The US Centers for Disease Control and Prevention and the US Food and Drug Administration are recommending that the United States pause the use of Johnson & Johnson’s Covid-19 vaccine over six reported US cases of a “rare and severe” type of blood clot. One of the cases was fatal and one is currently in critical condition.
The six reported cases were among more than 6.8 million doses of the Johnson & Johnson vaccine administered in the United States.
All six cases occurred among women between the ages of 18 and 48, and symptoms occurred 6 to 13 days after vaccination, according to a joint statement on Tuesday from Dr. Anne Schuchat, principal deputy director of the CDC and Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research.
“CDC will convene a meeting of the Advisory Committee on Immunization Practices (ACIP) on Wednesday to further review these cases and assess their potential significance,” the statement said. “FDA will review that analysis as it also investigates these cases. Until that process is complete, we are recommending a pause in the use of this vaccine out of an abundance of caution. This is important, in part, to ensure that the health care provider community is aware of the potential for these adverse events and can plan for proper recognition and management due to the unique treatment required with this type of blood clot.”
Johnson & Johnson issued a statement on Tuesday noting that the company has decided to “proactively delay the rollout” of its vaccine in Europe.
“We have been working closely with medical experts and health authorities, and we strongly support the open communication of this information to healthcare professionals and the public,” the statement said in part.
For people who have received the Johnson & Johnson shot, those who have developed severe headache, abdominal pain, leg pain or shortness of breath within three weeks after vaccination should contact their health care provider, according to the statement.
“It’s a very rare event. You’re talking about 1 per million, and when you give millions of doses of vaccines, you will see events like this that you couldn’t see in the clinical trial just because you didn’t have millions of people enrolled,” Dr. Carlos del Rio, executive associate dean of the Emory University School of Medicine at Grady Health System, told CNN’s John Berman and Poppy Harlow on Tuesday morning.
“But I want to congratulate the CDC and the FDA for very quickly jumping on it, halting the vaccinations until we know more, and really trying to understand what’s going on,” del Rio said. “I think vaccine safety has always been a priority — and I think this is exactly the right move until we understand what’s going on and what’s the way forward.”” (A)
“Speaking at the White House, Dr. Anthony Fauci, the nation’s top expert on infectious disease, said the pause would allow the FDA and the CDC to investigate the clotting cases and “to make physicians more aware of this.”
A CDC committee will meet Wednesday to discuss the cases, and the FDA has launched an investigation into the cause of the clots and low platelet counts.
FDA officials emphasized that Tuesday’s action was not a mandate. Doctors and patients could still use J&J’s vaccine if they decide its benefits outweigh its risks for individual cases, said Dr. Peter Marks.
The agencies recommend that people who were given the J&J vaccine should contact their doctor if they experience severe headache, abdominal or leg pain or shortness of breath within three weeks.
J&J said in a statement that it was aware of the reports of blood clots, but that no link to its vaccine had been established. The company also said it would delay the rollout of its vaccine in Europe as a precaution.
U.S. health authorities cautioned doctors against using a typical clot treatment, the blood-thinner heparin.
European authorities investigating the AstraZeneca cases have concluded clots appear to be similar to a very rare abnormal immune response that sometimes strikes people treated with heparin, leading to a temporary clotting disorder.
While it’s not clear yet if the reports among J&J recipients are related, doctors would treat these kinds of unusual clots like they treat people who have the heparin reaction — with different kinds of blood thinners and sometimes an antibody infusion, said Dr. Geoffrey Barnes, a clot expert at the University of Michigan.
Even without J&J’s vaccine, White House officials said they remain on track to have enough supplies to vaccinate most American adults by the summer…
Asked if the government was overreacting to six cases out of more than 6 million vaccinations, the CDC’s Dr. Anne Schuchat said recommendations will come quickly.
Because these unusual clots require special treatment, “it was of the utmost importance to us to get the word out,” she said.” (B)
“No such issues have been reported with the Covid-19 vaccines made by Pfizer-BioNTech or Moderna, health officials said…
The pause “will not have a significant impact” on the country’s vaccination plan, Jeff Zients, the White House Covid-19 Response Coordinator, said in a statement, adding that there is “more than enough supply” to meet President Joe Biden’s “goal of 200 million shots by his 100th day in office.”..
“I know that the information we’re providing today is going to be very concerning to Americans who have already received the Johnson & Johnson vaccine,” Dr. Anne Schuchat, principal deputy director for CDC, said during the briefing. “For people who got the vaccine more than a month ago, the risk is very low.”
For those who recently got the Johnson & Johnson vaccine, Schuchat advised to be aware of sudden, severe headaches, abdominal pain or shortness of breath…
It was not clear if the woman, who spoke to NBC News on the condition of anonymity, was one of the six people in question. In a statement, the FDA said it was unable to “confirm or share personally identifiable information,” citing HIPAA rules.
The woman said she got the vaccine on March 19 at a Nashville hospital and initially experienced normal reactions, such as a fever. Then, about a week later, she went to the emergency room with uncontrollable shaking, troubling breathing and a fever.
“Since then, [I] have just had a few strange symptoms that could have been chalked up to a viral infection, mostly just a headache that persisted for two weeks, and some leg pain and swelling,” she said in a phone interview from her hospital bed, “and then also just some random bruises that would appear throughout my body.”
When she went to the ER the week after her shot, she said that doctors did not find anything strange in her blood work, and nothing at that point to suggest clotting or low platelets — so she went home. But the symptoms continued to worsen over the following week.
“Then, when I went back to the ER, it was because my leg was so swollen that I couldn’t really walk, so at that time they found the DVTs or the clots in my legs,” she said, saying they were in both legs and she had a low platelet count.
She added that she has been in the hospital for about a week, and she was in the intensive care unit until Sunday. When asked if she had any regrets, she said, “No, absolutely not. I just want to be clear, vaccines are good and they save lives.”” (C)
“Dr. Janet Woodcock, the acting commissioner of the F.D.A., said at a news conference Tuesday that the pause was only expected to last “a matter of days,” although she said the time frame depends on “what we learn in the next few days.” Dr. Schuchat said at the same briefing that the pause was enacted in part to “prepare the health care system to recognize and treat patients appropriately.”
The move could complicate the nation’s vaccination efforts at a time when many states are confronting a surge in new cases and seeking to address vaccine hesitancy. Regulators in Europe and elsewhere are concerned about a similar issue with another coronavirus vaccine, developed by AstraZeneca and Oxford University researchers, that has not been authorized for emergency use in the United States. At the news conference, Dr. Marks drew a connection between the two vaccines, saying the cases involving rare blood clots were very similar…
In the United States alone, 300,000 to 600,000 people a year develop blood clots, according to C.D.C. data. But the particular blood clotting disorder that the vaccine recipients developed, known as cerebral venous sinus thrombosis, is extremely rare. Dr. Schuchat described the condition as “a severe strokelike illness linked to low platelet counts.”…
Government experts are concerned that the blood clots are linked to an immune system response triggered by the vaccine. Federal officials said there was broad agreement in the senior ranks of the administration about the need to pause use of the vaccine while the cases are investigated.
Dr. Marks said that the federal government was not issuing an order to suspend the vaccine, adding that health providers may decide that for a particular patient, the benefits of a shot outweigh the risks. “We’re not going to stop that provider from administering the vaccine because it could be right,” he said…
It is common for regulators to investigate “safety signals” in new vaccines and other medical products. Very often, the signals prove not to be of concern. But the concerns about Johnson & Johnson’s vaccine mirror concerns about AstraZeneca’s, which European regulators began investigating last month after some recipients developed blood clots.
Out of 34 million people who received the vaccine in Britain, the European Union and three other countries, 222 experienced blood clots that were linked with a low level of platelets. The majority of these cases occurred within the first 14 days following vaccination, mostly in women under 60 years of age.” (D)
“In most clinical settings, an anticoagulant drug called heparin is administered to treat blood clots; however, health officials said using this drug in these instances could be dangerous, and they recommended alternative treatments.
Health officials don’t know the definitive cause of the blood clots but suspect similarities in cases of blood clots in a small number of people who received the AstraZeneca vaccine, which is made using the same technique as the Johnson & Johnson vaccine.
The immune system of the person who got the vaccine may react to the vaccine by attacking the body’s own blood platelets or other parts of the coagulation system.
“That’s the leading theory or hypothesis about what’s going on,” acting FDA Commissioner Janet Woodcock said.” (E)
“More than two dozen states took steps Tuesday to halt inoculations with Johnson & Johnson’s coronavirus vaccine, shortly after the Food and Drug Administration recommended to pause its use after reports some women developed a rare blood clotting disorder.
