnson & Johnson vaccine would surely outweigh the risks. But that’s not the case. There are two other very safe and effective vaccines that do not pose any risk of TTS. Why not issue a warning that advises women under 50 to receive one of these two other vaccines instead?…
In many parts of the United States, vaccine supply already exceeds demand. People should be empowered to decide which vaccine to get based on the risks, benefits and alternatives. For younger women, the CDC needs to be much more explicit to warn them against the Johnson & Johnson vaccine based on the very rare but very severe risk associated with it — and, critically, to direct them to alternatives that don’t carry this risk at all. After all the emphasis federal health officials put on prioritizing safety, it’s what we should expect from them.” (J)
“Millions of Americans are not getting the second doses of their Covid-19 vaccines, and their ranks are growing.
More than five million people, or nearly 8 percent of those who got a first shot of the Pfizer or Moderna vaccines, have missed their second doses, according to the most recent data from the Centers for Disease Control and Prevention. That is more than double the rate among people who got inoculated in the first several weeks of the nationwide vaccine campaign.
Even as the country wrestles with the problem of millions of people who are wary about getting vaccinated at all, local health authorities are confronting an emerging challenge of ensuring that those who do get inoculated are doing so fully….
Mounting evidence collected in trials and from real-world immunization campaigns points to the peril of people skipping their second doses. Compared with the two-dose regimen, a single shot triggers a weaker immune response and may leave recipients more susceptible to dangerous virus variants. And even though a single dose provides partial protection against Covid, it’s not clear how long that protection will last…
While millions of people have missed their second shots, the overall rates of follow-through, with some 92 percent getting fully vaccinated, are strong by historical standards. Roughly three-quarters of adults come back for their second dose of the vaccine that protects against shingles…
The C.D.C. says there is limited data on the vaccine’s effectiveness when shots are separated by more than six weeks, although some countries, including Britain and Canada, are giving shots with a gap of up to three or four months.” (K)
“Vaccination rates are falling in the United States, despite the spread of highly contagious virus variants that are fueling the country’s alarmingly high caseload.
More than 50,000 new U.S. cases were reported on Saturday, and case rates are similar to those of the second wave last summer. But the average number of vaccine doses being administered each day, which rose for months and peaked at 3.38 million, has now fallen to 2.86 million, its lowest level since March 31, according to data from the Centers for Disease Control and Prevention.
The vaccination rate stopped climbing on April 13, when federal health officials recommended pausing the use of Johnson & Johnson’s vaccine to allow researchers to examine a rare blood-clotting disorder that emerged in six recipients. The Food and Drug Administration lifted the pause on Friday, opting to add a warning about the risk to vaccine labeling…
“We’re entering a new phase” in the country’s vaccination effort, said Dr. Mark McClellan, former commissioner of the Food and Drug Administration and director of the Duke-Margolis Center for Health Policy at Duke University. “In most parts of the country now, there are unfilled vaccination appointments available.”
People who were clamoring for a vaccine have been inoculated, including those who were willing to schedule appointments and wait in long lines at mass vaccination sites, he said.
“Now, it’s more about bringing vaccines to the people who want them but haven’t been able to easily reach the existing sites,” Dr. McClellan said. Walk-in availability, which New York City allowed at city-run sites starting on Friday, could also help vaccinate more people, he said.
Dr. Ashish Jha, the dean of the Brown University School of Public Health, cautioned that it would be “hugely problematic” to broadly denounce those who had yet to get a vaccine — because of indifference or inconvenience — as “resisters.” He said on National Public Radio last week that “there are lots of people who are perfectly happy to get a vaccine but aren’t desperate for it — aren’t convinced that they need it badly.”
Rupali J. Limaye, a professor who studies vaccine behavior at Johns Hopkins Bloomberg School of Public Health, said as vaccinations continued, some might think: “If these other people are vaccinated, why do I need to get it?” but added, “We still need those people to get it to reach herd immunity.”” (L)
“Nearly as soon as vaccines entered clinical trials, wealthy countries began hoarding doses, ensuring that instead of the most vulnerable people everywhere being vaccinated, their residents would be first in line…
There is no shortage of solutions to these problems, but the countries with leverage, clout and excess supply — like the United States — need to act now, in the following ways:
Stop hoarding doses. The richest nations account for 16 percent of the global population but hold 53 percent of all purchased coronavirus doses, according to the Duke-Margolis Center for Health Policy. The United States is projected to have 300 million extra shots by late July, even after accounting for the supply needed to vaccinate the millions of children who are expected to be eligible by the end of the year…
Suspend patents. Nearly 60 nations have petitioned the World Trade Organization to allow countries to temporarily override intellectual property rights for coronavirus-related drugs and vaccines, but so far the measure is languishing. The Biden administration should support this waiver, nudge vaccine makers into voluntary licensing agreements and help build the public-private partnerships needed to bring those agreements to fruition. It should also press companies to offer better deals to the countries trying to secure doses — no more absurd indemnity clauses that protect company profits over human lives.
Share technology and resources. More than eight months ago, the World Health Organization established a technology access pool where companies and countries could share their technology and expertise with governments trying to scale up vaccine manufacturing. The Biden administration signaled its willingness to participate in this effort back in January, but so far, the National Institutes of Health has not joined in, nor have the major vaccine makers. That needs to change quickly…
Build more capacity. Experts say that virtually no vaccines are being manufactured in Africa and that very few are being made in Latin America. The reasons for this shortcoming are complex — a longstanding underinvestment in regional capacity combined with an overreliance on multinational corporations. But the solutions to it are clear. Britain has managed to scale up its manufacturing capacity from just two plants at the start of the pandemic to four now, with two more under construction. There’s no reason the same can’t be done in other countries where the need is even greater. Throwing his weight behind such an effort could be one of Mr. Biden’s most enduring legacies…
No country has cleared every hurdle to vaccinating its entire population. In the United States as much as anywhere, vaccine hesitancy persists and some especially vulnerable populations, like the homebound and unhoused, remain hard to reach even as supply increases. But the world cannot afford to wait for all of those problems to be solved in one country before it works to make coronavirus vaccines more available to all countries. The global vaccine gap is a matter of life and death, and all nations should be working to close it as quickly as possible.”..
