“Early in the pandemic, when vaccines for the coronavirus were still just a glimmer on the horizon, the term “herd immunity” came to signify the endgame: the point when enough Americans would be protected from the virus so we could be rid of the pathogen and reclaim our lives.
Now, more than half of adults in the United States have been inoculated with at least one dose of a vaccine. But daily vaccination rates are slipping, and there is widespread consensus among scientists and public health experts that the herd immunity threshold is not attainable — at least not in the foreseeable future, and perhaps not ever.
Instead, they are coming to the conclusion that rather than making a long-promised exit, the virus will most likely become a manageable threat that will continue to circulate in the United States for years to come, still causing hospitalizations and deaths but in much smaller numbers.
How much smaller is uncertain and depends in part on how much of the nation, and the world, becomes vaccinated and how the coronavirus evolves. It is already clear, however, that the virus is changing too quickly, new variants are spreading too easily and vaccination is proceeding too slowly for herd immunity to be within reach anytime soon.
Continued immunizations, especially for people at highest risk because of age, exposure or health status, will be crucial to limiting the severity of outbreaks, if not their frequency, experts believe.
“The virus is unlikely to go away,” said Rustom Antia, an evolutionary biologist at Emory University in Atlanta. “But we want to do all we can to check that it’s likely to become a mild infection.”
The shift in outlook presents a new challenge for public health authorities. The drive for herd immunity — by the summer, some experts once thought possible — captured the imagination of large segments of the public. To say the goal will not be attained adds another “why bother” to the list of reasons that vaccine skeptics use to avoid being inoculated.
Yet vaccinations remain the key to transforming the virus into a controllable threat, experts said.
Dr. Anthony S. Fauci, the Biden administration’s top adviser on Covid-19, acknowledged the shift in experts’ thinking.
“People were getting confused and thinking you’re never going to get the infections down until you reach this mystical level of herd immunity, whatever that number is,” he said.
“That’s why we stopped using herd immunity in the classic sense,” he added. “I’m saying: Forget that for a second. You vaccinate enough people, the infections are going to go down.” (A)
“What I really worry about is that those people who are already on the fence don’t get vaccinated (and) we don’t reach herd immunity come the fall,” CNN medical analyst Dr. Leana Wen told CNN.
“And then with the winter … we have a big resurgence, maybe we have variants coming in from other countries, and we could start this whole process all over again and have another huge pandemic come the winter.”
Experts including Dr. Anthony Fauci have estimated between 70% to 85% of the US population needs to be immune to the virus — through vaccination or previous infection — to control its spread…
Some experts think driving down infections will be good enough, even if herd immunity isn’t reached.
While it would be unfortunate for the United States to not reach herd immunity, most people will still be able to get back to their pre-pandemic lives if case numbers continue to fall, Dr. Ashish Jha, dean of the Brown University School of Health, told CNN on Monday.
“We may not get to zero, we probably won’t,” Jha said. “But if we can get the infections at very low levels, most of us can get back to our lives in normal ways. I think we can probably live with that.”
For the ongoing local, state and federal efforts to get more shots into Americans’ arms, now comes the hard part: reaching audiences that weren’t as eager to get vaccinated in the past few months or who may not have had access to a shot.
“We need to be … innovative around both culturally competent education and be thoughtful about where the holes are and where we can get shots in people’s arms,” infectious diseases expert Dr. Mati Hlatshwayo Davis told CNN over the weekend.
‘Make it really easy’ to get vaccinated, doctor says
New strategies to increase vaccinations must be tried, such as closing mass vaccination centers and distributing vaccine to more localized venues such as doctors’ offices, churches, schools and workplaces, Wen said.
The government should “make it really easy” for people to get vaccinated, Wen said, especially Americans who aren’t really vaccine hesitant but just can’t find the time because of jobs and family responsibilities….
New Jersey Gov. Phil Murphy said the state plans to put its efforts “into overdrive” to get more residents vaccinated, including allowing walk-up vaccinations to anyone over the age of 16 at the state’s six vaccine megasites at specific hours.
The state also will launch a vaccine awareness initiative that will include a “massive” email campaign and automated outgoing calls, Murphy said.
In a campaign dubbed “Shot and a Beer,” the state plans to offer a free beer to anyone over the age of 21 who shows their completed CDC vaccination card at thirteen participating breweries throughout the state, Murphy said.
In Florida, Gov. Ron DeSantis signed an executive order Monday suspending the remaining power of local governments to implement or enforce Covid-19 restrictions.
“I think that’s the evidence-based thing to do. I think folks that are saying they need to be policing people at this point, if you are saying that, you really are saying you don’t believe in the vaccines, you don’t believe in the data, you don’t believe in the science,” DeSantis said at a news conference in St. Petersburg.” (B)
“As COVID-19 vaccination rates pick up around the world, people have reasonably begun to ask: how much longer will this pandemic last? It’s an issue surrounded with uncertainties. But the once-popular idea that enough people will eventually gain immunity to SARS-CoV-2 to block most transmission — a ‘herd-immunity threshold’ — is starting to look unlikely.
That threshold is generally achievable only with high vaccination rates, and many scientists had thought that once people started being immunized en masse, herd immunity would permit society to return to normal. Most estimates had placed the threshold at 60–70% of the population gaining immunity, either through vaccinations or past exposure to the virus. But as the pandemic enters its second year, the thinking has begun to shift. In February, independent data scientist Youyang Gu changed the name of his popular COVID-19 forecasting model from ‘Path to Herd Immunity’ to ‘Path to Normality’. He said that reaching a herd-immunity threshold was looking unlikely because of factors such as vaccine hesitancy, the emergence of new variants and the delayed arrival of vaccinations for children.
Gu is a data scientist, but his thinking aligns with that of many in the epidemiology community. “We’re moving away from the idea that we’ll hit the herd-immunity threshold and then the pandemic will go away for good,” says epidemiologist Lauren Ancel Meyers, executive director of the University of Texas at Austin COVID-19 Modeling Consortium. This shift reflects the complexities and challenges of the pandemic, and shouldn’t overshadow the fact that vaccination is helping. “The vaccine will mean that the virus will start to dissipate on its own,” Meyers says. But as new variants arise and immunity from infections potentially wanes, “we may find ourselves months or a year down the road still battling the threat, and having to deal with future surges”.
Long-term prospects for the pandemic probably include COVID-19 becoming an endemic disease, much like influenza. But in the near term, scientists are contemplating a new normal that does not include herd immunity. Here are some of the reasons behind this mindset, and what they mean for the next year of the pandemic.” (C)
“How many people are already immune to SARS-CoV-2?
The short answer is that we don’t know. Study results released on April 27 suggest that 21% of New York City residents have antibodies to SARS-CoV-2, meaning they had likely been exposed to the virus. In most other places, these numbers are lower. For example, in testing done on April 3-4 in Santa Clara County, California, 3% of residents had these antibodies.
These studies used tests that look at antibodies, because antibodies are an easily detected measure of immune response and are sometimes an indicator of who is protected from infection. However, we do not know if people with antibodies to SARS-CoV-2 are immune—and if they are, how long any protection might last…
Ultimately, to know how many people are immune to SARS-CoV-2, we’ll need to know not only how many people have antibodies (a number that will increase in the coming months), but also how protective those antibodies are (so-called correlates of immunity). To know this, we need to make sure that existing antibody tests are high-quality, and we need to perform additional studies to evaluate whether having antibodies provides protection against reinfection.” (D)
Whether or not COVID-19 can be conquered through herd immunity is an open question, according to experts.
In an April 1, 2021, article in the Boston Globe, Marc Lipsitch, professor of epidemiology and director of the Center for Communicable Disease Dynamics at Harvard T.H. Chan School of Public Health, was among experts who said that a lack of clear data on the virus and vaccines makes it hard to determine the possibility of reaching herd immunity, which could occur if enough people are vaccinated or otherwise immune to the virus.
There’s a simple math formula for calculating herd immunity. But the problem is that one of the figures needed for the formula is a disease’s infectiousness rate—and scientists aren’t sure what that rate is.
Early in the pandemic, scientists thought that each infectious person with COVID-19 would infect 2.5 to 3 other people—meaning that reaching herd immunity would require roughly two-thirds of a population to be immune, according to the formula. But that estimate may be off. Many early cases may have been missed because of limited early testing for COVID-19. And because people have changed their behavior over time, it may have masked the disease’s true infectiousness. “We were sort of stuck with bad data,” said Lipsitch.
Other factors further complicate the herd immunity calculation. One is the presence of highly infectious variants. Another is that it’s not known whether, and to what extent, vaccinated people can still transmit the disease to others.
If COVID-19 is more infectious than previously thought, the herd immunity threshold would be higher too. So, for instance, if each infectious person could infect four people, 75% of the population would need to be immune to stop the virus from spreading. If each person could infect five others, 80% would need to be immune; if they could infect six others, 85% would need immunity. (E)
“And while the prospect of the coronavirus dying out through a combination of vaccinations and herd immunity is appealing, the nation’s top doctor is urging caution.
Earlier this month, Dr. Anthony Fauci said in a White House briefing that, in the COVID-19 context, it’s difficult to define what exactly would constitute herd immunity.
“Rather than concentrating on an elusive number, let’s get as many people vaccinated as quickly as we possibly can,” Fauci said.” (F)
“To that end, America still has to do a lot more work to vaccinate people. The number of doses administered daily has declined in recent weeks to around 2.4 million on average from a high of nearly 3.4 million.
Experts attribute this to America’s vaccine rollout problem shifting from supply to demand. Brown University School of Public Health dean Ashish Jha used the analogy of a new iPhone coming out: So far, the US has vaccinated the most enthusiastic, those willing to camp out overnight for the vaccines. Now, the US has to make it less difficult for the less enthusiastic to get the shot — make it easier to get an appointment or remove appointment requirements entirely, and bring vaccines closer to where people are, including their homes, workplaces, doctor’s offices, or even hot spots for socializing and entertainment.
The US also may have to do work with those who are truly resistant. Based on public polls, that’s about 10 to 25 percent of American adults. The country could hit 60 percent of Americans or even 75 percent of adults without them. But converting as many of those people as possible still would help get the US there quicker. That could require extensive messaging efforts, especially from Republican leaders whose constituents are more likely to be hesitant.
If the US does all of this right, there’s genuinely good news: The end not only may be in sight, it’s perhaps even closer than we think.
“After going through this, people have a tendency to go crazy,” Kates said. “[People] are like, ‘Is this real? Are we really okay?’ The trauma is deep, so there’s a bit of anxiety about that. But I think we’re just in a much better place than we were not too long ago.”
“Monica Gandhi, M.D., an infectious disease doctor and professor of medicine at the University of California, San Francisco, says we will know we’re on the road to normalcy based on what’s happening in hospitals and in the community.
“We will know it when we see it,” she says. “First, hospitalizations will be massively reduced, because people can’t get severe disease after they’re immunized. Second, cases will be so low that even when people [have respiratory symptoms and] test, they won’t have it.”
Estimates of when we will reach that point are all over the map. Some experts predict a return to normalcy as soon as April or May, while others say it may not be until 2022.
The wide discrepancy reflects the reality that a range of complex factors could affect the timeline, in ways both good and bad. Here are four of the biggest variables that will determine when we can return to some semblance of normalcy.
1. The pace of vaccination
2. How long natural immunity lasts
3. More contagious virus variants
4. Vaccine hesitancy..
New normal will likely include the coronavirus
Wolfe, Gandhi, Mansky and Murray are all hopeful that some semblance of regular life will resume for Americans in the fall of 2021 or by early 2022 at the latest.
But they emphasize that the coronavirus will never be totally eradicated. It’s already spread too far, and it’s changing too fast. Instead, they said, the goal of public health efforts is to make it a manageable virus, like the seasonal flu. The vaccines authorized for use in the U.S. have been shown to be highly effective at reducing the number of severe COVID-19 cases and hospitalizations.
Depending on how long immunity from the vaccines last, we may need to get a coronavirus shot every year, or once every three years.
“The coronavirus will be with us, but it will not be terrible,” Gandhi says. “What’s important is that we don’t want to get severe disease. The vaccines mean that we can defang the virus, taking it from causing severe disease to a virus that causes a cold.” (G)
Reaching herd immunity with a vaccine is a little more complicated than it seems, though. Not everyone has the same risk of getting and passing on the virus—some are more likely to be infected and spread it (think: essential workers), while others may not have as high of a risk of passing it on (think: people who have been working from home and mainly staying indoors), Dr. Adalja says. “You may get the benefits of herd immunity before you actually cross the threshold of herd immunity if the people who are responsible for the majority of cases get vaccinated,” he says.
What happens after we finally reach herd immunity for COVID-19?
Doctors think COVID-19 will eventually be a smaller threat. “I doubt it will go away,” says Richard Watkins, M.D., an infectious disease specialist and a professor of internal medicine at the Northeast Ohio Medical University. He predicts that “COVID-19 will probably become seasonal, like the flu, with increases in the winter.”
Dr. Adalja also thinks COVID-19 will become “a much more manageable respiratory illness,” and anticipates that cases will drop. “They’ll be much lower, because the virus will have a harder time finding people to infect,” he says.
Finally, keep this in mind, per Dr. Adalja: “We should go back to some semblance of normalcy even before we reach herd immunity.”” (H)
Nationwide herd immunity. The full population is well protected so that the country experiences, at most, occasional small flare-ups of disease. This scenario is most likely in smaller countries where immunity to COVID-19 can become uniformly high.
Regional herd immunity. Some regions, states, or cities are well protected, while others experience ongoing outbreaks of COVID-19. In large, diverse countries like the United States, this situation is especially easy to imagine.
Temporary herd immunity. A population or region achieves herd immunity for some period, but as variants are introduced, against which prior immunity is less effective, a new wave of cases is launched. Another potential trigger for such a wave could come as immunity (particularly natural immunity) wanes. As the number of new cases of COVID-19 falls globally, the rate of emergence of important variants should also decrease, but some risk will remain.