The states, like the FDA and the Centers for Disease Control and Prevention, stressed that they were acting out of an abundance of caution, as more than 6.8 million doses of J&J’s vaccine have been injected and only six of the blood clotting cases have so far been reported.
J&J said in a statement that “no clear causal relationship” has been identified between the rare type of blood clots and the vaccine, adding it is working closely with regulators to assess the data.
New York Health Commissioner Dr. Howard Zucker said the state will “immediately” stop administering the single-dose J&J inoculation, and will use Pfizer’s two-shot vaccine in its place for already scheduled appointments.
At least 25 other states, along with Washington, D.C., and Puerto Rico, also announced they are taking J&J’s vaccine doses out of their distribution plans.
Those precautions may not be in effect for long, however: Acting FDA Commissioner Janet Woodcock said Tuesday that she expected the pause to last only for a matter of days.
Dr. Anne Schuchat, principal deputy director of the CDC, noted Tuesday that people who got the J&J vaccine more than a month ago are at very low risk for developing the blood clots. All six reported cases occurred in women ages 18 to 48, whose symptoms developed within two weeks after they received the shot.
New Jersey’s Department of Health said that all vaccination sites in the state “have been told to cancel or put on hold appointments for the J&J vaccine until further notice.” The agency said it will work with those sites to replace J&J appointments with an alternative two-dose vaccine.
Virginia “will cease all Johnson & Johnson vaccines” while the FDA investigates the “extremely rare possible side effect,” according to a statement from the state’s vaccination coordinator, Dr. Danny Avula.
Connecticut’s Department of Public Health recommended all Covid vaccine providers stop using J&J’s vaccine “for the time being” while the FDA and the CDC complete their review.
Ohio Gov. Mike DeWine and top health officials in his state issued a similar advisory.
Massachusetts’ Department of Public Health notified all vaccine providers in the state to stop administering the J&J vaccine, “effective immediately.”
The other states are Colorado, Florida, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Missouri, Nebraska, New Hampshire, North Carolina, Rhode Island, South Dakota, Texas, Utah and West Virginia.” (F)
“Gov. Gretchen Whitmer and state health officials learned of the federal request for a pause at the same time as the general public. The state will follow the advice of medical professionals and stop the use of the Johnson & Johnson vaccine while the investigation is underway.
“More than 6.8 million doses of the Johnson & Johnson vaccine have been administered in the U.S., and these adverse events appear to be extremely rare. However, out of an abundance of caution, we are following recommendations from FDA and CDC and pausing the use of the Johnson & Johnson vaccine in Michigan,” said Dr. Joneigh Khaldun, the state’s chief medical executive, in a statement.
“As we learn more about this from our federal partners, we will update vaccine providers and Michiganders across the state. We encourage everyone to continue making appointments to be vaccinated with the safe and effective Pfizer and Moderna COVID-19 vaccines at this time.”
It couldn’t come at a worse time for Michigan, which is in the throes of the most severe COVID-19 outbreak in the nation. Whitmer has repeatedly asked the federal government to surge more vaccines to the state, where the per-capita COVID-19 case rate hit a seven-day average of 510.5 cases per 100,000 people Tuesday, according to the U.S. Centers for Disease Control & Prevention.” (G)
“The vaccine’s shelving has the governor doubling down on calls to President Joe Biden’s administration to deploy more vaccines to hot spots like Michigan. The government has sent more vaccination resources to the state, but not vaccines.
“With this latest development, it’s more important than ever for the federal government to implement a targeted strategy that allocates additional Pfizer and Moderna vaccines to hotspots like Michigan to slow the spread of COVID-19 and save lives,” Bobby Leddy, press secretary for the governor, told Detroit Free Press. “Gov. Whitmer will continue fighting for the vaccines we need to protect Michiganders, so we can get back to normal as soon as possible.”” (H)
“Michigan cannot rely on COVID-19 vaccinations alone to rein in rising COVID-19 cases and hospitalizations in the state, CDC Director Rochelle Walensky, MD, said during an April 12 news briefing.
Dr. Walensky said Michigan should enact shutdown measures to help flatten the curve and emphasized the importance of social distancing, testing and contact-tracing.
“When you have an acute situation, an extraordinary number of cases like we have in Michigan, the answer is not necessarily to give vaccine[s],” she said during the briefing. “The answer to that is to really close things down, to go back to our basics.”
She said the positive effects from vaccinations are often not seen in areas experiencing serious COVID-19 outbreaks for two to six weeks.
“I think if we tried to vaccinate our way out of what is happening in Michigan, we would be disappointed that it took so long for the vaccine to work, to actually have the impact,” she said.” (I)
“The suspension “will not have a significant impact on our vaccination plan: Johnson & Johnson vaccine makes up less than 5% of the recorded shots in arms in the U.S. to date,” Jeff Zients, White House COVID-19 response coordinator, said in a statement.
“Based on actions taken by the president earlier this year, the U.S. has secured enough Pfizer (PFE) – Get Report and Moderna (MRNA) – Get Report doses for 300 million Americans.”
Further, “Over the last few weeks, we have made available more than 25 million doses of Pfizer and Moderna each week, and in fact this week we will make available 28 million doses of these vaccines,” Zients said.
“This is more than enough supply to continue the current pace of vaccinations of 3 million shots per day, and meet the president’s goal of 200 million shots by his 100th day in office — and continue on to reach every adult who wants to be vaccinated.”
The White House is “working now with our state and federal partners to get anyone scheduled for a J&J vaccine quickly rescheduled for a Pfizer or Moderna vaccine.”” (J)
“The emergence of possible safety issues with the Johnson & Johnson Covid-19 vaccine is certainly unwelcome news, but it is far too early for either the general public or Wall Street to panic.
U.S. health authorities recommended a pause in the usage of the shot on Tuesday, following reports of severe blood clots in six women who received the shot. About 6.7 million people have received the vaccine so far in the U.S. J&J shares traded lower on Tuesday morning, while other vaccine makers such as Moderna rallied.
While the headline is scary, especially in a pandemic setting, there is no direct evidence that the vaccine is responsible for these rare cases. Moreover, such a pause is standard practice when possible safety issues arise in a new medication or vaccine. Regulators are historically quite sensitive to safety issues in vaccines, because they are meant for the entire public. In a nonpandemic setting, several years of safety data is typically collected before bringing a vaccine to market. No surprise then that regulators chose to err on the side of caution. For members of the public who are hesitant to take a vaccine, Tuesday’s action should boost confidence, not erode it.
It is possible that the regulators will allow J&J shots to resume in short order. But if not, the U.S. government has diversified its vaccine options, a decision that is looking increasingly prescient. As such, there is plenty of supply even if the J&J vaccine is mothballed over the long term. There were roughly 39 million doses of Pfizer ’s and Moderna’s vaccines delivered to care providers but yet to be administered as of Tuesday, according to Centers for Disease Control and Prevention data, and more supply is coming online.
There will be new challenges if the J&J vaccine doesn’t rejoin the mix. It requires only one dose, while Pfizer and Moderna each require two. If the J&J shot is no longer an option, the government will need to rethink how to supply rural and other hard-to-reach communities with vaccines.” (K)
“Dr. Scott Gottlieb said Tuesday that people should be “cautious not to overinterpret” the Food and Drug Administration’s decision to temporarily halt use of Johnson & Johnson’s coronavirus vaccine.
“Let’s start with what the FDA didn’t do,” the agency’s former commissioner said on CNBC’s “Squawk Box.” “They didn’t revoke the emergency use authorization. They didn’t order this off the market.”
“This was a requested pause, which is an awkward regulatory step, but I think it reflects the level of caution on their part to not to appear to act too forcefully here,” said Gottlieb, a member of Pfizer’s board of directors.
The agency’s decision, announced Tuesday, came after six women out of millions vaccinated developed blood clots.
Gottlieb predicted that the move will nonetheless “fuel the hesitancy” from some people to get a Covid vaccine.
“Even if there isn’t a causal relationship, even if this is exceedingly rare, I think we’re going to see that whole conversation now get ignited on social media,” he said…
Gottlieb said he believes the J&J vaccine could come back into use “with some additional, perhaps, restrictions on its target populations in the interim while they continue to investigate this.”” (L)
F.States rush to replace J&J vaccine appointments after FDA recommends pause, by Kevin Breuninger, https://www.cnbc.com/2021/04/13/states-rush-to-replace-jj-vaccine-appointments-after-fda-recommends-pause.html
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…”
“With millions of Americans being vaccinated against Covid-19 every day, a heated debate is underway — do these people need proof of immunization in the form of a vaccine passport?
Just like a national passport, a vaccine passport could allow the bearer entrance to a venue, like a crowded concert, or a foreign country that demands proof of vaccination in addition to a visa and valid national passport.
