‘The World Health Organization will reconvene an emergency committee on monkeypox due to the “evolving situation,” Director-General Dr. Tedros Adhanom Ghebreyesus said Wednesday—this after the organization declared Saturday that the virus wasn’t an international public health emergency “at present.”
The committee “advised that I should reconvene them quickly based on the evolving situation, which I will do,” Adhanom Ghebreyesus said at a press availability, adding that the virus is potentially poised to “move into high-risk groups including children, the immunocompromised, and pregnant women.”
“We are starting to see this with several children already infected,” he said.
The WHO did not immediately respond to an email inquiry regarding when the committee might meet.
Adhanom Ghebreyesus and the committee on Saturday acknowledged the situation should be “closely monitored,” and the decision not to declare an emergency be “reviewed after a few weeks,” noting the global outbreak’s “emergency nature” and the “intense response efforts” required to control it.
One or more of the following conditions should trigger a reassessment, they said:
Evidence of an increased growth rate in cases in the next three weeks.
Cases identified among sex workers.
An increase in cases in vulnerable groups like immunosuppressed individuals, those with poorly controlled HIV infection, pregnant women, and children.
An increase in morbidity or mortality and hospitalization rates.
Evidence of re-entry into the animal population.
Evidence of significant mutation affecting how the disease presents itself.
Evidence of clusters of cases of different clades with more significant virulence detected outside of West and Central Africa.
The news comes less than 24 hours after the White House announced the first phase of its national monkeypox vaccine strategy, saying it would release tens of thousands of doses “immediately” from the Strategic National Stockpile—with millions more on their way the coming weeks and months.” (A)
BEFORE THIS WHO ANNOUNCEMENT TO RECONVENE THE EMERGENCY COMMITTEE ON MONKEYPOX
“The World Health Organization on Saturday declined to declare the unprecedented monkeypox outbreak that has spread around the world a public health emergency as of now…
Despite the PHEIC decision, WHO Director-General Tedros Adhanom Ghebreyesus sought to underscore the seriousness of the threat, noting the convening an emergency committee in the first place was a sign of that. In a statement, Tedros noted that the outbreak “is clearly an evolving health threat” that “requires our collective attention and coordinated action now.” But he said that the committee that advised him on the issue decided that the outbreak did not yet constitute a PHEIC, and he agreed.
“What makes the current outbreak especially concerning is the rapid, continuing spread into new countries and regions and the risk of further, sustained transmission into vulnerable populations including people that are immunocompromised, pregnant women, and children,” Tedros said in the statement. “That is why it is urgent that all member states, communities and individuals take the recommendations of the committee for stepped-up surveillance, improved diagnostics community engagement and risk communication, and the appropriate use of therapeutics, vaccines, and public health measures including contact tracing and isolation.”
In a summary of the committee’s discussion, the WHO said the group acknowledged that facets of the outbreak are unusual and that the response clearly necessitated international efforts, but that “while a few members expressed differing views,” the committee reached a consensus that the outbreak did not amount to a PHEIC. The committee said it should reconsider the decision depending on whether cases accelerate in the next few weeks; more countries start reporting cases; if there are upticks in cases in other groups of people, including sex workers; and if there are any signs the virus is becoming more transmissible or starts causing more severe illness.
A PHEIC (pronounced like “fake”) describes an extraordinary or unusual health threat that poses risks to other places through international spread and requires a coordinated response. PHEICs are typically declared when urgent international action is needed…
In the past, monkeypox infections seen outside the countries where the virus is endemic have typically been imported cases or have involved limited household transmission. This is the first time the virus has started circulating more widely in other countries.
Gregg Gonsalves, an associate professor of epidemiology at Yale School of Public Health, disagreed with WHO’s decision, which he called a “punt.” He said he felt that the criteria had been met and that a PHEIC declaration could have pushed public health authorities to step up their response and coordinate better across countries.
Gonsalves served as an adviser to the emergency committee, but did not have a say in whether to recommend a PHEIC be declared.
“An expanding outbreak of this disease is not good for anyone,” he said, noting that African public health officials have been saying for years that monkeypox needs more global attention. “Right now, we are not on top of our game with monkeypox, at least in the United States,” he added, pointing to the patchy surveillance system and limited vaccine deployment.” (B)
“The overall risk is assessed as moderate at global level considering this is the first time that cases and clusters are reported concurrently in five WHO Regions. At the regional level, the risk is considered to be high in the European Region due to its report of a geographically widespread outbreak involving several newly-affected countries, as well as a somewhat atypical clinical presentation of cases. In other WHO Regions, the risk is considered moderate with consideration for epidemiological patterns, possible risk of importation of cases and capacities to detect cases and respond to the outbreak. In newly-affected countries, this is the first time that cases have mainly, but not exclusively, been confirmed among men who have had recent sexual contact with a new or multiple male* partners…
The risk is also represented by the difficulties involved in widespread lack of availability of laboratory diagnostics, antivirals and vaccines and as well as in ensuring adequate biosafety and biosecurity in diagnostic, clinical and referral laboratories everywhere that cases have occurred.
A large part of the population is vulnerable to monkeypox virus, as smallpox vaccination, which is expected to provide some protection against monkeypox has been discontinued since the 1980s. Only a relatively small number of military, frontline health professionals and laboratory workers have been vaccinated against smallpox in recent years. A third-generation vaccine MVA received authorization of use by the European Medicines Agency for smallpox. The authorization of use provided by Health Canada and the United States Food and Drug Administration (FDA) includes an indication for the prevention of monkeypox. An antiviral agent, tecovirimat, has been approved by the European Medicines Agency, Health Canada, and the United States FDA for the treatment of smallpox. It is also approved for use in the European Union for the treatment of monkeypox.
WHO urges all Member States, health authorities at all levels, clinicians, health and social sector partners, and academic, research and commercial partners to respond quickly to contain local spread and, by extension, the multi-country outbreak of monkeypox. Rapid action must be taken before the virus can be allowed to establish itself as a human pathogen with efficient person-to-person transmission in areas that have previously reported monkeypox, as well as in newly affected areas.” (C)
“The US Centers for Disease Control and Prevention announced on Tuesday the activation of its Emergency Operations Center (EOC) to respond to the US monkeypox outbreak.
The activation of the EOC “allows the agency to further increase operational support for the response to meet the outbreak’s evolving challenges,” the agency said in a news release.
This facility is currently activated for Covid-19 and is where experts monitor information on other public health emergencies, such as hurricanes, earthquakes and oil spills.
According to CDC’s webpage, the center works to outline a structure of response from the government and alongside non-government actors in emergency response.
Most recent data from the CDC show at least 244 probable or confirmed cases of monkeypox in the US.” (D)
“Nearly 60,000 doses of the Jynneos vaccine—the safer of two available—will be deployed from the stockpile, and nearly 250,000 additional doses will be made available in the coming weeks in an effort to slow spread of the disease. In the coming months, another 1.6 million doses will be released, federal health officials said on a Tuesday evening press call.
Individuals at high risk of contracting monkeypox and areas with the highest number of cases will be prioritized, officials added.
“While monkeypox poses minimal risk to most Americans, we are doing everything we can to offer vaccines to those at high-risk of contracting the virus,” U.S. Department of Health and Human Services Secretary Xavier Becerra said in a Tuesday evening news release. “This new strategy allows us to maximize the supply of currently available vaccines and reach those who are most vulnerable to the current outbreak.”” (A)
“Clinics nationwide will begin offering vaccinations against monkeypox to anyone who may have been exposed to the virus, federal health officials announced on Tuesday.
Until now, immunizations were offered only to people with a known exposure.
States will receive doses of a safer and newer monkeypox vaccine called Jynneos from the federal stockpile, based on the number of cases and the proportion of the state’s population at risk for severe disease, the officials said at a news briefing.
State health authorities may also request supplies of an older vaccine developed for smallpox, which is believed to protect against monkeypox, as well.
The Department of Health and Human services will provide 56,000 doses of the Jynneos vaccine immediately and an additional 240,000 doses in the coming weeks. Another 750,000 doses are expected to become available over the summer, and a total of 1.6 million doses by the end of this year.
“This vaccine currently has some limitations on supply, and for this reason the administration’s current vaccine strategy prioritizes making it available to those who need it most urgently,” Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said.
The older smallpox vaccine, called ACAM2000, is associated with harsh side effects, including death, in people who are immunocompromised, pregnant women and older adults.
The new vaccination plan drew quick criticism from experts, who said the campaign was too small and slow to make an impact. The longer it takes to contain the monkeypox outbreak, the greater the chances that the virus will become entrenched in the United States, particularly among men who have sex with men, researchers warned.
“Many of us are concerned that the window is closing for us to be able to eliminate monkeypox,” said Dr. Celine Gounder, an infectious disease expert and editor at large for public health at Kaiser Health News.
“If we don’t start vaccinating more quickly and broadly, we’re going to have a very difficult time containing this,” she said. Ideally, tests and vaccines for monkeypox could have been offered at L.G.B.T.Q. Pride events across the country in order to reach men at high risk of contracting the virus, Dr. Gounder added.
Some experts said the plan was also unfair to men at risk who will not have access to the Jynneos vaccine, especially those who have H.I.V. and cannot safely take the older smallpox vaccine.
“There won’t be enough to meet the need,” said Elizabeth Finley, director of communications for the National Coalition of STD Directors. “Plus, without better testing capacity, a strategy based on contacts with a positive case falls flat.”…
New York City, which had identified 55 cases of monkeypox as of Tuesday, had 1,000 doses of the Jynneos vaccine at hand. The city’s health department began administering the vaccines at a single clinic in Chelsea, where the clientele is largely affluent white men who have sex with men.
The city offered the first doses at noon on June 23. Less than two hours later, officials announced that the clinic could no longer accommodate walk-ins and had booked appointments through June 27. As of Tuesday, the city was still waiting for more vaccine doses to become available.” (E)
“The Biden administration announced steps to beef up its response to monkeypox on Tuesday, detailing plans to offer more vaccines and more tests to people who are most at risk of getting it — including men who have sex with men and their partners.
The move comes after pressure from states, who have been pushing the administration to release more doses of monkeypox vaccine from the Strategic National Stockpile managed by the Office of the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services. Critics have also charged that the United States is not offering enough testing to monitor the spread of the virus, which is thought to be more widespread than current case counts suggest.
The new plan tackles both. It will release more vaccines to areas with the highest case rates, and it will scale up testing, making tests available at five commercial laboratories in addition to an existing network of public health labs.
On Tuesday, HHS also activated the CDC’s Emergency Operations Center to give the agency more flexibility and manpower to manage the nation’s monkeypox response.
The new plan will allocate vaccine doses based on case rates in a state, focusing on men who have sex with men and their known partners, as well as anyone who thinks they might have been recently exposed to the virus as an anonymous partner.
“If you’re among those who have had a known exposure or in a group that is at higher risk for an exposure in the past two weeks, here’s what we’d like you to know,” said CDC Director Dr. Rochelle Walensky.
“Vaccination after exposure, or using vaccines for post-exposure prophylaxis, is meant to reduce your risk of becoming infected with a monkeypox virus and then become sick. Vaccination should occur within two weeks of a possible exposure, And the sooner you can get vaccinated after the exposure, the better.”
So far in the United States, there have been 306 cases of monkeypox identified across 28 jurisdictions. Globally, there have been more than 4,700 cases reported from 49 countries, she said.
Currently, 10 states would be considered to be in the first tier for priority in ordering vaccines.
The plan comes in the middle of Gay Pride, a month filled with parties celebrating gender and sexual diversity, and a season that many in public health have worried will only fuel the spread of the monkeypox virus, which is spread by close contact, including sex.
Currently, the only people who can get monkeypox vaccines are those with a known exposure, Walenksy said.
Given the large number of contacts and difficulty in identifying all contacts during the current outbreak, the new strategy will recommend vaccines for those who have a known exposure who are contacted by public health, as well as those who have been recently been exposed, but were not identified through contact tracing.
This includes those who had close physical contact with someone diagnosed with monkeypox, those who know their sexual partner was diagnosed with monkeypox, and men who have sex with men who have recently had multiple sex partners in a venue where there was known to be monkeypox or in an area where monkeypox is spreading.
The vaccination plan may require the US to use two different types of vaccines.
The first is a newer, modern vaccine called Jynneos which is manufactured by the Danish company Bavarian Nordic. It was evaluated and developed to treat monkeypox infection. The US currently has 64,000 doses of this vaccine in the stockpile. The government will make 56,000 of those doses available to states in the first phase of the roll out.
The US has ordered more of this vaccine, and the government plans to make 1.25 million more doses of the Jynneos vaccine available through the summer and fall, the administration said. There are 300,000 doses that were being held by the manufacturer that are currently on the way.
But, the US doesn’t have enough doses of Jynneos to vaccinate all who might want it, so public health officials are also considering whether to use a second, older type of vaccine called ACAM. The ACAM vaccine was developed to treat smallpox. It’s given by using a two pronged needle that’s repeatedly dipped into the vaccine and used to prick the skin on the upper arm, causing a small sore or “pock” to form.
“It’s a very kind of like, old-school technology that basically I don’t know any clinicians that actually know how to do that. So it’s actually very difficult to roll out because you have to train people in a new vaccine methodology,” said Dr. Jay Varma, professor and director of the Cornell Center for Pandemic Prevention and Response in New York City.
The other complications is that the ACAM vaccine uses a live, but weakened version of a virus to inoculate a person.
“It’s presumed not to be safe to be able to be used in people with HIV,” Varma said. The primary risk group for monkeypox — men who have sex with men — also has high rates of HIV infection.
On Tuesday, Walensky said that as more Jynneos vaccine arrives in the US, the country will adjust its strategy to include more people.
“You know, as soon as we have more vaccines available, we will of course continue to expand from a post-exposure prophylaxis strategy, ideally to a pre-exposure prophylaxis strategy,” Walensky said.
On Tuesday public health experts said that expansion would be important.
“It’s critical that we get vaccine out to the at-risk population and approach, vaccine use much as we’ve approached the pre exposure prophylaxis for HIV,” said Dr. Michael Osterholm who directs the Center for Infectious Disease Research and Policy at the University of Minnesota.” (F)
“The U.S. is underreacting to the monkeypox outbreak. Given that a vaccine is available for the infection—and can be targeted toward the people most at risk—public-health authorities and health-care providers need to move more quickly and forcefully to change the outbreak’s trajectory…
When the coronavirus spread worldwide in early 2020, we lacked an effective vaccine, so governments required masks, distancing, ventilation, testing, and contact tracing to try to minimize transmission until the COVID-19 shots arrived. The world is not at the same disadvantage with monkeypox; we have a vaccine, and our current attempts to test and contact trace our way out of this epidemic are failing. A swift, targeted vaccination campaign—one that identifies Americans at risk and persuades them to get a shot—is far more likely to stop the monkeypox outbreak.
Different diseases require different responses. The coronavirus is becoming endemic because it spreads quickly and easily, and even high-quality vaccines that protect against severe disease do not prevent initial infection or reinfection. Smallpox, among the most deadly pathogens in history, could be eliminated because of four distinguishing features that most human pathogens do not have: Its symptoms—most notably, the skin rash it causes—are very characteristic, so doctors could easily identify patients who had it; its infectious period was short; new infections were preventable by a highly effective vaccine; and the virus had no animal reservoirs from which it could infect unvaccinated humans. As such, routine smallpox vaccinations for U.S. populations were stopped in 1972. Yet because of the cessation of mass vaccination programs for smallpox, humans have waning protection from monkeypox…
Many of the current cases are in MSM ages 30 to 55, at first linked to two large raves held in Spain and Belgium. Of note, sexual transmission of monkeypox has never previously been described. Although monkeypox has been reported in semen, the most likely route of spread during the current outbreak is the close skin-to-skin and respiratory contact during sexual activity. Moreover, transmission from prolonged face-to-face contact can put household members and other close contacts of active cases at greater risk.
That monkeypox is spreading among gay men has led to calls to postpone this month’s Pride celebrations, and the CDC has faced some criticism for recent messaging that offers tips on how to avoid the pathogen during sex. Yet the agencies are following the well-grounded concept of harm reduction—which calls for both minimizing the impact of a health threat while also recognizing the other needs of the individuals and society involved. People crave companionship and intimacy, and messages that ignore those needs and recommend complete abstinence are unlikely to succeed. Harm reduction is the basis of most current public-health messaging about reducing HIV risk, and is profoundly important in the field of addiction and substance use.
Health agencies deserve credit for trying to minimize stigma in their communication, even as they recognize that relevant communities need to be alerted to how this particular outbreak is being spread. (The WHO is also considering a change in the very name monkeypox to prevent stigma against the geographic areas originally connected with the disease and to banish associations with animals that appear to play little role in its spread.)” (G)
“The monkeypox outbreak that health authorities first noticed in Europe back in May is getting worse. According to the World Health Organization’s latest report, there are over 2,100 confirmed cases, and at least one person has died.
Now geneticists finally have enough data to begin getting a handle on how exactly the outbreak started—and where it might be heading.
It’s not good news. Monkeypox, a viral disease that causes fever and a rash and can be fatal in a small percentage of cases, is endemic in Africa. And now it’s running amuck on every other permanently inhabited continent—and evolving quickly. While health officials have all the tools they need to contain it—primarily contact-tracing and vaccines—right now the virus is moving faster than we are, and adapting.
The current strain of monkeypox may have been circulating, undetected, months before we finally diagnosed the first case outside Africa. And because there are so many more copies of the virus than we first expected, each mutating separately, this new pox strain could evolve into dangerous new forms with disturbing speed.
The pox mostly spreads through close physical contact, especially sexual contact. It’s not a sexually transmitted disease, however. It just takes advantage of the skin-to-skin contact that accompanies sex. The virus can also travel short distances on spittle, although probably not far enough to qualify as “airborne.”
Monkeypox occasionally spreads to places where it’s not already endemic. In 2003, 47 people in the U.S. got sick with the West African strain after exposure to a shipment of pet rodents from Ghana to Texas. A rapid response by state and federal health officials—and a few doses of smallpox vaccine, which also works on monkeypox—prevented anyone dying and temporarily eliminated the virus in the U.S.
“Because there are so many more copies of the virus than we first expected, each mutating separately, this new pox strain could evolve into dangerous new forms with disturbing speed.”
Officials first noticed the current outbreak, also of the West African strain, after diagnosing a U.K. traveler returning from Nigeria in early May. Hitching a ride to Europe, the virus spread quickly through physical contact. David Heymann, who formerly headed the World Health Organization’s emergencies department, said that men attending raves in Spain and Belgium “amplified” the outbreak—apparently through close, sometimes sexual, contact with other men.
After that, the virus accompanied travelers on planes heading for countries far and wide. Doctors diagnosed the first U.S. case on May 27. As of Thursday, the U.S. Centers for Disease Control had tallied around 3,500 cases in 44 countries, including 172 in the U.S.
Just one person has died of the pox in the current outbreak—in Nigeria. But serious illness and death can lag an actual diagnosis by several weeks, so it’s possible many more deaths are coming.
Worse, on June 3 the CDC announced it had found genetic evidence of U.S. pox cases that predated the first cases in Europe from May. Doctors may not have noticed or reported these earlier cases, at first, owing to the similarity between pox symptoms and the symptoms of some common sexually-transmitted diseases such as herpes.
There was some speculation that the earlier U.S. cases were part of a totally separate outbreak that just happened to overlap with the May outbreak. Isidro and her team sequenced 15 samples taken from current pox patients and concluded that, no, there’s just one big outbreak. “All outbreak MPX strains sequenced so far tightly cluster together, suggesting that the ongoing outbreak has a single origin,” they wrote, using the scientific acronym for monkeypox…
One particularly disturbing possibility is that the pox is often or even usually circulating to some degree in non-endemic countries, but we rarely notice unless there’s a big surge in infections that compels doctors to look more closely at symptoms that could easily be mistaken for something else. Say, herpes. “When you start looking for something, you find it,” Michael Wiley, a public health expert at the University of Nebraska Medical Center who was not involved with the new study, told The Daily Beast.
In any event, undetected or overlapping transmission vectors are alarming—and not just because they could mean faster viral spread to more places before authorities finally, hopefully, contain an outbreak. No, the multiple introductions also represent an opportunity for a virus to mutate more, or more quickly, than usual.
When it comes to viral diseases, every infected person is a kind of living laboratory—a place where the virus can interact with the human immune system’s antibodies and T-cells and develop countermeasures. The more separate chains of transmission we hand the pox, the more likely the virus is to mutate along these vectors in some way that benefits it and hurts us. For example, developing resistance to our vaccines and antibodies…
Monkeypox may have been hiding in plain sight long before we finally noticed it two months ago. Maybe this strain of the virus got lucky and more than one traveler helped spread it outside Africa nearly simultaneously. Maybe it’s evolving faster because it’s getting cleverer. More likely, it’s changing at its current fast clip because there are so many more copies of the virus than we first expected, each mutating every chance it gets.” (H)
“Monkeypox cases continue to rise across the nation, with approximately 200 cases confirmed by the Centers for Disease Control and Prevention as of Monday afternoon.
Despite the rising number of cases, David J. Cennimo, an associate professor of medicine and pediatrics in the Division of Infectious Diseases at Rutgers New Jersey Medical School, said the overall caseload is still low.
“We’re finding cases, so I think that awareness of the disease is important because the more people are aware of monkeypox, especially if they are having symptoms, they’re going to seek medical care and that’s important for us to do good case finding,” he said.
Cennimo compared the current outbreak to one that occurred in 2003, which infected 47 people across six states after originating in Gambian pouched rats imported from Ghana.
He said that what worked to curb the virus two decades ago was alerting people who had come in contact with the pouched rats and advising them to avoid contact with others if they developed lesions, which is a symptom of monkeypox. Now, times have changed, he said, explaining that the current epidemiology indicates that the disease is being sexually transmitted.
Cennimo said that he has been advising patients to practice safe sex, especially those in heavily populated hotspots like the New York City metro area where people may have more than one sexual partner and thus increase their risk for infection.
This also means that public health officials should focus on messaging campaigns that emphasize how crucial it is to identify and report symptoms among at-risk patients without stigmatizing those who get infected.
“I’m hoping we can basically handle this the way we did in 2003 because what we definitely don’t want to see happen is monkeypox becoming another endemic virus,” he said. “If we can break the cycle of transmission now, take care of people who are already infected and not infect other people, in theory, we could do that.”
Another challenge facing public health officials, he said, is highlighting the dangers associated with monkeypox without causing a panic among the general public. Cennimo added that since the country is still dealing with the lingering effects of the COVID-19 pandemic, officials are faced with duelling priorities.” (I)
“As if dealing with continued waves of Covid-19 isn’t enough, the U.S. is facing a new outbreak — monkeypox — that highlights just how close the U.S. public health system is to its breaking point.
While monkeypox has not technically been categorized as a sexually transmitted infection (STI), it looks and acts like common STIs and shares the same barriers to detection and treatment, including stigma and access to knowledgeable providers.
For people like me who are working inside the broad national response to monkeypox, there are loud echoes of the earliest days of Covid-19 and, longer ago, of AIDS. But understanding the country’s capacity to contain monkeypox requires an examination of the STI epidemic that the nation has ignored for years, which is why these diseases continue to be out of control…
If HIV and Covid-19 were wake-up calls for the government to prioritize public health, monkeypox shows the consequences of hitting the snooze button too many times. HIV showed the importance of creating an infrastructure of health care workers who can provide approachable, competent care for stigmatized infections. Covid-19 revealed the make-or-break nature of coordinated logistics and communications.
The U.S. is at a crossroads regarding sexually transmitted infections. It can mount an effective monkeypox response and provide communities across the country with the infrastructure needed to promote health care for everyone. Or it can continue to play catchup in crisis after crisis and let common infections continue to rage in between.” (J)
“Some U.S. adults are a step closer to getting updated COVID-19 boosters this fall, as government advisers voted Tuesday that it’s time to tweak shots to better match the most recent virus variants.
The Food and Drug Administration will have to decide the exact recipe but expect a combination shot that adds protection against a version of the super-contagious omicron variant to the original vaccine.
Advisers to the FDA voted 19-2 that some version of omicron should be part a fall booster campaign, an effort to blunt an expected COVID-19 surge.
“We are going to be behind the eight-ball if we wait longer,” agreed Dr. Mark Sawyer of the University of California, San Diego.
Pfizer says its tweaked COVID-19 shots boost protection against the omicron variant…
Pfizer and Moderna tested shots updated to better match the omicron that surged over the winter, but that first mutant has disappeared — replaced by its genetically distinct relatives. The two newest omicron cousins, called BA.4 and BA.5, together now make up half of U.S. cases, according to the Centers for Disease Control and Prevention…
Both Moderna and Pfizer found what scientists call “bivalent” shots — a combination of the original vaccine plus omicron protection — substantially boosted levels of antibodies capable of fighting that variant, more than simply giving another regular dose. Many scientists favor the combination approach because it preserves the original vaccines’ proven benefits, which include some cross-protection against other mutants that have cropped up during the pandemic.
Both companies found the tweaked shots also boosted antibodies against BA.4 and BA.5 but not by nearly as many.” (K)
(A) WHO monkeypox emergency committee to reconvene due to ‘evolving situation’, ERIN PRATER,
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
POST 96. December 26, 2020. CORONAVIRUS. “Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci…”…”..he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….”
POST 97. December 27, 2020. “A new variant of the coronavirus that has been spreading through the UK and other countries has not yet been detected in the United States..”.. . But if new-wave medicines like antivirals and antibody therapy contributed to the development of viral variants, it will be “a reminder for all the medical community that we need to use these treatment options carefully.”
POST 99. December 29, 2020. CORONAVIRUS. “ICUs are being overwhelmed across many parts of California. Statewide aggregate ICU availability has been at 0% since Christmas Eve…. a surge on top of a surge on top of a surge.”… “hospitals are getting close to the point where they would begin putting COVID-positive patients under the care of COVID-positive staff who are asymptomatic.”
POST 100. December 29, 2020. CORONAVIRUS. Front line hospital workers – in the ER, ICUs, EMS, acute medical care, behavioral health – are amongst the most courageous, heroic and dedicated colleagues you will ever meet.
POST 101. December 30, 2020.CORONAVIRUS. Is there a point where the increasing Coronavirus trajectory so far exceeds the slow growth of the vaccination rate that reaching herd immunity through vaccinations becomes less likely?
POST 102. January 2, 2020. CORONAVIRUS. “We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination — which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, the dean of Brown University’s School of Public Health. “Ultimately, the buck seems to stop with no one,”…
POST 103. January 4, 2021. CORONAVIRUS. Dr. Fauci said “that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses…Dr. Moore – ”British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”
POST 104. January 6, 2021. CORONAVIRUS. “Paramedics in Southern California are being told to conserve oxygen and not to bring patients to the hospital who have little chance of survival…”
POST 105. January 8, 2021. CORONAVIRUS. POST 105. January 8, 2021. CORONAVIRUS. “Facing a shortage of vaccinators, the Association of Immunization Managers… recommends relaxing regulation or adjusting licensing requirements. At least two states, Massachusetts and New York, have changed their laws in recent weeks to expand those who are eligible to give shots.”
POST 106. January 9, 2021. CORONAVIRUS. The riots at the Capitol could have been a superspreader event. “From what I saw… you had a large congregation of individuals who were in close contact for an extended period of time and almost universally unmasked…. many coming and going on buses as well, also unmasked, and hanging out in hotel lobbies.”
POST 107. January 8, 2021. CORONAVIRUS. “Our job is to make sure the vaccine isn’t politicized the way masks were politicized,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said after getting her vaccine. South Carolina Rep.-elect Nancy Mace, a Republican, wrote that “Congress shouldn’t be putting themselves first in line for the COVID-19 vaccination when the average American can’t get it.”
POST 108. January 9, 2021. CORONAVIRUS. (vaccination)”Line-cutters will be named and shamed. It’s inevitable, as will be the congressional hearings and front-page investigative stories ferreting out who saved their own skin at the expense of others.”
POST 109.January 9, 2021. CORONAVIRUS. “President-elect Joe Biden will aim to release nearly every available dose of the coronavirus vaccine when he takes office, a break with the Trump administration’s strategy of holding back half of US vaccine production to ensure second doses are available.
POST 110. January 13, 2021. CORONAVIRUS. ““The (federal) government is changing the way it allocates Covid vaccine doses, now basing it on how quickly states can administer shots and the size of their elderly population.”… “New York State sent a letter to hospitals saying if they don’t use their vaccine allocations by the end of this week, they won’t receive any further allocations.”
POST 111. January 14, 2021. CORONAVIRUS. “Visitors from Toronto to New York to Buenos Aires have long flocked to Florida for sun, surf and shopping. Now they are coming for the Covid-19 vaccine….
POST 112. January 14, 2021. CORONAVIRUS. CHINA – “Eleven million people are under lockdown in Hebei province after a new cluster of coronavirus infections.
PART 113. January 17, 2021. CORONAVIRUS. The Next President Actually Has a Covid Plan… New York City and other places in the state expect to exhaust their supply of doses as early as next week… Charles Barkley said during the “NBA on TNT” broadcast that pro athletes should get the first round of the vaccine…..
POST 114. January 18, 2021. CORONAVIRUS. “When government programs that have been unattended, underfunded and bogged down by red tape suddenly have to meet a huge demand in a crisis, they can’t cope and people suffer….”
