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.
As President and CEO of Jersey City Medical Center for seventeen years I watched them work tirelessly through many complex and challenging events.
I’ve seen many mega-emergency events, but even if taken together they pale in comparison to the magnitude and personal risk of the Coronavirus response.
In 1989 when I started at JCMC we had a 60 bed inpatient AIDS unit, always full – physicians, nurses, therapists, housekeeping and dietary treating patients with this new, always fatal at the time, virus.
Under-the-radar on September 11th JCMC staff triaged thousands of refugees who crossed the Hudson River in an armada of ferry boats, then provided on-site emergency and trauma care to hundreds of patients, using and exhausting our full clinical capacity. The staff treated every patients using all their clinical skills while quietly “searching” for family members stranded in the City.
In my career I also worked at Elmhurst Hospital in Queens and Mount Sinai in Manhattan, both epicenters of pandemic medicine.
Working in a hospital continuously filled with Coronavirus patients, fraught with unknowns, staff must contend with many “first-time” situations. Redeployment to ID unit. Given responsibility for more patients than best practices allow. insufficient PPE. Supply chain problems with therapeutics. Exhaustion from long shifts and too few days off. In some hospitals, asymptomatic positive tested staff, being called in to work on Coronavirus units. The constant concern about in-hospital spread. AND anxiety about taking the virus home.
So to my colleagues at Jersey City, Mount Sinai and Elmhurst, and hospitals all over our country – you can’t see me but I’m standing behind you, worrying about you, and hoping that this will soon be behind us.
to read POSTS 1-99 in chronological order, highlight and click on
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.”
“This does not mean there are zero ICU beds vacant across California; rather, it means the two regions with 0% capacity — Southern California and the San Joaquin Valley — have reached extremely deep into surge protocols to continue treating severe patients, COVID-19 or otherwise.
Those two regions were placed under the state’s strict stay-at-home order, unveiled by Gov. Gavin Newsom in early December, three weeks ago. The order directs restaurants to cease both indoor and outdoor dining and mandates closures for personal care services like salons and barbershops, on top of the restrictions already in place for purple-tier counties.
State health officials reassess the projected ICU situation in each region after three weeks within the order to determine whether the tight restrictions must continue. Extensions for Southern California and San Joaquin Valley are essentially guaranteed, with an announcement likely coming today from the state as they hit the three-week mark.
For the 13-county Greater Sacramento area, it’s less clear. The region’s three-week window will end this Thursday, on New Year’s Eve. Greater Sacramento has fluctuated around but mostly above the 15% benchmark used as the initial trigger for the stay-at-home order since mid-December. As of Sunday, it had 17.8% ICU availability.
The Bay Area had 11.1% of its ICU beds available through Sunday and must stay under the order through at least Jan. 8. Only the 11-county Northern California region, north of Greater Sacramento, has not entered the shutdown; it still had 28% availability as of Sunday.
The impact on hospitals goes beyond just COVID-19 patients and overwhelmed intensive care units. Kaiser Permanente confirmed over the weekend that it will postpone “elective and non-urgent surgeries” at its Northern California hospitals for one week, from now through Jan. 4, the San Jose Mercury News reported Saturday.
Health experts are supremely concerned about holiday gatherings last week for Christmas, as well as any New Year’s revelry later this week, and their strong potential to deepen the current crisis.
Officials in ravaged Los Angeles County, as well as Newsom, have referred to the prospect of a “surge on top of a surge on top of a surge.” The initial surge started around early November and grew worse after Thanksgiving, with officials fearing Christmas will present an even bigger jolt to infections, hospitalizations and deaths in the weeks to come.
Ahead of Christmas, many in California and across the U.S. pleaded for people to either cancel or scale back their holiday gathering and travel plans. Many Americans appear not to have done so: federal data shows nearly 1.2 million passengers passed through security checkpoints last Wednesday and almost 1.3 million on Sunday, making those the two busiest air travel days since the start of the pandemic in mid-March.
It remains a bit too early to draw many conclusions, but there have been some modest signs of potential slowdown in California’s current surge in data from the past week…
The metrics are all still on upward trajectories — especially deaths, which lag weeks behind the other indicators — but the first step toward plateau or decline is a slower acceleration of increases. But, as health officials warn, it’ll take a couple of weeks to see whether Christmas and/or New Year’s celebrations undo this apparent progress, and if so, to what extent.
Given the holiday impact, Newsom said in a recent video message that the state projects its hospital number will double in the next month, up to more than 36,000 hospitalized patients.” (A)
“With ICUs filled, hospitals will step up measures to ensure the sickest patients still get the highest levels of care possible. That often means moving some patients who would typically be in the intensive care unit to other areas of the hospital, such as a recovery area, or keeping them in the emergency room for longer than normal.
The patients are still getting intensive care, and that strategy can work to a point. But eventually, there may be too many critically ill patients for the limited numbers of ICU doctors and nurses available, leading to greater chances of patients not getting the specialized care they need. And that can lead to increases in mortality.