Vaccination cards from the US Centers for Disease Control and Prevention aren’t quite the same as a vaccine passport. Though they are a record of what vaccine a person got and when, they can easily be forged.
A vaccine passport is just proof that a person has been immunized against Covid-19. It could be in the form of a smartphone app or a written certificate, for those who don’t have smartphones.
Some health experts argue that such proof of vaccination can be the ticket back to normalcy. It could reward people for getting vaccinated by allowing them into a crowded concert or ballgame, and offer them peace of mind that the person next to them has been immunized, too — thus helping to make crowded places safer….
But critics point to privacy concerns and overreach by authorities…” (A)
“What are the Downsides?
It’s already been established that more research into coronavirus vaccination and transmission is needed, but experts believe equity could be an additional concern with vaccine passports.
“It is hard to imagine how vaccine passports could be put into place in a way that would make travel safer around the world in an equitable manner,” Mercedes Carnethon, vice chairwoman of preventive medicine at Northwestern University Feinberg School of Medicine, says in an email.
While the U.S. has administered over 143 million doses of coronavirus vaccines, dozens of countries have yet to administer a single shot.
Should a coronavirus vaccine passport be put into place for international travel, it would clearly put countries that have less access to vaccines at a disadvantage.
WHO’s stance is that “national authorities and conveyance operators should not introduce requirements of proof of COVID-19 vaccination for international travel as a condition for departure or entry, given that there are still critical unknowns regarding the efficacy of vaccination in reducing transmission.” It added that “preferential vaccination of travellers could result in inadequate supplies of vaccines for priority populations considered at high risk of severe COVID-19 disease.”
There are also privacy concerns to consider, as people may not be willing to share their health data with companies.
“There’s always going to be hesitancy, whether it’s about getting the vaccine or giving information about their status,” Raymond says.
And it’s unclear how much interest U.S. citizens would have in such a system, given that people already seem to be willing to travel within the country regardless of their vaccination status. Young spring breakers have taken to Florida beaches, prompting officials to label the developments “warning signs” of a potential backslide in progress against the coronavirus.
In a country where the pandemic has demonstrated drastic political divides over coronavirus mitigation strategies, a vaccine passport system could be a hard sell.
“Our country has not shown a united front to date when it comes to [COVID-19] mitigation strategies, unlike countries in Europe, Asia and famously New Zealand who have gone through a series of rolling nationwide lockdowns as needed,” Carnethon says. “It seems that requiring visitors to the U.S. to show vaccine passports would be challenging to receive bipartisan support to put into place.” “(B)
“The World Health Organization (WHO) does not back the use of coronavirus vaccine passports for travel, a spokesperson said.
WHO spokeswoman Margaret Harris said the world health agency does not back the use of these passports — proof that one has been vaccinated against COVID-19 — because it is not yet known if those who have been vaccinated against the virus can still transmit it. She cited equity concerns as another reason the WHO does not endorse the use of them at this time.
“We as WHO are saying at this stage we would not like to see the vaccination passport as a requirement for entry or exit because we are not certain at this stage that the vaccine prevents transmission,” Harris said during a United Nations news briefing, per Reuters.
In the U.S., the issue of vaccine passports has largely become partisan, with Republican lawmakers mostly against the concept.
“There are all those other questions, apart from the question of discrimination against the people who are not able to have the vaccine for one reason or another,” she added.
The news comes after the nation’s top infectious disease expert also spoke to vaccine passports, saying that the federal government won’t be mandating them for travelers or businesses after the pandemic is over.
“I doubt that the federal government will be the main mover of a vaccine passport concept,” Dr. Anthony Fauci, who also serves as President Biden’s chief medical adviser, told the Politico Dispatch podcast on Monday.
“They may be involved in making sure things are done fairly and equitably, but I doubt if the federal government is going to be the leading element of that,” he added.
Some argue that mandating vaccine passports could speed the re-opening of international travel. But the issue of vaccine passports is complicated and has been hotly debated around the world, with questions largely around how much governments, employers and venues have a right to know about a person’s vaccination status.” (C)
Last month, New York became the first state in the nation to formally launch a digital vaccine passport for Empire State residents to verify that they’ve been immunized against the coronavirus.
The state’s program, dubbed the “Excelsior Pass,” allows New Yorkers to prove their vaccination status, or a recent negative COVID-19 test, in order to gain entry to events and businesses.
Manhattan’s Madison Square Garden and the Times Union Center in Albany have already begun using the app. Smaller arts, entertainment and event venues are also expected to utilize the pass, Gov. Andrew Cuomo’s office has said…
Illinois Gov. JB Pritzker has also said that he supports passports, but added that they should not be required to enter an event or facility.
“As long as it is your choice,” Pritzker told reporters, according to Patch.com. “If people ask you to show that for a particular venue or private venue, they have the ability and right to do that. You don’t have to show that to them. You don’t have to be to go to that venue or be engaged in that activity.”
Meanwhile, leaders in a slew of states — including Florida, Texas, Georgia, Tennessee, Missouri and Nebraska — have already expressed fierce opposition to any use of vaccine passports within their borders.
On Tuesday, Texas Gov. Greg Abbott issued an executive order prohibiting state agencies or organizations that receive state funds from requiring COVID-19 vaccine passports.
“Government should not require any Texan to show proof of vaccination and reveal private health information just to go about their daily lives. That is why I have issued an Executive Order that prohibits government-mandated vaccine passports in Texas,” Abbott said in a statement. “We will continue to vaccinate more Texans and protect public health — and we will do so without treading on Texans’ personal freedoms.”
“It’s completely unacceptable for either the government or the private sector to impose upon you the requirement that you show proof of vaccine to just simply be able to participate in normal society,” DeSantis has said.
Georgia Gov. Brian Kemp said he was opposed to “state-mandated” vaccine passports on Tuesday.
“I do not and will not support any kind of state-mandated vaccine passport. While the development of multiple safe, highly effective COVID-19 vaccines has been a scientific miracle, the decision to receive the vaccine should be left up to each individual,” Kemp said on Twitter….
The Biden administration has said that it is working to create a set of standards for the many private companies making their own versions of passports — but will not make or require its own federal version.
“The government is not now, nor will we be supporting a system that requires Americans to carry a credential,” White House press secretary Jen Psaki told reporters at a briefing on Tuesday.” (D)
“Cathay Pacific airlines, convinced that digital proof of coronavirus vaccination will bring about the return of safe international travel, asked its pilots and crew to try out a new mobile app that showed their vaccination status on a recent flight from Hong Kong to Los Angeles…
And Walmart, the nation’s largest private employer, is offering electronic verification apps to patients vaccinated in its stores so they “can easily access their vaccine status as needed,” the company says.
Around the country, businesses, schools and politicians are considering “vaccine passports” — digital proof of vaccination against the coronavirus — as a path to reviving the economy and getting Americans back to work and play. Businesses especially fear that too many customers will stay away unless they can be assured that the other patrons have been inoculated.
But the idea is raising charged legal and ethical questions: Can businesses require employees or customers to provide proof — digital or otherwise — that they have been vaccinated when the coronavirus vaccine is ostensibly voluntary?
Can schools require that students prove they have been injected with what is still officially an experimental prophylaxis the same way they require long-approved vaccines for measles and polio? And finally, can governments mandate vaccinations — or stand in the way of businesses or educational institutions that demand proof?
Legal experts say the answer to all of these questions is generally yes, though in a society so divided, politicians are already girding for a fight. Government entities like school boards and the Army can require vaccinations for entry, service and travel — practices that flow from a 1905 Supreme Court ruling that said states could require residents to be vaccinated against smallpox or pay a fine.
“A community has the right to protect itself against an epidemic of disease which threatens the safety of its members,” Justice John Marshall Harlan wrote in Jacobson v. Massachusetts, the 1905 case.
Private companies, moreover, are free to refuse to employ or do business with whomever they want, subject to only a few exceptions, ones that do not include vaccination status. And states can probably override that freedom by enacting a law barring discrimination based on vaccination status…
One arm of the government has offered some help: The Equal Employment Opportunity Commission has told employers that they can mandate coronavirus vaccination because public health comes first. If an employee cannot get vaccinated because of a disability or a sincerely held religious belief, and the company cannot make an accommodation, the agency said, “then it would be lawful for the employer to exclude the employee from the workplace.” (E)
“A southbound passenger train halted in southern Quebec near the Vermont border, where an elderly, bespectacled man boarded the train. This man, a physician named Dr. Hamilton, worked his way down the aisles, asking each passenger, “Been vaccinated?” Unless they had documentation proving that they had been, Hamilton asked them to display their arms, where he looked for a “fresh scar” indicating a recent inoculation. If he could find no scar, a local paper informed readers, he either vaccinated the passenger on the spot or asked them to leave the train before it entered the United States.
