“In rare circumstances, it’s OK for people to receive one shot of Pfizer’s Covid-19 vaccine and one shot of Moderna’s vaccine at least 28 days apart, the CDC said in updated guidance.
“Most of the times Dr. Anthony S. Fauci made an appearance in the White House briefing room in 2020 — before eventually being banished from public view for his grim assessments of the coronavirus pandemic — he had President Donald J. Trump glowering over his shoulder.
On Thursday, Dr. Fauci, the nation’s foremost infectious disease specialist, was back, this time with no one telling him what to say. And he made no effort to hide how he felt about it.
“The idea that you can get up here and talk about what you know — what the evidence, what the science is — and know that’s it, let the science speak,” Dr. Fauci said, pausing for a second. “It is somewhat of a liberating feeling.”
Dr. Fauci’s presence in the room where Mr. Trump and other administration officials repeatedly spread misleading and false information about the virus was part of a daylong effort by the Biden administration to show a willingness to level with the public about how severe the pandemic is and what can be done to slow its spread…
But what he said about the virus on Thursday may have been less important than the mere fact that he was able to say it without the possibility that Mr. Trump or his aides would undercut him, challenge him or try to silence him.
As director of the government’s National Institute of Allergy and Infectious Diseases, Dr. Fauci has spent decades fighting the worst of the world’s diseases. He became something of a national celebrity as he sought to navigate the need to level with the public about the raging pandemic while dealing with Mr. Trump’s insistence that the threat was overblown and would “disappear” overnight.
Dr. Fauci recalled on Thursday how frustrating those days became.
“I don’t want to be going back over history, but it’s very clear that there were things that were said, be it regarding things like hydroxychloroquine and other things like that, that really was uncomfortable because they were not based on scientific fact,” he said, referring to Mr. Trump’s embrace of an unproven and untested drug for use as a treatment for the coronavirus.” (A)
“More than 40,000 people in Florida are overdue to receive their second dose of the coronavirus vaccine and officials say it is a problem some experts said they saw coming.
Out of the nearly 850,000 people who have been vaccinated in Florida, almost 80,000 have returned for their second shot.
Most people are still waiting for the time when they can get their booster shot, but the Florida Department of Health reports that 40,661 people are overdue for their second shot.” (B)
“New York Governor Andrew Cuomo said the state on Friday will run out of all the Covid-19 vaccines that have been delivered….
Mayor Bill de Blasio said the city postponed more than 22,000 appointments this week alone because of the shortage in supply. According to the city’s main vaccine page, all appointments scheduled at any of the 15 community COVID-19 vaccine hubs across the five boroughs for Thursday, Jan. 21, through Sunday, Jan. 24, are being rescheduled for one week from the original appointment….
All first responders in the city, including NYPD, FDNY and the hard-hit EMS workers, have had to suspend their first doses for the time being. The FDNY said they have enough doses to cover everyone from their department who has received a first dose to ensure everyone gets properly vaccinated. The fire department has vaccinated more than 7,100 of their 17,000 employees, while the NYPD has given dosages to 12,000 of their 54,000 members…
Second dose appointments have not been affected, officials said. The city does have vaccine centers apart from its “hubs,” including state-run facilities like the one at the Javits Center and two 24/7 sites. Those remain open, as do an additional three sites run by the city’s public hospital system, with another 45,000 doses having been administered Wednesday, the mayor said. But all are running low on doses…
More than 300,000 of those total doses are reserved for second shots; the city has administered 23 percent of those, which makes sense considering a person can’t have a second shot without a first — and supply has been prohibitive. Complicating matter further, the city said, was a shipment of 100,000 Moderna vaccines that never arrived.” (C)
“Ninety-seven percent of New York State’s vaccine inventory, accumulated over the past five weeks, has been administered, the governor noted, and a total of 28,000 first doses were left in inventory Friday morning. Mr. Cuomo added that the state inoculates roughly 80,000 people per day….
Mr. Cuomo urged vaccine providers to only schedule appointments based on the number of doses they know they will receive.
“Some providers think if they schedule appointments ahead of time, people will feel more comfortable — not if you cancel those appointments,” Mr. Cuomo said. “So don’t schedule any appointment unless you know you have an approved state allocation coming, and appointments will be honored. “
Some parts of the state — including New York City and the Rochester and Buffalo areas — have had to delay vaccination appointments scheduled for this week because of supply issues.
New York State should receive 250,400 vaccine doses for use next week, with some arriving Friday. If supply allowed, New York State could inoculate 700,000 people each week, Mr. Cuomo said.
On Friday afternoon, Mayor Bill de Blasio sent a letter to President Biden requesting more doses and the “flexibility” to use second doses to vaccinate more New Yorkers sooner.
“While maintaining a secure reserve of second doses (two-week supply), the City is seeking the flexibility during this time to temporarily use the remaining supply of second doses to bridge the gap to a time of increased production, replenishing the second dose supply as production ramps,” Mr. de Blasio’s letter to Mr. Biden read.
But it was not immediately clear whether the Biden administration could guarantee any increase in supply. Federal health officials and corporate executives agree that it will be impossible to increase supply before April because of the lack of manufacturing capacity. And the current vaccination effort, which had little central direction under the Trump administration, has so far sown confusion and frustration. Some areas are complaining they are running out of doses, while others have unused vials sitting on shelves.” (D)
“U.S. health authorities said it is OK to delay second doses of Covid-19 vaccines up to six weeks after the first injection, which for some shots would be twice as long as recommended.
The Covid-19 vaccines from Pfizer Inc. and BioNTech SE, as well as Moderna Inc., are given in two doses several weeks apart, with the second aimed at giving the fullest-possible protection. Pfizer’s shot is given three weeks apart and Moderna’s four weeks later.
The U.S. Centers for Disease Control and Prevention said Friday that health providers could give the second dose up to six weeks after the first dose, should they be unable to adhere to the recommended intervals. There is limited data on the efficacy of the vaccines beyond six weeks, the agency said.
Second doses shouldn’t be scheduled earlier than the recommended intervals, but they can be given within a grace period of four days earlier than the recommended date, the agency said.
Given the limited vaccine supply around the world, adjusting the schedules of doses has been scrutinized and been subject to debate by vaccine experts and other scientists. The U.K. has told the country’s state-run health service to delay second doses of the vaccines and give priority to getting initial doses into as many vulnerable people as quickly as possible. Parts of Canada and some countries in Europe followed with similar approaches.
The U.S. Food and Drug Administration has criticized tinkering with planned dosing schedules as too risky.” (E)
“The second dose should be administered as close to the recommended interval as possible,” the latest guidance says.
“However, if it is not feasible to adhere to the recommended interval, the second dose of Pfizer-BioNTech and Moderna COVID-19 vaccines may be scheduled for administration up to 6 weeks (42 days) after the first dose. There are currently limited data on efficacy of mRNA COVID-19 vaccines administered beyond this window. If the second dose is administered beyond these intervals, there is no need to restart the series.”
The updated CDC guidance appears to clarify earlier language that said “there is no maximum interval between the first and second doses for either vaccine.”
Delaying the second dose up to six weeks is in line with what WHO advisers said earlier this month.
CDC says its guidance may be updated as new information and new types of Covid-19 vaccines become available.
“You’re taking a chance, the data from the clinical trials, showed that in the Moderna trial, you should get the boost 28 days after the prime, that’s what I got, I got it exactly 28 days later, when you’re dealing with Pfizer it’s 21, that’s where the data show is the optimal effect,” Fauci told CNN Chris Cuomo on Thursday.
