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“Former White House coronavirus task force official Dr. Deborah Birx revealed Sunday that Donald Trump used mysterious graphs during presentations on COVID-19 that she did not create, which provided selective, misleading data.
“I saw the president presenting graphs that I never made,” Birx said in an interview on “Face the Nation” on CBS. “I know that someone — someone out there or someone inside — was creating a parallel set of data and graphics that were shown to the president … You can’t do that,” she added. “You have to use the entire database.”
Trump was mocked for a fistful of charts he brought to an Axios interview last summer, which he had difficulty explaining or understanding…
Birx said there were people in the White House who “definitely” believed that COVID — which has now killed more than 400,000 people in the nation — was a “hoax.” (H)
“So how slow was the rollout under the Trump administration?
First target missed
As of 20 January, the day Mr Biden became president, about 16.5 million vaccines had been administered in the US, according to official statistics….
However, the US fell far short of the target set by the Trump administration to vaccinate 20 million people by the end of 2020….
The daily average for the week before Mr Trump left office was less than 900,000, according to Our World in Data, although there could be a slight lag in recording daily vaccination figures…
There are wide variations across different US states – for example, as of 20 January, Alaska had given out more than 9,000 doses per 100,000 people and Alabama less than 3,000…
Mr Trump focused attention on what he saw as slow delivery by individual states, rather than issues at the federal level.
He tweeted on 29 December: “The Federal Government has distributed the vaccines to the states. Now it is up to the states to administer. Get moving!”
There have been issues around co-ordination and preparedness at state level, but local authorities have put this down to a lack of support from the federal government once the vaccines are distributed….
President Biden’s Chief of Staff, Ron Klain has said a plan to distribute vaccines “out into the community as a whole, did not really exist when we came into the White House”.
Experts say significant logistical problems have arisen as well in administering the vaccines once they have been delivered to states.
As of 20 January, more than 35 million vaccines had been distributed across the US, but less than half of these had been put into people’s arms.
Public health professor at George Washington University, Dr Leana Wen said: “The federal government seemed to have ceded its responsibility at the point the vaccines were given to the states.
“The state and local health departments have been asking for months for additional funding, and have not been given the funding that they need,” she added… (A)
“New Jersey officials have conceded there is a disconnect between the state-run online vaccine registration system and the 200-plus COVID-19 vaccination sites run by local and county governments, health care providers and pharmacies.
The gap turns out to be significant, according to a state list updated Tuesday.
Less than 5% of the coronavirus immunization programs now operating in New Jersey are using the state’s registration system, with the vast majority running their own sign-up process through existing corporate or government websites or newly created portals specific to their location. Only one of the six state-overseen vaccine mega-sites — in Gloucester County — is linked to the New Jersey Vaccine Scheduling System, or NJVSS.
This uncoordinated registration system is frustrating the public as New Jersey residents eager to get vaccinated discover they cannot easily make an appointment through the state portal. Instead, the state scheduling system — which officials said has now pre-registered more than 2 million people — is designed to alert individuals when they are eligible and prompt them to make an appointment at a local vaccine clinic, which usually involves additional calls, emails or a separate sign-up process to secure a spot…
There are now 205 vaccine sites established, according to a DOH list updated Tuesday, although not all are operating at full capacity; nine rely on the NJVSS system.
All are connected to the state’s pre-existing vaccine inventory database, the New Jersey Immunization Information System, or NJIIS, which allows DOH to track their “throughput” and make allocation decisions for the week to come. Doses are shipped directly from federal stockpiles to the immunization sites.
While the state’s updated 190-page vaccine plan, submitted to federal officials in December, notes the importance of carefully tracking all doses — something that fell short during the H1N1 vaccine campaign in 2009 — it provides little detail on the public sign-up process and only mentions the NJVSS system once. Dispensing sites are responsible for everything from set-up to vaccine storage to patient registration, the plan notes, and offers various options for scheduling appointments…
“We are also exploring streamlining registration and scheduling at all of our sites that do not currently participate in NJVSS,” Persichilli said Monday. “Our attempt is to make appointment scheduling easier and one-stop shopping.”..
However, the NJVSS system does not currently have the capacity to schedule appointments for second doses, Persichilli noted Monday…
State officials also did not comment on why the registration system was not designed to handle return visits from the start, but stressed it was currently being updated to accommodate this element. The state’s vaccine plan appears to offer multiple suggestions on how clinics can schedule booster shots — including utilizing NJVSS.” (B)
“The big reason for the slow vaccine rollout in New Jersey “is the federal program with CVS and Walgreens,” Murphy said. “They basically amassed these doses, they schedule visits to long-term care nursing homes, extended living, and they’re punching under their weight, particularly Walgreens, and that’s where most of the yet to be used doses are.”
New Jersey has a population of approximately 8.882 million people, and has distributed 898,550 vaccines, while only administering 432,220 of them, according to the Centers for Disease Control and Prevention.
“There’s no question we have an enormous supply/demand imbalance, that begins, with all due respect, with the federal government, at least up until today, having dropped the ball – over promising and under delivering,” Murphy said.
New Jersey Gov. Phil Murphy (D) blamed Walgreens and the federal government for the Garden State’s sluggish vaccine rollout during a Wednesday evening interview on CNBC’s “The News with Shepard Smith.”
“The big reason is the federal program with CVS and Walgreens,” Murphy said. “They basically amassed these doses, they schedule visits to long-term care nursing homes, extended living, and they’re punching under their weight, particularly Walgreens, and that’s where most of the yet to be used doses are.”
Murphy suggested to host Shepard Smith that Walgreens “put more bodies on the case” in order to solve the rollout problem.
On Tuesday, Murphy said that New Jersey was effectively equipped to dole out the vaccine, but that all the providers were missing “are the vaccine doses.” New Jersey has a population of approximately 8.882 million people, and has distributed 898,550 vaccines, while only administering 432,220 of them, according to the Centers for Disease Control and Prevention.
Murphy pointed to the Covid vaccine doses under state control and said that they are getting into people’s arms more efficiently.
“You can’t find many doses in hospitals or other distribution points that we control directly, that are going unused,” Murphy said. “We’re getting shots into arms with all of the areas that we can control.” (E)
“President Joe Biden announced a series of measures on Tuesday aimed at ramping up coronavirus vaccine allocation and distribution, including the purchase of 200 million more vaccine doses and increased distribution to states by millions of doses next week.
With those additional doses, Biden said there would be enough to fully vaccinate 300 million Americans — nearly the entire US population — by the end of summer or early fall.
He described efforts to combat Covid-19 as a “wartime undertaking.”
“We now have a national strategy to beat Covid-19. It’s comprehensive. It’s based on science, not politics. It’s based on truth, not denial, and it is detailed,” he said.