The year was 1885. U.S. border officials in the late 19th century did not expect travelers to carry the identification documents that international transit requires today—but they did often require passengers to provide evidence that they had been vaccinated from smallpox. Whether at ports of entry including New York’s Ellis Island and San Francisco’s Angel Island, or along the U.S. border with Canada or Mexico, officials expected border-crossers to prove their immunity. As an El Paso newspaper put it in 1910, travelers needed to show one of three things: “A vaccination certificate, a properly scarred arm, or a pitted face” indicating that they had survived smallpox.” (F)
““They’re coming whether we like it or not,” said Dr. Saad Omer, director of the Yale Institute for Global Health, referring to programs that verify a person’s vaccination status. But he said the conversations policymakers and private businesses have right now could help depoliticize this public health tool and maintain public trust.
What is the precedent?
For centuries, yellow fever haunted the world’s port cities. The highly infectious mosquito-borne disease spread easily and often was deadly, especially in warmer climates, sickening an estimated 200,000 and killing 30,000 people each year among unvaccinated populations, according to the CDC. To this day, there is no cure for yellow fever.
But in 1937, virologist and physician Max Theiler developed an effective vaccine to thwart the disease. Two decades later, the World Health Organization issued the International Certification for Vaccination or Prophylaxis, a yellow-colored paper also known as a Yellow Card. These certificates served as proof that the bearer had been vaccinated and did not pose a risk of carrying yellow fever or causing a potential outbreak. It remains a standard document for U.S.
Unlike the physical Yellow Cards, there are growing concerns about data privacy as documents.. verifying COVID-19 vaccination would exist and generally be accessed digitally. These digital health records would operate outside of the Health Insurance Portability and Accountability Act of 1996, or HIPAA, which protects people’s private medical information from being disclosed by health care providers, health plans, or businesses. And there are instances when HIPAA allows that information to be released, such as when it is in the public interest. More broadly, some people are concerned that their data could be used against them by law enforcement, accessed by hackers or sold to third-party vendors if regulators fail to offer appropriate oversight.” (G)
“On Etsy, eBay, Facebook and Twitter, little rectangular slips of paper started showing up for sale in late January. Printed on card stock, they measured 3 by 4 inches and featured crisp black lettering. Sellers listed them for $20 to $60 each, with a discount on bundles of three or more. Laminated ones cost extra.
All were forgeries or falsified copies of the Centers for Disease Control and Prevention vaccination cards, which are given to people who have been inoculated against Covid-19 in the United States.
“We found hundreds of online stores selling the cards, potentially thousands were sold,” said Saoud Khalifah, the founder of Fakespot, which offers tools to detect fake listings and reviews online.
The coronavirus has made opportunists out of many people, like those who hoarded bottles of hand sanitizer at the start of the pandemic or those who cheated recipients out of their stimulus checks. Now online scammers have latched on to the latest profit-making initiative: the little white cards that provide proof of shots.
Online stores offering counterfeit or stolen vaccine cards have mushroomed in recent weeks, Mr. Khalifah said. The efforts are far from hidden, with Facebook pages named “vax-cards” and eBay listings with “blank vaccine cards” openly hawking the items.
Selling fake vaccination cards could break federal laws that forbid copying the C.D.C. logo, legal experts said. If the cards were stolen and filled out with false numbers and dates, they could also violate identity theft laws, they said….
The C.D.C. said it was “aware of cases of fraud regarding counterfeit Covid-19 vaccine cards.” It asked people not to share images of their personal information or vaccine cards on social media.” (H)
“Many technology and health care entities have banded together as the Vaccine Credential Initiative, to develop a broadly agreed-upon set of open standards, meaning that the software underlying a verification system is transparent and it can adapt easily to other systems, while safeguarding privacy. The W.H.O. has a similar initiative, the Smart Vaccination Certificate.
But several companies are creating closed, proprietary systems that they hope to sell to clients, and some apparently would have access to users’ information.
One concern is that a profusion of systems might not be compatible, defeating the purpose of making it easy to check someone’s status.
Another objection is that any requirement to prove vaccination status would discriminate against those who can’t get the shot or refuse to, and there is lingering uncertainty about how well inoculation prevents virus transmission.
For those reasons, the W.H.O. said this week that it does not support requiring proof of vaccination for travel — for now.” (I)
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.”
We have a way to respond and save lives: vaccinations, which prevent infection and have also shown they are effective in preventing transmission. There will be enough vaccines by summer to vaccinate every American, including children as young as 12. But summer is not here yet. And the recent spoilage of 15 million doses of Johnson & Johnson’s one-dose vaccine means we will need 30 million more doses of two-shot vaccines soon, to make up for the loss.
The supply we need is right in front of us. We need only to adopt the sensible, evidence-based policy used in the United Kingdom: Vaccinate as many people as possible with just one dose, by delaying the second dose of Pfizer and Moderna vaccines. Having adopted this strategy, the U.K. has vaccinated 46% of the population and effectively avoided a second surge of the highly contagious B.1.1.7 variant. This is the same strain that is spreading through Michigan, Minnesota and other surging states.
The United States does not have far to go. About 110 million Americans have received at least one shot. We need to vaccinate 40 million more people to reach the U.K. level. We are administering nearly 3 million doses a day. If we temporarily delay second doses and continue at that rate, we can get to the U.K. level in about two weeks. That is our best hope of quelling the fourth wave ignited by the B.1.1.7 variant. Because we did not start this strategy earlier, it is probably too late for Michigan, New York, New Jersey and the other Northeastern states. But it might be just in time for the South and California — the next places the more infectious strain will go if historical patterns repeat…
Some complain that postponing second doses is not “following the science.”..
Others worry that postponing second doses encourages the development of new variants…
Still others complain that postponing second doses will prompt hesitancy or confusion. (A)
“As Covid-19 cases spike and coronavirus variants continue to spread, the Biden administration is facing renewed calls to delay second vaccine doses and blanket more of the U.S. population with an initial shot.
Advocates of a strategy focused on first doses include Democratic and Republican senators, Trump administration surgeon general Jerome Adams, and at least four physicians or epidemiologists who advised President Biden on pandemic response issues prior to his inauguration, including the prominent surgeon and author Atul Gawande.
Despite the new advocacy, and its own warnings of “impending doom,” the Biden administration has given no indication it will budge. But the shift in opinion underscores the growing alarm at a possible fourth wave of U.S. Covid-19 cases — and frustration with the federal government’s lack of flexibility…
Gawande wrote this week that the Biden administration should delay second vaccine doses until 12 weeks following the first dose, as opposed to the current three- or four-week interval. Two other members, Emanuel and Michael Osterholm, have argued for delaying second doses since February. A fourth, Céline Gounder, recently announced she was reconsidering her stance after months of vocally opposing the strategy.
The latest push comes as U.S. case rates have begun to tick upward, and as some states, including Michigan, have begun to experience a surge in hospitalizations reminiscent of July 2020 and January 2021. The U.S. has reported roughly 60,000 new cases per day for the last week, far below the country’s January peak but similar to last summer’s surge.
The Biden administration has stayed the course despite new evidence suggesting that even a single dose of the vaccines manufactured by Moderna or the Pfizer-BioNTech partnership is highly effective at reducing Covid-19 infections. Risk of infection, according to a recent study, falls by 80% two weeks after an initial shot. The figure increases to 90% two weeks after a second dose.
A growing number of public health experts have used the new data to argue that the strategy is clear-cut. In the short term, they contend, giving twice as many people 80% protection against the virus would do dramatically more to stop the spread than giving the current number 90% protection…
Tony Fauci, the country’s chief infectious diseases researcher, has argued that there isn’t solid evidence to back a delayed-dose strategy. Even if an initial first dose gives good protection against Covid-19, he said at a recent White House briefing, it’s unclear how long that protection would last.
Beyond posing an unnecessary risk to individuals’ immunity, Fauci has also warned that pivoting midway through the vaccine rollout could send the message that there’s no need to return for a second shot, whether it’s three or 12 weeks after their first.
Fauci has also warned that delaying second doses could help foster the growth of “escape” variants, or strains of the SARS-CoV-2 virus that are more likely to evade existing vaccines’ protectiveness.
A paper published this week in Nature, however, argued the opposite: There is little evidence that so-called “dose-sparing” strategies help to select for escape variants. The math, its authors note, is simple.