Once ICU beds are full, hospitals go into surge mode, which can accommodate 20% over usual capacity. Officials have also been training medical personnel who work elsewhere in hospitals to allow them to work in ICUs, and seeking nurses from outside the United States.
But the forecasted size of the surge of severely ill COVID-19 patients needing hospitalization in the coming weeks is now so large, it blew past projections issued just a few weeks ago. Officials were forced to redraw their charts to accommodate the enormous surges in projected ICU bed demand.
There are now more than 1,000 people with COVID-19 in L.A. County’s intensive care units, quadruple the number from Nov. 1. Forecasts say that by early January, there could be 1,600 to 3,600 COVID-19 patients in need of ICU beds if virus transmission trends remain the same.
There are only 2,500 licensed ICU beds in L.A. County.
“There are simply not enough trained staff to care Coronavirus updates: California now for the volume of patients that are projected to come and need care,” Dr. Christina Ghaly, the county’s director of health services, said. “Our hospitals are under siege, and our model shows no end in sight.”
About 600 new patients with COVID-19 are now being admitted to hospitals daily in L.A. County, and officials say that could rise to 750 to 1,350 a day by New Year’s Eve.
“If the numbers continue to increase the way they have, I am afraid that we may run out of capacity within our hospitals,” said Dr. Denise Whitfield, associate medical director with the L.A. County emergency medical services agency and an emergency room physician at Harbor-UCLA Medical Center. “And the level of care that every resident in Los Angeles County deserves may be threatened just by the fact that we are overwhelmed.”
Though officials have noted that the number of available ICU beds changes constantly as new patients are admitted, stabilized or die, the number of unoccupied beds in California’s most populous region has steadily eroded as hospitals have been flooded by unprecedented numbers of COVID-19 patients…
“Many hospitals have already broken nurse staffing ratios, and their staff are not necessarily getting either the breaks or rest that they’re supposed to be getting,” Ghaly said.
Last weekend, Whitfield said, Harbor-UCLA was able to manage its COVID patients, but crowding meant that some patients needed to stay in the emergency department when they should have been transferred elsewhere in the hospital.
“What that means is that when a patient needs to be admitted to the hospital, requiring either an ICU or an inpatient bed, that we just don’t have the staffing or the actual bed space to care for them,” Whitfield said.
A backed-up emergency room then makes it harder for emergency physicians and nurses to take care of patients with other emergencies, including strokes, heart attacks and trauma.
Whitfield said she’s been an emergency room doctor for a decade, but the past weekend was the first time she felt the overcrowding situation “has actually threatened the level of care that we can provide for our patients.”
“And so looking at … how these numbers are increasing throughout the county, it’s really, really quite frightening to me,” Whitfield said.”” (B)
“Hospitals are now postponing elective surgeries in order to help alleviate the growing pressure on our healthcare system.
Emergent surgeries, meaning immediately life or limb threatening, are not being impacted. Any elective surgery that would require admission to a hospital is being looked at as something to potentially postpone.
But what will the delay or avoidance of medical care mean for overall patient health?
A report published by the U.S. Department of health and human services estimated 41% of adults nationwide avoided medical care before June 30th of 2020 because of concerns about the coronavirus, and 12% of adults put off urgent or emergency care.
In a press conference earlier this week, Fresno county’s interim public health officer Dr. Rais Vohra, explained the meaning of an elective procedure.
“You have to understand that, you know, just because something is elective, like for example a tumor operation, you know, that can’t go forever or else the patient is going to have a really bad outcome,” said Dr. Vohra, “So there’s some gray areas there and we’re asking all the hospitals to take really hard looks at exactly how they can conserve their operating room resources and convert those over to help with the acute management issues.”
The department of defense is sending a team of 10 to 12 people, which should help out a bit. Those air force doctors were supposed to get here Monday, but that’s been pushed back to December 31st.
And while Dr. Vohra says coronavirus fatalities are happening in every age group, the group with the highest numbers might surprise you.
“Every age group actually also has very tragic fatalities from the very young to the very old,” said Dr. Vohra, “It turns out one surprising trend is that the 45 to 65 age group is actually having more fatalities than the 65 to 75 age group.”
The county’s system for processing deaths is backed up due to the coronavirus. According to Dr. Vohra, there are still dozens of death certificates that have not been reported out.” (C)
“California’s health care system is in the throes of a coronavirus crisis stemming from ill-advised Thanksgiving gatherings, top executives from the state’s largest hospital systems said Tuesday as they put out a “desperate call” for residents to avoid a Christmas repeat they said would overwhelm the state’s medical system.
Increasingly exhausted staff, many pressed into service outside their normal duties, are now attending to virus patients stacked up in hallways and conference rooms, said officials from Kaiser Permanente, Dignity Health and Sutter Health, which together cover 15 million Californians.
The CEO of the Martin Luther King, Jr. Community Hospital in Los Angeles, Dr. Elaine Batchlor, separately said patients there have spilled over into the gift shop and five tents outside the emergency department.
