“A 20-something who works on computers. A young researcher who studies cancer. Technicians in basic research labs.
These are some of the thousands of people who have been immunized against the coronavirus at hospitals affiliated with Columbia University, New York University, Harvard and Vanderbilt, even as millions of frontline workers and older Americans are waiting their turns.
The Centers for Disease Control and Prevention has issued recommendations intended to ensure that the nation’s vaccines first reach those at highest risk: health care workers who interact with Covid-19 patients, and residents and staff members at nursing homes, followed by people age 75 and older and certain essential workers.” (I)
“University of Chicago researcher Sarah Cobey has spent nearly a year studying the spread of COVID-19, but she was still surprised when her employer offered to vaccinate her against the virus.
An associate professor of ecology and evolution, Cobey does not work in a clinical setting and has no exposure to patients. But University of Chicago Medicine has included her and several thousand other remote or off-site employees in its distribution of vaccines intended for health care workers.
“It really makes a difference if you’re giving vaccines to people who are at the greatest risk of severe disease and death, compared to people who aren’t,” Cobey said, noting she’s at low risk. “Who’s getting vaccinated now, it is a matter of life and death.”
Just three weeks into the national vaccination program, the actions by UChicago Medicine add to questions over which people should get vaccinated first, when more groups can start getting shots and exactly who will qualify in each group — with details yet to be fleshed out in a system overseen by already strained state and local health agencies.
Federal guidelines adopted by the state of Illinois say shots for health care workers should go only to people who have direct or indirect contact with patients or infectious material. But in the quick rollout of the vaccine, heavy trust has been placed in health systems to interpret who qualifies.
UChicago Medicine opened up vaccination to all its employees, even those who, like Cobey, work from home. Other local health systems have made different choices. Loyola Medicine, which also has a large academic arm, said it has vaccinated only those workers who have direct contact with patients.
Doctors who helped fashion the U.S. Centers for Disease Control and Prevention’s vaccination guidelines said the goal was to get the shots to all front-line health workers first, regardless of whether they worked in a big city hospital or small rural clinic. It wasn’t for health systems to vaccinate all their own employees, including those working from home, while other clinicians waited.
“I know from talking to colleagues in other states, there are people getting it who don’t fit the strict criteria,” said Florida doctor Jason M. Goldman, who helped shape the guidelines. “I’ve seen it happen. I’ve seen hospital administrators (get it) who don’t necessarily have direct patient care.”
UChicago Medicine, whose vaccination plan was posted online Dec. 18, said the system followed public health guidelines by prioritizing front-line health workers for vaccination before proceeding to other groups who “are critical to supporting patient care and health care operations.” The system also noted in a statement that just 55% of its health care personnel have agreed to be vaccinated…
But — like most things in the pandemic — it’s largely been left to the states to hash out the details, creating different configurations in different places. Illinois’ plan, released this fall, left many late-stage decisions up in the air.
But on the question of vaccinating health care workers, the state’s plan offers specific guidance. Like the Chicago Department of Public Health, which is in charge of vaccine distribution in the city, the state adopted word for word the CDC committee’s definition of who qualifies for an early vaccination: “paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials.”
“The intent really was to address front-line workers … understanding who is exposed because they have to come into work to fulfill their job role,” said Dr. Grace Lee, a Stanford University pediatrics and infectious diseases professor who sits on the committee.
The state’s plan lists about 40 examples of workers who would qualify — from nurses and dentists to morticians and laundry employees in hospitals.
Not mentioned: off-site academic researchers.” (A)
“The nation’s system for distributing coronavirus vaccines lacks safeguards to ensure the next wave of doses reaches the most critical workers and at-risk patients rather than star athletes or the well-connected.
There’s little chance for anyone to jump the line right now while an extremely limited supply of the vaccine is being distributed only in hospitals and nursing homes. But as soon as more doses become available to wider categories of people, much of the immunization program will rely on the honor system, and states will leave it to pharmacies, community health centers and individual employers to verify if someone requesting a shot falls into a priority category.
“I haven’t seen anything that’s going to say, ‘We’re going to stop people from gaming the system,’” said Jen Kates, a senior vice president at the Kaiser Family Foundation, who said the state vaccination plans she’s reviewed have had no language on requiring patients to provide proof of residency, which would prevent people from hopping to another state with more available vaccine to try and get a shot.
The loose controls threaten to continue the pattern of inequities seen throughout the pandemic. In the spring and summer, many waited in line for hours to have their noses swabbed while professional athletes were getting tested multiple times a week and concierge medical practices were supplying tests to celebrities.
For now, vaccines are reserved for front-line health workers and senior citizens in nursing home residents and other communal settings. A panel of Centers for Disease Control advisers on Sunday will recommend the next tiers of recipients, which could include teachers, first responders and other essential workers outside of health care, as well as people with chronic health conditions and people over 65.
But the final decision on who to prioritize rests with states. Some, like Alabama, plan to give some large employers in essential sectors allotments of vaccines, trusting the company to vaccinate its more vulnerable public-facing workers before the CEO.
Hospitals, clinics and pharmacies will play major roles as well. And while they can check electronic health records for their existing patients, and must collect people’s contact information in order to follow up with them for the second dose of the vaccine, people’s medical history can’t always be verified at the point where the vaccination is given.
“If a person presents at one of our health departments and says they have diabetes, we won’t ask for a note from their doctor or a list of their medications,” said Dr. Karen Landers, a medical officer at the Alabama Department of Public Health. “They have a reason for being there, and it’s a matter of trying to get a vaccine out in the most efficient way possible.”…
Unlike coronavirus tests, which the wealthy could purchase direct from an array of companies, Covid vaccines are scarce and tightly controlled.
Hospitals are receiving shipments now and vaccinating their own staffs while the federal government has contracted with major pharmacy chains to send teams of workers into elder care facilities to administer the shots….
“This is a medical operation, not a political operation,” New York Gov. Andrew Cuomo said Wednesday. “If you remember with the Covid testing there was a lot of back and forth, who got it first, and was there favoritism, etcetera. Medical professionals are going to administer Phase 2 [of the vaccine] by state guidelines, but it’s going to be done by medical professionals.”
While rich and famous individuals may not have an obvious advantage, rich and powerful corporations certainly will. As officials continue to hammer out their vaccine distribution plans for essential workers, lobbyists from a swath of industries are pressuring federal and state entities to give groups from pesticide manufacturers to zookeepers priority.
“It’s ultimately about who and what as a society do we value,” said former CDC Director Tom Frieden. “The key is to be completely transparent about the decision-making progress, because you aren’t going to maintain the public’s trust if it looks like people are jumping the line. When you’re in a situation of shortage like we’re in right now, you want to make sure that you don’t create even the appearance of impropriety.”
Others worry that if states define “essential workers” too broadly, it could mean months of delays for other priority groups, such as people with diabetes and other comorbidities.
“You risk not getting to people with bad health outcomes for a very long time,” Toner warned. “A lot of people with high risk could die while we’re vaccinating people who are lower risk.” (B)
“With vaccinations against the coronavirus now underway, at least one prominent individual has said he won’t jump the queue to procure a dose for himself — the CEO of Pfizer, the giant pharmaceutical company that is helping to manufacture and distribute the Pfizer-BioNTech vaccine.
“None of the executives and board members will cut the line,'” Albert Bourla recently said on CNBC’s Squawk Box.
With a limited supply of doses, government officials around the world have prioritized who gets the vaccine first. That means front-line health-care workers, people living and working in long-term care facilities and the elderly are generally first in line….
In the United States, Dr. Eric Toner, a senior scientist at the Johns Hopkins Bloomberg School of Public Health in Baltimore, said he believes it would still be difficult for the wealthy to get priority access, considering the registration process of getting the vaccine.
“Nothing’s impossible, but it’ll be pretty tough to game that system,” he said. “I suppose one could, and there are ways you could cheat.
“But I don’t think there are a lot of ways for a wealthy person to cheat any more effectively than somebody who wasn’t wealthy.”
The issue of queue-jumping was raised just last week following a report that the National Hockey League was looking into the private purchase of the COVID-19 vaccine.
That professional athletes might be able to receive the vaccine ahead of others sparked a social media backlash and prompted a clarification from the league that it would only consider purchasing any excess doses…
Currently, the ability to jump to the front of the line may also be made more challenging by the requirements of storing the Pfizer-BioNTech vaccine — it must be kept at temperatures between –80 C and –60 C.
“It’s possible that a wealthy organization like the Toronto Maple Leafs or the NHL could do a deal directly with Pfizer and procure the refrigeration units necessary to just store it,” said Dr. Joel Lexchin, an emergency physician and an associate professor of family and community medicine at the University of Toronto.
“For individuals, I don’t think that’s realistic.”
So far, however, Pfizer has been adamant that during the pandemic, it will not be making private sales.
“Our COVID-19 vaccine contract is only with the federal government, and we’ll be providing doses according to the designated vaccination locations,” Christina Antoniou, a spokesperson for Pfizer Canada, said in an email…
Following a report the NHL is interested in purchasing COVID-19 vaccinations for their players, Prime Minister Justin Trudeau told the media on Friday there is nothing any private company can do to “slow down the delivery of [free] vaccines to Canadians.”…
“At any time, if there’s a company willing to sell something and someone willing to buy it, that is a risk.”…Arthur Caplan, a professor of bioethics at New York University, said that certainly in the U.S., the potential that celebrities or persons of wealth might jump the queue to get a vaccine is “very real.”