Fauci said it’s possible that delaying the second dose is “not going to be a big deal.” However, he said, we don’t know for sure because the vaccine data hasn’t been looked at for this extended time-period between doses.” (F)
“In rare circumstances, it’s OK for people to receive one shot of Pfizer’s Covid-19 vaccine and one shot of Moderna’s vaccine at least 28 days apart, the CDC said in updated guidance.
The agency says the two products are not interchangeable.
The CDC acknowledged that it hadn’t yet studied whether its new recommendations would change the safety or effectiveness of either vaccine.
The Centers for Disease Control and Prevention quietly changed its guidance on Covid-19 vaccine shots, saying it’s now OK to mix Pfizer’s and Moderna’s shots in “exceptional situations” and that it’s also fine to wait up to six weeks to get the second shot of either company’s two-dose immunization.
While Pfizer’s and Moderna’s vaccines, which both use messenger RNA technology, were authorized to be given 21 and 28 days apart, respectively, the agency now says you can receive either shot so long as they are given at least 28 days apart, according to new guidance posted Thursday on its website.
Although “every effort” should be made to ensure a patient receives the same vaccine, in rare situations “any available mRNA COVID-19 vaccine may be administered at a minimum interval of 28 days between doses” — if supplies are limited or the patient doesn’t know which vaccine they originally received, the CDC’s new guidance says.
The agency says the two products are not interchangeable, and acknowledged that it hadn’t yet studied whether its new recommendations would change the safety or effectiveness of either vaccine. But vaccine research specialists who spoke with CNBC said that the two immunizations are so similar in design that people shouldn’t be worried about the rare instances in which the doses will be mixed…” (G)
“Some experts say there are not enough data on the amount and length of protection these altered dosing schedules provide, however. They argue that the bigger problem is distributing the existing vaccine supply and that changing the schedules without rigorous evidence could compromise public trust in vaccines.
“We should really think long and hard any time we advise people to deviate from what the evidence actually shows in terms of efficacy, which has only been tested for those standard dosing regimens,” says Angela Rasmussen, a virologist at Georgetown University’s Center for Global Health Science and Security. “Before we start tinkering with the vaccine regimens, we should worry about making sure that we can actually give people the vaccines that we already have.”…
Here’s what the data suggest about tweaking vaccine doses.
The Pfizer-BioNTech and Moderna vaccines—both of which involve viral genetic material known as mRNA—were given to clinical trial participants in two doses (a “prime” dose followed by a “booster” three or four weeks later). After both doses, the Pfizer vaccine was found to be 95 percent effective in preventing COVID, and Moderna’s came in at 94.1 percent.
In the trials, the Pfizer vaccine provided partial immunity about two weeks after the first dose, with an efficacy of 82 percent. But there are no data on whether protection lasts longer than three weeks, when the second dose was given. Immunological evidence suggests the antibody response to the vaccine increased substantially after the second dose as well.
“While decisions on alternative dosing regimens reside with health authorities, Pfizer believes it is critical to conduct surveillance efforts on any alternative schedules implemented and to ensure each recipient is afforded the maximum possible protection, which means immunization with two doses of the vaccine,” the company said in a statement shared with Scientific American. Rasmussen agrees. “The bottom line is that there’s not really any efficacy to support a delayed second dose, at least of [the] Moderna and Pfizer [vaccines],” she says…
Some have also suggested skipping the second dose altogether. But given the lack of data on how long protection from a single dose lasts, many experts are wary of this idea.
“I don’t think a single dose with mRNA [which the Pfizer and Moderna vaccines rely on] makes any sense,” Crotty says. “There’s clearly a substantial increase in immune response after the booster immunization.”
Natalie Dean, a biostatistician at the University of Florida, agrees. “I think every company would have preferred to have a one-dose vaccine if it worked similarly well. But they made [the decision to have two doses] based on what was most likely to work and what they saw in the immunological data,” she says. The only way to truly know whether a single dose would work is to run a clinical trial, Dean notes. Doing so would likely require a lot of time and resources that are in short supply, however. By the time the trials would yield data, other vaccines might have been authorized and could alleviate the shortage…
Perhaps the most plausible suggestion put forth to extend the vaccine supply is to halve the dose of certain vaccines. Earlier this month, Moncef Slaoui, chief adviser of the Trump administration’s vaccine effort Operation Warp Speed, said officials were contemplating giving half-doses of the Moderna vaccine to Americans between the ages of 18 and 55. (This week Slaoui resigned from his position, but he will remain for 30 days.) In clinical trials, he said, people who received half of the Moderna vaccine’s 100 microgram dose had an identical immune response to those who received a full dose. But he added that it would ultimately be up to the FDA to decide whether to authorize such a change in dosing. Additionally, the data on half-doses were from a phase II clinical trial—so there is not sufficient evidence that half-doses prevent disease, Crotty notes.
Ultimately, the risks of altering data-backed vaccine-dosing strategies could outweigh the benefits. Discussions of changing the dosing regimen with no data to support them could create doubt and skepticism about the process and lead to increased vaccine hesitancy, Rasmussen says.
Crotty agrees. “In emergency situations, I think it’s reasonable to have [this] dialogue,” he says. “But in the end, I think it’s important to go with what’s proven.” (H)
“Twelve minutes before noon on Wednesday, President Joe Biden was sworn into office as the nation’s 46th president. Seven hours later, the United States reported more than 4,409 new deaths from the novel coronavirus, according to data collected by the COVID-19 Tracking Project.
The Biden administration came into power with purpose and an extensive agenda to combat the coronavirus pandemic, but purpose and planning only gets you so far—particularly when the president’s team is only just now getting a clear picture of how badly the previous administration had managed the crisis.
“What we’re inheriting from the Trump administration is so much worse than we could have imagined,” Jeff Zients, the Biden administration’s COVID-19 czar, said in a call with reporters Wednesday. “We don’t have the visibility that we would hope to have into supply and allocations.”
“I think we have to level-set expectations,” added Tom Frieden, the former director for the Centers for Disease Control in the Obama administration. “There are lots of things that an incoming administration can do on Day One, including speaking honestly about the pandemic.”
The new administration is already behind, in part because the Trump administration was unprecedentedly hostile during the transition. The question now, however, is how Biden can get a handle on a raging pandemic when his team is already so far behind.
The task at hand is enormous. More than 400,000 Americans have died of COVID-19. Every state, territory and the District of Columbia is in a state of emergency. The number of people infected with the virus who are now hospitalized is more than double the number reached during the spring and summer peaks…
More urgently, Biden and his team will have to handle the growing frustration among states over the lack of a comprehensive vaccine-distribution program that enables them to inoculate their residents quickly. They will have to find a way to get states more vaccines needed to meet Americans’ growing demand for the shot…
The former Trump administration built out the vaccine distribution process within the confines of Operation Warp Speed, a public-private partnership to fast-track a novel COVID-19 vaccine. In the first few months of its existence, Operation Warp Speed focused on development—creating the country’s first effective mRNA vaccine and supporting companies’ clinical trials. The distribution strategizing came later. Developed by the military, the plan was to have the federal government, specifically the military officials within Operation Warp Speed, lead the logistics part of the vaccine delivery. The military would not actually touch the vaccine but would instead coordinate the effort from the Pentagon….
Part of the confusion among states is how the newest Trump administration federal guidelines on vaccine distribution have impacted the manufacturing process. The Department of Health and Human Services, along with the Centers for Disease Control, recently released a new set of recommendations that allow states to hand out the vaccine more freely—to widen the population of who can receive the shot in the first wave. The federal government also said it would start to release doses it had originally held in reserve for second-shot dosing.
