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.”

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“What seemed impossible months ago is now a reality: the first doses of a Covid-19 vaccine have been given to the American public, less than a year after the disease was first spotted in the US.

It’s an astonishing feat, since most vaccines take years to develop.

But it will be several months before most Americans can get a Covid-19 vaccine.

In the meantime, thousands of Americans are dying from the virus every day.

And the rates of new infections and deaths are accelerating at unprecedented rates, meaning Americans must hunker down this winter before rolling up their sleeves.

A critical care nurse was the first person in New York and among the first people in the country to get a first dose of the Pfizer/BioNTech vaccine…

The US Food and Drug Administration recently authorized the vaccine for emergency use, and the US Centers for Disease Control and Prevention has allowed it to be given to people 16 and older.

“We expect 145 sites across all the states to receive vaccine on Monday, another 425 sites on Tuesday, and the final 66 sites on Wednesday, which will complete the initial delivery of the Pfizer orders for vaccine,” said Gustave Perna, chief operating officer of Operation Warp Speed.

Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.

But the CDC has recommended that health care workers and residents of long-term care facilities get the vaccine first.”(A)

“In the US, the Pfizer/BioNTech vaccine is being distributed to hundreds of hospitals. Healthcare workers at high risk of being infected should get vaccinated first, the US Centers for Disease Control and Prevention’s vaccine advisory panel has recommended. Nursing home residents are next in line, and are due to start getting vaccinated from next week.

Mass vaccination could be a particular challenge in the US because it lacks a centralised healthcare system. Different states and hospitals can make different decisions on who gets the vaccine.

There is also concern about the rate of uptake, even though the vaccine will be free. Only half of US adults say they will get vaccinated, according to a recent survey. Another quarter are unsure and the remaining quarter say they won’t take it.” (B)

“Complicating the matter in Pennsylvania is the fact that the state has not disclosed how many doses are anticipated or how the vaccine will be allocated once it gets here.

The state released an interim vaccine plan Friday, but it doesn’t detail which regions or facilities will get the initial doses, making Pennsylvania and Puerto Rico the only places that haven’t released that information, according to a New York Times survey…

The Pennsylvania Department of Health will determine how much each region will receive, but those numbers have not been disclosed. After postponing release of the information twice last week, a department spokeswoman did not respond Friday, and a spokesman declined to comment on Saturday.

In next-door Ohio, Gov. Mike DeWine has released not only how many doses his state anticipates, but also how many will go to specific facilities statewide.” (F)

“President Donald Trump has asked White House staffers to receive the coronavirus vaccine “somewhat later in the program, unless specifically necessary,” he tweeted Sunday night after it surfaced that high-ranking administration officials were set to receive some of the first doses in the US.

The vaccinations, which were set to begin as soon as this week, would have come while the vaccine is in extremely limited supply and only generally available to high-risk health care workers. Other parts of the Trump administration were intended to be vaccinated in the coming days…

An administration official said health care providers at the National Institutes of Health will begin receiving the vaccine in the near future. Doctors and nurses in the intensive care unit at the NIH Clinical Center will be prioritized to receive the vaccine first. Other top officials, like Dr. Anthony Fauci, are on the list to receive the vaccine following those staffers who rank higher on the priority list, the official said.

“Senior officials across all three branches of government will receive vaccinations pursuant to continuity of government protocols established in executive policy,” National Security Council spokesman John Ullyot said in a statement. “The American people should have confidence that they are receiving the same safe and effective vaccine as senior officials of the United States government on the advice of public health professionals and national security leadership.”..

The President and other White House staff have regularly flouted US Centers for Disease Control and Prevention guidelines for safety during the pandemic such as the wearing of face masks and social distancing.

There have been several Christmas parties held at the White House recently where those guidelines weren’t followed, and Trump held many events during the campaign where large crowds gathered, maskless.” (E)

“With the Food and Drug Administration’s authorization of a coronavirus vaccine on Friday, the United States became the third highly developed Western country — after Britain and Canada — to approve such a shot, and is expected to start inoculating people within days.

But the three countries have very different health care systems. And they face different challenges in the race to get the vaccine to millions of people.

Here are some similarities and contrasts…

How centralized is the rollout?

In Britain, very. In the United States, not. In Canada, somewhere in between.

With a strong central government and a National Health Service that covers all of its people, Britain, which began giving the vaccine this past week, is directing the process from London. The national government chose the 50 hospitals that would initially get the vaccine and made sure they were prepared; decided how much each one would receive; and drafted the rules determining in what order people would be eligible to get it.

The Trump administration has deferred much of the decision-making to the states. The federal government will have the vaccine distributed to each state based on population, not need, but some states have complained that they do not know enough about the arrangements.

It will be up to the states to decide how to divide the doses among hospitals, clinics and, ultimately, drugstores and doctors’ offices, but at first, at least, the vaccine will go to hospitals with ultracold storage…

Like Britain, Canada has a universal health care system, but like the United States, it has a federal government. The Canadian health care system is decentralized, administered by the provinces and territories.

For vaccine distribution, the central government plans to work through those regional governments. Ottawa will play a large role in directing the process.

Canada had ordered enough of the Pfizer-BioNTech vaccine for all of its people, Britain enough for 30 percent and the United States enough for 15 percent…

In Canada, where the military is playing a central role in vaccine distribution, the government is sending shipments to all 10 provinces. The three northern territories will have to wait.

In the United States, FedEx and UPS will ship vaccines from distribution centers to every part of the country. But the holiday season is the busiest time of the year for delivery services, which could slow things down.

How fast will most people get vaccines?

That is even murkier.

Britain, Canada, the United States and the European Union have all followed similar strategies, pre-ordering huge numbers of doses — more than enough to inoculate everyone — from multiple makers, hedging their bets in case some of the vaccines are not approved or some manufacturers have production breakdowns.