“It’s definitely the case that there are clinics, hospitals, concierge practices, private companies that can throw money and try to divert some amount of supply either to an individual or to a group,” he said.
He acknowledged that with the supply currently controlled by government, it would make it more difficult to divert vaccines.
“But nonetheless, if you send your supply to Hospital X and CEO is there and somebody calls him up and says, ‘We need to get this,’ that’s where you might see some diversion.”
Caplan said he doesn’t believe queue-jumping would result in a major shift in resources, but even a small degree of diversion undermines trust and support for the rules.
However, Toner, of the Johns Hopkins Bloomberg School of Public Health, said what will likely be a bigger issue is the debate over who should be declared an essential worker in order to move ahead in line to get a shot.
“I’m already seeing lots of it here, that everybody, every group that has a national association, that national association is advocating for them to be a priority group.”
Naylor, of Canada’s immunity task force, suggested there could be some “gaming later on,” when the priority groups are larger and the delivery is highly decentralized.
“At that point, I doubt it will be only the wealthy and powerful.” (C)
“Hospitals and health care systems are taking unprecedented steps to safeguard the limited supplies of coronavirus vaccines amid concerns over security and the potential for black markets to emerge across the globe.
Operation Warp Speed, the government drive to develop and distribute the vaccines, requires medical facilities to develop a security plan. Every dose of vaccine shipped from manufacturing centers in Michigan and Belgium is tracked from the warehouse to hospitals where they are injected in staffers, medical officials said.
Extra security personnel and constantly running cameras watch over storage units, where the locks have been upgraded.
“We’ve known from the start that this was going to be a vaccine that’s going to be rationed, so we’ve been thinking all along about how to secure it in a couple of different ways,” said Melanie Swift, a physician leading the vaccine rollout at the Mayo Clinic. “That’s making sure none of it goes missing.”
Some doctors and medical officials said they were concerned about rumors of illicit markets for vaccines, in which wealthy individuals might be able to secure a dose for themselves before their turn in line. At least one hospital, Mount Sinai in New York, has hired an external auditor to oversee its vaccine distribution plan.
Law enforcement agencies have warned that criminal syndicates may target vaccine supply chains, either to steal doses or to run scams meant to steal money. Earlier this month, Interpol’s secretary general warned member nations to identify potential criminal activity around the vaccine…
Early on, scarcity helps. The front-line health care workers who are first in line for a vaccine are known to the hospitals that will distribute it, and alerting them that they are eligible is as simple as sending an email. Some hospitals can simply scan badges of those workers in line for a vaccine and check their names off a list.
Those next in line to receive a vaccine are similarly likely to be easily identified: First responders like police, fire fighters and emergency medical technicians will have government-issued identifications, and those who live in long-term care facilities will be easy enough to identify.
But as the vaccine becomes more widely available, the prospects for line-jumping will become more prevalent. National vaccine registries exist, but they have never been tested under such immediate and critical conditions.
“We’ve had to build new systems in the midst of a pandemic,” said Rebecca Weintraub, a vaccine distribution expert in the division of Global Health Equity at Brigham and Women’s Hospital in Boston. “They have not been tested in the midst of a global pandemic.”” (D)
“Health care workers have been getting their COVID-19 vaccines for the past few weeks. However, we’ve learned people outside of that group have been able to cut in line and also get the vaccine.
KRQE News 13 learned health care workers shared their so-called “special event codes” with family and friends, who shared them with more people, allowing them to get the vaccine, no matter their age, occupation, or health. Wednesday afternoon, News 13 asked the NMDOH why they’re getting to jump the line.
“Yes, we are aware of surrounding reports of people jumping the line by sharing codes,” said Dr. Tracie Collins, Secretary-Designate of the NMDOH. “What we’ve done immediately is implement a technical fix to try and prevent this from happening.”
A viewer tipped News 13 off to the confirmation code “BYE2020” being used to make appointments for the COVID vaccine at EXPO New Mexico; News 13 confirmed it worked. We were shown the appointment confirmation by someone who used the code and was able to get an appointment for the vaccine this week.
The code was originally given out by hospital employees who started circulating the limited-supply code which allowed hundreds to get the vaccine who were not in the high-risk categories like the elderly and chronically ill — which were next in line to get the shot. Some locals we’ve spoken to say they’re not happy others are taking the vaccine before those who need it most.” (G)
“New York Gov. Andrew Cuomo said Monday he intends to make it a crime in the state to administer a COVID-19 vaccine to anyone trying to skip their place in line, or to sell them the vaccine.
He also said anyone who misrepresents who they are, or administers the drug to an ineligible person, should lose their license as well as face criminal charges, CNN reported.
“This vaccine can be like gold to some people,” Cuomo said. “And if there’s any fraud in the distribution — you’re letting people get ahead of other people, or friends, or family, or they’re selling the vaccine — you’ll lose your license. But I do believe it should be criminal and I’m going to propose a law to that effect.”
Last week, New York-based ParCare Community Health Network was accused by State Health Commissioner Howard Zucker of acting “contrary to the state’s plan to administer it first to frontline healthcare workers, as well as nursing home residents and staffers.”
ParCare said it followed state guidelines and will cooperate with a state investigation.” (E)
“The Medical Board of California has released guidance for licensed physicians on COVID-19 vaccine distribution, noting that they are subject to discipline if they don’t comply with the phase structure in federal and state guidelines…
If licensed providers stray from the phases in their administration of vaccines, they face disciplinary actions, up to and including the revocation of their license and disenrollment from the COVID-19 Vaccination Program.
The guidance follows remarks from California Gov. Gavin Newsom, who on Dec. 28 warned of penalties that healthcare providers would face if they violate vaccine priority guidelines. Mr. Newsom said enforcement is needed at the state, county, local and clinic levels to ensure “someone’s not passing a few vials over to their cousin or aunt or uncle, or God forbid, making a buck or two on the backs of a vaccine that should be distributed to someone who is at high risk or at higher need.” (F)
“Concierge medical practices are fielding inquiries from their wealthy patients wondering when the COVID-19 vaccine will be available. Dr. Bill Lang of the WorldClinic was even fielding texts from patients on Thanksgiving day, according to the health publication Stat. The rules around who gets a vaccine when will shift from state to state, but the ethics and scrutiny around who will receive a vaccine first remain immutable. And they don’t require any late-night texts to answer….
There are already rumors of executives seeking special dispensation to have their workers newly designated “essential” in order to cut in line. Any new designations should be carefully examined, and governmental agencies should sequester their decision-making processes from undue political influence. The lives of those who have been risking theirs to care for our sick, work in our drive-thrus and stock our grocery stores and drugstore shelves should come first.
The optics of jumping the COVID-19 vaccine line will be terrible and should be damaging. Anyone who has the means to finagle access to a vaccination before essential workers who have no option to work from home should think twice. Media and political scrutiny of those who leverage connections and money for early access will be intense. Conveniently timed claims of fresh diagnoses of chronic asthma or sudden onset diabetes in order to engineer admission to the “at risk” group will — and should — be met with deep suspicion…
For those leaders who are healthy and still wealthy in the midst of the global health and economic meltdown, and whose employees have largely been able to work effectively from home, patience will be the name of the game and the path toward lasting trust with customers, global policymakers and the public. The ongoing inconvenience of remote work and more frequent testing — until those most at risk are protected first — could be preferable to the societal and media condemnation of those who don’t wait their turn.
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.
No one should want to be the metaphorical man in the fur coat elbowing his way through women and children to secure a seat in the lifeboat. Elites must think carefully about the collective social opprobrium bound to rain down before seeking a shortcut.” (H)
(E) Gov. Cuomo: Make It Criminal to Sell, Administer Vaccine to Line Jumpers, https://www.usatoday.com/story/opinion/2020/12/20/covid-vaccine-name-shame-elites-who-jump-the-line-column/3920917001/
“Top congressional leaders will receive the coronavirus vaccine in the coming days with dozens of lawmakers planning to quickly follow suit — an effort designed to maintain a continuity of government while also instilling public confidence in the shot.
The limited batch of doses, which is expected to soon arrive in the House and Senate and was first reported by POLITICO, marks a major development for lawmakers and frontline workers in a Capitol complex that has battled dozens of cases this year.
But the sudden announcement of vaccines stunned many lawmakers who had been kept in the dark about whether they would get doses at all. Now, members are preparing for their first doses in what’s expected to be the final week in session of the 116th Congress.
Vaccines for federal agencies and officials across Washington have been arriving at Walter Reed Medical Center in recent days, and thousands of doses are expected to be designated for Congress.
Lawmakers first received word that vaccinations were imminent on the Hill in a letter sent by the Capitol physician, Brian Monahan, on Thursday evening, outlining some key details of how the vaccination process will work.
Members of Congress will receive top priority and are being encouraged to schedule an appointment as soon as possible to receive their vaccination, which will require two shots. The Office of the Attending Physician will then identify “continuity-essential staff members” who will be next in line — likely campus police officers and other essential workers who keep the Capitol running amid the pandemic.
“The appointing process will then continue until the small vaccine supply is exhausted,” Monahan wrote to members.