Fortunately, there are other promising alternatives in the offing. One of them is based on the same technology used to make the hepatitis B vaccine that’s been in use for nearly 40 years. This coronavirus vaccine is cheap and easy to make, its early clinical data looks good and its creators — Dr. Peter Hotez and Maria Bottazzi at the Baylor College of Medicine — have no plans to patent it. If the United States put half as much weight behind this simple technology as it put behind the mRNA vaccines, manufacturers could churn out billions of doses of it in fairly short order.” (M)
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
POST 96. December 26, 2020. CORONAVIRUS. “Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci…”…”..he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….”
POST 97. December 27, 2020. “A new variant of the coronavirus that has been spreading through the UK and other countries has not yet been detected in the United States..”.. . But if new-wave medicines like antivirals and antibody therapy contributed to the development of viral variants, it will be “a reminder for all the medical community that we need to use these treatment options carefully.”
POST 99. December 29, 2020. CORONAVIRUS. “ICUs are being overwhelmed across many parts of California. Statewide aggregate ICU availability has been at 0% since Christmas Eve…. a surge on top of a surge on top of a surge.”… “hospitals are getting close to the point where they would begin putting COVID-positive patients under the care of COVID-positive staff who are asymptomatic.”
POST 100. December 29, 2020. CORONAVIRUS. Front line hospital workers – in the ER, ICUs, EMS, acute medical care, behavioral health – are amongst the most courageous, heroic and dedicated colleagues you will ever meet.
POST 101. December 30, 2020.CORONAVIRUS. Is there a point where the increasing Coronavirus trajectory so far exceeds the slow growth of the vaccination rate that reaching herd immunity through vaccinations becomes less likely?
POST 102. January 2, 2020. CORONAVIRUS. “We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination — which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, the dean of Brown University’s School of Public Health. “Ultimately, the buck seems to stop with no one,”…
POST 103. January 4, 2021. CORONAVIRUS. Dr. Fauci said “that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses…Dr. Moore – ”British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”
POST 104. January 6, 2021. CORONAVIRUS. “Paramedics in Southern California are being told to conserve oxygen and not to bring patients to the hospital who have little chance of survival…”
POST 105. January 8, 2021. CORONAVIRUS. POST 105. January 8, 2021. CORONAVIRUS. “Facing a shortage of vaccinators, the Association of Immunization Managers… recommends relaxing regulation or adjusting licensing requirements. At least two states, Massachusetts and New York, have changed their laws in recent weeks to expand those who are eligible to give shots.”
POST 106. January 9, 2021. CORONAVIRUS. The riots at the Capitol could have been a superspreader event. “From what I saw… you had a large congregation of individuals who were in close contact for an extended period of time and almost universally unmasked…. many coming and going on buses as well, also unmasked, and hanging out in hotel lobbies.”
POST 107. January 8, 2021. CORONAVIRUS. “Our job is to make sure the vaccine isn’t politicized the way masks were politicized,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said after getting her vaccine. South Carolina Rep.-elect Nancy Mace, a Republican, wrote that “Congress shouldn’t be putting themselves first in line for the COVID-19 vaccination when the average American can’t get it.”
POST 108. January 9, 2021. CORONAVIRUS. (vaccination)”Line-cutters will be named and shamed. It’s inevitable, as will be the congressional hearings and front-page investigative stories ferreting out who saved their own skin at the expense of others.”
POST 109.January 9, 2021. CORONAVIRUS. “President-elect Joe Biden will aim to release nearly every available dose of the coronavirus vaccine when he takes office, a break with the Trump administration’s strategy of holding back half of US vaccine production to ensure second doses are available.
POST 110. January 13, 2021. CORONAVIRUS. ““The (federal) government is changing the way it allocates Covid vaccine doses, now basing it on how quickly states can administer shots and the size of their elderly population.”… “New York State sent a letter to hospitals saying if they don’t use their vaccine allocations by the end of this week, they won’t receive any further allocations.”
POST 111. January 14, 2021. CORONAVIRUS. “Visitors from Toronto to New York to Buenos Aires have long flocked to Florida for sun, surf and shopping. Now they are coming for the Covid-19 vaccine….
POST 112. January 14, 2021. CORONAVIRUS. CHINA – “Eleven million people are under lockdown in Hebei province after a new cluster of coronavirus infections.
PART 113. January 17, 2021. CORONAVIRUS. The Next President Actually Has a Covid Plan… New York City and other places in the state expect to exhaust their supply of doses as early as next week… Charles Barkley said during the “NBA on TNT” broadcast that pro athletes should get the first round of the vaccine…..
POST 114. January 18, 2021. CORONAVIRUS. “When government programs that have been unattended, underfunded and bogged down by red tape suddenly have to meet a huge demand in a crisis, they can’t cope and people suffer….”
POST 115. January 21, 2020. CORONAVIRUS. A year ago today an unnumbered POST was headlined “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.” The CORONAVIRUS CONTENT TRACKING PROJECT started with HISTORIOGRAPHY and over time moved to LESSONS LEARNED, RAPID RESPONSE, and THE VACCINATION PROGRAM. Now 115 POSTS later – the BIDEN CORONAVIRUS PLAN.
POST 116. January 22, 2021. President Biden – “We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation.”
POST 117. January 23, 2021. CORONAVIRUS. 1.Dr. Fauci:“The idea that you can get up here….”and.. let the science speak”… “It is somewhat of a liberating feeling.” 2.updated CDC guidance:”.. providers could give the second dose up to six weeks after the first dose..” 3.Dr. Fauci: people would be “taking a chance” if they follow the CDC’s updated guidance.
POST 118. January 24, 2021. CORONAVIRUS. “Unfortunately, we’ve let this virus spread extensively and are launching the vaccination campaign at the height of the threat,” Dr. Meyers said. “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.”
POST 119. January 27, 2010. CORONAVIRUS. Amazon is offering its help to President Joe Biden with the rollout of COVID-19 vaccines. Washington’s governor, Jay Inslee, included the help of companies like Starbucks, Costco and Microsoft in a plan to vaccinate 45,000 residents a day.
POST 120. January 28, 2021. CORONAVIRUS. “The fact that four vaccines backed by the federal government seem to be less effective against the (South African) B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.”
POST 121. January 30, 2021. CORONVIRUS. Will our communities become stratified by which vaccine is distributed? 95%ters v. 72%ters? Will the easier distribution of the J&J vaccine drive its inequitable distribution to” hard-hit, marginalized, and medically underserved communities.” (thanx! to XJ/LA)
POST 123. February 4, 2021. CORONAVIRUS. “Nursing homes across the country are facing the same struggle, as workers have been more reluctant than residents to be vaccinated…
POST 124. February 5, 2021. CORONAVIRUS. Dr. Osterholm ” …it may be time to..go with a ‘first-dose only’ approach, so more people over the age of 65 can have at least some protection right away. He said that would require delaying second doses until this summer.” Dr.Fauci “warned against this practice, and cautioned people about “the danger” that could come with focusing only on the first dose.”