Relative to their populations, the United States has ordered far fewer doses than Canada or Britain, and last summer it passed up an offer to increase its advance order from Pfizer. Administration officials say the numbers are misleading, because the government has signed options to buy far more of the vaccine if it sees the need.

But in the face of intense global demand, it is not clear how fast pharmaceutical companies will be able to fulfill the orders they have, much less any additional orders.

And again, the speed of development, approval and production will affect how quickly supplies reach people. A country that places a bigger bet on one vaccine could be much better off than one that relies more heavily on another.” (G)

MEANWHILE –

“Heading into another holiday season, Texas has the fewest number of available intensive care beds to care for its sickest patients since the pandemic began, leaving health care experts worried hospitals could be pushed to the brink as coronavirus cases continue to climb.

As of Thursday, there were 672 staffed ICU beds available statewide. That’s compared with 2,100 open ICU beds available at the end of April, according to the Texas Department of State Health Services.

Intensive care units were full in at least 28 hospitals spread across Texas for the week ending Nov. 27, according to a Texas Tribune analysis of data released by the U.S. Department of Health and Human Services. More than 160 hospitals reported having less than 15% of their ICU beds available during the same period…

The Texas Tribune analyzed data for 200 of the largest hospitals that reported four or more ICU beds or ICU patients across the state. The numbers represent seven-day averages that were self-reported to the federal government.

There were 9,045 people in hospitals with COVID-19 as of Thursday, according to state data, near the record level last seen in late July.

The crush of demand for ICU beds is, in part, because many people put off treatment for non-coronavirus illnesses in the early months of the pandemic, Cummins said. Now, people are returning to emergency rooms with more severe complications for conditions like heart attacks and strokes…

Staff at Texas Health Frisco converted beds used for postpartum recovery to medical overflow, faced with an increasing number of patients with COVID-19, said Barclay Berdan, CEO of Texas Health Resources, one of the largest hospital systems in North Texas…

Texas Medical Center hospitals in Houston exceeded base ICU capacity Thursday for the first time since cases of COVID-19 surged this summer, the Houston Chronicle reported. That prompted hospitals to return to Phase 2 surge planning, in which regular beds are converted to ICU beds…

“The specter of the Christmas holiday is very nerve-wracking for hospitals,” … (D)

“A number of New York City hospitals are nearing capacity in their intensive care units as coronavirus cases rise across the city and state, new data shows.

A total of eight hospitals across the five boroughs have reached more than 90 percent fullness in their ICUs, according to the data, which was recently-released by the United States Department of Health and Human Services and compiled by Gothamist. The hospitals include three in Brooklyn, two in Manhattan, two in Queens and one in Staten Island.

The data comes as coronavirus hospitalizations increase across New York City. As of Friday, an average of 904 people have been admitted into the hospital each week over the last month.

Hospitals and public health officials have assured New Yorkers that, despite the surge, the state and medical response to the virus has improved since it first took hold of the city earlier this year.

“…NewYork-Presbyterian has been preparing for this possibility since the first wave,” NewYork-Presbyterian, which runs Brooklyn Methodist, told Patch in a statement. “We have expanded ICU capacity and are redeploying resources as needed within the hospital and across the NewYork-Presbyterian system, and every patient is receiving the care they need.”

One of the eight hospitals, Flushing Hospital in Queens, surpassed 100 percent capacity, with 123 percent of its ICU beds used by COVID-19 patients. Kingsbrook Jewish Medical Center in Brooklyn, with 100 percent fullness, was the second highest.

Gov. Andrew Cuomo said Friday that the average length of stay in the hospital for coronavirus patients has decreased in New York from 11 days earlier this year to just five days given new treatment methods and better preparation.

The death rate has decreased from 20 recent to 8 percent, Cuomo said.

The governor has also pointed to state-mandated “load balancing” among hospital systems — or distributing patients among hospitals so no one facility is overwhelmed — as a major difference between the handling of the current surge and the first crisis earlier this year.” (C)

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(A)The first public Covid-19 vaccines have been injected just as the US death toll nears 300,000, By Susannah Cullinane and Holly Yan, https://www.cnn.com/2020/12/14/health/us-coronavirus-monday/index.html

(B)The first US coronavirus vaccinations have taken place in New York, By Michael Le Page, https://www.newscientist.com/article/2262785-the-first-us-coronavirus-vaccinations-have-taken-place-in-new-york/

(C)8 NYC Hospital ICUs Near-Full With Coronavirus Patients: Data, By Anna Quinn, https://patch.com/new-york/new-york-city/8-nyc-hospital-icus-near-full-coronavirus-patients-data

(D)Ahead of the holiday season, Texas’ ICU capacity is the lowest since the start of the pandemic, BY SHAWN MULCAHY AND CARLA ASTUDILLO, https://www.texastribune.org/2020/12/11/texas-icu-coronavirus/

(E)Trump says he halted plan to immediately vaccinate White House staffers, By Jim Acosta and Kaitlan Collins, https://www.cnn.com/2020/12/13/politics/white-house-coronavirus-vaccine/index.html

(F) As COVID-19 vaccine distribution starts, Pa.’s lack of specifics complicates planning, by KRIS B. MAMULA, https://www.post-gazette.com/business/healthcare-business/2020/12/13/COVID-19-vaccine-distribution-butler-health-system-geisginer-main-line-Redstone-highlands-presbyterian-seniorcare/stories/202012130092

(G) In Britain, thousands received the first clinically authorized, fully tested coronavirus vaccine on Tuesday., By Richard Pérez-Peña, https://www.nytimes.com/2020/12/12/world/americas/covid-vaccine-us-uk-canada.html?referringSource=articleShare