The officials offered what they called a “prescription” for Californians to slow the virus spread, a marketing effort dubbed “Don’t share your air.” The underlying message is to stay away from people from other households, which is what many failed to do at Thanksgiving.
“We simply will not be able to keep up if the COVID surge continues to increase,” Kaiser Permanente chairman and CEO Greg Adams said. “We’re at or near capacity everywhere.”
The state reported 32,659 newly confirmed cases Tuesday and another 653 patients were admitted to hospitals, one of the biggest one-day hospitalization jumps. A state data models predict nearly 106,000 hospitalizations in a month if nothing changes. The current level is 17,843.
The officials blamed Thanksgiving transmissions they fear will be repeated if people gather for Christmas and New Year’s and don’t take precautions like wearing masks, socially distancing, staying home as much as possible and not socializing with others….
“We don’t have space for anybody. We’ve been holding patients for days because we can’t get them transferred, can’t get beds for them,” said Dr. Alexis Lenz, an emergency room physician at El Centro Regional Medical Center in Imperial County, in the southeast corner of the state. The facility has erected a 50-bed tent in its parking lot and was converting three operating rooms to virus care.
Imperial County now is seeing 20% of people tested come back positive, compared with the state average of about 13%.
Officials in hard-hit Fresno County in the San Joaquin Valley meanwhile said temperature trackers on their 14,800 Moderna vaccine doses show that some will need replacing, though the vaccine doesn’t need the same ultra-cold care as the Pfizer vaccine.
Vaccine shipments aren’t used if there are “temperature irregularities” as occurred Monday with a shipment to Fresno, said California Department of Public Health spokeswoman Ali Bay. A replacement shipment should arrive Wednesday, she said.
“Temperature irregularities are rare, but they do occur,” she said in an email. “The federal government, manufacturers, distributors, the state, and local government have all planned for this possible scenario and have a system in place to ensure it is immediately addressed.” “ (D)
“As Americans celebrate the rollout of a coronavirus vaccine, many of the doctors and nurses first in line for inoculation say a victory lap is premature. They fear that the optimism stirred by the vaccine will overshadow a crisis that has drawn scant public attention in recent months: the alarming shortage of personal protective equipment, or P.P.E., that has led frontline medical workers to ration their use of the disposable gloves, gowns and N95 respirator masks that reduce the spread of infection.
At St. Mary’s Medical Center in Duluth, Minn., health care workers who treat Covid-19 patients are required to reuse their tightfitting respirator masks up to six times before throwing them away. Although soiled N95s are sterilized each day with ultraviolet light, Chris Rubesch, 32, a cardiac nurse, says the masks invariably sag after two or three shifts, leaving gaps that can allow the virus to seep through. “Our days are filled with fear and doubt,” Mr. Rubesch said. “It’s like driving a car without seatbelts.”
Many of the shortages are the result of skyrocketing global demand, but supply chain experts and health care providers say the Trump administration’s largely hands-off approach to the production and distribution of protective gear over the past nine months has worsened the problem. That has left states and hospitals to compete for limited supplies. Price gouging has become the norm, and scores of desperate institutions have been duped into buying counterfeit products…
With the White House largely disengaged from the crisis, medical workers, supply chain specialists and public health experts are urging President-elect Biden to make good on his campaign promises to use the Defense Production Act to boost domestic manufacturing of personal protective equipment, test kits, vaccines and the medical supplies needed to immunize hundreds of millions of Americans. They are also hoping the incoming administration will take over the distribution of scarce goods and put an end to profiteering and the mad scramble for P.P.E. that has pitted states and deep-pocketed hospital chains against nursing homes and small rural hospitals…
Hospital purchasing agents say they are facing an unparalleled shortage of single-use nitrile gloves — one of the most important items for reducing the spread of infectious pathogens — with prices soaring to $300 a case from $30 before the pandemic. Get Us PPE, a volunteer organization that connects health care facilities to available protective gear, says requests for help have more than tripled in the first half of December compared with the same period last month. Nearly 90 percent of the frontline workers the group surveyed across the country say they are repeatedly reusing masks designed for single use.
The pandemic has exposed flaws in freewheeling distribution system that enables hoarding by wealthy hospital chains and a global supply network overly reliant on overseas manufacturers. This was evident in the early months of the pandemic, when transcontinental flights that ferry Asian-made medical gear to the United States were largely frozen. And the crisis grew worse as China turned off the export spigot and commandeered its mask factories for domestic use.” (E)
“A New York health care provider is being probed over accusations that it illegally acquired COVID-19 vaccines and inoculated people against state guidelines.
The State Department of Health received reports that ParCare Community Health Network in Orange County “may have fraudulently obtained COVID-19 vaccine, transferred it to facilities in other parts of the state in violation of state guidelines and diverted it to members of the public,” according to a statement from state Health Commissioner Dr. Howard Zucker.
The Department of Health and New York State Police are conducting a criminal investigation to determine if ParCare misappropriated the vaccine and violated its distribution plan.” (A)
“Governor Andrew Cuomo announced new penalties in order to rein in possible vaccination fraud as suspected by Parcare Community Health Network which allegedly received the vaccine and distributed to regions and individuals who were not prioritized under state and federal law.