POST 125. June 9, 2021. CORONAVIRUS. “States are rolling back Covid-19 restrictions as new cases trend down from record highs across the country. But experts warn it might be too much too soon as variants pose an increased risk and the pandemic… is far from over.”
POST 126. February 11, 2021. CORONAVIRUS. “There will be more coronavirus outbreaks in the future. Bats and other mammals are rife with strains and species of this abundant family of viruses. Some of these pathogens will inevitably spill over the species barrier and cause new pandemics. It’s only a matter of time.” (A)
POST 127. February 12, 2021. CORONAVIRUS. “… Trump only agreed to be hospitalized when aides told him that he could walk to Marine One or he could wait until his case progressed and he would be carried out.”
POST 128. February 14, 2021. CORONAVIRUS. “The Centers for Disease Control and Prevention released new research on Wednesday that found wearing a cloth mask over a surgical mask offers more protection against the coronavirus, as does tying knots on the ear loops of surgical masks…
POST 129. February 15, 2021, CORONAVIRUS. “ “The CDC released its much-anticipated, updated guidance to help school leaders decide how to safely bring students back into classrooms, or keep them there.”…” For politicians, parents and school leaders looking for a clear green light to reopen schools, this is not it.”
POST 130. February 16, 2021. CORONAVIRUS. “A second person who had contracted the Ebola virus died this week in the Democratic Republic of Congo, marking another outbreak just three months after the nation outlasted the virus’s second-worst outbreak in history…”
POST 131. February 17, 2021. CORONAVIRUS. “It really is right now – a race between how quickly new variants, particularly the U.K. variant, can spread in the United States and how quickly we can get people vaccinated”
POST 132. February 20, 2021. CORONAVIRUS. “In Texas, where over 2.5 million people are still without power, the state health department said this week’s vaccine shipments wouldn’t arrive until Wednesday at the earliest.”
POST 133. February 23, 2021. CORONAVIRUS. “Going off your meds is a surefire way to aggravate your doctor. What if a whole country did it?” The United Kingdom has veered into uncharted territory by changing tack and introducing a revised COVID-19 vaccination protocol, one that involves distributing the second dose at 12 weeks, rather than the prescribed 21 days.”
POST 134. February 24, 2021. CORONAVIRUS. The first tranche of the J&J (single dose) vaccine must go to K-12 teachers, so schools can open safely in the first 100 days of the Biden Administration. The federal government…”can set up its own vaccination centers in regions with eligible populations it’s trying to target.” We owe our front-line teachers nothing less!
POST 135. February 27, 2021. CORONAVIRUS. “As Chief Executive Officers of New York’s major health care systems, we would like to provide facts to clear up confusion in the public and the media regarding decisions to discharge patients to nursing homes during New York’s spring coronavirus surge.”
POST 136. March 2, 2021. CORONAVIRUS. ““The governors of Texas and Mississippi both announced on Tuesday they would be lifting their states’ mask mandates and rolling back many of their Covid-19 health mandates..”…while “The US could experience a “fourth surge” of coronavirus before the majority of the country is vaccinated.”
POST 137. March 4, 2021. CORONAVIRUS. “The clamor for hard-to-get Covid-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system. They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow? Some pharmacists have even given them a nickname: vaccine lurkers.” (H)
POST 138. March 6, 2021. CORONAVIRUS. “New cases are decreasing in the third wave because we are past the holidays, not because of vaccinations. It is a common misconception that the decrease we are seeing in new cases, hospitalizations, and deaths in the U.S. is due to vaccinations. The two aren’t related; at least yet.”
POST 139. March 8, 2021. CORONAVIRUS. CDC Issues First Set of Guidelines on How Fully Vaccinated People Can Visit Safely with Others…” In practice, that means fully vaccinated grandparents may visit unvaccinated healthy adult children and healthy grandchildren of the same household without masks or physical distancing.” (C)
POST 140. March 9, 2021. CORONAVIRUS. “In West Virginia, they are bracing for the second wave….. Not coronavirus but opioid overdoses, with one scourge driving a resurgence of the other.
POST 141. March 11, 2021. CORONAVIRUS. Today is the first anniversary of the WHO declaration that the novel coronavirus was a Public Health Emergency of International Concern… “To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like.”
POST 142. March 15, 2021. CORONAVIRUS. “Candida auris is a superbug, a pathogen that can evade drugs made to kill it—and early signs suggest the COVID-19 pandemic may be propelling infections of the highly dangerous yeast. That’s because C. auris is particularly prominent in hospital settings, which have been flooded with people this year due to the coronavirus.”
POST 143. March 17, 2021. CORONAVIRUS. “The Trump administration sought to suppress Covid-19 testing in the United States last year by softening guidance from the Centers for Disease Control and Prevention on who needed to be tested, a House panel said Monday.”
POST 144. March 20, 2021. CORONAVIRUS. ““The vaccine hesitancy we are seeing isn’t just about Covid vaccines,”… “It is a general reflection of Americans’ lack of trust in science, the pharmaceutical industry, and large health care institutions. We need a full court press on science and vaccine education right now to prevent more aggressive Covid-19 variants from developing and taking hold.”
POST 145. March 25, 2021. CORONAVIRUS. “Efforts to disseminate Covid-19 vaccines as widely as possible are hitting an unexpected obstacle: health-care workers who decline the shots.
POST 146. March 30, 2021. CORONAVIRUS. Dr. Osterholm told Becker’s: “This is the perfect storm,”…”Here is Europe locking down and having problems containing B.1.1.7, even with vaccinations and previous infection histories. Here we are opening up as wide as we can. We are literally just walking into the mouth of the virus saying, ‘Don’t worry.’” (M)
POST 147. April 5, 2021. CORONAVIRUS. “The pandemic helped cement the shift to “a philosophy of really focusing on the role of the physician in reasoning through ambiguous and unknown problems as the focus of education, rather than teaching students that the role of physician was to memorize a body of knowledge that was already in existence and good enough for what usually happens.”
POST 148. April 7, 2021. CORONAVIRUS. While the Biden administration accelerates vaccinations to ward off numerous variants and as more young people are being hospitalized, states, even with increasing case rates are on paths to fully reopen. Politics v. public health!