“[If] individuals who receive half as much vaccine (one versus two doses, or half the quantity of antigen per dose) achieve more than half the protection from clinical infection of those given a full regimen, then spreading the vaccine among more individuals will produce greater reductions in the number of clinical infections,” they wrote.” (B)
“When you’re talking about doing something that may have real harm, you need empirical data to back that,” said Dr. Céline R. Gounder, an infectious-disease specialist at Bellevue Hospital Center and a member of Mr. Biden’s coronavirus advisory board. “I don’t think you can logic your way out of this.”…
Sarah E. Cobey, an epidemiologist and evolutionary biologist at the University of Chicago, said she thought that the United States had lost a precious opportunity to save many lives with such a strategy. “We’ve missed a window, and people have died,” she said.
But even now, Dr. Emanuel said, it’s worth delaying doses. The United States is giving out roughly three million vaccines a day, but nearly half are going to people who have already received one shot. The nation’s entire supply, he argued, should instead be going to first-timers.
If that happened, it would take two or three weeks for the United States to catch up with Britain, according to his team’s calculations. The extra protection would not just save the lives of the vaccinated but would help reduce transmission of the virus to people yet to get any protection.
Still, some scientists say it’s premature to credit the delayed vaccination schedule for Britain’s drop in cases.
“They’ve done a few other things, like shut down,” Dr. Fauci said.
“I think the real test will be whether we see a rebound in cases now that the U.K. is reopening,” Dr. Gounder said.
Instead of experimenting with vaccination schedules, critics say it would be wiser to get serious about basic preventive measures like wearing masks. “It’s crucial that we don’t just reopen into a big national party,” Dr. Borio said.
She and others are also worried by recent studies that show that a single dose of Moderna or Pfizer-BioNTech does not work as well against certain variants, such as B.1.351, which was first found in South Africa.
“Relying on one dose of Moderna or Pfizer to stop variants like B.1.351 is like using a BB gun to stop a charging rhino,” said John P. Moore, a virologist at Weill Cornell Medicine.
Dr. Moore said he also worried that delaying doses could promote the spread of new variants that can better resist vaccines. As coronaviruses replicate inside the bodies of some vaccinated people, they may acquire mutations that allow them to evade the antibodies generated by the vaccine.
But Dr. Cobey, who studies the evolution of viruses, said she wasn’t worried about delayed doses breeding more variants. “I would put my money on it having the opposite effect,” she said.
Last week, she and her colleagues published a commentary in Nature Reviews Immunology in defense of delaying doses. Getting more people vaccinated — even with moderately less protection — could translate into a bigger brake on the spread of the virus in a community than if fewer people had stronger protection, they said. And that decline wouldn’t just mean more lives were saved. Variants would also have a lower chance of emerging and spreading.
“There are fewer infected people in which variants can arise,” she said.” .” (C)
“Delaying the dose could make way for more people to get their first shots and stem the coronavirus’s spread, proponents say. Opponents say there’s not enough data to show if that one-shot protection is long-lasting enough. And they worry that changing timing now could confuse people, undermine trust and lead to more widespread hesitancy to get the vaccine…
Arguing for delay
Those numbers justify temporarily postponing second doses to ensure that more people get their first shots, says Robert Wachter, who heads the Department of Medicine at the University of California, San Francisco.
“That’s not a hard math question,” he says. “You’ll save far, far more lives — on the order of tens of thousands more lives — giving those extra vaccine doses to people for their first shot, getting them from zero to 85 percent protected, than using that same capacity [for] giving people their second shot and getting them from 85 to 95 [percent efficacy].”
The real driving force behind proposals to delay the second shots is that there just isn’t enough vaccine to go around. It’s all about getting jabs into as many arms as possible, Skowronski says.
Postponing the second dose doesn’t mean cancelling it, she says. It’s just a delay that could allow for more widespread distribution of the vaccine, especially to people at high risk of hospitalization and death from COVID-19.
Even though no one knows how long protection from a single shot will last, immunity doesn’t disappear overnight. That buys time, she says.
“We should be ensuring as many people as possible, by whatever means possible, get the first dose before we double back and try to top up with a second dose,” Skowronski says. “Every second dose we administer is essentially depriving someone else of the substantial protection they could have got from that vaccine supply as a first dose.”
Arguing against delay
Yes, the data overall suggest the first doses work pretty well, but scientists don’t know how durable that protection is, says virologist Onyema Ogbuagu. That may not be as much of a problem in countries like Israel and the United Kingdom, which have been vaccinating people pretty quickly. But in the United States, the vaccine rollout has been creeping and crawling, Ogbuagu says. Because of that slow progress, “you could be six months or 10 months into vaccination and the first people you vaccinated could become vulnerable again.”
The second shot should make immunity last longer. “The role of the second dose is, without question, an advantage,” he says. “It optimizes the efficacy and durability.” Ogbuagu, who oversees COVID-19 clinical trials at Yale School of Medicine, was involved in testing the Pfizer vaccine’s efficacy.
Earlier Phase I and II safety trials also tested people’s immune responses to the mRNA vaccines. Those data showed that antibody levels after the first shot are respectable but often don’t get close to matching levels seen in people who have recovered from COVID-19, Ogbuagu says. “But the pattern after the second dose is just so striking, antibody levels just skyrocket,” often exceeding levels from recovered patients, he says.
He also notes that the dosing data from the AstraZeneca trial came from a part of the study wasn’t planned and other unknown things might be influencing the outcome, A new clinical trial mixing the Pfizer and AstraZeneca vaccines will test in which order the shots should be given, and whether a four- or 12-week interval between doses produces better efficacy. That trial will produce more reliable data on which to base a decision about shot schedules. For now, though, “we have to deal with the unknowns,” he says, “and I think the benefits of giving that second shot outweigh giving just the first one and hoping for the best.”
There’s another big worry: Even under a best case scenario, some people are bound to get sick after getting vaccinated. The vaccines aren’t perfect and some new variants of the coronavirus can evade antibodies generated by the jabs. Some researchers are concerned that delaying a second dose could help produce new variants (SN: 1/14/21).
And if infections happen while monkeying with untried dosing intervals, it could undermine public confidence in the shots, worries Nicole Lurie, a strategic adviser for the Coalition for Epidemic Preparedness Innovations, an organization that funds vaccine development.
It may feed a narrative that health officials didn’t fully follow the science as promised, Lurie says. If public confidence erodes to the point that people turn down vaccines, “then in the long run, you’re doing the nation a disservice.” (D)
“One dose may not always be enough
The study found that one-dose strategies may, as expected, reduce case numbers in the short term by more rapidly immunizing a greater number of individuals. However, if immune responses after one dose are less robust, subsequent epidemic peaks may be larger.
“More optimistically, we find that as vaccine capacity increases, increasing vaccination rates or changing the dosing regime to closer to the recommended two-dose schedule can mitigate these longer term epidemiological effects, which is important for public health planning,” adds Wagner…
“At least one variant has already emerged that may be adapted for partial immune escape,” notes Holmes. “Simple theory underlines that the evolution and transmission of variants by infected hosts with intermediate levels of immunity may be important. Therefore, the strength and duration of immunity, and particularly the effect of these on retransmission, are key parameters to determine” adds Grenfell.
One intuitive finding that the paper emphasizes is that very low rates of vaccine administration may be associated with larger case numbers and, possibly, more elevated potential for viral adaptation. “This strongly underlines the importance of equitable global vaccine distribution, as immune escape in one location will rapidly spread,” explains C. Jessica E. Metcalf, a co-author on the paper, and an Associate Professor in EEB and the School of Public and International Affairs at Princeton and an associated faculty member at the High Meadows Environmental Institute.
“The models are relatively simple conceptually, but they illustrate the complexities of the problem and highlight the challenges that we still face,” notes Michael Boots, a Professor of Integrative Biology at UC Berkeley who was not affiliated with the present study. “This important piece of work provides a framework that we can use to inform our approach going forward and moreover identifies the key knowledge gaps that we need to address,” adds Boots.” (E)
“Washington will rush federal resources to support vaccinations, testing and treatments, but not vaccines, to Michigan in an effort to control the state’s worst-in-the-nation COVID-19 outbreak, the White House said Friday…
President Joe Biden outlined the federal actions late Thursday in a call with Whitmer to discuss the dire situation in the state, according to senior administration officials. The response will not include a “surge” of vaccine doses, a move Whitmer has advocated and which is backed by Michigan legislators and members of Congress.
Instead, Biden talked about how the federal government was planning to help Michigan better utilize doses already allocated to the state, as well as to increase testing capacity and provide more medications used to treat the sick.
Whitmer, a Democrat, confirmed that she asked Biden on the call to send more vaccine doses to Michigan, particularly the single-dose Johnson & Johnson shot.
“I made the case for a surge strategy,” she said. “At this point, that’s not being deployed, but I am not giving up.”