As part of the new efforts announced Tuesday, the US will buy 100 million more doses from Pfizer/BioNTech and 100 million more from Moderna — the two-dose vaccines that have been granted emergency use authorization by the US Food and Drug Administration. Pfizer and Moderna are working to step up production, and Biden said that the additional doses will be available this summer.
The new purchase will increase the planned Covid-19 vaccine supply from 400 million to 600 million, an official told reporters on a call on Tuesday ahead of Biden’s remarks.
The President also took action on Tuesday to increase the weekly vaccine supply to states, tribes and territories — upping the current 8.6 million doses to a minimum of 10 million doses weekly. Additionally, the White House will be providing three week vaccine supply look-ahead reports to states as opposed to one week look-aheads.
Biden’s Covid coordinator, Jeff Zients, informed governors on a call Tuesday afternoon that Covid vaccine allocations for states would increase by around 16% starting next week.
A White House document explaining the move says the Biden administration is committing to maintaining this as the minimum supply level for the next three weeks.
The new efforts come one day after the President said he expects the US will soon be able to vaccinate 1.5 million people a day, which is a notable increase from the administration’s previously stated target of 1 million per day. The President said that the US could surpass that initial target in about three weeks, and said that he thinks anyone who wants a vaccine will be able to get it by this spring.
Biden’s official goal on administering vaccines still remains 100 million shots in his first 100 days in office, multiple White House officials told CNN, after Biden raised the new 1.5 million doses a day aspiration. That initial goal is enough to cover 50 million Americans with vaccines that require two doses.” (C)
“Smarter testing, faster vaccinations and health equity are cornerstones of the 200-page COVID-19 strategy released by US President Joe Biden’s administration on 21 January, as the country surpassed 420,000 deaths due to the coronavirus. The plan pledges to “listen to science” — a shift from the approach of former president Donald Trump, who, at times, politicized scientific evidence and ignored public health recommendations.
Many researchers posted messages on Twitter expressing relief that scientific evidence would play a central role in Biden’s plan. They also celebrated the existence of a coordinated national pandemic strategy, complaining that Trump’s failure to enact one impaired testing, tracing and other responses required to tame the outbreak.
Joe Biden’s COVID plan is taking shape — and researchers approve
“This marks a pretty radical shift,” says J. Stephen Morrison, director of global health policy at the Center for Strategic and International Studies in Washington DC, who compares Biden’s strategy to a wartime national mobilization…
The Biden plan aims to ensure that all Americans can be tested regularly for coronavirus infection by increasing the number of testing sites, and by scaling up the production of rapid tests. Helen Chu, an infectious disease researcher at the University of Washington in Seattle, says more testing will help, but it won’t be enough if the tests don’t reach communities hit hardest by the virus. She says the US government must figure out how to expand home testing for people who can’t get to testing sites because of work, childcare duties or a lack of transportation.
Increasing the United States’ surveillance for new, potentially dangerous, variants of SARS-CoV-2 is also part of the Biden administration’s plan. But Chu wants to see a systematic strategy for sequencing the genomes of coronaviruses across the country, as opposed to researchers conducting studies on samples they happen to obtain through fragmented projects. “Right now, surveillance is being led by academic research labs in a piecemeal way,” she says, “and not at the coordinated high-throughput level that you need to identify and act on new variants quickly.”
Biden’s strategy also calls for a better online dashboard for tracking the prevalence of the virus in cities and towns across the United States, so that people and officials can make evidence-based decisions about socializing, or opening offices and schools. His plan also pledges to enhance data analysis at hospitals and health departments, and to modernize data systems used within the US healthcare system, which are often painfully outdated…
Chasing an ambitious goal of administering 100 million shots to US residents in its first 100 days in office, the Biden team proposes 100 new vaccination centers run by the federal government, mobile vaccination units in underserved areas, and using grocery stores and stadiums as vaccination venues. The ramp-up includes growing the ranks of vaccinators with retired or foreign-trained doctors, as well as medical students, and by directing federal staff like nurses, physician assistants and doctors at various federal agencies to assist US states.” (D)
“Amazon is offering its help to President Joe Biden with the rollout of COVID-19 vaccines, while seeking to get its employees inoculated “at the earliest appropriate time.”
In a letter written to Biden and dated Wednesday, Amazon Worldwide Consumer CEO Dave Clark said the e-commerce giant is prepared to leverage its operations to help vaccinate 100 million Americans in the first 100 days of the president’s administration.
“Our scale allows us to make a meaningful impact immediately in the fight against COVID-19, and we stand ready to assist you in this effort,” wrote Clark.” (F)
“Amazon wrote to President Biden on Thursday offering to assist with communication and technology. Microsoft is opening up its largely empty office campus as a vaccination center as part of a broader partnership with the State of Washington. Starbucks is assigning workers from its operations and analytics departments to help design vaccination sites, donating the labor to the same state while continuing to pay employees.
While some retailers and pharmacy chains have been directly involved in the rollout of coronavirus vaccinations, more surprising is the number of companies that have offered help despite having little to do with health care.
What these companies do have are vast national footprints, significant manpower, huge distribution warehouses and, in some cases, empty office buildings. And they have the money to spare for a public service effort that could boost both their public image and their bottom line.
“Big companies can think big,” said Arthur Herman, senior fellow at the Hudson Institute, a think tank in Washington, D.C. “They can afford to step back and think about their role as a social force in their state and in the country. They also have enormous supply chains and logistical connections.”
As Mr. Biden tries to ramp up vaccination efforts, he will need all the help he can get. The president has asked Congress for $20 billion to help fund vaccinations at stadiums, pharmacies and the like. He said Friday that he had tapped the Federal Emergency Management Agency to operate up to 100 mass vaccination sites.
But the private sector could assist the administration’s efforts with data storage, appointment scheduling, the delivery of supplies to clinics and hospitals, and more.
“Amazon, Google, Microsoft, these guys are consumer-facing people who can deal with billions of transactions on a daily basis,” said Suketu Gandhi, a partner Kearney, a management and consulting firm.
Washington’s governor, Jay Inslee, included the help of companies like Starbucks, Costco and Microsoft in a plan to vaccinate 45,000 residents a day.
“We are not a health care company,” Kevin Johnson, the chief executive of Starbucks, said at a news conference announcing the partnership on Monday, “but Starbucks does operate 33,000 stores at scale, serving 100 million customers a week. And we have a world-class team of human-centered-design engineers who are working under the direction of the state, and health care providers like Swedish, Kaiser Permanente and others.”
The coffee chain will lend its expertise in “operational efficiency,” among other things, Governor Inslee said in a news release.