POST 149. April 10, 2021. CORONAVIRIUS. “From Michigan to Massachusetts, COVID-19 cases and hospitalizations are on the rise again. Deaths will soon follow. “ ”.. the Biden administration is facing renewed calls to delay second vaccine doses and blanket more of the U.S. population with an initial shot.”
POST 150. April 10, 2021. CORONAVIRUS. “The use of so-called COVID-19 “vaccine passports” is quickly becoming a divisive issue across the US – with several states, including New York, embracing the idea, while others have already moved to ban them.”
POST 151. April 14, 2021. CORONAVIRUS. the J&J vaccination pause. “ Federal officials are concerned that doctors may not be trained to spot or treat the rare disorder if recipients of the vaccine develop symptoms of it…” “…a standard treatment for blood clots — use of an anticoagulant drug — could be dangerous or even fatal in such cases…”
POST 152. April 15, 2021. CORONAVIRUS. “The Chinese Center for Disease Control and Prevention’s director said Saturday authorities are considering mixing COVID-19 vaccines because the country’s domestically made doses “don’t have very high protection rates,”
POST 153. April 18, 2021. CORONAVIRUS. “At least 35 hospitals across Michigan were listed Thursday as nearing capacity and three were at full capacity for COVID-19 patients..”.. We can manufacture beds. We can open up beds. We can create entire wings of the hospital if we have to, but if we don’t have staff for those beds, we’ve got nothing.”..
POST 154. April 19, 2021. CORONAVIRUS. “Breakthrough infections, which occur when fully vaccinated people are infected by the pathogen that their shots were designed to protect against, are an entirely expected part of any vaccination process.” “Pfizer’s chief executive said that a third dose of the company’s Covid-19 vaccine was “likely” to be needed within a year of the initial two-dose inoculation — followed by annual vaccinations.”
POST 155. April 24, 2021. CORONAVIRUS. As the J&J vaccine pause is ended Senator Johnson said “The science tells us that vaccines are 95% effective. So if you have a vaccine, quite honestly, what do you care if your neighbor has one or not? I mean, what is it to you?”
“White House chief advisor Dr. Anthony Fauci said people may need to get booster shots for the Covid vaccines in a year, during an interview with MSNBC’s Medhi Hasan Monday.
Recent data suggests that Pfizer and Moderna’s Covid vaccines provide protection for at least six months, Fauci said…
“We know for sure it’s effective for six months and highly likely that it will be effective for considerably longer period of time,” Fauci said.
The Pfizer study only measured to the six-month mark, and more research needs to be done to determine when or how vaccine protection wanes.
“The way to get the answer is to just follow people closely enough to determine when that level of efficacy or protection diminishes, both with regard to the level of the antibodies as well as clinical data with regard to breakthrough infections,” Fauci said. (Breakthrough cases refer to when people who are vaccinated get infected.)
Ultimately, “if it turns out [to last] a year or a year and a half, we very well may need to get booster shots to keep up the level of protection,” Fauci said.
Protection could end up lasting two to three years, but the point is that boosters are still on the table as a possibility, he told Politico on April 5.” (A)
“The Centers for Disease Control and Prevention has documented approximately 5,800 breakthrough coronavirus cases in individuals who have been vaccinated.
“All of the available vaccines have been proven effective at preventing severe illness, hospitalizations, and deaths,” the agency said in an emailed statement. “However, like is seen with other vaccines, we expect thousands of vaccine breakthrough cases will occur even though the vaccine is working as expected.”
The number of breakthrough incidents reported to the CDC represents far less than 1% of the Americans who have been fully vaccinated, which is over 76 million.
“Vaccine breakthrough infections make up a small percentage of people who are fully vaccinated,” the agency said. “CDC recommends that all eligible people get a COVID-19 vaccine as soon as one is available to them.” (B)
“The CDC told The Hill on Thursday that about 7 percent of the recorded breakthrough cases resulted in hospitalization and about 1 percent of the people who contracted breakthrough infections died.
The breakthrough COVID-19 infections reported to the CDC were out of more than 75 million fully vaccinated individuals in the U.S., occurring in less than 0.008 percent of fully vaccinated people. Hospitalizations have occurred in 0.0005 percent of all full vaccinations and deaths in almost 0.0001 percent.
“To date, no unexpected patterns have been identified in case demographics or vaccine characteristics,” the CDC said…
The CDC said COVID-19 breakthrough cases were reported among “all people of all ages eligible for vaccination.”…
“CDC is monitoring reported cases for clustering by patient demographics, geographic location, time since vaccination, vaccine type or lot number, and SARS-CoV-2 lineage,” the agency said.” (C)
“One study found that just four out of 8,121 fully vaccinated employees at the University of Texas Southwestern Medical Center in Dallas became infected. The other found that only seven out of 14,990 workers at UC San Diego Health and the David Geffen School of Medicine at the University of California, Los Angeles tested positive two or more weeks after receiving a second dose of either the Pfizer-BioNTech or Moderna vaccines. Both reports, published on Tuesday in the New England Journal of Medicine, show how well the vaccines work in the real world, and during a period of intense transmission.
But these breakthrough cases, though quite rare, are a sharp reminder that vaccinated people are not invincible, especially when the virus continues to circulate widely.
“We felt really strongly that this data should not lead people to say, ‘Let’s all get vaccinated and then we can all stop wearing masks,’” said Dr. Francesca J. Torriani, an infectious disease specialist at UC San Diego Health who led the California study. “These measures have to continue until a larger segment of the population is vaccinated.”” (D)
“In public health, a “breakthrough case” is when a fully vaccinated person later gets the disease they were vaccinated for. No vaccine provides 100 percent protection against infection, so breakthrough cases are not new, and not unique, to COVID-19. There have been reports of COVID-19 breakthrough cases in South Carolina and throughout the U.S., and this is not unexpected.
COVID-19 vaccines are very effective in preventing mild symptoms, severe disease, and hospitalizations due to COVID-19 disease. But it is still possible for a fully vaccinated person to get infected if they are exposed to the virus. These individuals may have no symptoms or mild symptoms, yet they can still spread the virus to others. That’s why even after getting vaccinated for COVID-19 we recommend continuing to wear a mask, keep your distance, avoid crowded settings, and wash your hands: this helps you to prevent exposure to the virus and unknowingly spreading it to others.