“Today it’s Michigan and the Midwest,” she added. “Tomorrow, it could be another section of our country. I really believe that the most important thing we can do is put our efforts into squelching where the hot spots are.”
Doses are allocated to states proportionally by population, but Whitmer has called for extra doses to be shifted to states, like hers, that are experiencing a sharp rise in cases. The Biden administration isn’t ready to make such changes.
“We’re going to stick with the allocation system of allocating by state adult population,” said White House COVID-19 coordinator Jeff Zients, calling it “the fair and equitable way” to distribute vaccines. He said the administration was looking to help Michigan administer more of its vaccines efficiently…
Federal officials said providing more doses would not be as immediately effective in curbing Michigan’s virus spike as increasing testing, restoring measures like mask wearing, and foregoing high-risk activities. That’s because vaccines take at least two weeks to begin providing immunity.
Biden told Whitmer that his administration stands ready to send an additional 160 Federal Emergency Management Agency and CDC personnel to Michigan to assist in vaccinations, on top of the 230 federal personnel already deployed to the state to support pandemic response operations.
He’s also directing the administration to prioritize the distribution of doses through federal channels, like the retail pharmacy program and community health centers, to areas of the state Whitmer identifies.
“We are at war with this virus, which requires leaders from across the country to work together,” said White House spokesperson Chris Meagher. “We’re in close contact with Gov. Whitmer, who is working hard to keep Michigan safe, and working in close coordination through a range of options that can help stop the spread of the virus.”
Michigan ranked 35th among states in its vaccination rate. About 40% of Michigan residents ages 16 and older have gotten at least one vaccine dose.
The governor’s recommended high school closure drew mixed reaction in education circles. Her administration closed high schools for a month during the state’s second surge late last fall.
“Research has shown schools can be safe places for in-person learning, so long as community spread is under control — but with higher risk in our communities comes higher risk in classrooms,” said Michigan Education Association President Paula Herbart, whose union urged a similar two-week suspension of in-person learning at elementary and middle schools and colleges.
Restaurants, meanwhile, questioned Whitmer’s recommendation not to eat inside but welcomed the call for more vaccines.
“We trust our operators to continue to provide a safe environment indoors or out in the coming weeks and we trust Michiganders to do their part to act responsibly and respectfully to help us all achieve that outcome,” said Justin Winslow, president and CEO of the Michigan Restaurant & Lodging Association.” (F)
“When it comes to getting the coronavirus vaccine, Mississippi residents have an abundance of options. On Thursday, there were more than 73,000 slots to be had on the state’s scheduling website, up from 68,000 on Tuesday.
In some ways, the growing glut of appointments in Mississippi is something to celebrate: It reflects the mounting supplies that have prompted states across the country to open up eligibility to anyone over 16.
But public health experts say the pileup of unclaimed appointments in Mississippi exposes something more worrisome: the large number of people who are reluctant to get vaccinated.
“It’s time to do the heavy lifting needed to overcome the hesitancy we’re encountering,” said Dr. Obie McNair, an internal medicine practitioner in Jackson, the state capital, whose office has a plentiful supply of vaccines but not enough takers.
Though access remains a problem in rural Mississippi, experts say that the state — one of the first to open eligibility to all adults three weeks ago — may be a harbinger of what much of the country will confront in the coming weeks, as increasing supplies enable most Americans who want the vaccine to easily make appointments.
The hesitancy has national implications. Experts say between 70 percent to 90 percent of all Americans must be vaccinated for the country to reach herd immunity, the point at which the virus can no longer spread through the population.
When it comes to rates of vaccination, Mississippi still has a way to go, with just a quarter of all residents having received at least one dose compared to the nationwide average of 33 percent, according to state data. Other southern states, among them Tennessee, Arkansas, Alabama and Georgia, have similarly low rates of vaccination. “(G)
“There will be 86% fewer Johnson & Johnson vaccine doses allocated to states next week, new data from the Centers for Disease Control and Prevention show, highlighting the company’s yo-yoing vaccine supply from week to week…
Next week, 1.5 million J&J doses will be distributed, including 700,000 doses that will go out through the state allocation system, and another 800,000 that will be handed out through other federal programs, which have grown significantly during the Biden administration.
Supply of the Johnson & Johnson vaccine has been lumpy since its FDA authorization on Feb. 27. The CDC allocated 2.8 million doses to states the next week, followed by no doses the week after that, according to the CDC’s state allocation database. Then, there were fewer than a half-million doses in each of the next two weeks. (The state allocation table is not a complete accounting of doses distributed, however, because many are allocated through other federal programs and not included in the data.)
It’s no secret that Johnson & Johnson has been having manufacturing difficulties. Although its Aug. 5 Operation Warp Speed contract says it expected to deliver 37 million doses by the end of March, that goal had shrunk to 20 million doses, as Dr. Richard Nettles, vice president of medical affairs for the company’s pharmaceutical division, told a congressional subcommittee on Feb. 23.
The Biden administration stepped in with help in early March, when it brokered a deal between J&J and a pharmaceutical, Merck, to increase the vaccine supply.” (H)
“The U.K.’s bold call to delay giving people a second dose of a Covid-19 vaccine has put it out in front in the race to inoculate the world against the disease.
Behind that decision: a group of 16 scientists who advocated a controversial move to overrule some vaccine manufacturers’ guidelines in order to get more first doses to more people.
The gamble appears to have paid off, with incoming data pointing to durable protection against falling ill after just one vaccine dose. But while some countries, such as Canada, have followed the U.K.’s lead, others including the U.S. are refusing, saying to do so could pose a risk to public health.
The decision by British authorities holds lessons for other countries as they fight to contain the pandemic. Indeed, the dosing debate raises difficult questions about whether some governments and their scientific advisers—for instance in the European Union, where vaccination campaigns are painfully slow—are being too risk averse.
In December, as a highly infectious Covid-19 variant ripped across the U.K., the group of scientists sitting on Britain’s Joint Committee on Vaccination and Immunisation concluded that delaying a second vaccine dose by up to 12 weeks could save lives.” (I)
“The race to beat the coronavirus variants, and to get as many people vaccinated as quickly as possible has intensified a debate in the scientific community about what the best strategy is to end the pandemic.
The question at the heart of the debate: would delaying a second dose of the Pfizer and Moderna Covid-19 vaccine get more people protected more quickly?..
A January editorial published in the Annals of Internal Medicine explained the reason for the delayed dose strategy this way: “A single-dose SARS-CoV-2 vaccine approach deals directly with the shortage of vaccines by vaccinating twice the number of people while maximizing the probability of achieving herd immunity.”
The math is pretty simple, Dr. Michael Osterholm, the director for the Center for Infectious Disease Research and Policy at the University of Minnesota, said.
If you have two people in a room and you give one person two doses they get 90% protection, but the other person gets none. Give each a single dose, in three weeks they both have 80% protection.
“Right now, with the surge that’s about to occur, this is what we want to do right now,” Osterholm told CNN Monday. “Get as many people protected as we can so they don’t get severe illness and hospitalizations and death.”
Dr. Atul Gawande, a member of the Biden administration’s coronavirus transition team, and a surgeon who works at the Harvard’s School of Public Health, said that behavioral measures alone aren’t going to be enough to curb the spread, especially in places seeing surges like in the Midwest and Northeast.
“In these areas where we are having a surge, vaccine appointments go in minutes,” Gawande said. “We need to be vaccinating a lot more people.”
Gawande had been on the fence about it, but as more contagious variants have spread, he started to think a delayed second dose would protect the population more quickly. He said many more people in these areas will need to be vaccinated to bring an end to the surge. The strategy would also reduce the number of variants.
Dr. Ashish Jha had been calling for the delayed second dose strategy for months, but the Dean of Brown University’s School of Public Health now thinks it may be too late.
“By the end of May we’re going to have more vaccines than arms for them to go into,” Jha told CNN Monday. “I don’t know that strategy has quite the same value as it did before.”
Unless something changes with the supply, Dr. Kent Sepkowitz, an infectious disease specialist at Memorial Sloan Kettering Cancer Center in New York, agrees.
“If the stockpile is running low, than yeah, I think we ought to prioritize ‘pretty good’ vaccination for more people than ‘super duper’ protection for the fewer,” Sepkowitz told CNN Monday. “If, however, the vaccine supply isn’t so sparse, than I think we ought to plow ahead with what we’re doing.”…
Dr. William Schaffner, an infectious disease specialist at Vanderbilt University, said with so much supply at this point in the pandemic, the more effective strategy may be to concentrate on helping the hesitant get vaccinated.
“The eager beavers, the early acceptors, they’re still coming in, but we’re getting to the end of that group,” Schaffner said. “We’re now reaching out to the people who are more skeptical that they need the vaccine.”” (J)
PREQUEL
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.”