According to the governor, practitioners who break this law will be subject to a $1 million fine as well as all state licenses being revoked.
“You’ll have fraud in the vaccine process it’s almost an inevitable function of human nature, and of the marketplace. Vaccines are valuable and there’ll be people who break the law. And we’re looking at one health care provider who may have done that,” Cuomo said. “That will apply to a provider, a doctor, a nurse, a pharmacist any licensed health care professional. So, if you engage in fraud on this vaccine, we will remove your license to practice in the state of New York.”
New York State Police will be leading investigations into healthcare providers who misrepresent how they will be distributing the vaccine will then be in the hands of Attorney General Letitia James.
“We provide them the vaccine because they fraudulently filled out a form that said that they were a qualified health center, that was incorrect, so that was strike one and number two they moved it from one area to another area, which was inappropriate,” state Health Commissioner Howard Zucker said. “So that strike two, and then they gave it to people who were not on the priority list and so that was strike three.” (B)
“At NewYork-Presbyterian Morgan Stanley Children’s Hospital, one of the most highly regarded hospitals in New York City, a rumor spread last week that the line for the coronavirus vaccine on the ninth floor was unguarded and anyone could stealthily join and receive the shot.
Under the rules, the most exposed health care employees were supposed to go first, but soon those from lower-risk departments, including a few who spent much of the pandemic working from home, were getting vaccinated.
The lapse, which occurred within 48 hours of the first doses arriving in the city, incited anger among staff members — and an apology from the hospital…
The arrival of thousands of vaccine doses in New York City hospitals last week was greeted with an outpouring of hope from doctors and nurses who had worked through the devastating first wave in March and April. But for now, the vaccine is in very short supply, and some hospitals seem to have stumbled through the rollout.
Most of the vaccinations in the New York region to date have involved hospitals giving shots to their own employees, a relatively easy process compared with what is to come as part of the largest vaccination initiative in the nation since the 1940s…
Health care workers and nursing home residents and staff members form what is called Phase 1 of New York State’s vaccine distribution plan. About two million people are in this group, and the state’s initial allocation of the vaccine most likely means that Phase 2, which includes essential workers, won’t begin until late January. (Widespread distribution isn’t likely to begin until the summer, officials have said.)
But the state has left it mostly to each health care institution to devise a vaccination plan during the first phase. In the first week of vaccinations, many hospitals chose a wide variety of health care workers — nurses, doctors, housekeepers — from emergency rooms and intensive care units to be the first at their institutions to receive the vaccine. But in the days after the celebrations accompanying the first shots, the moods at hospitals have shifted.” (C)
“I wouldn’t be surprised that it’s already here,” said Dr. Peter Chin-Hong, an infectious disease professor at UCSF School of Medicine, referring to the new coronavirus variant.
He says unlike the UK, the United States has not done much genomic testing on positive COVID-19 samples to track emerging variants.
“Mainly because we have so many numbers,” said Chin-Hong.
The CDC says out of 17 million positive cases, only 51,000 have been sequenced since the pandemic began. For comparison, the CDC says the UK has sequenced at least 125,000 samples.” (A)
“Millions of people in the U.K. woke up a day after Christmas to tougher coronavirus restrictions on Saturday as officials in France and other European countries reported their first cases of the mutated, potentially more contagious strain.
Swathes of England were placed under the toughest set of lockdown rules, known as “Tier 4,” which will result in the closure of gyms, cinemas, hairdressers and most shops. People will also be restricted to meeting just one other person from another household in an outdoor public space.
The U.K.’s capital, London, has been living under “Tier 4” regulations since last week, while other parts of the country were under lower, less restrictive tiers numbered from one to three.
From Saturday, the number of people living in “Tier 4” in England will increase by 6 million to 24 million people or just over 40 percent of the population.
Scotland, which has its own tier system, moved much of the mainland into the highest level of restrictions for three weeks from Saturday, while Northern Ireland began six weeks of tight limits including a partial evening curfew. Wales remains under a national lockdown.
The total number of deaths from Covid-19 in the U.K. passed 70,000 on Christmas Day, while more than 2 million cases have been reported, according to Johns Hopkins University data…
A French man arrived in France on Dec. 19 from London and tested positive for the new variant Friday, the French public health agency said in a statement.
He had no symptoms and was isolating in his home in the central city of Tours, the statement said. Adding, that authorities were tracing his contacts and laboratories were analyzing tests from several other people who may have the new variant.
The new strain has also been detected in Sweden, Japan, Ireland and Spain, health officials in those countries said. While it was found in places as far flung as Denmark, Iceland and Australia earlier last week.” (B)
“No matter the underlying reason, policymakers should take this new variant very seriously, says epidemiologist Bill Hanage of the Harvard T.H. Chan School of Public Health. If it’s indeed 50% more transmissible, it will be difficult to stop its spread.