Because fully vaccinated people usually have some immunity against the disease, breakthrough cases usually have either no symptoms or mild symptoms. A breakthrough case occurs when an individual has had a lower immune response from the vaccine. No vaccine is 100 percent effective.”(E)
“”CDC has developed a national COVID-19 vaccine breakthrough database where state health department investigators can currently enter, store, and manage data for cases in their jurisdiction,” the CDC said.
“Vaccine breakthrough infections make up a small percentage of people who are fully vaccinated. CDC recommends that all eligible people get a COVID-19 vaccine as soon as one is available to them. CDC also continues to recommend people who have been fully vaccinated should keep taking precautions in public places, like wearing a mask, staying at least six feet apart from others, avoiding crowds and poorly ventilated spaces, and washing their hands often.”
Outside experts agreed.
The likelihood of these “very rare” infections depends on how much virus is circulating within a community, Dr. Kawsar Talaat, an infectious disease physician and assistant professor at Johns Hopkins Bloomberg School of Public Health, told CNN.
“That’s the whole point of getting to herd immunity,” Talaat said. “Because once we get to a point where enough people in the community are vaccinated, then if somebody develops Covid in that community, the people around them are protected and it’s much harder for that person to spread the virus to somebody else, and therefore the transmission stops.”
Less transmission means fewer breakthrough cases, said Dr. Carlos del Rio, executive associate dean at Emory University School of Medicine.
“There is currently a lot of transmission in many parts of the country. Vaccines will help decrease that,” del Rio said. “Get vaccinated as soon as you can and help control this pandemic.”” (F)
“This incomplete protection that some people experience occurs to some extent with a vaccine against any disease, says Dr. Saad Omer, a vaccine researcher at Yale University, and the numbers gathered so far are in line with what’s expected, the CDC says.
The three vaccines authorized for use against COVID-19 in the United States appear to be at least 94% effective at preventing severe disease and death (starting about two weeks after a person is fully vaccinated), according to data reported so far, and about 80% effective at preventing infection. But that’s not 100%, Omer notes, so a relatively small number of infections despite immunization with these very effective vaccines is to be expected…
Meanwhile, scientists are trying to figure out why breakthrough infections occur.
“Right now we don’t have a great understanding of exactly where we’re open — our sort of Achilles’ heel,” says Dr. Alexander Greninger, an infectious disease researcher at the University of Washington.
Is the determining factor how much virus someone is exposed to? Or maybe exposure to one of the variants that can evade the immune system?
“Is it people in the lower part of the vaccine response mixing with the variants? I think it’s a little bit more — honestly — mysterious,” Greninger says.
Solving that mystery could help scientists improve the vaccines to prevent more breakthrough infections. Booster shots might become part of the answer down the road, they say.
The CDC is continuing to monitor breakthrough coronavirus infections “for clustering by patient demographics, geographic location, time since vaccination and vaccine type or lot number.” In addition, the agency is studying specimens of virus from people who experience breakthrough infections, including conducting genetic studies to see if any particular variants are more likely to be involved than others.” (G)
“Some of the breakthrough infections are thought to stem from certain strains of the virus that may be more resistant to vaccines, experts say. They also say some highly contagious variants may pose a greater risk of reinfection from other variants, but much of the research around that has been lab-based and lacks real-world context.
In New York City, health officials are trying to extrapolate more real-world data as it relates to its most dominant variants, including the B.1.526 strain that is thought to have originated in Washington Heights last year before spreading to other boroughs and states. Right now, the city is still investigating whether that variant poses a higher risk of reinfection from other variants or causes more severe outcomes, according to a detailed report from health officials earlier this week.
Reinfection remains highly rare, though New York City hasn’t publicly reported data on any potential cases of that it may be investigating locally…
Overall, health officials admit the presence of variants is likely highly underreported. The CDC, along with individual states and cities, only conducts the exhaustive genetic sequencing to detect variants in about 5 percent of samples, which is up from 2 percent a number of months ago. It’s still a fraction of all positive cases.” (H)
“In some ways, the shots’ staggering success in trials—where breakthrough cases were also observed, causing appropriately minimal stir—may have papered over the inevitability of post-vaccination infections in more natural settings. “The vaccines exceeded expectations,” Luciana Borio, a former acting chief scientist at the FDA, told me. Now, as we exit what Borio calls the “honeymoon phase” of our relationship with the jabs, we need to temper our enthusiasm with the right amount of realism, especially as more data on the shots’ strength and longevity accumulate. Even excellent vaccines aren’t foolproof, and they shouldn’t be criticized when they’re not. “We can’t expect it’s going to be perfect, on day one, always,” Borio said…
Efficacy, a figure specific to clinical trials, also doesn’t always translate perfectly to the messiness of the real world, where there’s immense variability in how, when, where, by whom, and to whom shots are administered. The vaccine’s performance under these conditions is tracked by a separate measure, called effectiveness. Studies rigorously examining vaccine effectiveness are challenging, but early data suggest that the Pfizer-BioNTech and Moderna shots are living up to their initial hype…
There’s something a touch counterintuitive about breakthrough cases: The more people we vaccinate, the more such cases there will be, in absolute numbers. But the rate at which they appear will also decline, as rising levels of population immunity cut the conduits that the virus needs to travel. People with lackluster responses to vaccines—as well as those who can’t get their jabs—will receive protection from the many millions in whom the shots did work. In a crowd of people holding umbrellas, even those who are empty-handed will stay more dry.” (I)
“To Topol, there was nothing surprising about a case like mine. He and his colleagues had been looking at some seventy cases of breakthrough infections in San Diego. On March 23rd, The New England Journal of Medicine published a letter to the editor from a group of researchers in Southern California who had found that the risk of infection in fully vaccinated health-care workers there was higher than in the original vaccine trials, but still extremely low—around one per cent. Breakthrough infections have been reported in Florida, Michigan, and Washington. Much of the time, these cases are caught through routine testing of health-care workers, and the infections are asymptomatic. Symptomatic cases like mine are more unusual….