But as some lawmakers grapple with whether it’s fair to be among the first to receive the vaccine, Monahan was clear: “My recommendation to you is absolutely unequivocal: there is no reason why you should defer receiving this vaccine,” he wrote. “The benefit far exceeds any small risk.”…
Congressional leaders are only just beginning to tackle the complicated task of allocating doses among hundreds of lawmakers and essential building workers…The arrival of the vaccine on Capitol Hill — where cases continue to climb — could force lawmakers into a tricky political and personal dilemma. Members will want to avoid any perception that high-ranking government officials are getting special treatment. Just 16 percent of the public thinks elected officials should be among the first in line for the vaccines, according to a recent ABC News/Ipsos poll.
But many lawmakers also recognize that they and their colleagues are at high-risk because of the nature of their jobs, which requires traveling back and forth to Washington each week. And top congressional officials say taking the vaccine would also send an important signal to the American people that it’s safe.
“We do a lot, we see a lot of people, and we have to do business,” said Rep. Bennie Thompson (D-Miss.), who chairs the House Homeland Security Committee. “It’s a difficult job. … If the vaccine is there, I think we should take it.”
“I don’t want to break the line,” added Sen. Dick Durbin (D-Ill.), the minority whip, while also noting that lawmakers travel more frequently than most Americans. “And I think because of that vulnerability, it should be taken into consideration.”
Party leaders wrestled with concerns over optics earlier this year over implementing widespread coronavirus testing in the Capitol, which didn’t arrive in the building until last month…Yet Republicans continue to disparage House Democrats for holding virtual meetings and using proxy voting, a system designed to reduce physical interactions in the building.” (A)
“House Speaker Nancy Pelosi, Senate Majority Leader Mitch McConnell, top Senate Democrat Chuck Schumer and House Republican leader Kevin McCarthy were among those with first dibs. Other members soon followed suit, saying it could inspire public confidence in the vaccine.
“Our job is to make sure the vaccine isn’t politicized the way masks were politicized,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said in a Twitter exchange after getting her vaccine.
McConnell, who was treated for polio as a child, repeatedly cites public opinion polls showing reticence among the public about the vaccine, and he emphasizes the importance of getting inoculated.
“It took decades to develop the polio vaccine. This vaccine was developed in under a year, a modern medical miracle, and we need to take the vaccine,” McConnell said in an interview on Fox News.
The efforts could also stem the flow of coronavirus cases linked to Congress, where more than 270 individuals — including 50 lawmakers — have become infected during the pandemic.
Utah Republican Sen. Mitt Romney, Ohio Democratic Sen. Sherrod Brown, North Carolina Republican Rep. Virginia Foxx and California Democratic Rep. Karen Bass were among the first wave of members to get the vaccine.
“When public health officials say it’s your turn to get a vaccine, roll up your sleeves — I’ll be doing the same when my turn arrives,” Sen. Chuck Grassley, R-Iowa, who was infected with the coronavirus this year, said on the Senate floor on Monday. “Getting immunized is the only way we’ll beat the virus and get back to the normal way of American life.”…
While members such as Ocasio-Cortez have said getting the vaccine will encourage others to follow suit, they’ve faced criticism from a smaller minority of colleagues such as Sen. Rand Paul, R-Ky., a critic of mask mandates.
Paul, who was infected with the coronavirus early on during the pandemic, says younger members shouldn’t take part now, while those who have had COVID-19 should be “last in line.”
“I think it would be unconscionable for somebody who’s had it to get in front of somebody who hasn’t had it to take a vaccine,” Paul told a Capitol Hill pool reporter on Monday. “I think it’s unconscionable for [Ocasio-Cortez] … to be smiling gleefully and getting the vaccine when you got 85-year-old people in nursing homes who haven’t gotten it.”
Paul later tweeted his attack of Ocasio-Cortez, triggering a heated exchange.
Ocasio-Cortez responded that “maybe if the GOP hadn’t spent so much time undermining public faith” in science and mask usage for COVID-19, she wouldn’t have to weigh in on potential misinformation…” (B)
“Lawmakers on both sides of the political aisle squabbled over whether to immediately get the COVID-19 vaccine, potentially before health care professionals and others.
Rep. Ilhan Omar, D-Minn., criticized fellow lawmakers for getting the vaccine ahead of vulnerable populations.
Omar wrote on Twitter on Sunday night: “It would makes sense if it was age, but unfortunately it’s of importance and its shameful.”
Lawmakers aren’t more important than front-line workers, teachers and others who are making sacrifices every day, she wrote. “Which is why I won’t take it. People who need it most, should get it. Full stop.”
Omar announced in June that her father died of complications related to the coronavirus…
Many members of Congress have been vaccinated, including older lawmakers such as Speaker of the House Nancy Pelosi and Senate Majority Leader Mitch McConnell, who are 80 and 78 years old, respectively, and thus at higher risk for complications related to the virus.
However, some younger lawmakers have also been vaccinated…
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.”
“For as long as the vaccines are limited, we should prioritize healthcare and frontline workers, and every person at greater risk, especially the elderly,” she continued.” (C)
“A slate of GOP lawmakers who downplayed different concerns about the coronavirus pandemic or ignored public health advice are now facing a wave of backlash for being among the first to receive a vaccine.
With only limited doses available across the US, members of Congress have been prioritized for inoculation in an effort to maintain governmental continuity on Capitol Hill. But some GOP lawmakers who have publicized their shots — something public health experts have recommended to advertise the vaccine’s safety — are fielding fierce disapproval given their past comments downplaying or misrepresenting the virus earlier this year.
This includes Iowa Sen. Joni Ernst, who tweeted Sunday that she had “received the first dose of the #COVID19 vaccine” at the recommendation of the Office of the Attending Physician.
“I encourage all Iowans and Americans to do the same when their time comes,” she said. “Thanks to #OperationWarpSpeed and the tireless work of Americans across the country, we are one step closer to defeating this virus.”
But her early vaccination drew swift condemnation on social media, with many pointing to comments she had made in September during her successful reelection campaign suggesting that health care workers were inflating Covid-19 death numbers for profit.
One viral tweet from Sawyer Hackett, a senior adviser to former Housing and Urban Development Secretary Julian Castro, placed Ernst’s false comments under the caption “How it started” alongside her photo receiving the vaccine under the caption “how it’s going.”
The backlash underscores a larger rift unfolding in Congress about when to receive the vaccine. Some lawmakers in recent days have vowed to wait to get vaccinated until vulnerable groups in the US have a chance to get vaccinated as well.
Hawaii Democratic Rep. Tulsi Gabbard tweeted earlier Monday, “I had planned to get the vaccine but will now stand in solidarity with our seniors by not doing so until THEY can. I urge my colleagues who are under 65 and healthy to join me.”…
And many in Congress are considered vulnerable for Covid-19 complications because of their advanced ages.
Most Americans, however, won’t have access for months. While the US Food and Drug Administration has granted emergency use authorization to two vaccines, it’s clear there will not be enough for everyone who wants a vaccination right away.
Vaccine advisers have already broken down priority groups into subgroups, and have designated only the very, very first people to get vaccines. Those in this 1a group designated by the Advisory Committee on Immunization Practices include front-line health care workers and people in long-term care homes.
The limited supply for those priority groups has helped fuel the scrutiny aimed at some of the GOP lawmakers who have received the vaccine.
Like Ernst, Sen. Lindsey Graham — a close ally of President Donald Trump who has often echoed the President’s misleading coronavirus messages — has faced considerable condemnation.
“Thank God for nurses who help people in need and know how to use a needle,” the South Carolina Republican tweeted on Saturday alongside a photo of himself receiving the vaccine…
Sen. Marco Rubio fielded particularly sharp rebukes after tweeting a photo of himself getting the vaccine and noting that he is “so confident” in it that he “decided to take it myself.” The Florida Republican, who is 49 years old, spoke at a largely maskless rally for the Georgia US Senate contests last month.
CNN political commentator Ana Navarro took particular issue with Rubio joking on Twitter that he “looked away from the needle” and knows that he needs “a tan.”
“Something that really pissed me off — triggered me of that post, was, you know, he started by making a joke about how he looked away from the needle and how he needed a tan in his arm. You’ve got privilege that others don’t. You are getting a precious vaccine that millions are waiting for,” she told CNN’s Brooke Baldwin on “Newsroom.”
“There’s people risking their lives on a daily basis that are not getting that vaccine yet, and you crack a joke about your pasty white arm? Really?”” (D)
“Lawmakers acknowledged that the timing wasn’t ideal for them to be receiving the vaccine before Congress had passed a long-stalled coronavirus relief package on Monday.
The package includes funding for national vaccine distribution, Paycheck Protection Program aid for small businesses, unemployment insurance, housing assistance and direct checks of up to $600 per eligible person.
“Well, it’s certainly embarrassing and discouraging that it’s taken us eight months since we passed the CARES Act to finally get relief,” said Rep. Don Beyer (D-Va.). “I mean, if you’re busy feeling really guilty about not helping the hundreds of millions of Americans who needed the help and then you’re going to go get the vaccine? But yeah, I think somebody that’s voted against all the packages should feel guilty right now.”
Beyer, 70, was among the first rank-and-file members of Congress to receive a vaccine on Friday. He reported no side effects and said he wanted to set an example for others.