Endemicity. A region fails to achieve herd immunity. Endemicity is most likely in places where vaccine access is limited, where few people choose to be vaccinated, if the duration of immunity is short, or variants that reduce vaccine efficacy are common and widespread. Endemicity might include cyclic, seasonal waves of disease, broadly similar to the flu, or a multiyear cycle of resurgence.
The next few years are likely to see a combination of some or all of these options around the world. Given the likely timing of herd immunity in various geographies and the uncertain duration of protection from vaccines (both duration of immune response and efficacy versus new variants), it is likely that some measures such as booster vaccines are likely to be required indefinitely. Herd immunity is not the same as eradication. SARS-CoV-2 will continue to exist. Even when a country reaches herd immunity, ongoing surveillance, booster vaccines, and potentially other measures may be needed.” (I)
PREQUELS
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 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 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 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….”
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
POST 96. December 26, 2020. CORONAVIRUS. “Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci…”…”..he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….”
POST 97. December 27, 2020. “A new variant of the coronavirus that has been spreading through the UK and other countries has not yet been detected in the United States..”.. . But if new-wave medicines like antivirals and antibody therapy contributed to the development of viral variants, it will be “a reminder for all the medical community that we need to use these treatment options carefully.”
POST 99. December 29, 2020. CORONAVIRUS. “ICUs are being overwhelmed across many parts of California. Statewide aggregate ICU availability has been at 0% since Christmas Eve…. a surge on top of a surge on top of a surge.”… “hospitals are getting close to the point where they would begin putting COVID-positive patients under the care of COVID-positive staff who are asymptomatic.”
POST 100. December 29, 2020. CORONAVIRUS. Front line hospital workers – in the ER, ICUs, EMS, acute medical care, behavioral health – are amongst the most courageous, heroic and dedicated colleagues you will ever meet.
POST 101. December 30, 2020.CORONAVIRUS. Is there a point where the increasing Coronavirus trajectory so far exceeds the slow growth of the vaccination rate that reaching herd immunity through vaccinations becomes less likely?
POST 102. January 2, 2020. CORONAVIRUS. “We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination — which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, the dean of Brown University’s School of Public Health. “Ultimately, the buck seems to stop with no one,”…
POST 103. January 4, 2021. CORONAVIRUS. Dr. Fauci said “that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses…Dr. Moore – ”British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”
POST 104. January 6, 2021. CORONAVIRUS. “Paramedics in Southern California are being told to conserve oxygen and not to bring patients to the hospital who have little chance of survival…”
POST 105. January 8, 2021. CORONAVIRUS. POST 105. January 8, 2021. CORONAVIRUS. “Facing a shortage of vaccinators, the Association of Immunization Managers… recommends relaxing regulation or adjusting licensing requirements. At least two states, Massachusetts and New York, have changed their laws in recent weeks to expand those who are eligible to give shots.”
POST 106. January 9, 2021. CORONAVIRUS. The riots at the Capitol could have been a superspreader event. “From what I saw… you had a large congregation of individuals who were in close contact for an extended period of time and almost universally unmasked…. many coming and going on buses as well, also unmasked, and hanging out in hotel lobbies.”
POST 107. January 8, 2021. CORONAVIRUS. “Our job is to make sure the vaccine isn’t politicized the way masks were politicized,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said after getting her vaccine. South Carolina Rep.-elect Nancy Mace, a Republican, wrote that “Congress shouldn’t be putting themselves first in line for the COVID-19 vaccination when the average American can’t get it.”
POST 108. January 9, 2021. CORONAVIRUS. (vaccination)”Line-cutters will be named and shamed. It’s inevitable, as will be the congressional hearings and front-page investigative stories ferreting out who saved their own skin at the expense of others.”
POST 109.January 9, 2021. CORONAVIRUS. “President-elect Joe Biden will aim to release nearly every available dose of the coronavirus vaccine when he takes office, a break with the Trump administration’s strategy of holding back half of US vaccine production to ensure second doses are available.
POST 110. January 13, 2021. CORONAVIRUS. ““The (federal) government is changing the way it allocates Covid vaccine doses, now basing it on how quickly states can administer shots and the size of their elderly population.”… “New York State sent a letter to hospitals saying if they don’t use their vaccine allocations by the end of this week, they won’t receive any further allocations.”
POST 111. January 14, 2021. CORONAVIRUS. “Visitors from Toronto to New York to Buenos Aires have long flocked to Florida for sun, surf and shopping. Now they are coming for the Covid-19 vaccine….
POST 112. January 14, 2021. CORONAVIRUS. CHINA – “Eleven million people are under lockdown in Hebei province after a new cluster of coronavirus infections.
PART 113. January 17, 2021. CORONAVIRUS. The Next President Actually Has a Covid Plan… New York City and other places in the state expect to exhaust their supply of doses as early as next week… Charles Barkley said during the “NBA on TNT” broadcast that pro athletes should get the first round of the vaccine…..
POST 114. January 18, 2021. CORONAVIRUS. “When government programs that have been unattended, underfunded and bogged down by red tape suddenly have to meet a huge demand in a crisis, they can’t cope and people suffer….”
POST 115. January 21, 2020. CORONAVIRUS. A year ago today an unnumbered POST was headlined “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.” The CORONAVIRUS CONTENT TRACKING PROJECT started with HISTORIOGRAPHY and over time moved to LESSONS LEARNED, RAPID RESPONSE, and THE VACCINATION PROGRAM. Now 115 POSTS later – the BIDEN CORONAVIRUS PLAN.
POST 116. January 22, 2021. President Biden – “We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation.”
POST 117. January 23, 2021. CORONAVIRUS. 1.Dr. Fauci:“The idea that you can get up here….”and.. let the science speak”… “It is somewhat of a liberating feeling.” 2.updated CDC guidance:”.. providers could give the second dose up to six weeks after the first dose..” 3.Dr. Fauci: people would be “taking a chance” if they follow the CDC’s updated guidance.
POST 118. January 24, 2021. CORONAVIRUS. “Unfortunately, we’ve let this virus spread extensively and are launching the vaccination campaign at the height of the threat,” Dr. Meyers said. “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.”
POST 119. January 27, 2010. CORONAVIRUS. Amazon is offering its help to President Joe Biden with the rollout of COVID-19 vaccines. Washington’s governor, Jay Inslee, included the help of companies like Starbucks, Costco and Microsoft in a plan to vaccinate 45,000 residents a day.
POST 120. January 28, 2021. CORONAVIRUS. “The fact that four vaccines backed by the federal government seem to be less effective against the (South African) B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.”
POST 121. January 30, 2021. CORONVIRUS. Will our communities become stratified by which vaccine is distributed? 95%ters v. 72%ters? Will the easier distribution of the J&J vaccine drive its inequitable distribution to” hard-hit, marginalized, and medically underserved communities.” (thanx! to XJ/LA)
POST 123. February 4, 2021. CORONAVIRUS. “Nursing homes across the country are facing the same struggle, as workers have been more reluctant than residents to be vaccinated…
POST 124. February 5, 2021. CORONAVIRUS. Dr. Osterholm ” …it may be time to..go with a ‘first-dose only’ approach, so more people over the age of 65 can have at least some protection right away. He said that would require delaying second doses until this summer.” Dr.Fauci “warned against this practice, and cautioned people about “the danger” that could come with focusing only on the first dose.”
POST 125. June 9, 2021. CORONAVIRUS. “States are rolling back Covid-19 restrictions as new cases trend down from record highs across the country. But experts warn it might be too much too soon as variants pose an increased risk and the pandemic… is far from over.”
POST 126. February 11, 2021. CORONAVIRUS. “There will be more coronavirus outbreaks in the future. Bats and other mammals are rife with strains and species of this abundant family of viruses. Some of these pathogens will inevitably spill over the species barrier and cause new pandemics. It’s only a matter of time.” (A)
POST 127. February 12, 2021. CORONAVIRUS. “… Trump only agreed to be hospitalized when aides told him that he could walk to Marine One or he could wait until his case progressed and he would be carried out.”
POST 128. February 14, 2021. CORONAVIRUS. “The Centers for Disease Control and Prevention released new research on Wednesday that found wearing a cloth mask over a surgical mask offers more protection against the coronavirus, as does tying knots on the ear loops of surgical masks…
POST 129. February 15, 2021, CORONAVIRUS. “ “The CDC released its much-anticipated, updated guidance to help school leaders decide how to safely bring students back into classrooms, or keep them there.”…” For politicians, parents and school leaders looking for a clear green light to reopen schools, this is not it.”
POST 130. February 16, 2021. CORONAVIRUS. “A second person who had contracted the Ebola virus died this week in the Democratic Republic of Congo, marking another outbreak just three months after the nation outlasted the virus’s second-worst outbreak in history…”
POST 131. February 17, 2021. CORONAVIRUS. “It really is right now – a race between how quickly new variants, particularly the U.K. variant, can spread in the United States and how quickly we can get people vaccinated”
POST 132. February 20, 2021. CORONAVIRUS. “In Texas, where over 2.5 million people are still without power, the state health department said this week’s vaccine shipments wouldn’t arrive until Wednesday at the earliest.”
POST 133. February 23, 2021. CORONAVIRUS. “Going off your meds is a surefire way to aggravate your doctor. What if a whole country did it?” The United Kingdom has veered into uncharted territory by changing tack and introducing a revised COVID-19 vaccination protocol, one that involves distributing the second dose at 12 weeks, rather than the prescribed 21 days.”
POST 134. February 24, 2021. CORONAVIRUS. The first tranche of the J&J (single dose) vaccine must go to K-12 teachers, so schools can open safely in the first 100 days of the Biden Administration. The federal government…”can set up its own vaccination centers in regions with eligible populations it’s trying to target.” We owe our front-line teachers nothing less!
POST 135. February 27, 2021. CORONAVIRUS. “As Chief Executive Officers of New York’s major health care systems, we would like to provide facts to clear up confusion in the public and the media regarding decisions to discharge patients to nursing homes during New York’s spring coronavirus surge.”
POST 136. March 2, 2021. CORONAVIRUS. ““The governors of Texas and Mississippi both announced on Tuesday they would be lifting their states’ mask mandates and rolling back many of their Covid-19 health mandates..”…while “The US could experience a “fourth surge” of coronavirus before the majority of the country is vaccinated.”
POST 137. March 4, 2021. CORONAVIRUS. “The clamor for hard-to-get Covid-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system. They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow? Some pharmacists have even given them a nickname: vaccine lurkers.” (H)
POST 138. March 6, 2021. CORONAVIRUS. “New cases are decreasing in the third wave because we are past the holidays, not because of vaccinations. It is a common misconception that the decrease we are seeing in new cases, hospitalizations, and deaths in the U.S. is due to vaccinations. The two aren’t related; at least yet.”
POST 139. March 8, 2021. CORONAVIRUS. CDC Issues First Set of Guidelines on How Fully Vaccinated People Can Visit Safely with Others…” In practice, that means fully vaccinated grandparents may visit unvaccinated healthy adult children and healthy grandchildren of the same household without masks or physical distancing.” (C)
POST 140. March 9, 2021. CORONAVIRUS. “In West Virginia, they are bracing for the second wave….. Not coronavirus but opioid overdoses, with one scourge driving a resurgence of the other.
POST 141. March 11, 2021. CORONAVIRUS. Today is the first anniversary of the WHO declaration that the novel coronavirus was a Public Health Emergency of International Concern… “To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like.”
POST 142. March 15, 2021. CORONAVIRUS. “Candida auris is a superbug, a pathogen that can evade drugs made to kill it—and early signs suggest the COVID-19 pandemic may be propelling infections of the highly dangerous yeast. That’s because C. auris is particularly prominent in hospital settings, which have been flooded with people this year due to the coronavirus.”
POST 143. March 17, 2021. CORONAVIRUS. “The Trump administration sought to suppress Covid-19 testing in the United States last year by softening guidance from the Centers for Disease Control and Prevention on who needed to be tested, a House panel said Monday.”
POST 144. March 20, 2021. CORONAVIRUS. ““The vaccine hesitancy we are seeing isn’t just about Covid vaccines,”… “It is a general reflection of Americans’ lack of trust in science, the pharmaceutical industry, and large health care institutions. We need a full court press on science and vaccine education right now to prevent more aggressive Covid-19 variants from developing and taking hold.”
POST 145. March 25, 2021. CORONAVIRUS. “Efforts to disseminate Covid-19 vaccines as widely as possible are hitting an unexpected obstacle: health-care workers who decline the shots.
POST 146. March 30, 2021. CORONAVIRUS. Dr. Osterholm told Becker’s: “This is the perfect storm,”…”Here is Europe locking down and having problems containing B.1.1.7, even with vaccinations and previous infection histories. Here we are opening up as wide as we can. We are literally just walking into the mouth of the virus saying, ‘Don’t worry.’” (M)
POST 147. April 5, 2021. CORONAVIRUS. “The pandemic helped cement the shift to “a philosophy of really focusing on the role of the physician in reasoning through ambiguous and unknown problems as the focus of education, rather than teaching students that the role of physician was to memorize a body of knowledge that was already in existence and good enough for what usually happens.”
POST 148. April 7, 2021. CORONAVIRUS. While the Biden administration accelerates vaccinations to ward off numerous variants and as more young people are being hospitalized, states, even with increasing case rates are on paths to fully reopen. Politics v. public health!
POST 149. April 10, 2021. CORONAVIRIUS. “From Michigan to Massachusetts, COVID-19 cases and hospitalizations are on the rise again. Deaths will soon follow. “ ”.. the Biden administration is facing renewed calls to delay second vaccine doses and blanket more of the U.S. population with an initial shot.”