The recommendations almost worked too well—they ramped up demand significantly. Now, states say they don’t have enough doses.” (A)
NOVEMBER 9, 2020
“President-elect Biden’s transition team unveiled the members of his Covid-19 task force on Monday, a who’s-who of former government health officials, academics, and major figures in medicine.
The list includes Rick Bright, the former head of the vaccine-development agency BARDA ousted by the Trump administration in April; Atul Gawande, the surgeon, writer, and recently departed CEO of Haven, the joint JP Morgan Chase-Berkshire Hathaway-Amazon health care venture; and Luciana Borio, a former Food and Drug Administration official and biodefense specialist.
Biden has cast the escalating Covid-19 crisis as a priority for his incoming administration. The task force, he said, would quickly consult with state and local health officials on how to best prevent coronavirus spread, reopen schools and businesses, and address the racial disparities that have left communities of color harder hit than others by the pandemic.
“Dealing with the coronavirus pandemic is one of the most important battles our administration will face, and I will be informed by science and by experts,” Biden said in a statement Monday. “The advisory board will help shape my approach to managing the surge in reported infections; ensuring vaccines are safe, effective, and distributed efficiently, equitably, and free; and protecting at-risk populations.”
As expected, the board’s three co-chairs are Marcella Nunez-Smith, a Yale physician and researcher; Vivek Murthy, a former U.S. surgeon general; and David Kessler, a former FDA commissioner.
…the full list of task force members: David Kessler, co-chair, former FDA commissioner; Marcella Nunez-Smith, co-chair, Yale associate dean for health equity research; Vivek Murthy, co-chair, former surgeon general; Luciana Borio, former assistant FDA commissioner; Rick Bright, former BARDA director; Zeke Emanuel, former Obama administration health policy adviser; Atul Gawande, Brigham and Women’s hospital professor of surgery; Celine Gounder, NYU Grossman School of Medicine assistant professor; Dr. Julie Morita, former Chicago public health commissioner; Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota; Loyce Pace, executive director of the Global Health Council; Dr. Robert Rodriguez, UCSF emergency medicine professor; Eric Goosby, former Ryan White Care Act director. (B)
“Joe Biden’s transition team found a culture of coronavirus skepticism within Donald Trump’s federal government as they prepared to take office, sources close to the Biden transition told CNN, with political appointees loyal to the President reflecting his dismissiveness of public health guidelines and sometimes mocking career employees for wearing masks.
The findings from Biden’s agency review teams are some of the earliest readouts from the Biden officials who were tasked with preparing for the new administration and signal one of the most apparent early changes that the incoming administration will make. They observed a federal bureaucracy devoid of clear leadership on the pandemic, the sources said…
CNN has previously reported that current and former administration officials said there was no one in the White House or the National Security Council whose singular focus was to coordinate the Covid response among the Cabinet and various agencies. Efforts to mandate masks among government employees and inside government offices were shot down by the White House as Trump worked to portray strength and assure the public that the situation was under control. Even after Trump himself tested positive for Covid-19 and had to be hospitalized, staff within the West Wing largely opted against the use of masks….” (C)
“Mask-wearing represents one of three objectives Biden laid out in his speech, along with setting a goal of 100 million vaccine shots in the administration’s first 100 days and opening a majority of schools by the end of that time frame, a feat that he says will require more action by Congress.
Biden said the plan was developed with Dr. Anthony Fauci, who will serve as Biden’s chief medical adviser on COVID-19 and will maintain his role as director of the National Institute of Allergy and Infectious Diseases.
Fauci, who gave remarks by video, said that the plan is bold but doable and “essential to help the public avoid unnecessary risks, to help us save lives, reopen schools and businesses and to eventually beat the pandemic.”
Biden first announced key members of his health team on Monday, including his nomination of California Attorney General Xavier Becerra to lead the Health and Human Services Department…
Biden has also selected Jeff Zients, a veteran of the Obama administration, to be the White House coordinator of the coronavirus response.
Biden will nominate Dr. Vivek Murthy, a key coronavirus adviser to the president-elect, as surgeon general. Murthy was surgeon general during the Obama administration.
“The very best policies, and even the best vaccines and treatments, will not heal our nation unless we also overcome the fear, anxiety, anger and distrust that so many Americans are feeling right now,” Murthy said in his remarks…
Dr. Marcella Nunez-Smith, director of the Equity Research and Innovation Center at Yale School of Medicine, has been tapped to lead a new task force aimed at reducing disparities in response, care and treatment….
Biden will also nominate Dr. Rochelle Walensky, chief of infectious diseases at Massachusetts General Hospital, as the director of the Centers for Disease Control and Prevention.” (D)
““One last myth that I want to dispel is a concern that I’ve heard from some people that this vaccine was developed too fast, right? So, even the name of the entity in government that was charged with trying to figure out how to get a vaccine quickly was called Operation Warp Speed, right?” Vivek Murthy, who Biden has tapped to be surgeon general, said in a call with U.S. faith leaders this week.
He assured them the vaccines are safe and effective and asked for help communicating that message.
“For some people, they heard and they said, ‘Why is this happening so fast? Are there corners being cut? Are there safety precautions that are not being taken?’” he said.
The vaccine push will now be led by David Kessler, the former commissioner of the Food and Drug Administration, who will serve as chief science officer of Biden’s “Covid Response.” He will replace Moncef Slaoui, one of the officials who led what the Trump administration had called “Operation Warp Speed.” Another, General Gustave Perna, will remain as chief operating officer.
“Warp Speed” will be folded in to Kessler’s portfolio, which will be broader than vaccine development, one official said.
Kessler’s top priorities as chief science officer are ensuring every American who wants to be vaccinated gets a shot, building out a significant antiviral program and building major, sustainable manufacturing capability, in part so that a vaccine for another pathogen can be produced quickly if the U.S. ever needs it again, one official familiar with the matter said. (E)
The National Strategy provides a roadmap to guide America out of the worst public health crisis in a century. It outlines an actionable plan across the federal government to address the COVID-19 pandemic, including twelve initial executive actions issued by President Biden on his first two days in office:
The National Strategy is organized around seven goals:
1. Restore trust with the American people.
2. Mount a safe, effective, and comprehensive vaccination campaign.
3. Mitigate spread through expanding masking, testing, data, treatments,
health care workforce, and clear public health standards.
4. Immediately expand emergency relief and exercise the Defense Production Act.
5. Safely reopen schools, businesses, and travel while protecting workers.
6. Protect those most at risk and advance equity, including across racial, ethnic and rural/urban lines.
7. Restore U.S. leadership globally and build better preparedness for future threats.
To execute on the National Strategy, the White House will establish a COVID-19 Response Office responsible for coordinating the pandemic response across all federal departments and agencies. Through implementation of the National Strategy, the United States will make immediate progress on the seven goals. To monitor outcomes, the National Strategy includes the creation of publicly accessible performance dashboards, establishing a data-driven, evidence-based approach to evaluating America’s progress in the fight against COVID-19 (G)
President Joe Biden’s first full day in office on Thursday focused on rolling out his national strategy to get the coronavirus pandemic under control and signing several executive actions, including ramping up vaccination supplies and requiring international travelers to provide proof of a negative Covid-19 test prior to traveling to the US.
“Our national strategy is comprehensive, it’s based on science, not politics. It’s based on truth, not denial, and it’s detailed,” Biden said, speaking from the White House. He said the 198-page plan is posted on WhiteHouse.gov.