Microsoft will open up an empty building on its campus in Redmond to vaccinations in partnership with the state and health care providers. It is also offering its technology, building on abilities it has already offered to the government, including artificial intelligence to the State Department of Health to help track hospitalizations and tests.
“Certainly technology plays a role in the distribution of vaccines, as it basically does in the distribution of everything in the world,” Microsoft’s president and chief legal officer, Brad Smith, said at the event announcing the rollout.
Amazon is holding a pop-up vaccine clinic in Seattle on Sunday, through a partnership with Virginia Mason Medical Center; they hope to vaccinate 2,000 people. The company has also offered to vaccinate its own employees in the state, many of whom it says are essential workers — an offer it has made to Tennessee as well.” (G)
“As many as 90,000 Americans are projected to die from the coronavirus in the next four weeks, the Biden administration warned in its first science briefing on the COVID-19 pandemic, as experts outlined efforts to improve the delivery and injection of COVID-19 vaccines.
The hourlong briefing Wednesday by the team charged by President Joe Biden with ending the pandemic, was meant to deliver on his promise of “leveling” with the American people about the state of the outbreak that has already claimed more than 425,000 U.S. lives. It marked a sharp contrast from what had become the Trump show, in the last administration, when public health officials were repeatedly undermined by a president who shared his unproven ideas without hesitation.
The striking deaths projection wasn’t much different from what Biden himself has said, but nonetheless served as a stark reminder of the brutal road ahead.
Wednesday’s briefing was conducted virtually, rather than in person at the White House, to allow for questions from health journalists and to maintain a set timing no matter the situation in the West Wing. But it was not without technical glitches.
It featured Jeff Zients, the Biden administration’s coordinator for pandemic response; his deputy, Andy Slavitt; Dr. Anthony Fauci, the nation’s top infectious disease expert; Dr. Marcella Nunez-Smith, the chair of Biden’s COVID-19 equality task force, and Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention.
“The White House respects and will follow the science, and the scientists will speak independently,” said Slavitt.” (I)
POSTS 116, 117 & 118…….. POST 118. January 24, 2021. CORONAVIRUS. “Unfortunately, we’ve let this virus spread extensively and are launching the vaccination campaign at the height of the threat,”… “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.”
“The coronavirus pandemic in the United States has raged almost uncontrollably for so long that millions of vaccinations will not be able to stop the spread of the disease unless people continue to wear masks and maintain social distancing measures until midsummer or later…
The arrival of highly effective vaccines in December lifted hopes that they would eventually slow or stop the spread of the disease through the rest of the population. But vaccines alone are not enough, the model shows. And if precautions like working remotely, limiting travel and wearing masks are relaxed too soon, it could mean millions more infections and thousands more deaths….
POST 117. January 23, 2021. CORONAVIRUS. 1.Dr. Fauci:“The idea that you can get up here….”and.. let the science speak”… “It is somewhat of a liberating feeling.” 2.updated CDC guidance:”.. providers could give the second dose up to six weeks after the first dose..” 3.Dr. Fauci: people would be “taking a chance” if they follow the CDC’s updated guidance.
“In rare circumstances, it’s OK for people to receive one shot of Pfizer’s Covid-19 vaccine and one shot of Moderna’s vaccine at least 28 days apart, the CDC said in updated guidance.
“U.S. health authorities said it is OK to delay second doses of Covid-19 vaccines up to six weeks after the first injection, which for some shots would be twice as long as recommended.
POST 116. January 22, 2021. President Biden – “We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation.”
“Twelve minutes before noon on Wednesday, President Joe Biden was sworn into office as the nation’s 46th president. Seven hours later, the United States reported more than 4,409 new deaths from the novel coronavirus, according to data collected by the COVID-19 Tracking Project.
The Biden administration came into power with purpose and an extensive agenda to combat the coronavirus pandemic, but purpose and planning only gets you so far—particularly when the president’s team is only just now getting a clear picture of how badly the previous administration had managed the crisis.
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
POST 96. December 26, 2020. CORONAVIRUS. “Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci…”…”..he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….”
POST 97. December 27, 2020. “A new variant of the coronavirus that has been spreading through the UK and other countries has not yet been detected in the United States..”.. . But if new-wave medicines like antivirals and antibody therapy contributed to the development of viral variants, it will be “a reminder for all the medical community that we need to use these treatment options carefully.”
POST 99. December 29, 2020. CORONAVIRUS. “ICUs are being overwhelmed across many parts of California. Statewide aggregate ICU availability has been at 0% since Christmas Eve…. a surge on top of a surge on top of a surge.”… “hospitals are getting close to the point where they would begin putting COVID-positive patients under the care of COVID-positive staff who are asymptomatic.”
POST 100. December 29, 2020. CORONAVIRUS. Front line hospital workers – in the ER, ICUs, EMS, acute medical care, behavioral health – are amongst the most courageous, heroic and dedicated colleagues you will ever meet.
POST 101. December 30, 2020.CORONAVIRUS. Is there a point where the increasing Coronavirus trajectory so far exceeds the slow growth of the vaccination rate that reaching herd immunity through vaccinations becomes less likely?
POST 102. January 2, 2020. CORONAVIRUS. “We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination — which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, the dean of Brown University’s School of Public Health. “Ultimately, the buck seems to stop with no one,”…
POST 103. January 4, 2021. CORONAVIRUS. Dr. Fauci said “that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses…Dr. Moore – ”British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”
POST 104. January 6, 2021. CORONAVIRUS. “Paramedics in Southern California are being told to conserve oxygen and not to bring patients to the hospital who have little chance of survival…”
POST 105. January 8, 2021. CORONAVIRUS. POST 105. January 8, 2021. CORONAVIRUS. “Facing a shortage of vaccinators, the Association of Immunization Managers… recommends relaxing regulation or adjusting licensing requirements. At least two states, Massachusetts and New York, have changed their laws in recent weeks to expand those who are eligible to give shots.”
POST 106. January 9, 2021. CORONAVIRUS. The riots at the Capitol could have been a superspreader event. “From what I saw… you had a large congregation of individuals who were in close contact for an extended period of time and almost universally unmasked…. many coming and going on buses as well, also unmasked, and hanging out in hotel lobbies.”
POST 107. January 8, 2021. CORONAVIRUS. “Our job is to make sure the vaccine isn’t politicized the way masks were politicized,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said after getting her vaccine. South Carolina Rep.-elect Nancy Mace, a Republican, wrote that “Congress shouldn’t be putting themselves first in line for the COVID-19 vaccination when the average American can’t get it.”
POST 108. January 9, 2021. CORONAVIRUS. (vaccination)”Line-cutters will be named and shamed. It’s inevitable, as will be the congressional hearings and front-page investigative stories ferreting out who saved their own skin at the expense of others.”