POST 150. April 10, 2021. CORONAVIRUS. “The use of so-called COVID-19 “vaccine passports” is quickly becoming a divisive issue across the US – with several states, including New York, embracing the idea, while others have already moved to ban them.”
POST 151. April 14, 2021. CORONAVIRUS. the J&J vaccination pause. “ Federal officials are concerned that doctors may not be trained to spot or treat the rare disorder if recipients of the vaccine develop symptoms of it…” “…a standard treatment for blood clots — use of an anticoagulant drug — could be dangerous or even fatal in such cases…”
POST 152. April 15, 2021. CORONAVIRUS. “The Chinese Center for Disease Control and Prevention’s director said Saturday authorities are considering mixing COVID-19 vaccines because the country’s domestically made doses “don’t have very high protection rates,”
POST 153. April 18, 2021. CORONAVIRUS. “At least 35 hospitals across Michigan were listed Thursday as nearing capacity and three were at full capacity for COVID-19 patients..”.. We can manufacture beds. We can open up beds. We can create entire wings of the hospital if we have to, but if we don’t have staff for those beds, we’ve got nothing.”..
POST 154. April 19, 2021. CORONAVIRUS. “Breakthrough infections, which occur when fully vaccinated people are infected by the pathogen that their shots were designed to protect against, are an entirely expected part of any vaccination process.” “Pfizer’s chief executive said that a third dose of the company’s Covid-19 vaccine was “likely” to be needed within a year of the initial two-dose inoculation — followed by annual vaccinations.”
POST 155. April 24, 2021. CORONAVIRUS. As the J&J vaccine pause is ended Senator Johnson said “The science tells us that vaccines are 95% effective. So if you have a vaccine, quite honestly, what do you care if your neighbor has one or not? I mean, what is it to you?”
POST 156. April 28, 2021. CORONAVIRUS. As CDC revises guidance on outdoor masking, Texas Governor Abbott says “the state is “very close” to herd immunity… despite acknowledging that he does not know what the herd immunity threshold is for the virus, an uncertainty echoed by the public health community.”
POST 157. April 25, 2021. CORONAVIRUS. Ohio hospitals; “We agreed in multiple conversations, there’s nothing in fighting a pandemic that creates a competitive advantage.”…
POST 158. May 5, 2021. CORONAVIRUS. . As populations get closer to herd immunity “ it may be helpful to introduce some nuance to what we mean by the term. Nationwide herd immunity. Regional herd immunity. Temporary herd immunity. Endemicity.”
“From March through May (2020), a group of Colorado health systems with hospitals spread mostly across the Front Range collaborated to care for 96% of Colorado’s hospitalized COVID-19 patients.
That coalition, which presented data Tuesday on its efforts to treat cases and curb the virus’ spread during that three-month period, includes Banner Health, UCHealth, Boulder Community Health, Centura Health, Denver Health, HCA Healthcare/HealthOne and SCL Health.
“In early March, we realized that this is bigger than one physician, one hospital or one health system,” SCL Health chief clinical officer Dr. J.P. Valin said during a virtual press conference Tuesday.
“Since that time, we’ve been meeting regularly — daily for the first seven weeks and now three to four times a week,” Valin said. “This close collaboration has allowed us to see broadly across the state to identify trends and act quickly in a unified way.”..
Together, the seven members of the collaborative cared for 4,903 confirmed positive COVID-19 hospital admissions.
Of those patients, more than 65.5% were released from the hospitals to their homes. Another 18.4% were discharged to another facility such as a rehabilitation center or hospice. The mortality rate for the seven-system collaborative was 14.3%…
Sharing data within the coalition helped doctors and nurses adapt as the outbreak progressed and develop best practices for care, hospital leaders said.
“As we have progressed collaboratively over the past three months, we’ve learned so much about how to appropriately care for patients,” Centura chief clinical officer Shauna Gulley said.
“One of the most important things we learned early on is that permissive hypoxemia — allowing oxygen levels to float a little lower than normal — made a big difference,” Gulley said. “It allowed us to avoid mechanical ventilation and overall improved outcomes.”” (A)
“In the spring (2020), as patients with COVID-19 poured into Massachusetts hospitals, an unusual, ad hoc collaboration kicked in. Boston Children’s Hospital took in kids from other institutions that needed more space for adults. Hospitals loaned ventilators and other equipment to competitors. And they handed over vials of scarce meds.
Now, with agreement from the Massachusetts Health and Hospital Association (MHA), the Baker administration is turning those informal arrangements into a formal, regional plan. Hospitals, grouped into five areas, will meet at least weekly to share updates about their bed capacity, staffing levels, PPE and other supplies, and ability to accept transfer patients.
Hospitals are divided by the regions outlined in this map from the Massachusetts Department of Public Health. For the purpose of resurgence planning, the metro area and the Boston area are combined. (Screenshot via Massachusetts Office of Preparedness and Emergency Management)
The goals are to avoid having any one hospital or region become overwhelmed by a spike in cases, to continue elective and non-urgent care, and to make sure patients in every part of the state have equal access to the best possible care.
Gov. Charlie Baker says he does not want to stop routine care for adults or children, which happened during the first surge, so that hospitals could reassign beds, equipment and staff to COVID patients.
“Those resources are finite,” Baker said Tuesday. “We don’t want to go back to the restrictions we put in place last spring.”” (B)
“Dr. Richard Lofgren remembered the meeting, early on as the crisis bore down, when the leaders of the Cincinnati area’s hospitals each presented plans for how each would address the novel coronavirus. They were solid plans, even elegant. They had plenty of plans.
Then Michael Fisher spoke. Words from the president of Cincinnati Children’s Hospital Medical Center always carried extra weight, but Fisher’s recommendation had not been done before. Break down walls, and unify, with one plan. Now.
“He asked us to do better. It was a fateful moment,” said Lofgren, president and chief executive officer of UC Health. “We needed to work together as collaborators.”
That choice built an unprecedented network among fierce competitors amid crisis that could well have been the edge that kept the Cincinnati region from an even heavier burden from COVID-19. Federal officials come into town to see how the systems harnessed their teams with public health and other entities to pull together.
Out of Fisher’s March 2020 appeal, “We were able to go on offense, on short order, and it was impressive to watch,” said Mark Clement, president and CEO of TriHealth. “The community should feel really good at how their health care systems put the public health first. … We agreed in multiple conversations, there’s nothing in fighting a pandemic that creates a competitive advantage.”…
The pandemic opened with the CEOs collaborating on acquiring more personal protective equipment for the staff and community, at profiteering costs. “On the phone six hours a day trying to get PPE for a month straight, and we were not the only ones,” said Garren Colvin, president and CEO of St Elizabeth Healthcare, the major provider in Northern Kentucky. He paid $10 each for masks that once cost a dollar.
“The most important meeting of the day was the PPE meeting,” Colvin said, “to understand how much quantity was on site, how much you anticipated that day, that week.”
Dr. Richard Lofgren, president and CEO of UC Health, is among the key advisers to Gov. Mike DeWine through the pandemic. Lofgren said the Cincinnati region’s hospitals realized they had to pull as one to get the community through the pandemic.
A key revelation of the collaboration was that the region has a lot more hospital beds than anyone knew, even as the pandemic surged in the summer and more dangerously at year’s end. The region’s leaders scrapped early plans for the Duke Energy Convention Center as an auxiliary facility. The more than 20 hospitals in the region’s 14 counties realized they could expand again and again.” (C)
“Reflecting on the pandemic’s one-year anniversary during a news conference, leaders at New Mexico’s largest hospitals said the virus drastically changed hospitals’ approach to medical care — and opened up new ways of thinking that can be applied to future outbreaks and health care in general…
Forced by necessity, hospitals learned to collaborate more than they ever had, and not just with each other. There had always been some cooperation, officials said, but the deadly pandemic raging through the state drove it to a new level.
That teamwork culminated late last year, when a third COVID-19 wave hit a peak and put a record number of people into critical care, said Dr. Jason Mitchell, Presbyterian Health Services’ chief medical officer.
Hospitals were meeting regularly about lending each other ventilators, transferring patients to available beds and doing everything else possible to get people treated, he said.
“If we didn’t have the team approach across all of our health care systems … we would’ve exceeded capacity in some of our areas,” he said.
The crisis in late 2020 put the state on the verge of declaring “crisis care” standards — a scenario that terrified state officials for weeks as hospitalizations increased and ICU capacities dwindled. At one point, more than 900 people were hospitalized. On Thursday, that number had fallen to 130.” (D)
“As with most challenges in life, cooperation has been the key to many of the problems presented by the COVID-19 pandemic. Whether it is adjusting to working from home; figuring out how to manage distance learning; or working together as a community to slow the spread, teamwork has helped to make our new reality a little easier for everyone.
It is no different for those tasked with managing the health aspects of the pandemic: Collaboration is key. Fortunately for Nevada County communities, local leaders realized this early on, creating a system of cooperation that helped all of us, whether we know it or not, beginning in the early weeks of the pandemic.
“More than ever, there has been strong collaboration between the hospital, community providers and public health officials,” says Jill Fitzpatrick, MD, Family Medicine physician with Dignity Health Medical Group – Sierra Nevada. “Last spring, we created a weekly touch base so we could stay aligned and informed of the constant changes we were being faced with and how we were approaching it.”
That “touch base” evolved into a weekly call every Friday morning that continues today. Among the participants are officials with Nevada County Public Health, the area’s two federally qualified health care centers, Dignity Health Sierra Nevada Memorial Hospital, Dignity Health Medical Foundation and all of the community physician partners.
Dr. Fitzpatrick says the group immediately went to work, collaborating to find solutions to issues affecting their ability to care for the community. “We address issues such as testing availability and accuracy, PPE needs, staffing issues, treatment protocols, and much more.”
From the perspective of the community’s hospital, the meeting has proven incredibly valuable.
“This weekly meeting has been a tremendous exchange of information and collaboration,” explains Jeffrey Rosenburg, MD, SNMH Chief Medical Officer. “We will continue it after the pandemic.”” (E)
“This article focuses on our experiences — caring for more than 5,000 hospitalized patients with Covid-19 over 2 months — in the Department of Medicine at New York University (NYU) Grossman School of Medicine, through NYC locations across four hospital sites: NYC Health + Hospitals/Bellevue Hospital (BH), NYU Langone Health–Tisch/Kimmel Hospital (NYU-Tisch), NYU Langone Hospital–Brooklyn (NYU-Brooklyn), and the Veterans Affairs New York Harbor Healthcare System (VA). The relationship of these NYU-affiliated hospitals offers a unique perspective on the pandemic. These hospitals participate in the educational programs of the internal medicine residents, medical students, and subspecialty fellows, in addition to sharing many clinical protocols across sites. However, these four hospitals have different funding mechanisms, organizational hierarchies, and supply chains. In this article, we highlight the coordinated response and the nuanced challenges that each hospital faced during the Covid-19 pandemic. We focus on four core domains based on challenges faced: communication strategies, development of surge capacity (expansion of beds, staffing, and patient triage), clinical care, and staff wellness ….” (F)
“By the middle of April 2020, New Jersey’s 72-acute care facilities were facing an unprecedented wave of hospitalizations, with more than 8,000 COVID-19 patients receiving care, according to state data. Nearly 2,000 of these patients were in intensive care, where three in four were attached to ventilators to help them to breathe. A year later, there are fewer than 2,000 COVID-19 patients hospitalized across the state…
“All of a sudden, not just in New Jersey, but all our sister states, the country, globally, we were all fighting to get our hands on PPE” [or personal protective equipment, the masks gowns and other items needed to keep staff and patients safe], Bennett said. “We had PPE on hand — we always keep a supply on hand — but certainly nothing for a novel virus like this.”
To accommodate the surge in patients, Bennett said hospital teams worked tirelessly to identify new space — in cafeterias, empty hallways, medical offices — to set up new beds as the federal government created field medical stations to reduce the pressure on acute care sites. The state created four health care regions; and hospitals, emergency responders, public health officials and other leaders all came together to collaborate on the response, she said.
Bennett would like to leverage these partnerships to do more to address underlying social factors — like poverty and housing — that have an outsize impact on an individual’s and community’s health. “What really played out for us in the pandemic, and I think this is a good lesson learned,” she said, “is that public health, together with clinical health, together with the government and the private sector, we all need to come together because this is a team sport.”
“No one entity is going to drive this forward alone,” she added.” (G)
AMERICAN HOSPITAL ASSOCIATION (H)
During the COVID-19 pandemic, hospitals and health systems are challenged with a limited supply of screening/testing kits as well as a lack of personal protective equipment (PPE) for staff, ventilators, respirators, space, etc. Hospitals cannot adequately respond to these challenges alone. You will need to collaborate, and quickly, with stakeholders in the health care field and beyond to leverage your collective resources, nd expertise.
This three-step guide provides strategskills aic considerations to form partnerships during the COVID-19 pandemic. In less than an hour, think through what you should be collaborating on, who your partners should be, and how you can work together to combat COVID-19.
STEP 1 | Understand your goals, assets and gaps. (10 minutes)
Assemble a diverse team from across your hospital to discuss your goals and assets, as well as what gaps will need to be filled. Partnerships should be informed by a clear understanding of your hospital’s goals and challenges. Consider:
• What do we want to accomplish during the COVID-19 pandemic?
• What are our strengths, assets and weaknesses at this time?
• What assets are available in our community to support our goals?
• What resources are we lacking (e.g., health care workforce, equipment, financial resources, medical supplies, PPE, etc.)?
• What do we have today that might not be accessible tomorrow?
• What do we need to prepare for? How is that going to impact our assets?
• How are we communicating with our existing partners and the public health department?
View page 26 of A Playbook for Fostering Hospital-Community Partnerships to gain a better understanding of developing goals.