Biden’s plan starts with a national vaccination campaign in order to meet the President’s goal of administering 100 million shots, which is enough to cover 50 million Americans with vaccines that require two doses, in his first 100 days in office.
“We’re at Day 1,” Biden said.
He said the plan was developed with input from the nation’s top infectious disease expert, Dr. Anthony Fauci, among other advisers and experts. Fauci was at the event at the White House, along with Biden’s Covid czar Jeff Zients.
Biden said the American public would be “hearing a lot more from Dr. Fauci again, not from the President, but from the real genuine experts and scientists.”
Former President Donald Trump sidelined and undermined his own medical experts as the pandemic raged across the country.
“We’re going to make sure they work free from political interference and that they make decisions strictly based on science and health care alone, science and health alone, not what the political consequences are,” Biden said.
The day after being sworn-in, Biden signed at least 10 executive orders, memorandums and directives focused on tackling the pandemic, which, as of Thursday afternoon, has claimed the lives of more than 408,000 Americans and infected more than 24 million in the US.
Biden signed executive orders ramping up supplies for vaccination, testing and personal protective equipment and another boosting development of therapeutics to treat Covid-19. (H)
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.”
(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.”
“Chinese researchers say they have identified a new virus behind an illness that has infected dozens of people across Asia, setting off fears in a region that was struck by a deadly epidemic 17 years ago.
There is no evidence that the new virus is readily spread by humans, which would make it particularly dangerous, and it has not been tied to any deaths. But health officials in China and elsewhere are watching it carefully to ensure that the outbreak does not develop into something more severe.
Researchers in China have “initially identified” the new virus, a coronavirus, as the pathogen behind a mysterious, pneumonialike illness that has sickened 59 people in the city of Wuhan and caused a panic in the central Chinese region, the state broadcaster, China Central Television, said on Thursday. They detected this virus in 15 of the people who fell ill, the report said.
The new coronavirus “is different from previous human coronaviruses that were previously discovered, and more scientific research is needed for further understanding,” the report said.” (A)
PART 21. April 23, 2020. CORONAVIRUS. “We need to ask, are we using ventilators in a way that makes sense for other diseases but not for this one?” (B)
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.” (C)
POST 35. June 29, 2020. CORONAVIRUS. VP 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…” (D)
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).. (E)
POST 37. July 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.” (F)
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.” (2) (G)
POST 53. October 20, 2020. CORONAVIRUS. “a…“herd-immunity strategy” is a contradiction in terms, in that herd immunity is the absence of a strategy.” (H)
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.” (I)
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. (J)
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,….” (K)
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.” (L)
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.” (M)
POST 80. November 29, 2020. CORONAVIRUS. With coronavirus, the hospital to which you are admitted is most likely the hospital where you will stay. We don’t have “emerging virus” hospital designations like we do for trauma centers, cardiac surgery and newborn nurseries….(N)
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? (O)
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 (P)
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.” — (July 4th Trump appointee email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”) (Q)
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….” (R)
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? (S)
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,”… (T)
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….”
“Until I spoke with them, I didn’t grasp the complexity of what public health authorities are doing to get people vaccinated. The hard part is not just the scheduling hotlines or websites that you and I see; it’s everything that the public doesn’t see.
Officials at the organization outlined eight or more discrete requirements for local governments to manage their vaccination programs. The steps include keeping tabs on the incoming and outgoing inventory of shots, making sure people meet the eligibility requirements for vaccines, scheduling appointments (twice!) and reminding people of them, collecting patient information, keeping records to report to state and federal health authorities, and potentially billing health insurance programs.
Government officials must also keep the public informed about where and when to get vaccines, make sure health care information is secure and private, and ensure services are accessible for people who don’t have computers or speak languages other than English. Sounds super fun and easy, right?!..” (U)
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….”
“Overall, we find states are increasingly diverging from CDC guidance and from each other, suggesting that access to COVID-19 vaccines in these first months of the U.S. vaccine campaign may depend a great deal on where one lives. In addition, timelines vary significantly across states, regardless of priority group, resulting in a vaccine roll-out labyrinth across the country.
CDC ACIP Recommendations for COVID-19 Vaccine Prioritization for Phase 1
Phase 1a: health care workers and long-term care facility residents
Phase 1b: persons aged ≥75 years and frontline essential workers (non–health care workers). ACIP classifies the following workers as frontline non–health care essential workers: first responders (including firefighters and police officers), corrections officers, food and agricultural workers, U.S. Postal Service workers, manufacturing workers, grocery store workers, public transit workers, and those who work in the education sector (teachers and support staff members), and child care workers.
Phase 1c: persons aged 65–74 years, persons aged 16–64 years with high-risk medical conditions, and any essential workers not included in Phase 1a or 1b. Essential worker sectors recommended for vaccination in Phase 1c include those in transportation and logistics, water and wastewater, food service, shelter and housing (e.g., construction), finance (e.g., bank tellers), information technology and communications, energy, legal, media, public safety (e.g., engineers), and public health workers.” (A)
“The Centers for Disease Control and Prevention recommended that the Covid-19 vaccine should go to healthcare workers first—guidance most states seem to be following—but many states have indicated they will deviate from the CDC’s suggestion on who gets it next: people 75 and older and essential workers.
States following CDC guidelines: Alabama, Maine, South Carolina
States offering vaccines to essential workers and a wider group of older residents (65+) in the second phase: Delaware, Washington D.C., Georgia, Mississippi, Missouri, Pennsylvania, Utah, Colorado
States prioritizing older residents over essential workers: Texas, Florida, Hawaii, Oklahoma (adults with pre-existing conditions included)
States prioritizing essential workers over older residents: Alaska, Arizona, Arkansas, Idaho, Kentucky, Michigan, Nebraska, New Jersey, New York, Virginia, West Virginia, New Hampshire, Vermont, Massachusetts, and Nevada.
States prioritizing older residents and people with preexisting conditions over essential workers: Hawaii (first responders were included in the first phase), Indiana, Kansas, Tennessee, Texas
States prioritizing people with preexisting conditions over older residents and essential workers: North Carolina (B)
“All states have released updated prioritization criteria for Phase 1, primarily in response to ACIP deliberations and guidance. Some had planned emergency meetings in anticipation of the FDA’s announcement and ACIP’s follow-on recommendation. Importantly, most indicate that these criteria could change depending on supply, vaccine characteristics, and other factors.
Most states are following ACIP’s Phase 1a recommendation.
45 states are following ACIP’s interim Phase 1a recommendation to prioritize HCWs and LTC residents. Some states will start vaccinating both of these groups together, while others will start with one of these groups first as they await more supply to start vaccinating the other. Still, even with these state criteria, decisions about how to allocate limited initial vaccines to HCWs and LTC residents will mostly be left to facilities.
7 states depart from ACIP’s Phase 1a recommendation in some way. For example, the District of Columbia and Utah include HCWs in Phase 1a but LTC residents in Phase 1b. In addition to HCWs and LTC residents, Nevada, New Hampshire, and Wyoming also include law enforcement in Phase 1a (per ACIP’s proposed framework, they are in 1b). Massachusetts also includes people incarcerated in prisons and those living in homeless shelters in Phase 1a (neither is explicitly mentioned in ACIP’s Phase 1 framework).
More than 20 states also provide further sub-prioritization rankings or criteria within HCW and/or LTC resident groupings. For example, Alabama segments HCWs into “very-high”, “high”, and “medium” risk. Idaho provides specific rankings within each group. Texas groups Phase 1a into “first” and “second” tier.