POST 109.January 9, 2021. CORONAVIRUS. “President-elect Joe Biden will aim to release nearly every available dose of the coronavirus vaccine when he takes office, a break with the Trump administration’s strategy of holding back half of US vaccine production to ensure second doses are available.
POST 110. January 13, 2021. CORONAVIRUS. ““The (federal) government is changing the way it allocates Covid vaccine doses, now basing it on how quickly states can administer shots and the size of their elderly population.”… “New York State sent a letter to hospitals saying if they don’t use their vaccine allocations by the end of this week, they won’t receive any further allocations.”
POST 111. January 14, 2021. CORONAVIRUS. “Visitors from Toronto to New York to Buenos Aires have long flocked to Florida for sun, surf and shopping. Now they are coming for the Covid-19 vaccine….
POST 112. January 14, 2021. CORONAVIRUS. CHINA – “Eleven million people are under lockdown in Hebei province after a new cluster of coronavirus infections.
PART 113. January 17, 2021. CORONAVIRUS. The Next President Actually Has a Covid Plan… New York City and other places in the state expect to exhaust their supply of doses as early as next week… Charles Barkley said during the “NBA on TNT” broadcast that pro athletes should get the first round of the vaccine…..
POST 114. January 18, 2021. CORONAVIRUS. “When government programs that have been unattended, underfunded and bogged down by red tape suddenly have to meet a huge demand in a crisis, they can’t cope and people suffer….”
POST 115. January 21, 2020. CORONAVIRUS. A year ago today an unnumbered POST was headlined “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.” The CORONAVIRUS CONTENT TRACKING PROJECT started with HISTORIOGRAPHY and over time moved to LESSONS LEARNED, RAPID RESPONSE, and THE VACCINATION PROGRAM. Now 115 POSTS later – the BIDEN CORONAVIRUS PLAN.
POST 116. January 22, 2021. President Biden – “We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation.”
POST 117. January 23, 2021. CORONAVIRUS. 1.Dr. Fauci:“The idea that you can get up here….”and.. let the science speak”… “It is somewhat of a liberating feeling.” 2.updated CDC guidance:”.. providers could give the second dose up to six weeks after the first dose..” 3.Dr. Fauci: people would be “taking a chance” if they follow the CDC’s updated guidance.
POST 118. January 24, 2021. CORONAVIRUS. “Unfortunately, we’ve let this virus spread extensively and are launching the vaccination campaign at the height of the threat,” Dr. Meyers said. “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.”
POST 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? (A)
Here’s one answer.
“The coronavirus pandemic in the United States has raged almost uncontrollably for so long that millions of vaccinations will not be able to stop the spread of the disease unless people continue to wear masks and maintain social distancing measures until midsummer or later, according to a new model by scientists at Columbia University.
The arrival of highly effective vaccines in December lifted hopes that they would eventually slow or stop the spread of the disease through the rest of the population. But vaccines alone are not enough, the model shows. And if precautions like working remotely, limiting travel and wearing masks are relaxed too soon, it could mean millions more infections and thousands more deaths….
There is no doubt that getting vaccinated protects the recipient. Still, several infectious-disease researchers contacted by The New York Times cautioned that it would be months before enough people in the United States will have gotten the shots to allow for normal life to begin again.
Only then will the number of people with immunity — those who have had the disease and recovered, plus those who have been vaccinated — be large enough to take the wind out of the pandemic, said Jeffrey Shaman, an epidemiologist at Columbia who shared his team’s modeling calculations.
Dr. Shaman estimates that more than 105 million people have already been infected across the U.S., well above the number of cases that have been reported. And his projections show millions more infections are yet to come as the vaccine rolls out.
Social distancing, masking and other measures should remain in place until late July, “and that may be optimistic,” said Dr. Shaman. Otherwise, yet another resurgence of the virus is possible…
The model takes into account factors like the speed and order of vaccine distribution, the effectiveness of the vaccine after one and two doses, current social distancing measures and the transmissibility of the virus. It assumes that groups like health care workers and older adults will be prioritized according to C.D.C. guidelines, and vaccination will continue at a pace ramping up to five million doses per week…
Lauren Ancel Meyers, a professor of biology and statistics at the University of Texas at Austin, said that Dr. Shaman’s reasoning “all makes intuitive sense.” Dr. Meyers said she agreed that the uncontrolled outbreaks in many places in 2020 have lowered the benefits of a vaccine.
“Unfortunately, we’ve let this virus spread extensively and are launching the vaccination campaign at the height of the threat,” Dr. Meyers said. “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.” (B)
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
POST 96. December 26, 2020. CORONAVIRUS. “Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci…”…”..he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….”
POST 97. December 27, 2020. “A new variant of the coronavirus that has been spreading through the UK and other countries has not yet been detected in the United States..”.. . But if new-wave medicines like antivirals and antibody therapy contributed to the development of viral variants, it will be “a reminder for all the medical community that we need to use these treatment options carefully.”
POST 99. December 29, 2020. CORONAVIRUS. “ICUs are being overwhelmed across many parts of California. Statewide aggregate ICU availability has been at 0% since Christmas Eve…. a surge on top of a surge on top of a surge.”… “hospitals are getting close to the point where they would begin putting COVID-positive patients under the care of COVID-positive staff who are asymptomatic.”
POST 100. December 29, 2020. CORONAVIRUS. Front line hospital workers – in the ER, ICUs, EMS, acute medical care, behavioral health – are amongst the most courageous, heroic and dedicated colleagues you will ever meet.
POST 101. December 30, 2020.CORONAVIRUS. Is there a point where the increasing Coronavirus trajectory so far exceeds the slow growth of the vaccination rate that reaching herd immunity through vaccinations becomes less likely?
POST 102. January 2, 2020. CORONAVIRUS. “We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination — which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, the dean of Brown University’s School of Public Health. “Ultimately, the buck seems to stop with no one,”…
POST 103. January 4, 2021. CORONAVIRUS. Dr. Fauci said “that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses…Dr. Moore – ”British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”
POST 104. January 6, 2021. CORONAVIRUS. “Paramedics in Southern California are being told to conserve oxygen and not to bring patients to the hospital who have little chance of survival…”
POST 105. January 8, 2021. CORONAVIRUS. POST 105. January 8, 2021. CORONAVIRUS. “Facing a shortage of vaccinators, the Association of Immunization Managers… recommends relaxing regulation or adjusting licensing requirements. At least two states, Massachusetts and New York, have changed their laws in recent weeks to expand those who are eligible to give shots.”