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.”
“Doctors are warning that specifically with the B.1.1.7 variant, which was first identified in the UK, children could play a major role in the rate of transmission.
A report out of the National Institutes of Health stated it is “considerably more contagious” than the original virus, with evidence showing an increased risk of severe illness and death.
“Please understand, this B.1.1.7 variant is a brand new ball game,” said Dr. Michael Osterholm, an epidemiologist.
Osterholm said this variant is making him re-evaluate his own advice about sending kids back to school. In Florida, thousands of students have been back in the classroom since last fall.
Nationally, more and more young people are being hospitalized as cases of this new variant rise. And Osterholm said, “kids now are really major challenges in terms of how they transmit.”
“It infects kids very readily. Unlike previous strains of the virus, we didn’t see children under 8th grade get infected often or they were not frequently very ill, they didn’t transmit to the rest of the community,” Osterholm said.” (A)
“Michigan reported 8,413 new Covid-19 cases on Saturday, bringing the state’s total pandemic case count to 692,206, according to the state’s health department.
Saturday’s daily case count is the highest the state has reported since December 7, when the reported case count was 9,350, state statistics show.
Just eight weeks ago, state data showed the daily reported case count was as low as 563 cases.
Michael Osterholm, director of the University of Minnesota Center for Infectious Disease Research and Policy, said the Upper Midwest is beginning to see its fourth surge.
“I think it was a wake-up call to everyone yesterday when Michigan reported out at 8,400 new cases, and we’re now seeing increasing number of severe illnesses, ICU hospitalizations, in individuals who are between 30 and 50 years of age who have not been vaccinated,” Osterholm said Sunday on NBC’s “Meet the Press.”
Osterholm said that over the past year, there have been surges of cases that cycle between US regions, starting in the Upper Midwest and Northeast, which then subside, and move to the southern sunbelt states, which then subside and go back to the original regions.
Michigan also reported 57 Covid-19 deaths Saturday, with 51 of the deaths having been identified during a vital records review that the state conducts three times per week, the health department said. The state has recorded 9,947 Covid-19 deaths since the pandemic began.
In the first three weeks of March, hospitalizations due to Covid-19 rose 633% for unvaccinated people between the ages of 30-39 and 800% for those aged 40-49, according to the Michigan Health and Hospital Association.
Dr. Justin Skrzynski, a Covid hospitalist for Beaumont Health in Royal Oak, Michigan, said a random sampling of the Covid-19 tests in the state that are sent for DNA analysis indicate a worrying sign — a sharp increase in the variant first found in the UK, which experts say may be more contagious and possibly more lethal.
More than 12,500 cases of the B.1.1.7 variant have been reported across the United States, according to CDC data, including more than 1,200 in Michigan.
Michigan had the second-highest number of cases of the variant, after Florida.
“Right now the regular Covid test we do still just shows Covid/no Covid. But we do send a lot of those out to the state, and we are seeing something like 40% of our patients now with B.1.1.7,” he told CNN’s Miguel Marquez.” (B)
“At an event for veterans in Chesterfield Township, (Michigan Governor) Whitmer said the surge is not a failure of policy, it’s a failure of following protocols. She reiterated that the state is moving as fast as it can to vaccinate people.
“If we see serious hospital numbers or increased variants, we may have to make some changes,” she said.
In an interview with 7 Action News, Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said it’s “very likely” Michigan may have opened up too soon which could be causing the massive surge in COVID-19 cases.
Fauci said the pressure to pull back could be causing the spike.
“I think the idea of pulling back prematurely, under pressure, it’s understandable why you might want to do that, but the results, I think, are being manifested in what you’re seeing in Michigan,” he said.
“I hesitate to criticize anything the governor did because she’s really quite a good governor,” Fauci said.
In response, Whitmer said that while she respects Dr. Fauci, Michigan is not in the same position compared to other states that have dropped mask mandates.
“We’ve had a very strategic response to the virus,” she said. “Variants are here, and with that, increased abandonment of protocols and mobility.”
The state shut down in mid-November due to a surge, but reopened bars and restaurants in February to 25% capacity, then increased it to 50% on March 5.
The number of active cases in the state coincides with the surge in new cases. It went from 32,400 active cases on March 1 to 86,700 active cases on March 31, the highest number of active cases since early January.” (C)
“Michigan Gov. Gretchen Whitmer (D), battling a surge of coronavirus infections in her state, appealed on Tuesday to White House officials to shift away from a strict population-based formula for vaccine allocation and instead rush more doses to hard-hit parts of the country.
“I know that some national public health experts have suggested this as an effective mitigation tool,” she said during the White House coronavirus response team’s weekly call with governors, according to a recording of the conversation obtained by The Washington Post. “And I know we’d certainly welcome this approach in our state.”
The inquiry reflects growing unease among state officials on the front lines of what health experts say could be a new wave of the virus already afflicting parts of Europe. And it illustrates the pressure President Biden is under, even from members of his own party, to show he is taking steps to address disquieting trends after a prolonged period of declining infections.
The accelerating pace of inoculations has not been sufficient to fend off case increases as more-transmissible variants circulate in the United States, especially among young people who have fallen sick in outbreaks tied to schools. As of Monday, Michigan’s seven-day average of new daily cases stood at 5,157, a 58 percent increase from a week ago and the steepest increase nationwide, according to Post data. The state, where restrictions were recently relaxed, also reported the largest growth in that same time frame in coronavirus hospitalizations, which rose by more than 47 percent.
But Jeff Zients, the White House’s coronavirus coordinator, told Whitmer the Biden administration is not inclined to change its formula for allocating vaccines. The federal government sends all three authorized vaccines to states and other jurisdictions based on the size of their populations, while setting aside separate portions for retail pharmacies, federally run mass vaccination sites and community health centers…
As manufacturing continues to ramp up, some experts have suggested further changes to how vaccines are distributed.
Citing outbreaks in particular states such as Michigan, Scott Gottlieb, a former commissioner of the Food and Drug Administration, said over the weekend that the Biden administration should “surge vaccine into those parts of the country.”
With “the incremental vaccine that’s coming onto the market, I think the Biden administration can allocate to parts of the country that look hot right now,” he said on CBS News’s “Face the Nation.”
By diverting some of the expanded supply to hot spots, the government could avoid cutting any current allocations to states, he told The Post on Tuesday.
Arnold Monto, an epidemiologist at the University of Michigan and the chairman of the FDA’s vaccine advisory committee, said the government may also need to adjust its formula to reflect waning demand for the shots in some parts of the country while others face continued scarcity.
“I’m not sure what the solution is, but clearly there are some problems with distribution,” he said.
Data released this week by the Michigan Department of Health and Human Services shows hundreds of students and staff have been infected at schools throughout the state — with the most significant outbreak occurring among 36 students at Lake Superior State University in Sault Ste. Marie in Michigan’s Upper Peninsula.
Earlier this month, Whitmer loosened capacity limits for restaurants and other businesses, and eased restrictions on both indoor and outdoor gatherings. Joneigh Khaldun, the state’s chief medical executive, told reporters last week that there was no single metric officials were using to decide whether to reimpose restrictions.” (D)
“While vaccinations in Michigan are helping to protect senior citizens and other vulnerable people, the upswing is driving up hospitalizations among younger adults and forcing a halt to in-person instruction at some schools.
“It’s a stark reminder that this virus is still very real. It can come roaring back if we drop our guard,” said Democratic Gov. Gretchen Whitmer, who does not plan to tighten restrictions on indoor dining, sports and other activities that were eased in recent months….
“It’s very troublesome and very worrisome,” said Dr. Dawn Misra, an epidemiology and biostatistics professor at Michigan State University.
She cautioned that the trend should not be blamed solely on a variant that has been identified more in Michigan than in all but one other state, Florida, noting that lags and disparities in the amount of genetic analysis being done on the virus around the U.S. make comparisons difficult.
“We’re doing a lot of things that lead to increases in risk. That’s where it’s coming from,” said Misra, who urged health officials to emphasize strategies such as double-masking…
Michigan will soon require regular testing of all teen athletes amid outbreaks that occurred after a months long ban on contact sports was lifted. About 100 teams are sitting out the boys’ and girls’ state basketball tournaments.
And some schools are temporarily closing or delaying their long-anticipated reopenings.
The Lansing school district, which has 10,000 students, had planned to resume face-to-face learning for the first time next week, starting with grades four through six. But the reopening was pushed off to April 12, after spring break, because of rising virus cases in the community.