POST 115. January 21, 2020. CORONAVIRUS. A year ago today an unnumbered POST was headlined “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.” The CORONAVIRUS CONTENT TRACKING PROJECT started with HISTORIOGRAPHY and over time moved to LESSONS LEARNED, RAPID RESPONSE, and THE VACCINATION PROGRAM. Now 115 POSTS later – the BIDEN CORONAVIRUS PLAN.
POST 116. January 22, 2021. President Biden – “We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation.”
POST 117. January 23, 2021. CORONAVIRUS. 1.Dr. Fauci:“The idea that you can get up here….”and.. let the science speak”… “It is somewhat of a liberating feeling.” 2.updated CDC guidance:”.. providers could give the second dose up to six weeks after the first dose..” 3.Dr. Fauci: people would be “taking a chance” if they follow the CDC’s updated guidance.
POST 118. January 24, 2021. CORONAVIRUS. “Unfortunately, we’ve let this virus spread extensively and are launching the vaccination campaign at the height of the threat,” Dr. Meyers said. “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.”
POST 119. January 27, 2010. CORONAVIRUS. Amazon is offering its help to President Joe Biden with the rollout of COVID-19 vaccines. Washington’s governor, Jay Inslee, included the help of companies like Starbucks, Costco and Microsoft in a plan to vaccinate 45,000 residents a day.
POST 120. January 28, 2021. CORONAVIRUS. “The fact that four vaccines backed by the federal government seem to be less effective against the (South African) B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.”
POST 121. January 30, 2021. CORONVIRUS. Will our communities become stratified by which vaccine is distributed? 95%ters v. 72%ters? Will the easier distribution of the J&J vaccine drive its inequitable distribution to” hard-hit, marginalized, and medically underserved communities.” (thanx! to XJ/LA)
POST 123. February 4, 2021. CORONAVIRUS. “Nursing homes across the country are facing the same struggle, as workers have been more reluctant than residents to be vaccinated…
POST 124. February 5, 2021. CORONAVIRUS. Dr. Osterholm ” …it may be time to..go with a ‘first-dose only’ approach, so more people over the age of 65 can have at least some protection right away. He said that would require delaying second doses until this summer.” Dr.Fauci “warned against this practice, and cautioned people about “the danger” that could come with focusing only on the first dose.”
POST 125. June 9, 2021. CORONAVIRUS. “States are rolling back Covid-19 restrictions as new cases trend down from record highs across the country. But experts warn it might be too much too soon as variants pose an increased risk and the pandemic… is far from over.”
POST 126. February 11, 2021. CORONAVIRUS. “There will be more coronavirus outbreaks in the future. Bats and other mammals are rife with strains and species of this abundant family of viruses. Some of these pathogens will inevitably spill over the species barrier and cause new pandemics. It’s only a matter of time.” (A)
POST 127. February 12, 2021. CORONAVIRUS. “… Trump only agreed to be hospitalized when aides told him that he could walk to Marine One or he could wait until his case progressed and he would be carried out.”
POST 128. February 14, 2021. CORONAVIRUS. “The Centers for Disease Control and Prevention released new research on Wednesday that found wearing a cloth mask over a surgical mask offers more protection against the coronavirus, as does tying knots on the ear loops of surgical masks…
POST 129. February 15, 2021, CORONAVIRUS. “ “The CDC released its much-anticipated, updated guidance to help school leaders decide how to safely bring students back into classrooms, or keep them there.”…” For politicians, parents and school leaders looking for a clear green light to reopen schools, this is not it.”
POST 130. February 16, 2021. CORONAVIRUS. “A second person who had contracted the Ebola virus died this week in the Democratic Republic of Congo, marking another outbreak just three months after the nation outlasted the virus’s second-worst outbreak in history…”
POST 131. February 17, 2021. CORONAVIRUS. “It really is right now – a race between how quickly new variants, particularly the U.K. variant, can spread in the United States and how quickly we can get people vaccinated”
POST 132. February 20, 2021. CORONAVIRUS. “In Texas, where over 2.5 million people are still without power, the state health department said this week’s vaccine shipments wouldn’t arrive until Wednesday at the earliest.”
POST 133. February 23, 2021. CORONAVIRUS. “Going off your meds is a surefire way to aggravate your doctor. What if a whole country did it?” The United Kingdom has veered into uncharted territory by changing tack and introducing a revised COVID-19 vaccination protocol, one that involves distributing the second dose at 12 weeks, rather than the prescribed 21 days.”
POST 134. February 24, 2021. CORONAVIRUS. The first tranche of the J&J (single dose) vaccine must go to K-12 teachers, so schools can open safely in the first 100 days of the Biden Administration. The federal government…”can set up its own vaccination centers in regions with eligible populations it’s trying to target.” We owe our front-line teachers nothing less!
POST 135. February 27, 2021. CORONAVIRUS. “As Chief Executive Officers of New York’s major health care systems, we would like to provide facts to clear up confusion in the public and the media regarding decisions to discharge patients to nursing homes during New York’s spring coronavirus surge.”
POST 136. March 2, 2021. CORONAVIRUS. ““The governors of Texas and Mississippi both announced on Tuesday they would be lifting their states’ mask mandates and rolling back many of their Covid-19 health mandates..”…while “The US could experience a “fourth surge” of coronavirus before the majority of the country is vaccinated.”
POST 137. March 4, 2021. CORONAVIRUS. “The clamor for hard-to-get Covid-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system. They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow? Some pharmacists have even given them a nickname: vaccine lurkers.” (H)
POST 138. March 6, 2021. CORONAVIRUS. “New cases are decreasing in the third wave because we are past the holidays, not because of vaccinations. It is a common misconception that the decrease we are seeing in new cases, hospitalizations, and deaths in the U.S. is due to vaccinations. The two aren’t related; at least yet.”
POST 139. March 8, 2021. CORONAVIRUS. CDC Issues First Set of Guidelines on How Fully Vaccinated People Can Visit Safely with Others…” In practice, that means fully vaccinated grandparents may visit unvaccinated healthy adult children and healthy grandchildren of the same household without masks or physical distancing.” (C)
POST 140. March 9, 2021. CORONAVIRUS. “In West Virginia, they are bracing for the second wave….. Not coronavirus but opioid overdoses, with one scourge driving a resurgence of the other.
POST 141. March 11, 2021. CORONAVIRUS. Today is the first anniversary of the WHO declaration that the novel coronavirus was a Public Health Emergency of International Concern… “To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like.”
POST 142. March 15, 2021. CORONAVIRUS. “Candida auris is a superbug, a pathogen that can evade drugs made to kill it—and early signs suggest the COVID-19 pandemic may be propelling infections of the highly dangerous yeast. That’s because C. auris is particularly prominent in hospital settings, which have been flooded with people this year due to the coronavirus.”
POST 143. March 17, 2021. CORONAVIRUS. “The Trump administration sought to suppress Covid-19 testing in the United States last year by softening guidance from the Centers for Disease Control and Prevention on who needed to be tested, a House panel said Monday.”
POST 144. March 20, 2021. CORONAVIRUS. ““The vaccine hesitancy we are seeing isn’t just about Covid vaccines,”… “It is a general reflection of Americans’ lack of trust in science, the pharmaceutical industry, and large health care institutions. We need a full court press on science and vaccine education right now to prevent more aggressive Covid-19 variants from developing and taking hold.”
POST 145. March 25, 2021. CORONAVIRUS. “Efforts to disseminate Covid-19 vaccines as widely as possible are hitting an unexpected obstacle: health-care workers who decline the shots.
POST 146. March 30, 2021. CORONAVIRUS. Dr. Osterholm told Becker’s: “This is the perfect storm,”…”Here is Europe locking down and having problems containing B.1.1.7, even with vaccinations and previous infection histories. Here we are opening up as wide as we can. We are literally just walking into the mouth of the virus saying, ‘Don’t worry.’” (M)
POST 147. April 5, 2021. CORONAVIRUS. “The pandemic helped cement the shift to “a philosophy of really focusing on the role of the physician in reasoning through ambiguous and unknown problems as the focus of education, rather than teaching students that the role of physician was to memorize a body of knowledge that was already in existence and good enough for what usually happens.”
POST 148. April 7, 2021. CORONAVIRUS. While the Biden administration accelerates vaccinations to ward off numerous variants and as more young people are being hospitalized, states, even with increasing case rates are on paths to fully reopen. Politics v. public health!
POST 149. April 10, 2021. CORONAVIRIUS. “From Michigan to Massachusetts, COVID-19 cases and hospitalizations are on the rise again. Deaths will soon follow. “ ”.. the Biden administration is facing renewed calls to delay second vaccine doses and blanket more of the U.S. population with an initial shot.”
POST 150. April 10, 2021. CORONAVIRUS. “The use of so-called COVID-19 “vaccine passports” is quickly becoming a divisive issue across the US – with several states, including New York, embracing the idea, while others have already moved to ban them.”
POST 151. April 14, 2021. CORONAVIRUS. the J&J vaccination pause. “ Federal officials are concerned that doctors may not be trained to spot or treat the rare disorder if recipients of the vaccine develop symptoms of it…” “…a standard treatment for blood clots — use of an anticoagulant drug — could be dangerous or even fatal in such cases…”
POST 152. April 15, 2021. CORONAVIRUS. “The Chinese Center for Disease Control and Prevention’s director said Saturday authorities are considering mixing COVID-19 vaccines because the country’s domestically made doses “don’t have very high protection rates,”
POST 153. April 18, 2021. CORONAVIRUS. “At least 35 hospitals across Michigan were listed Thursday as nearing capacity and three were at full capacity for COVID-19 patients..”.. We can manufacture beds. We can open up beds. We can create entire wings of the hospital if we have to, but if we don’t have staff for those beds, we’ve got nothing.”..
POST 154. April 19, 2021. CORONAVIRUS. “Breakthrough infections, which occur when fully vaccinated people are infected by the pathogen that their shots were designed to protect against, are an entirely expected part of any vaccination process.” “Pfizer’s chief executive said that a third dose of the company’s Covid-19 vaccine was “likely” to be needed within a year of the initial two-dose inoculation — followed by annual vaccinations.”
POST 155. April 24, 2021. CORONAVIRUS. As the J&J vaccine pause is ended Senator Johnson said “The science tells us that vaccines are 95% effective. So if you have a vaccine, quite honestly, what do you care if your neighbor has one or not? I mean, what is it to you?”
POST 156. April 28, 2021. CORONAVIRUS. As CDC revises guidance on outdoor masking, Texas Governor Abbott says “the state is “very close” to herd immunity… despite acknowledging that he does not know what the herd immunity threshold is for the virus, an uncertainty echoed by the public health community.”
POST 157. April 25, 2021. CORONAVIRUS. Ohio hospitals; “We agreed in multiple conversations, there’s nothing in fighting a pandemic that creates a competitive advantage.”…
POST 158. May 5, 2021. CORONAVIRUS. . As populations get closer to herd immunity “ it may be helpful to introduce some nuance to what we mean by the term. Nationwide herd immunity. Regional herd immunity. Temporary herd immunity. Endemicity.”
POST 159. May 9, 2021. CORONAVIRUS. “Without deeper sharing of expertise in how to make vaccines…waiving patent obligations is unlikely to be a game-changer… Having access to the “recipe” certainly helps, but understanding how to put it together and produce it at scale is something else.”
POST 160. May 13, 2021.CORONAVIRUS. “The CDC acknowledged Friday that airborne spread of COVID-19 among people more than 6 feet apart “has been repeatedly documented.”” Meanwhile states relax or eliminate indoor dining restrictions. HUH?
POST 161. May 15, 2021. CORONAVIRUS. “Even if the spread of Covid-19 decreases enough to allow a return of most activities, there are some aspects of pandemic life that epidemiologists say will persist much longer. In particular, they say that masks are a norm that should continue, even if that view puts them at odds with the new C.D.C. guidance. More than 80 percent of them say people should continue to wear masks when indoors with strangers for at least another year, and outdoors in crowds.”
POST 162. May 21, 2021. CORONAVIRUS. “New Jersey Gov. Phil Murphy is refusing to lift his indoor mask mandate for vaccinated residents…” “…fully vaccinated residents in New York and Connecticut are no longer required to wear masks..”..” “California says it isn’t ready to follow the federal lead and unmask, at least for another month..”.. “..Texas Gov. Greg Abbott issued an executive order Tuesday prohibiting state governmental entities such as counties, public school districts, public health authorities and government officials from requiring mask wearing.”
POST 163. May 23, 2021. CORONAVIRUS. RWJBarnabas Health in New Jersey announced a mandate…saying supervisors and those of higher rank must get the vaccine by June 30. They will eventually require the system’s 35,000 employees to do the same.
POST 164. May 26, 2021. CORONAVIRUS. On Wednesday, health minister Norihisa Tamura warned Olympic organizers they would have to “secure their own” hospital beds for anyone falling ill at the Games, explaining the government would not release beds set aside for Japanese covid-19 patients.”
POST 165. May 31,2001. CORONAVIRUS. “Like all pandemics, this one will end either with millions — maybe billions — being infected or being vaccinated. This time, world leaders have a choice, but little time to make that choice before it is made for them.”
POST 166. June 3, 2020. CORONAVIRUS. “President Biden said Wednesday that he has asked intelligence agencies to double down on their efforts to investigate whether the coronavirus originated from human contact with an animal or in an laboratory in China, saying there is not “sufficient information” to assess whether one is more likely than the other.”
POST 167. June 9, 2021. CORONAVIRUS. Hospitals prevaricate on mandatory staff vaccinations. Florida’s Governor forbids cruise ship vaccine mandates. Pfizer and Moderna apply for FDA full approval.
POST 168. June 10, 2021. CORONAVIRUS. “Our species has a tendency to get distracted. We have a very strong appetite for distraction, and when something is not in the spotlight, when it’s not a crisis anymore, we tend to forget and move on to something else. So the biggest challenge is going to be maintaining focus on this next step of developing vaccines that anticipate pandemics.”
POST 169. June 14, 2021. CORONAVIRUS. “Hospitals in Washington, D.C…announced a consensus agreement to mandate COVID-19 vaccinations for more than 30,000 workers, 70% of which are already vaccinated. Each of 14 hospitals will set their own deadline…”
POST 170. June 17, 2021. CORONAVIRUS. “Dr. Ashish Jha…is worried about the potential impact the delta variant could have in the United States… “I’m concerned about the Delta variant,”… “Why? Most contagious variant yet. Wreaked havoc in India. Spiking cases in UK. Growing rapidly in the US.”
POST 171. June 19, 2021. “A 34-year-old man (a Covid-19 survivor) has been diagnosed with India’s first known case of “green fungus” infection.”… “Green fungus is the new infection to join the earlier known cases of black, white and yellow fungus.”…”green fungus was earlier seen only as a “junior partner” in other infections… In the current patient, this fungus is acting as the aggressor.”
POST 172. June 23, 2021. CORONAVIRUS. Morgan Stanley chief executive James Gorman said: “If you can go into a restaurant in New York City, you can come into the office.”…”remote work can “dramatically undermine” the character and culture a company is attempting to build; and “virtually eliminates spontaneous learning and creativity.”
POST 173. June 26, 2021. CORONAVIRUS. “The daily toll of COVID-19, as measured by new cases and the growing number of deaths, overlooks a shadowy set of casualties: the rising risk of mental health problems among health care professionals working on the frontlines of the pandemic.”
POST 174. July 1, 2021. CORONAVIRUS. “..while the WHO is encouraging people to keep wearing masks even if they’re vaccinated, Dr. Anthony Fauci says it doesn’t look like the CDC currently plans to change its guidelines.” … health officials in Los Angeles recommended that “everyone, regardless of vaccination status, wear masks indoors in public places as a precautionary measure.”..”
POST 175. July 5, 2021. CORONAVIRUS. “Can a health care worker who is not against vaccines in general still harbor sincere concerns that scientists don’t yet know about all the side effects of these vaccines? Yes, says Ezekiel Emanuel, MD, PhD — but those people should not work in health care.”
POST 176. July 9, 2021. CORONAVIRUS. Mercy Springfield ( Missouri) hospital…” ran out of ventilators for its patients over the Fourth of July weekend…”…“Mercy will require all current and future employees to be fully vaccinated.”…“The US government is deploying a Covid-19 surge team to provide public health support in southwest Missouri
POST 177. July 12, 2021. CORONAVIRUS. the Delta variant is “the 2020 version of Covid-19 on steroids,”… “It is the most hypertransmissible, contagious version of the virus we’ve seen to date…it’s a superspreader strain if there ever was one .” but… now, there’s a Delta Plus variant…
POST 178. July 15, 2021. CORONAVIRUS. “Tennessee’s top vaccine official says she has been fired as punishment for doing her job in the face of political pushback.”..” More than 180 state and local public health leaders…have resigned, retired or been fired since April 1…”“Former President Trump and his GOP allies have stepped up attacks on Anthony Fauci…”
POST 179. July 16, 2021. CORONAVIRUS. “It, therefore, follows that the “harm principle” (“first, do no harm.”) can be used to justify compulsory vaccination programs in specific instances where the community interests or benefits are deemed to be significant.”
POST 180, July 20, 2021. CORONAVIRUS. “Most people will either get vaccinated, or have been previously infected, or they will get this Delta variant,”.. “And for most people who get this Delta variant, it’s going to be the most serious virus that they get in their lifetime in terms of the risk of putting them in the hospital,”
POST 181. July 22, 2021. CORONAVIRUS. “Health experts fear the Tokyo Olympics could become a COVID-19 superspreader event.” “Whatever happens in Japan isn’t likely going to stay in Japan since all of the athletes and accompanying coaches and staff will be returning to their home countries.”
POST 182. July 26, 2021. CORONAVIRUS. Alabama Gov. Kay Ivey (R): “Folks supposed to have common sense.”…“But it’s time to start blaming the unvaccinated folks, not the regular folks. It’s the unvaccinated folks that are letting us down.” ““Beginning in mid-September, New York City will require all of its 340,000 municipal workers, including police, firefighters and teachers, to either be vaccinated against COVID-19 or tested weekly.”
POST 183. July 29, 2021. CORONAVIRUS. When I was appointed President and CEO of Jersey City Medical Center in1989 in the peak of the HIV/ AIDS crisis, we had a dedicated, and always full, dedicated 60 bed AIDS unit, staffed by one full time nurse and numerous part-time and per diem nurses. Today, right now, hospitals caught in the Covid-19 surge, are forced to redeploy nursing staff, respiratory therapists and other clinicians, most without prior infectious diseases experience. Why are we tolerating the unvaccinated putting our hospital staffs at risk?
POST 184. August 1, 2021. CORONAVIRUS. “The coronavirus could be “just a few mutations potentially away” from evolving into a variant that can evade existing COVID-19 vaccines, CDC director Rochelle Walensky said..” (A) “The Delta variant is more transmissible than the viruses that cause MERS, SARS, Ebola, the common cold, the seasonal flu and smallpox, and it is as contagious as chickenpox..” (I)
POST 185. August 6, 2021. CORONAVIRUS. ‘If you aren’t going to help, please get out of the way’: Biden turns up the pressure on GOP governors as Delta spreads”
POST 186. August 8, 2021. CORONAVIRUS. “One of the last things they do before they’re intubated is beg me for the vaccine. I hold their hand and tell them that I’m sorry, but it’s too late,” she added, referring to patients who have to be put on a ventilator.” (A) “There is no one definition of what the end of a pandemic means.”.. “The question of when the crisis will be over is a layered one — with different answers from local, national and global perspectives.”
POST 187. August 11, 2021. CORONAVIRUS. “As a result of the increase in COVID-19 cases and hospitalizations, the state of Florida requested 300 ventilators from the federal government.”… “An 11-month-old girl with Covid-19 is stable and no longer intubated one day after she was airlifted to a Texas hospital 150 miles away because of a shortage of pediatric beds in the Houston area.”
POST 188. August 15, 20201. CORONAVIRUS. “According to an internal CDC briefing….an estimated 1.1 million people have already gotten unauthorized booster shots…”….”If it is left up to the honor system, I think many Americans will suddenly wake up and find themselves immunocompromised enough to get a 3rd dose,”
POST 189. August 19,2021. CORONAVIRUS. “There wasn’t a single I.C.U. bed available in Alabama on Wednesday…”…”A triage plan on the Alabama health department’s website suggests that “persons with severe mental retardation” are among those who “may be poor candidates for ventilator support.”
POST 190, August 21, 2021. CORONAVIRUS. “We’re looking, in essence, at running two systems — a COVID system and a non-COVID system of care,”..“Emergency medical technicians (EMTs) and certified paramedics can now care for patients in Mississippi hospitals and emergency rooms under a new health office order issued by the Mississippi State Department of Health on Wednesday.”
POST 191. August 27, 2021. CORONAVIRUS. “Anthony Fauci, MD, chief medical advisor to the president and director of the National Institute of Allergy and Infectious Diseases, explained that late September gives the United States time to set up the logistics.” This is not medical science, but perhaps Political Science?
POST 192. August 30, 2021. CORONAVIRUS. Gov. John Bel Edwards on Hurricane Ida – “I hate to say it this way, but we have a lot of people on ventilators today and they don’t work without electricity,” he said.”
POST 193. September 3, 2021. CORONAVIRUS. Nurses are leaving their hospitals and becoming travel nurses at hospitals across town “because they can make $4,000, $5,000, $6,000, $7,000 a week while not having to relocate anywhere..”
POST 194. August 2, 2021. CORONAVIRUS. “Recently-released data is painting a grim picture of the opioid epidemic that has gripped the United States — as the country is still grappling with the coronavirus pandemic that has killed more than half a million Americans. Some people are calling them twin pandemics that have collided”…“Faced with a novel health crisis, researchers are collecting data on the long-term impact of using opioids to treat COVID-19 pain…
POST 195. September 6, 2021. CORONAVIRUS. “…there are “zero ICU beds left for children in Dallas County, Texas,”.,..”That means if your child’s in a car wreck, if your child has a congenital heart defect or something and needs an ICU bed, or more likely if they have Covid and need an ICU bed, we don’t have one. Your child will wait for another child to die… (county judge Clay Jenkins)
POST 196. SEPTEMBER 11, 2001. PART 1. Military helicopters and jets were overhead, as President Bush was getting ready to leave NYC. PART 2. LESSONS LEARNED memorandum by hospital CEO Jonathan Metsch goes “viral”…
POST 197. September 12, 2021. CORONAVIRUS. Idaho officials have instituted “crisis standards of care” to help 10 hospitals and health care systems decide how to allocate personnel and resources to deal with a crush of COVID-19 patients.”… “The Washington Medical Coordination Center oversees facilitating transfers in the state, and it’s warning we could be nearing the point of “Crisis Standards of Care,” just like Idaho.” .. “These crisis models don’t actually save more lives, they just save different lives..”
POST 198. September 15, 2021. CORONAVIRUS. A pundit said “The most elegant policy riposte to the anti-vaxxers… is to refuse to allow Medicare or Medicaid to pay their medical bills in the event they become seriously ill. Private health insurers might also follow suit.” (but is making our hospitals become the bill collectors right?)
POST 199. September 19, 2021. CORONAVIRUS. Crisis Standards of Care. “… to his knowledge, no patient in Idaho has been taken off life-support therapy in order to provide that therapy to another patient who has a better prognosis.” “While that has yet to occur, if we continue on this path, it will,”
POST 200. September 23, 2021. CORONAVIRUS. CDC Director overrides a recommendation of its scientific advisors saying “that people can get a booster if they are ages 18 to 64 years and are health-care workers or have another job that puts them at increased risk of being exposed to the virus.”…“In a pandemic, even with uncertainty, we must take actions that we anticipate will do the greatest good.”
POST 201. September 27, 2021. CORONAVIRUS. “A multibillion-dollar institution in the Seattle area is sitting on nearly $12 billion in cash… received at least $509 million in government funds (from) a federal program that is supposed to prevent health care providers from capsizing during the coronavirus pandemic.”
“Based on our estimates…we find preventable COVID-19 hospitalizations cost $5.7 billion from June to August in 2021.”…
POST 202. September 30, 2021. CORONAVIRUS. “..NY Governor Hochul signed an executive order expanding healthcare worker eligibility requirements…to head off potential staffing shortages fueled by the state’s new COVID-19 vaccination requirements.” “The.. order allows out-of-state/ out-of-country healthcare workers to practice in New York…”..”It allows EMTs graduates to temporarily pitch in at additional healthcare settings; allows various types of healthcare workers to more easily administer and order COVID-19 vaccinations; enables telemedicine physician visits in nursing homes; permits facilities to more quickly discharge, transfer or receive patients…”
POST 203. October 3, 2021. CORONAVIRUS. “.. more than 125,000 laboratory-confirmed COVID-19 cases have been reported in pregnant people, including more than 22,000 hospitalized cases and 161 deaths”…The risk is not just to the mother. Covid-19 in pregnancy can cause preterm birth or babies born so sick they have to go straight to the neonatal intensive care unit, or NICU.”
POST 204. October 5, 2021.CORONAVIRUS. “News that an experimental antiviral drug from Merck appears to halve the risk of hospitalization or death from Covid-19 has bolstered hopes of finding a simple at-home treatment for the virus.”..” A more blunt assessment came from vaccine scientist Dr. Peter Hotez of Baylor College of Medicine’s National School of Tropical Medicine. “It’s not a miracle cure but a companion tool, So get vaccinated.””
POST 205. October 11, 2021. CORONAVIRUS. The AAP reported nearly 226,000 new child cases over the past week ending. “Hospital care for children does not occur in isolation from that of adults. Many of the resources we use are the same—a twenty-pound baby and a two-hundred-pound man might use the same kind of ventilator, for example. Dialysis machines, which could cleanse a seven-year-old’s blood as easily as his grandfather’s, are in high demand. Pediatric resident physicians, nurses, and respiratory therapists get cross-deployed to care for adults during the surges.”
POST 206. October 15, 2021. CORONAVIRUS. to borrow from Winston Churchill about where we are with the pandemic – “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”
POST 207. October 17, 2021. CORONAVIRUS. “…if you choose your own unauthorized booster shot, what happens if later research proves a different combination is better? That’s why experts say it’s a bad idea to become your own vaccine advisory committee and get a shot out of turn.”
POST 208. October 22, 2021, CORONAVIRUS. “What is the “delta plus” variant?” Scientists are monitoring the delta-related variant — known as AY.4.2. — to see if it might spread more easily or be more deadly than previous versions of the coronavirus.
POST 209. October 28, 2021. CORONAVIRUS. “The quest at Mount Sinai began with a mystery.”…”America was not simply struggling to contain a once-in-a-century pandemic, caused by a virus far more dangerous than seasonal influenza. Many patients were, for unknown reasons, not recovering.”
POST 210. October 31, 2021. CORONAVIRUS. “Some people want the FDA to speed up. Others want it to be more cautious…There’s a fundamental tension between the right to get access to a drug people are desperate for and the right to protection from dangerous failures of quality. The first demands speed; the second requires time…”
POST 211. November 4, 2021. CORONAVIRUS. Colorado – “…there are patients who really ought to be in an intensive care unit but instead they’re in an emergency room. Or they ought to be in a step-down unit but instead they’re on the floor. Or they ought to be getting one-to-one nursing, and instead they’re getting two-to-one, or three-to-one nursing….”
POST 212. November 9, 2021. CORONAVIRUS. “They went into hospitals with heart attacks, kidney failure or in a psychiatric crisis. They left with covid-19…” “A new report shows the coronavirus pandemic had a direct increase on the number of healthcare-acquired infections in hospitals nationwide.”
POST 213. November 13, 2021. CORONAVIRUS. “Since the earliest days of the pandemic, there has been one collective goal for bringing it to an end: achieving herd immunity…Now the herd is restless. And experts at the Centers for Disease Control and Prevention have set aside herd immunity as a national goal.”
POST 214. November 20, 2021. CORONAVIRUS. “This virus is doing what this virus does,” said Michael Osterholm… “We don’t understand why surges start, we don’t understand why they end.” (A)
POST 215. November 26, 2021. CORONAVIRUS. Dr. Fauci on the new South African variant: “It’s not going to be possible to keep this infection out of the country. The question is: Can you slow it down?”
POST 216. December 1, 2021. CORONAVIRUS. Covid cacophony: as states struggle to address health care staffing shortages, a federal court puts Biden administration health care worker vaccination mandate on hold.
POST 217. December 3, 2021. CORONAVIRUS. President Biden Announces New Actions to Protect Americans Against the Delta and Omicron Variants as We Battle COVID-19 this Winter
POST 218. December 5, 2021. CORONAVIRUS. “In some ways, Delta is the ideal variant: It’s transmissible enough to dominate more dangerous variants, and its virulence can be controlled through vaccination. In the next few weeks, we’ll find out whether Omicron will have its own silver lining—or whether it’ll be catastrophically worse.”
POST 219. December 9, 2021. CORONAVIRUS. “Entering uncharted territory, the U.S. counts 500,000 Covid-related deaths.”… “So yes, I am furious at the unvaccinated, and I am not ashamed of disclosing that. I am no longer trying to understand them or educate them.”
POST 220 December 13, 2021. CORONAVIRUS. Dr. Osterholm. “You cannot outrun the game clock with this pandemic. This virus will find you… We’ve seen health care systems virtually broken by this pandemic. They just couldn’t provide critical care to non-Covid patients.” (A)
POST 221. December 18, 2021. CORONAVIRUS. “Johnson & Johnson’s Covid vaccine was going to be a shot for the world. Now, under the weight of a mountain of bad PR, one wonders if the world will want it.”