POST 106. January 9, 2021. CORONAVIRUS. The riots at the Capitol could have been a superspreader event. “From what I saw… you had a large congregation of individuals who were in close contact for an extended period of time and almost universally unmasked…. many coming and going on buses as well, also unmasked, and hanging out in hotel lobbies.”
POST 107. January 8, 2021. CORONAVIRUS. “Our job is to make sure the vaccine isn’t politicized the way masks were politicized,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said after getting her vaccine. South Carolina Rep.-elect Nancy Mace, a Republican, wrote that “Congress shouldn’t be putting themselves first in line for the COVID-19 vaccination when the average American can’t get it.”
POST 108. January 9, 2021. CORONAVIRUS. (vaccination)”Line-cutters will be named and shamed. It’s inevitable, as will be the congressional hearings and front-page investigative stories ferreting out who saved their own skin at the expense of others.”
POST 109.January 9, 2021. CORONAVIRUS. “President-elect Joe Biden will aim to release nearly every available dose of the coronavirus vaccine when he takes office, a break with the Trump administration’s strategy of holding back half of US vaccine production to ensure second doses are available.
POST 110. January 13, 2021. CORONAVIRUS. ““The (federal) government is changing the way it allocates Covid vaccine doses, now basing it on how quickly states can administer shots and the size of their elderly population.”… “New York State sent a letter to hospitals saying if they don’t use their vaccine allocations by the end of this week, they won’t receive any further allocations.”
POST 111. January 14, 2021. CORONAVIRUS. “Visitors from Toronto to New York to Buenos Aires have long flocked to Florida for sun, surf and shopping. Now they are coming for the Covid-19 vaccine….
POST 112. January 14, 2021. CORONAVIRUS. CHINA – “Eleven million people are under lockdown in Hebei province after a new cluster of coronavirus infections.
PART 113. January 17, 2021. CORONAVIRUS. The Next President Actually Has a Covid Plan… New York City and other places in the state expect to exhaust their supply of doses as early as next week… Charles Barkley said during the “NBA on TNT” broadcast that pro athletes should get the first round of the vaccine…..
POST 114. January 18, 2021. CORONAVIRUS. “When government programs that have been unattended, underfunded and bogged down by red tape suddenly have to meet a huge demand in a crisis, they can’t cope and people suffer….”
POST 115. January 21, 2020. CORONAVIRUS. A year ago today an unnumbered POST was headlined “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.” The CORONAVIRUS CONTENT TRACKING PROJECT started with HISTORIOGRAPHY and over time moved to LESSONS LEARNED, RAPID RESPONSE, and THE VACCINATION PROGRAM. Now 115 POSTS later – the BIDEN CORONAVIRUS PLAN.
POST 116. January 22, 2021. President Biden – “We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation.”
POST 117. January 23, 2021. CORONAVIRUS. 1.Dr. Fauci:“The idea that you can get up here….”and.. let the science speak”… “It is somewhat of a liberating feeling.” 2.updated CDC guidance:”.. providers could give the second dose up to six weeks after the first dose..” 3.Dr. Fauci: people would be “taking a chance” if they follow the CDC’s updated guidance.
“In rare circumstances, it’s OK for people to receive one shot of Pfizer’s Covid-19 vaccine and one shot of Moderna’s vaccine at least 28 days apart, the CDC said in updated guidance.
“Most of the times Dr. Anthony S. Fauci made an appearance in the White House briefing room in 2020 — before eventually being banished from public view for his grim assessments of the coronavirus pandemic — he had President Donald J. Trump glowering over his shoulder.
On Thursday, Dr. Fauci, the nation’s foremost infectious disease specialist, was back, this time with no one telling him what to say. And he made no effort to hide how he felt about it.
“The idea that you can get up here and talk about what you know — what the evidence, what the science is — and know that’s it, let the science speak,” Dr. Fauci said, pausing for a second. “It is somewhat of a liberating feeling.”
Dr. Fauci’s presence in the room where Mr. Trump and other administration officials repeatedly spread misleading and false information about the virus was part of a daylong effort by the Biden administration to show a willingness to level with the public about how severe the pandemic is and what can be done to slow its spread…
But what he said about the virus on Thursday may have been less important than the mere fact that he was able to say it without the possibility that Mr. Trump or his aides would undercut him, challenge him or try to silence him.
As director of the government’s National Institute of Allergy and Infectious Diseases, Dr. Fauci has spent decades fighting the worst of the world’s diseases. He became something of a national celebrity as he sought to navigate the need to level with the public about the raging pandemic while dealing with Mr. Trump’s insistence that the threat was overblown and would “disappear” overnight.
Dr. Fauci recalled on Thursday how frustrating those days became.
“I don’t want to be going back over history, but it’s very clear that there were things that were said, be it regarding things like hydroxychloroquine and other things like that, that really was uncomfortable because they were not based on scientific fact,” he said, referring to Mr. Trump’s embrace of an unproven and untested drug for use as a treatment for the coronavirus.” (A)
“More than 40,000 people in Florida are overdue to receive their second dose of the coronavirus vaccine and officials say it is a problem some experts said they saw coming.
Out of the nearly 850,000 people who have been vaccinated in Florida, almost 80,000 have returned for their second shot.
Most people are still waiting for the time when they can get their booster shot, but the Florida Department of Health reports that 40,661 people are overdue for their second shot.” (B)
“New York Governor Andrew Cuomo said the state on Friday will run out of all the Covid-19 vaccines that have been delivered….
Mayor Bill de Blasio said the city postponed more than 22,000 appointments this week alone because of the shortage in supply. According to the city’s main vaccine page, all appointments scheduled at any of the 15 community COVID-19 vaccine hubs across the five boroughs for Thursday, Jan. 21, through Sunday, Jan. 24, are being rescheduled for one week from the original appointment….
All first responders in the city, including NYPD, FDNY and the hard-hit EMS workers, have had to suspend their first doses for the time being. The FDNY said they have enough doses to cover everyone from their department who has received a first dose to ensure everyone gets properly vaccinated. The fire department has vaccinated more than 7,100 of their 17,000 employees, while the NYPD has given dosages to 12,000 of their 54,000 members…
Second dose appointments have not been affected, officials said. The city does have vaccine centers apart from its “hubs,” including state-run facilities like the one at the Javits Center and two 24/7 sites. Those remain open, as do an additional three sites run by the city’s public hospital system, with another 45,000 doses having been administered Wednesday, the mayor said. But all are running low on doses…
More than 300,000 of those total doses are reserved for second shots; the city has administered 23 percent of those, which makes sense considering a person can’t have a second shot without a first — and supply has been prohibitive. Complicating matter further, the city said, was a shipment of 100,000 Moderna vaccines that never arrived.” (C)
“Ninety-seven percent of New York State’s vaccine inventory, accumulated over the past five weeks, has been administered, the governor noted, and a total of 28,000 first doses were left in inventory Friday morning. Mr. Cuomo added that the state inoculates roughly 80,000 people per day….