“People with breakthrough infections really need to be studied,” Topol said. “The highest priority is to sequence the virus of the breakthrough infections.” Currently, labs in New York City are sequencing a fraction of the virus samples, every week. These samples are then cross-referenced with patient databases to see whether the person has been vaccinated against or was previously diagnosed with covid-19. Statistics on breakthrough infections, and on the role of variants in these infections, come from this process. The problem, however, is that vaccinated people are unlikely to shed enough virus to sequence; this means that breakthrough infections may be passing under the radar.” (J)
“However, according to the Washington Post, there are some challenges in collecting accurate information about breakthrough cases. For instance, people who’ve been vaccinated may be less likely to get tested if they get symptoms of Covid-19, writing off a stuffy nose or cough to a cold rather than Covid-19. And even some of the post-vaccination fatalities are still under investigation to determine if they were caused by Covid-19 or something else…
According to the Post, there’s no clear-cut explanation as to why some people remain susceptible to the virus after vaccination. However, Fauci on Friday hypothesized that some people, such as the elderly and those with underlying health conditions, may have a weak immune response to the vaccine—an issue that has more to do with the characteristics of an individual patient than the overall efficacy of a given vaccine. “I don’t think that there needs to be any concern about any shift or change in the efficacy of the vaccine.”
According to the Post, while none of the currently authorized vaccines are 100% effective at preventing infection, research last year indicated that the Pfizer-BioNTech and Moderna vaccines had nearly 100% efficacy at preventing hospitalization. In addition, studies suggest that in real-world conditions, the vaccines are about 80% effective at reducing the odds of infection after the first shot, and about 90% effective after the second dose.
And although conducted at a different time, when more variants had emerged, research on Johnson & Johnson’s vaccine—whose use federal officials are currently pausing—presented 100% efficacy rate against hospitalization and death, as well as a 85% efficacy rate against severe illness, Becker’s Hospital Review reports.
Moreover, research indicates that the protection afforded by these vaccines could last for a substantial amount of time, with at least one study finding that fully vaccinated individuals had high antibody levels more than six months after being inoculated. Emerging research suggests the vaccines may also limit how infectious vaccinated people are if they do contract the virus, the Post reports.” (K)
“Scientists have long said that giving people a single course of a Covid-19 vaccine might not be sufficient in the long term, and that booster shots and even annual vaccinations might prove necessary.
In recent days, that proposition has begun to sound less hypothetical.
Vaccine makers are getting a jump-start on possible new rounds of shots, although they sound more certain of the need for boosters than independent scientists have.
Pfizer’s chief executive Albert Bourla said on Thursday that a third dose of the company’s Covid-19 vaccine was “likely” to be needed within a year of the initial two-dose inoculation — followed by annual vaccinations.
Dr. David Kessler, who runs the Biden administration’s vaccine effort, told a House subcommittee on Thursday that the government was also looking ahead. One factor at play is the spread of coronavirus variants and whether further vaccination could better target mutant strains.
Mr. Bourla said that “a likely scenario” is “a third dose somewhere between six and 12 months, and from there it would be an annual re-vaccination.” Moderna said this week that it was at work on a booster for its vaccine, and Johnson & Johnson has said that its single-shot vaccine will probably need to be given annually.
Dr. Kessler emphasized the “strong efficacy” of the current vaccines, including against the variants, but said that the government was “taking steps to develop next generation of vaccines that are directed against these variants if in fact they can be more effective.”… (L)
“In the first four months that COVID-19 vaccines have been available — between Dec. 14 and April 13 — more than 75 million people in the U.S. were fully vaccinated against the virus. Of those who were fully vaccinated, just under 6,000 later became infected with COVID-19.
Those statistics mean that the “breakthrough rate” of COVID-19 infections in fully vaccinated people in the U.S. is a measly 0.008%.
The CDC further reports that only about 400 of those who suffered a breakthrough infection were sent to the hospital, and 130 of those who were hospitalized were “asymptomatic or hospitalized for a reason not related to COVID-19.”
A total of 74 people have died after suffering a COVID-19 breakthrough infection — meaning less than one out of every 1 million people who were vaccinated later died after contracting COVID-19. Of those deaths, nine were “reported as asymptomatic or the patient died due to a cause not related to COVID-19.”
The CDC study is consistent with the findings published by drug companies during their trials last year — that the vaccines are safe and highly effective.” (M)
“Noting that there’s “nothing surprising” about the breakthrough rate, Francis Collins, director of the National Institutes of Health, added, “These are still vaccines that are fantastically safe and effective. But 95% [efficacy] is not 100%.”
He voiced concern that people opposed to the vaccines will use breakthrough cases to claim the vaccines don’t work—an argument he pushed back on. “Would you stop wearing your seat belt because you heard somebody who was wearing a seat belt got run over by an 18-wheeler and didn’t survive?” he asked.” “ (K)
“DOCTOR” is looking to affiliate with a healthcare organization. Contact [email protected]
POST 153. April 18, 2021. CORONAVIRUS. “At least 35 hospitals across Michigan were listed Thursday as nearing capacity and three were at full capacity for COVID-19 patients..”.. We can manufacture beds. We can open up beds. We can create entire wings of the hospital if we have to, but if we don’t have staff for those beds, we’ve got nothing.”..
for links to POSTS 1-153 in chronological order, highlight and click on
Beaumont Health is warning its hospitals and staff have hit critical capacity levels higher than the state’s fall surge.
The hospital chain’s CEO said Michigan’s climbing rate of infections is “very troubling and alarming” and warned that Beaumont “cannot do this alone.”
“We need everyone’s help immediately,” said John Fox. A statement from the hospital sent Thursday morning said the number of patients that Beaumont was caring for had jumped from 128 to more than 800 patients since the end of February. Just two weeks ago, the hospital was caring for 500 patients infected with COVID-19.
The rate of hospitalizations in Michigan has followed one has been a breathtakingly fast rate of new infections that have placed Michigan at the top of the country for coronavirus outbreaks.
Hospital data from the health department reports that more than 4,100 people have been hospitalized due to a confirmed or suspected COVID-19 infection. The number of people in emergency rooms with coronavirus symptoms is also higher than it was in December.
And it’s not just Beaumont that’s reporting its facilities are near or at capacity. Several area hospitals are at or are close to 100% capacity. So far, about 77% of all beds in the state dedicated to coronavirus patients are filled….
“The new COVID-19 variants are more contagious. The patients we are seeing are younger and some are sicker and in need of intense medical attention,” Dr. Nick Gilpin, Beaumont’s medical director of Infection Prevention and Epidemiology, said…
Gov. Gretchen Whitmer has opted not to implement new restrictions. Instead, she’s asking residents to continue taking precautions and get vaccinated as soon as they can. “ (A)
“It has left Beaumont in a place where it is beginning to put up modular triage units and tents outside some of its hospitals to manage the stress on its emergency rooms. Curbside triage units already are in use at its Grosse Pointe and Troy hospitals. A tent is up outside the Dearborn hospital, said Mark Geary, a spokesperson for the health system.