STEP 2 | Identify partners and establish roles. (10 minutes)
Based on the goals and gaps identified in Step 1, you may need to expand the scope of your partnerships to include some non-traditional partners. Based on the need, potential partners could include:
• Community-based organizations – social service organizations, food banks, unions
• Educational organizations – early childhood care centers, primary schools, colleges and universities
• Housing and community development organizations – homeless shelters, supportive housing
• Government – local, state or national
• Local business – chambers of commerce, grocery stores, restaurants, manufacturers
• Public health departments – county and state
• Service organizations – United Way, YMCA, Rotary International
• Other health care organizations – FQHCs, physician practices, ambulatory centers, other hospitals
• Philanthropy – local or national foundations
Which of these organizations do you already have a relationship with? Given the urgent need to address COVID-19, start by leveraging resources from existing partners. For example, if you are already partnering with your state hospital association or state health department, determine if they are working with external parties to acquire resources such as funding, supplies, etc. to support hospitals.
Which of these organizations could help you achieve your goals and help fill in your gaps? Explore how other community stakeholders can be deployed to combat COVID-19. What functions do they fulfill with their assets and resources? How can they address your identified needs? Asset mapping, both internally and externally, can help your organization hone in on the resources you need to achieve your goals and fulfill any gaps. View pages 12-17 of the A Playbook for Fostering Hospital-Community Partnerships to learn more. Once you have determined who you would like to pursue a partnership with, reach out to them to set up an action planning call.
STEP 3 | Create and implement an action plan. (30 minutes)
To bring the partnership to life, hold a 30-minute virtual action planning call with your potential partner. Come prepared to explain your goals, challenges and gaps and why you think your organizations should collaborate to address COVID-19. Discuss the following as seen in Figure 10 of A Playbook for Fostering Hospital-Community Partnerships:
• Your goals and current challenges;
• Propose a partnership goal, of what you want to accomplish and the resources you need to be successful;
• Finalize your common goal;
• Define roles and tasks of partners to maximize your efforts within the limited time you have; and
• Settle on frequent check-ins to quickly update partners on progress and challenges.
F.Collaborating Across Private, Public, Community, and Federal Hospital Systems: Lessons Learned from the Covid-19 Pandemic Response in NYC, by ByVerity E. Schaye, MD, MHPE, Jenna A. Reich, Brian P. Bosworth, MD, David T. Stern, MD, PhD, Frank Volpicelli, MD, Neil M. Shapiro, MD, Kevin D. Hauck, MD, Ian M. Fagan, MD, Seagram M. Villagomez, MD, Amit Uppal, MD, et al., https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0343
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
POST 96. December 26, 2020. CORONAVIRUS. “Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci…”…”..he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….”
POST 97. December 27, 2020. “A new variant of the coronavirus that has been spreading through the UK and other countries has not yet been detected in the United States..”.. . But if new-wave medicines like antivirals and antibody therapy contributed to the development of viral variants, it will be “a reminder for all the medical community that we need to use these treatment options carefully.”
POST 99. December 29, 2020. CORONAVIRUS. “ICUs are being overwhelmed across many parts of California. Statewide aggregate ICU availability has been at 0% since Christmas Eve…. a surge on top of a surge on top of a surge.”… “hospitals are getting close to the point where they would begin putting COVID-positive patients under the care of COVID-positive staff who are asymptomatic.”
POST 100. December 29, 2020. CORONAVIRUS. Front line hospital workers – in the ER, ICUs, EMS, acute medical care, behavioral health – are amongst the most courageous, heroic and dedicated colleagues you will ever meet.
POST 101. December 30, 2020.CORONAVIRUS. Is there a point where the increasing Coronavirus trajectory so far exceeds the slow growth of the vaccination rate that reaching herd immunity through vaccinations becomes less likely?
POST 102. January 2, 2020. CORONAVIRUS. “We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination — which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, the dean of Brown University’s School of Public Health. “Ultimately, the buck seems to stop with no one,”…
POST 103. January 4, 2021. CORONAVIRUS. Dr. Fauci said “that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses…Dr. Moore – ”British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”
POST 104. January 6, 2021. CORONAVIRUS. “Paramedics in Southern California are being told to conserve oxygen and not to bring patients to the hospital who have little chance of survival…”
POST 105. January 8, 2021. CORONAVIRUS. POST 105. January 8, 2021. CORONAVIRUS. “Facing a shortage of vaccinators, the Association of Immunization Managers… recommends relaxing regulation or adjusting licensing requirements. At least two states, Massachusetts and New York, have changed their laws in recent weeks to expand those who are eligible to give shots.”
POST 106. January 9, 2021. CORONAVIRUS. The riots at the Capitol could have been a superspreader event. “From what I saw… you had a large congregation of individuals who were in close contact for an extended period of time and almost universally unmasked…. many coming and going on buses as well, also unmasked, and hanging out in hotel lobbies.”
POST 107. January 8, 2021. CORONAVIRUS. “Our job is to make sure the vaccine isn’t politicized the way masks were politicized,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said after getting her vaccine. South Carolina Rep.-elect Nancy Mace, a Republican, wrote that “Congress shouldn’t be putting themselves first in line for the COVID-19 vaccination when the average American can’t get it.”
POST 108. January 9, 2021. CORONAVIRUS. (vaccination)”Line-cutters will be named and shamed. It’s inevitable, as will be the congressional hearings and front-page investigative stories ferreting out who saved their own skin at the expense of others.”
POST 109.January 9, 2021. CORONAVIRUS. “President-elect Joe Biden will aim to release nearly every available dose of the coronavirus vaccine when he takes office, a break with the Trump administration’s strategy of holding back half of US vaccine production to ensure second doses are available.
POST 110. January 13, 2021. CORONAVIRUS. ““The (federal) government is changing the way it allocates Covid vaccine doses, now basing it on how quickly states can administer shots and the size of their elderly population.”… “New York State sent a letter to hospitals saying if they don’t use their vaccine allocations by the end of this week, they won’t receive any further allocations.”
POST 111. January 14, 2021. CORONAVIRUS. “Visitors from Toronto to New York to Buenos Aires have long flocked to Florida for sun, surf and shopping. Now they are coming for the Covid-19 vaccine….
POST 112. January 14, 2021. CORONAVIRUS. CHINA – “Eleven million people are under lockdown in Hebei province after a new cluster of coronavirus infections.
PART 113. January 17, 2021. CORONAVIRUS. The Next President Actually Has a Covid Plan… New York City and other places in the state expect to exhaust their supply of doses as early as next week… Charles Barkley said during the “NBA on TNT” broadcast that pro athletes should get the first round of the vaccine…..
POST 114. January 18, 2021. CORONAVIRUS. “When government programs that have been unattended, underfunded and bogged down by red tape suddenly have to meet a huge demand in a crisis, they can’t cope and people suffer….”
POST 115. January 21, 2020. CORONAVIRUS. A year ago today an unnumbered POST was headlined “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.” The CORONAVIRUS CONTENT TRACKING PROJECT started with HISTORIOGRAPHY and over time moved to LESSONS LEARNED, RAPID RESPONSE, and THE VACCINATION PROGRAM. Now 115 POSTS later – the BIDEN CORONAVIRUS PLAN.
POST 116. January 22, 2021. President Biden – “We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation.”
POST 117. January 23, 2021. CORONAVIRUS. 1.Dr. Fauci:“The idea that you can get up here….”and.. let the science speak”… “It is somewhat of a liberating feeling.” 2.updated CDC guidance:”.. providers could give the second dose up to six weeks after the first dose..” 3.Dr. Fauci: people would be “taking a chance” if they follow the CDC’s updated guidance.
POST 118. January 24, 2021. CORONAVIRUS. “Unfortunately, we’ve let this virus spread extensively and are launching the vaccination campaign at the height of the threat,” Dr. Meyers said. “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.”
POST 119. January 27, 2010. CORONAVIRUS. Amazon is offering its help to President Joe Biden with the rollout of COVID-19 vaccines. Washington’s governor, Jay Inslee, included the help of companies like Starbucks, Costco and Microsoft in a plan to vaccinate 45,000 residents a day.
POST 120. January 28, 2021. CORONAVIRUS. “The fact that four vaccines backed by the federal government seem to be less effective against the (South African) B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.”
POST 121. January 30, 2021. CORONVIRUS. Will our communities become stratified by which vaccine is distributed? 95%ters v. 72%ters? Will the easier distribution of the J&J vaccine drive its inequitable distribution to” hard-hit, marginalized, and medically underserved communities.” (thanx! to XJ/LA)
POST 123. February 4, 2021. CORONAVIRUS. “Nursing homes across the country are facing the same struggle, as workers have been more reluctant than residents to be vaccinated…
POST 124. February 5, 2021. CORONAVIRUS. Dr. Osterholm ” …it may be time to..go with a ‘first-dose only’ approach, so more people over the age of 65 can have at least some protection right away. He said that would require delaying second doses until this summer.” Dr.Fauci “warned against this practice, and cautioned people about “the danger” that could come with focusing only on the first dose.”
POST 125. June 9, 2021. CORONAVIRUS. “States are rolling back Covid-19 restrictions as new cases trend down from record highs across the country. But experts warn it might be too much too soon as variants pose an increased risk and the pandemic… is far from over.”
POST 126. February 11, 2021. CORONAVIRUS. “There will be more coronavirus outbreaks in the future. Bats and other mammals are rife with strains and species of this abundant family of viruses. Some of these pathogens will inevitably spill over the species barrier and cause new pandemics. It’s only a matter of time.” (A)
POST 127. February 12, 2021. CORONAVIRUS. “… Trump only agreed to be hospitalized when aides told him that he could walk to Marine One or he could wait until his case progressed and he would be carried out.”
POST 128. February 14, 2021. CORONAVIRUS. “The Centers for Disease Control and Prevention released new research on Wednesday that found wearing a cloth mask over a surgical mask offers more protection against the coronavirus, as does tying knots on the ear loops of surgical masks…
POST 129. February 15, 2021, CORONAVIRUS. “ “The CDC released its much-anticipated, updated guidance to help school leaders decide how to safely bring students back into classrooms, or keep them there.”…” For politicians, parents and school leaders looking for a clear green light to reopen schools, this is not it.”
POST 130. February 16, 2021. CORONAVIRUS. “A second person who had contracted the Ebola virus died this week in the Democratic Republic of Congo, marking another outbreak just three months after the nation outlasted the virus’s second-worst outbreak in history…”
POST 131. February 17, 2021. CORONAVIRUS. “It really is right now – a race between how quickly new variants, particularly the U.K. variant, can spread in the United States and how quickly we can get people vaccinated”
POST 132. February 20, 2021. CORONAVIRUS. “In Texas, where over 2.5 million people are still without power, the state health department said this week’s vaccine shipments wouldn’t arrive until Wednesday at the earliest.”
POST 133. February 23, 2021. CORONAVIRUS. “Going off your meds is a surefire way to aggravate your doctor. What if a whole country did it?” The United Kingdom has veered into uncharted territory by changing tack and introducing a revised COVID-19 vaccination protocol, one that involves distributing the second dose at 12 weeks, rather than the prescribed 21 days.”
POST 134. February 24, 2021. CORONAVIRUS. The first tranche of the J&J (single dose) vaccine must go to K-12 teachers, so schools can open safely in the first 100 days of the Biden Administration. The federal government…”can set up its own vaccination centers in regions with eligible populations it’s trying to target.” We owe our front-line teachers nothing less!
POST 135. February 27, 2021. CORONAVIRUS. “As Chief Executive Officers of New York’s major health care systems, we would like to provide facts to clear up confusion in the public and the media regarding decisions to discharge patients to nursing homes during New York’s spring coronavirus surge.”
POST 136. March 2, 2021. CORONAVIRUS. ““The governors of Texas and Mississippi both announced on Tuesday they would be lifting their states’ mask mandates and rolling back many of their Covid-19 health mandates..”…while “The US could experience a “fourth surge” of coronavirus before the majority of the country is vaccinated.”
POST 137. March 4, 2021. CORONAVIRUS. “The clamor for hard-to-get Covid-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system. They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow? Some pharmacists have even given them a nickname: vaccine lurkers.” (H)
POST 138. March 6, 2021. CORONAVIRUS. “New cases are decreasing in the third wave because we are past the holidays, not because of vaccinations. It is a common misconception that the decrease we are seeing in new cases, hospitalizations, and deaths in the U.S. is due to vaccinations. The two aren’t related; at least yet.”
POST 139. March 8, 2021. CORONAVIRUS. CDC Issues First Set of Guidelines on How Fully Vaccinated People Can Visit Safely with Others…” In practice, that means fully vaccinated grandparents may visit unvaccinated healthy adult children and healthy grandchildren of the same household without masks or physical distancing.” (C)
POST 140. March 9, 2021. CORONAVIRUS. “In West Virginia, they are bracing for the second wave….. Not coronavirus but opioid overdoses, with one scourge driving a resurgence of the other.
POST 141. March 11, 2021. CORONAVIRUS. Today is the first anniversary of the WHO declaration that the novel coronavirus was a Public Health Emergency of International Concern… “To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like.”
POST 142. March 15, 2021. CORONAVIRUS. “Candida auris is a superbug, a pathogen that can evade drugs made to kill it—and early signs suggest the COVID-19 pandemic may be propelling infections of the highly dangerous yeast. That’s because C. auris is particularly prominent in hospital settings, which have been flooded with people this year due to the coronavirus.”
POST 143. March 17, 2021. CORONAVIRUS. “The Trump administration sought to suppress Covid-19 testing in the United States last year by softening guidance from the Centers for Disease Control and Prevention on who needed to be tested, a House panel said Monday.”
POST 144. March 20, 2021. CORONAVIRUS. ““The vaccine hesitancy we are seeing isn’t just about Covid vaccines,”… “It is a general reflection of Americans’ lack of trust in science, the pharmaceutical industry, and large health care institutions. We need a full court press on science and vaccine education right now to prevent more aggressive Covid-19 variants from developing and taking hold.”