Mr. Cuomo urged vaccine providers to only schedule appointments based on the number of doses they know they will receive.
“Some providers think if they schedule appointments ahead of time, people will feel more comfortable — not if you cancel those appointments,” Mr. Cuomo said. “So don’t schedule any appointment unless you know you have an approved state allocation coming, and appointments will be honored. “
Some parts of the state — including New York City and the Rochester and Buffalo areas — have had to delay vaccination appointments scheduled for this week because of supply issues.
New York State should receive 250,400 vaccine doses for use next week, with some arriving Friday. If supply allowed, New York State could inoculate 700,000 people each week, Mr. Cuomo said.
On Friday afternoon, Mayor Bill de Blasio sent a letter to President Biden requesting more doses and the “flexibility” to use second doses to vaccinate more New Yorkers sooner.
“While maintaining a secure reserve of second doses (two-week supply), the City is seeking the flexibility during this time to temporarily use the remaining supply of second doses to bridge the gap to a time of increased production, replenishing the second dose supply as production ramps,” Mr. de Blasio’s letter to Mr. Biden read.
But it was not immediately clear whether the Biden administration could guarantee any increase in supply. Federal health officials and corporate executives agree that it will be impossible to increase supply before April because of the lack of manufacturing capacity. And the current vaccination effort, which had little central direction under the Trump administration, has so far sown confusion and frustration. Some areas are complaining they are running out of doses, while others have unused vials sitting on shelves.” (D)
“U.S. health authorities said it is OK to delay second doses of Covid-19 vaccines up to six weeks after the first injection, which for some shots would be twice as long as recommended.
The Covid-19 vaccines from Pfizer Inc. and BioNTech SE, as well as Moderna Inc., are given in two doses several weeks apart, with the second aimed at giving the fullest-possible protection. Pfizer’s shot is given three weeks apart and Moderna’s four weeks later.
The U.S. Centers for Disease Control and Prevention said Friday that health providers could give the second dose up to six weeks after the first dose, should they be unable to adhere to the recommended intervals. There is limited data on the efficacy of the vaccines beyond six weeks, the agency said.
Second doses shouldn’t be scheduled earlier than the recommended intervals, but they can be given within a grace period of four days earlier than the recommended date, the agency said.
Given the limited vaccine supply around the world, adjusting the schedules of doses has been scrutinized and been subject to debate by vaccine experts and other scientists. The U.K. has told the country’s state-run health service to delay second doses of the vaccines and give priority to getting initial doses into as many vulnerable people as quickly as possible. Parts of Canada and some countries in Europe followed with similar approaches.
The U.S. Food and Drug Administration has criticized tinkering with planned dosing schedules as too risky.” (E)
“The second dose should be administered as close to the recommended interval as possible,” the latest guidance says.
“However, if it is not feasible to adhere to the recommended interval, the second dose of Pfizer-BioNTech and Moderna COVID-19 vaccines may be scheduled for administration up to 6 weeks (42 days) after the first dose. There are currently limited data on efficacy of mRNA COVID-19 vaccines administered beyond this window. If the second dose is administered beyond these intervals, there is no need to restart the series.”
The updated CDC guidance appears to clarify earlier language that said “there is no maximum interval between the first and second doses for either vaccine.”
Delaying the second dose up to six weeks is in line with what WHO advisers said earlier this month.
CDC says its guidance may be updated as new information and new types of Covid-19 vaccines become available.
“You’re taking a chance, the data from the clinical trials, showed that in the Moderna trial, you should get the boost 28 days after the prime, that’s what I got, I got it exactly 28 days later, when you’re dealing with Pfizer it’s 21, that’s where the data show is the optimal effect,” Fauci told CNN Chris Cuomo on Thursday.
Fauci said it’s possible that delaying the second dose is “not going to be a big deal.” However, he said, we don’t know for sure because the vaccine data hasn’t been looked at for this extended time-period between doses.” (F)
“In rare circumstances, it’s OK for people to receive one shot of Pfizer’s Covid-19 vaccine and one shot of Moderna’s vaccine at least 28 days apart, the CDC said in updated guidance.
The agency says the two products are not interchangeable.
The CDC acknowledged that it hadn’t yet studied whether its new recommendations would change the safety or effectiveness of either vaccine.
The Centers for Disease Control and Prevention quietly changed its guidance on Covid-19 vaccine shots, saying it’s now OK to mix Pfizer’s and Moderna’s shots in “exceptional situations” and that it’s also fine to wait up to six weeks to get the second shot of either company’s two-dose immunization.
While Pfizer’s and Moderna’s vaccines, which both use messenger RNA technology, were authorized to be given 21 and 28 days apart, respectively, the agency now says you can receive either shot so long as they are given at least 28 days apart, according to new guidance posted Thursday on its website.
Although “every effort” should be made to ensure a patient receives the same vaccine, in rare situations “any available mRNA COVID-19 vaccine may be administered at a minimum interval of 28 days between doses” — if supplies are limited or the patient doesn’t know which vaccine they originally received, the CDC’s new guidance says.
The agency says the two products are not interchangeable, and acknowledged that it hadn’t yet studied whether its new recommendations would change the safety or effectiveness of either vaccine. But vaccine research specialists who spoke with CNBC said that the two immunizations are so similar in design that people shouldn’t be worried about the rare instances in which the doses will be mixed…” (G)
“Some experts say there are not enough data on the amount and length of protection these altered dosing schedules provide, however. They argue that the bigger problem is distributing the existing vaccine supply and that changing the schedules without rigorous evidence could compromise public trust in vaccines.
“We should really think long and hard any time we advise people to deviate from what the evidence actually shows in terms of efficacy, which has only been tested for those standard dosing regimens,” says Angela Rasmussen, a virologist at Georgetown University’s Center for Global Health Science and Security. “Before we start tinkering with the vaccine regimens, we should worry about making sure that we can actually give people the vaccines that we already have.”…
Here’s what the data suggest about tweaking vaccine doses.
The Pfizer-BioNTech and Moderna vaccines—both of which involve viral genetic material known as mRNA—were given to clinical trial participants in two doses (a “prime” dose followed by a “booster” three or four weeks later). After both doses, the Pfizer vaccine was found to be 95 percent effective in preventing COVID, and Moderna’s came in at 94.1 percent.
In the trials, the Pfizer vaccine provided partial immunity about two weeks after the first dose, with an efficacy of 82 percent. But there are no data on whether protection lasts longer than three weeks, when the second dose was given. Immunological evidence suggests the antibody response to the vaccine increased substantially after the second dose as well.