The health system also is postponing some non-urgent surgeries and procedures that would require at least an overnight stay, such as knee replacements or knee reconstruction surgeries, on a case-by-case basis, Gilpin said. Cancer surgeries and other urgent medical services, he noted, are continuing.
“If we continue to see COVID numbers rise, we’ll have to make some accommodations, open up some additional beds,” he said. “The challenge here … is where are we going to get the staff from? We can manufacture beds. We can open up beds. We can create entire wings of the hospital if we have to, but if we don’t have staff for those beds, we’ve got nothing.”..
Michiganders, Riney and Gilpin agreed, must step up now to get vaccinated. To wear masks. To stay home when they’re sick and get tested. To avoid gatherings and practice social distancing.
But it also may be time, Gilpin said, to consider more restrictive measures.
“I do agree with the CDC (Centers for Disease Control and Prevention) that it is going to be difficult to vaccinate our way out of this,” he said.
With a little more than 25% of the state’s adult population fully vaccinated, “that’s a far cry from where we need to be to get those herd immunity numbers that will really bring this under control,” Gilpin said.
It will take about five to six weeks for people who get Pfizer and Moderna COVID-19 vaccines now to be fully protected. And injections of the one-shot Johnson & Johnson vaccine, which offers protection within two weeks of vaccination, are temporarily paused while federal regulators conduct a safety review.
“Six weeks is a long time, and especially when you’re in the middle of a surging pandemic,” Gilpin said. “That is, frankly, too long to wait for some of us that are working in these hospitals.
Gov. Gretchen Whitmer has urged Michiganders to voluntarily avoid indoor dining, and suggested that schools should take a two-week pause from face-to-face high school classes after spring break. She also asked youth athletic teams to pause for two weeks.” (B)
“Add the medical director of infection prevention at Beaumont Health to the list of experts who believe Michigan needs to mandate more COVID-19 restrictions to slow the spread of the virus.
Dr. Nick Gilpin said Thursday (April 14) that he agrees with the director of the Centers For Disease Control and Prevention, who believes Michigan needs to shut down to combat the alarming spread of COVID-19…
Gilpin and CDC Director Dr. Rochelle Walensky both said it would be difficult for Michigan to turn its metrics around simply relying on vaccinations…
He said Gov. Gretchen Whitmer, who has said multiple times in the last week that she doesn’t plan to mandate more restrictions, is in a very difficult position of balancing the virus with the “radioactive political environment.”
But with the statewide case and positivity rates five times higher than they were in mid-February, he thinks the right move is to issue more restrictions.
“At a time like this, right now, in Southeast Michigan and Michigan at large, I do think that we have to be a little bit more prescriptive right now,” Gilpin said.” (C)
“Chief nursing officer Susan Grant said Thursday (April 15) that Beaumont hospitals are currently at 90-95% capacity.
Dr. Nick Gilpin, the medical director of infection prevention, said the COVID-19 situation is “just like a runaway train right now.”
But Grant and Gilpin aren’t worried about space or supplies. Their main concern is for hospital workers.
If we continue to see COVID numbers rise, we’ll have to make some accommodations, open up some additional beds, but again, the challenge here and the theme of the day is: Where are we going to get that staff from?” Gilpin said.
Grant said after having done this for over a year now, hospital workers are tired and worn out both physically and mentally.
“At this time last year, none of us would have imagined, going through that extraordinarily difficult time, that we would be here again, same time this year,” Grant said. “That we would be working and seeing so many patients who are infected with the coronavirus. Hundreds and hundreds of them coming through our emergency rooms.
“That emotional exhaustion has come from experiencing and being present for, observing the enormous toll that this virus has taken on patients, on families, on their own personal lives. They have seen a lot of death over the last year, and now, they are experiencing and seeing younger people who are in our ICU beds, who are very, very sick, who are in the emergency rooms and our hospital beds who are very sick, and some who are dying.”
Grant said it’s been particularly hard for her nurses to see so many younger people coming into hospitals with COVID-19.
“It literally is an all hands on deck, and people are willing to step up and do what they need to do, but we need help,” Grant said.
Beaumont has reached out to external agencies to bring in supplemental staff to help with vaccine clinics and to deal with the surge of cases. Beaumont is also in contact with other health systems in terms of possible transfers when hospitals fill up.
Grant was asked if she’s worried about nurses leaving the profession because of the demands being put on them by the pandemic. She said some nurses who might have been considering retirement in the upcoming years have even retired early because of the strains of caring for COVID-19 patients.
“We worry about (losing nurses) every day, and we are seeing it already, unfortunately,” she answered. “It’s very concerning.”” (D)
“At least 35 hospitals across Michigan were listed Thursday as nearing capacity and three were at full capacity for COVID-19 patients as Michigan’s largest hospital system said it’s nearing its capacity, a development Beaumont Health CEO John Fox called “troubling and alarming.”..
Overall, hospitals in Metro Detroit are at or nearing capacity, with COVID-19 units at 75% to 100% capacity, according to state data.
Health care officials attribute Michigan’s case surge to a combination of COVID variants, including B.1.1.7, a United Kingdom variant for which Michigan has the second-highest number of cases in the nation; a lack of herd immunity; hesitancy to get the vaccine; and Michigan’s cool weather driving more people indoors.
“This variant seems to me like a whole new pandemic because it is more virulent, it is highly contagious and it causes serious illness,” said Dr. Teena Chopra, a professor of Infectious diseases at Detroit’s Wayne State University Medical School…
Hospitals across Michigan are worried about soaring admissions, said John Karasinski, spokesman for the Michigan Health and Hospital Association.
“Concerns about rising hospital admissions and nearing capacity is felt across the state,” Karasinski said. “As with the other surges, the key concern with capacity is staffing levels.”
A significant number of staff are out ill with COVID-19 or on vacation due to spring break, he said. A good share of health care workers have been diverted to provide vaccinations, he added.
“Our hospitals have been staffing vaccination clinics for the past several months, but that does require staff to be allocated toward those clinics,” Karasinski said.
Chopra said more than 60% of cases in Michigan are caused by the more infectious U.K. variant. Michigan had 3,023 cases of the U.K. variant through Thursday….
Michigan hit a new record of 4,011 adults hospitalized with COVID-19 on Tuesday, surpassing the spring and fall 2020 surge peaks. By Thursday, the number had dipped slightly to 3,960 adults hospitalized — still about a 300% jump from one month ago. Of those hospitalized Thursday, 833 patients are in incentive care and 497 are on ventilators.