POST 145. March 25, 2021. CORONAVIRUS. “Efforts to disseminate Covid-19 vaccines as widely as possible are hitting an unexpected obstacle: health-care workers who decline the shots.
POST 146. March 30, 2021. CORONAVIRUS. Dr. Osterholm told Becker’s: “This is the perfect storm,”…”Here is Europe locking down and having problems containing B.1.1.7, even with vaccinations and previous infection histories. Here we are opening up as wide as we can. We are literally just walking into the mouth of the virus saying, ‘Don’t worry.’” (M)
POST 147. April 5, 2021. CORONAVIRUS. “The pandemic helped cement the shift to “a philosophy of really focusing on the role of the physician in reasoning through ambiguous and unknown problems as the focus of education, rather than teaching students that the role of physician was to memorize a body of knowledge that was already in existence and good enough for what usually happens.”
POST 148. April 7, 2021. CORONAVIRUS. While the Biden administration accelerates vaccinations to ward off numerous variants and as more young people are being hospitalized, states, even with increasing case rates are on paths to fully reopen. Politics v. public health!
POST 149. April 10, 2021. CORONAVIRIUS. “From Michigan to Massachusetts, COVID-19 cases and hospitalizations are on the rise again. Deaths will soon follow. “ ”.. the Biden administration is facing renewed calls to delay second vaccine doses and blanket more of the U.S. population with an initial shot.”
POST 150. April 10, 2021. CORONAVIRUS. “The use of so-called COVID-19 “vaccine passports” is quickly becoming a divisive issue across the US – with several states, including New York, embracing the idea, while others have already moved to ban them.”
POST 151. April 14, 2021. CORONAVIRUS. the J&J vaccination pause. “ Federal officials are concerned that doctors may not be trained to spot or treat the rare disorder if recipients of the vaccine develop symptoms of it…” “…a standard treatment for blood clots — use of an anticoagulant drug — could be dangerous or even fatal in such cases…”
POST 152. April 15, 2021. CORONAVIRUS. “The Chinese Center for Disease Control and Prevention’s director said Saturday authorities are considering mixing COVID-19 vaccines because the country’s domestically made doses “don’t have very high protection rates,”
POST 153. April 18, 2021. CORONAVIRUS. “At least 35 hospitals across Michigan were listed Thursday as nearing capacity and three were at full capacity for COVID-19 patients..”.. We can manufacture beds. We can open up beds. We can create entire wings of the hospital if we have to, but if we don’t have staff for those beds, we’ve got nothing.”..
POST 154. April 19, 2021. CORONAVIRUS. “Breakthrough infections, which occur when fully vaccinated people are infected by the pathogen that their shots were designed to protect against, are an entirely expected part of any vaccination process.” “Pfizer’s chief executive said that a third dose of the company’s Covid-19 vaccine was “likely” to be needed within a year of the initial two-dose inoculation — followed by annual vaccinations.”
POST 155. April 24, 2021. CORONAVIRUS. As the J&J vaccine pause is ended Senator Johnson said “The science tells us that vaccines are 95% effective. So if you have a vaccine, quite honestly, what do you care if your neighbor has one or not? I mean, what is it to you?”
POST 156. April 28, 2021. CORONAVIRUS. As CDC revises guidance on outdoor masking, Texas Governor Abbott says “the state is “very close” to herd immunity… despite acknowledging that he does not know what the herd immunity threshold is for the virus, an uncertainty echoed by the public health community.”
POST 157. April 25, 2021. CORONAVIRUS. Ohio hospitals; “We agreed in multiple conversations, there’s nothing in fighting a pandemic that creates a competitive advantage.”…
“A lot has changed since early 2020, when countries around the world first realized the potential threat of a highly contagious, and still mysterious, flulike virus.
In the early days of the coronavirus pandemic, no one knew for sure how the virus spread. People were scrubbing their groceries. Governments urged people to stay home, to wash their hands frequently and to avoid touching their faces.
Masks quickly emerged as a point of confusion, as public health officials at first discouraged people from wearing them, citing shortages, and then endorsed them. Mask mandates became a flash point in the culture wars as states, counties and cities across the country adopted a patchwork of policies.
On Tuesday, the Centers for Disease Control and Prevention said that it was no longer necessary for fully vaccinated people to wear masks in small groups outdoors, bringing the public guidance in line with a growing body of research indicating that the risk of spreading the coronavirus is much greater indoors.
Here is how the public health guidance on masking in the United States has shifted since the start of the pandemic.
FEBRUARY 2020
‘Stop buying masks,’ surgeon general pleads
“Seriously people — STOP BUYING MASKS!” the surgeon general at the time, Dr. Jerome M. Adams, wrote on Twitter in February 2020. “They are NOT effective in preventing general public from catching #Coronavirus, but if health care providers can’t get them to care for sick patients, it puts them and our communities at risk!”
APRIL 2020
A change in policy, with more mixed messaging
In April, officials reversed course, with the C.D.C. urging all Americans to wear a mask outside their homes to supplement other public health measures, such as social distancing and hand washing.
SEPTEMBER 2020
Health officials speak out for masks
Many officials have emphasized the public health benefits of masks. In September, Dr. Robert R. Redfield, then the C.D.C.’s director, told a Senate committee that masks were “the most important, powerful public health tool we have” for fighting the pandemic, adding that the universal use of face coverings could bring the pandemic under control in months.
JANUARY 2021
President Biden imposes some masking rules
President Biden in January used his executive authority to impose mask requirements where he could — including on federal property and in interstate travel.
MARCH 2021
The C.D.C. issues its first guidelines for vaccinated people
In March, almost exactly a year since the pandemic first gripped Americans in fear, the C.D.C. said that people who had been fully vaccinated against the coronavirus could gather in small groups indoors without masks or social distancing. Vaccinated adults could begin to plan mask-free dinners with vaccinated friends, the agency said.
MARCH 2021
States begin lifting mask mandates
With vaccinations on the rise, some states began lifting mask mandates. Others, including Florida and South Dakota, never had one.
Gov. Greg Abbott of Texas, a Republican, lifted the mask mandate and capacity limits on all businesses starting March 10. The order ensured that “all businesses and families in Texas have the freedom to determine their own destiny,” Mr. Abbott said.
APRIL 2021
C.D.C. relaxes masking advice for people who gather outdoors
On April 27, the C.D.C. said that fully vaccinated people generally no longer needed to wear masks outdoors, but should continue to wear them at indoor gatherings or at crowded outdoor events. People who haven’t gotten their shots can also go without a mask in small gatherings held outside as long as they are with fully vaccinated friends and family, the agency said.
Vaccinated adults should continue to wear masks and stay at least six feet from others in large public spaces — such as at outdoor performances or sporting events, or in shopping malls and movie theaters — where the vaccination and health status of others would be unknown, the agency said. And they should still avoid medium-size and large gatherings, crowds and poorly ventilated spaces, officials said.
A growing body of research indicates that the risk of spreading the virus is far lower outdoors than indoors. Viral particles quickly disperse outdoors, public health officials have said, so the transmission risk is far lower, though not impossible.
“I think it’s pretty common sense now that outdoor risk is really, really quite low,” Dr. Fauci said Sunday on “This Week” on ABC. Particularly “if you are a vaccinated person, wearing a mask outdoors — I mean, obviously, the risk is minuscule.” “ (A)
“The Centers for Disease Control and Prevention says people who are fully vaccinated do not need to wear a mask when they’re outdoors unless they’re in a crowd, such as attending a live performance, sporting event or parade. People are considered fully vaccinated two weeks after receiving the second dose of the Pfizer or Moderna vaccines, or two weeks after the single dose of the Johnson & Johnson shot.
“If you are vaccinated, things are much safer for you,” CDC Director Rochelle Walensky said Tuesday at a White House briefing. “If you are fully vaccinated and want to attend a small outdoor gathering — with people who are vaccinated and unvaccinated — or dine at an outdoor restaurant with friends from multiple households, the science shows you can do so safely, unmasked.”
As part of the new guidance, the agency spelled out settings in which it’s OK for fully vaccinated people to be unmasked, including:
Walking, running, hiking or biking outdoors alone or with members of your household;
Attending a small outdoor gathering with fully vaccinated family and friends;
Attending a small outdoor gathering with a mixture of fully vaccinated and unvaccinated people;
Dining at an outdoor restaurant with friends from multiple households.
And, the risk is low enough that even unvaccinated people can exercise, bike and hike outside and attend small outdoor gatherings with fully vaccinated friends and family without wearing a mask.
“We continue to recommend masking in crowded outdoor settings and venues such as packed stadiums and concerts where there is decreased ability to maintain physical distance and where many unvaccinated people may also be present,” Walensky said. “We will continue to recommend this until widespread vaccination is achieved.”…
The agency lists a range of settings where masking is still recommended for people who are fully vaccinated:
Attending a crowded outdoor event such as a live performance, parade or sporting event;
Visiting a barber or hair salon;
Visiting an indoor shopping mall or museum;
Riding public transport;
Attending a small indoor gathering with a mixture of fully vaccinated and unvaccinated people;
Going to an indoor movie theater;
Attending a full capacity service at a house of worship. (B)
Three reasons public masking is still important — no matter your vaccination status
A handful of states have lifted their mask mandates — and plenty of them never introduced them in the first place. But that doesn’t mean people shouldn’t still wear masks in public, according to infectious disease experts. Especially now, when most people are still unvaccinated and some places are seeing surging case numbers.
1) Lots of people remain vulnerable to infection who can’t get a vaccine yet — including babies and kids. Some of them also can’t wear masks…
2) New variants could put us all at higher risk…
3) When the majority still isn’t vaccinated, masks help others feel safer… (C)
Where masks are extra important, and where we might be able to ease up
As people graduate to full vaccination status — two weeks after their final dose — they can finally restart many activities, such as close gatherings with small groups of vaccinated friends. But they also don’t yet have carte blanche to do everything mask-free. “Nobody loves wearing masks, but they give us that added level of protection and you can do activities that we all want to be doing,” Guthrie says.
The types of places where it’s highest-priority for everyone to continue masking include mass transit, airports, and other venues where people from different areas are mixing; locations with vulnerable individuals such as hospitals and long-term care facilities; gyms; and stores where distancing is difficult.
The new CDC guidance notes that even with a mask on, certain indoor venues — including movie theaters, high-intensity exercise classes, and full-capacity religious services — remain among the “least safe” places for people who are unvaccinated.
In general, “indoor, crowded, unventilated spaces have always been the most unsafe,” Gandhi says — and are the most important venues to keep a mask on. “The longer people share the same air indoors, the more chance there is of spread,” Smith adds.
In areas where cases and hospitalizations are high, such as Michigan, Colorado, New Jersey, and Pennsylvania, masking indoors is especially crucial.
And, of course, public places — especially indoors — where people will not always be wearing masks remain chancy, particularly for those who are unvaccinated. These include indoor restaurants and bars, which have long been known to be frequent loci of Covid-19 transmission.” (D)
“More than a month has passed since Gov. Greg Abbott ended virtually all statewide restrictions related to the coronavirus pandemic. Nationwide, new coronavirus cases are on the rise as new variants of the virus spread. And about four-fifths of Texans are not yet fully vaccinated.
But at least for now, the most dire predictions of a new major wave of cases in Texas have not come true, prompting a mix of theories from public health experts.
Those experts caution that a major increase in cases could still come and it may still be too early to tell whether Abbott’s decisions to lift the statewide mask mandate and allow businesses to fully reopen could prompt a new wave of infections. Still, daily new cases and the positivity rate have leveled off over the past month, while deaths and hospitalization have gone down substantially.
Experts point out that vaccination is ramping up, many businesses are still requiring masks and there are unique factors impacting individual metrics — like a drop in demand for testing that is driving down raw case numbers.
They also emphasize that, especially at this point in the pandemic, a stabilization of such metrics, or even a modest decline, is not exactly cause for celebration.
“I think we could’ve been even lower at this point in time,” if not for Abbott’s latest decisions, said Dr. Luis Ostrosky, an infectious disease specialist at UTHealth’s McGovern Medical School in Houston. “The fact that we’re sort of stable is not necessarily good news — because we’re stable at a very high level. It’s like everybody saying you’re at a stable cruising speed — but at 100 miles per hour.”..
The nation’s top infectious disease expert, Dr. Anthony Fauci, was asked in a TV interview last week about Texas’ numbers and gave an uncertain response about what was driving them at the moment. Speaking with MSNBC, he said “it can be confusing because you may see a lag and a delay because often you have to wait a few weeks before you see the effect of what you’re doing right now.”
“We’ve been fooled before by situations where people begin to open up, nothing happens and then all of a sudden, several weeks later, things start exploding on you,” Fauci said. “So we’ve got to be careful we don’t prematurely judge that.”
Until recently, Abbott has been restrained in openly touting the Texas trend lines, instead focusing much of his celebratory public messaging on vaccination progress.
“We absolutely are not declaring victory at this time,” Abbott told Fox News on Sunday. “We remain very vigilant and guarded and proactive in our response, but there’s simple math behind the reason why we continue to have success,” he added, citing the combination of increasing vaccinations and the “acquired immunity” among Texans who have already had the virus and recovered from it.
E.Texas coronavirus cases haven’t surged since Gov. Greg Abbott lifted the mask order. Experts warn it’s too soon to celebrate., Daily new cases and the positivity rate have leveled off over the past month, while deaths and hospitalization have gone down substantially., BY PATRICK SVITEK, https://www.texastribune.org/2021/04/14/texas-coronavirus-mask-order-abbott/
CDC – Interim Public Health Recommendations for Fully Vaccinated People
Underscores that immunocompromised people need to consult their healthcare provider about these recommendations, even if fully vaccinated.