“I really want to make sure we’re setting the right example. That we’re doing everything we can to encourage people to get the vaccine. First, for their health, and second, for the herd immunity of the country,” Beyer said.” (E)
“At a superspreading event, the number of cases transmitted will be disproportionately high compared to general transmission, Dr Karan says.
And the risk of these superspreading events may balloon in the presence of superspreading people, who pass on their infection more widely either by being in contact with more people or emitting more of the virus.
“I tend to think of it as this: the vast majority of people may not infect any other people, and some people in certain situations infect a lot of people,” he says. “One person may infect 10 people, or 15 people or 20 people.”
Research is still being done, Dr Karan says, but early results indicate that coronavirus spread is primarily powered by these supercharged events.
“Different models have looked at this and they suggest that 20% of people account for 80% of spread.”
And while risk profiles will vary widely between similar events, Dr Karan says there are certain factors that should raise a red flag.
“If you have any of the following in combination: indoors, crowded, closed spaces, without any sort of personal protective equipment like masks, which you’re not going to have eating – I think those are all high-risk,” he says.” (A)
“On Jan. 6, pro-Trump rioters stormed into the Capitol building in Washington, D.C. Prior to that, many in the crowd attended a rally put on by the president and gathered outside the Capitol. Many videos and photos of the people at the Capitol have surfaced, often showing people without masks or face coverings and standing in close proximity to others who were also maskless. Some health experts think this riot could be a superspreader event for COVID-19.
Large mass gatherings are not always superspreader events. Many people gathered in 2020 for Black Lives Matter protests safely, some events numbering in the thousands or tens of thousands. At the protests, organizers often encouraged people to wear masks, and people who had mask supplies went through the crowd offering them to those without. Volunteers also gave out hand sanitizer to those who wanted it. Health experts believe there isn’t evidence that the Black Lives Matter events may be superspreader events.
“It certainly could be,” says Tara Smith, a professor of epidemiology at Kent State University, in an email to Changing America. “From what I saw in pictures and video, you had a large congregation of individuals who were in close contact for an extended period of time and almost universally unmasked. I saw many photos of individuals coming and going on buses as well, also unmasked, and hanging out in hotel lobbies.”
The scenes at the Capitol suggest that many of the people there didn’t follow public health guidelines.
“Many rioters were yelling, not wearing masks, and there was little to no social distancing – all actions that allow COVID to easily spread. It is possible that this could be a superspreader event,” says infectious disease epidemiologist Beth Linas in an email to Changing America. “More concerning is that many rioters were not from DC and are likely headed home and could bring COVID with them (and they could have brought it to DC as well).”
“If just a few percentage of them are positive for the virus, this could lead to a considerable amount of spread, as we saw with other events such as the Sturgis rally,” says Smith. The Sturgis rally was a mass motorcycle event that happened over the summer in South Dakota. The event lasted 10 days and led to at least 51 primary cases and 21 secondary cases in nearby Minnesota, according to the Centers for Disease Control and Prevention (CDC). That may not be all the cases related to the Sturgis event as it only represents one state’s data and cases may be underreported.
However, most of the rioters were outdoors, and that may have prevented some disease transmission from occurring.” (B)
“Being outdoors is often seen as inherently safe, but it’s only safer. The vast, stirring outdoor air can more easily disperse any virus-toting respiratory droplets that float or shoot out of an infected person’s face. That’s in contrast to crowded and/or poorly ventilated indoor spaces where there’s less chance that droplets will be whisked away, possibly allowing them to build up to higher concentrations, increasing the risk of infection for those in the space. We still don’t know the exact amount of virus particles it takes to infect a person, but higher concentrations are absolutely riskier.
Still, being outside does not mean the virus can’t spread, particularly when maskless people are packed into a dense, stationary mob. Being outdoors or in a well-ventilated space are but single layers in the multilayered approach necessary to reduce risk of spreading the virus. People, even outdoors, should wear masks, stay physically distanced, avoid crowded areas, and practice good hand hygiene. That certainly wasn’t the case in the Trump rally yesterday, just as it hasn’t been in previous rallies, which have also been associated with mass spreading of the virus…” (C)
“The mob that stormed the Capitol on Wednesday did not just threaten the heart of American democracy. To scientists who watched dismayed as the scenes unfolded on television, the throngs of unmasked intruders who wandered through hallways and into private offices may also have transformed the riot into a super-spreader event…
Three distinct groups — Capitol Police, rioters and members of Congress — “were spending time indoors, without social distancing, for long periods of time,” said Dr. Joshua Barocas, an infectious diseases physician at Boston University. The melee likely was a super-spreader event, he added, “especially given the backdrop of the highly transmissible variants that are circulating.”
Dr. Barocas was referring to a highly contagious new variant of the coronavirus, first identified in Britain. It has been spotted in several U.S. states but may well have spread everywhere in the country, making events like the Capitol riot even more risky, he said.
The idea that members of Congress may have been exposed, amid an already difficult transfer of power, particularly disturbed some scientists. “I am worried not only that it could lead to super-spreading, but also super-spreading to people who are elected officials,” said Dr. Tom Inglesby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health.
And infected members of Congress and law enforcement could have spread the virus to one another as they sheltered from the violence, he noted.
Rep. Jake LaTurner, Republican of Kansas, announced on Twitter early Thursday morning that he had tested positive for the virus. Mr. LaTurner was cloistered in the chamber with other members of Congress for much of the day.
At least a dozen of the 400 or so lawmakers and staff who were huddling in one committee room refused to wear masks even after being offered one, or wore them improperly below their chins, said Representative Susan Wild, Democrat of Pennsylvania.
They gathered in a committee room that quickly became crowded, making social distancing impossible, she said. Some of the lawmakers were unmasked, and several were shouting: “Tensions were high, and people were yelling at each other.”
“I just started getting really kind of angry, thinking about the holidays just passed, and how so many people did not spend time with their immediate families for fear of spreading,” she added, referring to her unmasked colleagues.
Representative Debbie Dingell, Democrat of Michigan, said the environment made her so nervous she sat on the floor at one point, hoping to duck whatever virus might be floating about. She has asked experts whether the lawmakers present should now quarantine, she said. She was wearing two masks, as she often does.
“I get that they think they have their individual freedoms,” she said of Republican lawmakers who eschewed masks. “It’s a rule for a reason. It’s to protect the common good.”
The risk for members of Congress will depend greatly on ventilation in the room where they sheltered, said Joseph Allen, an expert on buildings quality at the Harvard T.H. Chan School of Public Health in Boston.
“If there is a well-designed secure facility, then it would have great ventilation and filtration,” Dr. Allen said. “If it’s a place where they were just hunkered down wherever they could go that was safe, and it was not a place that was designed like that, then we don’t really know.”
It’s natural in a heart-pounding crisis to disregard risks that seem intangible or theoretical, he and other scientists noted.
“You cannot keep distance if you’re trying to leave a very intense and dangerous situation,” said Seema Lakdawala, an expert in respiratory virus transmission at the University of Pittsburgh. “You’re weighing the risk of your life over the risk of getting a virus at that moment.”
Members of Congress returned to continue the electoral count after the rioters were cleared from the Capitol. Some legislators took off their masks before giving a speech, Dr. Barocas noted, at precisely the time they needed to wear them. Talking at a high volume can expel vast quantities of aerosols, propelling them through an enclosed space.
Scientists have documented infectious aerosols suspended in air nearly 20 feet from an infected person. And a recent study from South Korea found that two people had become infected after spending just five minutes in a restaurant, 15 feet away from an infected patron.” (D)
“As for the lawmakers on the receiving end of the chaos, those involved in the electoral count — already facing a transmission risk by gathering in-person for a symbolic vote — were then cramped together, lying on the floor of the chamber in an attempt to take shelter. Many members of Congress have been vaccinated, but it’s a two-dose vaccine, and it’s unclear how protected people are in between the first and second shot, as well as how long it takes for the vaccine to kick in. Even if vaccinated lawmakers achieved immunity, the health of dozens of staff, reporters, and police was endangered as the chaos ensued.
Representative Susan Wild of Pennsylvania said there were 300 to 400 other evacuees in the holding location where she was placed, about half of whom weren’t wearing masks, despite being offered them. “It’s exactly the kind of situation that we’ve been told by the medical doctors not to be in,”…(E)
“As the pandemic has evolved, infectious disease experts have zeroed in on so-called superspreaders who are thought to play a major and disproportionate role in transmitting the virus.
Although pieces of the puzzle are still missing, understanding those broader patterns of transmission will help scientists pinpoint not only how the virus spreads, but also what public health strategies will be most effective to curb runaway outbreaks.
There is no official definition for superspreader events, but they are characterized by incidents that result in large clusters of infections. In March, a Biogen corporate meeting in Boston is thought to have been linked to 20,000 Covid-19 cases, according to a study published to the preprint server medRxiv that has yet to be peer-reviewed. In Michigan, a cluster of more than 180 cases in June was traced to a restaurant and bar in East Lansing. And an indoor wedding in Maine in August is thought to have resulted in at least 176 coronavirus cases and seven deaths.
Those episodes and others suggest that although any infected person can spread the virus, there are circumstances in which transmissions can spiral out of control.