POST 224. December 29, 2021. CORONAVIRUS. “crisis standards of care protocols in Maryland – “It also allows us to slim down documentation,… allows unconventional staffing models such as using nurses that have not been bedside. It also sets the expectations for the community that it’s not business as usual.”
POST 225. January 3, 2021. CORONAVIRUS. “Be first, be right, be credible,” are among the most important principles for health authorities to follow in a crisis, the Centers for Disease Control and Prevention shared in a pamphlet on crisis communication in 2018….”
Post 226. January 5, 2022. CORONAVIRUS. New York City – “The city’s ambulance corps are so understaffed because of the COVID-19 surge, they’re now under new orders to try to convince stable patients with flu-like symptoms not to go to the hospital.”
POST 227. January 10, 2020. CORONAVIRUS. “Stay indoors. But also return in person. Wear a mask. Not that one. The expensive one, that you can’t find. Take rapid tests. Which you also can’t find. But if you find them, don’t buy them. Rapid tests don’t work. You need PCR. There are zero appointments in your area.” (F)
POST 228. January 13, 2022. CORONAVIRUS. “State officials are attempting to address California’s staffing shortage through a sweeping policy change that allows asymptomatic healthcare workers who have tested positive for the coronavirus to return to work immediately.” “Asymptomatic health professionals who had tested positive for COVID-19 should “preferably be assigned to work with COVID positive patients.”
POST 229. January 16, 2020. CORONAVIRUS. “It is now highly unlikely that the U.S. will hit the ~85-90% of Americans vaccinated to get to the other side of the pandemic…”
POST 230. January 20, 2022. CORONAVIRUS. “Dr. Fauci also said that the world is still in the first of what he considered to be the five phases of the pandemic. The first is the “truly pandemic” phase, “where the whole world is really very negatively impacted,” followed by deceleration, control, elimination and eradication.”…to paraphrase Churchill – “This is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”..
POST 231. January 24, 202. CORONAVIRUS. “Florida’s top public health official in Orlando has been placed on administrative leave after sending an email to his employees noting their lackluster coronavirus vaccination rates and urging them to get the shots.”
POST 232. January 28, 2022. CORONAVIRUS. “A Boston hospital’s denial of a heart transplant to a man who is unvaccinated for Covid-19 has generated national attention, but experts say mandating vaccines is in keeping with other long-standing requirements that patients have to meet to receive an organ — including getting other shots…”
POST 233. February 2, 2022. CORONAVIRUS. “The same virus can cause endemic, epidemic or pandemic infections: it depends on the interplay of a population’s behaviour, demographic structure, susceptibility and immunity, plus whether viral variants emerge.”
POST 234. February 2, 2022. CORONAVIRUS. “Senate Republican leader Mitch McConnell demanded an end to the COVID-19 state of emergency on Wednesday , saying it was time for Americans to get on with their lives after two years on a ‘hellish highway.’”
POST 235. February 17, 2020. CORONAVIRUS. “Over time, the U.S. health care sector has implemented various pieces of the (pandemic) safety-assessment-and-improvement puzzle, but it has not instituted a thorough system of safety that reaches from the boardroom to the front lines and that can be maintained during times of crisis.”
POST 236. February 22, 2021. CORONAVIRUS. MOUNT SINAI AT HOME – “We began thinking about how we could use hospital-at-home to meet the needs of our hospital system in our community, in terms of responding to the crisis of COVID-19…”
POST 237. February 27, 2020. CORONAVIRUS. “Decision-makers are increasingly embracing the reality that we will have to “learn to live with” the coronavirus. But how will they know when to impose or lift restrictions?” “Now, the CDC’s “Covid-19 community level” metrics are based on three pieces of data in a community: new Covid-19 hospitalizations, hospital capacity and new Covid-19 cases.”
POST 238. March 5, 2022, CORONAVIRUS. “Two different scientists can look at the same set of data and come up with different conclusions. That’s not to say that one person is being unscientific or ignoring the scientific process,” said Leana Wen, an emergency physician and a professor at George Washington University. “Public health policy is also a measure of values.””
POST 239. March 9, 2022. CORONAVIRUS. “War is an infectious disease’s best friend,” says Michael Osterholm, “It challenges every public health program you can possibly have. It limits the medical care available for those who might be seriously ill, and often fosters transmission when so many people are crowded into bomb shelter locations and on trains. This is going to be the perfect storm of one serious challenge after another.” (E)
POST 241. March 20, 2022, CORONAVIRUS. Dr. Ashish Jha will serve as the new White House COVID-19 response coordinator.” He is not, for the record, a virologist, immunologist, or vaccinologist…But he is a public health expert and a practicing internist, which means he has years of experience explaining complicated and often incomplete information to people who neither know nor care about the correct pronunciation of “adenovirus.” That’s who he imagines on the other end of his webcam.”
POST 242. March 24, 2022. CORONAVIRUS. “How worried should people be about the BA.2 variant? Will vaccines protect against it? What if someone contracted a previous variant — could they become reinfected? Is BA.2 milder than previous versions, and if so, should people try to get it? Could BA.2 cause another surge in the US, and is it time for restrictions to be put back into place?”
POST 243. March 28, 2022. CORONAVIRUS. “…the US Food and Drug Administration is planning authorize a fourth dose of the Pfizer and Moderna mRNA vaccines for adults over age 50 next week.”…”The decision to make fourth doses available now will bypass independent groups of scientific advisers for both the FDA and CDC, which would normally meet and publicly review the available science and then make recommendations to the agencies.”
POST 245. April 10, 2022. CORONAVIRUS. We can’t react to a wave we don’t see coming. “I keep thinking back to this idea of If we don’t measure it, it won’t happen,”…(As President Donald Trump once put it, “If we stop testing, we’d have fewer cases.”) In reality, “it’s very well happening, and we just don’t see it yet.”
POST 246. April 15, 2022. CORONAVIRUS. “State authorities and health care organizations could pay a high price for reinstating SCOPE OF PRACTICE (SOP) restrictions when the pandemic ends.” (e.g. NPs, PAs, Pharmacists +++)
POST 247. April 23, 2020. CORONAVIRUS. “The DOJ lawyers tasked with defending the CDC’s mask mandate authority have warned Biden administration officials that continuing to push the legal fight over the mask mandate could backfire, if the conservative-leaning appeals court upholds the order.”….”A Supreme Court ruling upholding the decision to strike down the mask mandate would make the Florida judge’s conclusions about CDC authority binding nationwide.”
POST 248. April 27, 2022. CORONAVIRUS. “For at-risk Americans without access to a “test-to-treat” drugstore that has a qualifying provider available, this means some will have to make multiple trips to get the pills. You have to develop COVID symptoms, you have to subsequently get a test for COVID-19, get the result of that test, find and go to see a provider, get a prescription, and then fill that prescription. That’s six steps in five days,”…
POST 249. May 6, 2022. CORONAVIRUS. “The United States is “certainly, right now, in this country, out of the pandemic phase..” (Dr. Anthony Fauci). “The US should prepare for a possible summer surge of Covid-19 cases across Southern states..” (Dr. Deborah Birx)
POST 250. May 11, 2022. Herd Immunity Deja vu. “Not so long ago, the world was clinging to the hope of herd immunity—to the notion that the population would eventually reach some communal level of protection sufficient to quash the outbreak for good. Maybe, experts posited many months back, once 60 to 90 percent of people had been infected or vaccinated or both, the virus would run out of viable hosts, and simply fizzle out. Now it’s clear that “that’s too simplistic…”
POST 252. May 20, 2022. CORONAVIRUS. “The stakes, two years into the pandemic, should be clear. Fewer vaccines, fewer treatments, and fewer tests will mean more infections, more serious illnesses, and more deaths. That is the scenario the country is staring down: one million people already dead and more to come because politicians became complacent.”
POST 253. May 29, 2020. CORONAVIRUS. “Significant obstacles persist in getting Paxlovid to everyone who could benefit from it; more than a million courses of Paxlovid purchased by the government are still available…”..” However, some doctors have also voiced concerns over wider use of the antiviral drug amid reports of so-called “rebound” symptoms following use of Paxlovid, which might raise the risk of the virus evolving resistance to the pills.”
POST 254. June 2, 2022. MONKEYPOX, “Massachusetts General Hospital this week began vaccinating a small group of workers against monkeypox — the first time the new medicine has been used in this country outside of clinical trials. The workers were in close contact with a man diagnosed with the virus and hospitalized at Mass General from May 12 to May 20. The patient was the first person in the United States to be tied to an ongoing outbreak of the rare virus in Europe and North America.”
POST 255. June 5, 2022. CORONAVIRUS. “More than a year after U.S. health care workers were saluted for saving lives in the COVID-19 outbreak and celebrated with nightly clapping from windows and balconies, some are being issued panic buttons in case of assault and ditching their scrubs before going out in public for fear of harassment.”
“The shooting in Tulsa is an extreme example of a growing trend: violence against doctors, nurses, and other health care workers.”
POST 256. June 10, 2022. MONKEYPOX. “This is one of the rare diseases in which you can vaccinate somebody after they’ve been infected, before they have symptoms, and block the disease,”… “We would have to really screw things up not to be able to contain this..”
POST 257. June 17, 2022. CORONAVIRUS. “We’re now in a very weird pandemic phase. On Twitter, doctors such as Eric Topol sound five-alarm warnings about the latest subvariants of omicron. Offline, even in blue states, people are back to parties, bars and restaurants — and will soon be flying around the world with no testing requirements to return to the US. Things feel as if they’ve lost any coherence. There’s no discernible strategy or guidance on what Covid precautions we should still be taking.”
POST 258. June 26, 2022. CORONAVIRUS. “For a long time, whenever companies wanted to hire a CEO or another key executive, they knew what to look for: somebody with technical expertise, superior administrative skills, and a track record of successfully managing financial resources.”..” That practice now feels like ancient history. So much has changed during the past two decades that companies can no longer assume that leaders with traditional managerial pedigrees will succeed in the C-suite..”
POST 259. June, 2022. Monkeypox. ”If HIV and Covid-19 were wake-up calls for the government to prioritize public health, monkeypox shows the consequences of hitting the snooze button too many times. HIV showed the importance of creating an infrastructure of health care workers who can provide approachable, competent care for stigmatized infections. Covid-19 revealed the make-or-break nature of coordinated logistics and communications.”
This curated note on innovation was inspired when I recently reconnected with Drs. James Veney & Arnold Kaluzny, my doctoral advisors at the University of North Carolina Gillings School of Global Public Health, pioneer researchers on innovation and evaluation in health care (Google Veney & Kalunzy). Thanx! Jim and Arnie for your singular roles in jump starting my career.
for links to POSTS 1-258 in chronological order highlight and click on
“For weeks now, as COVID-19 cases have ticked upward in the Northeast and mid-Atlantic, pundits and political leaders have offered a supposedly reassuring refrain: Cases might be climbing, but hospitalizations aren’t yet following suit. In some places, that has been true. Several health-care workers around the country told me they’re seeing the lowest caseloads since last summer. A few aren’t having to treat COVID patients at all. Others are only seeing mildly sick people who need little more than IV fluids. “I don’t think there’s a huge amount of anxiety over what the next month might bring,” Debra Poutsiaka, an infectious-disease specialist at Tufts Medical Center, told me. “I could be wrong. I hope not.”
The Biden administration shares those hopes: Having apparently given up on curtailing the coronavirus, it is counting on vaccines and treatments decoupling infection from severe illness enough to prevent the health-care system from becoming inundated again. The CDC’s current guidelines effectively say that Americans can act as if COVID is not a crisis—until hospitalizations reach a high enough threshold.
The country still may be heading to that point. Hospitalizations are climbing in 43 states, especially in the Northeast. In Vermont, the rate of new admissions has already neared the peak of the recent Omicron surge. Earlier this month, “three different emergency-room docs said this is by far the worst that COVID has been at any point,” Tim Plante, an internist at the University of Vermont, told me. “They’re bewildered that it’s happening again.” Meanwhile, people in most of New York City are now advised to mask indoors again, after rising hospitalizations triggered the CDC’s “high” alert level.
But even in calmer spots, Biden’s strategy overlooks a crucial truth: The health-care system is still in crisis mode. The ordeals of the past two years have tipped the system—and its people—into a chronic, cumulative state of overload that does not fully abate in the moments of respite between COVID waves…
The problems are substantial and numerous enough that “if this moment was occurring without the horror of the moments that preceded it, we’d be shocked,” Lindsay Ryan, a physician at UC San Francisco, told me. “The calamity of the last years has numbed us to the calamity of the present moment.”..
Even when missing people can be replaced, missing knowledge cannot. The pandemic pushed many veteran health-care workers into early retirement, lowering the average experience level in American hospitals. “I don’t think the public really understands how great the loss of this generational knowledge is,” Cabrera told me. In her current job, she had just four days of orientation, which she describes as “shockingly short,” from some people who had been in the ER for less than a year. When inexperienced recruits are trained by inexperienced staff, the knowledge deficit deepens, and not just in terms of medical procedures. The system has also lost indispensable social savvy—how to question an inappropriate decision, or recognize when you’re out of your depth—that acts as a safeguard against medical mistakes. And with established teams now ruptured by resignations, many health-care workers no longer know—or trust—the people at their side. “In an industry where our communication has to be spot-on and effective, that’s a setup for unsafe conditions,” Lisa Zegan, a patient safety officer based in Maryland, told me.” (A)
“From Queensland, Australia…
1. Innovation was enhanced by “adaptive” management style and processes. Rather than incremental movement and gradual refinement leading towards eventual change; in the COVID context, participants described an openness on the part of managers which facilitated change through processes that were adaptive and focused. This enabled staff to propose and implement logical and constructive innovations, then review and refine. “All of the myths about what we can change and what we can’t have been blown up. People are open to things.”
2. Devolved authority structures enabled innovation. An important factor commonly described was a devolved authority and management… During the early days of the COVID response, key staff felt empowered to make decisions about service change to a level they had not previously experienced. When management enabled some devolution of authority, it facilitated the introduction of new models, the pace of change, and subsequent adoption.
3. “Management said, ‘Go make it happen.’” Trusting the capability and actions of staff facilitated innovation. Closely connected with devolved authority was the sense of trust that accompanied most examples of innovation among allied health professionals. Service managers spoke about the trust they needed to place in their staff, and staff described being (and feeling) trusted in ways that were not typical of their usual experience. The foundation of trust between service leaders, managers, and staff in the COVID context appeared instrumental in fostering innovation…
On reflection, it was evident that enacting the above enablers will necessitate a level of reframing or “unlearning” current assumptions and practices, which currently constrain innovation. ..Potential areas for unlearning to support implementing and sustaining innovative practice include:
• Reframing concerns about imposed changes. Rather than disruption being seen as a risk and threat, COVID-related disruption precipitated constructive action towards positive outcomes. This requires management openness to change.
• Unlearning the status quo. By setting aside the usual frame of reference to clinical practice and imagining different ways of tackling often long-term perspectives brief challenges to delivering care, managers and clinicians have room to ‘relearn’ new approaches to care. “We could give things a go and learn from it, rather than having to get it perfect first.”
• Unlearning traditional views of roles. Rather than allied health professionals simply being seen as providers of therapy and clinical services, in the early part of the COVID crisis, they were permitted to be effective problem-solvers and creative thinkers. This requires management to foster such latitude.
• Rethinking how we incorporate change. Rather than potential innovations being fully refined, trialled and evaluated prior to implementation, the above examples were dynamic processes, involving adaptive change, and often included a subsequent and ongoing process of monitoring,reviewing, and refining. This requires some challenging of the goal of perfection prior to implementation. “Perfect is the enemy of good.”
• Unlearning some management practices. In contrast to the prevailing view that managers must take control and guide decision making, especially in a crisis, devolved authority and shared decision making was conducive to innovation.
• Recognising the importance of trust. In contrast to the perspective that managers should oversee the details of staff actions in times of uncertainty, trust was integral to the implementation of innovative practices. In the context of uncertainty, staff were able to effectively utilise and build upon the trust placed in them. This requires unlearning of some management styles, particularly in situations of crisis and change.
During the COVID pandemic, the capacity to set aside past assumptions and ways of working was clearly demonstrated in a number of allied health settings, as well as across the health system. A challenge facing health services, and particularly managers, is to sustain this momentum and harness the opportunities afforded to staff, patients, the workplace, and the service system. This will in part be supported by an understanding of key factors that enabled innovation as well as future explorations as to how those innovations were implemented.” (B)
“Minnestoa. “Final thoughts and lessons learned: Put a stake in the ground early on from a clinical leadership perspective as to what the goals of the response are, through a medical operations coordination center if possible. It’s like trying to drive on the highway while other people are yanking on the steering wheel. You have political, commercial, and healthcare system interests trying to get your attention, and it’s a fight to stay on the road, doing what you know needs to be done. There were many well-intended thoughts and requests from various parties that were not consistent with what we needed to do strategically, mainly reflecting a lack of understanding of how the ACS would support the overall COVID-19 response….
(SE TEXAS) Final thoughts and lessons learned: Politics and being able to defend the decisions you are making are both huge challenges. Not backing down when you know what is being done is in the patient’s best interest is key. We will continue to ingrain that into our process…” (C)
“When the winds of change blow, some people build walls, others build windmills. This Chinese proverb reminds us that crises present choices. Those choices, in turn, shape organizations’ future growth paths. Last fall, we wrote about the healthcare sector’s successful shift from merely sustaining core operations when the COVID-19 crisis hit to driving rapid innovations that saved lives and lessened the pandemic’s impact. But the winds remain strong, with new outbreaks and variants of the virus continuing to destabilize our lives and economies, even as vaccines are rolled out. Maintaining the innovation momentum will be critical to a continued effective response…
To better understand how healthcare leaders’ priorities have shifted, we interviewed executives from across the value chain. Specifically, we examined how they plan to position their organizations to deliver on their innovation aspirations and which innovation capabilities they expect to grow in importance. They highlighted two main areas where the COVID-19 pandemic has brought major changes they expect to endure.
Digital acceleration. The healthcare sector has long been a laggard in digital adoption, but the pandemic delivered a massive jolt of urgency to embrace new tools and technologies. Providers rapidly scaled offerings and were seeing 50 to 175 times the number of patients via telehealth a few months into the pandemic compared with what they did before…
Workplace of the future. Many parts of healthcare require in-person care, but the pandemic has illuminated the extent to which healthcare can be delivered remotely, such as virtual care and remote patient monitoring, and virtual collaboration for professionals in the pharmaceutical and medtech industries. This model supports greater flexibility and has enabled organizations to draw from a more diverse talent pool. “You can now attract anyone, anywhere,” one executive said in reference to hiring. Healthcare leaders are also reevaluating old workplace norms and introducing new measures, such as offering assistance to help combat videoconferencing fatigue. “COVID-19 has shone a light on culture, good or bad,” another interviewee told us, and it has led healthcare players to reassess work conditions and extend greater flexibility to employees…
Choose. In a world of dynamic change and heightened uncertainty, it is more important than ever to actively manage portfolios of innovation initiatives, consciously choosing to invest in innovation during a crisis. “There is so much chaos, it’s like a constantly changing game board,” one healthcare leader said. “We need even more discipline to make sure we don’t miss something or get overly enamored of shiny new things.”…
Evolve. Another priority that healthcare executives cited was evolving their business models to address new delivery constraints and client expectations. This finding is in line with our recent analysis of profit pools in the sector, which suggests healthcare players that develop innovative business models will generate disproportionate value…
Accelerate. From vaccines to new designs of personal protective equipment (PPE) and ventilators, numerous recent examples demonstrate the healthcare sector’s ability to innovate at previously unimagined speeds. In the United States, the US Food and Drug Administration deployed a range of measures (such as issuing new guidance, establishing new industry engagement models, and issuing emergency use authorizations) designed to support the COVID-19 response across the range of products it regulates. In several instances, the FDA stipulated or requested that manufacturers gather data derived from the real-world use of products in order to better characterize performance, understand supply-chain vulnerability, and support additional development activity, both throughout and beyond the pandemic…
Extend. The COVID-19 pandemic has highlighted the benefits of nontraditional and creative partnerships and collaborations in quickly finding creative solutions to urgent problems—from the health and auto industries teaming up to build ventilators, to pharmaceutical sector competitors collaborating to hasten the development of a COVID-19 vaccine, to healthcare providers partnering with technology companies to deliver COVID-19 apps and solutions…
From the rise of the sharing economy in the wake of the financial crisis to airport security measures following the 9/11 attacks, deep crises tend to create shifts that stick. The COVID-19 crisis is likewise bringing changes to the healthcare sector that are here to stay. As past downturns have shown, innovation is a critical part of any recovery and will be necessary for healthcare players to stay abreast of their industry…” (D)
“Life and business will never be the same after the pandemic, especially in healthcare.
Everything from how patients see their doctors and get treated to how hospitals use tools and share information will forever be altered.
The healthcare industry has long been ripe for innovation, and the pandemic has served as a powerful catalyst. Research from McKinsey found that 90% of healthcare executives believe COVID-19 will fundamentally change their businesses, and 85% predict lasting changes to customers’ preferences.
Innovative practices are being used not only to fight the spread of the virus, but also to continue delivering care to all types of patients in the safest ways possible.
Here are 10 examples of healthcare innovation in the face of COVID.
1 . Health Company Uses Drones For Medical Supplies Deliveries
North Carolina’s Novant Health partnered with Zipline, a company that specializes in delivering medical supplies to remote areas, to create a drone to deliver COVID supplies…
2 . ResMed Enables Cloud-Based CPAP Monitoring
Ventilation device company ResMed sped up the European release of its patient data management software AirView to better serve patients during COVID…
3 . Docdot App Can Detect COVID Remotely
Instead of seeing their patients in person, an app called Docdot allows doctors to track patients’ vital signs virtually and detect COVID symptoms with medical-grade accuracy…
4 . TytoCare Monitors Quarantined Patients Via Stethoscope
COVID-19 has been a boost for telehealth, but one company is taking it a step further. TytoCare has partnered with major hospitals to use special stethoscopes that both listen to patients’ hearts and transmit images of the lungs…
5 . Military Unveils Low-Cost Ventilators For Expanded COVID Care
As part of the Department of Defense Hack-a-Vent Innovation Challenge, military scientists and engineers designed a low-cost, easily assembled ventilator that can be used in hospital and field settings. These ventilators can be quickly produced for less than $500..
6 . Hospitals Use VR For Training
The pandemic has re-emphasized to healthcare workers the need to continually upskill and learn. Unable to meet in large groups but still wanting to quickly train on up-to-date methods, hospitals are turning to virtual reality training…
7 . AI Software Company 3D Prints Nasal Testing Swabs
Faced with a shortage of testing supplies around the world, AI software company Axial3D designed 3D printed nasal swabs for COVID tests.
8 . Mayo Clinic Uses De-identified Data To Create Treatments
Before the pandemic, Mayo Clinic had partnered with AI company nference to de-identify patient records, but the project accelerated when COVID hit. Together, the groups created the Clinical Data Analytics Platform…
9 . Hospitals Use Robots To Deliver COVID Relief
Moxi is a one-armed rolling robot designed to help hospitals. Unveiled shortly before the pandemic, Moxi’s duties have pivoted to deliver PPE, lab samples and COVID tests…
10 . Sutter Health Expands Chatbot To Cover COVID
Sutter Health quickly added COVID to its chatbot symptom checker. By answering a series of questions, the algorithm evaluates a patient’s medical history, risk factors and symptoms to provide a recommendation. Sutter’s bot is the equivalent of having 60 doctors in a patient’s pocket to answer questions around the clock…
Healthcare will be permanently changed by the COVID pandemic. But these innovations show that the industry is primed to grow and find new solutions to deliver the best care possible, no matter the circumstances.” (E)
“Lessons Learned
Lesson 1: The Health Care Workforce Is A Ready Source Of Creative Ideas
During the pandemic, the common image of a creator as entrepreneur or artist was expanded to include professionals on the front lines of the COVID-19 response. We saw critical care doctors and nurses creatively re-purpose split-respirators, baby monitors, snorkels, and hairdryer hoods for COVID-19 care; supply chain supervisors contact laundromats and hardware stores to help maintain personal protective equipment; and environmental services managers experiment with sanitizer placement and clever signage. As vaccine distribution faced challenges, public health workers turned closed Sears stores into vaccine centers…
Lesson 2: Creativity And Standardization Are Complements, Not Antagonists
Prior to COVID-19, creativity was often described as contradictory to health systems’ goal of evidence-based standardized care on the theory that creativity introduces variance whereas standardization seeks to reduce variance. COVID-19 showed, however, that these “contradictory” processes can be complementary and thus managed jointly. Creativity supports the identification of innovations worth standardizing. Clear surgical masks to facilitate lip-reading and family inclusion in palliative care virtual discussions have become standard practice in some organizations, for example…
Lesson 3: Implementation Of Creative Ideas Can Be Fast And Effective
It is reported that evidence-based medical practices, which often start as creative ideas, take 17 years to be incorporated into routine practice. Telemedicine—a creative, evidence-based practice of electronic and telecommunications technologies used to provide care at a distance—appeared to be on this path until COVID-19. After a decade of slow uptake, virtual visits rose 150 percent in a month during the pandemic, with organizations such as Emory Healthcare scaling their programs within eight weeks. Similar rapid implementation occurred for other creative ideas that had been marginalized, such as integration of behavioral health services into primary care, which have streamlined previously siloed care delivery processes…
Lesson 4: Creativity Benefits From Collaborations With Diverse Stakeholders
During the pandemic, creativity was frequently used to build supportive networks and systems to care for vulnerable communities, enhancing commitment and effort to address local needs. Public-private partnerships among community health workers, organizers, and governments fueled the success of pop-up events and mobile vans to deliver COVID-19 testing and vaccine services to Black, Latinx, and underrepresented populations…
Operationalizing Lessons Through Policy And Management
Together, these four lessons indicate the potential and feasibility of leveraging creativity for improvements. Doing so requires actions by organizations and policy makers. Organizations must take at least four steps.
Invite Creativity
Support Creativity By Providing Resources
Creativity And Standardization
Reward Creativity
Updating Regulations
Cross-Industry Collaboration…
Self-reliance is unlikely to generate the creative ideas and implementation required to address the big, remaining issues in health care. While COVID-19 brought much devastation, it also showed the power of creativity and creative potential of the industry to address serious problems. That lesson is something that should not be lost.” (F)
“Eleven students are typing notes on their laptops at Nashville State Community College. For several, it’s been a while since they were last in a classroom.
They’re training to become medical assistants, which will take 12 weeks of work in both the classroom and in the hospital…
Clifford Johnson, 52, was the lead driver for a team that shuttles surgical instruments back and forth to get sterilized. He’s worked at Vanderbilt for seven years…
But like so many hospitals, Vanderbilt is looking for creative hiring solutions. So beyond covering tuition, the hospital offered to pay employees like Johnson their salaries as they train full time.
“The turnover has been tremendous,” said Vanderbilt’s vice president for allied health education, Peggy Valentine. “So the thinking was, why don’t we work with our employees, build a sense of loyalty? And then we’ve got a workforce that’s likely to stay with us in the long haul.”
The “grow your own” concept is catching on around the country as the market for all clinical roles becomes more competitive — from a community hospital in Comanche County, Okla., to community health centers across California.” (G)
These changes present a phenomenal challenge for executive recruitment, because the capabilities required of top leaders include new and often “softer” skills that are rarely explicitly recognized or fostered in the corporate world. Simply put, it’s getting harder and less prudent to rely on traditional indicators of managerial potential.
What should organizations do to face this challenge? A critical first step is to develop greater clarity about what it now takes for C-suite executives to succeed. Yes, the range of necessary skills appears to have expanded—but how exactly? For example, what does the term “soft skills” really mean? And to what extent does the need to hire executives with more-expansive skills vary across organizations?…
Our study yielded a variety of insights. Chief among them is this: Over the past two decades, companies have significantly redefined the roles of C-suite executives. The traditional capabilities mentioned earlier—notably the management of financial and operational resources—remain highly relevant. But when companies today search for top leaders, especially new CEOs, they attribute less importance to those capabilities than they used to and instead prioritize one qualification above all others: strong social skills…
When we refer to “social skills,” we mean certain specific capabilities, including a high level of self-awareness, the ability to listen and communicate well, a facility for working with different types of people and groups, and what psychologists call “theory of mind”—the capacity to infer how others are thinking and feeling. The magnitude of the shift in recent years toward these capabilities is most significant for CEOs but also pronounced for the four other C-suite roles we studied…
In the years ahead, some companies may focus on trying to better identify and hire leaders with “the right stuff”; others may pay more attention to executive training and retention. But no matter what approach they adopt, it’s clear that to succeed in an increasingly challenging business environment, they’ll have to profoundly rethink their current practices.” (H)
_____________________________
“Some 20 million babies, toddlers, and preschoolers are now eligible to be vaccinated for COVID-19, after the Centers for Disease Control and Prevention’s Director Dr. Rochelle Walensky signed off on unanimous votes from her agency’s outside vaccine advisers to recommend shots from Moderna as well as Pfizer and BioNTech for children as young as six months old.
“Together, with science leading the charge, we have taken another important step forward in our nation’s fight against COVID-19,” Walensky said in a statement.
Around a third of parents say they plan to get their child in the age group vaccinated, according to CDC survey findings released on Saturday. Some of the long-awaited shots could begin as soon as this holiday weekend. Federal officials expect the bulk of vaccinations will commence after doctor’s offices reopen on Tuesday.