“Given the assumptions in their models, it’s really quite hard to avoid a situation very much like what happened last spring, in terms of hospital bed capacity and surges, without a very high rate of vaccination,” Hanage says.
That said, Hanage says there’s no reason for people to panic or be scared. “It’s not a magic virus,” he says — that’s the message virus expert Ian Mackay at the University of Queensland also wrote on Twitter.
“We have actually come across a large number of ways that we can use to stop it. However, we need to redouble our efforts in that direction.”
The variant will likely come to the U.S. — if isn’t here already. The study strongly suggests that people should be even more diligent about preventive measures: avoiding large gatherings. wearing masks, physical distancing and washing hands. On top of that, Hanage says, “the vaccine needs to be getting out at a very, very high rate.”
Because right now, scientists believe the vaccine will still be effective with this new variant. And Hanage says the quicker we immunize the vulnerable members of a community the safer the whole community will be from the original and future versions of the novel coronavirus.” (C)
“New York Gov. Andrew Cuomo is coordinating with hospitals in the state to test for the fast-spreading COVID-19 variant found in the U.K.
At a Dec. 22 news conference, the governor said the state laboratory, Wadsworth Center, has agreements in place with Montefiore Medical Center, Memorial Sloan Kettering Cancer Center, Northwell, University of Rochester Medical Center, Albany Medical Center and Saratoga Hospital to perform the tests.
A spokesperson for Northwell said the system is selecting samples at random and sending them to Wadsworth to test for the new highly contagious strain. Mr. Cuomo said that the state’s health department is making arrangements with other hospitals in the state to facilitate testing for the new strain, and will provide any hospital that has the lab capacity to test for the variant with the right reagents to test for the mutated strain.
Models have shown the COVID-19 variant found in the U.K. spreads 70 percent faster. It has not been detected in the U.S., and the 4,000 tests that Wadsworth has completed so far have come back negative for the variant. Yet Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said this week it is possible that the new variant is already in the United States.
“We have no evidence at this point that it is in this state,” Mr. Cuomo said. “We do know it has been moving globally. Chances are, if it’s been moving globally, it came here. That was the lesson from the spring.”
Mr. Cuomo said if the new variant is identified in New York, he wants to contact trace immediately from that point back and isolate it immediately.
“This is about time and urgency, and this would be urgent. And that’s why we’re mobilizing every hospital lab in the state that can perform this test, to perform this test,” he said.” (D)
“One thing that the emergence of the new variant has made clear is that scientists must pay greater attention to how the virus is changing in the real world. Though mutations are common, and indeed expected, these changes could ultimately affect how well drugs and vaccines work against the virus.
BioNTech, the German company that has partnered with Pfizer on a Covid-19 vaccine, said in a statement that it is “currently investigating the impact of our vaccine on this mutation.” Several countries, including the U.K. and the U.S., have started administering Pfizer-BioNTech’s vaccine, and the European Union authorized use of the vaccine on Monday.
“So far we have tested approximately 20 different mutations and the vaccine was able to address all of them,” the statement continued. “It is too early to draw any conclusions at this stage, but our vaccine is able to mount a strong and broad immune response so we remain optimistic.”
If the vaccine did need to be modified, it would take about 6 weeks to do so, BioNTech CEO Ugur Sahin said during a press conference Tuesday.
David Engelthaler, a geneticist at the Translational Genomics Research Institute in Arizona, said that we need to increase our surveillance of genetic changes to the coronavirus to study how the virus is changing in real time.
“It’s becoming more and more clear that we really need to watch this virus closely. It is not a static thing. It is continuing to evolve and change in slight ways
arose or what they mean long-term for the virus’s transmission. One possible hypothesis for their origin involves chronically ill patients treated with experimental therapies like convalescent plasma donated by recovered COVID-19 patients. In such lengthy illnesses, the virus has more opportunities to replicate, increasing the odds for mutations. The consistent use of the therapies, meanwhile, may put more pressure on the germ to evolve. that may make a big difference” he said. “Otherwise the virus will always be 10 steps ahead.”
The U.K. has a robust system in place to monitor for genetic changes in the virus; in the U.S., however, just 0.3 percent of infections have been genetically sequenced, according to the CDC. That means that while the variant has not been reported in the U.S., it’s possible that it’s already here, undetected.
Rasmussen and Kindrachuk both described the new variant as a “wake-up call” to expand genetic sequencing of the virus in the U.S., regardless of whether this variant turns out to be more transmissible…
“In the end, it’s possible that seasonal adjustments to the vaccine may need to be done, like for flu. We don’t know yet.””(E)
“Scientists are still uncertain about how the cluster of mutations
“Some of these people who are chronically infected have some quite big shifts in the virus,” says Ravindra Gupta, a virologist at the University of Cambridge. “Some are immune-suppressed. Some of them have had convalescent plasma. Some of them have had [the antiviral] remdesivir.”
“Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci said in an interview published Thursday.
Fauci, the country’s top infectious diseases expert, acknowledged in the New York Times interview that he has been incrementally raising his estimate of herd immunity numbers.