One major factor is the setting. The virus can be spread through airborne transmission, which means it can linger in tiny droplets in the air. That makes certain environments particularly risky, Lloyd-Smith said.
“A perfect storm is someone who is shedding a lot of virus in a space where they are able to share that virus effectively, so an indoor space without much ventilation with a lot of other people — and particularly if those people are inconsistent with practices like wearing masks,” he said.
But there’s also a lot of individual variation, and it’s not clear whether any infected person — given the right environmental factors — could become a superspreader.
“I don’t think we can differentiate whether it’s due to the individual or just the event,” said Seema Lakdawala, an assistant professor of microbiology and molecular genetics at the University of Pittsburgh School of Medicine. “I would argue that they are both really important.”
It’s thought that an infected person’s viral load — or the amount of virus that is actually in the body — plays an important role, but it’s unclear how.
“It’s nearly impossible to trace back to the actual individual-level traits in these superspreading events, because you don’t know they’re happening when they’re happening,” Lloyd-Smith said. “We can’t zip back in time and swab their nose for a sample at that critical moment of transmission.”
Another challenging aspect is that people infected with the virus can spread it before they experience any symptoms, which means some superspreaders could be exposing others without knowing they’re infected, Lakdawala said.
It’s also not known whether there are biological differences that make the virus more stable in certain people’s mucus, Lakdawala said. If that’s the case, it could mean superspreaders are just more effective at transmitting the pathogen when they cough, sneeze or speak….
While scientists are working to understand what factors are most important in creating superspreader events, there is mounting evidence that they are driving the bulk of the virus’s spread.” (F)
C.How the Trump-incited mob may have caused a COVID superspreader event, by BETH MOLE,https://arstechnica.com/science/2021/01/capitol-insurrection-was-recipe-for-covid-superspreader-event/
“As New Jersey expands its COVID-19 vaccination efforts to larger groups of people, qualified volunteers are needed to help give shots into arms, officials said.
State Commissioner of Health Judy Persichelli called for volunteers across the state to help distribute shots through the Medical Reserve Corps, saying recently retired healthcare workers are desired.
“Individuals that can serve as vaccinators; physicians, nurses, pharmacists, paramedics, anyone who is certified to inoculate, to sign up with their County Medical Reserve Corps, because we do need vaccinators particularly when we bring up all the mega0sites,” Persichilli said. “I encourage particularly recently retired individuals to sign up.”
Gov. Phil Murphy echoed that call out during a Wednesday press briefing.
“If you have these skills we need you. So, we asked for health care help out of the bullpen in the spring, we’re asking for it again, please visit that website,” Murphy said.
Volunteers must have had previous experience and training with intramuscular injections, Persichilli said on Wednesday. There is no state training program at this time, she said.
The Medical Reserve Corps is a local-level branch of the Federal Citizen Corps, a federally-run volunteer program that works to harness civilian expertise during times of need. Members of the Medical Reserve Corps are used during public health emergencies, including pandemics, and can help provide emergency medical services, vaccine distribution, and assist with logistics, a description on the Middlesex County government website says…
In addition to vaccinators, local units are also looking for volunteers with experience in security, language translation/interpretation, education and outreach, warehouse operations, clerical, and counseling, Kearney said.
Volunteers are needed because they fill a role other emergency response organizations, like the National Guard, might not be qualified to fill, Murphy said at Monday’s press briefing.” (A)
“Drs. Peggy Pennoyer and Don Endrizzi came out of retirement this month to help Maine Medical Center launch an effort to vaccinate thousands of front-line health care workers against COVID-19….
At Maine Med alone, more than 300 retired nurses, doctors, students in medical fields, hospital employees between shifts and others have stepped up to help paid staff and fill a critical need at the start of a statewide vaccination effort that’s expected to last through most of 2021.
About 70 employees of the Central Maine Healthcare system based in Lewiston have volunteered to help vaccinate their co-workers on their own time, and Brewer-based Northern Light Health has enlisted students in advanced health care fields with the potential to bring in volunteers in the future.
The crucial role that volunteers played in staffing the first two weeks of Maine’s vaccine rollout suggests a shortage of qualified vaccinators and a need for volunteers, both clinical and clerical, that will grow as the inoculation effort expands into the community amid a surging pandemic….
But while state officials say they have been planning the vaccination program for months, and they’re hoping for more federal money to carry out the program, Maine’s COVID-19 interim draft vaccination plan doesn’t address how it will staff an effort that anticipates vaccinating more than 1 million people over the next six to nine months.
The plan identifies 468 potential partners in the rollout, including hospitals, pharmacies, municipal health departments, and businesses, but it doesn’t say exactly who will operate vaccination clinics and administer doses while those partners also maintain normal operations.
And while the volunteer response so far has been greatly appreciated, there is growing concern that the COVID-19 vaccination effort is too complicated and critical to be dependent on volunteer staffing, with strict federal record-keeping requirements, pandemic-related public health protocols and demand that are far greater than the flu shot…
Recognizing the growing need, the University of New England is organizing and training a large contingent of students and faculty to help staff vaccination clinics in both clerical and clinical positions, said Jennifer Gunderman, a professor of public health and epidemiology who heads the university’s workforce development team.
The effort will include more than 200 students in the university’s medical, pharmacy, physician assistant and nursing programs, and the staff members required to oversee them in the field. It’s being coordinated with MaineHealth, the Maine CDC and Guardian pharmacies in congregate facilities, and it will help students who have yet to fulfill required clinical practice hours, in part because of the pandemic.” (B)
“A group representing Missouri’s nurses says the state could be facing a coronavirus vaccine crunch with too few workers to administer the vaccine.
Heidi Lucas, director of the Missouri Nurses Association, told ABC 17 News she’s concerned that once the vaccine is available to the public there will be a shortage of nurses and staff who are qualified to administer it.
“Once the vaccine is in the state we are going to have a massive need for people who know how to give injections to be giving those,” Lucas said. “The vaccine rollout is going to be a huge undertaking and I don’t think people realize exactly how big of an undertaking that’s going to be. We haven’t seen anything in this country like this probably since the smallpox rollout.”
Lucas said there is already a nursing shortage nationally and statewide that could translate into not having enough people to provide injections…
Lucas said students currently in nursing programs will be trained on injections and will be on the front lines of administering the vaccine. She said the need will be so great that retired nurses will be asked to administer vaccinations. Lucas said she has already seen programs in Kansas City to get volunteers certified to provide injections.
States across the country are getting creative to fill the need for people to administer the vaccine.
Organizations representing dentists and optometrists in California and Oregon are talking with public officials about providing coronavirus vaccinations. Nursing students at Montana State University have already been given the green light to administer flu shots this fall because of the national nursing shortage…
Eric Maze, spokesman for MU Health care said in a statement, “We are confident that we will have enough staff to administer the COVID-19 vaccine when it becomes available. We work closely within our organization to identify and properly train those who will be administering the vaccine, including nursing students who are trained to perform vaccinations as part of their learning and educational requirements. In the past, MU Health Care has also utilized retired nursing staff to assist with vaccination clinics, and we anticipate this practice will be part of the COVID-19 vaccination effort as well.” (C)
“The need for a Covid-19 vaccine is as urgent in Arizona as anywhere else. Numbers show that the coronavirus is spreading faster here than in almost any other state, and Arizona is home to a large number of older people who tend to be at higher risk of dying if they contract the virus.
But that doesn’t mean vaccine doses are flying off the shelves. Instead, 4 out of 5 doses that arrived in Arizona by early this week hadn’t been used, waiting for someone qualified to give the shots.
The halting rollout has sparked anger and disappointment nationwide, even as officials said there was still plenty of time to pick up the pace of vaccinations before they start for the general public.
At least in Arizona, one reason for the slow pace was frustratingly simple: Years of belt-tightening and neglect of state and local health budgets mean there aren’t enough trained people to administer vaccinations, current and former government officials said.
“In our state, it’s a skeleton crew by design,” said Will Humble, executive director of the Arizona Public Health Association and former director of the state’s Department of Health Services. He said a desire for low taxes and smaller government was coming back to bite residents of the state, which has a long history of conservative politics.
Maricopa County, the fourth most populous county in the U.S., with 4.5 million people, has gotten about 133,000 vaccine doses for its 125,000 front-line health care workers. But through this week, only about 44,000 people had gotten their initial vaccinations.
The snags are affecting a relatively small number of people eligible to be vaccinated now, so the impact may not be long-lasting. But they raise questions about the larger rollout that is still to come, and they risk damaging public confidence in the country’s capacity to deliver shots quickly, especially after testing was delayed throughout the pandemic.
The job of vaccinating the public has fallen to the same county health departments and hospitals that have been working under the strain of the pandemic for 10 months. And there are only so many workers to go around.
“It’s easy to say you should have 123,000 people through in one week, but we’re also talking about the fact that these are people who are trying to service these hospitals, and these individuals administering the vaccines also have to medically be able to provide a vaccine,” said Marcy Flanagan, executive director of the Maricopa County Public Health Department…
Delays and snags have been reported in other states, and Trump administration officials this week acknowledged their disappointment in the rollout. They said Christmas and other holidays have caused delays, as have snowstorms and problems storing the vaccine doses at the required temperatures.