“We know millions of parents and caregivers are eager to get their young children vaccinated, and with today’s decision, they can. I encourage parents and caregivers with questions to talk to their doctor, nurse, or local pharmacist to learn more about the benefits of vaccinations and the importance of protecting their children by getting them vaccinated,” added Walensky.
The CDC’s Advisory Committee on Immunization Practices voted following a two day-long meeting to mull data on the benefits and risks of the shots in young children. A panel of the Food and Drug Administration’s own outside advisers had also voted unanimously on Wednesday to back authorization.” (I)
F.COVID-19 Inspired Creativity In Health Care: Lessons For Management And Policy, Yuna S. H. Lee Ingrid M. Nembhard, https://www.healthaffairs.org/do/10.1377/forefront.20220617.857677/
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
POST 96. December 26, 2020. CORONAVIRUS. “Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci…”…”..he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….”
POST 97. December 27, 2020. “A new variant of the coronavirus that has been spreading through the UK and other countries has not yet been detected in the United States..”.. . But if new-wave medicines like antivirals and antibody therapy contributed to the development of viral variants, it will be “a reminder for all the medical community that we need to use these treatment options carefully.”
POST 99. December 29, 2020. CORONAVIRUS. “ICUs are being overwhelmed across many parts of California. Statewide aggregate ICU availability has been at 0% since Christmas Eve…. a surge on top of a surge on top of a surge.”… “hospitals are getting close to the point where they would begin putting COVID-positive patients under the care of COVID-positive staff who are asymptomatic.”
POST 100. December 29, 2020. CORONAVIRUS. Front line hospital workers – in the ER, ICUs, EMS, acute medical care, behavioral health – are amongst the most courageous, heroic and dedicated colleagues you will ever meet.
POST 101. December 30, 2020.CORONAVIRUS. Is there a point where the increasing Coronavirus trajectory so far exceeds the slow growth of the vaccination rate that reaching herd immunity through vaccinations becomes less likely?
POST 102. January 2, 2020. CORONAVIRUS. “We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination — which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, the dean of Brown University’s School of Public Health. “Ultimately, the buck seems to stop with no one,”…
POST 103. January 4, 2021. CORONAVIRUS. Dr. Fauci said “that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses…Dr. Moore – ”British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”
POST 104. January 6, 2021. CORONAVIRUS. “Paramedics in Southern California are being told to conserve oxygen and not to bring patients to the hospital who have little chance of survival…”
POST 105. January 8, 2021. CORONAVIRUS. POST 105. January 8, 2021. CORONAVIRUS. “Facing a shortage of vaccinators, the Association of Immunization Managers… recommends relaxing regulation or adjusting licensing requirements. At least two states, Massachusetts and New York, have changed their laws in recent weeks to expand those who are eligible to give shots.”
POST 106. January 9, 2021. CORONAVIRUS. The riots at the Capitol could have been a superspreader event. “From what I saw… you had a large congregation of individuals who were in close contact for an extended period of time and almost universally unmasked…. many coming and going on buses as well, also unmasked, and hanging out in hotel lobbies.”
POST 107. January 8, 2021. CORONAVIRUS. “Our job is to make sure the vaccine isn’t politicized the way masks were politicized,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said after getting her vaccine. South Carolina Rep.-elect Nancy Mace, a Republican, wrote that “Congress shouldn’t be putting themselves first in line for the COVID-19 vaccination when the average American can’t get it.”
POST 108. January 9, 2021. CORONAVIRUS. (vaccination)”Line-cutters will be named and shamed. It’s inevitable, as will be the congressional hearings and front-page investigative stories ferreting out who saved their own skin at the expense of others.”
POST 109.January 9, 2021. CORONAVIRUS. “President-elect Joe Biden will aim to release nearly every available dose of the coronavirus vaccine when he takes office, a break with the Trump administration’s strategy of holding back half of US vaccine production to ensure second doses are available.
POST 110. January 13, 2021. CORONAVIRUS. ““The (federal) government is changing the way it allocates Covid vaccine doses, now basing it on how quickly states can administer shots and the size of their elderly population.”… “New York State sent a letter to hospitals saying if they don’t use their vaccine allocations by the end of this week, they won’t receive any further allocations.”
POST 111. January 14, 2021. CORONAVIRUS. “Visitors from Toronto to New York to Buenos Aires have long flocked to Florida for sun, surf and shopping. Now they are coming for the Covid-19 vaccine….
POST 112. January 14, 2021. CORONAVIRUS. CHINA – “Eleven million people are under lockdown in Hebei province after a new cluster of coronavirus infections.
PART 113. January 17, 2021. CORONAVIRUS. The Next President Actually Has a Covid Plan… New York City and other places in the state expect to exhaust their supply of doses as early as next week… Charles Barkley said during the “NBA on TNT” broadcast that pro athletes should get the first round of the vaccine…..
POST 114. January 18, 2021. CORONAVIRUS. “When government programs that have been unattended, underfunded and bogged down by red tape suddenly have to meet a huge demand in a crisis, they can’t cope and people suffer….”
POST 115. January 21, 2020. CORONAVIRUS. A year ago today an unnumbered POST was headlined “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.” The CORONAVIRUS CONTENT TRACKING PROJECT started with HISTORIOGRAPHY and over time moved to LESSONS LEARNED, RAPID RESPONSE, and THE VACCINATION PROGRAM. Now 115 POSTS later – the BIDEN CORONAVIRUS PLAN.
POST 116. January 22, 2021. President Biden – “We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation.”
POST 117. January 23, 2021. CORONAVIRUS. 1.Dr. Fauci:“The idea that you can get up here….”and.. let the science speak”… “It is somewhat of a liberating feeling.” 2.updated CDC guidance:”.. providers could give the second dose up to six weeks after the first dose..” 3.Dr. Fauci: people would be “taking a chance” if they follow the CDC’s updated guidance.
POST 118. January 24, 2021. CORONAVIRUS. “Unfortunately, we’ve let this virus spread extensively and are launching the vaccination campaign at the height of the threat,” Dr. Meyers said. “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.”
POST 119. January 27, 2010. CORONAVIRUS. Amazon is offering its help to President Joe Biden with the rollout of COVID-19 vaccines. Washington’s governor, Jay Inslee, included the help of companies like Starbucks, Costco and Microsoft in a plan to vaccinate 45,000 residents a day.
POST 120. January 28, 2021. CORONAVIRUS. “The fact that four vaccines backed by the federal government seem to be less effective against the (South African) B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.”
POST 121. January 30, 2021. CORONVIRUS. Will our communities become stratified by which vaccine is distributed? 95%ters v. 72%ters? Will the easier distribution of the J&J vaccine drive its inequitable distribution to” hard-hit, marginalized, and medically underserved communities.” (thanx! to XJ/LA)
POST 123. February 4, 2021. CORONAVIRUS. “Nursing homes across the country are facing the same struggle, as workers have been more reluctant than residents to be vaccinated…
POST 124. February 5, 2021. CORONAVIRUS. Dr. Osterholm ” …it may be time to..go with a ‘first-dose only’ approach, so more people over the age of 65 can have at least some protection right away. He said that would require delaying second doses until this summer.” Dr.Fauci “warned against this practice, and cautioned people about “the danger” that could come with focusing only on the first dose.”
POST 125. June 9, 2021. CORONAVIRUS. “States are rolling back Covid-19 restrictions as new cases trend down from record highs across the country. But experts warn it might be too much too soon as variants pose an increased risk and the pandemic… is far from over.”
POST 126. February 11, 2021. CORONAVIRUS. “There will be more coronavirus outbreaks in the future. Bats and other mammals are rife with strains and species of this abundant family of viruses. Some of these pathogens will inevitably spill over the species barrier and cause new pandemics. It’s only a matter of time.” (A)
POST 127. February 12, 2021. CORONAVIRUS. “… Trump only agreed to be hospitalized when aides told him that he could walk to Marine One or he could wait until his case progressed and he would be carried out.”
POST 128. February 14, 2021. CORONAVIRUS. “The Centers for Disease Control and Prevention released new research on Wednesday that found wearing a cloth mask over a surgical mask offers more protection against the coronavirus, as does tying knots on the ear loops of surgical masks…
POST 129. February 15, 2021, CORONAVIRUS. “ “The CDC released its much-anticipated, updated guidance to help school leaders decide how to safely bring students back into classrooms, or keep them there.”…” For politicians, parents and school leaders looking for a clear green light to reopen schools, this is not it.”
POST 130. February 16, 2021. CORONAVIRUS. “A second person who had contracted the Ebola virus died this week in the Democratic Republic of Congo, marking another outbreak just three months after the nation outlasted the virus’s second-worst outbreak in history…”
POST 131. February 17, 2021. CORONAVIRUS. “It really is right now – a race between how quickly new variants, particularly the U.K. variant, can spread in the United States and how quickly we can get people vaccinated”
POST 132. February 20, 2021. CORONAVIRUS. “In Texas, where over 2.5 million people are still without power, the state health department said this week’s vaccine shipments wouldn’t arrive until Wednesday at the earliest.”
POST 133. February 23, 2021. CORONAVIRUS. “Going off your meds is a surefire way to aggravate your doctor. What if a whole country did it?” The United Kingdom has veered into uncharted territory by changing tack and introducing a revised COVID-19 vaccination protocol, one that involves distributing the second dose at 12 weeks, rather than the prescribed 21 days.”
POST 134. February 24, 2021. CORONAVIRUS. The first tranche of the J&J (single dose) vaccine must go to K-12 teachers, so schools can open safely in the first 100 days of the Biden Administration. The federal government…”can set up its own vaccination centers in regions with eligible populations it’s trying to target.” We owe our front-line teachers nothing less!
POST 135. February 27, 2021. CORONAVIRUS. “As Chief Executive Officers of New York’s major health care systems, we would like to provide facts to clear up confusion in the public and the media regarding decisions to discharge patients to nursing homes during New York’s spring coronavirus surge.”
POST 136. March 2, 2021. CORONAVIRUS. ““The governors of Texas and Mississippi both announced on Tuesday they would be lifting their states’ mask mandates and rolling back many of their Covid-19 health mandates..”…while “The US could experience a “fourth surge” of coronavirus before the majority of the country is vaccinated.”
POST 137. March 4, 2021. CORONAVIRUS. “The clamor for hard-to-get Covid-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system. They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow? Some pharmacists have even given them a nickname: vaccine lurkers.” (H)
POST 138. March 6, 2021. CORONAVIRUS. “New cases are decreasing in the third wave because we are past the holidays, not because of vaccinations. It is a common misconception that the decrease we are seeing in new cases, hospitalizations, and deaths in the U.S. is due to vaccinations. The two aren’t related; at least yet.”
POST 139. March 8, 2021. CORONAVIRUS. CDC Issues First Set of Guidelines on How Fully Vaccinated People Can Visit Safely with Others…” In practice, that means fully vaccinated grandparents may visit unvaccinated healthy adult children and healthy grandchildren of the same household without masks or physical distancing.” (C)
POST 140. March 9, 2021. CORONAVIRUS. “In West Virginia, they are bracing for the second wave….. Not coronavirus but opioid overdoses, with one scourge driving a resurgence of the other.
POST 141. March 11, 2021. CORONAVIRUS. Today is the first anniversary of the WHO declaration that the novel coronavirus was a Public Health Emergency of International Concern… “To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like.”
POST 142. March 15, 2021. CORONAVIRUS. “Candida auris is a superbug, a pathogen that can evade drugs made to kill it—and early signs suggest the COVID-19 pandemic may be propelling infections of the highly dangerous yeast. That’s because C. auris is particularly prominent in hospital settings, which have been flooded with people this year due to the coronavirus.”
POST 143. March 17, 2021. CORONAVIRUS. “The Trump administration sought to suppress Covid-19 testing in the United States last year by softening guidance from the Centers for Disease Control and Prevention on who needed to be tested, a House panel said Monday.”
POST 144. March 20, 2021. CORONAVIRUS. ““The vaccine hesitancy we are seeing isn’t just about Covid vaccines,”… “It is a general reflection of Americans’ lack of trust in science, the pharmaceutical industry, and large health care institutions. We need a full court press on science and vaccine education right now to prevent more aggressive Covid-19 variants from developing and taking hold.”
POST 145. March 25, 2021. CORONAVIRUS. “Efforts to disseminate Covid-19 vaccines as widely as possible are hitting an unexpected obstacle: health-care workers who decline the shots.
POST 146. March 30, 2021. CORONAVIRUS. Dr. Osterholm told Becker’s: “This is the perfect storm,”…”Here is Europe locking down and having problems containing B.1.1.7, even with vaccinations and previous infection histories. Here we are opening up as wide as we can. We are literally just walking into the mouth of the virus saying, ‘Don’t worry.’” (M)
POST 147. April 5, 2021. CORONAVIRUS. “The pandemic helped cement the shift to “a philosophy of really focusing on the role of the physician in reasoning through ambiguous and unknown problems as the focus of education, rather than teaching students that the role of physician was to memorize a body of knowledge that was already in existence and good enough for what usually happens.”
POST 148. April 7, 2021. CORONAVIRUS. While the Biden administration accelerates vaccinations to ward off numerous variants and as more young people are being hospitalized, states, even with increasing case rates are on paths to fully reopen. Politics v. public health!
POST 149. April 10, 2021. CORONAVIRIUS. “From Michigan to Massachusetts, COVID-19 cases and hospitalizations are on the rise again. Deaths will soon follow. “ ”.. the Biden administration is facing renewed calls to delay second vaccine doses and blanket more of the U.S. population with an initial shot.”
POST 150. April 10, 2021. CORONAVIRUS. “The use of so-called COVID-19 “vaccine passports” is quickly becoming a divisive issue across the US – with several states, including New York, embracing the idea, while others have already moved to ban them.”
POST 151. April 14, 2021. CORONAVIRUS. the J&J vaccination pause. “ Federal officials are concerned that doctors may not be trained to spot or treat the rare disorder if recipients of the vaccine develop symptoms of it…” “…a standard treatment for blood clots — use of an anticoagulant drug — could be dangerous or even fatal in such cases…”
POST 152. April 15, 2021. CORONAVIRUS. “The Chinese Center for Disease Control and Prevention’s director said Saturday authorities are considering mixing COVID-19 vaccines because the country’s domestically made doses “don’t have very high protection rates,”
POST 153. April 18, 2021. CORONAVIRUS. “At least 35 hospitals across Michigan were listed Thursday as nearing capacity and three were at full capacity for COVID-19 patients..”.. We can manufacture beds. We can open up beds. We can create entire wings of the hospital if we have to, but if we don’t have staff for those beds, we’ve got nothing.”..
POST 154. April 19, 2021. CORONAVIRUS. “Breakthrough infections, which occur when fully vaccinated people are infected by the pathogen that their shots were designed to protect against, are an entirely expected part of any vaccination process.” “Pfizer’s chief executive said that a third dose of the company’s Covid-19 vaccine was “likely” to be needed within a year of the initial two-dose inoculation — followed by annual vaccinations.”
POST 155. April 24, 2021. CORONAVIRUS. As the J&J vaccine pause is ended Senator Johnson said “The science tells us that vaccines are 95% effective. So if you have a vaccine, quite honestly, what do you care if your neighbor has one or not? I mean, what is it to you?”
POST 156. April 28, 2021. CORONAVIRUS. As CDC revises guidance on outdoor masking, Texas Governor Abbott says “the state is “very close” to herd immunity… despite acknowledging that he does not know what the herd immunity threshold is for the virus, an uncertainty echoed by the public health community.”
POST 157. April 25, 2021. CORONAVIRUS. Ohio hospitals; “We agreed in multiple conversations, there’s nothing in fighting a pandemic that creates a competitive advantage.”…
POST 158. May 5, 2021. CORONAVIRUS. . As populations get closer to herd immunity “ it may be helpful to introduce some nuance to what we mean by the term. Nationwide herd immunity. Regional herd immunity. Temporary herd immunity. Endemicity.”
POST 159. May 9, 2021. CORONAVIRUS. “Without deeper sharing of expertise in how to make vaccines…waiving patent obligations is unlikely to be a game-changer… Having access to the “recipe” certainly helps, but understanding how to put it together and produce it at scale is something else.”
POST 160. May 13, 2021.CORONAVIRUS. “The CDC acknowledged Friday that airborne spread of COVID-19 among people more than 6 feet apart “has been repeatedly documented.”” Meanwhile states relax or eliminate indoor dining restrictions. HUH?
POST 161. May 15, 2021. CORONAVIRUS. “Even if the spread of Covid-19 decreases enough to allow a return of most activities, there are some aspects of pandemic life that epidemiologists say will persist much longer. In particular, they say that masks are a norm that should continue, even if that view puts them at odds with the new C.D.C. guidance. More than 80 percent of them say people should continue to wear masks when indoors with strangers for at least another year, and outdoors in crowds.”
POST 162. May 21, 2021. CORONAVIRUS. “New Jersey Gov. Phil Murphy is refusing to lift his indoor mask mandate for vaccinated residents…” “…fully vaccinated residents in New York and Connecticut are no longer required to wear masks..”..” “California says it isn’t ready to follow the federal lead and unmask, at least for another month..”.. “..Texas Gov. Greg Abbott issued an executive order Tuesday prohibiting state governmental entities such as counties, public school districts, public health authorities and government officials from requiring mask wearing.”
POST 163. May 23, 2021. CORONAVIRUS. RWJBarnabas Health in New Jersey announced a mandate…saying supervisors and those of higher rank must get the vaccine by June 30. They will eventually require the system’s 35,000 employees to do the same.
POST 164. May 26, 2021. CORONAVIRUS. On Wednesday, health minister Norihisa Tamura warned Olympic organizers they would have to “secure their own” hospital beds for anyone falling ill at the Games, explaining the government would not release beds set aside for Japanese covid-19 patients.”
POST 165. May 31,2001. CORONAVIRUS. “Like all pandemics, this one will end either with millions — maybe billions — being infected or being vaccinated. This time, world leaders have a choice, but little time to make that choice before it is made for them.”
POST 166. June 3, 2020. CORONAVIRUS. “President Biden said Wednesday that he has asked intelligence agencies to double down on their efforts to investigate whether the coronavirus originated from human contact with an animal or in an laboratory in China, saying there is not “sufficient information” to assess whether one is more likely than the other.”
POST 167. June 9, 2021. CORONAVIRUS. Hospitals prevaricate on mandatory staff vaccinations. Florida’s Governor forbids cruise ship vaccine mandates. Pfizer and Moderna apply for FDA full approval.
POST 168. June 10, 2021. CORONAVIRUS. “Our species has a tendency to get distracted. We have a very strong appetite for distraction, and when something is not in the spotlight, when it’s not a crisis anymore, we tend to forget and move on to something else. So the biggest challenge is going to be maintaining focus on this next step of developing vaccines that anticipate pandemics.”
POST 169. June 14, 2021. CORONAVIRUS. “Hospitals in Washington, D.C…announced a consensus agreement to mandate COVID-19 vaccinations for more than 30,000 workers, 70% of which are already vaccinated. Each of 14 hospitals will set their own deadline…”
POST 170. June 17, 2021. CORONAVIRUS. “Dr. Ashish Jha…is worried about the potential impact the delta variant could have in the United States… “I’m concerned about the Delta variant,”… “Why? Most contagious variant yet. Wreaked havoc in India. Spiking cases in UK. Growing rapidly in the US.”
POST 171. June 19, 2021. “A 34-year-old man (a Covid-19 survivor) has been diagnosed with India’s first known case of “green fungus” infection.”… “Green fungus is the new infection to join the earlier known cases of black, white and yellow fungus.”…”green fungus was earlier seen only as a “junior partner” in other infections… In the current patient, this fungus is acting as the aggressor.”
POST 172. June 23, 2021. CORONAVIRUS. Morgan Stanley chief executive James Gorman said: “If you can go into a restaurant in New York City, you can come into the office.”…”remote work can “dramatically undermine” the character and culture a company is attempting to build; and “virtually eliminates spontaneous learning and creativity.”
POST 173. June 26, 2021. CORONAVIRUS. “The daily toll of COVID-19, as measured by new cases and the growing number of deaths, overlooks a shadowy set of casualties: the rising risk of mental health problems among health care professionals working on the frontlines of the pandemic.”
POST 174. July 1, 2021. CORONAVIRUS. “..while the WHO is encouraging people to keep wearing masks even if they’re vaccinated, Dr. Anthony Fauci says it doesn’t look like the CDC currently plans to change its guidelines.” … health officials in Los Angeles recommended that “everyone, regardless of vaccination status, wear masks indoors in public places as a precautionary measure.”..”
POST 175. July 5, 2021. CORONAVIRUS. “Can a health care worker who is not against vaccines in general still harbor sincere concerns that scientists don’t yet know about all the side effects of these vaccines? Yes, says Ezekiel Emanuel, MD, PhD — but those people should not work in health care.”
POST 176. July 9, 2021. CORONAVIRUS. Mercy Springfield ( Missouri) hospital…” ran out of ventilators for its patients over the Fourth of July weekend…”…“Mercy will require all current and future employees to be fully vaccinated.”…“The US government is deploying a Covid-19 surge team to provide public health support in southwest Missouri
POST 177. July 12, 2021. CORONAVIRUS. the Delta variant is “the 2020 version of Covid-19 on steroids,”… “It is the most hypertransmissible, contagious version of the virus we’ve seen to date…it’s a superspreader strain if there ever was one .” but… now, there’s a Delta Plus variant…
POST 178. July 15, 2021. CORONAVIRUS. “Tennessee’s top vaccine official says she has been fired as punishment for doing her job in the face of political pushback.”..” More than 180 state and local public health leaders…have resigned, retired or been fired since April 1…”“Former President Trump and his GOP allies have stepped up attacks on Anthony Fauci…”
POST 179. July 16, 2021. CORONAVIRUS. “It, therefore, follows that the “harm principle” (“first, do no harm.”) can be used to justify compulsory vaccination programs in specific instances where the community interests or benefits are deemed to be significant.”
POST 180, July 20, 2021. CORONAVIRUS. “Most people will either get vaccinated, or have been previously infected, or they will get this Delta variant,”.. “And for most people who get this Delta variant, it’s going to be the most serious virus that they get in their lifetime in terms of the risk of putting them in the hospital,”
POST 181. July 22, 2021. CORONAVIRUS. “Health experts fear the Tokyo Olympics could become a COVID-19 superspreader event.” “Whatever happens in Japan isn’t likely going to stay in Japan since all of the athletes and accompanying coaches and staff will be returning to their home countries.”
POST 182. July 26, 2021. CORONAVIRUS. Alabama Gov. Kay Ivey (R): “Folks supposed to have common sense.”…“But it’s time to start blaming the unvaccinated folks, not the regular folks. It’s the unvaccinated folks that are letting us down.” ““Beginning in mid-September, New York City will require all of its 340,000 municipal workers, including police, firefighters and teachers, to either be vaccinated against COVID-19 or tested weekly.”
POST 183. July 29, 2021. CORONAVIRUS. When I was appointed President and CEO of Jersey City Medical Center in1989 in the peak of the HIV/ AIDS crisis, we had a dedicated, and always full, dedicated 60 bed AIDS unit, staffed by one full time nurse and numerous part-time and per diem nurses. Today, right now, hospitals caught in the Covid-19 surge, are forced to redeploy nursing staff, respiratory therapists and other clinicians, most without prior infectious diseases experience. Why are we tolerating the unvaccinated putting our hospital staffs at risk?
POST 184. August 1, 2021. CORONAVIRUS. “The coronavirus could be “just a few mutations potentially away” from evolving into a variant that can evade existing COVID-19 vaccines, CDC director Rochelle Walensky said..” (A) “The Delta variant is more transmissible than the viruses that cause MERS, SARS, Ebola, the common cold, the seasonal flu and smallpox, and it is as contagious as chickenpox..” (I)
POST 185. August 6, 2021. CORONAVIRUS. ‘If you aren’t going to help, please get out of the way’: Biden turns up the pressure on GOP governors as Delta spreads”
POST 186. August 8, 2021. CORONAVIRUS. “One of the last things they do before they’re intubated is beg me for the vaccine. I hold their hand and tell them that I’m sorry, but it’s too late,” she added, referring to patients who have to be put on a ventilator.” (A) “There is no one definition of what the end of a pandemic means.”.. “The question of when the crisis will be over is a layered one — with different answers from local, national and global perspectives.”
POST 187. August 11, 2021. CORONAVIRUS. “As a result of the increase in COVID-19 cases and hospitalizations, the state of Florida requested 300 ventilators from the federal government.”… “An 11-month-old girl with Covid-19 is stable and no longer intubated one day after she was airlifted to a Texas hospital 150 miles away because of a shortage of pediatric beds in the Houston area.”
POST 188. August 15, 20201. CORONAVIRUS. “According to an internal CDC briefing….an estimated 1.1 million people have already gotten unauthorized booster shots…”….”If it is left up to the honor system, I think many Americans will suddenly wake up and find themselves immunocompromised enough to get a 3rd dose,”
POST 189. August 19,2021. CORONAVIRUS. “There wasn’t a single I.C.U. bed available in Alabama on Wednesday…”…”A triage plan on the Alabama health department’s website suggests that “persons with severe mental retardation” are among those who “may be poor candidates for ventilator support.”
POST 190, August 21, 2021. CORONAVIRUS. “We’re looking, in essence, at running two systems — a COVID system and a non-COVID system of care,”..“Emergency medical technicians (EMTs) and certified paramedics can now care for patients in Mississippi hospitals and emergency rooms under a new health office order issued by the Mississippi State Department of Health on Wednesday.”
POST 191. August 27, 2021. CORONAVIRUS. “Anthony Fauci, MD, chief medical advisor to the president and director of the National Institute of Allergy and Infectious Diseases, explained that late September gives the United States time to set up the logistics.” This is not medical science, but perhaps Political Science?
POST 192. August 30, 2021. CORONAVIRUS. Gov. John Bel Edwards on Hurricane Ida – “I hate to say it this way, but we have a lot of people on ventilators today and they don’t work without electricity,” he said.”
POST 193. September 3, 2021. CORONAVIRUS. Nurses are leaving their hospitals and becoming travel nurses at hospitals across town “because they can make $4,000, $5,000, $6,000, $7,000 a week while not having to relocate anywhere..”
POST 194. August 2, 2021. CORONAVIRUS. “Recently-released data is painting a grim picture of the opioid epidemic that has gripped the United States — as the country is still grappling with the coronavirus pandemic that has killed more than half a million Americans. Some people are calling them twin pandemics that have collided”…“Faced with a novel health crisis, researchers are collecting data on the long-term impact of using opioids to treat COVID-19 pain…
POST 195. September 6, 2021. CORONAVIRUS. “…there are “zero ICU beds left for children in Dallas County, Texas,”.,..”That means if your child’s in a car wreck, if your child has a congenital heart defect or something and needs an ICU bed, or more likely if they have Covid and need an ICU bed, we don’t have one. Your child will wait for another child to die… (county judge Clay Jenkins)
POST 196. SEPTEMBER 11, 2001. PART 1. Military helicopters and jets were overhead, as President Bush was getting ready to leave NYC. PART 2. LESSONS LEARNED memorandum by hospital CEO Jonathan Metsch goes “viral”…
POST 197. September 12, 2021. CORONAVIRUS. Idaho officials have instituted “crisis standards of care” to help 10 hospitals and health care systems decide how to allocate personnel and resources to deal with a crush of COVID-19 patients.”… “The Washington Medical Coordination Center oversees facilitating transfers in the state, and it’s warning we could be nearing the point of “Crisis Standards of Care,” just like Idaho.” .. “These crisis models don’t actually save more lives, they just save different lives..”
POST 198. September 15, 2021. CORONAVIRUS. A pundit said “The most elegant policy riposte to the anti-vaxxers… is to refuse to allow Medicare or Medicaid to pay their medical bills in the event they become seriously ill. Private health insurers might also follow suit.” (but is making our hospitals become the bill collectors right?)
POST 199. September 19, 2021. CORONAVIRUS. Crisis Standards of Care. “… to his knowledge, no patient in Idaho has been taken off life-support therapy in order to provide that therapy to another patient who has a better prognosis.” “While that has yet to occur, if we continue on this path, it will,”
POST 200. September 23, 2021. CORONAVIRUS. CDC Director overrides a recommendation of its scientific advisors saying “that people can get a booster if they are ages 18 to 64 years and are health-care workers or have another job that puts them at increased risk of being exposed to the virus.”…“In a pandemic, even with uncertainty, we must take actions that we anticipate will do the greatest good.”
POST 201. September 27, 2021. CORONAVIRUS. “A multibillion-dollar institution in the Seattle area is sitting on nearly $12 billion in cash… received at least $509 million in government funds (from) a federal program that is supposed to prevent health care providers from capsizing during the coronavirus pandemic.”
“Based on our estimates…we find preventable COVID-19 hospitalizations cost $5.7 billion from June to August in 2021.”…
POST 202. September 30, 2021. CORONAVIRUS. “..NY Governor Hochul signed an executive order expanding healthcare worker eligibility requirements…to head off potential staffing shortages fueled by the state’s new COVID-19 vaccination requirements.” “The.. order allows out-of-state/ out-of-country healthcare workers to practice in New York…”..”It allows EMTs graduates to temporarily pitch in at additional healthcare settings; allows various types of healthcare workers to more easily administer and order COVID-19 vaccinations; enables telemedicine physician visits in nursing homes; permits facilities to more quickly discharge, transfer or receive patients…”
POST 203. October 3, 2021. CORONAVIRUS. “.. more than 125,000 laboratory-confirmed COVID-19 cases have been reported in pregnant people, including more than 22,000 hospitalized cases and 161 deaths”…The risk is not just to the mother. Covid-19 in pregnancy can cause preterm birth or babies born so sick they have to go straight to the neonatal intensive care unit, or NICU.”