Fauci said he has been increasing the estimates in his public pronouncements because he thinks Americans are now able to handle the message that getting back to normal may take longer than anticipated, and fewer Americans are reporting being skeptical of taking a vaccine.
“When polls said only about half of all Americans would take a vaccine, I was saying herd immunity would take 70 to 75 percent,” Fauci told the Times. “Then, when newer surveys said 60 percent or more would take it, I thought, ‘I can nudge this up a bit,’ so I went to 80, 85.”
The Times noted that about a month ago, Fauci began saying herd immunity would take “70, 75 percent” of Americans being vaccinated.
Last week, in an interview with CNBC News, Fauci estimated “between 75 and 80, 85 percent of the population.”
At that level of vaccination, Fauci said, “we would develop a umbrella of immunity. That would be able to protect, even the vulnerables, who have not been vaccinated, or those in which the vaccine has not been effective.”
Fauci said experts don’t really know for sure the level of vaccinations needed for herd immunity, but the initial estimates of 60 to 70 percent were based on early data.” (A)
“Dr. Fauci told The Times in an interview published Thursday that he had slowly but deliberately been moving the goal posts, partly based on new science, and partly on his gut feeling that the American public was ready to receive the information, which is that 70-90% herd immunity should be achieved before the country can go back to normal.
He said he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….
““We need to have some humility here,” he added. “We really don’t know what the real number is. I think the real range is somewhere between 70 to 90 percent. But, I’m not going to say 90 percent.”” (B)
“Asked about Dr. Fauci’s conclusions, prominent epidemiologists said that he might be proven right. The early range of 60 to 70 percent was almost undoubtedly too low, they said, and the virus is becoming more transmissible, so it will take greater herd immunity to stop it…
Measles is thought to be the world’s most contagious disease; it can linger in the air for hours or drift through vents to infect people in other rooms. In some studies of outbreaks in crowded military barracks and student dormitories, it has kept transmitting until more than 95 percent of all residents are infected.
Interviews with epidemiologists regarding the degree of herd immunity needed to defeat the coronavirus produced a range of estimates, some of which were in line with Dr. Fauci’s. They also came with a warning: All answers are merely “guesstimates.”
“You tell me what numbers to put in my equations, and I’ll give you the answer,” said Marc Lipsitch, an epidemiologist at Harvard’s T.H. Chan School of Public Health. “But you can’t tell me the numbers, because nobody knows them.”…
The original assumption that it would take 60 to 70 percent immunity to stop the disease was based on early data from China and Italy, health experts noted.
Epidemiologists watching how fast cases doubled in those outbreaks calculated that the virus’s reproduction number, or R0 — how many new victims each carrier infected — was about 3. So two out of three potential victims would have to become immune before each carrier infected fewer than one. When each carrier infects fewer than one new victim, the outbreak slowly dies out.
Two out of three is 66.7 percent, which established the range of 60 to 70 percent for herd immunity….
Further complicating matters, there is a growing consensus among scientists that the virus itself is becoming more transmissible. A variant “Italian strain” with the mutation known as D614G has spread much faster than the original Wuhan variant. A newly identified mutation, sometimes called N501Y, that may make the virus even more infectious has recently appeared in Britain, South Africa and elsewhere.
The more transmissible a pathogen, the more people must become immune in order to stop it.
Dr. Morens and Dr. Lipsitch agreed with Dr. Fauci that the level of herd immunity needed to stop Covid-19 could be 85 percent or higher. “But that’s a guesstimate,” Dr. Lipsitch emphasized.
“Tony’s reading the tea leaves,” Dr. Morens said.
The Centers for Disease Control and Prevention offers no herd immunity estimate, saying on its website that “experts do not know.”
Although W.H.O. scientists still sometimes cite the older 60 to 70 percent estimate, Dr. Katherine O’Brien, the agency’s director of immunization, said that she now thought that range was too low. She declined to estimate what the correct higher one might be.
“We’d be leaning against very thin reeds if we tried to say what level of vaccine coverage would be needed to achieve it,” she said. “We should say we just don’t know. And it won’t be a world or even national number. It will depend on what community you live in.”
Dr. Dean noted that to stop transmission in a crowded city like New York, more people would have to achieve immunity than would be necessary in a less crowded place like Montana.
Even if Dr. Fauci is right and it will take 85 or even 90 percent herd immunity to completely stop coronavirus transmission, Dr. Lipsitch said, “we can still defang the virus sooner than that.”
He added: “We don’t have to have zero transmission in order to have a decent society. We have lots of diseases, like flu, transmitting all the time, and we don’t shut down society for that. If we can vaccinate almost all the people who are most at risk of severe outcomes, then this would become a milder disease.” (C)
“Dr. Anthony Fauci, the nation’s senior official for infectious diseases, predicts the United States could begin to achieve early stages of herd immunity against the deadly coronavirus by late spring or summer. And if that happens, Fauci anticipates, “we could really turn this thing around” toward the end of 2021…
Fauci said if all goes according to plan, by the end of March or beginning of April more vaccines will be available to the general public.