Fully vaccinated people no longer need to wear a mask outdoors, except in certain crowded settings and venues.
Clarification that fully vaccinated workers no longer need to be restricted from work following an exposure as long as they are asymptomatic.
Fully vaccinated residents of non-healthcare congregate settings no longer need to quarantine following a known exposure.
Fully vaccinated asymptomatic people without an exposure may be exempted from routine screening testing, if feasible.
Key Points
This set of public health recommendations for fully vaccinated people will be updated and expanded based on the level of community spread of SARS-CoV-2, the proportion of the population that is fully vaccinated, and the rapidly evolving science on COVID-19 vaccines.
For the purposes of this guidance, people are considered fully vaccinated for COVID-19 ≥2 weeks after they have received the second dose in a 2-dose series (Pfizer-BioNTech or Moderna), or ≥2 weeks after they have received a single-dose vaccine (Johnson and Johnson (J&J)/Janssen).±
± This guidance applies to COVID-19 vaccines currently authorized for emergency use by the U.S. Food and Drug Administration: Pfizer-BioNTech, Moderna, and Johnson and Johnson (J&J)/Janssen COVID-19 vaccines. This guidance can also be applied to COVID-19 vaccines that have been authorized for emergency use by the World Health Organization (e.g. AstraZeneca/Oxford).
The following recommendations apply to non-healthcare settings. For related information for healthcare settings, visit Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination.
Fully vaccinated people can:
Visit with other fully vaccinated people indoors without wearing masks or physical distancing
Visit with unvaccinated people (including children) from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing
Participate in outdoor activities and recreation without a mask, except in certain crowded settings and venues
Resume domestic travel and refrain from testing before or after travel or self-quarantine after travel
Refrain from testing before leaving the United States for international travel (unless required by the destination) and refrain from self-quarantine after arriving back in the United States
Refrain from testing following a known exposure, if asymptomatic, with some exceptions for specific settings
Refrain from quarantine following a known exposure if asymptomatic
Refrain from routine screening testing if asymptomatic and feasible
For now, fully vaccinated people should continue to:
Take precautions in indoor public settings like wearing a well-fitted mask
Wear well-fitted masks when visiting indoors with unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease
Wear well-fitted masks when visiting indoors with unvaccinated people from multiple households
Avoid indoor large-sized in-person gatherings
Get tested if experiencing COVID-19 symptoms
Follow guidance issued by individual employers
Follow CDC and health department travel requirements and recommendations (F)
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
POST 96. December 26, 2020. CORONAVIRUS. “Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci…”…”..he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….”
POST 97. December 27, 2020. “A new variant of the coronavirus that has been spreading through the UK and other countries has not yet been detected in the United States..”.. . But if new-wave medicines like antivirals and antibody therapy contributed to the development of viral variants, it will be “a reminder for all the medical community that we need to use these treatment options carefully.”
POST 99. December 29, 2020. CORONAVIRUS. “ICUs are being overwhelmed across many parts of California. Statewide aggregate ICU availability has been at 0% since Christmas Eve…. a surge on top of a surge on top of a surge.”… “hospitals are getting close to the point where they would begin putting COVID-positive patients under the care of COVID-positive staff who are asymptomatic.”
POST 100. December 29, 2020. CORONAVIRUS. Front line hospital workers – in the ER, ICUs, EMS, acute medical care, behavioral health – are amongst the most courageous, heroic and dedicated colleagues you will ever meet.
POST 101. December 30, 2020.CORONAVIRUS. Is there a point where the increasing Coronavirus trajectory so far exceeds the slow growth of the vaccination rate that reaching herd immunity through vaccinations becomes less likely?
POST 102. January 2, 2020. CORONAVIRUS. “We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination — which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, the dean of Brown University’s School of Public Health. “Ultimately, the buck seems to stop with no one,”…
POST 103. January 4, 2021. CORONAVIRUS. Dr. Fauci said “that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses…Dr. Moore – ”British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”
POST 104. January 6, 2021. CORONAVIRUS. “Paramedics in Southern California are being told to conserve oxygen and not to bring patients to the hospital who have little chance of survival…”
POST 105. January 8, 2021. CORONAVIRUS. POST 105. January 8, 2021. CORONAVIRUS. “Facing a shortage of vaccinators, the Association of Immunization Managers… recommends relaxing regulation or adjusting licensing requirements. At least two states, Massachusetts and New York, have changed their laws in recent weeks to expand those who are eligible to give shots.”
POST 106. January 9, 2021. CORONAVIRUS. The riots at the Capitol could have been a superspreader event. “From what I saw… you had a large congregation of individuals who were in close contact for an extended period of time and almost universally unmasked…. many coming and going on buses as well, also unmasked, and hanging out in hotel lobbies.”
POST 107. January 8, 2021. CORONAVIRUS. “Our job is to make sure the vaccine isn’t politicized the way masks were politicized,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said after getting her vaccine. South Carolina Rep.-elect Nancy Mace, a Republican, wrote that “Congress shouldn’t be putting themselves first in line for the COVID-19 vaccination when the average American can’t get it.”
POST 108. January 9, 2021. CORONAVIRUS. (vaccination)”Line-cutters will be named and shamed. It’s inevitable, as will be the congressional hearings and front-page investigative stories ferreting out who saved their own skin at the expense of others.”
POST 109.January 9, 2021. CORONAVIRUS. “President-elect Joe Biden will aim to release nearly every available dose of the coronavirus vaccine when he takes office, a break with the Trump administration’s strategy of holding back half of US vaccine production to ensure second doses are available.
POST 110. January 13, 2021. CORONAVIRUS. ““The (federal) government is changing the way it allocates Covid vaccine doses, now basing it on how quickly states can administer shots and the size of their elderly population.”… “New York State sent a letter to hospitals saying if they don’t use their vaccine allocations by the end of this week, they won’t receive any further allocations.”
POST 111. January 14, 2021. CORONAVIRUS. “Visitors from Toronto to New York to Buenos Aires have long flocked to Florida for sun, surf and shopping. Now they are coming for the Covid-19 vaccine….
POST 112. January 14, 2021. CORONAVIRUS. CHINA – “Eleven million people are under lockdown in Hebei province after a new cluster of coronavirus infections.
PART 113. January 17, 2021. CORONAVIRUS. The Next President Actually Has a Covid Plan… New York City and other places in the state expect to exhaust their supply of doses as early as next week… Charles Barkley said during the “NBA on TNT” broadcast that pro athletes should get the first round of the vaccine…..
POST 114. January 18, 2021. CORONAVIRUS. “When government programs that have been unattended, underfunded and bogged down by red tape suddenly have to meet a huge demand in a crisis, they can’t cope and people suffer….”
POST 115. January 21, 2020. CORONAVIRUS. A year ago today an unnumbered POST was headlined “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.” The CORONAVIRUS CONTENT TRACKING PROJECT started with HISTORIOGRAPHY and over time moved to LESSONS LEARNED, RAPID RESPONSE, and THE VACCINATION PROGRAM. Now 115 POSTS later – the BIDEN CORONAVIRUS PLAN.
POST 116. January 22, 2021. President Biden – “We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation.”
POST 117. January 23, 2021. CORONAVIRUS. 1.Dr. Fauci:“The idea that you can get up here….”and.. let the science speak”… “It is somewhat of a liberating feeling.” 2.updated CDC guidance:”.. providers could give the second dose up to six weeks after the first dose..” 3.Dr. Fauci: people would be “taking a chance” if they follow the CDC’s updated guidance.
POST 118. January 24, 2021. CORONAVIRUS. “Unfortunately, we’ve let this virus spread extensively and are launching the vaccination campaign at the height of the threat,” Dr. Meyers said. “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.”
POST 119. January 27, 2010. CORONAVIRUS. Amazon is offering its help to President Joe Biden with the rollout of COVID-19 vaccines. Washington’s governor, Jay Inslee, included the help of companies like Starbucks, Costco and Microsoft in a plan to vaccinate 45,000 residents a day.
POST 120. January 28, 2021. CORONAVIRUS. “The fact that four vaccines backed by the federal government seem to be less effective against the (South African) B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.”
POST 121. January 30, 2021. CORONVIRUS. Will our communities become stratified by which vaccine is distributed? 95%ters v. 72%ters? Will the easier distribution of the J&J vaccine drive its inequitable distribution to” hard-hit, marginalized, and medically underserved communities.” (thanx! to XJ/LA)
POST 123. February 4, 2021. CORONAVIRUS. “Nursing homes across the country are facing the same struggle, as workers have been more reluctant than residents to be vaccinated…
POST 124. February 5, 2021. CORONAVIRUS. Dr. Osterholm ” …it may be time to..go with a ‘first-dose only’ approach, so more people over the age of 65 can have at least some protection right away. He said that would require delaying second doses until this summer.” Dr.Fauci “warned against this practice, and cautioned people about “the danger” that could come with focusing only on the first dose.”
POST 125. June 9, 2021. CORONAVIRUS. “States are rolling back Covid-19 restrictions as new cases trend down from record highs across the country. But experts warn it might be too much too soon as variants pose an increased risk and the pandemic… is far from over.”
POST 126. February 11, 2021. CORONAVIRUS. “There will be more coronavirus outbreaks in the future. Bats and other mammals are rife with strains and species of this abundant family of viruses. Some of these pathogens will inevitably spill over the species barrier and cause new pandemics. It’s only a matter of time.” (A)
POST 127. February 12, 2021. CORONAVIRUS. “… Trump only agreed to be hospitalized when aides told him that he could walk to Marine One or he could wait until his case progressed and he would be carried out.”
POST 128. February 14, 2021. CORONAVIRUS. “The Centers for Disease Control and Prevention released new research on Wednesday that found wearing a cloth mask over a surgical mask offers more protection against the coronavirus, as does tying knots on the ear loops of surgical masks…
POST 129. February 15, 2021, CORONAVIRUS. “ “The CDC released its much-anticipated, updated guidance to help school leaders decide how to safely bring students back into classrooms, or keep them there.”…” For politicians, parents and school leaders looking for a clear green light to reopen schools, this is not it.”
POST 130. February 16, 2021. CORONAVIRUS. “A second person who had contracted the Ebola virus died this week in the Democratic Republic of Congo, marking another outbreak just three months after the nation outlasted the virus’s second-worst outbreak in history…”
POST 131. February 17, 2021. CORONAVIRUS. “It really is right now – a race between how quickly new variants, particularly the U.K. variant, can spread in the United States and how quickly we can get people vaccinated”
POST 132. February 20, 2021. CORONAVIRUS. “In Texas, where over 2.5 million people are still without power, the state health department said this week’s vaccine shipments wouldn’t arrive until Wednesday at the earliest.”
POST 133. February 23, 2021. CORONAVIRUS. “Going off your meds is a surefire way to aggravate your doctor. What if a whole country did it?” The United Kingdom has veered into uncharted territory by changing tack and introducing a revised COVID-19 vaccination protocol, one that involves distributing the second dose at 12 weeks, rather than the prescribed 21 days.”
POST 134. February 24, 2021. CORONAVIRUS. The first tranche of the J&J (single dose) vaccine must go to K-12 teachers, so schools can open safely in the first 100 days of the Biden Administration. The federal government…”can set up its own vaccination centers in regions with eligible populations it’s trying to target.” We owe our front-line teachers nothing less!
POST 135. February 27, 2021. CORONAVIRUS. “As Chief Executive Officers of New York’s major health care systems, we would like to provide facts to clear up confusion in the public and the media regarding decisions to discharge patients to nursing homes during New York’s spring coronavirus surge.”
POST 136. March 2, 2021. CORONAVIRUS. ““The governors of Texas and Mississippi both announced on Tuesday they would be lifting their states’ mask mandates and rolling back many of their Covid-19 health mandates..”…while “The US could experience a “fourth surge” of coronavirus before the majority of the country is vaccinated.”
POST 137. March 4, 2021. CORONAVIRUS. “The clamor for hard-to-get Covid-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system. They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow? Some pharmacists have even given them a nickname: vaccine lurkers.” (H)
POST 138. March 6, 2021. CORONAVIRUS. “New cases are decreasing in the third wave because we are past the holidays, not because of vaccinations. It is a common misconception that the decrease we are seeing in new cases, hospitalizations, and deaths in the U.S. is due to vaccinations. The two aren’t related; at least yet.”
POST 139. March 8, 2021. CORONAVIRUS. CDC Issues First Set of Guidelines on How Fully Vaccinated People Can Visit Safely with Others…” In practice, that means fully vaccinated grandparents may visit unvaccinated healthy adult children and healthy grandchildren of the same household without masks or physical distancing.” (C)
POST 140. March 9, 2021. CORONAVIRUS. “In West Virginia, they are bracing for the second wave….. Not coronavirus but opioid overdoses, with one scourge driving a resurgence of the other.
POST 141. March 11, 2021. CORONAVIRUS. Today is the first anniversary of the WHO declaration that the novel coronavirus was a Public Health Emergency of International Concern… “To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like.”
POST 142. March 15, 2021. CORONAVIRUS. “Candida auris is a superbug, a pathogen that can evade drugs made to kill it—and early signs suggest the COVID-19 pandemic may be propelling infections of the highly dangerous yeast. That’s because C. auris is particularly prominent in hospital settings, which have been flooded with people this year due to the coronavirus.”
POST 143. March 17, 2021. CORONAVIRUS. “The Trump administration sought to suppress Covid-19 testing in the United States last year by softening guidance from the Centers for Disease Control and Prevention on who needed to be tested, a House panel said Monday.”
POST 144. March 20, 2021. CORONAVIRUS. ““The vaccine hesitancy we are seeing isn’t just about Covid vaccines,”… “It is a general reflection of Americans’ lack of trust in science, the pharmaceutical industry, and large health care institutions. We need a full court press on science and vaccine education right now to prevent more aggressive Covid-19 variants from developing and taking hold.”