POST 204. October 5, 2021.CORONAVIRUS. “News that an experimental antiviral drug from Merck appears to halve the risk of hospitalization or death from Covid-19 has bolstered hopes of finding a simple at-home treatment for the virus.”..” A more blunt assessment came from vaccine scientist Dr. Peter Hotez of Baylor College of Medicine’s National School of Tropical Medicine. “It’s not a miracle cure but a companion tool, So get vaccinated.””
POST 205. October 11, 2021. CORONAVIRUS. The AAP reported nearly 226,000 new child cases over the past week ending. “Hospital care for children does not occur in isolation from that of adults. Many of the resources we use are the same—a twenty-pound baby and a two-hundred-pound man might use the same kind of ventilator, for example. Dialysis machines, which could cleanse a seven-year-old’s blood as easily as his grandfather’s, are in high demand. Pediatric resident physicians, nurses, and respiratory therapists get cross-deployed to care for adults during the surges.”
POST 206. October 15, 2021. CORONAVIRUS. to borrow from Winston Churchill about where we are with the pandemic – “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”
POST 207. October 17, 2021. CORONAVIRUS. “…if you choose your own unauthorized booster shot, what happens if later research proves a different combination is better? That’s why experts say it’s a bad idea to become your own vaccine advisory committee and get a shot out of turn.”
POST 208. October 22, 2021, CORONAVIRUS. “What is the “delta plus” variant?” Scientists are monitoring the delta-related variant — known as AY.4.2. — to see if it might spread more easily or be more deadly than previous versions of the coronavirus.
POST 209. October 28, 2021. CORONAVIRUS. “The quest at Mount Sinai began with a mystery.”…”America was not simply struggling to contain a once-in-a-century pandemic, caused by a virus far more dangerous than seasonal influenza. Many patients were, for unknown reasons, not recovering.”
POST 210. October 31, 2021. CORONAVIRUS. “Some people want the FDA to speed up. Others want it to be more cautious…There’s a fundamental tension between the right to get access to a drug people are desperate for and the right to protection from dangerous failures of quality. The first demands speed; the second requires time…”
POST 211. November 4, 2021. CORONAVIRUS. Colorado – “…there are patients who really ought to be in an intensive care unit but instead they’re in an emergency room. Or they ought to be in a step-down unit but instead they’re on the floor. Or they ought to be getting one-to-one nursing, and instead they’re getting two-to-one, or three-to-one nursing….”
POST 212. November 9, 2021. CORONAVIRUS. “They went into hospitals with heart attacks, kidney failure or in a psychiatric crisis. They left with covid-19…” “A new report shows the coronavirus pandemic had a direct increase on the number of healthcare-acquired infections in hospitals nationwide.”
POST 213. November 13, 2021. CORONAVIRUS. “Since the earliest days of the pandemic, there has been one collective goal for bringing it to an end: achieving herd immunity…Now the herd is restless. And experts at the Centers for Disease Control and Prevention have set aside herd immunity as a national goal.”
POST 214. November 20, 2021. CORONAVIRUS. “This virus is doing what this virus does,” said Michael Osterholm… “We don’t understand why surges start, we don’t understand why they end.” (A)
POST 215. November 26, 2021. CORONAVIRUS. Dr. Fauci on the new South African variant: “It’s not going to be possible to keep this infection out of the country. The question is: Can you slow it down?”
POST 216. December 1, 2021. CORONAVIRUS. Covid cacophony: as states struggle to address health care staffing shortages, a federal court puts Biden administration health care worker vaccination mandate on hold.
POST 217. December 3, 2021. CORONAVIRUS. President Biden Announces New Actions to Protect Americans Against the Delta and Omicron Variants as We Battle COVID-19 this Winter
POST 218. December 5, 2021. CORONAVIRUS. “In some ways, Delta is the ideal variant: It’s transmissible enough to dominate more dangerous variants, and its virulence can be controlled through vaccination. In the next few weeks, we’ll find out whether Omicron will have its own silver lining—or whether it’ll be catastrophically worse.”
POST 219. December 9, 2021. CORONAVIRUS. “Entering uncharted territory, the U.S. counts 500,000 Covid-related deaths.”… “So yes, I am furious at the unvaccinated, and I am not ashamed of disclosing that. I am no longer trying to understand them or educate them.”
POST 220 December 13, 2021. CORONAVIRUS. Dr. Osterholm. “You cannot outrun the game clock with this pandemic. This virus will find you… We’ve seen health care systems virtually broken by this pandemic. They just couldn’t provide critical care to non-Covid patients.” (A)
POST 221. December 18, 2021. CORONAVIRUS. “Johnson & Johnson’s Covid vaccine was going to be a shot for the world. Now, under the weight of a mountain of bad PR, one wonders if the world will want it.”
POST 224. December 29, 2021. CORONAVIRUS. “crisis standards of care protocols in Maryland – “It also allows us to slim down documentation,… allows unconventional staffing models such as using nurses that have not been bedside. It also sets the expectations for the community that it’s not business as usual.”
POST 225. January 3, 2021. CORONAVIRUS. “Be first, be right, be credible,” are among the most important principles for health authorities to follow in a crisis, the Centers for Disease Control and Prevention shared in a pamphlet on crisis communication in 2018….”
Post 226. January 5, 2022. CORONAVIRUS. New York City – “The city’s ambulance corps are so understaffed because of the COVID-19 surge, they’re now under new orders to try to convince stable patients with flu-like symptoms not to go to the hospital.”
POST 227. January 10, 2020. CORONAVIRUS. “Stay indoors. But also return in person. Wear a mask. Not that one. The expensive one, that you can’t find. Take rapid tests. Which you also can’t find. But if you find them, don’t buy them. Rapid tests don’t work. You need PCR. There are zero appointments in your area.” (F)
POST 228. January 13, 2022. CORONAVIRUS. “State officials are attempting to address California’s staffing shortage through a sweeping policy change that allows asymptomatic healthcare workers who have tested positive for the coronavirus to return to work immediately.” “Asymptomatic health professionals who had tested positive for COVID-19 should “preferably be assigned to work with COVID positive patients.”
POST 229. January 16, 2020. CORONAVIRUS. “It is now highly unlikely that the U.S. will hit the ~85-90% of Americans vaccinated to get to the other side of the pandemic…”
POST 230. January 20, 2022. CORONAVIRUS. “Dr. Fauci also said that the world is still in the first of what he considered to be the five phases of the pandemic. The first is the “truly pandemic” phase, “where the whole world is really very negatively impacted,” followed by deceleration, control, elimination and eradication.”…to paraphrase Churchill – “This is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”..
POST 231. January 24, 202. CORONAVIRUS. “Florida’s top public health official in Orlando has been placed on administrative leave after sending an email to his employees noting their lackluster coronavirus vaccination rates and urging them to get the shots.”
POST 232. January 28, 2022. CORONAVIRUS. “A Boston hospital’s denial of a heart transplant to a man who is unvaccinated for Covid-19 has generated national attention, but experts say mandating vaccines is in keeping with other long-standing requirements that patients have to meet to receive an organ — including getting other shots…”
POST 233. February 2, 2022. CORONAVIRUS. “The same virus can cause endemic, epidemic or pandemic infections: it depends on the interplay of a population’s behaviour, demographic structure, susceptibility and immunity, plus whether viral variants emerge.”
POST 234. February 2, 2022. CORONAVIRUS. “Senate Republican leader Mitch McConnell demanded an end to the COVID-19 state of emergency on Wednesday , saying it was time for Americans to get on with their lives after two years on a ‘hellish highway.’”
POST 235. February 17, 2020. CORONAVIRUS. “Over time, the U.S. health care sector has implemented various pieces of the (pandemic) safety-assessment-and-improvement puzzle, but it has not instituted a thorough system of safety that reaches from the boardroom to the front lines and that can be maintained during times of crisis.”
POST 236. February 22, 2021. CORONAVIRUS. MOUNT SINAI AT HOME – “We began thinking about how we could use hospital-at-home to meet the needs of our hospital system in our community, in terms of responding to the crisis of COVID-19…”
POST 237. February 27, 2020. CORONAVIRUS. “Decision-makers are increasingly embracing the reality that we will have to “learn to live with” the coronavirus. But how will they know when to impose or lift restrictions?” “Now, the CDC’s “Covid-19 community level” metrics are based on three pieces of data in a community: new Covid-19 hospitalizations, hospital capacity and new Covid-19 cases.”
POST 238. March 5, 2022, CORONAVIRUS. “Two different scientists can look at the same set of data and come up with different conclusions. That’s not to say that one person is being unscientific or ignoring the scientific process,” said Leana Wen, an emergency physician and a professor at George Washington University. “Public health policy is also a measure of values.””
POST 239. March 9, 2022. CORONAVIRUS. “War is an infectious disease’s best friend,” says Michael Osterholm, “It challenges every public health program you can possibly have. It limits the medical care available for those who might be seriously ill, and often fosters transmission when so many people are crowded into bomb shelter locations and on trains. This is going to be the perfect storm of one serious challenge after another.” (E)
POST 241. March 20, 2022, CORONAVIRUS. Dr. Ashish Jha will serve as the new White House COVID-19 response coordinator.” He is not, for the record, a virologist, immunologist, or vaccinologist…But he is a public health expert and a practicing internist, which means he has years of experience explaining complicated and often incomplete information to people who neither know nor care about the correct pronunciation of “adenovirus.” That’s who he imagines on the other end of his webcam.”
POST 242. March 24, 2022. CORONAVIRUS. “How worried should people be about the BA.2 variant? Will vaccines protect against it? What if someone contracted a previous variant — could they become reinfected? Is BA.2 milder than previous versions, and if so, should people try to get it? Could BA.2 cause another surge in the US, and is it time for restrictions to be put back into place?”
POST 243. March 28, 2022. CORONAVIRUS. “…the US Food and Drug Administration is planning authorize a fourth dose of the Pfizer and Moderna mRNA vaccines for adults over age 50 next week.”…”The decision to make fourth doses available now will bypass independent groups of scientific advisers for both the FDA and CDC, which would normally meet and publicly review the available science and then make recommendations to the agencies.”
POST 245. April 10, 2022. CORONAVIRUS. We can’t react to a wave we don’t see coming. “I keep thinking back to this idea of If we don’t measure it, it won’t happen,”…(As President Donald Trump once put it, “If we stop testing, we’d have fewer cases.”) In reality, “it’s very well happening, and we just don’t see it yet.”
POST 246. April 15, 2022. CORONAVIRUS. “State authorities and health care organizations could pay a high price for reinstating SCOPE OF PRACTICE (SOP) restrictions when the pandemic ends.” (e.g. NPs, PAs, Pharmacists +++)
POST 247. April 23, 2020. CORONAVIRUS. “The DOJ lawyers tasked with defending the CDC’s mask mandate authority have warned Biden administration officials that continuing to push the legal fight over the mask mandate could backfire, if the conservative-leaning appeals court upholds the order.”….”A Supreme Court ruling upholding the decision to strike down the mask mandate would make the Florida judge’s conclusions about CDC authority binding nationwide.”
POST 248. April 27, 2022. CORONAVIRUS. “For at-risk Americans without access to a “test-to-treat” drugstore that has a qualifying provider available, this means some will have to make multiple trips to get the pills. You have to develop COVID symptoms, you have to subsequently get a test for COVID-19, get the result of that test, find and go to see a provider, get a prescription, and then fill that prescription. That’s six steps in five days,”…
POST 249. May 6, 2022. CORONAVIRUS. “The United States is “certainly, right now, in this country, out of the pandemic phase..” (Dr. Anthony Fauci). “The US should prepare for a possible summer surge of Covid-19 cases across Southern states..” (Dr. Deborah Birx)
POST 250. May 11, 2022. Herd Immunity Deja vu. “Not so long ago, the world was clinging to the hope of herd immunity—to the notion that the population would eventually reach some communal level of protection sufficient to quash the outbreak for good. Maybe, experts posited many months back, once 60 to 90 percent of people had been infected or vaccinated or both, the virus would run out of viable hosts, and simply fizzle out. Now it’s clear that “that’s too simplistic…”
POST 252. May 20, 2022. CORONAVIRUS. “The stakes, two years into the pandemic, should be clear. Fewer vaccines, fewer treatments, and fewer tests will mean more infections, more serious illnesses, and more deaths. That is the scenario the country is staring down: one million people already dead and more to come because politicians became complacent.”
POST 253. May 29, 2020. CORONAVIRUS. “Significant obstacles persist in getting Paxlovid to everyone who could benefit from it; more than a million courses of Paxlovid purchased by the government are still available…”..” However, some doctors have also voiced concerns over wider use of the antiviral drug amid reports of so-called “rebound” symptoms following use of Paxlovid, which might raise the risk of the virus evolving resistance to the pills.”
POST 254. June 2, 2022. MONKEYPOX, “Massachusetts General Hospital this week began vaccinating a small group of workers against monkeypox — the first time the new medicine has been used in this country outside of clinical trials. The workers were in close contact with a man diagnosed with the virus and hospitalized at Mass General from May 12 to May 20. The patient was the first person in the United States to be tied to an ongoing outbreak of the rare virus in Europe and North America.”
POST 255. June 5, 2022. CORONAVIRUS. “More than a year after U.S. health care workers were saluted for saving lives in the COVID-19 outbreak and celebrated with nightly clapping from windows and balconies, some are being issued panic buttons in case of assault and ditching their scrubs before going out in public for fear of harassment.”
“The shooting in Tulsa is an extreme example of a growing trend: violence against doctors, nurses, and other health care workers.”
POST 256. June 10, 2022. MONKEYPOX. “This is one of the rare diseases in which you can vaccinate somebody after they’ve been infected, before they have symptoms, and block the disease,”… “We would have to really screw things up not to be able to contain this..”
POST 257. June 17, 2022. CORONAVIRUS. “We’re now in a very weird pandemic phase. On Twitter, doctors such as Eric Topol sound five-alarm warnings about the latest subvariants of omicron. Offline, even in blue states, people are back to parties, bars and restaurants — and will soon be flying around the world with no testing requirements to return to the US. Things feel as if they’ve lost any coherence. There’s no discernible strategy or guidance on what Covid precautions we should still be taking.”
POST 258. June 26, 2022. CORONAVIRUS. “For a long time, whenever companies wanted to hire a CEO or another key executive, they knew what to look for: somebody with technical expertise, superior administrative skills, and a track record of successfully managing financial resources.”..” That practice now feels like ancient history. So much has changed during the past two decades that companies can no longer assume that leaders with traditional managerial pedigrees will succeed in the C-suite..”
It’s one of those weeks with no big COVID-19 headlines perhaps except for Dr. Fauci testing positive. But under-the-radar a number of unrelated reports suggest that policy makers know we can’t get ahead of the virus and are no longer following the data, and instead are capitulating and normalizing non-compliant activity. Because of the current low increase in hospitalizations and continued flat death rates are they accepting a slow road to herd immunity? Are they letting our guard down and our readiness for a surge of a highly transmissible and deadly COVID variant? (or a different emerging virus?)
for links to POSTS 1-257 in chronological order highlight and click on
“The cost of the COVID-19 pandemic is staggering, in terms of both human life and and economic activity. But Bill Gates believes humanity is fortunate that the virus was not even more devastating…
While the official global death toll from COVID-19 is about 6.3 million, experts estimate that the real number of deaths is much higher. In May, the World Health Organization estimated that there were about 14.9 million excess deaths associated with the pandemic in 2020 and 2021.
Gates warned that we should not count on similar lucky during the next global pandemic. Considering how destabilizing the COVID-19 pandemic has been, if another virus emerges with similar virulence but a much higher fatality rate—say, 5%— it could be “society ending,” Gates said.
And Gates believes there may very well be a next time for many people alive today. “The chance of another pandemic in the next 20 years, either natural or intentional, I’d say, is over 50%,” he said…
As Gates explained…. the COVID-19 pandemic has created a unique opportunity to prevent another pandemic from ever happening again—but only if the world is willing to make key investments.
Specifically that means improving technology, including vaccines, therapeutics, and diagnostics; building up health systems; and improving global monitoring of diseases. In his interview with TIME, Gates emphasized that these changes are necessary in both wealthy and poor countries, to ensure that scientists everywhere have the resources they need to raise red flags about bourgeoning outbreaks, and to get them under control within just 100 days, a key window during the COVID-19 pandemic, Gates said, before the virus began to spread exponentially.” (A)
“COVID-19 cases have risen in the U.S. to around 100,000 per day, and the real number could be as much as five times that, given many go unreported.
But the situation is far different from the early months of the pandemic. There are now vaccines and booster shots, and new treatments that dramatically cut the risk of the virus. So how much do cases alone still matter?
That question has prompted debate among experts, even as much of America goes on with their lives, despite the recent surge in cases.
How much concern high case numbers alone should prompt is “the trillion-dollar question,” said Bob Wachter, chair of the department of medicine at the University of California-San Francisco.
In the early days of the pandemic, dying of COVID-19 was a concern for him, but now, in an era of vaccines and treatments, “it doesn’t even cross my mind anymore,” he said.
But he noted there are other risks, including long COVID-19: symptoms like fatigue or difficulty concentrating that can linger for months.
“I think long COVID is pretty scary,” he said.
While cases have risen to around 100,000 reported per day, deaths have stayed flat, a testament to the power of vaccines and booster shots in preventing severe illness, as well as the Pfizer treatment pills Paxlovid, which cut the risk of hospitalization or death by around 90 percent.
Hospitalizations have risen, but only modestly, to around 27,000, one of the lowest points of the pandemic, according to a New York Times tracker.
Cases have now been “partially decoupled” from causing hospitalizations and deaths, said Preeti Malani, an infectious disease expert at the University of Michigan, such that hospitals are no longer overwhelmed.
“[Cases are] not without any consequence, but in terms of pressure on the health system, so far we’re not seeing that, which is really what drove all of this,” she said.
The behavior of much of America reflects a lessened concern about the risk of being infected. Restaurants and bars are packed. Many people do not wear masks even on airplanes or on the subway.
An Axios-Ipsos poll in May found just 36 percent of Americans said there was significant risk in returning to their “normal pre-coronavirus life.”
In the Biden administration, health officials are still advising people to wear masks in areas the Centers for Disease Control and Prevention classifies as at “high” risk. But President Biden himself is talking about the virus far less than he did at the start of his administration, and is not making sustained calls for people to wear masks.
White House COVID-19 response coordinator Ashish Jha touted progress in defanging cases on Thursday.
“We see cases rising, nearly 100,000 cases a day, and yet we’re still seeing death numbers that are substantially, about 90 percent lower, than where they were when the president first took office,” he told reporters.
Some experts are pushing back on the deemphasis of case numbers, saying they still matter.
“The bunk that cases are not important is preposterous,” Eric Topol, professor of molecular medicine at Scripps Research, wrote last month. “They are infections that beget more cases, they beget Long Covid, they beget sickness, hospitalizations and deaths. They are also the underpinning of new variants.”
Even if one does not get severely ill oneself, more cases mean more chances for the virus to spread on to someone who is more vulnerable, like the elderly or immunocompromised.
While deaths are way down from their peak earlier in the pandemic, there are still around 300 people dying from the virus every day, a number that would have proved shocking in a pre-COVID-19 world.” “(C)
“At one point last month, children were admitted to Yale New Haven Children’s Hospital with a startling range of seven respiratory viruses. They had adenovirus and rhinovirus, respiratory syncytial virus and human metapneumovirus, influenza and parainfluenza, as well as the coronavirus — which many specialists say is to blame for the unusual surges.
“That’s not typical for any time of year and certainly not typical in May and June,” said Thomas Murray, an infection-control expert and associate professor of pediatrics at Yale. Some children admitted to the hospital were coinfected with two viruses and a few with three, he said.
More than two years into the coronavirus pandemic, familiar viruses are acting in unfamiliar ways. Respiratory syncytial virus, known as RSV, typically limits its suffocating assaults to the winter months.
Rhinovirus, cause of the common cold, rarely sends people to the hospital.
And the flu, which seemed to be making a comeback in December after being a no-show the year before, disappeared again in January once the omicron variant of the coronavirus took hold. Now flu is back, but without one common lineage known as Yamagata, which hasn’t been spotted since early 2020. It could have gone extinct or may be lying in wait to attack our unsuspecting immune systems, researchers said.
The upheaval is being felt in hospitals and labs. Doctors are rethinking routines, including keeping preventive shots on hand into the spring and even summer. Researchers have a rare opportunity to figure out whether behavioral changes like stay-at-home orders, masking and social distancing are responsible for the viral shifts, and what evolutionary advantage SARS CoV-2 may be exercising over its microscopic rivals.
“It’s a massive natural experiment,” said Michael Mina, an epidemiologist and chief science officer at the digital health platform eMed. Mina said the shift in seasonality is explained largely by our lack of recent exposure to common viruses, making us vulnerable to their return…
She and other infectious-disease specialists are also revisiting their response to RSV, a common virus that hospitalizes about 60,000 children younger than 5 each year, according to the Centers for Disease Control and Prevention. It can create deadly lung infections in preemies and other high-risk infants. The typical treatment for them is monthly shots of a monoclonal antibody, palivizumab, from around November through February. But last summer, RSV suddenly surged and this year it is causing trouble in May and June. Infectious-disease experts are carefully tracking cases so that they are prepared to reactivate the pricey protocol.
“We monitor the number of cases so that if it exceeds a number, we are ready,” Murray said. The Yale hospital, which typically holds meetings to prepare for upswings in fall through spring, is preparing pandemic-fatigued staffers for out-of-season surges…
The moment you stop seeing a virus on this regular cadence, as happened during the pandemic, that natural balance is upset, Mina said. The extraordinary measures we took to limit exposure to the coronavirus — necessary steps to contain a deadly new foe — also limited our exposure to other viruses. If you do get exposed to a virus again once too much time has passed, you may not be able to protect yourself as well, leading to out-of-season surges across the population and surprisingly virulent infections for individuals.
That, Mina and others say, is what happened once people doffed their masks and started gathering indoors. Viruses began circulating out of season because population immunity was low even if other conditions for them were not optimal.
“All of these decisions have consequences,” Murray said. “You do the best you can with the information you have.”” (D)
“Efforts to update COVID vaccines can’t seem to keep up with changes in the virus itself.
State of play: New variants appear to be even more immune-resistant than the original Omicron strain, raising the possibility that even retooled vaccines could be outdated by the time they become available this fall.
Driving the news: Preliminary data suggests that the most recent Omicron subvariants are significantly different from the original version that began spreading late last year.
One preprint released last week found that BA.4 and BA.5, which originated in South Africa, are substantially more resistant to antibodies — compared to an earlier strain, and also to the one that’s dominant in the U.S. right now — and thus more likely to lead to breakthrough infections.
Other preliminary research has found that the latest subvariants are more pathogenic and can potentially evade even the immune protection that comes from a previous Omicron infection.
The big picture: Clinical trials are underway to study tweaked versions of the Pfizer and Moderna vaccines, and the FDA has said it will decide this summer whether to recommend these updated versions for use later this year.
A leading option is to target multiple variants, including Omicron, with the same vaccine. But the Omicron version that’s around in a few months may be significantly different than the strain the vaccine was designed to target.
Between the lines: Although the vaccine manufacturers have said they can quickly adapt to produce new vaccine versions, collecting data on those vaccines’ effectiveness through real-world clinical trials takes time.
“It takes six months for the omicron BA.1 vaccines to be properly tested and then longer to produce them. That’s inevitable,” Cornell virologist John Moore said.
What they’re saying: “It’s unclear what the mix will be in the vaccine that’s used in the fall, but there’s a very good chance that it’ll be against the original Omicron,” said Celine Gounder, an infectious disease specialist and KHN editor-at-large.
“But it’s really unclear that it’s going to be much of an improvement versus the original vaccine when BA.4 and BA.5 are so significantly different than the original Omicron.”
“It’s pretty challenging. We’re very much behind the virus given the speed at which it’s moving,” Gounder added…
.
The bottom line: Keeping up with a virus that is evolving this quickly is inherently in tension with collecting the data traditionally required to make big regulatory decisions.” (E)
“We’re now in a very weird pandemic phase. On Twitter, doctors such as Eric Topol sound five-alarm warnings about the latest subvariants of omicron. Offline, even in blue states, people are back to parties, bars and restaurants — and will soon be flying around the world with no testing requirements to return to the US. Things feel as if they’ve lost any coherence. There’s no discernible strategy or guidance on what Covid precautions we should still be taking.
Danish social scientist Michael Bang Petersen, of Aarhus University, told me that familiarity with Covid is changing people’s attitudes. Many stopped fearing the virus once they contracted it and recovered. In Denmark, he said, studies show 80% of the population has been infected. Here in the US, a similar study showed about 60% had had Covid as of last February — before the latest wave started.
And people are taking cues from those around them. Social signals are really important, he said, so it’s very difficult to keep your guard up when others are going back to normal. Behavior can change in a cascading way. People wonder why they should bother if nobody else is. “That’s straight out of basic psychology of collective action,” said Bang Petersen.
Of course, some people are still being cautious and still have not caught Covid, such as epidemiologist Michael Osterholm of the Center for Infectious Disease Research and Policy…
And that means it’s hard to adapt our behavior to the situation — the way public health officials urged us to do during previous waves. Osterholm added that compared with previous surges, there are relatively few deaths this time, so the death rate is getting closer to something people are used to seeing with flu. “We don’t really know for certain how to act,” Osterholm said. We’ve never been expected to change our everyday lives because of influenza. But that might all change again if the next variant is more dangerous.” (F)
“Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and President Biden’s chief medical adviser, has tested positive for Covid-19, the institute said Wednesday.
Fauci, 81, has mild symptoms and has been boosted twice, the institute said in a statement. The institute told CNN that he is being treated with the antiviral medication Paxlovid.” (G)
“As COVID-19 cases began to accelerate again this spring, federal data suggests the rate of breakthrough COVID infections in April was worse in boosted Americans compared to unboosted Americans — though rates of deaths and hospitalizations remained the lowest among the boosted.
The new data do not mean booster shots are somehow increasing the risk. Ongoing studies continue to provide strong evidence of additional protection offered by booster shots against infection, severe disease, and death.
Instead, the shift underscores the growing complexity of measuring vaccine effectiveness at this stage of the pandemic. It comes as officials are weighing key decisions on booster shots and pandemic surveillance, including whether to continue using the “crude case rates” at all.
It also serves to illustrate a tricky reality facing health authorities amid the latest COVID-19 wave: even many boosted Americans are vulnerable to catching and spreading the virus, at a time when officials are wary of reimposing pandemic measures like mask requirements.
“During this Omicron wave, we’re seeing an increased number of mild infections — at-home type of infections, the inconvenient, having a cold, being off work, not great but not the end of the world. And that’s because these Omicron variants are able to break through antibody protection and cause these mild infections,” John Moore, a professor of microbiology and immunology at Weill Cornell Medical College, told CBS News.
“So, one of the dynamics here is that people feel, after vaccination and boosting, that they’re more protected than they actually are, so they increase their risks,” he said. “That, I think, is the major driver of these statistics.”…
Further down the road, a panel of the Food and Drug Administration’s outside vaccine advisers is scheduled to meet later this month to weigh data from new booster candidates produced by Pfizer and BioNTech as well as Moderna.
BioNTech executives told investors last month that regulators had asked to see data for both shots specifically adapted for the Omicron variant in addition to “bivalent vaccines,” which target a blend of mutations.
Those new vaccines would take about three months to manufacture, the White House’s top COVID-19 official Dr. Ashish Jha told reporters.
“It’s a little bit of a challenge here because we don’t know how much further the virus will evolve over the next few months, but we have no choice because if we want to produce the hundreds of millions of doses that need to be available for a booster campaign, we have to start at risk in the early July timeframe or even somewhat sooner,” Dr. Peter Marks, the FDA’s top vaccines official, said at a recent webinar hosted by the American Medical Association.
Marks said that bivalent shots seemed likely to be favored, given the “wiggle room” it could offer for unforeseen variants beyond Omicron.
Vaccines that might offer even better “mucosal immunity” – actually fighting off the virus where it first infects the respiratory system – are still a ways off, Marks cautioned.
“I think that we are in a transition time and I, again, will speak openly to the fact that 2022 to 2023 is a year where we have to plan for trying to minimize the effect of COVID-19 with the tools that we have in hand,” Marks said at a recent event with the National Foundation for Infectious Diseases.
“I do believe that, potentially by the 2023-2024 season, we’ll start to see second generation SARS-CoV-2 vaccines,” he added later.” (H)
“Pharmacies, states, U.S. territories and federal agencies discarded 82.1 million Covid vaccine doses from December 2020 through mid-May — just over 11 percent of the doses the federal government distributed, according to data the Centers for Disease Control and Prevention shared with NBC News. That’s an increase from the 65 million doses the CDC told the Associated Press had been wasted as of late February.
Two retail pharmacy chains, CVS and Walmart, were responsible for over a quarter of the doses thrown away in the United States in that time period, in part due to the sheer volume of vaccine they handled.
Five other pharmacies or dialysis centers — Health Mart, DaVita, Rite Aid, Publix and Costco — wasted fewer overall doses, but a higher share: more than a quarter of the vaccine doses they received, well above the national average. Two states also discarded more than a quarter of their doses: Oklahoma, which tossed 28 percent of the nearly 4 million doses it received, and Alaska, which threw away almost 27 percent of its 1 million doses, according to the CDC data.