“There really has to be a lot more effort, in the sense of resources for the locals,” Dr. Anthony Fauci, the government’s top infectious disease expert, said Thursday on “TODAY.” “We have to support the local groups, the states and the cities to help them to get this task done.”
Fauci said the federal government should provide more resources to states and localities, rather than take over the effort entirely. Congress only recently approved $8.8 billion for vaccine distribution. Cara Christ, director of the state Department of Health Services, said it would be a “monumental task” to vaccinate the entire state population over the coming months. “It’s going to seem like it’s moving very slowly,” she said. “Everyone is figuring this out as we go.”…
Gov. Doug Ducey, a Republican, issued an executive order Wednesday empowering the Health Services Department to “take possession of any vaccine allocation and reallocate it to provide statewide coverage” for faster distribution and administration.” (D)
“As New Jersey prepares to establish its first vaccine “megasites” this week, state officials are looking for retired medical professionals to help administer COVID-19 immunizations to fellow health care workers at risk for infection.
Gov. Phil Murphy said Monday that 100,000 New Jerseyans have been vaccinated so far through the state’s program, which began Dec. 15 at select hospitals and two weeks later at nursing homes under a federal partnership with pharmacy giants CVS and Walgreens.
As of last week, the state had received some 400,000 doses from vaccine manufacturers Pfizer and Moderna, officials said, 120,000 of which are slated for nursing homes and other long-term care facilities. Eventually the state hopes to immunize 4.7 million people, a process that could last well into the fall.
Murphy and state health commissioner Judy Persichilli defended the pace of the rollout, but suggested the process has been complicated by changes in the federal shipping schedule and a limited pool of clinicians available to actually administer the inoculations.
“You’re basically shipping these (vaccines) out and asking the very people at the front lines fighting the pandemic to be the same people to not just get the vaccine, but to administer” the shots, Murphy said Monday during a media briefing. As a result of the limited staff, few vaccines have been administered over the weekends in New Jersey, he noted.
Persichilli said some 200 sites — hospitals, urgent-care centers, drug stores — and dozens of nursing homes are now immunizing the priority, or 1a group of residents, which includes all paid and unpaid health care workers at risk for COVID-19 exposure and residents and staff at long-term care facilities.
On Friday the state will open the first two of six planned vaccine megasites, Persichilli said, in Gloucester and Morris counties. Those operations will initially serve members of the 1a group and will aim to vaccinate 1,000 people a week, she said Monday.
Murphy said members of the National Guard or other military branches may be deployed to help set up the immunization operations — as they did with field hospitals in the spring — but only someone with the proper license and training can provide the shot in the arm. And that means more work for clinical staff already strained by rising COVID-19 hospitalizations and growing community spread.
To beef up the immunization workforce, Persichilli said the state Department of Health has put out an alert via a vaccine-related newsletter seeking to recruit retired physicians, nurses, pharmacists, paramedics and others whose training and license enables them to immunize patients. Those who want to help are urged to sign up to volunteer through their county branch of the New Jersey Medical Reserve Corps, a 5,000-member group that can serve as a backstop during a public health crisis.
We do need vaccinators, particularly when we bring up all the megasites. So I encourage particularly recently retired individuals to sign up,” Persichilli said.” (E)
“While inoculation is currently focused on frontline healthcare workers, the vaccination drive is expected to expand to tens of millions of essential industry workers beginning in January or February.
From New York to Tennessee, states are hoping medical and nursing students will free up medical staff focused on tending to the record numbers of new COVID-19 patients.
“Being able to staff vaccination clinics with volunteers from our reserve workforce means that staff at the vaccination sites can continue to perform their normal duties, which is crucial as our hospitalization rate has increased,” said a spokeswoman for Indiana University’s School of Medicine.
As the first vaccines arrived, Indiana health officials called on the state university because of its far-reaching campuses. More than 630 of Indiana University’s medical and nursing students have signed up as volunteers and receive 90 minutes of online and hands-on training.
Fourth-year medical student Nicholas Clough began administering COVID-19 vaccines to frontline healthcare workers last Wednesday. He has lost several family members during the pandemic.
“It finally felt like it was a real, tangible strike back against COVID,” said Clough, 26.
The University of Wisconsin is offering a $500 tuition credit to students with medical credentials working at understaffed hospitals during the winter break, including administering vaccines.
The university is also talking to government officials to turn universities into vaccine distribution hubs, a spokesman said.
In California, fire department paramedics have been trained to administer the vaccine, initially to fellow employees.
“They have already received online training and will have another one-hour live training session,” said Peter Sanders, a spokesman for the Los Angeles Fire Department, which expected its first shipment of the Moderna COVID-19 vaccine on Wednesday.
Michigan has set up a volunteer registry (here www.mivolunteerregistry.org), allowing officials and hospitals to recruit help for upcoming vaccine clinics.
“We encourage all medical and nursing students to register now so they will be ready when their assistance is needed!” a health department spokeswoman said.
Other states are not actively recruiting nursing students. A spokeswoman for Georgia’s health department said the state might do so later, as the vaccine becomes more widely available to the public.
Depending on state licensing laws, medical and nursing students are allowed to administer vaccines, often under supervision of a fully-licensed professional.
Facing a shortage of vaccinators, the Association of Immunization Managers, a nonprofit representing state and local health officials, 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.
New York Governor Andrew Cuomo on Dec. 13 allowed medical, nursing, pharmacy, dentistry, podiatric and midwifery students to administer flu and COVID-19 shots under supervision.” (F)
“County officials who have for years been planning for a mass vaccination said they are seeing that training and preparation — much of it funded by millions of dollars in federal grants — pushed aside as the administration of Gov. Andrew M. Cuomo has retained control of the state’s coronavirus vaccination program, including having hospitals rather than local health departments administer the doses…
Gareth Rhodes, a member of Cuomo’s coronavirus task force, said the county health departments and their pre-designated “points of distribution” for vaccinations are still integral to the governor’s plan, which is being done on a regional rather than county-by-county basis. As part of that process, the state is gathering details from counties about their vaccination plans and capabilities.
“The state then refines and approves and we implement the regional plan, of which every single health department plays a large role,” Rhodes said. “It’s not like we’re sitting on 50 million vaccine doses. … We’re getting a very small number every week, and criteria for who is eligible is obviously very narrow at this point.”
Rhodes, who is helping lead the administration’s vaccination strategy, said the planning is complicated because every person needs to receive two doses of the same vaccine — roughly three weeks apart — and the vaccine being distributed by Pfizer must be kept in deep-freeze storage containers until it’s thawed for use.
Rhodes took issue with the idea that the county plans were being ignored. “We’ve been working very closely with them, have had a number of calls with them,” he said. “I think our goals are all the same; we want to get this thing done as quickly as possible and in the most efficient way as possible.”
Still, the tensions between some county officials and the state were palpable this week.
“Public health departments should be distributing the #COVID-19 vaccine, not hospitals. It has always been their role,” Oneida County Executive Anthony Picente Jr. said in a tweet directed to the Times Union. “#OneidaCounty has the plan, the training and the experience and stands ready to execute.”
Rhodes said the points-of-distribution sites — such as churches, fire departments and senior centers — will still be used, but he stopped short of saying that counties would be called on to administer vaccinations or to use their own computer systems to track who has received their shots.
“The state already has an IT (information technology) vendor. … It would not make any sense to have 62 different scheduling systems and 62 different reporting systems,” he said. “There has to be a real statewide coordination here, which is what we’re doing. … It’s just a completely different level of coordination and logistics than a lot of people were expecting … and that is why were are doing the planning the way we are, which is on a regional level.”..
During a press conference on Wednesday, Albany County Executive Dan McCoy acknowledged the Cuomo administration “threw us for a loop when it went to Albany Med and it took it out of of the control of the (county) health department, but it’s a good thing and it’s a different approach.”
McCoy also noted that Albany Medical Center had “never done this” and that the county — and other counties across the state — had for years been practicing and planning for mass vaccinations under a program involving the state and the federal government…
As the Times Union reported last month, five years after the 2001 terror attacks, the New York City Department of Health and Mental Hygiene sought a uniform procedure to deal with a mass-casualty event, including a bioterror attack. All citywide hospitals were directed to participate in a drill in which a small team of health professionals, including a pharmacist and two nurses, took part in a mass vaccination exercise.
According to a report in the Journal of the American Pharmacists Association, one five-person team was able to immunize 942 health care workers in a four-hour period. The drill indicated that in a 48-hour operation, the team would be able to immunize 12,000 health care workers.
“By allowing pharmacists to expand their scope of practice, New York state will inevitably see a drastic improvement in its adult immunization rates for influenza and pneumococcal vaccinations through greater public awareness and expanded vaccine access,” the report noted.
The integral role pharmacists play in vaccination has been driven by a proliferation of pharmacies in the past 20 years, including 2,869 licensed pharmacies in New York City’s five boroughs.
It remains unclear how many of the state’s pharmacies will be authorized to distribute the COVID-19 vaccines. The state Department of Health (DOH) earlier this month Thursday said it had received nearly 1,200 “provider enrollment applications,” which are necessary to become authorized by the U.S. Department of Health and Human Services for vaccine distribution. But the state agency declined to say how many of those applications — which have been submitted by county health departments, hospitals and long-term care facilities — also included pharmacies or county health departments.