“While decisions on alternative dosing regimens reside with health authorities, Pfizer believes it is critical to conduct surveillance efforts on any alternative schedules implemented and to ensure each recipient is afforded the maximum possible protection, which means immunization with two doses of the vaccine,” the company said in a statement shared with Scientific American. Rasmussen agrees. “The bottom line is that there’s not really any efficacy to support a delayed second dose, at least of [the] Moderna and Pfizer [vaccines],” she says…
Some have also suggested skipping the second dose altogether. But given the lack of data on how long protection from a single dose lasts, many experts are wary of this idea.
“I don’t think a single dose with mRNA [which the Pfizer and Moderna vaccines rely on] makes any sense,” Crotty says. “There’s clearly a substantial increase in immune response after the booster immunization.”
Natalie Dean, a biostatistician at the University of Florida, agrees. “I think every company would have preferred to have a one-dose vaccine if it worked similarly well. But they made [the decision to have two doses] based on what was most likely to work and what they saw in the immunological data,” she says. The only way to truly know whether a single dose would work is to run a clinical trial, Dean notes. Doing so would likely require a lot of time and resources that are in short supply, however. By the time the trials would yield data, other vaccines might have been authorized and could alleviate the shortage…
Perhaps the most plausible suggestion put forth to extend the vaccine supply is to halve the dose of certain vaccines. Earlier this month, Moncef Slaoui, chief adviser of the Trump administration’s vaccine effort Operation Warp Speed, said officials were contemplating giving half-doses of the Moderna vaccine to Americans between the ages of 18 and 55. (This week Slaoui resigned from his position, but he will remain for 30 days.) In clinical trials, he said, people who received half of the Moderna vaccine’s 100 microgram dose had an identical immune response to those who received a full dose. But he added that it would ultimately be up to the FDA to decide whether to authorize such a change in dosing. Additionally, the data on half-doses were from a phase II clinical trial—so there is not sufficient evidence that half-doses prevent disease, Crotty notes.
Ultimately, the risks of altering data-backed vaccine-dosing strategies could outweigh the benefits. Discussions of changing the dosing regimen with no data to support them could create doubt and skepticism about the process and lead to increased vaccine hesitancy, Rasmussen says.
Crotty agrees. “In emergency situations, I think it’s reasonable to have [this] dialogue,” he says. “But in the end, I think it’s important to go with what’s proven.” (H)
“Twelve minutes before noon on Wednesday, President Joe Biden was sworn into office as the nation’s 46th president. Seven hours later, the United States reported more than 4,409 new deaths from the novel coronavirus, according to data collected by the COVID-19 Tracking Project.
The Biden administration came into power with purpose and an extensive agenda to combat the coronavirus pandemic, but purpose and planning only gets you so far—particularly when the president’s team is only just now getting a clear picture of how badly the previous administration had managed the crisis.
“What we’re inheriting from the Trump administration is so much worse than we could have imagined,” Jeff Zients, the Biden administration’s COVID-19 czar, said in a call with reporters Wednesday. “We don’t have the visibility that we would hope to have into supply and allocations.”
“I think we have to level-set expectations,” added Tom Frieden, the former director for the Centers for Disease Control in the Obama administration. “There are lots of things that an incoming administration can do on Day One, including speaking honestly about the pandemic.”
The new administration is already behind, in part because the Trump administration was unprecedentedly hostile during the transition. The question now, however, is how Biden can get a handle on a raging pandemic when his team is already so far behind.
The task at hand is enormous. More than 400,000 Americans have died of COVID-19. Every state, territory and the District of Columbia is in a state of emergency. The number of people infected with the virus who are now hospitalized is more than double the number reached during the spring and summer peaks…
More urgently, Biden and his team will have to handle the growing frustration among states over the lack of a comprehensive vaccine-distribution program that enables them to inoculate their residents quickly. They will have to find a way to get states more vaccines needed to meet Americans’ growing demand for the shot…
The former Trump administration built out the vaccine distribution process within the confines of Operation Warp Speed, a public-private partnership to fast-track a novel COVID-19 vaccine. In the first few months of its existence, Operation Warp Speed focused on development—creating the country’s first effective mRNA vaccine and supporting companies’ clinical trials. The distribution strategizing came later. Developed by the military, the plan was to have the federal government, specifically the military officials within Operation Warp Speed, lead the logistics part of the vaccine delivery. The military would not actually touch the vaccine but would instead coordinate the effort from the Pentagon….
Part of the confusion among states is how the newest Trump administration federal guidelines on vaccine distribution have impacted the manufacturing process. The Department of Health and Human Services, along with the Centers for Disease Control, recently released a new set of recommendations that allow states to hand out the vaccine more freely—to widen the population of who can receive the shot in the first wave. The federal government also said it would start to release doses it had originally held in reserve for second-shot dosing.
The recommendations almost worked too well—they ramped up demand significantly. Now, states say they don’t have enough doses.” (A)
NOVEMBER 9, 2020
“President-elect Biden’s transition team unveiled the members of his Covid-19 task force on Monday, a who’s-who of former government health officials, academics, and major figures in medicine.
The list includes Rick Bright, the former head of the vaccine-development agency BARDA ousted by the Trump administration in April; Atul Gawande, the surgeon, writer, and recently departed CEO of Haven, the joint JP Morgan Chase-Berkshire Hathaway-Amazon health care venture; and Luciana Borio, a former Food and Drug Administration official and biodefense specialist.
Biden has cast the escalating Covid-19 crisis as a priority for his incoming administration. The task force, he said, would quickly consult with state and local health officials on how to best prevent coronavirus spread, reopen schools and businesses, and address the racial disparities that have left communities of color harder hit than others by the pandemic.
“Dealing with the coronavirus pandemic is one of the most important battles our administration will face, and I will be informed by science and by experts,” Biden said in a statement Monday. “The advisory board will help shape my approach to managing the surge in reported infections; ensuring vaccines are safe, effective, and distributed efficiently, equitably, and free; and protecting at-risk populations.”
As expected, the board’s three co-chairs are Marcella Nunez-Smith, a Yale physician and researcher; Vivek Murthy, a former U.S. surgeon general; and David Kessler, a former FDA commissioner.
…the full list of task force members: David Kessler, co-chair, former FDA commissioner; Marcella Nunez-Smith, co-chair, Yale associate dean for health equity research; Vivek Murthy, co-chair, former surgeon general; Luciana Borio, former assistant FDA commissioner; Rick Bright, former BARDA director; Zeke Emanuel, former Obama administration health policy adviser; Atul Gawande, Brigham and Women’s hospital professor of surgery; Celine Gounder, NYU Grossman School of Medicine assistant professor; Dr. Julie Morita, former Chicago public health commissioner; Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota; Loyce Pace, executive director of the Global Health Council; Dr. Robert Rodriguez, UCSF emergency medicine professor; Eric Goosby, former Ryan White Care Act director. (B)
“Joe Biden’s transition team found a culture of coronavirus skepticism within Donald Trump’s federal government as they prepared to take office, sources close to the Biden transition told CNN, with political appointees loyal to the President reflecting his dismissiveness of public health guidelines and sometimes mocking career employees for wearing masks.