The overall amount of waste is in line with World Health Organization estimates for large vaccination campaigns. But public health experts said the waste is still alarming at a time when less than half of fully vaccinated Americans have a booster shot — which is critical to fight newer, more contagious virus strains — and when many poorer countries continue to struggle with vaccine supply.
“It’s a tremendous loss to pandemic control — especially in the context of millions of people around the world who haven’t even been able to get a first dose,” said Dr. Sheela Shenoi, an infectious disease expert at the Yale School of Medicine.
The millions of wasted vaccine doses include some that expired on pharmacy shelves before they could be used, others that were spoiled by the thousands when power went out or freezers broke, and still others that were tossed at the end of the day when no one wanted the last few doses in an opened vial.
Unlike most other immunizations in the U.S., the coronavirus vaccines come in multidose vials, which means all the doses must be used within hours once the vials are opened — or discarded.
State health officials and pharmacies said that’s been a major contributor to vaccine waste. Some also said the vaccines come in such large minimum orders that they are left with more than they need…
“The latest CDC guidance advises that providing COVID-19 vaccinations should be prioritized, even if it leads to vaccine waste,” the company said.
The challenge of getting shots into arms and avoiding waste has become especially difficult as demand wanes for the vaccines, experts and officials say.
“The demand has plateaued or is coming down, and that leads to open-vial wastage — especially with multidose vials,” said Ravi Anupindi, a professor of operations research and management at the University of Michigan who has studied vaccination campaigns.
“It’s a demand problem,” he added.” (I)
“Inspectors for the Centers for Medicare & Medicaid Services will no longer check for provider compliance with the staff COVID-19 vaccine mandate during all surveys.
The agency, in a memo to state survey agencies on Wednesday, announced that oversight of the regulation will now be performed primarily in response to complaints alleging non-compliance with the requirement, rather than during all surveys. Compliance will also continue to be checked during initial and recertification surveys.
CMS said the reduction in survey frequency is “supported by the high rates of compliance in initial surveys” and keeping with the normal survey process for oversight of any Medicare requirement…
The healthcare worker vaccine mandate has been effective in all states since late February, and about 12,000 providers and suppliers have been surveyed for compliance with the rule. So far, 95% of those surveyed have been found in “substantial compliance” with the rule, according to CMS.
Federal data also shows that 87.1% of nursing home staffers have been vaccinated for COVID-19.
“While we are seeing a significant increase in COVID-19 cases in parts of the country — driven by the highly transmissible omicron subvariants — hospitalizations and deaths currently remain relatively low nationwide,” CMS wrote Wednesday.
“This is a testament to the tools and protections in place today, particularly the work that federal, state, local, and private partners have done to get over 220 million people vaccinated and over 100 million boosted.” (M)
“One passenger on a recent Carnival cruise bound for Seattle claimed there were about 200 people sick with COVID-19 on board, and that the crew were overwhelmed. Carnival downplayed the situation with Seattle press, but wouldn’t disclose the case count.
That ship, the Carnival Spirit, is now cruising between Seattle and Southeast Alaska for the summer. If its crew are following protocol, the Centers for Disease Control and Prevention, the U.S. Coast Guard and the Alaska Department of Health and Social Services should all have good data about the COVID situation on board on any given day. But very little of that information is available to the public for the Spirit, or any of the ships operating in Alaska this summer.
This year, the cruise lines operating all of the big ships in Alaska committed to regularly report illness data by opting into the CDC’s COVID-19 Program for Cruise Ships. They’ve agreed to fill out and send a form every day for every ship so the CDC can track COVID-19 cases on board.
Individuals’ health information is protected. That hasn’t stopped state health authorities from publishing individual communities’ overall case counts, hospitalization figures, hospital capacity, deaths or other stats helpful for gauging COVID-19 risk. But the CDC isn’t doing that for cruise ships.
The CDC does publish and update daily a color-coded cruise ship status on its website for each ship. Green means they have no cases of COVID-19 or COVID-like illnesses.
The Carnival Spirit has been in the orange category. That could mean as few as seven passengers are sick — or it could be hundreds. The majority of the ships sailing right now are in that category…
The CDC’s most severe category for cruise ships is red, which indicates the medical capacity onboard is overwhelmed. Some of the Spirit’s recent passengers described a poorly managed COVID-19 outbreak that did overwhelm the crew. However, Carnival told Seattle press that there were no serious health issues and that it maintained its health and safety protocols.
The CDC has not made anyone available for an interview about its cruise ship program.
Like last year, the cruise lines have made a lot of commitments to Alaska port communities to reduce the spread of COVID-19 and to manage cases themselves. Cruise passengers and crew aren’t supposed to burden local health care systems. Barr said the agreements this year say that medical facilities in the bigger ports like Juneau, Ketchikan and Whittier could help out if the need arises.
“But occasionally, occasionally we can assist,” Barr said. “In the event that we can’t, then each line is required in the agreement to transport impacted passengers and/or crew to Seattle.”
The CDC’s description of its cruise ship program also says the Coast Guard is supposed to get the most timely information about illness before ships arrive in a port. The Coast Guard has not made anyone available for an interview about this.
That leaves the Alaska Department of Health and Social Services. It’s been regularly publishing COVID-19 data statewide on online dashboards of its own since the pandemic began. The data can be narrowed to specific Alaska regions and communities. But it’s not helpful for teasing out cruise ships.
Department spokesperson Clinton Bennett said lots of factors affect how cases identified aboard a cruise ship operating in Alaska get published. And there is potential for cruise ship cases to cause spikes in different communities’ COVID-19 data that don’t reflect higher risk.
For example, a cruise ship passenger could spend a day in one community, get back on board, test positive at sea, then end up in the case counts for the next port of call — even though they would stay quarantined aboard the ship.
Bennett said cases caught in Alaska waters could also be geographically tagged as “at sea,” which isn’t searchable.
“Our overall takeaway,” Bennett wrote in an email, “is that the dashboard case counts announced in relation to the cruise industry shouldn’t be relied upon alone in understanding impact to local communities or the total size of an outbreak on a vessel.”..
“This lack of transparency — you know, I’m sorry, but for CDC to expect the cruise ships to honestly report? … These are the same ships in many cases that have polluted our waters and falsified their pollution records,” she said.
Carnival and its subsidiaries, which include Holland America and Princess, recently completed a five-year probation period for the environmental crimes Schrader mentioned.
“And we’re supposed to now believe them that they’re going to report how many potential crew and passengers have COVID?” she said.
For the state’s top health officials, the answer appears to be yes. Health Commissioner Adam Crum and Chief Medical Officer Dr. Anne Zink recently described the cruise lines as good stewards in protecting public health on board and in the communities they visit. They say the industry has demonstrated its desire to be transparent, good partners.” (J)
“The Jewel of the Seas sailed from Amsterdam on May 20th with 1,752 guests onboard the Royal Caribbean cruise ship. There were twelve (12) crew members and three (3) guests who initially tested positive for COVID-13. After two days of the cruise, the number of guests who tested positive for the virus increased to seven (7)…
The ship has recently focused on the fact that, according to Royal Caribbean, there has been an increase in the number of infected crew members, leading to a senior officer reminding the crew to wear KN95 masks on the ship.
The ship’s Staff Captain, Frank Jensen, recently sent this email to the crew:
“Good morning fellow Ship Mates,
We have unfortunately lately seen a spike in the COVID19 cases among our crew!
Please ensure following is strictly adhered to in order for us to break this inclining curve of C+ cases:
KN95 Masks are to be worn at all the times, except when in your cabin or when eating, drinking or smoking.
We will keep you posted.
Regards”
As far as passengers are concerned, the wearing of masks on the ship is strictly optional. As a practical matter, no guests seem to wear masks voluntarily. Royal Caribbean does not instruct guests to wear mask though it knows that COVID-19 cases are “spiking” among the crew.
As we previously reported, the Jewel of Seas had as many as one hundred (100) to two hundred (200) infected crew members at any given time late last year and earlier this year during a surge in cases as the Omicron variant emerged. The Jewel was one of three Royal Caribbean cruise ships (including the Serenade of the Seas and the Vision of the Seas) used by the cruise line as a floating quarantine hotel / walk-in clinic at sea for infected crew members. The ship previously would rendevous with other Royal Caribbean ships to pick up hundreds of other infected/ill crew members. It is our understanding that Royal Caribbean is no longer housing infected crew members on quarantine-ships after the Omicron variant surge largely abated.
Nonetheless, it remains risky to board a cruise ship maskless, as Royal Caribbean seems to privately realize.” (K)
“As an infectious diseases doctor at Rutgers Robert Wood Johnson Medical School, I’ve been watching the spread of Candida auris with great concern.
This fungus can cause serious infection, pain, suffering, and even death — and people with weak immune systems are at particularly high risk. It has caused outbreaks in health care facilities across the country. We saw 61 cases in New Jersey last year — more than in more populous states like Pennsylvania, Ohio and Texas. More than 1,000 cases were reported nationwide.
Considering the COVID-19 pandemic, that may not sound like much, but Candida auris is on the rise. There were no cases before 2009 and, in recent years, it has been noted to be highly resistant to antifungal drugs. In many instances, there are few therapies left that can successfully treat it, and some strains are resistant to all available treatments.
The emergence and spread of C. auris is part of a wider crisis known as antimicrobial resistance, or AMR. Like other organisms, disease-causing bacteria and fungi evolve to become increasingly resistant to available therapies. When exposed to an effective medication, most of the pathogens die, but some resist. These survivors can grow into drug-resistant “superbugs” and can pass their resistance on to their next-generation offspring.
Antimicrobial drugs are the foundations of modern medicine — but deep cracks are causing that foundation to crumble. Superbugs took at least 1.27 million lives worldwide in 2019, shattering previous estimates.
In some cases, we’re unable to provide critically needed organ transplants because we lack effective antibiotics. Since transplant patients must have their immune systems suppressed so they don’t reject the transplanted organs, their compromised immune systems often cannot fend off superbugs without effective antimicrobials.
If we don’t strengthen the development of new treatments, it will be increasingly difficult to safely provide many types of surgeries because the risk of untreatable antimicrobial-resistant infection will be too high. The pipeline for new antimicrobials is already inadequate to address current threats, let alone future superbugs that are bound to emerge.
Moreover, antimicrobial resistance and the pandemic have exacerbated one another. Amid the first surges of COVID-19, as intensive care units filled with critically ill patients on ventilators, I found myself treating multidrug-resistant infections more frequently than ever. Secondary bacterial infections led to serious illness and death in a significant share of COVID-19 patients.” (B)
“The intensive care unit is full. A patient coded early in the morning, and my pager alerts me that an older man is intubated in the emergency department and a woman with cystic fibrosis is coughing up blood. There is so much sickness that I am almost too busy to notice what once would have been a remarkable fact: I am not taking care of a single patient with the coronavirus.
In many ways, my hospital is back to normal. Families can enter once again, though still with limited visiting hours. There is no more talk of canceling elective procedures. The cafeteria salad bar has returned. We still wear masks, but I do not obsessively check the seal of my N95. Though this virus is not gone, I am no longer scared.
But I find myself wondering whether we should expect more. At the height of the pandemic, as we watched the vulnerable die, we made promises that when this ended, so much would be different. And yet here in the hospital, we seem to have settled into a new kind of normal, one characterized by limited staffing and medication shortages and an erosion of the family presence that we once embraced. So yes, I am not taking care of a single patient with the coronavirus. But is that as good as it gets?” (L)
“Confirmation of one case of monkeypox, in a country, is considered an outbreak. The unexpected appearance of monkeypox in several regions in the initial absence of epidemiological links to areas that have historically reported monkeypox, suggests that there may have been undetected transmission for some time.
WHO assesses the risk at the global level as moderate considering this is the first time that many monkeypox cases and clusters are reported concurrently in many countries in widely disparate WHO geographical areas, balanced against the fact that mortality has remained low in the current outbreak…
Interim guidance is being or has been developed to support Member States with raising awareness; surveillance, case investigation and contact tracing; laboratory diagnostics and testing; clinical management and infection prevention and control (IPC); vaccines and immunization; and risk communication and community engagement (please refer to the WHO Guidance and Public Health Recommendations section below).
Currently, the public health risk at the global level is assessed as moderate considering this is the first time that monkeypox cases and clusters are reported concurrently in many countries in widely disparate WHO geographical areas, balanced against the fact that mortality has remained low in the current outbreak.
In apparently newly affected countries, cases have mainly, but not exclusively, been confirmed amongst men who self-identify as men who have sex with men, participating in extended sexual networks. Person to person transmission is ongoing, still primarily occurring in one demographic and social group. It is likely that the actual number of cases remains an underestimate. This may in part be due to the lack of early clinical recognition of an infectious disease previously thought to occur mostly in West and Central Africa, a non-severe clinical presentation for most cases, limited surveillance, and a lack of widely available diagnostics. While efforts are underway to address these gaps, it is important to remain vigilant for monkeypox in all population groups to prevent onward transmission…
All countries should be on the alert for signals related to patients presenting with a rash that progresses in sequential stages – macules, papules, vesicles, pustules, scabs, at the same stage of development over all affected areas of the body – that may be associated with fever, enlarged lymph nodes, back pain, and muscle aches. During this current outbreak, many individuals are presenting with atypical symptoms, which includes a localized rash that may present as little as one lesion. The appearance of lesions may be asynchronous and persons may have primarily or exclusively peri-genital and/or peri-anal distribution associated with local, painful swollen lymph nodes. Some patients may also present with sexually transmitted infections and should be tested and treated appropriately. These individuals may present to various community and health care settings including but not limited to primary and secondary care, fever clinics, sexual health services, infectious disease units, obstetrics and gynaecology, emergency departments and dermatology clinics.
Increasing awareness among potentially affected communities, as well as health care providers and laboratory workers, is essential for identifying and preventing further cases and effective management of the current outbreak.
Any individual meeting the definition for a suspected case should be offered testing. The decision to test should be based on both clinical and epidemiological factors, linked to an assessment of the likelihood of infection. Due to the range of conditions that cause skin rashes and because clinical presentation may more often be atypical in this outbreak, it can be challenging to differentiate monkeypox solely based on the clinical presentation.
Caring for patients with suspected or confirmed monkeypox requires early recognition through screening adapted to local settings, prompt isolation and rapid implementation of appropriate IPC measures (standard and transmission-based precautions, including the addition of respirator use for health workers caring for patients with suspected/confirmed monkeypox, and an emphasis on safe handling of linen and management of the environment), physical examination of patient, testing to confirm diagnosis, symptomatic management of patients with mild or uncomplicated monkeypox and monitoring for and treatment of complications and life-threatening conditions such as progression of skin lesions, secondary bacterial infection of skin lesions, ocular lesions, and rarely, severe dehydration, severe pneumonia or sepsis. Patients with less severe monkeypox who isolate at home require careful assessment of the ability to safely isolate and maintain required IPC precautions in their home to prevent transmission to other household and community members.
Precautions (isolation) should remain in place until lesions have crusted, scabs have fallen off and a fresh layer of skin has formed underneath.” (N)
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
POST 49. October 4, 2020. CORONAVIRUS. RAPID RESPONSE. “The possibility that the president and his White House entourage were traveling superspreaders is a nightmare scenario for officials in Minnesota, Ohio, New Jersey and Pennsylvania…”
POST 50. October 6, 2020. CORONAVIRUS. Monday October 5th will go down as one of the most fraught chapters in the history of American public Health (and national security).
POST 51. October 12, 2020. Rather than a hodge-podge of Emergency Use Authorizations, off-label “experimentation”, right-to-try arguments, and “politicized” compassionate use approvals maybe we need to designate REGIONAL EMERGING VIRUSES REFERRAL CENTERS (REVRCs).
POST 52. October 18, 2020. ZIKA/ EBOLA/ CANDIDA AURIS/ SEVERE FLU/ Tracking. “… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days… Boy, do we not have our act together.” —”- Bill Gates. July 1, 2018
POST 54. October 22, 2020. CORONAVIRUS. POST 54A. New Jersey’s Coronavirus response, led by Governor Murphy and Commissioner of Health Persichilli started with accelerated A+ traditional, evidence-based Public Health practices, developed over years of experience with seasonal flu, swine flu, Zika, and Ebola.
POST 55. October 26, 2020. CORONAVIRUS. The Testing Conundrum: “ It’s thus very possible to be antigen negative but P.C.R. positive, while still harboring the virus in the body..”
POST 57. November 3, 2020. CORONAVIRUS. Dr. Deborah Birx: the US is entering its “most deadly phase” yet, one that requires “much more aggressive action,”
POST 58. November 4, 2020. CORONAVIRUS. “…the president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language…”
POST 59. November 5, 2020. Coronavirus. “The United States on Wednesday recorded over 100,000 new coronavirus cases in a single day for the first time since the pandemic began..
POST 61. November 7, 2020. CORONAVIRUS. “Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath…” “Here are the key ways he plans to get US coronavirus cases under control.”
POST 62. November 8, 2020. CORONAVIRUS. “The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days,…”
POST 63. November 9, 2020. CORONAVIRUS. “New York City-based Mount Sinai Health System has opened a center to help patients recovering from COVID-19 and to study the long-term impact of the disease….”
POST 64. November 10, 2020. CORONAVIRUS. “It works! Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.”
POST 65. November 11, 2020. CORONAVIRUS, “The Centers for Disease Control and Prevention took a stronger stance in favor of masks on Tuesday, emphasizing that they protect the people wearing them, rather than just those around them…
POST 66. November.12, 2020. CORONAVIRUS.”… as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged.”… “President-elect Biden has formed a special transition team dedicated to coordinating the coronavirus response across the government…”
POST 67. November 13, 2020. CORONAVIRUS. “When all other options are exhausted, the CDC website says, workers who are suspected or confirmed to have COVID-19 (and “who are well enough to work”) can care for patients who are not severely immunocompromised — first for those who are also confirmed to have COVID-19, then those with suspected cases.”
POST 68. November 14, 2020. CORONAVIRUS. The CDC “now is hewing more closely to scientific evidence, often contradicting the positions of the Trump administration.”..” “A passenger aboard the first cruise ship to set sail in the Caribbean since the start of the pandemic has tested positive for coronavirus..”
POST 69. November 15, 2020. CORONAVIRUS. “Colorado Gov. Jared Polis will issue a new executive order outlining steps hospitals will need to take to ready themselves for a surge in COVID-19 hospitalizations and directing the hospitals to finalize plans for converting beds into ICU beds, adding staffing and scaling back on or eliminating elective procedures….
POST 70. November 16, 2020. CORONAVIRUS. “White House coronavirus task force member Dr. Atlas criticized Michigan’s new Covid-19 restrictions..urging people to “rise up” against the new public health measures.
POST 71. November 17, 2020. CORONAVIRUS. ”Hospitals overrun as U.S. reports 1 million new coronavirus cases in a week.” “But in Florida, where the number of coronavirus infections remains the third-highest in the nation, bars and schools remain open and restaurants continue to operate at full capacity.”
POST 72. November 18, 2020. CORONAVIRUS. “The Health and Human Services Department will not work with President-elect Joe Biden’s (PANDEMIC) team until the General Services Administration makes a determination that he won the election,….”
POST 73. November 19, 2020. CORONAVIRUS. “…officials at the CDC…urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households…” When will I trust a vaccine? to the last question I always answer: When I see Tony Fauci take one….”
POST 74. November 20, 2020. CORONAVIRUS. Pfizer…submitted to the FDA for emergency use authorization for their coronavirus vaccine candidate. —FDA issued an EUA for the drug baricitinib, in combination with remdesivir, as WHO says remdesivir doesn’t do much of anything.
POST 75. November 21, 2020. CORONAVIRUS. “The president and CEO of one of the nation’s largest non-profit health systems says he won’t be wearing a mask at work because he’s recovered from COVID-19, and doing so would only be a “symbolic gesture” because he considers himself immune from the virus….
POST 76. November 23, 2020. CORONAVIRUS. “No battle plan survives contact with the enemy.” Ventilators..”just keep people alive while the people caring for them can figure out what’s wrong and fix the problem. And at the moment, we just don’t have enough of those people.”
POST 77. November 26, 2020. CORONAVIRUS. Pope Francis: “When I got really sick at the age of 21, I had my first experience of limit, of pain and loneliness.”.. “….Aug. 13, 1957. I got taken to a hospital…”….” I remember especially two nurses from this time.”…” They fought for me to the end, until my eventual recovery.”
POST 78. November 27, 2020. CORONAVIRUS. “Kelby Krabbenhoft is no longer president and CEO of Sioux Falls, S.D.-based Sanford Health.” “…for not wearing a face covering… “ because “He considered himself immune from the virus.”
POST 79. November 28, 2020. CORONAVIRUS. Mayo Clinic. “”Our surge plan expands into the garage…”..””Not where I’d want to put my grandfather or my grandmother,” … though it “may have to happen.”
POST 81. December 1, 2020. CORONAVIRUS. “Dr. Atlas, … who espoused controversial theories and rankled government scientists while advising President Trump on the coronavirus pandemic, resigned…”
POST 82. December 3, 2020. CORONAVIRIUS. The NBA jumped to the front of the line for Coronavirus testing….while front line nurses often are still waiting. Who will similarly “hijack” the vaccine?
POST 83. December 4, 2020. CORONAVIRUS. “California Gov. Gavin Newsom says he will impose a new, regional stay-at-home order for areas where capacity at intensive care units falls below 15%.”… East Tennessee –“This is the first time the health care capability benchmark has been in the red..”
POST 84. December 6, 2020. CPRONAVIRUS. “ More than 100,000 Americans are in the hospital with COVID-19…” “We’re seeing C.D.C. …awaken from (its) politics-induced coma…”…Dr. Fauci “to be a chief medical adviser in Biden’s incoming administration..”.. “Trump administration leaves states to grapple with how to distribute scarce vaccines..”
POST 85. December 7, 2020. CORONAVIRUS. “…Florida, Gov. DeSantis’ administration engaged in a pattern of spin and concealment that misled the public on the gravest health threat the state has ever faced..”.. “NY Gov. Cuomo said…the state will implement a barrage of new emergency actions..”… Rhode Island and Massachusetts open field hospitals… “Biden Names Health Team to Fight Pandemic”
POST 86. December 9, 2020. If this analysis seems a bit incomprehensible it is because “free Coronavirus test” is often an oxymoron! with charges ranging from as little as $23 to as much as $2,315… Laws (like for free Coronavirus tests) are Like Sausages. Better Not to See Them Being Made. (Please allow about 20 seconds for the text to download. Thanx!)
POST 87. December 10, 2020. CORONAVIRUS. “…Rudolph W. Giuliani, the latest member of President Trump’s inner circle to contract Covid-19, has acknowledged that he received at least two of the same drugs the president received. He even conceded that his “celebrity” status had given him access to care that others did not have.”
POST 88. December 11, 2020. CORONAVIRUS. “As COVID-19 cases surge, the federal government is releasing data about hospital capacity at facilities around the country….”The new data paints the picture of how a specific hospital is experiencing the pandemic,”…
PART 89. December 12, 2020. CORONAVIRUS. THE VACCINE!!! “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill
POST 90. December 14, 2020. CORONAVIRUS. “…the first doses of a Covid-19 vaccine have been given to the American public..”…” Each person who receives a vaccine needs two doses, and it’s up to states to allocate their share of vaccines.”
POST 91. December 15, 2020. CORONAVIRUS. “UPMC will first give (vaccination) priority to those in critical jobs. That includes a range of people working in critical units, from workers cleaning the emergency room and registering patients to doctors and nurses.. “Finally, if needed, UPMC will use a lottery to select who will be scheduled first.”
POST 92. December 17, 2020. CORONAVIRUS. “..each state — and each hospital system — has come up with its own (vaccination) plan and priorities. The result has been a sometimes confusing constellation of rules and groupings that has left health care workers wondering where they stand.” (Trump appointee July 4th email “…we need to establish herd, and it only comes about allowing the non-high risk groups expose themselves to the virus. PERIOD,”)
POST 93. December 19, 2020. CORONAVIRUS. On NPR Congresswoman Shalala (D-Florida) said she wouldn’t jump the vaccination line in Miami; then added she would get vaccinated in Washington this week. This, even though Congress has failed to pass “essential” Coronavirus legislation. So who are our “essential” workers?
POST 94. December 21, 2020. CORONAVIRUS. “A doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.”.. “I haven’t done ICU medicine since I was a resident — you don’t want me adjusting your ventilator,” he said. “That’s the challenge, actually — it isn’t so much space, it’s staff…”
POST 96. December 26, 2020. CORONAVIRUS. “Achieving herd immunity against the coronavirus could require as much as 90 percent of the population to be vaccinated, Anthony Fauci…”…”..he hesitated to state a number as high as 90% weeks ago because many Americans still seemed skeptical about vaccine….”
POST 97. December 27, 2020. “A new variant of the coronavirus that has been spreading through the UK and other countries has not yet been detected in the United States..”.. . But if new-wave medicines like antivirals and antibody therapy contributed to the development of viral variants, it will be “a reminder for all the medical community that we need to use these treatment options carefully.”
POST 99. December 29, 2020. CORONAVIRUS. “ICUs are being overwhelmed across many parts of California. Statewide aggregate ICU availability has been at 0% since Christmas Eve…. a surge on top of a surge on top of a surge.”… “hospitals are getting close to the point where they would begin putting COVID-positive patients under the care of COVID-positive staff who are asymptomatic.”
POST 100. December 29, 2020. CORONAVIRUS. Front line hospital workers – in the ER, ICUs, EMS, acute medical care, behavioral health – are amongst the most courageous, heroic and dedicated colleagues you will ever meet.
POST 101. December 30, 2020.CORONAVIRUS. Is there a point where the increasing Coronavirus trajectory so far exceeds the slow growth of the vaccination rate that reaching herd immunity through vaccinations becomes less likely?
POST 102. January 2, 2020. CORONAVIRUS. “We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination — which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, the dean of Brown University’s School of Public Health. “Ultimately, the buck seems to stop with no one,”…
POST 103. January 4, 2021. CORONAVIRUS. Dr. Fauci said “that the United States would not follow Britain’s lead in front-loading first vaccine injections, potentially delaying the administration of second doses…Dr. Moore – ”British officials “seem to have abandoned science completely now and are just trying to guess their way out of a mess.”
POST 104. January 6, 2021. CORONAVIRUS. “Paramedics in Southern California are being told to conserve oxygen and not to bring patients to the hospital who have little chance of survival…”
POST 105. January 8, 2021. CORONAVIRUS. POST 105. January 8, 2021. CORONAVIRUS. “Facing a shortage of vaccinators, the Association of Immunization Managers… recommends relaxing regulation or adjusting licensing requirements. At least two states, Massachusetts and New York, have changed their laws in recent weeks to expand those who are eligible to give shots.”
POST 106. January 9, 2021. CORONAVIRUS. The riots at the Capitol could have been a superspreader event. “From what I saw… you had a large congregation of individuals who were in close contact for an extended period of time and almost universally unmasked…. many coming and going on buses as well, also unmasked, and hanging out in hotel lobbies.”
POST 107. January 8, 2021. CORONAVIRUS. “Our job is to make sure the vaccine isn’t politicized the way masks were politicized,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said after getting her vaccine. South Carolina Rep.-elect Nancy Mace, a Republican, wrote that “Congress shouldn’t be putting themselves first in line for the COVID-19 vaccination when the average American can’t get it.”
POST 108. January 9, 2021. CORONAVIRUS. (vaccination)”Line-cutters will be named and shamed. It’s inevitable, as will be the congressional hearings and front-page investigative stories ferreting out who saved their own skin at the expense of others.”
POST 109.January 9, 2021. CORONAVIRUS. “President-elect Joe Biden will aim to release nearly every available dose of the coronavirus vaccine when he takes office, a break with the Trump administration’s strategy of holding back half of US vaccine production to ensure second doses are available.
POST 110. January 13, 2021. CORONAVIRUS. ““The (federal) government is changing the way it allocates Covid vaccine doses, now basing it on how quickly states can administer shots and the size of their elderly population.”… “New York State sent a letter to hospitals saying if they don’t use their vaccine allocations by the end of this week, they won’t receive any further allocations.”
POST 111. January 14, 2021. CORONAVIRUS. “Visitors from Toronto to New York to Buenos Aires have long flocked to Florida for sun, surf and shopping. Now they are coming for the Covid-19 vaccine….
POST 112. January 14, 2021. CORONAVIRUS. CHINA – “Eleven million people are under lockdown in Hebei province after a new cluster of coronavirus infections.
PART 113. January 17, 2021. CORONAVIRUS. The Next President Actually Has a Covid Plan… New York City and other places in the state expect to exhaust their supply of doses as early as next week… Charles Barkley said during the “NBA on TNT” broadcast that pro athletes should get the first round of the vaccine…..
POST 114. January 18, 2021. CORONAVIRUS. “When government programs that have been unattended, underfunded and bogged down by red tape suddenly have to meet a huge demand in a crisis, they can’t cope and people suffer….”
POST 115. January 21, 2020. CORONAVIRUS. A year ago today an unnumbered POST was headlined “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.” The CORONAVIRUS CONTENT TRACKING PROJECT started with HISTORIOGRAPHY and over time moved to LESSONS LEARNED, RAPID RESPONSE, and THE VACCINATION PROGRAM. Now 115 POSTS later – the BIDEN CORONAVIRUS PLAN.