The majority of states are still developing criteria for subsequent Phase 1 prioritization, but there are already some differences from ACIP’s preliminary framework.
30 states indicate that they are still developing more specific criteria for these next phases.
Of the 21 with criteria, 8 follow ACIP for Phase 1b and 5 follow ACIP for 1c.
The main differences lie in where states place people ages 65 and older and those with high risk medical conditions, relative to essential workers. For example, Alabama, Delaware, Florida, Maryland, North Carolina, and Tennessee each prioritize those 65+ and/or those with high risk medical conditions over non-health essential workers; North Carolina and Tennessee prioritize those with high risk medical conditions over those ages 65 and older.
In addition, some include other congregate settings (not indicated in ACIP’s framework). Alabama, Nebraska, Nevada, North Carolina and Oklahoma explicitly include those living in homeless shelters and prisons in Phases 1b or c. Delaware and Tennessee explicitly include people incarcerated in prisons in 1c.
Discussion
Our review finds that almost all states hew to ACIP regarding initial allocations of a COVID-19 vaccine (Phase 1a) and have looked specifically at ACIP for decision-making. Beyond that, a good number of states are still developing criteria for Phases 1b-c. Given that ACIP has yet to issue recommendations for these phases, states may be waiting for further guidance. However, based on ACIP’s preliminary framework, there are some differences between state priorities and where ACIP is likely to land, primarily related to the prioritization of seniors and/or those with high risk medical conditions relative to non-health essential workers. Moreover, these later prioritization decisions are likely to be more difficult given the large numbers of people in these groups and continued limits on vaccine supply.” (C)
“The rapid expansion of COVID-19 vaccinations to senior citizens across the U.S. has led to bottlenecks, system crashes and hard feelings in many states because of overwhelming demand for the shots.
Mississippi’s Health Department stopped taking new appointments the same day it began accepting them because of a “monumental surge” in requests. People had to wait hours to book vaccinations through a state website or a toll-free number Tuesday and Wednesday, and many were booted off the site because of technical problems and had to start over.
In California, counties begged for more coronavirus vaccine to reach millions of their senior citizens. Hospitals in South Carolina ran out of appointment slots within hours. Phone lines were jammed in Georgia.
“It’s chaos,” said New York City resident Joan Jeffri, 76, who had to deal with broken hospital web links and unanswered phone calls before her daughter helped her secure an appointment. “If they want to vaccinate 80% of the population, good luck, if this is the system. We’ll be here in five years.”
Up until the past few days, health care workers and nursing home patients had been given priority in most places around the U.S. But amid frustration over the slow rollout, states have thrown open the line to many of the nation’s 54 million senior citizens with the blessing of President Donald Trump’s administration, though the minimum age varies from place to place, at 65, 70 or higher.
On Thursday, New Jersey expanded vaccinations to people between 16 and 65 with certain medical conditions — including up to 2 million smokers, who are more prone to health complications…
Hard-hit Los Angeles County, the nation’s most populous county with 10 million residents, said it couldn’t immediately provide shots to the elderly because it had inoculated only about a quarter of its 800,000 health care workers….
In Mississippi, officials said new appointments will probably have to wait until a hoped-for shipment of vaccine in mid-February.
In South Carolina, Kershaw Health in Camden implored people not to call its hospitals or doctors to schedule vaccination appointments after receiving more than 1,000 requests in two days. State health authorities said their hot line got 5,000 calls on Wednesday….
Meanwhile, some states, like Minnesota, are waiting before throwing open the doors.
“As we learn more, we will work to make sure everyone who is eligible for a vaccine knows how, where, and when they can get their shots,” the state Health Department said in an email. “Everyone’s opportunity to get vaccinated will come; it will just take some time.”
Arizona, which had the nation’s highest COVID-19 diagnosis rate over the past week, will start signing up people 65 and older next week. It also plans to open a vaccination site at Phoenix Municipal Stadium in addition to the one dispensing thousands of shots daily at the home of the NFL’s Arizona Cardinals.
To step up the pace of vaccinations, South Carolina made a rule change allowing medical students, retired nurses and other certain professionals to administer the shots.” (D)
“NYC has launched a city vaccine finder tool to help the hundreds of thousands of New Yorkers who are now eligible to schedule an appointment for the shot. But a patchwork of scheduling systems between providers and different government websites for making appointments has caused confusion—raising immediate questions about how older, less tech-savvy New Yorkers will gain access.
Comptroller Scott Stringer, a mayoral candidate, called the sign-up process “bewildering” on Sunday evening.
“We should be #1 in vaccinations in the nation from day one—and we should be using every tool at our disposal to vaccinate as many New Yorkers as possible as quickly as possible. Instead we’ve set up a gauntlet that requires tech support,” Stringer wrote in a tweet.
The city has created an aggregated information site for vaccine locations called the NYC vaccine finder. But the Health Department and NYC Health + Hospitals still have sign-up sites for their locations, and clinics or other smaller healthcare centers have their individual sign-up processes as well. Those seeking appointments must fill out a multi-step verification process to set up an account and face about 51 questions or fields to check off on the Health Department’s site, according to Stringer.
“Any barrier to getting shots in arms is only going to prolong the agony of this crisis,” Stringer wrote…
On Monday, the city launched a hotline—877-VAX-4NYC—to make appointments by phone, with 750 customer service reps answering the phones 8 a.m. to 9 p.m. De Blasio said 24/7 hours are coming soon.
New York State will launch its own hotline at 4 p.m. Monday at 1-833-NYS-4VAX.
The state also set up another website for New Yorkers to determine eligibility and schedule an appointment. Demand is expected to outweigh supplies, so Governor Andrew Cuomo’s office noted those eligible should be prepared to schedule an appointment as far as 14 weeks in the future…” (G)
“It’s enraging that after the scientific marvel of inventing Covid-19 vaccines, now there are bureaucratic and technical bottlenecks that have slowed the vaccine rollout. (Feel free to scream out loud with me.) But don’t be angry about botched government technology or direct your fury only at your local officials. Be mad about the broad systemic failure.
As we have seen with other frailties of government programs during the pandemic, botched technology is often a symptom of misguided policy choices, chronic underfunding of public health and the generally dysfunctional and decentralized coronavirus response in the United States.
When I read several tales last week about botched vaccine scheduling in some parts of Florida, I contacted the U.S. Digital Response, an organization I’ve written about before that pairs tech-savvy volunteers with state and local governments needing tech assistance.
Until I spoke with them, I didn’t grasp the complexity of what public health authorities are doing to get people vaccinated. The hard part is not just the scheduling hotlines or websites that you and I see; it’s everything that the public doesn’t see.
Officials at the organization outlined eight or more discrete requirements for local governments to manage their vaccination programs. The steps include keeping tabs on the incoming and outgoing inventory of shots, making sure people meet the eligibility requirements for vaccines, scheduling appointments (twice!) and reminding people of them, collecting patient information, keeping records to report to state and federal health authorities, and potentially billing health insurance programs.
Government officials must also keep the public informed about where and when to get vaccines, make sure health care information is secure and private, and ensure services are accessible for people who don’t have computers or speak languages other than English. Sounds super fun and easy, right?!..
When you start to pull your hair out because you can’t register for a vaccine on a local website, remember that it’s not (only) the fault of a bad tech company or misguided choices by government leaders today. It’s a systematic failure years in the making.” (H)
“While bureaucratic snafus, delivery problems and a lack of planning has bogged down the initial rollout of COVID-19 vaccines, more and more states are expanding the list of eligible recipients.