Several weeks ago, the state Association of Counties set up an online meeting with DOH officials and county leaders to discuss New York’s vaccine distribution plans, which include mobilizing the points-of-distribution sites.
Loretta Santilli, director of DOH’s Office of Public Health, briefed county leaders on the state’s plan and noted that “it will be a state-driven, directed implementation response, but it will be all hands on deck. … Gov. Cuomo’s charge is to put the best vaccination program in the nation out there.” (G)
“New York hospitals may face $100,000 in fines if they do not use up their share of COVID-19 vaccines by the end of the week, Gov. Andrew Cuomo said in a Jan. 4 media briefing.
Mr. Cuomo said the state health department issued regulations to speed the vaccine allocation process.
Specifically, vaccine providers now will have seven days to use all vaccine doses allocated to them. Those that fail to comply may face fines or be disqualified from administrating future vaccine doses. The regulations take effect immediately, Mr. Cuomo said.” (H)
“As governments around the world rush to vaccinate their citizens against the surging coronavirus, scientists are locked in a heated debate over a surprising question: Is it wisest to hold back the second doses everyone will need, or to give as many people as possible an inoculation now — and push back the second doses until later?
Since even the first shot appears to provide some protection against Covid-19, some experts believe that the shortest route to containing the virus is to disseminate the initial injections as widely as possible now.
Officials in Britain have already elected to delay second doses of vaccines made by the pharmaceutical companies AstraZeneca and Pfizer as a way of more widely distributing the partial protection afforded by a single shot.
Health officials in the United States have been adamantly opposed to the idea. “I would not be in favor of that,” Dr. Anthony S. Fauci, the nation’s top infectious disease expert, told CNN on Friday. “We’re going to keep doing what we’re doing.”
But on Sunday, Moncef Slaoui, scientific adviser of Operation Warp Speed, the federal effort to accelerate vaccine development and distribution, offered up an intriguing alternative: giving some Americans two half-doses of the Moderna vaccine, a way to possibly milk more immunity from the nation’s limited vaccine supply…
That would be a remarkable departure from the original plan. Since the vaccine rollout began last month in the United States, second shots of the vaccines have been held back to guarantee that they will be available on schedule for people who have already gotten their first injections.
But in Britain, doctors have been told to postpone appointments for second doses that had been scheduled for January, so that those doses can be given instead as first shots to other patients. Officials are now pushing the second doses of both the Pfizer-BioNTech and Oxford-AstraZeneca vaccines as far back as 12 weeks after the first one…
Shweta Bansal, a mathematical biologist at Georgetown University, and others also raised concerns about the social and psychological impacts of delaying second doses.
“The longer the duration between doses, the more likely people are to forget to come back,” she said. “Or people may not remember which vaccine that they got, and we don’t know what a mix and match might do.”…
Dr. Slaoui of Operation Warp Speed said in an emailed statement on Sunday that “the approach some countries are taking of delaying the booster shot could backfire and could decrease confidence in the vaccines.”
The vaccine makers themselves have taken divergent positions.
In a trial of the Oxford-AstraZeneca vaccine, volunteers in Britain were originally intended to receive two doses given four weeks apart. But some vaccinated participants ended up receiving their doses several months apart, and still acquired some protection against Covid-19.
An extended gap between doses “gives you a lot of flexibility for how you administer your vaccines, dependent on the supply that you have,” said Menelas Pangalos, executive vice president of biopharmaceuticals research and development at AstraZeneca.
Delayed dosing could help get countries “in very good shape for immunizing large swaths of their populations to protect them quickly.”
Steven Danehy, a spokesman for Pfizer, struck a far more conservative tone. “Although partial protection from the vaccine appears to begin as early as 12 days after the first dose, two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95 percent,” he said.
“There are no data to demonstrate that protection after the first dose is sustained after 21 days,” he added.” (I)
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
POST 96. December 26, 2020. CORONAVIRUS. “Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci…”…”..he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….”
POST 97. December 27, 2020. “A new variant of the coronavirus that has been spreading through the UK and other countries has not yet been detected in the United States..”.. . But if new-wave medicines like antivirals and antibody therapy contributed to the development of viral variants, it will be “a reminder for all the medical community that we need to use these treatment options carefully.”
POST 99. December 29, 2020. CORONAVIRUS. “ICUs are being overwhelmed across many parts of California. Statewide aggregate ICU availability has been at 0% since Christmas Eve…. a surge on top of a surge on top of a surge.”… “hospitals are getting close to the point where they would begin putting COVID-positive patients under the care of COVID-positive staff who are asymptomatic.”
POST 100. December 29, 2020. CORONAVIRUS. Front line hospital workers – in the ER, ICUs, EMS, acute medical care, behavioral health – are amongst the most courageous, heroic and dedicated colleagues you will ever meet.
POST 101. December 30, 2020.CORONAVIRUS. Is there a point where the increasing Coronavirus trajectory so far exceeds the slow growth of the vaccination rate that reaching herd immunity through vaccinations becomes less likely?
POST 102. January 2, 2020. CORONAVIRUS. “We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination — which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, the dean of Brown University’s School of Public Health. “Ultimately, the buck seems to stop with no one,”…
POST 103. January 4, 2021. CORONAVIRUS. Dr. Fauci said “that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses…Dr. Moore – ”British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”
POST 104. January 6, 2021. CORONAVIRUS. “Paramedics in Southern California are being told to conserve oxygen and not to bring patients to the hospital who have little chance of survival…”
……as Los Angeles County grapples with a new wave of COVID-19 patients that is expected to get worse in the coming days….
In a separate memo from the county’s EMS Agency, paramedic crews have been told not to transfer patients who experience cardiac arrest unless spontaneous circulation can be restored on the scene.
Both measures announced Monday, which were issued by the agency’s medical director, Dr. Marianne Gausche-Hill, were taken in an attempt to get ahead of an expected surge to come following the winter holidays.
Many hospitals in the region “have reached a point of crisis and are having to make very tough decisions about patient care,” Dr. Christina Ghaly, the LA County director of health services, said at a briefing Monday…
Speaking to the CBS affiliate in Los Angeles, Gausche-Hill said personnel would continue to do everything possible to save the lives of patients, both at the scene and in the hospital.
“We are not abandoning resuscitation,” she said. “We are absolutely doing best practice resuscitation and that is do it in the field, do it right away.”
“[We] are emphasizing the fact that transporting these patients arrested leads to very poor outcomes. We knew that already and we just don’t want to impact our hospitals,” she added.” (A)
“Officials in California have painted an increasingly catastrophic picture of the state’s Covid-19 crisis over the past several days, precisely what they had warned was coming, as the state faces an oxygen shortage.
California has deployed the U.S. Army Corps of Engineers and the California Emergency Medical Services Authority to deliver and refill oxygen tanks.
In Los Angeles County, emergency workers have been told to conserve oxygen and administer the minimum amount of oxygen to keep patients’ oxygen saturation level at or just above 90 percent. (A level in the low 90s or below is a concern for people with Covid-19.)…
In some cases, there will be nowhere for the victims of that surge to go.
Health authorities in Los Angeles County have directed ambulance crews not to transport some cardiac arrest patients whose survival is unlikely. At some hospitals, patients are being lined up outside while workers try to find bed space.” (B)
“California is so swamped by coronavirus cases that the state has ordered those with room to accept patients from others that have maxed out on intensive care beds.
The public health order issued late Tuesday is the latest attempt by authorities in the nation’s most populous state to confront a surge in coronavirus infections and hospitalizations, a deteriorating situation that could worsen before it gets better, as gatherings during the recent holidays possibly accelerate cases.
The order, which will last three weeks, could result in patients being shipped to Northern California from Southern California and the agricultural San Joaquin Valley, where 14 counties were ordered to delay nonessential “and non-life threatening” surgeries in order to provide beds. The directive also applies to any county where ICU capacity to treat COVID-19 patients is bottoming out.
“If we continue to see an alarming increase of COVID-19 patient admissions at hospitals statewide, some facilities may not be able to provide the critical and necessary care Californians need, whether those patients have COVID-19 or another medical condition,” said Dr. Tomás J. Aragón, the state’s public health officer…
Martin Luther King Jr. Community Hospital in Los Angeles, where patients are being housed in its former gift shop, a chapel, tents and hallways, had more COVID-19 patients on Tuesday than its total capacity. The hospital, which serves a largely Black and Latino population in the south part of the city, has a capacity of 131 patients but was treating 215 patients, 135 with COVID-19, said Jeff Stout, interim chief nursing and operating officer…
Some hospitals have had to close their doors at times because they’ve become so overwhelmed, leaving ambulances waiting up to eight hours and diverting others to different emergency rooms.
Stout said Martin Luther King hospital was finalizing its crisis standards of care, which are guidelines for rationing treatment when staff, medicine and equipment are in short supply.
“We’re not there yet,” Stout said. “Every day, every hour we’re trying to avoid going into crisis care. The ultimate goal with crisis care is never to get there.”
The state on Tuesday formally requested that 500 federal medical personnel be deployed in California to help staff hospitals and skilled nursing homes after learning that the USNS Mercy Hospital ship, which docked off Los Angeles earlier in the year for overflow patients, was in dry dock and would not be returning.” (C)
“Los Angeles County Department of Health Services Director Dr. Christina Ghaly described the medical facility situation as on the “brink of catastrophe.”