POST 116. January 22, 2021. President Biden – “We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation.”
POST 117. January 23, 2021. CORONAVIRUS. 1.Dr. Fauci:“The idea that you can get up here….”and.. let the science speak”… “It is somewhat of a liberating feeling.” 2.updated CDC guidance:”.. providers could give the second dose up to six weeks after the first dose..” 3.Dr. Fauci: people would be “taking a chance” if they follow the CDC’s updated guidance.
POST 118. January 24, 2021. CORONAVIRUS. “Unfortunately, we’ve let this virus spread extensively and are launching the vaccination campaign at the height of the threat,” Dr. Meyers said. “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.”
POST 119. January 27, 2010. CORONAVIRUS. Amazon is offering its help to President Joe Biden with the rollout of COVID-19 vaccines. Washington’s governor, Jay Inslee, included the help of companies like Starbucks, Costco and Microsoft in a plan to vaccinate 45,000 residents a day.
POST 120. January 28, 2021. CORONAVIRUS. “The fact that four vaccines backed by the federal government seem to be less effective against the (South African) B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.”
POST 121. January 30, 2021. CORONVIRUS. Will our communities become stratified by which vaccine is distributed? 95%ters v. 72%ters? Will the easier distribution of the J&J vaccine drive its inequitable distribution to” hard-hit, marginalized, and medically underserved communities.” (thanx! to XJ/LA)
POST 123. February 4, 2021. CORONAVIRUS. “Nursing homes across the country are facing the same struggle, as workers have been more reluctant than residents to be vaccinated…
POST 124. February 5, 2021. CORONAVIRUS. Dr. Osterholm ” …it may be time to..go with a ‘first-dose only’ approach, so more people over the age of 65 can have at least some protection right away. He said that would require delaying second doses until this summer.” Dr.Fauci “warned against this practice, and cautioned people about “the danger” that could come with focusing only on the first dose.”
POST 125. June 9, 2021. CORONAVIRUS. “States are rolling back Covid-19 restrictions as new cases trend down from record highs across the country. But experts warn it might be too much too soon as variants pose an increased risk and the pandemic… is far from over.”
POST 126. February 11, 2021. CORONAVIRUS. “There will be more coronavirus outbreaks in the future. Bats and other mammals are rife with strains and species of this abundant family of viruses. Some of these pathogens will inevitably spill over the species barrier and cause new pandemics. It’s only a matter of time.” (A)
POST 127. February 12, 2021. CORONAVIRUS. “… Trump only agreed to be hospitalized when aides told him that he could walk to Marine One or he could wait until his case progressed and he would be carried out.”
POST 128. February 14, 2021. CORONAVIRUS. “The Centers for Disease Control and Prevention released new research on Wednesday that found wearing a cloth mask over a surgical mask offers more protection against the coronavirus, as does tying knots on the ear loops of surgical masks…
POST 129. February 15, 2021, CORONAVIRUS. “ “The CDC released its much-anticipated, updated guidance to help school leaders decide how to safely bring students back into classrooms, or keep them there.”…” For politicians, parents and school leaders looking for a clear green light to reopen schools, this is not it.”
POST 130. February 16, 2021. CORONAVIRUS. “A second person who had contracted the Ebola virus died this week in the Democratic Republic of Congo, marking another outbreak just three months after the nation outlasted the virus’s second-worst outbreak in history…”
POST 131. February 17, 2021. CORONAVIRUS. “It really is right now – a race between how quickly new variants, particularly the U.K. variant, can spread in the United States and how quickly we can get people vaccinated”
POST 132. February 20, 2021. CORONAVIRUS. “In Texas, where over 2.5 million people are still without power, the state health department said this week’s vaccine shipments wouldn’t arrive until Wednesday at the earliest.”
POST 133. February 23, 2021. CORONAVIRUS. “Going off your meds is a surefire way to aggravate your doctor. What if a whole country did it?” The United Kingdom has veered into uncharted territory by changing tack and introducing a revised COVID-19 vaccination protocol, one that involves distributing the second dose at 12 weeks, rather than the prescribed 21 days.”
POST 134. February 24, 2021. CORONAVIRUS. The first tranche of the J&J (single dose) vaccine must go to K-12 teachers, so schools can open safely in the first 100 days of the Biden Administration. The federal government…”can set up its own vaccination centers in regions with eligible populations it’s trying to target.” We owe our front-line teachers nothing less!
POST 135. February 27, 2021. CORONAVIRUS. “As Chief Executive Officers of New York’s major health care systems, we would like to provide facts to clear up confusion in the public and the media regarding decisions to discharge patients to nursing homes during New York’s spring coronavirus surge.”
POST 136. March 2, 2021. CORONAVIRUS. ““The governors of Texas and Mississippi both announced on Tuesday they would be lifting their states’ mask mandates and rolling back many of their Covid-19 health mandates..”…while “The US could experience a “fourth surge” of coronavirus before the majority of the country is vaccinated.”
POST 137. March 4, 2021. CORONAVIRUS. “The clamor for hard-to-get Covid-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system. They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow? Some pharmacists have even given them a nickname: vaccine lurkers.” (H)
POST 138. March 6, 2021. CORONAVIRUS. “New cases are decreasing in the third wave because we are past the holidays, not because of vaccinations. It is a common misconception that the decrease we are seeing in new cases, hospitalizations, and deaths in the U.S. is due to vaccinations. The two aren’t related; at least yet.”
POST 139. March 8, 2021. CORONAVIRUS. CDC Issues First Set of Guidelines on How Fully Vaccinated People Can Visit Safely with Others…” In practice, that means fully vaccinated grandparents may visit unvaccinated healthy adult children and healthy grandchildren of the same household without masks or physical distancing.” (C)
POST 140. March 9, 2021. CORONAVIRUS. “In West Virginia, they are bracing for the second wave….. Not coronavirus but opioid overdoses, with one scourge driving a resurgence of the other.
POST 141. March 11, 2021. CORONAVIRUS. Today is the first anniversary of the WHO declaration that the novel coronavirus was a Public Health Emergency of International Concern… “To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like.”
POST 142. March 15, 2021. CORONAVIRUS. “Candida auris is a superbug, a pathogen that can evade drugs made to kill it—and early signs suggest the COVID-19 pandemic may be propelling infections of the highly dangerous yeast. That’s because C. auris is particularly prominent in hospital settings, which have been flooded with people this year due to the coronavirus.”
POST 143. March 17, 2021. CORONAVIRUS. “The Trump administration sought to suppress Covid-19 testing in the United States last year by softening guidance from the Centers for Disease Control and Prevention on who needed to be tested, a House panel said Monday.”
POST 144. March 20, 2021. CORONAVIRUS. ““The vaccine hesitancy we are seeing isn’t just about Covid vaccines,”… “It is a general reflection of Americans’ lack of trust in science, the pharmaceutical industry, and large health care institutions. We need a full court press on science and vaccine education right now to prevent more aggressive Covid-19 variants from developing and taking hold.”
POST 145. March 25, 2021. CORONAVIRUS. “Efforts to disseminate Covid-19 vaccines as widely as possible are hitting an unexpected obstacle: health-care workers who decline the shots.
POST 146. March 30, 2021. CORONAVIRUS. Dr. Osterholm told Becker’s: “This is the perfect storm,”…”Here is Europe locking down and having problems containing B.1.1.7, even with vaccinations and previous infection histories. Here we are opening up as wide as we can. We are literally just walking into the mouth of the virus saying, ‘Don’t worry.’” (M)
POST 147. April 5, 2021. CORONAVIRUS. “The pandemic helped cement the shift to “a philosophy of really focusing on the role of the physician in reasoning through ambiguous and unknown problems as the focus of education, rather than teaching students that the role of physician was to memorize a body of knowledge that was already in existence and good enough for what usually happens.”
POST 148. April 7, 2021. CORONAVIRUS. While the Biden administration accelerates vaccinations to ward off numerous variants and as more young people are being hospitalized, states, even with increasing case rates are on paths to fully reopen. Politics v. public health!
POST 149. April 10, 2021. CORONAVIRIUS. “From Michigan to Massachusetts, COVID-19 cases and hospitalizations are on the rise again. Deaths will soon follow. “ ”.. the Biden administration is facing renewed calls to delay second vaccine doses and blanket more of the U.S. population with an initial shot.”
POST 150. April 10, 2021. CORONAVIRUS. “The use of so-called COVID-19 “vaccine passports” is quickly becoming a divisive issue across the US – with several states, including New York, embracing the idea, while others have already moved to ban them.”
POST 151. April 14, 2021. CORONAVIRUS. the J&J vaccination pause. “ Federal officials are concerned that doctors may not be trained to spot or treat the rare disorder if recipients of the vaccine develop symptoms of it…” “…a standard treatment for blood clots — use of an anticoagulant drug — could be dangerous or even fatal in such cases…”
POST 152. April 15, 2021. CORONAVIRUS. “The Chinese Center for Disease Control and Prevention’s director said Saturday authorities are considering mixing COVID-19 vaccines because the country’s domestically made doses “don’t have very high protection rates,”
POST 153. April 18, 2021. CORONAVIRUS. “At least 35 hospitals across Michigan were listed Thursday as nearing capacity and three were at full capacity for COVID-19 patients..”.. We can manufacture beds. We can open up beds. We can create entire wings of the hospital if we have to, but if we don’t have staff for those beds, we’ve got nothing.”..
POST 154. April 19, 2021. CORONAVIRUS. “Breakthrough infections, which occur when fully vaccinated people are infected by the pathogen that their shots were designed to protect against, are an entirely expected part of any vaccination process.” “Pfizer’s chief executive said that a third dose of the company’s Covid-19 vaccine was “likely” to be needed within a year of the initial two-dose inoculation — followed by annual vaccinations.”
POST 155. April 24, 2021. CORONAVIRUS. As the J&J vaccine pause is ended Senator Johnson said “The science tells us that vaccines are 95% effective. So if you have a vaccine, quite honestly, what do you care if your neighbor has one or not? I mean, what is it to you?”
POST 156. April 28, 2021. CORONAVIRUS. As CDC revises guidance on outdoor masking, Texas Governor Abbott says “the state is “very close” to herd immunity… despite acknowledging that he does not know what the herd immunity threshold is for the virus, an uncertainty echoed by the public health community.”
POST 157. April 25, 2021. CORONAVIRUS. Ohio hospitals; “We agreed in multiple conversations, there’s nothing in fighting a pandemic that creates a competitive advantage.”…
POST 158. May 5, 2021. CORONAVIRUS. . As populations get closer to herd immunity “ it may be helpful to introduce some nuance to what we mean by the term. Nationwide herd immunity. Regional herd immunity. Temporary herd immunity. Endemicity.”
POST 159. May 9, 2021. CORONAVIRUS. “Without deeper sharing of expertise in how to make vaccines…waiving patent obligations is unlikely to be a game-changer… Having access to the “recipe” certainly helps, but understanding how to put it together and produce it at scale is something else.”
POST 160. May 13, 2021.CORONAVIRUS. “The CDC acknowledged Friday that airborne spread of COVID-19 among people more than 6 feet apart “has been repeatedly documented.”” Meanwhile states relax or eliminate indoor dining restrictions. HUH?
POST 161. May 15, 2021. CORONAVIRUS. “Even if the spread of Covid-19 decreases enough to allow a return of most activities, there are some aspects of pandemic life that epidemiologists say will persist much longer. In particular, they say that masks are a norm that should continue, even if that view puts them at odds with the new C.D.C. guidance. More than 80 percent of them say people should continue to wear masks when indoors with strangers for at least another year, and outdoors in crowds.”
POST 162. May 21, 2021. CORONAVIRUS. “New Jersey Gov. Phil Murphy is refusing to lift his indoor mask mandate for vaccinated residents…” “…fully vaccinated residents in New York and Connecticut are no longer required to wear masks..”..” “California says it isn’t ready to follow the federal lead and unmask, at least for another month..”.. “..Texas Gov. Greg Abbott issued an executive order Tuesday prohibiting state governmental entities such as counties, public school districts, public health authorities and government officials from requiring mask wearing.”
POST 163. May 23, 2021. CORONAVIRUS. RWJBarnabas Health in New Jersey announced a mandate…saying supervisors and those of higher rank must get the vaccine by June 30. They will eventually require the system’s 35,000 employees to do the same.
POST 164. May 26, 2021. CORONAVIRUS. On Wednesday, health minister Norihisa Tamura warned Olympic organizers they would have to “secure their own” hospital beds for anyone falling ill at the Games, explaining the government would not release beds set aside for Japanese covid-19 patients.”
POST 165. May 31,2001. CORONAVIRUS. “Like all pandemics, this one will end either with millions — maybe billions — being infected or being vaccinated. This time, world leaders have a choice, but little time to make that choice before it is made for them.”
POST 166. June 3, 2020. CORONAVIRUS. “President Biden said Wednesday that he has asked intelligence agencies to double down on their efforts to investigate whether the coronavirus originated from human contact with an animal or in an laboratory in China, saying there is not “sufficient information” to assess whether one is more likely than the other.”
POST 167. June 9, 2021. CORONAVIRUS. Hospitals prevaricate on mandatory staff vaccinations. Florida’s Governor forbids cruise ship vaccine mandates. Pfizer and Moderna apply for FDA full approval.
POST 168. June 10, 2021. CORONAVIRUS. “Our species has a tendency to get distracted. We have a very strong appetite for distraction, and when something is not in the spotlight, when it’s not a crisis anymore, we tend to forget and move on to something else. So the biggest challenge is going to be maintaining focus on this next step of developing vaccines that anticipate pandemics.”
POST 169. June 14, 2021. CORONAVIRUS. “Hospitals in Washington, D.C…announced a consensus agreement to mandate COVID-19 vaccinations for more than 30,000 workers, 70% of which are already vaccinated. Each of 14 hospitals will set their own deadline…”
POST 170. June 17, 2021. CORONAVIRUS. “Dr. Ashish Jha…is worried about the potential impact the delta variant could have in the United States… “I’m concerned about the Delta variant,”… “Why? Most contagious variant yet. Wreaked havoc in India. Spiking cases in UK. Growing rapidly in the US.”
POST 171. June 19, 2021. “A 34-year-old man (a Covid-19 survivor) has been diagnosed with India’s first known case of “green fungus” infection.”… “Green fungus is the new infection to join the earlier known cases of black, white and yellow fungus.”…”green fungus was earlier seen only as a “junior partner” in other infections… In the current patient, this fungus is acting as the aggressor.”
POST 172. June 23, 2021. CORONAVIRUS. Morgan Stanley chief executive James Gorman said: “If you can go into a restaurant in New York City, you can come into the office.”…”remote work can “dramatically undermine” the character and culture a company is attempting to build; and “virtually eliminates spontaneous learning and creativity.”
POST 173. June 26, 2021. CORONAVIRUS. “The daily toll of COVID-19, as measured by new cases and the growing number of deaths, overlooks a shadowy set of casualties: the rising risk of mental health problems among health care professionals working on the frontlines of the pandemic.”
POST 174. July 1, 2021. CORONAVIRUS. “..while the WHO is encouraging people to keep wearing masks even if they’re vaccinated, Dr. Anthony Fauci says it doesn’t look like the CDC currently plans to change its guidelines.” … health officials in Los Angeles recommended that “everyone, regardless of vaccination status, wear masks indoors in public places as a precautionary measure.”..”
POST 175. July 5, 2021. CORONAVIRUS. “Can a health care worker who is not against vaccines in general still harbor sincere concerns that scientists don’t yet know about all the side effects of these vaccines? Yes, says Ezekiel Emanuel, MD, PhD — but those people should not work in health care.”
POST 176. July 9, 2021. CORONAVIRUS. Mercy Springfield ( Missouri) hospital…” ran out of ventilators for its patients over the Fourth of July weekend…”…“Mercy will require all current and future employees to be fully vaccinated.”…“The US government is deploying a Covid-19 surge team to provide public health support in southwest Missouri
POST 177. July 12, 2021. CORONAVIRUS. the Delta variant is “the 2020 version of Covid-19 on steroids,”… “It is the most hypertransmissible, contagious version of the virus we’ve seen to date…it’s a superspreader strain if there ever was one .” but… now, there’s a Delta Plus variant…
POST 178. July 15, 2021. CORONAVIRUS. “Tennessee’s top vaccine official says she has been fired as punishment for doing her job in the face of political pushback.”..” More than 180 state and local public health leaders…have resigned, retired or been fired since April 1…”“Former President Trump and his GOP allies have stepped up attacks on Anthony Fauci…”
POST 179. July 16, 2021. CORONAVIRUS. “It, therefore, follows that the “harm principle” (“first, do no harm.”) can be used to justify compulsory vaccination programs in specific instances where the community interests or benefits are deemed to be significant.”
POST 180, July 20, 2021. CORONAVIRUS. “Most people will either get vaccinated, or have been previously infected, or they will get this Delta variant,”.. “And for most people who get this Delta variant, it’s going to be the most serious virus that they get in their lifetime in terms of the risk of putting them in the hospital,”
POST 181. July 22, 2021. CORONAVIRUS. “Health experts fear the Tokyo Olympics could become a COVID-19 superspreader event.” “Whatever happens in Japan isn’t likely going to stay in Japan since all of the athletes and accompanying coaches and staff will be returning to their home countries.”
POST 182. July 26, 2021. CORONAVIRUS. Alabama Gov. Kay Ivey (R): “Folks supposed to have common sense.”…“But it’s time to start blaming the unvaccinated folks, not the regular folks. It’s the unvaccinated folks that are letting us down.” ““Beginning in mid-September, New York City will require all of its 340,000 municipal workers, including police, firefighters and teachers, to either be vaccinated against COVID-19 or tested weekly.”
POST 183. July 29, 2021. CORONAVIRUS. When I was appointed President and CEO of Jersey City Medical Center in1989 in the peak of the HIV/ AIDS crisis, we had a dedicated, and always full, dedicated 60 bed AIDS unit, staffed by one full time nurse and numerous part-time and per diem nurses. Today, right now, hospitals caught in the Covid-19 surge, are forced to redeploy nursing staff, respiratory therapists and other clinicians, most without prior infectious diseases experience. Why are we tolerating the unvaccinated putting our hospital staffs at risk?
POST 184. August 1, 2021. CORONAVIRUS. “The coronavirus could be “just a few mutations potentially away” from evolving into a variant that can evade existing COVID-19 vaccines, CDC director Rochelle Walensky said..” (A) “The Delta variant is more transmissible than the viruses that cause MERS, SARS, Ebola, the common cold, the seasonal flu and smallpox, and it is as contagious as chickenpox..” (I)
POST 185. August 6, 2021. CORONAVIRUS. ‘If you aren’t going to help, please get out of the way’: Biden turns up the pressure on GOP governors as Delta spreads”
POST 186. August 8, 2021. CORONAVIRUS. “One of the last things they do before they’re intubated is beg me for the vaccine. I hold their hand and tell them that I’m sorry, but it’s too late,” she added, referring to patients who have to be put on a ventilator.” (A) “There is no one definition of what the end of a pandemic means.”.. “The question of when the crisis will be over is a layered one — with different answers from local, national and global perspectives.”
POST 187. August 11, 2021. CORONAVIRUS. “As a result of the increase in COVID-19 cases and hospitalizations, the state of Florida requested 300 ventilators from the federal government.”… “An 11-month-old girl with Covid-19 is stable and no longer intubated one day after she was airlifted to a Texas hospital 150 miles away because of a shortage of pediatric beds in the Houston area.”
POST 188. August 15, 20201. CORONAVIRUS. “According to an internal CDC briefing….an estimated 1.1 million people have already gotten unauthorized booster shots…”….”If it is left up to the honor system, I think many Americans will suddenly wake up and find themselves immunocompromised enough to get a 3rd dose,”
POST 189. August 19,2021. CORONAVIRUS. “There wasn’t a single I.C.U. bed available in Alabama on Wednesday…”…”A triage plan on the Alabama health department’s website suggests that “persons with severe mental retardation” are among those who “may be poor candidates for ventilator support.”
POST 190, August 21, 2021. CORONAVIRUS. “We’re looking, in essence, at running two systems — a COVID system and a non-COVID system of care,”..“Emergency medical technicians (EMTs) and certified paramedics can now care for patients in Mississippi hospitals and emergency rooms under a new health office order issued by the Mississippi State Department of Health on Wednesday.”
POST 191. August 27, 2021. CORONAVIRUS. “Anthony Fauci, MD, chief medical advisor to the president and director of the National Institute of Allergy and Infectious Diseases, explained that late September gives the United States time to set up the logistics.” This is not medical science, but perhaps Political Science?
POST 192. August 30, 2021. CORONAVIRUS. Gov. John Bel Edwards on Hurricane Ida – “I hate to say it this way, but we have a lot of people on ventilators today and they don’t work without electricity,” he said.”
POST 193. September 3, 2021. CORONAVIRUS. Nurses are leaving their hospitals and becoming travel nurses at hospitals across town “because they can make $4,000, $5,000, $6,000, $7,000 a week while not having to relocate anywhere..”
POST 194. August 2, 2021. CORONAVIRUS. “Recently-released data is painting a grim picture of the opioid epidemic that has gripped the United States — as the country is still grappling with the coronavirus pandemic that has killed more than half a million Americans. Some people are calling them twin pandemics that have collided”…“Faced with a novel health crisis, researchers are collecting data on the long-term impact of using opioids to treat COVID-19 pain…
POST 195. September 6, 2021. CORONAVIRUS. “…there are “zero ICU beds left for children in Dallas County, Texas,”.,..”That means if your child’s in a car wreck, if your child has a congenital heart defect or something and needs an ICU bed, or more likely if they have Covid and need an ICU bed, we don’t have one. Your child will wait for another child to die… (county judge Clay Jenkins)
POST 196. SEPTEMBER 11, 2001. PART 1. Military helicopters and jets were overhead, as President Bush was getting ready to leave NYC. PART 2. LESSONS LEARNED memorandum by hospital CEO Jonathan Metsch goes “viral”…
POST 197. September 12, 2021. CORONAVIRUS. Idaho officials have instituted “crisis standards of care” to help 10 hospitals and health care systems decide how to allocate personnel and resources to deal with a crush of COVID-19 patients.”… “The Washington Medical Coordination Center oversees facilitating transfers in the state, and it’s warning we could be nearing the point of “Crisis Standards of Care,” just like Idaho.” .. “These crisis models don’t actually save more lives, they just save different lives..”
POST 198. September 15, 2021. CORONAVIRUS. A pundit said “The most elegant policy riposte to the anti-vaxxers… is to refuse to allow Medicare or Medicaid to pay their medical bills in the event they become seriously ill. Private health insurers might also follow suit.” (but is making our hospitals become the bill collectors right?)
POST 199. September 19, 2021. CORONAVIRUS. Crisis Standards of Care. “… to his knowledge, no patient in Idaho has been taken off life-support therapy in order to provide that therapy to another patient who has a better prognosis.” “While that has yet to occur, if we continue on this path, it will,”
POST 200. September 23, 2021. CORONAVIRUS. CDC Director overrides a recommendation of its scientific advisors saying “that people can get a booster if they are ages 18 to 64 years and are health-care workers or have another job that puts them at increased risk of being exposed to the virus.”…“In a pandemic, even with uncertainty, we must take actions that we anticipate will do the greatest good.”
POST 201. September 27, 2021. CORONAVIRUS. “A multibillion-dollar institution in the Seattle area is sitting on nearly $12 billion in cash… received at least $509 million in government funds (from) a federal program that is supposed to prevent health care providers from capsizing during the coronavirus pandemic.”
“Based on our estimates…we find preventable COVID-19 hospitalizations cost $5.7 billion from June to August in 2021.”…
POST 202. September 30, 2021. CORONAVIRUS. “..NY Governor Hochul signed an executive order expanding healthcare worker eligibility requirements…to head off potential staffing shortages fueled by the state’s new COVID-19 vaccination requirements.” “The.. order allows out-of-state/ out-of-country healthcare workers to practice in New York…”..”It allows EMTs graduates to temporarily pitch in at additional healthcare settings; allows various types of healthcare workers to more easily administer and order COVID-19 vaccinations; enables telemedicine physician visits in nursing homes; permits facilities to more quickly discharge, transfer or receive patients…”
POST 203. October 3, 2021. CORONAVIRUS. “.. more than 125,000 laboratory-confirmed COVID-19 cases have been reported in pregnant people, including more than 22,000 hospitalized cases and 161 deaths”…The risk is not just to the mother. Covid-19 in pregnancy can cause preterm birth or babies born so sick they have to go straight to the neonatal intensive care unit, or NICU.”
POST 204. October 5, 2021.CORONAVIRUS. “News that an experimental antiviral drug from Merck appears to halve the risk of hospitalization or death from Covid-19 has bolstered hopes of finding a simple at-home treatment for the virus.”..” A more blunt assessment came from vaccine scientist Dr. Peter Hotez of Baylor College of Medicine’s National School of Tropical Medicine. “It’s not a miracle cure but a companion tool, So get vaccinated.””
POST 205. October 11, 2021. CORONAVIRUS. The AAP reported nearly 226,000 new child cases over the past week ending. “Hospital care for children does not occur in isolation from that of adults. Many of the resources we use are the same—a twenty-pound baby and a two-hundred-pound man might use the same kind of ventilator, for example. Dialysis machines, which could cleanse a seven-year-old’s blood as easily as his grandfather’s, are in high demand. Pediatric resident physicians, nurses, and respiratory therapists get cross-deployed to care for adults during the surges.”
POST 206. October 15, 2021. CORONAVIRUS. to borrow from Winston Churchill about where we are with the pandemic – “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”
POST 207. October 17, 2021. CORONAVIRUS. “…if you choose your own unauthorized booster shot, what happens if later research proves a different combination is better? That’s why experts say it’s a bad idea to become your own vaccine advisory committee and get a shot out of turn.”
POST 208. October 22, 2021, CORONAVIRUS. “What is the “delta plus” variant?” Scientists are monitoring the delta-related variant — known as AY.4.2. — to see if it might spread more easily or be more deadly than previous versions of the coronavirus.
POST 209. October 28, 2021. CORONAVIRUS. “The quest at Mount Sinai began with a mystery.”…”America was not simply struggling to contain a once-in-a-century pandemic, caused by a virus far more dangerous than seasonal influenza. Many patients were, for unknown reasons, not recovering.”
POST 210. October 31, 2021. CORONAVIRUS. “Some people want the FDA to speed up. Others want it to be more cautious…There’s a fundamental tension between the right to get access to a drug people are desperate for and the right to protection from dangerous failures of quality. The first demands speed; the second requires time…”
POST 211. November 4, 2021. CORONAVIRUS. Colorado – “…there are patients who really ought to be in an intensive care unit but instead they’re in an emergency room. Or they ought to be in a step-down unit but instead they’re on the floor. Or they ought to be getting one-to-one nursing, and instead they’re getting two-to-one, or three-to-one nursing….”
POST 212. November 9, 2021. CORONAVIRUS. “They went into hospitals with heart attacks, kidney failure or in a psychiatric crisis. They left with covid-19…” “A new report shows the coronavirus pandemic had a direct increase on the number of healthcare-acquired infections in hospitals nationwide.”
POST 213. November 13, 2021. CORONAVIRUS. “Since the earliest days of the pandemic, there has been one collective goal for bringing it to an end: achieving herd immunity…Now the herd is restless. And experts at the Centers for Disease Control and Prevention have set aside herd immunity as a national goal.”
POST 214. November 20, 2021. CORONAVIRUS. “This virus is doing what this virus does,” said Michael Osterholm… “We don’t understand why surges start, we don’t understand why they end.” (A)
POST 215. November 26, 2021. CORONAVIRUS. Dr. Fauci on the new South African variant: “It’s not going to be possible to keep this infection out of the country. The question is: Can you slow it down?”
POST 216. December 1, 2021. CORONAVIRUS. Covid cacophony: as states struggle to address health care staffing shortages, a federal court puts Biden administration health care worker vaccination mandate on hold.
POST 217. December 3, 2021. CORONAVIRUS. President Biden Announces New Actions to Protect Americans Against the Delta and Omicron Variants as We Battle COVID-19 this Winter
POST 218. December 5, 2021. CORONAVIRUS. “In some ways, Delta is the ideal variant: It’s transmissible enough to dominate more dangerous variants, and its virulence can be controlled through vaccination. In the next few weeks, we’ll find out whether Omicron will have its own silver lining—or whether it’ll be catastrophically worse.”
POST 219. December 9, 2021. CORONAVIRUS. “Entering uncharted territory, the U.S. counts 500,000 Covid-related deaths.”… “So yes, I am furious at the unvaccinated, and I am not ashamed of disclosing that. I am no longer trying to understand them or educate them.”
POST 220 December 13, 2021. CORONAVIRUS. Dr. Osterholm. “You cannot outrun the game clock with this pandemic. This virus will find you… We’ve seen health care systems virtually broken by this pandemic. They just couldn’t provide critical care to non-Covid patients.” (A)
POST 221. December 18, 2021. CORONAVIRUS. “Johnson & Johnson’s Covid vaccine was going to be a shot for the world. Now, under the weight of a mountain of bad PR, one wonders if the world will want it.”
POST 224. December 29, 2021. CORONAVIRUS. “crisis standards of care protocols in Maryland – “It also allows us to slim down documentation,… allows unconventional staffing models such as using nurses that have not been bedside. It also sets the expectations for the community that it’s not business as usual.”