“Once we get there, if in the subsequent months, April, May, June, July, we get as many people vaccinated as possible, we could really turn this thing around before we get towards the end of the year,” Fauci said…
“We still have a raging outbreak that we need to get under control, so at the same time as we’re administering the vaccine as quickly and as expeditiously as possible, we still have to implement the public health measures to prevent the surges we’re seeing throughout the country.” (D)
“The nation’s top infectious disease expert estimates that most Americans will have access to the new COVID-19 vaccines by mid-summer.
Dr. Anthony Fauci told Good Morning America on Tuesday that he expects to start vaccinating the general population “somewhere in the end of March, the beginning of April.”
He said the process could take up to four months to reach all Americans who want to receive the vaccine.” (E)
“As the nationwide vaccination effort ramps up, the federal government announced it has reached a deal to buy 100 million additional doses of Pfizer’s vaccine. Fauci expressed optimism in the availability of vaccines going into 2021. After the first round of doses goes to frontline health care workers, nursing home residents and others at highest risk, more and more of the American public will be able to get the shots in the months ahead.
“At the end of the summer, if we can get the overwhelming majority of the people in this country to accept vaccinations, I think, we will be in good shape towards approaching what all of us would want, a return to some form of normality,” Fauci said.
There have been more than 18 million confirmed COVID-19 cases in the U.S. since the start of the pandemic, and more than 322,000 Americans have died.
Asked about a mutated strain of the virus recently detected in the U.K. which may be more transmissible than before, Fauci explained that viral mutations are nothing new.
“These RNA viruses mutate all the time. The more infection and the more replication you have, the more likelihood is that you are going to get mutations,” he said, and noted that most viral mutations “have no relevant functional impact.”
He said there was no data thus far that indicated the new variant would withstand the vaccine.
“Having said that, we’ve got to take this seriously. We’ve got to follow it very carefully,” he cautioned.
Viruses like influenza that mutate more rapidly are usually combatted by a modified vaccine. Flu shots, for example, need modification “almost every year.”
However, he said the COVID-19 vaccines may not need such frequent updates. “This vaccine does not drift… it does not drift the way influenza does,” he said, and he expressed confidence that adjustments would be made if needed.” (F)
“On a recent Skype call with my grandmother, I broached the topic of the fast-arriving Covid-19 vaccines.
Advanced age brings wisdom, but it also brings an elevated risk of severe illness from infection with the coronavirus, so I wanted to prime her to get an FDA-approved vaccine as early as possible.
But as I was extolling the benefits of vaccination, I noticed a furrowed brow, a frown, and a look of uncertainty on her face. That took me by surprise. Surely someone who gets a flu shot every year and who raised two doctors shouldn’t feel anxious to get the Covid jab. But she clearly was.
That conversation left me worried not only about her safety but about the safety of our country. If my Grandma was feeling hesitant, millions of other Americans are probably feeling the same way. A nagging question popped into my mind: If vaccine distrust plagues our country, when will we be able to achieve herd immunity and transition to a new normal?
Herd immunity protects those with vulnerable immune systems. Here’s how.
Herd immunity occurs when a critical mass of people become immune to a pathogen like SARS-CoV-2, the virus that causes Covid-19. With enough people immune to the virus, the chain of transmission is halted, which provides indirect protection to individuals who aren’t immune.
Inspired by Dr. Jacob E. Jones, a family medicine physician at my hospital who made some predictions on the time required to achieve herd immunity based on vaccine adoption, I set out to answer my question with a model that uses the following variables and definitions:
The basic reproduction number R0 (pronounced R-naught). This number represents how infectious a pathogen is. An R0 of 2 means one individual infected with SARS-CoV-2 is likely to infect two other people. Currently, most estimates of R0 are between 2.5 and 4. For the sake of this thought experiment, I assumed an R0 of 4.
Base prevalence. This is the percentage of people immune to the virus at a given moment in time, either from acquired infection or vaccination.
Monthly infection rate. This is the percentage of people who become infected and acquire immunity to the virus every month.
Using just the basic reproduction number, it’s possible to calculate the percentage of people needed to achieve herd immunity:
If R0 is 4, then 75% of the population needs to acquire immunity to the virus in order to halt transmission.
In late September, a Stanford study estimated that 9.3% of Americans have antibodies against SARS-CoV-2. To be sure, antibody testing may suffer from low positive predictive value when the prevalence of infection is low, but this is the best estimate we have so far. I’ll use that as the base prevalence.
If the base prevalence at the end of September — eight months from the onset of the epidemic in the United States on January 21, 2020 — was 9.3%, the coronavirus has an infection rate of approximately 1.2% of the population per month. This back-of-the-envelope calculation is in line with estimates from the medical literature, with one study estimating 52.9 million infections in the U.S. from February 27 to September 30, or an infection rate of 1.3% per month.