Still, while political figures and celebrities have already received the vaccine, distribution for the public will take more time. Each state has set priorities about who gets the vaccine first, based on recommendations from the federal government. Currently, the states are rolling the vaccine out in categories based on need. Health care workers and people living in nursing homes are highest priority, and they began receiving the vaccine in mid-December. People ages 75 years and older, along with essential workers like first responders, will be next, although several states have lowered that requirement to 65
Adults between 65 and 75 years old, and younger people (between 16 and 64) at high risk, along with other essential workers, will get the vaccine in the next phase. Assuming there is enough of the vaccine to go around after that, everyone else will be able to get one, likely sometime in the late spring or early summer.
Most vaccinations are now taking place at hospitals or public health clinics. But, the vaccine will likely be available to the public at most pharmacy chain stores like CVS, Walgreens, and others; along with in-store pharmacies at Costco, Kroger, Target, Publix, HEB, and other national and regional chains.
Experts suggest regularly checking state public health department websites for information. Some states offer vaccine safety information, details about who qualifies for vaccines now, where to get them, and ways to sign up for COVID-19 and vaccine alerts. Those websites are listed below.” (E)
“It isn’t easy, and it’s probably going to be that way for a while. Right now, there are more eligible people than doses of vaccine. You need diligence and luck.
People are swapping tips in text chains and social media groups to try to gain an edge, and there is a dizzying array of websites and phone numbers to keep track of.
At every turn there are more questions about how best to book a slot, what happens when you arrive for an appointment, and what might happen if you just show up without one. The answers seem to change from moment to moment.
“In its framework for the equitable allocation of the COVID-19 vaccine, the National Academies of Science, Engineering and Medicine offered a bit more detail, explicitly recommending that high-risk health care workers, first responders, people with two or more underlying medical conditions, and older adults in long-term care facilities or other overcrowded settings be prioritized. That rough framework for prioritization was subsequently adopted by the CDC’s vaccine advisory group.
However, the reality of vaccine distribution thus far — at a critical moment when COVID-19 cases are surging and vaccination resources are still scarce — has been marred by a patchwork of variable vaccination strategies on the local and state level, logistical inconsistency, and the exploitation of long-standing socioeconomic power structures….
Biden says his administration will work with states to quickly move to the next phase of vaccine distribution — allowing people age 65 and older as well as front-line workers like teachers, first responders and grocery store workers to get immunized. He’s pledged to also work with community-based organizations and trusted health care providers to make sure people in marginalized and medically-underserved communities quickly get access to the vaccine.
But there is still reason to be deeply concerned that over the next few months — as hospital systems, states, and nations begin to distribute vaccines to the wider public — the process could become even more flawed and inequitable…
Already, there are early signs that the privileged and wealthy are eager to access the vaccine before others — once again trying to buy and leverage their connections to achieve a spot at the front of the line.
The scarcity of vaccines combined with the fear and desperation surrounding the pandemic is exposing a true moral tragedy: People are willing to save themselves at the expense of others.
The prioritization of certain groups for early COVID-19 vaccination is not arbitrary. When drafting guidelines about vaccine distribution, the CDC aimed to both reduce illness and deaths by helping those most at risk, and to preserve those integral to the everyday functioning of society to be able to keep doing their essential work…(F)
We are currently in Phase 1a and initial groups from Phase 1b.
Eligible New Yorkers in Phase 1a and 1b are:
High-risk hospital workers (emergency room workers, ICU staff and Pulmonary Department staff)
Residents and staff at nursing homes and other congregate care facilities
Federally Qualified Health Center employees
EMS workers
Coroners, medical examiners and certain funeral workers
Staff and residents at OPWDD, OMH and OASAS facilities
Urgent Care providers
Individuals administering COVID-19 vaccines, including local health department staff
All Outpatient/Ambulatory front-line, high-risk health care workers of any age who provide direct in-person patient care
All staff who are in direct contact with patients (i.e., intake staff)
All front-line, high-risk public health workers who have direct contact with patients, including those conducting COVID-19 tests, handling COVID-19 specimens and COVID-19 vaccinations
This includes, but is not limited to,
Doctors who work in private medical practices and their staff
Doctors who work in hospital-affiliated medical practices and their staff
Doctors who work in public health clinics and their staff
Registered Nurses
Specialty medical practices of all types
Dentists and Orthodontists and their staff
Psychiatrists and Psychologists and their staff
Physical Therapists and their staff
Optometrists and their staff
Pharmacists and Pharmacy Aides
Home care workers
Hospice workers
Staff of nursing homes/skilled nursing facilities who did not receive COVID vaccination through the Pharmacy Partnership for Long-Term Care Program
Beginning January 11, 2021:
Individuals Age 65 and older
First Responder and Support Staff for First Responder Agencies
Fire Service
State Fire Service, including firefighters and investigators (professional and volunteer)
Local Fire Services, including firefighters and investigators (professional and volunteer)
Police and Investigators
State Police, including Troopers
State Park Police, DEC Police, Forest Rangers
SUNY Police
Sheriffs’ Offices
County Police Departments and Police Districts
City, Town, and Village Police Departments
Transit of other Public Authority Police Departments
State Field Investigators, including Department of Motor Vehicles, State Commission of Correction, Justice Center, Department of Financial Services, Inspector General, Department of Tax and Finance, Office of Children and Family Services, and State Liquor Authority
Public Safety Communications
Emergency Communication and Public Safety Answering Point Personnel, including dispatchers and technicians
Other Sworn and Civilian Personnel
Court Officers
Other Police or Peace Officers
Support or Civilian Staff for Any of the above services, agencies, or facilities
Corrections
State Department of Corrections and Community Supervision Personnel, including correction and parole officers
Local Correctional Facilities, including correction officers
Local Probation Departments, including probation officers
State Juvenile Detention and Rehabilitation Facilities
Local Juvenile Detention and Rehabilitation Facilities
In-person college instructors
P-12 Schools
P-12 school or school district faculty or staff (includes all teachers, substitute teachers, student teachers, school administrators, paraprofessional staff and support staff including bus drivers)
Contractors working in a P-12 school or school district (including contracted bus drivers)
Licensed, registered, approved or legally exempt group Childcare Providers
Exempt Childcare setting
Grocery store workers
Employees or Support Staff of Licensed or Registered Childcare Setting
Licensed, Registered, Approved or Legally Exempt Childcare Providers
Public Transit
Airline and airport employees
Passenger railroad employees
Subway and mass transit employees (i.e., MTA, LIRR, Metro North, NYC Transit, Upstate transit)
Ferry employees
Port Authority employees
Public bus employees
Individuals living in a homeless shelter where sleeping, bathing or eating accommodations must be shared with individuals and families who are not part of the same household
Individual working (paid or unpaid) in a homeless shelter where sleeping, bathing or eating accommodations must be shared by individuals and families who are not part of the same household, in a position where there is potential for interaction with shelter residents
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…..
On Thursday, Mount Sinai Health System, one of the city’s largest hospital networks, canceled many upcoming vaccination appointments for older patients, saying the doses it had anticipated receiving were no longer likely to arrive.
Northwell Health, the largest health provider in the state, said it had mostly stopped scheduling additional appointments for the next several days given its limited supply.
Around New York, officials in at least one county said they had only enough doses to last through the weekend, echoing a similar sentiment by city officials.
Mayor Bill de Blasio said Friday on Brian Lehrer’s radio show that New York City would run out of doses by next week.