POST 225. January 3, 2021. CORONAVIRUS. “Be first, be right, be credible,” are among the most important principles for health authorities to follow in a crisis, the Centers for Disease Control and Prevention shared in a pamphlet on crisis communication in 2018….”
Post 226. January 5, 2022. CORONAVIRUS. New York City – “The city’s ambulance corps are so understaffed because of the COVID-19 surge, they’re now under new orders to try to convince stable patients with flu-like symptoms not to go to the hospital.”
POST 227. January 10, 2020. CORONAVIRUS. “Stay indoors. But also return in person. Wear a mask. Not that one. The expensive one, that you can’t find. Take rapid tests. Which you also can’t find. But if you find them, don’t buy them. Rapid tests don’t work. You need PCR. There are zero appointments in your area.” (F)
POST 228. January 13, 2022. CORONAVIRUS. “State officials are attempting to address California’s staffing shortage through a sweeping policy change that allows asymptomatic healthcare workers who have tested positive for the coronavirus to return to work immediately.” “Asymptomatic health professionals who had tested positive for COVID-19 should “preferably be assigned to work with COVID positive patients.”
POST 229. January 16, 2020. CORONAVIRUS. “It is now highly unlikely that the U.S. will hit the ~85-90% of Americans vaccinated to get to the other side of the pandemic…”
POST 230. January 20, 2022. CORONAVIRUS. “Dr. Fauci also said that the world is still in the first of what he considered to be the five phases of the pandemic. The first is the “truly pandemic” phase, “where the whole world is really very negatively impacted,” followed by deceleration, control, elimination and eradication.”…to paraphrase Churchill – “This is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”..
POST 231. January 24, 202. CORONAVIRUS. “Florida’s top public health official in Orlando has been placed on administrative leave after sending an email to his employees noting their lackluster coronavirus vaccination rates and urging them to get the shots.”
POST 232. January 28, 2022. CORONAVIRUS. “A Boston hospital’s denial of a heart transplant to a man who is unvaccinated for Covid-19 has generated national attention, but experts say mandating vaccines is in keeping with other long-standing requirements that patients have to meet to receive an organ — including getting other shots…”
POST 233. February 2, 2022. CORONAVIRUS. “The same virus can cause endemic, epidemic or pandemic infections: it depends on the interplay of a population’s behaviour, demographic structure, susceptibility and immunity, plus whether viral variants emerge.”
POST 234. February 2, 2022. CORONAVIRUS. “Senate Republican leader Mitch McConnell demanded an end to the COVID-19 state of emergency on Wednesday , saying it was time for Americans to get on with their lives after two years on a ‘hellish highway.’”
POST 235. February 17, 2020. CORONAVIRUS. “Over time, the U.S. health care sector has implemented various pieces of the (pandemic) safety-assessment-and-improvement puzzle, but it has not instituted a thorough system of safety that reaches from the boardroom to the front lines and that can be maintained during times of crisis.”
POST 236. February 22, 2021. CORONAVIRUS. MOUNT SINAI AT HOME – “We began thinking about how we could use hospital-at-home to meet the needs of our hospital system in our community, in terms of responding to the crisis of COVID-19…”
POST 237. February 27, 2020. CORONAVIRUS. “Decision-makers are increasingly embracing the reality that we will have to “learn to live with” the coronavirus. But how will they know when to impose or lift restrictions?” “Now, the CDC’s “Covid-19 community level” metrics are based on three pieces of data in a community: new Covid-19 hospitalizations, hospital capacity and new Covid-19 cases.”
POST 238. March 5, 2022, CORONAVIRUS. “Two different scientists can look at the same set of data and come up with different conclusions. That’s not to say that one person is being unscientific or ignoring the scientific process,” said Leana Wen, an emergency physician and a professor at George Washington University. “Public health policy is also a measure of values.””
POST 239. March 9, 2022. CORONAVIRUS. “War is an infectious disease’s best friend,” says Michael Osterholm, “It challenges every public health program you can possibly have. It limits the medical care available for those who might be seriously ill, and often fosters transmission when so many people are crowded into bomb shelter locations and on trains. This is going to be the perfect storm of one serious challenge after another.” (E)
POST 241. March 20, 2022, CORONAVIRUS. Dr. Ashish Jha will serve as the new White House COVID-19 response coordinator.” He is not, for the record, a virologist, immunologist, or vaccinologist…But he is a public health expert and a practicing internist, which means he has years of experience explaining complicated and often incomplete information to people who neither know nor care about the correct pronunciation of “adenovirus.” That’s who he imagines on the other end of his webcam.”
POST 242. March 24, 2022. CORONAVIRUS. “How worried should people be about the BA.2 variant? Will vaccines protect against it? What if someone contracted a previous variant — could they become reinfected? Is BA.2 milder than previous versions, and if so, should people try to get it? Could BA.2 cause another surge in the US, and is it time for restrictions to be put back into place?”
POST 243. March 28, 2022. CORONAVIRUS. “…the US Food and Drug Administration is planning authorize a fourth dose of the Pfizer and Moderna mRNA vaccines for adults over age 50 next week.”…”The decision to make fourth doses available now will bypass independent groups of scientific advisers for both the FDA and CDC, which would normally meet and publicly review the available science and then make recommendations to the agencies.”
POST 245. April 10, 2022. CORONAVIRUS. We can’t react to a wave we don’t see coming. “I keep thinking back to this idea of If we don’t measure it, it won’t happen,”…(As President Donald Trump once put it, “If we stop testing, we’d have fewer cases.”) In reality, “it’s very well happening, and we just don’t see it yet.”
POST 246. April 15, 2022. CORONAVIRUS. “State authorities and health care organizations could pay a high price for reinstating SCOPE OF PRACTICE (SOP) restrictions when the pandemic ends.” (e.g. NPs, PAs, Pharmacists +++)
POST 247. April 23, 2020. CORONAVIRUS. “The DOJ lawyers tasked with defending the CDC’s mask mandate authority have warned Biden administration officials that continuing to push the legal fight over the mask mandate could backfire, if the conservative-leaning appeals court upholds the order.”….”A Supreme Court ruling upholding the decision to strike down the mask mandate would make the Florida judge’s conclusions about CDC authority binding nationwide.”
POST 248. April 27, 2022. CORONAVIRUS. “For at-risk Americans without access to a “test-to-treat” drugstore that has a qualifying provider available, this means some will have to make multiple trips to get the pills. You have to develop COVID symptoms, you have to subsequently get a test for COVID-19, get the result of that test, find and go to see a provider, get a prescription, and then fill that prescription. That’s six steps in five days,”…
POST 249. May 6, 2022. CORONAVIRUS. “The United States is “certainly, right now, in this country, out of the pandemic phase..” (Dr. Anthony Fauci). “The US should prepare for a possible summer surge of Covid-19 cases across Southern states..” (Dr. Deborah Birx)
POST 250. May 11, 2022. Herd Immunity Deja vu. “Not so long ago, the world was clinging to the hope of herd immunity—to the notion that the population would eventually reach some communal level of protection sufficient to quash the outbreak for good. Maybe, experts posited many months back, once 60 to 90 percent of people had been infected or vaccinated or both, the virus would run out of viable hosts, and simply fizzle out. Now it’s clear that “that’s too simplistic…”
POST 252. May 20, 2022. CORONAVIRUS. “The stakes, two years into the pandemic, should be clear. Fewer vaccines, fewer treatments, and fewer tests will mean more infections, more serious illnesses, and more deaths. That is the scenario the country is staring down: one million people already dead and more to come because politicians became complacent.”
POST 253. May 29, 2020. CORONAVIRUS. “Significant obstacles persist in getting Paxlovid to everyone who could benefit from it; more than a million courses of Paxlovid purchased by the government are still available…”..” However, some doctors have also voiced concerns over wider use of the antiviral drug amid reports of so-called “rebound” symptoms following use of Paxlovid, which might raise the risk of the virus evolving resistance to the pills.”
POST 254. June 2, 2022. MONKEYPOX, “Massachusetts General Hospital this week began vaccinating a small group of workers against monkeypox — the first time the new medicine has been used in this country outside of clinical trials. The workers were in close contact with a man diagnosed with the virus and hospitalized at Mass General from May 12 to May 20. The patient was the first person in the United States to be tied to an ongoing outbreak of the rare virus in Europe and North America.”
POST 255. June 5, 2022. CORONAVIRUS. “More than a year after U.S. health care workers were saluted for saving lives in the COVID-19 outbreak and celebrated with nightly clapping from windows and balconies, some are being issued panic buttons in case of assault and ditching their scrubs before going out in public for fear of harassment.”
“The shooting in Tulsa is an extreme example of a growing trend: violence against doctors, nurses, and other health care workers.”
POST 256. June 10, 2022. MONKEYPOX. “This is one of the rare diseases in which you can vaccinate somebody after they’ve been infected, before they have symptoms, and block the disease,”… “We would have to really screw things up not to be able to contain this..”
POST 257. June 17, 2022. CORONAVIRUS. “We’re now in a very weird pandemic phase. On Twitter, doctors such as Eric Topol sound five-alarm warnings about the latest subvariants of omicron. Offline, even in blue states, people are back to parties, bars and restaurants — and will soon be flying around the world with no testing requirements to return to the US. Things feel as if they’ve lost any coherence. There’s no discernible strategy or guidance on what Covid precautions we should still be taking.”
“Luciana Borio, a former director of medical and biodefense preparedness at the National Security Council, said the country should recall a lesson from the testing fiasco at the beginning of the Covid-19 pandemic and bring commercial diagnostic testing companies into the response.”
for links to POSTS 1-256 in chronological order highlight and click on
“More than 30 cases of monkeypox have now been reported around the U.S.
According to the Centers for Disease Control and Prevention (CDC), there are now 31 confirmed monkeypox and orthopoxvirus cases nationwide.
New York leads the 13 states with reported infections, confirming seven. California has six, Florida has four and Colorado has three.
Illinois and Utah have two cases each.
There is one case reported in Washington state, Virginia, Pennsylvania, Massachusetts, Hawaii, Georgia and the District of Columbia.
The World Health Organization (WHO) said Sunday that more than two dozen countries where monkeypox virus is not endemic have reported 780 cases.
However, no monkeypox deaths outside of Africa have been identified…
Monkeypox spreads when there is close contact with an infected individual, but it is not yet known whether it is being transmitted now exclusively by sex…
It also remains unclear if people could spread monkeypox without symptoms or if the disease might be airborne.
Traditionally, monkeypox virus is spread by touching or getting bitten by infected wild animals in western and central Africa.” (A)
“World Health Organization Director-General Tedros Adhanom Ghebreyesus cautioned Wednesday that the window to contain the global monkeypox outbreak may be narrowing.
“Multiple epidemics around the world would constitute a pandemic. But experts aren’t betting on that outcome — WHO leaders and disease experts agree it’s not too late to reverse the trend.
“There’s still a window of opportunity to prevent the onward spread of monkeypox in those at highest risk right now,” Dr. Rosamund Lewis, the WHO’s technical lead on monkeypox, said at the briefing.
Two smallpox vaccines — both approved by the Food and Drug Administration — may be key to the prevention effort. The U.S. government’s preferred shot, called Jynneos, is specifically approved for use against monkeypox.
“We would have to really screw things up not to be able to contain this,” he added…
In the current outbreak, the primary driver of transmission seems to be skin-to-skin contact between people, often involving exposure to infected people’s rashes or lesions.
“Right now we’re more at risk for the virus maybe becoming endemic due to ongoing human-to-human transmission and our inability to stop the transmission cycle,” Roess said.
Several factors are involved in that cycle. For one, some monkeypox cases are hard to identify. Patients develop rashes that can be confused with chickenpox, syphilis or herpes, but in some cases it may be limited to the genital area, making it harder to detect.
Second, disease experts worry that the U.S. isn’t processing tests quickly enough to identify new cases in a timely manner.
“It still does take a few days from the time someone is identified to the time that we can confirm their diagnosis,” Roess said.
Dr. Stuart Isaacs, an associate professor of medicine at the University of Pennsylvania, said the virus could have “epidemic potential” in the U.S. — meaning there would be a major surge in cases — if a single infected person spread monkeypox to more than one other person on average. That hasn’t been the case in the past, and the U.S. has recorded fewer than 40 cases thus far.
“We’re still too early to really say definitively that this [outbreak] isn’t going to explode, although the likelihood is still very low,” Isaacs said.
“The reason this is endemic in Africa is there’s animal reservoirs,” he added. “The virus is propagating and spreading among animals, and then it jumps into humans or nonhuman primates every now and then.”
In the past, Roess said, countries outside Africa quickly halted monkeypox outbreaks through testing and contact tracing, but the current outbreak is unprecedentedly large and widespread.
Experts don’t yet know whether its scale is a clue that monkeypox has evolved to get better at human-to-human transmission or whether countries are simply uncovering the extent of an outbreak that went undetected for some time.
Already, the monkeypox outbreak may meet the formal definition of a pandemic: The virus is spreading from person to person in at least two countries, and there are community-level outbreaks in several parts of the world.
“But generally, when we talk about pandemics, we talk about diseases in which everyone is significantly at risk in every country or almost every country,” Toner said. “So far, this has not reached that threshold, and I don’t think it ever will.”
Roess said the fact that the Covid-19 pandemic isn’t over likely makes global health leaders wary of an emergency declaration.
“There’s a lot of hesitation to declare this a pandemic,” she said.
A reason for optimism, however, is that this version of monkeypox isn’t usually life-threatening. Although monkeypox rashes can be painful and cause scarring, experts said, doctors know how to treat them with smallpox antivirals and supportive care. No deaths have been reported in non-endemic countries thus far.
“We should be raising alarms and studying this and understanding this,” Isaacs said. “But we’re not at a panic stage yet.” (B)
“The monkeypox virus, which has now been diagnosed in hundreds of people in 26 countries, may have been quietly circulating for years before its sudden emergence worldwide, some scientists speculate.
Infectious disease experts and scientists at genetic labs are urgently looking for clues to explain why a virus that has been found in West Africa for half a century and typically doesn’t spread readily from person to person made such a dramatic and troubling appearance in the past month.
“There may have been undetected transmission for a while,” said Dr. Rosamund Lewis, the World Health Organization’s technical lead for monkeypox during a briefing Wednesday. “What we don’t know is how long that may have been. We don’t know if it’s weeks, months or possibly a couple of years.”…
“What’s likely happened is an endemic infectious disease from Africa found its way into a social and sexual network and then was greatly aided by major amplification events like raves in Belgium to disseminate around the world,” Dr. Amesh A. Adalja, a senior scholar at the Johns Hopkins Center for Health Security, said.
“And then,” Adalja added, “because it’s being transmitted through close contact in sexual encounters, many of the lesions are getting mistaken for other sexually transmitted infections, which may be delaying diagnosis.”..
“Whenever you start looking for a disease that’s new in a population, you find many, many more cases,” Dr. David Heymann, a professor at the London School of Hygiene and Tropical Medicine who formerly led the WHO’s Programme on Emerging and other Communicable Diseases, told NBC News.
Heymann supported the theory that the disease may have been present in some populations for several years outside the 11 Central and West Africa countries where the virus has become endemic. Cases may be circulating stealthily among people outside the global gay community, he suggested.
“The concern is looking in only one population rather than looking more broadly,” he said.;
Van Ranst said the coming days of the outbreak will be critical for controlling the disease. As of June 1, there were 643 confirmed cases, according to the WHO. If by next week the cumulative case count follows an exponential curve and hits perhaps 4,000, “then this is not under control,” he said.
If the figure instead only increases to about 1,000, then the outbreak is likely only expanding linearly, which bodes well for global control of the virus, Van Ranst said.” (C)
“As the number of monkeypox cases climbs amid an ongoing global outbreak, US health officials said Friday that they are ramping up testing and contact tracing and expanding access to vaccines and treatments.
As part of those efforts, about 1,200 doses of vaccine for monkeypox have been offered in the United States, said Dr. Raj Panjabi, White House senior director for global health security and biodefense.
“We want to ensure that people with high-risk exposures have rapid access to vaccines and, if they become sick, can receive appropriate treatment. To date, we’ve delivered around 1,200 vaccines,” Panjabi said. “And 100 treatment courses to eight jurisdictions, and we have more to offer states.”
Health care workers in Massachusetts treating monkeypox patients were among the first to receive vaccinations to protect them against the virus.
In the United States, the two-dose Jynneos vaccine is licensed to prevent smallpox and specifically to prevent monkeypox. Another smallpox vaccine licensed in the United States, ACAM2000, can also be used for monkeypox.
To date, more than 120 PCR orthopox tests have been performed across the United States as part of monitoring the outbreak.
“This is just a fraction of what’s available,” Panjabi said, adding that 67 labs across 46 states — part of a network known as the Laboratory Response Network — have the “collective ability” to perform more than 1,000 tests per day.
“So what we’re working on now is to ensure that that testing capacity is used,” he said. People with monkeypox symptoms are encouraged to see a health care provider, and providers are urged to test if they suspect that someone might have monkeypox…
“The high proportion of initial cases diagnosed in this outbreak in persons who identify as gay, bisexual, or other MSM, might simply reflect an early introduction of monkeypox into interconnected social networks; this finding might also reflect ascertainment bias because of strong, established relationships between some MSM and clinical providers with robust STI services and broad knowledge of infectious diseases, including uncommon conditions,” CDC researchers wrote in the report.
“However, infections are often not confined to certain geographies or population groups; because close physical contact with infected persons can spread monkeypox, any person, irrespective of gender or sexual orientation, can acquire and spread monkeypox.”..
Rosamund Lewis, WHO’s technical lead for monkeypox, said Tuesday that this outbreak is different from previous ones because “we’re seeing cases all appearing in a relatively short period of time.” (D)
“Infectious disease specialists are growing increasingly concerned by the U.S. strategy for testing for monkeypox, warning that it’s creating a bottleneck and squandering the limited time the country may have to get the outbreak under control.
Under the current system, specimens must be sent to one of 74 laboratories across the country before being sent to the Centers for Disease Control and Prevention. Experts who spoke with STAT argue the United States should be testing more broadly for monkeypox, allowing more labs to become part of the process.
“Every single day that we’re not fixing the testing bottleneck, every single day that we’re not getting on top of getting the information out to the networks that need to be aware of this, is time that we are losing in terms of that window closing on containment,” said Boghuma Titanji, an assistant professor of infectious diseases at Emory University…
Jennifer Nuzzo, director of Brown University’s new Center for Pandemic Preparedness and Response, said the current system makes sense for a smaller outbreak, but doesn’t suit the needs of clinicians who should be actively looking for monkeypox infections.
“This two-step process is not going to scale,” she said in an interview. “This is a cumbersome process. When you have something that’s spreading in ways that we’re not able to see — in the sense that we’re finding cases without known contacts or known links of transmission — it really feels like we’re in a different mode of the response.” ..
“That level of community spread is not being detected, and we cannot help people make good risk decisions, we cannot help people protect their loved ones and sex partners unless we know what’s going on,” said Joseph Osmundson, a molecular microbiologist at New York University…
Currently if a medical worker suspects a patient has monkeypox, someone has to contact the state health department and send a swab from the patient to a facility in what’s called the Laboratory Response Network, which was set up to test for biological or chemical threats. These laboratories can determine if the sample is positive for an orthopoxvirus — the family to which monkeypox and smallpox belong. The combined orthopox testing capacity for this network is nearly 7,000 tests per week at 74 labs in 46 states, the CDC has said.
If the sample tests positive, the CDC conducts confirmatory testing. The CDC has said its two-step method has been sufficient thus far, and stressed that a positive orthopox test was being treated as a presumed monkeypox infection, activating all of the clinical and containment measures that a final diagnosis requires. That includes contact tracing, vaccination of high-risk contacts, and access to antiviral drugs for the patient, if warranted.
Ranu Dhillon, an instructor of global health at Harvard Medical School, said the testing system ought to be designed to normalize monkeypox testing, so that the net can be cast more broadly to find more cases. Dhillon, who works part of his time at a community hospital in Vallejo, Calif., said that as it stands now, he would need to clear the ordering of a test with the head of his hospital’s lab.
“It would be a process, it would be a discussion,” he said. “I think the sooner we move to normalizing, the better to lower that professional stress or awkwardness of requesting a test for something that you’ve never seen [before]…. You have to be able to screen widely as we learn from Covid and have a lot of tests come back negative. That’s how you’re going to find the ones that are positive.”…
“We need to open up testing and bring testing to where it’s normally done. We learned that from Covid, right?” said Borio, who is a senior fellow for global health at the Council on Foreign relations. “It’s a lot more efficient.”
It will undoubtedly take time for companies to make and validate tests. But that work should be underway, she said.
“It has to start now — if it hasn’t already,” Borio said. “And it will take how long it takes. But we shouldn’t be debating whether it’s needed.”” (E)
“As global monkeypox cases continue to rise, public-health officials and researchers are questioning whether the current outbreaks can be contained. The World Health Organization (WHO) has said that the situation is unlikely to escalate into a full-blown pandemic. But there are now more than 1,000 confirmed infections in nearly 30 countries where outbreaks do not usually occur (see ‘Unusual spread’).
Countries including Canada, the United Kingdom and the United States have begun implementing a strategy called ‘ring vaccination’ to try to halt the spread of the virus. This involves administering smallpox vaccines — which are thought to be effective against monkeypox because the viruses are related — to people who have been exposed to monkeypox through close contact with an infected person.
But there are unknowns and challenges that come with this strategy, says Natalie Dean, a biostatistician at Emory University in Atlanta, Georgia. Although the vaccines are considered safe and effective for use in people with smallpox infection, they have had limited testing against monkeypox. The strategy also relies on rigorous contact tracing, which might not be implemented in every country, and people must agree to be inoculated with vaccines that can trigger rare, but serious, side effects.
Ring vaccination can be a powerful tool, Dean says, but to be effective, it needs to be used early — while case numbers are still manageable. “As the numbers crop up and you think about the number of contacts each individual has, the logistics just become more complicated.” She adds that there is a narrowing window of opportunity to prevent the virus from gaining a more permanent foothold in human or animal populations in countries where the global outbreaks are occurring.
These concerns were heightened on 3 June, when the US Centers for Disease Control and Prevention (CDC) reported genomic data showing that there are at least two strains of the monkeypox virus responsible for the outbreaks. This finding suggests that the virus might have been circulating internationally for longer than was thought. But Andrea McCollum, an epidemiologist who heads the poxvirus team at the CDC in Atlanta, Georgia, says that, although the new genomic data do not change the agency’s efforts to contain the virus, they will complicate the investigation into the outbreak’s origins.
Some countries maintain stockpiles of smallpox vaccines, mainly because public-health officials have been worried that variola — the virus that causes smallpox, which was eradicated more than 40 years ago and that kills about 30% of the people who get it — could be weaponized or accidentally released from laboratories where samples are still kept. Two main types of smallpox vaccine are available today. Each contains a live poxvirus, called vaccinia virus, that is closely related to the smallpox virus. ‘Second-generation’ vaccines can cause rare but serious side effects because they contain vaccinia that can replicate in a person’s cells. ‘Third-generation’ versions have fewer side effects because they contain a weakened virus…
Unlike their response to COVID-19, public-health officials aren’t currently mulling a mass-vaccination campaign for monkeypox. That’s because countries have stockpiled more second-generation smallpox vaccines than third-generation versions — and the side effects of the second-generation ones prevent them from being given to children, pregnant individuals, people who are immunocompromised or those with one of a spectrum of skin conditions that are classified as ‘eczema’. Third-generation vaccines, which fewer countries have access to, have fewer side effects and could therefore be given to more people.
At the moment, the risk posed by monkeypox to the general public isn’t high enough to warrant mass vaccination, given the side effects and availability issues, says Daniel Bausch, the director of emerging threats and global health security at FIND, the global alliance for diagnostics in Geneva, Switzerland. But if the virus starts spreading in vulnerable populations, such as pregnant people or children, or if it turns out to have a higher fatality rate than expected, the risk–benefit calculation could change…
So far, the United States has been offering either a second- or third-generation smallpox vaccine regimen to people at ‘high’ or ‘intermediate’ exposure risk, which the CDC defines as a person who had “unprotected contact” with the skin or bodily fluids of a person with monkeypox, or who was within 1.8 metres (6 feet) of an infected person. Smallpox vaccines are thought to protect against monkeypox infection if administered within four days of exposure, according to the CDC…
Even if more nations procure smallpox vaccines and begin a ring vaccination campaign, there is a large difference between theory and reality when it comes to implementing the strategy, MacIntyre warns. In theory, monkeypox is conducive to a ring vaccination campaign because it spreads slower than most human viruses and has a long incubation period. But in reality, the success of this approach relies on robust testing and contact-tracing infrastructure, as well as the ability to quickly vaccinate any high-risk contacts, she says…
To stop the spread of the virus, health officials will probably need to look beyond vaccination and focus on quarantine and isolation, as well as community education, he adds. As Bausch wrote in a 2021 comment about Ebola in Nature Medicine3, although ring vaccination has had its successes, “it is far from a panacea”. (G)
The Centers for Disease Control and Prevention (CDC) removed a mask recommendation from its monkeypox travel alert.
The agency told Fox News on Tuesday it took that part of the notice out late on Monday “because it caused confusion.”
“Travel Health Notices inform travelers and clinicians about current health issues that impact travelers’ health, like disease outbreaks, special events or gatherings and natural disasters, in destinations around the world,” the CDC continued. “In countries where there is a current monkeypox outbreak, CDC continues to recommend masking in high-risk situations including for household contacts and healthcare workers, or for other people who may be in close contact with a person who has been confirmed with monkeypox.”
In the initial CDC travel alert, it said wearing a mask can “help protect you from many diseases, including monkeypox.”
Now, its website advises travelers to avoid contact with dead or live wild animals and sick people, including those with skin lesions or genital lesions.
This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 prairie dog outbreak. Monkeypox, a disease that rarely appears outside Africa, has been identified by European and American health authorities in recent days.
This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 prairie dog outbreak. Monkeypox, a disease that rarely appears outside Africa, has been identified by European and American health authorities in recent days. (Cynthia S. Goldsmith, Russell Regner/CDC via AP)
In addition, people should avoid eating or preparing meat from wild game or using products derived from wild animals from Africa and avoid contact with contaminated materials used by sick people or that came into contact with infected animals.
The CDC raised its alert level for monkeypox to level 2 on Monday.
As of June 3, there have been 35 reported monkeypox cases across the country.
Hundreds have been reported in Europe and numerous other countries globally.
Although the majority of new monkeypox cases have been seen in gay or bisexual men, experts caution that anyone is at potential risk.
People normally become infected with the monkeypox virus through contact with the skin lesions or bodily fluids of infected animals or humans – including respiratory droplets – or through contact with materials contaminated with the virus.
Monkeypox, which is related to smallpox, has milder symptoms.
Some of those symptoms include fever, chills, rash and aches, before lesions develop.” (H)
“The spread of monkeypox through small virus particles that linger in the air “has not been reported,” the US Centers for Disease Control and Prevention said in guidance posted Thursday. It may spread through “saliva or respiratory secretions” during face-to-face contact, but these secretions “drop out of the air quickly,” and studies have found that this method of transmission seems uncommon.
Unlike other viral diseases like Covid-19 and measles, the monkeypox virus isn’t subject to “airborne transmission,” which involves small particles that linger in the air or spread on air currents, the CDC notes. “In instances where people who have monkeypox have travelled on airplanes, no known cases of monkeypox occurred in people seated around them, even on long international flights.”
But because of the potential for monkeypox to spread through respiratory secretions, the agency “recommends that people infected with monkeypox wear a mask if they must be around others in their homes if close, face-to-face contact is likely.”
Masks are also recommended for health care workers and others who may be in close contact with an infected person.
Previous CDC guidance had said that wearing a mask could help protect travelers from monkeypox, but that recommendation was removed late Monday because “it caused confusion,” the agency said.” (I)
“Public health experts currently do not expect the virus to become a major health threat, but are concerned about the recent spread.
“I think any time there’s an outbreak that is ongoing with no evidence of control, I think we should be concerned,” Dr. Wafaa El-Sadr, a professor of epidemiology and medicine at Columbia University Mailman School of Public Health in New York, told ABC News. “I think that’s different from being panic-stricken. But I think the continued increase in numbers of cases of monkeypox and continued increase in countries reporting cases is certainly of concern.”
If the outbreak isn’t contained, this means the virus could be ever-present in a community, circulating at low levels.
But Dr. Scott Roberts, an assistant professor and the associate medical director of infection prevention at Yale School of Medicine, said he does not envision the outbreak as being similar to the COVID-19 pandemic because of the different mechanisms of spread.
COVID-19 generally spreads through the air via tiny droplets and can require as little as 15 minutes of face-to-face contact. In the current outbreak, most of the spread has come from coming into contact with infected people’s lesions.
“It’s not like you’ll pass someone in the elevator, and you’ll get monkeypox,” Roberts told ABC News. “That’s pretty unlikely. The classic COVID definition was within six feet for 15 minutes. This one is more like within six feet for three hours, is what the CDC has said, or contact with the infected lesions.”…
But, most importantly, they said the virus is not spreading uncontrollably yet.” (J)
Prequel
POST 254. June 2, 2022. MONKEYPOX, “Massachusetts General Hospital this week began vaccinating a small group of workers against monkeypox — the first time the new medicine has been used in this country outside of clinical trials. The workers were in close contact with a man diagnosed with the virus and hospitalized at Mass General from May 12 to May 20. The patient was the first person in the United States to be tied to an ongoing outbreak of the rare virus in Europe and North America.”