“We’re back to where we were right after Christmas with some of our numbers,” Superintendent Sam Sinicropi said Thursday. “I understand the importance of kids being there and staff being there. But we’re going to make the call because of what’s happening in our area.” (E)
“Michigan could reduce coronavirus deaths by 2,500 over the next three months by reenacting COVID-19 restrictions and doubling the current rate of vaccine administration for a two-week period, estimates a University of California researcher.
“With regard to the reopening pause, this might be possible by closing indoor dining, indoor bars and indoor gyms for two weeks,” wrote Joshua Schwab, a Berkeley biostatistician.
In an April 3 post, Schwab said his calculations estimated that enacting both strategies — tighter restrictions and faster pace of vaccine administration, each for two weeks — would reduce new hospital admissions by 23,000 and deaths by 2,500 from April 3 to July 1.
Just doubling vaccine administration would reduce hospital admissions by 10,000 and deaths by 1,200, Schwab wrote.
Restrictions on restaurants, bars and gyms would reduce hospital admissions by 16,000 and deaths by 1,700, he projected.
Without interventions, Schwab projects that COVID-19 hospitalizations will peak around May 1 at around 5,500 inpatients or more than 700 new inpatients a day.
That would exceed the previous peak of 4,300 during the first week of November. Michigan hospitals had more than 3,300 coronavirus inpatients on Monday, April 5.
In regards to deaths, Schwab estimates the state will have more than 20,000 coronavirus deaths by July 1 if no interventions are taken. The state has 16,239 confirmed coronavirus deaths as of Monday, April 5.” (F)
“In the race against COVID’s spread, a vaccine for adolescents might offer an opportunity to sprint toward herd immunity — especially as COVID cases surge among the youngest Michiganders.
In a little more than five weeks, cases involving Michigan residents 19 and younger jumped from 1,526 on Feb. 20 to 6,783 on March 27, a more than four-fold increase, according to state data. Michiganders 10 to 19 years old now make up nearly 16 percent of state COVID cases, up from 8.5 percent before January, the data shows.
It’s not just the more contagious B.1.17. variant that’s causing problems, experts told Bridge Michigan. Prep sports have resumed. And there’s some evidence teens and young adults are less likely to follow safety protocols such as mask-wearing and social distancing as those who feel more at risk, experts said.
“They don’t tend to get terribly sick, but the infection rates are going up in this population,” said Dr. Arnold Monto, an infectious disease expert at the University of Michigan and national authority on the coronavirus.
“I think the schools have done a great job” in ensuring students follow safety protocols, said Dr. Catherine Bodnar, medical director at Midland Health Department. The outbreaks, she said, are taking root “before and after school and even before and after practice.”..
To be sure, COVID has mostly spared Michigan’s youngest demographic from serious illness. Nearly 90 percent of its COVID-linked deaths are among those 60 and older, according to state data.
Though rare, however, COVID can cause life-threatening symptoms even among the young and healthy. At least 95 Michigan children with COVID infections were diagnosed with multisystem inflammatory syndrome, also known as MIS-C, according to state data. At least 33 children died nationally from MIS-C, according to the U.S. Centers for Disease Control & Prevention.
The condition can inflame heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs, and other parts of the body. Of the 95 who died, 65 were admitted to an intensive care unit, according to the same data.
“MIS-C is rare, that’s fair. But that’s not to say that it’s not a risk,” said Veronica McNally, founder of Michigan’s I Vaccinate campaign, which aims to increase vaccines among children, and a consumer representative to the CDC’s Advisory Committee for Immunization Practices, or ACIP.
More than 300 children have died nationally from COVID-19, according to the CDC.” (G)
“Many children and teenagers who developed the mysterious inflammatory syndrome that can emerge several weeks after contracting the coronavirus never had classic Covid-19 symptoms at the time of their infection, according to the largest study so far of cases in the United States.
The study, led by researchers from the Centers for Disease Control and Prevention, found that in over 1,000 cases in which information about whether they got sick from their initial Covid-19 illness was available, 75 percent of the patients did not experience such symptoms. But two to five weeks later, they became sick enough to be hospitalized for the condition, called Multisystem Inflammatory Syndrome in Children (MIS-C), which can affect multiple organs, especially the heart.
Published Tuesday in JAMA Pediatrics, the study said that “most MIS-C illnesses are believed to result from asymptomatic or mild Covid-19” followed by a hyper-inflammatory response that appears to occur when the patients’ bodies have produced their maximum level of antibodies to the virus. Experts do not yet know why some young people, and a smaller number of adults, respond this way.
“It means primary-care pediatricians need to have a high index of suspicion for this because Covid is so prevalent in the society and children often have asymptomatic disease as their initial Covid infection,” said Dr. Jennifer Blumenthal, a pediatric intensivist and pediatric infectious disease specialist at Boston Children’s Hospital, who was not involved in the study.” (H)
“California is aiming to fully reopen its economy June 15, more than a year after the COVID-19 pandemic upended the lives and businesses of millions across the state.
Officials emphasize the move hinges on two factors: a sufficient vaccine supply and stable and low hospitalization numbers.
There also will not be a full return to pre-pandemic life. Notably, California’s mask mandate will remain in place.
But officials expressed confidence that the state, through continued improvement in its coronavirus metrics and the steady rollout of vaccines, is now positioned to begin actively planning for what comes after COVID-19.
“With the expectation of an abundance of doses coming in from the federal government through the end of this month and into May, we can confidently say by June 15 that we can start to open up as business as usual — subject to ongoing mask wearing and ongoing vigilance,” Gov. Gavin Newsom said during a news conference in San Francisco on Tuesday.
“So this is a big day.”
Vaccinated and eager for normal life, Californians are venturing out. Is it too much too soon?
June 15 is expected to be the end of California’s current reopening roadmap, which sorts counties into one of four color-coded tiers based on three metrics: coronavirus case rates, adjusted based on the number of tests performed; the rate of positive test results; and a health-equity metric intended to ensure that the positive test rate in poorer communities is not significantly higher than the county’s overall figure.
“The entire state will move into this phase as a whole. This will not be county-by-county,” Dr. Mark Ghaly, California’s health and human services secretary, said in a call with reporters.
In a statement, officials said those sectors included in the state’s reopening blueprint will be allowed to “return to usual operations in compliance with Cal/OSHA requirements and with common-sense public health policies in place, such as required masking, testing and with vaccinations encouraged. Large-scale indoor events, such as conventions, will be allowed to occur with testing or vaccination verification requirements.”
Ghaly emphasized that, “if we see any concerning rise in our hospitalizations, we will take the necessary precautions. But right now, we are hopeful in what we’re seeing as we continue to build on the 20 million vaccines already administered.”
Though state officials said they will keep a watchful eye on vaccine supply and hospitalizations — including how many fully vaccinated people end up requiring that level of care — they did not establish any hard benchmarks to determine whether California is ready to progress.
“We don’t have a specific number, per se, on the hospitalizations, but are looking at impacts on hospital capacity and the delivery systems’ ability to continue to deliver routine care,” Ghaly said.
On Monday, 1,989 coronavirus-positive patients were hospitalized in California — with 493 of them in intensive care. The state hasn’t seen numbers that low since last spring.
Part of the reason June 15 was chosen as the target date, Ghaly said, was that it falls two months after the state will extend vaccine eligibility to anyone 16 and older.
“We wanted to be able to provide at least a couple of weeks, two to three weeks, for individuals interested in getting vaccinated who suddenly become eligible on April 15 to get in line to get their vaccines started,” he said.” (I)
“On NBC’s Meet the Press, Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, called the B.1.1.7 variant a “brand-new ballgame” because of how quickly it has spread among children, citing roughly 750 Minnesota schools that have reported the variant in just the last two weeks.
Osterholm also suggested the U.S. may need to consider new lockdowns before school lets out this summer, saying vaccination alone won’t curb rising cases in the next six to eight weeks and telling Fox News Sunday that “there isn’t a country in the world right now that has seen a big increase in this [variant] that is not locking down.”
“We’re going to have to reconsider what we’re doing,” Osterhold said, noting that the new variant is between 50% to 100% more infectious than previous strains and causes more severe illness about 55% of the time.
He also said experts are “very worried” that variants can evolve in a way that evades the protection of a vaccine and called for the U.S. to rev up its global response measures to vaccinate low- and middle-income countries in order to help curb the development of new strains that could challenge vaccine efficacy; so far, the World Health Organization has said the current slate of vaccines is expected to provide “at least some protection” against new strains….
“I think that there’s enough immunity in the population that you’re not going to see a true fourth wave of infection,” Scott Gottlieb, the former head of the Food and Drug Administration, said Sunday. Roughly 162 million vaccines have been administered domestically, and about 60 million Americans, or nearly 20% of the nation’s population, are fully vaccinated, according to the CDC.” (J)