“It makes no sense that we’re being starved of the capacity we need,” the mayor said.
State officials warned this week that they were growing increasingly worried about the supply, pleading with federal officials to increase the number of doses they send every week. Gov. Andrew M. Cuomo has said the state receives only about 300,000 doses per week, although he indicated on Friday that the state had been told its weekly supply would be sliced to 250,000. About 100,000 of them go to New York City, Mr. de Blasio said on Friday.
Across the country, governors have expressed similar frustrations and made similar requests in the wake of federal health officials recommending that anyone over 65 be eligible for vaccination — making tens of millions more people eligible.”
This week, federal officials indicated that more doses from a stockpile would be sent to states. But they have since clarified that the batch is actually from a tranche saved for second doses. (People are considered fully vaccinated after receiving two doses.)
Until recently, New York City had been struggling to quickly administer vaccines, leading to a backlog of doses. But in recent days, the pace of vaccinations has picked up drastically because of expanded eligibility and because many new vaccination sites have opened over the last week.” (A)
“To even get an appointment for the vaccine, New Yorkers must navigate multiple buggy and complex systems,” City Comptroller Scott Stringer tweeted.
“There are widespread reports of vaccine doses languishing in freezers rather than being deployed to the long list of people anxiously waiting their turn. Successful vaccine rollout is essential to our survival as a city. We need to resolve these tech issues ASAP and optimize vaccine access and distribution on the front and back ends.”
Stringer has slammed the “bewildering” complexity of the sign-up process, which has as many questions as the city council has legislators — 51. He said the site is rife with technical issues…
Earlier in the week, Gov. Cuomo announced that around 500 pharmacies statewide would begin offering the shots, and that another 700 have agreed to participate in the future.
But many of the pharmacies that were approved to administer the shots, and were listed on a state website have not received the vaccine.” (B)
“At least 28 states and Washington, D.C., have begun vaccinating older people, a New York Times survey shows, in many cases marking a shift in earlier plans that had put medical workers and nursing home residents at the front of the line for Covid-19 inoculations.
As cases and deaths from the virus reach record levels across the United States, much is in flux when it comes to states’ plans for distributing the vaccine. At least 32 states have expanded their vaccination programs to include critical workers, such as police officers, teachers, grocery store employees and other people at risk of being exposed to the virus on the job. More than a dozen states have said they are expecting to expand their vaccination pools significantly before the end of the month.
More than half the states have begun vaccinations for older adults, in addition to health care workers and residents of long-term care facilities.
The changing vaccine rollout in many states, which matches a new federal appeal this week that all people over 65 — not just those in long-term care facilities — should be prioritized, was embraced by many older people, who have been the most vulnerable to Covid-19 and have been waiting eagerly for vaccinations and a return to normal life. But the sudden availability to so many more people also caused a deluge of problems as people tried to figure out whether their state was now allowing them to get shots, how to sign up, and where to go…
In states across the country, demand for the vaccine has far outweighed supply, leading to crashed websites, long lines outside vaccination clinics and overwhelmed public health departments that are facing a torrent of calls and emails.
While the federal government advises states on how best to distribute vaccines, states follow their own plans, and that has created a patchwork of policies. While a few states offered shots to older people in December or early January, most focused their initial vaccination plans on medical workers and those in long-term care facilities. But the rules are changing by the day: At least 14 states and Washington, D.C., opened up vaccinations to older people this week, and some of those changes came after the new federal call on Tuesday to open up vaccines to a wider group.
In Connecticut, people 75 and older are newly eligible for shots. In a few states, including Arizona and North Dakota, which opened up access this week to a far larger group, the rules vary from county to county. In Indiana, people 70 and older were permitted to start signing up for vaccines on Wednesday, and, by that afternoon, nearly 60,000 of them had done so. The state’s call center had long waits.
“You can imagine it’s almost like a gold rush, but it’s a vaccine rush,” Gov. Eric Holcomb of Indiana said.” (C)
“It’s the most massive vaccine rollout in U.S. history, but many local governments are consigning patient appointments to web-based services better known for handling birthday-party RSVPs and online yoga sessions.
Several Florida counties have deployed Eventbrite. Some Oklahoma governments dabbled with SignUpGenius and one New Jersey county was still using the service. Elsewhere, some seekers of Covid-19 protection reported hours-long holds on appointment hotlines — only to be disconnected — or logging on to websites that lock them out.
“Signing up to get a Covid vaccine is like trying to get a Beatles ticket,” said Jacob Saur, public safety director in Florida’s Manatee County, where demand for the shot crashed the web sign-up sheet he had set up.
In its first three weeks, the effort to inoculate 328 million Americans has overwhelmed government websites and left unlucky shutouts fuming in first-come, first-served lines. The difficulty is one reason that distribution of the long-awaited vaccine is taking so long. States have also had to contend with deciding which groups have priority access, confusion over available doses and navigating the daunting logistics of providing shots that must be kept at subzero temperatures.
Overall, the U.S. has administered 4.73 million doses of the Covid-19 vaccine, but that’s just about a third of the doses distributed.
Options are often confusing. A resident of Newark, New Jersey, can sign up for a shot with the city, surrounding Essex County or the state itself. And as elderly people in Florida and Georgia wait overnight in lawn chairs at pop-up sites, other vulnerable Americans — or quite often, their tech-savvy children — are spending hours refreshing computer screens.
Florida is piloting a scheduler of its own in certain counties, Saur said. But many of his peers turned to Eventbrite because it was familiar. It also was free…
In Florida’s Brevard County, the government decided to use Eventbrite on Wednesday when the phone lines stopped working at the local division of the Department of Health, according to Jesi Ray, a county spokeswoman. She said it took the county about three hours to set up the event, run tests, obtain approval and put out a press release…
In Hamilton County, Tennessee, which encompasses Chattanooga, there is no list at all. People eligible for early shots must show up and wait in line at a temporary site.
One 83-year-old heart and lung patient on New Year’s Eve waited in line for five hours in his car with his wife, breathing with the help of a supplemental oxygen tank. Twelve spots from the front, though, the shots ran out…
New Jersey, among the hardest-hit states early in the pandemic, is immunizing only health professionals and residents of long-term care facilities — in all, about 650,000 people — through at least the end of the month.
New Jersey’s statewide scheduling system went live on Tuesday, but the site went down before noon. Even before shots are available to the broad population, the state is struggling to assemble an inoculation-certified workforce, and appealing to medical retirees to help.
Meanwhile, some of the state’s 21 counties, including Essex and Passaic, are operating their own appointment websites. Hunterdon County was offering appointments via SignUpGenius, whose users more typically organize potlucks, carpools and bridal showers…
But states weren’t blindsided by the vaccine rollout in the same way, with the federal Operation Warp Speed announced officially on May 15 — half a year before the vials started arriving.
“It just seems there’s a general lack of preparedness, even though we knew that there was a vaccine coming in the near future that would be a game changer,” said Salemi, the Florida epidemiologist. “Because of the lack of a national coordinated effort, we’re finding that we can’t get these vaccines into people’s arms.”” (D)
“In December, the Centers for Disease Control and Prevention announced guidelines establishing priorities of who should get the vaccines first as the rollout began. Although the guidelines were broad, medical students learned that they could be included among the first wave of health care workers, especially those involved with care of Covid patients. But the rollout has varied widely across the country’s 155 medical schools, which have each set priorities based on the availability of vaccine doses in their state.
This has caused stress for some medical students continuing their clinical rotations. Although some schools bar students from treating Covid patients, that rule can be difficult to enforce, especially with asymptomatic cases.
