“New York City-based drug company Pfizer made the announcement on 9 November. It offers the first compelling evidence that a vaccine can prevent COVID-19 — and bodes well for other COVID-19 vaccines in development. But the information released at this early stage does not answer key questions that will determine whether the Pfizer vaccine, and others like it, can prevent the most severe cases or quell the coronavirus pandemic.
“We need to see the data in the end, but that still doesn’t dampen my enthusiasm. This is fantastic,” says Florian Krammer, a virologist at Icahn School of Medicine at Mount Sinai in New York City, who is one of the trial’s more than 40,000 participants. “I hope I’m not in the placebo group.”
The vaccine, which is being co-developed by BioNTech in Mainz, Germany, consists of molecular instructions — in the form of messenger RNA — for human cells to make the coronavirus spike protein, the immune system’s key target for this type of virus. The two-dose vaccine showed promise in animal studies and early-stage clinical trials. But the only way to know whether the vaccine works is to give it to a large number of people and then follow them over weeks or months to see whether they become infected and symptomatic. These results are compared with those for a group of participants who are given a placebo.”(A)
“A preliminary analysis of the race frontrunner, Pfizer-BioNTech’s mRNA vaccine, suggested it was 90% effective in preventing symptomatic Covid disease. While these are early findings — the trial is still ongoing — they suggest the vaccine could be very protective.
There’s another important caveat. We don’t yet have details about whether the vaccine blocked mainly mild cases, or if there is evidence that it seemed to prevent some severe infections, too.
Still, the early results are encouraging for the Pfizer-BioNTech partnership. But embedded in the announcement is broader good news for Covid-19 vaccine development. Here are four reasons for encouragement based on the early results, starting with the most important.
We are likely to have multiple successful Covid-19 vaccines.
The Pfizer vaccine targets the spike protein, the knobby protrusion on the SARS-CoV-2 virus that allows the virus to attach to and invade human cells, initiating infection.
In fact, all of the vaccines being developed by major manufacturers working with Operation Warp Speed, the U.S. government effort to fast-track vaccines, target the spike protein.
There have been at least theoretical concerns that this was the vaccine development equivalent of putting all our eggs in one basket. The interim Pfizer data suggests the basket is the right one.
“There was always a discussion: Is the spike protein the right target? Well, now we know it’s the right target,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told STAT on Monday. “So, it’s not only immediate good news, it really is optimistic about what’s going to roll out in the next several months with the other vaccines.”
That forecast applies globally. All the vaccines being developed with the help of the Coalition for Epidemic Preparedness Innovations — which has been funding research and production with the aim of producing vaccine for worldwide distribution — target the spike protein.
“We believe these interim results also increase the probability of success of other Covid-19 candidate vaccines which use a similar approach,” CEPI CEO Richard Hatchett said in a statement.” (B)
“The news — the first results from any late-stage vaccine trial — buoyed stock markets and spirits as the public saw a glimmer of hope. But it’s worth noting that the news is still preliminary, and there is much that is still not known about how well the vaccine works.
And one thing remained clear: The vaccine will not come in time to rescue the world from the next several months, when the virus will take many more lives unless the public takes more stringent public health measures.
Here’s what we know, and don’t know, about the vaccine.
What did these scientists find out?
Is that a good result?
Is the Pfizer vaccine safe?
Who will get the new vaccine first?
When will the general public be able to get it?
What is left to do in the trial?
Will it work on older people?
The new results also don’t tell us whether older people will get strong protection from the vaccine.
What about children? (C)
“It’s said that success has many authors, and the encouraging data from Pfizer Inc.’s experimental Covid-19 vaccine had plenty of people in Washington lining up to take credit.
Vice President Mike Pence was among Trump administration officials saying support from the government’s Operation Warp Speed program helped accelerate the development of the vaccine, which was found to be more than 90% effective in preventing symptomatic Covid-19 infections in an interim analysis.
The truth is that Pfizer didn’t receive any funding from Operation Warp Speed for the development, clinical trial and manufacturing of the vaccine. Rather, its partner, BioNTech SE, has received money — from the German government.
BioNTech is credited for contributing the messenger RNA technology, which prompts the body to make a key protein from the virus, creating an immune response. The biotechnology company already had a history of working with Pfizer on influenza vaccines, and in March they clinched a deal to co-develop a shot to prevent against Covid-19 at research sites both in the U.S. and Germany. The two companies began human testing of the vaccine in April, before the existence of Operation Warp Speed was revealed publicly.
Berlin gave the German company $445 million in an agreement in September to help accelerate the vaccine by building out manufacturing and development capacity in its home market.