POST 145. March 25, 2021. CORONAVIRUS. “Efforts to disseminate Covid-19 vaccines as widely as possible are hitting an unexpected obstacle: health-care workers who decline the shots.
POST 146. March 30, 2021. CORONAVIRUS. Dr. Osterholm told Becker’s: “This is the perfect storm,”…”Here is Europe locking down and having problems containing B.1.1.7, even with vaccinations and previous infection histories. Here we are opening up as wide as we can. We are literally just walking into the mouth of the virus saying, ‘Don’t worry.’” (M)
POST 147. April 5, 2021. CORONAVIRUS. “The pandemic helped cement the shift to “a philosophy of really focusing on the role of the physician in reasoning through ambiguous and unknown problems as the focus of education, rather than teaching students that the role of physician was to memorize a body of knowledge that was already in existence and good enough for what usually happens.”
POST 148. April 7, 2021. CORONAVIRUS. While the Biden administration accelerates vaccinations to ward off numerous variants and as more young people are being hospitalized, states, even with increasing case rates are on paths to fully reopen. Politics v. public health!
POST 149. April 10, 2021. CORONAVIRIUS. “From Michigan to Massachusetts, COVID-19 cases and hospitalizations are on the rise again. Deaths will soon follow. “ ”.. the Biden administration is facing renewed calls to delay second vaccine doses and blanket more of the U.S. population with an initial shot.”
POST 150. April 10, 2021. CORONAVIRUS. “The use of so-called COVID-19 “vaccine passports” is quickly becoming a divisive issue across the US – with several states, including New York, embracing the idea, while others have already moved to ban them.”
POST 151. April 14, 2021. CORONAVIRUS. the J&J vaccination pause. “ Federal officials are concerned that doctors may not be trained to spot or treat the rare disorder if recipients of the vaccine develop symptoms of it…” “…a standard treatment for blood clots — use of an anticoagulant drug — could be dangerous or even fatal in such cases…”
POST 152. April 15, 2021. CORONAVIRUS. “The Chinese Center for Disease Control and Prevention’s director said Saturday authorities are considering mixing COVID-19 vaccines because the country’s domestically made doses “don’t have very high protection rates,”
POST 153. April 18, 2021. CORONAVIRUS. “At least 35 hospitals across Michigan were listed Thursday as nearing capacity and three were at full capacity for COVID-19 patients..”.. We can manufacture beds. We can open up beds. We can create entire wings of the hospital if we have to, but if we don’t have staff for those beds, we’ve got nothing.”..
POST 154. April 19, 2021. CORONAVIRUS. “Breakthrough infections, which occur when fully vaccinated people are infected by the pathogen that their shots were designed to protect against, are an entirely expected part of any vaccination process.” “Pfizer’s chief executive said that a third dose of the company’s Covid-19 vaccine was “likely” to be needed within a year of the initial two-dose inoculation — followed by annual vaccinations.”
POST 155. April 24, 2021. CORONAVIRUS. As the J&J vaccine pause is ended Senator Johnson said “The science tells us that vaccines are 95% effective. So if you have a vaccine, quite honestly, what do you care if your neighbor has one or not? I mean, what is it to you?”
POST 156. April 28, 2021. CORONAVIRUS. As CDC revises guidance on outdoor masking, Texas Governor Abbott says “the state is “very close” to herd immunity… despite acknowledging that he does not know what the herd immunity threshold is for the virus, an uncertainty echoed by the public health community.”
“People in the United States will once again be able to receive the one-shot Johnson & Johnson coronavirus vaccine after a review by the Centers for Disease Control and Prevention and the Food and Drug Administration. Federal health officials decided to end the pause on the vaccine, ultimately determining that its benefits far outweigh the rare risks of a severe blood clot. Officials said 15 vaccine recipients had developed the blood clot out of 8 million shots that were given. Overall, there were three deaths. State and local officials can now immediately resume giving out any of the vaccine they still have available.
In lifting the pause, the FDA decided against putting any limits on the use of the vaccine by age or gender. But Information about the rare possibility of blood clots will be made available at vaccination sites and the FDA and Johnson & Johnson will update the vaccine’s label so that it mentions the rare risk of blood clots. The label specifies that “most cases” have occurred in women between 18 and 49 years old. European regulators earlier in the week had come to the same decision that the risk was rare enough to allow the vaccine to be administered.” (G)
“Johnson & Johnson’s COVID vaccine will be made available to the public again, ending an 11-day pause initiated after a rare blood clotting disorder was associated with the shot.
The Food and Drug Administration and Centers for Disease Control and Prevention determined the benefits of the J&J vaccine outweighed the risks of keeping it off the market. Out of nearly 8 million who received the vaccine, 15 people have developed the condition and three have died.
The two agencies held a joint news conference Friday evening to announce their decision to allow distribution of the J&J vaccine to resume.
“Both agencies have full confidence that this vaccine’s known and potential benefits outweigh its known and potential risks in individuals 18 years and older,” said Dr. Janet Woodcock, the FDA’s acting commissioner.
The J&J vaccine should be available almost immediately, “by tomorrow morning even,” said Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research.
Everyone who receives the shot should receive an information sheet mentioning the rare clotting problem and the symptoms to look out for, officials said. Providers also will be given information about the condition and the appropriate treatment for managing it.
The rare condition involves a combination of blood clots, many in unusual locations such as the brain or abdomen, and low levels of platelets, which help wounds heal. It has been dubbed thrombosis with thrombocytopenia syndrome or TTS.
The unusual side effect, seen six to 14 days after receiving the J&J vaccine, seems to most often strike women under age 50.
The effect has not been seen with the two other vaccines authorized for use in the U.S., by Pfizer-BioNTech and Moderna, which have so far been given to about 130 million Americans.
Earlier Friday, a CDC advisory committee voted to resume distribution of the vaccine…
Resuming the use of the J&J vaccine in the United States would prevent 1,435 deaths from COVID-19 and 2,236 admissions to hospital intensive care units, according to a CDC analysis. It could cause approximately 24 cases of TTS, a CDC staffer said…
Women should be aware of this rare side effect, but if they’re unlikely to come back for a second dose, then they’re far better off getting the J&J than getting a single shot of Moderna or Pfizer-BioNTech, said Dr. Paul Offit, a pediatrician and head of the Vaccine Education Center at Children’s Hospital of Philadelphia.” (A)
“ACIP members heard from Tom Shimabukuro, MD, MPH, MBA, the deputy director of the Immunization Safety Office at the CDC, who shared that the agency had detected a total of 15 TTS cases, including 3 fatalities, up from 6 when the pause was first instated. The cases had been detected using the Vaccine Adverse Event Reporting System (VAERS).
“TTS is rare but clinically serious and potentially life threatening and a potentially life threatening adverse event that has been observed in association with the Janssen COVID-19 vaccine,” Shimabukuro said.
All 15 of the cases were women, and all but 2 were under the age of 50. Seven of the 16 cases were in women ages 30 to 39. As of Apr 21, Shimabukuro said the CDC was investigating less than 10 additional possible cases.
Seven of the 15 cases were in obese women, and two women were taking oral contraceptives. None had blood clotting disorders.
Of the 15 cases, 3 women died, 5 were recovered or recovering at home, and 7 remained hospitalized, including 4 in the intensive care unit. All women experienced symptom onset no sooner than 6 days post-vaccination, but no later than day 15, and all reported headache, fatigue, and abdominal pain.
Using the data that’s been collected, Shimabukuro said the risk of TTS from the J&J vaccine would be 7 TTS cases per 1 million doses administered to women ages 18 to 49. The risk for women older than 50 would be .9 per 1 million doses.
Shimabukuro said no TTS has been documented in recipients of the Moderna or Pfizer vaccines, the two mRNA vaccines authorized for COVID-19 in the United States…
Those who were in favor of lifting the pause said the 10-day window had allowed clinicians to understand the threat of TTS and improve clinical outcomes in patients. They also cautioned that most vaccination sites do not offer a choice of vaccines, but rather have one option for adult recipients.
In the end, the group decided to fully recommend the vaccine for use in all adults over the age of 18. Those who voted against lifting the pause argued the vaccine should contain patient warning language for women under the age of 50.
J&J said the company had agreed on warning language with the FDA, which will say the vaccine has, in rare instances, caused TSS in women under the age of 50.” (B)
“Specialists say the warning isn’t just a regulatory maneuver to please lawyers or to make clear the benefits outweigh the one-in-a-million risk. Instead, despite the disruption caused by the pause, there has been one clear public health benefit: Doctors are now aware of this rare complication, and how best to treat it.
“[The pause] has brought the condition to public and broader scientific attention,” said Dr. Laura Finn, director of hematology and bone marrow transplants at Ochsner Health.
The handful of initial cases were discovered when entered into the Department of Health and Human Services’ national Vaccine Adverse Event Reporting System database. They were investigated rapidly and revealed that if you get the J&J shot, you should be aware of the symptoms. Doctors will also be on alert for how to treat this uncommon disorder and, perhaps, just as importantly how not to treat it.
“This is a treatable condition if you recognize it right away,” Dr. Francis Collins, director of the National Institutes of Health, told “Good Morning America” Friday prior to the recommendation. “One of the reasons I think it’s been good to have this pause is to get everybody apprised of that so that all physicians know this is something to watch out for and can be prepared to treat it appropriately if it should happen again in the future.”
The pause will allow the CDC to offer recommendations and guidelines for doctors and patients, according to Dr. Simone Wildes, an infectious disease specialist at South Shore Health in Massachusetts.
Crucially, doctors have already been warned not to use a common blood thinner called heparin, which might accelerate the problem.
“Until we have a full grasp on this interplay of the vaccine, the blood system and anticoagulation, it’s best to avoid heparin when treating blood clots possibly related to a COVID-19 vaccine and treat with alternative anticoagulation medications and possibly IVIG (intravenous immunoglobulin) instead,” Finn told ABC News.
Meanwhile, anyone suspected of having a rare blood clot can be given a blood test screen for PF4 enzyme-linked immunosorbent, and consult with a hematologist that specializes in these types of clotting events.
Patients who get the J&J vaccine now know that the symptoms to watch out for are different than typical post-vaccine discomfort like a sore arm or flu-like symptoms that come on within 48 hours after the injection and usually go away within days.
The more rare, but concerning clots seem to come on within six to 15 days after injection and may include a persistent headache, a full-body rash, swelling, abdominal pain, leg pain and or shortness of breath. These are the symptoms for which you should contact your doctor immediately.
This warning is meant to empower patients and health care workers alike, because although the risks from the vaccine are extremely rare, the risk of complications from COVID-19 are significant.
“The risk of thrombosis with COVID-19 infection far outweighs the risk with any of the vaccines,” said Dr. Carol Gonsalves, a thrombosis expert and associate professor of medicine at the University of Ottawa. “It is in our best interest for personal safety but also our civic duty to be vaccinated.”” (C)
“Blood clots are formed by platelets, which bind together to form a clot, and typically a lot of them are needed to do that. The clots seen with the Johnson & Johnson vaccine formed even in patients who had low platelet counts in their bloodstream. That combination is unusual. Typically, when you have really low platelet counts—a condition called thrombocytopenia—you actually have problems with being able to form clots, and you can develop ongoing bleeding that is hard to stop. Furthermore, we’re seeing this phenomenon of clots forming in serious places such as the brain, the lungs, the legs or the abdomen, despite the fact that platelet counts are really low. That’s a very unique phenomenon. The closest thing we’ve seen is a rare condition called heparin-induced thrombocytopenia (HIT)…
What are the symptoms of these blood clots in people who have had the Johnson & Johnson vaccine?
They are different than some of the symptoms people experience right after getting their vaccination, such as fatigue, soreness at the injection site or joint aches. These sorts of things are common, they appear shortly after the vaccination, and they usually go away after about three to five days. The symptoms related to the blood clots tend to appear about a week or two after the vaccination and then continue to worsen. A headache that won’t go away is one symptom. Now, if you’ve just exerted yourself by going for a run or gardening in the sun on a hot day, you might have a headache, fatigue, leg or abdomen pain, or shortness of breath, but if you sit in a cool spot and drink some water, these will probably go away. But if you are experiencing these symptoms, and they continue to get worse despite the fact that you’re doing things that would normally make you feel better, that would be more concerning.
We’re not precisely sure yet, but it sounds like it should not be heparin because of the risk of HIT. There are similar, more expensive blood-thinner medications that may be able to treat these blood clots. An April 12 study in the BMJ recommended the use of non-heparin anticoagulants along with immunoglobulins—antibodies produced by white blood cells—to treat vaccine-induced clotting.
We don’t know for sure. But our leading hypothesis is that they might be associated with this antibody against the protein platelet factor four, PF4 for short. That antibody seems to be implicated in the AstraZeneca clots and also is the mechanism for heparin-induced thrombotic thrombocytopenia, so the evidence all seems to be pointing in the same direction. HITT Is definitively linked to that antibody. And we have some evidence that it may be implicated in the AstraZeneca and Johnson & Johnson clotting cases. Hopefully, as we get more evidence, it will make us more confident in that mechanism.” (D)
“Lifting the pause will allow states to restart vaccination efforts among hard-to-reach populations like rural Americans, migrants and elderly people who have difficulty leaving their homes. Their access to the vaccine had been hampered by the suspension, which left roughly 10 million doses sitting on shelves.
In Wisconsin, officials said they intended to begin using their Johnson & Johnson doses as soon as possible.
“We have also heard from a number of vaccinators who say that there are lots of people who don’t like needles,” said Julie Willems Van Dijk, the deputy secretary of the state health department. “They just want to get the vaccine that requires them to have one shot versus two shots.”
Dr. Rochelle P. Walensky, the C.D.C. director, said governors in a number of states had expressed intense interest in resuming use of the shots.