Michigan has an 18% infection rate. The percentage of COVID-19 tests returning positive are nearly 21% in Detroit, where 419 people are hospitalized.
Detroit Mayor Mike Duggan warned residents Wednesday, saying if the city continues on a track of 700 new cases per day, the racial health care gap in the region will widen should the city’s hospitals be overwhelmed with suburban residents.
“Our lower vaccine rate is leaving our neighbors vulnerable in a terrible way,” Duggan said about the city during a Wednesday news conference. “The worst is still ahead of us. There is no doubt that that wave is going to continue to spread down into our city and we have got to protect ourselves.”
Dr. Adnan Munkarah, chief clinical officer of Henry Ford Health System, said at a Wednesday press conference with Whitmer that COVID-19 patients have grown from 75 to 550 during the past five weeks.
“Positivity rates from inpatients were 1 in 25 and are now 1 in 5. This is extremely troubling,” Munkarah said.” (E)
“With Michigan’s case rate of 515.8 per 100,000 people over the last week — the worst in the nation and four times higher than the rate in neighboring Ohio, according to data from the CDC — more people in general are going to get sick.
That includes kids, said Dr. Prashant Mahajan, an emergency medicine physician and division chief of children’s emergency medicine at the University of Michigan’s C.S. Mott Children’s Hospital.
“There is definitely an increase in the total number of patients that are coming to the ER, both on the pediatric side and the adult side,” Mahajan said. “And the reason I bring both pediatric and adult is because we see children up to 21 years of age at Mott Children’s.
“Cases among kids ages 10-19 are at an all-time high, the state’s top epidemiologist, Sarah Lyon-Callo, reported last week, quadrupling from four weeks earlier.
Dr. Matthew Sims, director of infectious disease research at Beaumont Health, said Michigan’s kids might be contracting the virus at a higher rate now than they did in previous surges because they’re able to socialize, attend in-person classes and continue to play sports now — spreading the virus during these activities — in a way that wasn’t possible during previous waves.
When the first huge spike in coronavirus infections slammed the state in March and April of 2020, Gov. Gretchen Whitmer issued an executive order pushing all K-12 schools to virtual learning. Sports were stopped, restaurants closed and the opportunity for the virus to spread shrank.
In November, when the state was hit yet again with high coronavirus case rates and hospitalizations, the state health department issued a public health order mandating a temporary pause for in-person high school and college classes. High school sports were suspended and in-person dining was stopped, too.
That’s not the case this time. Although Whitmer has encouraged people to avoid in-person dining, urged schools to take a two-week pause from in-person classes following spring break, and asked youth sports teams to also suspend playing, there is no requirement shutting them down.
“In the last couple of surges, sports were closed,” Sims said. “And while they may not be getting it directly from the sporting event, there’s a lot of things that go along with sports. A lot of people go in to watch. There’s the celebration after, where people are gathering together. There have been a bunch of outbreaks linked to sporting events, and so I think that’s part of it.
“Schools have said they’re not all built to keep 6 feet of distance, or sometimes 3 feet of distance, between kids. All of these things play into it. Also, a large number of kids are asymptomatic and we’re not doing enough testing. Often, it spreads without us knowing it.”
The more contagious B.1.1.7 variant, which originated in the United Kingdom, is another factor, Valentini said.
“We know from a statewide statistics that the state of Michigan definitely has one of the highest variant rates of the U.K. variant, the B.1.1.7 variant,” Valentini said, which is 50% to 100% more transmissible than other strains of the virus. “That seems to be higher in our state, and so it could very well be that it is contributing to some of the change.”
The way the state and nation have targeted vaccines to older populations also could play a role in more kids getting sick with the virus now, Valentini said.
Nearly 60% of adults 65 and older in Michigan have been fully vaccinated, according to state data, and almost 50% of people ages 50-64 have gotten at least one dose of a coronavirus vaccine.
That leaves unvaccinated younger adults and children more vulnerable to infection. Just 10.7% of 16- to 19-year-olds have been vaccinated, state data show…
State health officials also have reported at least 99 cases of the rare pediatric condition known as Multisystem Inflammatory Syndrome-Children, or MIS-C, which can develop several weeks after a coronavirus infection and can lead to organ failure and death in kids.
As many as five Michigan children have died of MIS-C and/or active COVID-19 infections, though state health officials won’t release an exact total number of deaths from either disease.” (F)
“Michigan cities account for 9 of the 10 worst Covid-19 outbreaks in the country’s metropolitan areas, according to the latest Covid-19 Community Profile Report published by the US Department of Health and Human Services and the White House.
The state has averaged 7,870 new Covid-19 cases a day across the last week — far above the winter’s low average of 1,044 on February 20. It’s also around Michigan’s highest-ever levels, seen back in late November and early December, according to Johns Hopkins University data.
Statewide hospitalizations also are way up. More than 4,230 Covid-19 patients were in Michigan hospitals on Tuesday — far above the winter low of 825 on February 22 and close to the peak of 4,305 on November 30, according to HHS data.” (G)
“Health officials in Colorado are warning about another wave of infections as new coronavirus cases in the state jump to levels not seen since January and as counties start to loosen virus restrictions.
The state is reporting an average of 1,661 new cases a day, up by 18 percent in the past two weeks, according to a New York Times database. Hospitalizations have climbed by 19 percent in the same time period. Deaths from the virus, which tend to lag behind infections for several weeks, have slightly increased.
“We are seeing what appears to be the beginning of a fourth wave of Covid-19 in Colorado,” Scott Bookman, the state’s Covid-19 incident commander, said at a news briefing on Thursday. He urged people to remain vigilant about getting tested as more of the state’s population becomes vaccinated….
Even as cases mount, the state on Friday ended its “dial system” that required counties to place capacity limits on restaurants, offices and gyms, depending on case counts, positive test percentages and hospitalizations in those areas. That change shifted control of pandemic regulations to local counties, prompting concerns from some public health experts that the move could result in cases and hospitalizations continuing to rise. Several counties experiencing an increase in cases and hospitalizations, like El Paso and Douglas Counties, have said they do not plan to impose restrictions beyond those mandated by the state…
An analysis published this month and led by researchers at the Colorado School of Public Health found that delaying policy changes, at the state or local level, until mid-May would “prevent large numbers of deaths and hospitalizations.” According to the report, mobility in the state is also reaching its highest levels since the start of the pandemic.” (H)