The findings from Biden’s agency review teams are some of the earliest readouts from the Biden officials who were tasked with preparing for the new administration and signal one of the most apparent early changes that the incoming administration will make. They observed a federal bureaucracy devoid of clear leadership on the pandemic, the sources said…
CNN has previously reported that current and former administration officials said there was no one in the White House or the National Security Council whose singular focus was to coordinate the Covid response among the Cabinet and various agencies. Efforts to mandate masks among government employees and inside government offices were shot down by the White House as Trump worked to portray strength and assure the public that the situation was under control. Even after Trump himself tested positive for Covid-19 and had to be hospitalized, staff within the West Wing largely opted against the use of masks….” (C)
“Mask-wearing represents one of three objectives Biden laid out in his speech, along with setting a goal of 100 million vaccine shots in the administration’s first 100 days and opening a majority of schools by the end of that time frame, a feat that he says will require more action by Congress.
Biden said the plan was developed with Dr. Anthony Fauci, who will serve as Biden’s chief medical adviser on COVID-19 and will maintain his role as director of the National Institute of Allergy and Infectious Diseases.
Fauci, who gave remarks by video, said that the plan is bold but doable and “essential to help the public avoid unnecessary risks, to help us save lives, reopen schools and businesses and to eventually beat the pandemic.”
Biden first announced key members of his health team on Monday, including his nomination of California Attorney General Xavier Becerra to lead the Health and Human Services Department…
Biden has also selected Jeff Zients, a veteran of the Obama administration, to be the White House coordinator of the coronavirus response.
Biden will nominate Dr. Vivek Murthy, a key coronavirus adviser to the president-elect, as surgeon general. Murthy was surgeon general during the Obama administration.
“The very best policies, and even the best vaccines and treatments, will not heal our nation unless we also overcome the fear, anxiety, anger and distrust that so many Americans are feeling right now,” Murthy said in his remarks…
Dr. Marcella Nunez-Smith, director of the Equity Research and Innovation Center at Yale School of Medicine, has been tapped to lead a new task force aimed at reducing disparities in response, care and treatment….
Biden will also nominate Dr. Rochelle Walensky, chief of infectious diseases at Massachusetts General Hospital, as the director of the Centers for Disease Control and Prevention.” (D)
““One last myth that I want to dispel is a concern that I’ve heard from some people that this vaccine was developed too fast, right? So, even the name of the entity in government that was charged with trying to figure out how to get a vaccine quickly was called Operation Warp Speed, right?” Vivek Murthy, who Biden has tapped to be surgeon general, said in a call with U.S. faith leaders this week.
He assured them the vaccines are safe and effective and asked for help communicating that message.
“For some people, they heard and they said, ‘Why is this happening so fast? Are there corners being cut? Are there safety precautions that are not being taken?’” he said.
The vaccine push will now be led by David Kessler, the former commissioner of the Food and Drug Administration, who will serve as chief science officer of Biden’s “Covid Response.” He will replace Moncef Slaoui, one of the officials who led what the Trump administration had called “Operation Warp Speed.” Another, General Gustave Perna, will remain as chief operating officer.
“Warp Speed” will be folded in to Kessler’s portfolio, which will be broader than vaccine development, one official said.
Kessler’s top priorities as chief science officer are ensuring every American who wants to be vaccinated gets a shot, building out a significant antiviral program and building major, sustainable manufacturing capability, in part so that a vaccine for another pathogen can be produced quickly if the U.S. ever needs it again, one official familiar with the matter said. (E)
The National Strategy provides a roadmap to guide America out of the worst public health crisis in a century. It outlines an actionable plan across the federal government to address the COVID-19 pandemic, including twelve initial executive actions issued by President Biden on his first two days in office:
The National Strategy is organized around seven goals:
1. Restore trust with the American people.
2. Mount a safe, effective, and comprehensive vaccination campaign.
3. Mitigate spread through expanding masking, testing, data, treatments,
health care workforce, and clear public health standards.
4. Immediately expand emergency relief and exercise the Defense Production Act.
5. Safely reopen schools, businesses, and travel while protecting workers.
6. Protect those most at risk and advance equity, including across racial, ethnic and rural/urban lines.
7. Restore U.S. leadership globally and build better preparedness for future threats.
To execute on the National Strategy, the White House will establish a COVID-19 Response Office responsible for coordinating the pandemic response across all federal departments and agencies. Through implementation of the National Strategy, the United States will make immediate progress on the seven goals. To monitor outcomes, the National Strategy includes the creation of publicly accessible performance dashboards, establishing a data-driven, evidence-based approach to evaluating America’s progress in the fight against COVID-19 (G)
President Joe Biden’s first full day in office on Thursday focused on rolling out his national strategy to get the coronavirus pandemic under control and signing several executive actions, including ramping up vaccination supplies and requiring international travelers to provide proof of a negative Covid-19 test prior to traveling to the US.
“Our national strategy is comprehensive, it’s based on science, not politics. It’s based on truth, not denial, and it’s detailed,” Biden said, speaking from the White House. He said the 198-page plan is posted on WhiteHouse.gov.
Biden’s plan starts with a national vaccination campaign in order to meet the President’s goal of administering 100 million shots, which is enough to cover 50 million Americans with vaccines that require two doses, in his first 100 days in office.
“We’re at Day 1,” Biden said.
He said the plan was developed with input from the nation’s top infectious disease expert, Dr. Anthony Fauci, among other advisers and experts. Fauci was at the event at the White House, along with Biden’s Covid czar Jeff Zients.
Biden said the American public would be “hearing a lot more from Dr. Fauci again, not from the President, but from the real genuine experts and scientists.”
Former President Donald Trump sidelined and undermined his own medical experts as the pandemic raged across the country.
“We’re going to make sure they work free from political interference and that they make decisions strictly based on science and health care alone, science and health alone, not what the political consequences are,” Biden said.
The day after being sworn-in, Biden signed at least 10 executive orders, memorandums and directives focused on tackling the pandemic, which, as of Thursday afternoon, has claimed the lives of more than 408,000 Americans and infected more than 24 million in the US.
Biden signed executive orders ramping up supplies for vaccination, testing and personal protective equipment and another boosting development of therapeutics to treat Covid-19. (H)