Using the herd immunity threshold, the base prevalence, and the monthly infection rate, it’s possible to calculate the number of months (m) to achieve herd immunity:
If the virus is left to spread at its current rate with no vaccine, it would take 55 months from October 2020 to achieve herd immunity. That means May 2025. Even if I had assumed an R0 of 3, it would still take 48 months to reach herd immunity.” G)
“Vaccination offers two benefits, said Joshua Epstein, a professor of epidemiology at the NYU School of Global Public Health: direct protection of the person vaccinated, as well as the social benefit of vaccinated people not spreading the disease to others.
“If enough get vaccinated, the disease can die out on its own for lack of fuel,” Epstein said. “That’s the herd-immunity idea: Protect enough people that it has insufficient fuel to keep burning.” The goal of a vaccination strategy, he added, “is to tip the epidemic into that declining state.”
How many people need to get vaccinated
The vaccine candidate from Pfizer PFE, -0.45% and its German partner, BioNTech BNTX, -3.10%, showed 95% efficacy in protecting against COVID-19 in a late-stage clinical trial. Moderna’s MRNA, -5.33% vaccine showed about 94% efficacy.
It remains unclear whether the two vaccines, which received emergency-use authorization from the Food and Drug Administration this month, protect against symptomless COVID-19 infection or transmission. Preliminary data from Moderna’s trial suggested there may be a lower risk of asymptomatic infection after one dose, though further analysis is needed.
Estimates vary on what share of the population would need to get vaccinated against COVID-19 in order to achieve herd immunity, and experts warn that it’s hard to pin down a definitive figure just yet.
Both consist of two doses: Pfizer’s requires a second shot three weeks after the first, while the Moderna shots come four weeks apart.
At least 614,117 U.S. vaccine doses had been administered as of Monday morning, according to the Centers for Disease Control and Prevention; that tally only included Pfizer doses. Some 4.6 million doses of both vaccines had been distributed.
The U.S. has never reached herd immunity from natural infection with a novel virus; so far, vaccination has always been required. Estimates vary on what share of the population would need to get vaccinated against COVID-19 in order to achieve herd immunity, and experts warn that it’s hard to pin down a definitive figure just yet.
Moncef Slaoui, the Trump administration’s vaccine czar, told CNN in November that with the roughly 95% efficacy level demonstrated by Pfizer’s and Moderna’s vaccines, “70% or so of the population being immunized would allow for true herd immunity to take place.” “That is likely to happen somewhere in the month of May, or something like that, based on our plans,” he said.
Anthony Fauci, the nation’s top infectious-disease doctor, said during a Nov. 30 livestream with Facebook FB, -0.26% CEO Mark Zuckerberg that while he wasn’t yet sure what percentage of the population would need to get vaccinated against COVID-19 to achieve herd immunity, “I would imagine it’s somewhere between 75 and 85% at least.”
“If you have a highly efficacious vaccine and only 50% of the country gets vaccinated, you’re not going to have that umbrella of protection of herd immunity,” Fauci added. “What you really want is one, what we have, a highly efficacious vaccine — but you want 75, 85% of the people to get vaccinated.”
The percentage of people that will need to be vaccinated will depend on the actual vaccine efficacy in real life and any future vaccine efficacy, Landon added.
“If everyone got one of the mRNA vaccines and they worked about 90% of the time, we would need to vaccinate about 10% more than the ‘herd immunity’ target, whatever that may be,” she said. (mRNA technology, employed in both the Pfizer and Moderna vaccines, teach the body’s cells to create proteins that generate an immune response.) (H)
“County officials who have for years been planning for a mass vaccination said they are seeing that training and preparation — much of it funded by millions of dollars in federal grants — pushed aside as the administration of Gov. Andrew M. Cuomo has retained control of the state’s coronavirus vaccination program, including having hospitals rather than local health departments administer the doses.
Interviews with multiple county officials over the past week confirm that many are unclear why the governor’s administration has not activated the county-by-county system, a plan that included recent practice sessions in which members of the public received regular flu vaccines at drive-thru sites…
Gareth Rhodes, a member of Cuomo’s coronavirus task force, said the county health departments and their pre-designated “points of distribution” for vaccinations are still integral to the governor’s plan, which is being done on a regional rather than county-by-county basis. As part of that process, the state is gathering details from counties about their vaccination plans and capabilities.
“The state then refines and approves and we implement the regional plan, of which every single health department plays a large role,” Rhodes said. “It’s not like we’re sitting on 50 million vaccine doses. … We’re getting a very small number every week, and criteria for who is eligible is obviously very narrow at this point.”
Rhodes, who is helping lead the administration’s vaccination strategy, said the planning is complicated because every person needs to receive two doses of the same vaccine — roughly three weeks apart — and the vaccine being distributed by Pfizer must be kept in deep-freeze storage containers until it’s thawed for use.
Rhodes took issue with the idea that the county plans were being ignored. “We’ve been working very closely with them, have had a number of calls with them,” he said. “I think our goals are all the same; we want to get this thing done as quickly as possible and in the most efficient way as possible.” (I)