What the U.S. did, meanwhile, was commit to buying hundreds of millions of vaccines in advance to ensure Americans were among the first in line if it clinches an emergency-use authorization or approval from the FDA. The Trump administration agreed in July to pay almost $2 billion for 100 million doses, with an option to acquire as many as 500 million more, once that clearance comes.
As part of that agreement, the U.S. gets to decide who gets the vaccine first, and will work with the company on logistical support. While most vaccine front-runners that have been tapped by Warp Speed will distribute their doses through a government partnership with McKesson Corp., Pfizer is handling its own delivery of its products. The company has designed reusable containers that can keep the doses at ultracold temperatures, and is organizing trucks and flights to move them.” (D)
“…The Center for Post-COVID Care, opened May 13, will help patients hospitalized for COVID-19 transition from the hospital to their homes. The center is also open to patients who were never hospitalized but need help during their recovery.
At the center, patients will be offered a personalized treatment plan that will include input from several specialties, including primary care, pulmonary medicine, cardiology, infectious disease and physiatry, as well as social workers and pharmacists.
The center will also focus on evaluating the long-term effects of the disease, which are largely unknown. Mount Sinai will create a COVID-19 registry and collect information on sociodemographics, behaviors, underlying conditions, mental health conditions and medications from patients with the disease.
“This center will provide a unique opportunity to follow this population and systematically evaluate the long-term impact of COVID-19,” said Dennis S. Charney, MD, president for academic affairs at Mount Sinai Health System.” (A)
“Because the Center for Post-COVID Care was established to conduct research on the potential long-term health outcomes of COVID-19 in addition to providing care, it has so far prioritized patients who have tested positive for COVID-19 or for antibodies, which can develop as part of the immune system’s response to the disease. But Chen acknowledges that it’s a flawed system and says he is working on getting appointments for people who were waitlisted by the Center because they lacked a positive test.
“Initially, what we were designed to do was take care of patients we knew had COVID-19, meaning they had a positive PCR test or had a positive antibody test, so we’re sure these are [COVID-19-related] symptoms and can enroll them in research,” Chen said. “But even from the beginning, we realized you have patients who didn’t get tested in New York and around the country and there are patients who may have had a not-so-good test because testing was not perfect.”
COVID-19 diagnostic tests were harder to access early in the pandemic and many patients were simply told to stay home if they were sick in order to conserve resources and prevent the spread of the disease. Meanwhile, the reliability of antibody tests has been called into question and experts have said they are more useful on a population level than for determining whether an individual has had COVID-19…
The inclination to put certain criteria in place to identify long-haul patients for the purpose of research is understandable. The symptoms COVID-19 long-haulers report are extremely wide-ranging and there is a risk that some people may think they fall into that group, but are, in fact, suffering from an unrelated health issue.
“Part of the challenge is separating out these patients from patients who had COVID-19,” Chen said.
Adina Gerver, a Washington Heights resident, still suffers from extreme fatigue as well as ear, throat, and chest pain months after getting sick with COVID-19 in March. She says she was able to get an appointment at Mount Sinai’s Center for Post-COVID Care in about three weeks when she reached out in mid-July and appreciates that the model combines research and care.
“I feel like Mount Sinai is a little bit helping people and a little bit studying people and all of it is fine with me because I feel like they’re going to learn things that will help everyone,” Gerver said…. (B)
“Michael Reagan first got sick with COVID-19 on March 22 and spent the next 2 months in and out of Mount Sinai Hospital in New York City. He had pneumonia, scarring in his lungs, and blood clotting issues, and while he was never put on a ventilator, he came close.
By the end of May, the 50-year-old felt well enough to go for a jog — but that unexpectedly set him back severely. He started having seizures, tremors in his left hand, numbness, and muscle weakness on the left side of his body, and involuntary muscle movements on the left side of his face.
He also suffered memory loss and even had trouble navigating around his neighborhood. Then there was the debilitating joint pain in his elbows and knees, and his heart rate would sometimes skyrocket to 200 beats per minute with the slightest exertion.
“Before all this happened, I was always on the go,” Reagan told MedPage Today. “I played the cello, I was into biking, rock climbing, horseback riding. Now some days I can’t even get out of bed. Taking a shower and getting dressed feels like a superhuman effort.”
Reagan is among a growing number of COVID-19 “long-haulers” who suffer with long-term and often varied consequences from the virus. These patients often require care from a gamut of specialists, including pulmonologists, cardiologists, neurologists, rheumatologists, and psychiatrists.
That’s why health systems in the hard-hit greater New York area have launched COVID-19 rehabilitation and recovery programs, to serve as a medical home for patients with myriad complications who require coordinated care.