“They wondered why we had paused, and they were anxious to have this back, have an opportunity for a single-dose vaccine, for a one-and-done possibility,” she said.
About 135.8 million people in the United States have received at least one shot of a coronavirus vaccine. But daily doses have fallen by almost 13 percent since last week, from a peak of 3.38 million daily doses on average to about 2.95 million.
It is difficult to say what is driving the decrease. Even before use of the Johnson & Johnson vaccine was paused, shipments had dipped because of a factory error that had ruined millions of doses…
Dr. Walensky said the federal government planned to emphasize the vaccine’s safety to Americans who might be hesitant to take it after the pause.
“We have to do extraordinary outreach to clinicians, as we have been doing this past week,” she said. “We already have plans to start that on Monday, to public health officials. And then we have to do extraordinary outreach to patients, to meet people where they’re at, to educate them.”…
“As we did this intensive scientific evaluation over recent days, I think we became more and more confident about the decision that was made today,” Dr. Janet Woodcock, the acting F.D.A. commissioner, said on Friday…
Top U.S. health officials have stressed that finding the small number of cases of a rare disorder and pausing use of the vaccine demonstrated that safeguards were in place to assess risks and to raise awareness among doctors and hospitals about the unusual symptoms.
“This pause was essential to our ability to inform the public,” Dr. José R. Romero, chairman of the expert panel, the Advisory Committee on Immunization Practices, said on Friday.
A poll released this week from Ipsos/Axios found that the pause itself boosted confidence in federal vaccine monitors, with 81 percent saying that the C.D.C. and the F.D.A. acted appropriately. The sentiment was unusually bipartisan, with 87 percent of Republicans and 91 percent of Democrats sharing that view.
Measuring the impact of the Johnson & Johnson pause is tricky, said Liz Hamel, vice president of public opinion and research survey at the Kaiser Family Foundation. “You don’t know what the trajectory of the vaccine uptake would have been in the absence of this pause,” she said.
The biggest challenge ahead, she noted, will be the creation of vaccine-confidence messages that resonate with the public. “We don’t know whether it has increased hesitancy among women in particular,” she said.” (E)
“Sen. Ron Johnson on Thursday downplayed the urgency of vaccinating all Americans against Covid-19, putting the controversial Wisconsin Republican at odds with public health guidance aimed at easing the ongoing pandemic.
“The science tells us that vaccines are 95% effective. So if you have a vaccine, quite honestly, what do you care if your neighbor has one or not? I mean, what is it to you?” Johnson said in an interview with conservative radio host Vicki McKenna.
“You got a vaccine, and science is telling you it’s very, very effective. So why is this big push to make sure everybody gets a vaccine?” Johnson asked.
Johnson’s comments come as all states expanded their updated Covid-19 vaccine eligibility guidelines this week, opening up vaccinations to all Americans 16 years of age and older, and as the country’s leading medical experts urge all Americans to get a vaccine as soon as possible. Both President Joe Biden and Senate Minority Leader Mitch McConnell have stressed the importance of getting vaccinated and have encouraged Americans to do so.
In the McKenna interview, however, Johnson said he is skeptical of the “big push” to vaccinate all Americans.
“From my standpoint, because it’s not a fully approved vaccine, I think we probably should have limited the distribution to the vulnerable. To people that really aren’t, you know, for the very young, I see no reason to be pushing vaccines on people,” Johnson said.
Asked by CNN on Friday if he believed every American over the age of 16 should receive the vaccine, Johnson would not directly answer the question and instead insisted that he favored Americans making their own decisions about whether to get vaccinated.
“I believe government’s role (and therefore my role) is to help ensure transparency so that people have as much information as possible to make an informed decision for themselves,” Johnson said in a statement. “It is a legitimate question as to whether people at very low risk of suffering serious illness from Covid, particularly the young and healthy, should be encouraged to take a vaccine that is being administered under an Emergency Use Authorization — in other words, before it has been fully tested and fully approved.”
However, Johnson’s caution about the emergency use authorization is misleading. Both the Pfizer/BioNTech and Moderna vaccines — the two current US vaccination options — received emergency use authorization from the US Food and Drug Administration in December. For Pfizer/BioNTech, that includes everyone over the age of 16, and for Moderna, everyone who is 18 and older.” (F)
“After the Center for Disease Control signed off on the use of the Johnson & Johnson vaccine late Friday afternoon, Governor Andrew Cuomo said administration of the single-shot COVID vaccine will resume at all state-run sites ‘effective immediately.’
In a statement sent by the Governor Saturday morning, he said the following…
“World-renowned public health experts from the federal government and our own independent state task force have reviewed the data and reaffirmed that the use of the Johnson & Johnson vaccine can resume. The state of New York will resume administration of this vaccine at all of our state-run sites effective immediately. The vaccine is the weapon that will win the war against COVID and allow everyone to resume normalcy, and we have three proven vaccines at our disposal. I urge every New Yorker to take whichever one is available to them first. The sooner we all get vaccinated, the sooner we can put the long COVID nightmare behind us once and for all.” (H)
“R.I. Department of Health spokesperson Joseph Wendelken said Saturday the state will wait until next week to make a decision, adding Rhode Island has enough vaccine doses currently available that operations will not be disrupted without it.
“We only have a limited amount of Johnston & Johnson vaccine on-hand right now, and we would not expect another shipment for two or three weeks anyway,” Wendelken said. “On top of that, we have been getting more Moderna and Pfizer vaccine. For those reasons, this pause is not significantly impacting our current operations.”
The U.S. Centers for Disease Control and Prevention and the FDA ended a pause that began April 13 when federal health officials decided to investigate six out of nearly 7 million J&J vaccine recipients who reported severe and unusual blood clots. In an announcement Friday, federal regulators said use could resume with an updated label that warned of blood-clot risks.
Prior to the announcement, Rhode Island medical director Dr. James McDonald told 12 News the state would make an independent decision about whether to proceed with the vaccine regardless.
“Rhode Island is going to look at the data, look at the recommendations and make a customized recommendation for you, because we’re your doctor, Rhode Island, and we need to make sure what we have is good for you,” he said.
The decision to wait differs from Massachusetts and Connecticut, where state health officials almost immediately directed their vaccinating partners to resume use of the single-dose regimen.” (I)
“Friday’s vote by an advisory committee to the Centers for Disease and Control Prevention to resume administering the Johnson & Johnson coronavirus vaccine was the right decision, but with a serious mistake: There should be an explicit warning against the vaccine’s use in women under the age of 50.
I’m in this group. I’m also a participant in the Johnson & Johnson clinical trial who was told that I’d received the placebo. I then opted to get the Johnson & Johnson vaccine. If I knew then what I know now, I would have chosen the Pfizer or Moderna vaccines instead…
All of this more than justifies the decision to allow the Johnson & Johnson vaccine to be administered once again. In recognition of the risk of TTS, the FDA says that it will add information to the vaccine’s label that alerts people to its signs and symptoms. This is particularly important because the standard treatment for blood clots, administering the blood thinner heparin, is dangerous and can be fatal when there are low platelets.
But this is not enough for the highest-risk group of women under age 50. We are not talking about run-of-the-mill blood clots here. TTS is a severe, life-threatening illness afflicting otherwise healthy, young women. Of the 15 women with TTS after vaccination, seven remain hospitalized, four in critical condition. Three have died.
If there were no alternatives, the benefits of the Johnson & Johnson vaccine would surely outweigh the risks. But that’s not the case. There are two other very safe and effective vaccines that do not pose any risk of TTS. Why not issue a warning that advises women under 50 to receive one of these two other vaccines instead?…
In many parts of the United States, vaccine supply already exceeds demand. People should be empowered to decide which vaccine to get based on the risks, benefits and alternatives. For younger women, the CDC needs to be much more explicit to warn them against the Johnson & Johnson vaccine based on the very rare but very severe risk associated with it — and, critically, to direct them to alternatives that don’t carry this risk at all. After all the emphasis federal health officials put on prioritizing safety, it’s what we should expect from them.” (J)
“Millions of Americans are not getting the second doses of their Covid-19 vaccines, and their ranks are growing.
More than five million people, or nearly 8 percent of those who got a first shot of the Pfizer or Moderna vaccines, have missed their second doses, according to the most recent data from the Centers for Disease Control and Prevention. That is more than double the rate among people who got inoculated in the first several weeks of the nationwide vaccine campaign.
Even as the country wrestles with the problem of millions of people who are wary about getting vaccinated at all, local health authorities are confronting an emerging challenge of ensuring that those who do get inoculated are doing so fully….
Mounting evidence collected in trials and from real-world immunization campaigns points to the peril of people skipping their second doses. Compared with the two-dose regimen, a single shot triggers a weaker immune response and may leave recipients more susceptible to dangerous virus variants. And even though a single dose provides partial protection against Covid, it’s not clear how long that protection will last…
While millions of people have missed their second shots, the overall rates of follow-through, with some 92 percent getting fully vaccinated, are strong by historical standards. Roughly three-quarters of adults come back for their second dose of the vaccine that protects against shingles…
The C.D.C. says there is limited data on the vaccine’s effectiveness when shots are separated by more than six weeks, although some countries, including Britain and Canada, are giving shots with a gap of up to three or four months.” (K)
“Vaccination rates are falling in the United States, despite the spread of highly contagious virus variants that are fueling the country’s alarmingly high caseload.
More than 50,000 new U.S. cases were reported on Saturday, and case rates are similar to those of the second wave last summer. But the average number of vaccine doses being administered each day, which rose for months and peaked at 3.38 million, has now fallen to 2.86 million, its lowest level since March 31, according to data from the Centers for Disease Control and Prevention.
The vaccination rate stopped climbing on April 13, when federal health officials recommended pausing the use of Johnson & Johnson’s vaccine to allow researchers to examine a rare blood-clotting disorder that emerged in six recipients. The Food and Drug Administration lifted the pause on Friday, opting to add a warning about the risk to vaccine labeling…
“We’re entering a new phase” in the country’s vaccination effort, said Dr. Mark McClellan, former commissioner of the Food and Drug Administration and director of the Duke-Margolis Center for Health Policy at Duke University. “In most parts of the country now, there are unfilled vaccination appointments available.”
People who were clamoring for a vaccine have been inoculated, including those who were willing to schedule appointments and wait in long lines at mass vaccination sites, he said.
“Now, it’s more about bringing vaccines to the people who want them but haven’t been able to easily reach the existing sites,” Dr. McClellan said. Walk-in availability, which New York City allowed at city-run sites starting on Friday, could also help vaccinate more people, he said.
Dr. Ashish Jha, the dean of the Brown University School of Public Health, cautioned that it would be “hugely problematic” to broadly denounce those who had yet to get a vaccine — because of indifference or inconvenience — as “resisters.” He said on National Public Radio last week that “there are lots of people who are perfectly happy to get a vaccine but aren’t desperate for it — aren’t convinced that they need it badly.”
Rupali J. Limaye, a professor who studies vaccine behavior at Johns Hopkins Bloomberg School of Public Health, said as vaccinations continued, some might think: “If these other people are vaccinated, why do I need to get it?” but added, “We still need those people to get it to reach herd immunity.”” (L)
“Nearly as soon as vaccines entered clinical trials, wealthy countries began hoarding doses, ensuring that instead of the most vulnerable people everywhere being vaccinated, their residents would be first in line…
There is no shortage of solutions to these problems, but the countries with leverage, clout and excess supply — like the United States — need to act now, in the following ways:
Stop hoarding doses. The richest nations account for 16 percent of the global population but hold 53 percent of all purchased coronavirus doses, according to the Duke-Margolis Center for Health Policy. The United States is projected to have 300 million extra shots by late July, even after accounting for the supply needed to vaccinate the millions of children who are expected to be eligible by the end of the year…
Suspend patents. Nearly 60 nations have petitioned the World Trade Organization to allow countries to temporarily override intellectual property rights for coronavirus-related drugs and vaccines, but so far the measure is languishing. The Biden administration should support this waiver, nudge vaccine makers into voluntary licensing agreements and help build the public-private partnerships needed to bring those agreements to fruition. It should also press companies to offer better deals to the countries trying to secure doses — no more absurd indemnity clauses that protect company profits over human lives.
Share technology and resources. More than eight months ago, the World Health Organization established a technology access pool where companies and countries could share their technology and expertise with governments trying to scale up vaccine manufacturing. The Biden administration signaled its willingness to participate in this effort back in January, but so far, the National Institutes of Health has not joined in, nor have the major vaccine makers. That needs to change quickly…
Build more capacity. Experts say that virtually no vaccines are being manufactured in Africa and that very few are being made in Latin America. The reasons for this shortcoming are complex — a longstanding underinvestment in regional capacity combined with an overreliance on multinational corporations. But the solutions to it are clear. Britain has managed to scale up its manufacturing capacity from just two plants at the start of the pandemic to four now, with two more under construction. There’s no reason the same can’t be done in other countries where the need is even greater. Throwing his weight behind such an effort could be one of Mr. Biden’s most enduring legacies…
No country has cleared every hurdle to vaccinating its entire population. In the United States as much as anywhere, vaccine hesitancy persists and some especially vulnerable populations, like the homebound and unhoused, remain hard to reach even as supply increases. But the world cannot afford to wait for all of those problems to be solved in one country before it works to make coronavirus vaccines more available to all countries. The global vaccine gap is a matter of life and death, and all nations should be working to close it as quickly as possible.”..
Fortunately, there are other promising alternatives in the offing. One of them is based on the same technology used to make the hepatitis B vaccine that’s been in use for nearly 40 years. This coronavirus vaccine is cheap and easy to make, its early clinical data looks good and its creators — Dr. Peter Hotez and Maria Bottazzi at the Baylor College of Medicine — have no plans to patent it. If the United States put half as much weight behind this simple technology as it put behind the mRNA vaccines, manufacturers could churn out billions of doses of it in fairly short order.” (M)