At some institutions, like Duke School of Medicine, students working in intensive care units and emergency departments were placed in the highest level priority group, 1A, while all others were told they would be vaccinated under group 1B. At Yale School of Medicine, all medical students, regardless of their level of patient exposure, were told they would be vaccinated in reverse alphabetical order (“by the first letter of their last name, starting at the end of the alphabet”).
“Those who were at the later stages of the alphabet were happy but a bit confused as to how arbitrary it was,” said Sumun Khetpal, a fourth-year student.
Students at Texas College of Osteopathic Medicine in Fort Worth said that for weeks they had received no communication from the school about when they would receive their vaccines, so some drove hours across the state looking for private pharmacists who would give them shots. And at the University of Pittsburgh School of Medicine, students said they also had to “take matters into their own hands,” and reach out to private pharmacies to inquire about getting vaccinated because until last weekend, they were not told how to receive vaccines from their school.
“The C.D.C. guidelines did not have the level of granularity needed for hospitals and schools to make decisions,” said Dr. Alison Whelan, chief academic officer of the Association of American Medical Colleges. “There’s been a fair amount of variability because of the lack of a national plan.”
Adding to the confusion, the vaccines were allocated to states according to their populations, which do not always reflect their populations of health care workers, added Dr. Janis Orlowski, chief health care officer of the association. There are 21,000 med students in the country.” (E)
“As the pandemic continues to rage nationwide and a vaccine program to control it struggles, governors are increasingly turning to the National Guard to help expedite the process. At least 16 states and territories are using Guard members to give shots, drawing on doctors, nurses, medics and others skilled in injections.
Many more states are using thousands more Guard personnel for logistical tasks, like putting together vaccine kits and moving them around, logging in patients and controlling lines at state vaccination sites. In West Virginia, for example, about 100 Guard troops are assisting with distribution across the state.
“We are a logistical operation here,” said Maj. Holli Nelson, a spokeswoman for the Guard there. “That is what the military does best.”” (F)
“The incoming Biden administration plans to retire the name for the coronavirus vaccine effort under President Donald Trump — Operation Warp Speed — with a transition official for the incoming president telling CNN they are “moving to a new phase” of the coronavirus response.
“Operation Warp Speed was the Trump administration’s name for their response. We are structuring it differently and ours will have a new name,” said an official, who added that many of the “people who are working for Warp Speed who were critical to that operation will be critical to our response, too.”
As part of that effort, Biden has picked Dr. David Kessler, a former head of the US Food and Drug Administration, to be the chief scientific officer of Covid response, Biden’s presidential transition team announced Friday.
Kessler, who is currently the co-chair of the Biden transition’s coronavirus task force, will work out of the US Department of Health and Human Services under HHS secretary-designee Xavier Becerra, the official said, and his role will focus primarily on maximizing the supply of vaccines that are authorized or approved, and getting other vaccines online. The process of getting shots in arms will be run out of the White House and the team led by Jeff Zients, the official said.
Operation Warp Speed has been successful in rapidly manufacturing a safe and effective Covid-19 vaccine but has failed to meet expectations in administering doses to Americans. Biden has laid out a timeline for 100 million shots in the first 100 days of his term.
Gen. Gustave Perna, who is currently the chief operating officer of Operation Warp Speed, will stay on in the Biden administration, the official said, but under its “new structure.”” (G)
“This week, in an attempt to speed things up, the outgoing administration abandoned its own prioritization guidelines, and deemed some 152 million more people immediately eligible for vaccination. Officials also indicated that they would release an untold number of additional doses to the states quickly, rather than holding them in reserve as was originally planned. But those pronouncements have only made matters worse. Health departments have been overrun, web portals and phone lines have crashed, and consumers scrambling to secure appointments have been outraged to find that the vaccine is still not widely available. As The Washington Post has since reported, there are no reserve doses to be had.
To get more people vaccinated, states need trained vaccinators. They also need the technical capacity to schedule appointments for hundreds of thousands of people and public messaging campaigns to combat hesitancy. Officials need to inform people of where they stand in line and tell them when and how they should sign up to be inoculated.
President-elect Biden has vowed to get those measures in place quickly, and to vaccinate 100 million people in his first 100 days. That’s a worthy goal. But to succeed, he’ll have to do a much better job than his predecessor of communicating with and supporting states. The mass vaccination sites the Biden administration plans to establish will work great in some places, but support for community clinics will be the wiser course in others, and pharmacies will have a much bigger role to play in yet others.
The incoming president can help keep the overall effort on track by adhering to a clear national vaccination strategy: Is the goal to save as many lives as possible or to reopen businesses? Is the goal to vaccinate as quickly as possible or to ensure that precious shots are equitably distributed?” (H)
“Especially in this current phase, when we have an enormous vaccine supply sitting in freezers, instead of focusing on how to prevent some people from getting vaccinated, we should get the vaccine to the priority groups even if it sometimes means that people nearby who are not on the priority list get vaccinated, too.
Simpler schemas are less likely to be gamed by the privileged. The C.D.C. has recommended that everyone over 65 be eligible for vaccination, and that requires nothing more than an ID or a declaration required for proof — we’re not going to get overrun by 20-year-olds showing up pretending they are 65.” (L)
“The U.S. secretary of health and human services, Alex M. Azar II, excoriated China on Thursday for its “bullying of international experts and scientists” and acknowledged for the first time that a top official at the Centers for Disease Control and Prevention was correct when she warned in February that the novel coronavirus might cause a severe disruption to American lives.
The official, Dr. Nancy Messonnier, was muzzled for nine months after issuing the Feb. 25 warning, which threw the stock market into a nosedive and infuriated President Trump, who was on his way back from India at the time. But she was merely repeating what she had learned from a White House Task Force meeting days earlier, Mr. Azar recalled.
“She got a little ahead of the briefing of the president and the official announcement,” Mr. Azar said. “But she and we were correct.”” (I)
“Amid a sputtering vaccine rollout and fears of a new and potentially more transmissible variant of the coronavirus, Britain has quietly updated its vaccination playbook to allow for a mix-and-match vaccine regimen. If a second dose of the vaccine a patient originally received isn’t available, or if the manufacturer of the first shot isn’t known, another vaccine may be substituted, health officials said.
The new guidance contradicts guidelines in the United States, where the Centers for Disease Control and Prevention has noted that the authorized Covid-19 vaccines “are not interchangeable,” and that “the safety and efficacy of a mixed-product series have not been evaluated. Both doses of the series should be completed with the same product.”
Some scientists say Britain is gambling with its new guidance. “There are no data on this idea whatsoever,” said John Moore, a vaccine expert at Cornell University. Officials in Britain “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”” (J)
“Health care workers, first responders and the elderly are all in line to get the initial doses of the coronavirus vaccine first, but Charles Barkley offered a different idea Thursday.
Barkley said during the “NBA on TNT” broadcast that pro athletes should get the first round of the vaccine.
“I think they should let NBA players and coaches all get the vaccine. That’s just my personal opinion. We need 300 million shots. Give some thousand to NBA players … NFL players, hockey players … As much taxes as these players pay, let me repeat that, as much taxes as these players pay, they deserve some preferential treatment,” Barkley said.
His co-hosts Ernie Johnson and Kenny Smith didn’t think that was a good idea. He didn’t really find any people on his side of the argument on social media, either.
NBA Commissioner Adam Silver told NBA teams last month the league “would not jump the line” to obtain the vaccines early, ESPN reported.” (K)