Reagan is a patient at the Center for Post-COVID Care at Mount Sinai…
“Right now, we have almost every medical specialty working with the program,” Chen told MedPage Today. “We’re looking at a broad spectrum of disease. Some may have permanent lung fibrosis … that may last for the rest of their lives. Others have reactive airway or inflammatory problems that will subside over time. It’s unpredictable. It’s the same for cardiac symptoms and neurological symptoms.”..
Mount Sinai is creating a registry of COVID long-haulers for further study. Chen said his team spoke with the health system’s World Trade Center victims program when they were developing the COVID recovery center. Between 7,000 and 8,000 COVID patients were treated in the Mount Sinai system, and Chen’s team is assessing symptom surveys to determine which of those patients may benefit from their post-COVID care program.” (C)
“Mount Sinai has been in the forefront of understanding and treating COVID-19. We were among the first to develop an antibody test to identify individuals who have recovered from COVID-19. We were then able to use plasma from these individuals to help critically ill patients recover. Researchers at the Icahn School of Medicine at Mount Sinai have been helping our frontline physicians treat all the varied aspects of the disease—from thrombosis to the sudden inflammatory response known as a “cytokine storm.” Because COVID-19 behaves so differently in many patients, we have created this multi-disciplinary team working together for your recovery to health.
Experts from Every Specialty, Working for Your Care
The long-term effects of COVID-19 are not clear yet. The virus can affect many different systems within the body—from the lungs to the heart to the kidneys. But by bringing in specialists who have been on the frontlines of the outbreak, you will have the most knowledgeable experts available. Your team and clinical staff may include disciplines such as:
Primary Care; Pulmonary Medicine; Cardiology; Infectious Diseases; Nephrology; Physiatry; Physical and Occupational Therapy; Radiology; Neuropsychiatry; Behavioral Health; Social Workers; Pharmacists
Treating the Whole Person, Not Just the Disease
This time has caused all of us anxiety—and some, more than others. The Center has the resources to help you manage anxiety and depression, PTSD, and other emotional issues. Getting “back to normal” may require physical therapy, occupational therapy, or other types of support—whether in groups or one-on-one. Whatever your needs, the Center is a compassionate, holistic source of care.
You Can Help Us Understand COVID-19
To understand the long-term effects of COVID-19, we are offering patients the opportunity to participate in the Mount Sinai COVID-19 Registry. Participation is voluntary, and you don’t have to register to get care at the Center. However, by being part of the Registry, you will help us understand the effects of COVID-19 on long-term health and well-being. Together, we will overcome COVID-19.” (D)
Note: I have been a proud member of the Mount Sinai faculty since the mid 1970’s (currently voluntary Adjunct Professor of Environmental Medicine and Public Health). I am not involved with the new Center. JMM
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….”
“ When the country reached the million-case mark in late April, the virus was more concentrated geographically — the New York area and the West Coast were the main hot spots — but outbreaks were surfacing elsewhere in vulnerable settings like nursing homes, prisons and meat packing plants…
Six weeks after reaching a million cases, the nation passed the two million case mark. It took four weeks to add the third million, and less than three weeks each to add the fourth and fifth, as states in the Sunbelt struggled following early reopenings. By the end of August, the pace had slowed slightly, and the nation was taking three weeks or more to pass each million-case milestone.
That changed in mid-October, when the virus began surging again across much of the country. The ninth million followed the eighth by just over two weeks, and now the 10th has taken just 10 days.” (A)
“Joe Biden’s top priority entering the White House is fighting both the immediate coronavirus crisis and its complex long-term aftermath by embracing science, pushing mask-wearing as a patriotic act and leaning on Congress to pass a massive stimulus package.
It’s a strategy that would toss out the Trump administration’s patchwork response that put the burden on states and install a top-down national framework for testing, contact tracing and targeted business closures. Biden’s also promised a national mask mandate, calling it “a patriotic duty.” And public health experts rather than politicians will update the public once Biden is sworn in — meaning sober assessments and realistic timelines will replace Trump’s declarations that the pandemic is all but over and the virus will “disappear” with or without a vaccine.
“You’ll immediately see a change of tone, a change in communication,” said Dr. Ezekiel Emanuel, a health policy and bioethics expert advising Biden. “People can roll their eyes at that, but this is the stuff of real leadership: telling the truth, modeling the right behaviors like wearing a mask, only having small crowds, putting the scientists out there.”