Some health department primary care clinics have had to close or reduce their hours because the county’s hospitals are “so incredibly taxed,” Ghaly said.
More than 700 nurses have been reassigned to fulfill duties within the inpatient units, the emergency department, as well as the quarantine and isolation beds provided by the health department. All types of health care staff are being used and the county is requesting additional help.
Teams from the US military with 75 doctors, nurses and staff are being deployed to the state.
While no hospitals in the L.A. County have formally declared they are operating under “crisis care,” health officials have said that some Southern California hospitals have put in place practices that would be a part of crisis care, including redirecting ambulances when facilities are overwhelmed.” (D)
“A COVID-19 outbreak at Oakland, Calif.-based Kaiser Permanente’s San Jose hospital is linked to confirmed cases for 60 emergency department staff members, according to a statement shared with Becker’s Hospital Review.
San Jose (Calif.) Medical Center previously reported that 44 emergency department staff members tested positive between Dec. 27 and Jan. 1, and one of those workers has died. As of Jan. 5, 60 staff members who worked in the emergency department on Dec. 25 have tested positive.” (E)
“When the coronavirus began spreading through New York, Gov. Andrew M. Cuomo ordered state-run hospitals to stop suing patients over unpaid medical bills, and almost all of the major private hospitals in the state voluntarily followed suit by suspending their claims.
But one chain of hospitals plowed ahead with thousands of lawsuits: Northwell Health, which is the state’s largest health system and is run by one of Mr. Cuomo’s closest allies.
The nonprofit Northwell sued more than 2,500 patients last year, records show, a flood of litigation even as the pandemic has led to widespread job losses and economic uncertainty.
The Northwell lawsuits each sought an average of $1,700 in unpaid bills, plus large interest payments. They hit teachers, construction workers, grocery store employees and others, including some who had lost work in the pandemic or gotten sick themselves.
After this article was published Tuesday morning, Northwell abruptly announced it would stop suing patients during the pandemic and would rescind all legal claims it filed in 2020.” (F)
“This week, the U.K. decided to delay second doses in order to prioritize getting the first doses to more people.
The U.K. decision has restarted conversations about whether the U.S. and Florida should do the same…
Pfizer’s two vaccines are given 21 days apart, and Moderna’s can be given 28 days apart.
Early vaccine trial results show a 50% to 60% efficacy after participants took the first vaccine.
The Food and Drug Administration’s emergency authorization was based on the efficacy and immunity of two doses.
Doctors say only one dose will leave people only partially protected and will leave the virus diminished but still spreading.
In the beginning, Pfizer was only sending that second shot as it was needed, but as millions and millions of doses are delivered in future months, it could be up to states to determine whether they want to follow the U.K.’s decision.” (A)
“In a shift from practices in the US, Britain plans to give people second doses of the coronavirus vaccines within 12 weeks of their first shot rather than within 21 days, to accelerate immunizations across as many people as quickly as possible. The practice has drawn some criticism from experts around the world…
More than a million people in the UK have already received their first jab of the Pfizer vaccine. Earlier this week, Britain also approved a vaccine developed by the University of Oxford and British pharmaceutical firm AstraZeneca that is substantially cheaper and easier to use.
British authorities then outlined the new dosing regimen, which delays a person’s second vaccine shot from being done at three weeks to being given up to 12 weeks after the first shot. According to The New York Times, British health authorities were also given permission to combine the vaccines, should a second dose by one of the companies not be available.
“In the short term, the additional increase of vaccine efficacy from the second dose is likely to be modest. The great majority of the initial protection from clinical disease is after the first dose of vaccine,” British medical officers said.
The UK plans to ramp up vaccinations on Monday using 530,000 doses of the AstraZeneca vaccine and has set a goal of vaccinating 2 million people a week as soon as possible.
Still, the new plan has faced criticism. The UK’s main union for doctors warned that delaying the second dose causes huge scheduling problems for thousands of partially vaccinated elderly and vulnerable people.
“It is grossly and patently unfair to tens of thousands of our most at-risk patients to now try to reschedule their appointments,” said Richard Vautrey from the British Medical Association.
Responding to the intention to mix the vaccines — a practice banned by the CDC, — John Moore, a vaccine expert at Cornell University, told The New York Times that British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.” (B)
The UK’s chief medical officers have defended a decision to delay second doses of the Pfizer/BioNTech vaccine in order to prioritize first doses, saying it will protect as many vulnerable people as possible while the coronavirus is running rampant.
The new strategy, announced Wednesday by the head of the UK’s medicines regulator MHRA, means that the interval between doses could be extended to up to 12 weeks, instead of the three weeks previously stipulated.
It has prompted a debate among experts, with the British Medical Association (BMA), a body representing UK doctors, criticizing the move to postpone appointments for the very vulnerable patients currently awaiting their second shots…
“This group of very elderly patients is at the highest risk of death if they contract Covid-19, which is why GPs are so concerned for them. It is grossly and patently unfair to tens of thousands of our most at-risk patients to now try to reschedule their appointments,” Dr. Richard Vautrey, chair of the BMA General Practitioners Committee, said in a statement Thursday.
The Doctors’ Association UK also raised “real and grave concerns” over the new vaccination strategy, warning Friday that it could undermine the National Health Service’s patient consent process, “as well as completely failing to follow the science.”
Meanwhile, Pfizer said it did not have data to demonstrate that just a single dose of its vaccine would provide protection against the disease after more than 21 days.
“Pfizer and BioNTech’s Phase 3 study for the Covid-19 vaccine was designed to evaluate the vaccine’s safety and efficacy following a 2-dose schedule, separated by 21 days,” Pfizer said in a statement on Thursday. “There are no data to demonstrate that protection after the first dose is sustained after 21 days.”
But the chief medical officers for England, Scotland, Wales and Northern Ireland defended the move in a letter to healthcare professionals published Thursday, saying it was based on the “balance of risks and benefits,” and that the “great majority” of initial protection came from the first jab….
Pfizer said it had not evaluated different dosing schedules because “the majority of trial participants received the second dose within the window specified in the study design.”
In its open letter, the Doctors’ Association UK wrote: “Protection provided by the first dose of the Pfizer vaccine is considerably lower at 52.4% compared to 95% if two doses given three weeks apart.”
Vautrey told CNN that greater assurances would be needed from both the UK chief medical officers and Pfizer in order to give healthcare professionals and patients confidence in the government’s strategy.
“We need Pfizer themselves to be confident that this new dosage regime is going to deliver effective coverage and protection to our patients, particularly our most vulnerable patients,” Vautrey said.” (C)
“As governments around the world rush to vaccinate their citizens, scientists and policymakers are locked in a heated debate over a surprising question: Is it wisest to hold back the second doses everyone will need, or to give as many people as possible an inoculation now — and push back the second doses?…
The vaccines authorized so far in the United States are produced by Pfizer-BioNTech and Moderna. Britain has greenlit the Pfizer-BioNTech and Oxford-AstraZeneca vaccines.
All of them are intended to be delivered in two doses on a strict schedule. The first injection teaches the immune system to recognize a new pathogen by showing it a harmless version of some of the virus’s most salient features. After the body has had time to study up on this material, as it were, a second shot presents these features again, helping immune cells commit the lesson to memory.
Clinical trials run by Pfizer-BioNTech and Moderna showed the vaccines were highly effective at preventing cases of Covid-19 when delivered in two doses separated by three or four weeks.
Some protection appears to kick in after the first shot of vaccine, although it’s unclear how quickly it may wane. Still, some experts now argue that spreading vaccines more thinly across a population by concentrating on first doses may save more lives than making sure half as many individuals receive both doses on schedule.
That would be a remarkable departure from the original plan. Since the rollout began last month in the United States, second shots of the vaccines have been held back to guarantee that they will be available for people who have gotten their first injections…
But some researchers fear the delayed-dose approach could prove disastrous, particularly in the United States, where rollouts are already stymied by logistical hurdles and a patchwork approach to prioritizing who gets the first vaccinations.
“We have an issue with distribution, not the number of doses,” said Saad Omer, a vaccine expert at Yale University. “Doubling the number of doses doesn’t double your capacity to give doses.” (D)
“I would not be in favor of that,” Dr. Fauci told CNN’s Elizabeth Cohen, regarding altering dosing schedules for the vaccines authorized for use in the United States, made by Pfizer and Moderna. “We’re going to keep doing what we’re doing.”
His opinion was met with approval by some experts, including Dr. Eric Topol, a clinical trials expert at the Scripps Research Translational Institute in California, who tweeted, “That’s good because that it’s following what we know, the trial data with extraordinary 95 percent efficacy, avoiding extrapolation and the unknowns.”…
Straying from this regimen “is like going into the Wild West,” said Dr. Phyllis Tien, an infectious disease physician at the University of California, San Francisco. “It needs to be data driven if they’re going to make a change.”
Widening the gap between vaccine doses could risk blunting the benefits of the second shot, which is intended to boost the body’s defenses against the coronavirus, increasing the strength and durability of the immune response. In the interim, the protective effects of the first shot could also wane faster than anticipated.
With Pfizer’s vaccine, for example, “we don’t really know what happens when you only have one dose after, like, a month,” said Natalie Dean, a biostatistician at the University of Florida. “It’s just not the way it was tested.” (E)