The shift, however, won’t be immediate. A defeated Trump stays in office until Jan. 20, and public health experts expect the coronavirus to keep spreading throughout the country during the transition, adding thousands to a death toll that’s already crossed 230,000. In addition, even the most thoughtful Biden plans won’t be able to wipe out much of the country’s deep cultural divide and skepticism about the virus and antagonism toward the public health steps needed to combat it. Red states and MAGA world will strongly resist Biden’s approach, having embraced Trump’s rosy assessments and his portrayals of masks and business closures as a form of tyranny. New restrictions could also rattle millions of less partisan but crisis-weary Americans who face looming evictions or the expiration of unemployment benefits. For those reasons, the makeup of the next Congress will play a big part determining if Biden can make his plan stick, or whether it will get mired in more rancor.
One of Biden’s first actions, his campaign told POLITICO, would be to press Congress to get a sweeping stimulus bill to his desk by late January that guarantees paid sick leave to all workers, covers the cost of Covid-19 testing and treatment for the uninsured and under-insured and gives states and public health workers the resources they need to slow the spread of the virus and distribute a vaccine if and when one is approved…
Biden will have to do it all while recruiting people to fill out a hollowed out federal workforce that’s been a frequent target of Trump attacks — and restore morale at federal health agencies like the Centers for Disease Control and Prevention where career scientists were repeatedly undercut by the White House.” (A)
“With President Donald Trump’s coronavirus task force sidelined, Joe Biden is planning to create his own task force to help grapple with the country’s surge in cases should he win tonight’s election, according to plans obtained by POLITICO.
The task force would include former Surgeon General Vivek Murthy, former Food and Drug Administration Commissioner David Kessler, New York University’s Dr. Celine Gounder, Yale’s Dr. Marcella Nunez-Smith, former Obama White House aide Dr. Zeke Emanuel and former Chicago Health Commissioner Dr. Julie Morita, who is now an executive vice president at the Robert Wood Johnson Foundation. In line with Biden’s repeated campaign pledges to “listen to the scientists” if elected, the team features well-respected, veteran public health experts, some of whom ran agencies under the Obama and Clinton administrations.
The team is expected to advise transition officials on managing the latest spike of Covid-19 cases, ensuring vaccines are safe, and protecting at risk populations, according to an official close to the Biden team with knowledge of the plans, which are still evolving
Many of the members have already been working with the Biden campaign and transition for months. Starting in the pandemic’s earliest days, Murthy and Kessler have led briefings for Biden as often as four times a week, pulling in other former officials and experts in public health, infectious diseases and epidemiology to update the former vice president on the virus’s spread and the ongoing development of a vaccine. Biden’s campaign has featured these briefings in its closing advertisements as part of his argument that he is better prepared than Trump to confront Covid-19…
The transition team has also discussed contingency plans for the possibility that the Trump administration would refuse to cooperate and share information during a transition, according to another source close to Biden…
Mr. Biden’s policy advisers have been developing plans that would go into effect as soon as he took office, including ramping up testing, ensuring a steady supply of protective equipment, distributing a vaccine and securing money from Congress for schools and hospitals….
Former Health and Human Services Secretary Kathleen Sebelius said in an interview that given the state of the pandemic, the task force’s creation is “good news.”
“We are still 11 weeks away from the inauguration — that’s a potentially dangerous and damaging time for the American public with the virus still raging,” she said. “So hopefully this can give the American public some confidence that they’re not on their own, that the pandemic isn’t a Democratic plot, that the numbers are very real and that we have choices.” (B)
“President-elect Joseph R. Biden Jr. plans to announce a Covid-19 task force as early as Monday, a source familiar with the plans of the Biden transition team said Saturday.
Mr. Biden, who made President Trump’s mishandling of the pandemic a centerpiece of his campaign, is expected to name three co-chairs of the 12-member panel: Vivek Murthy, a former surgeon general; David Kessler, the former commissioner of the F.D.A.; and Dr. Marcella Nunez-Smith, a Yale University professor.
The announcement of the task force is part of a weeklong focus that Mr. Biden intends to place on health care and the pandemic as he begins the process of building his administration, a person close to the transition said.
“We’re not waiting to get the work done,” Mr. Biden said in a speech on Friday night.
During the campaign, Mr. Biden repeatedly assailed Mr. Trump for mishandling the virus, refusing to wear a mask and playing down the threat from the pandemic, which has spread across the country.
In the last several days, the number of new cases of the virus has soared to record levels, with more than 130,000 new cases reported in a single day on Friday. So far, nearly 250,000 people have died since the pandemic arrived in the United States.
Mr. Murthy has been a key adviser to Mr. Biden and his campaign for months and aides to the president-elect say they expect him to serve as the public face of the new, Democratic administration when it comes to public health issues and the virus.
Mr. Biden’s aides have assembled an internal group of roughly two dozen health policy and technology experts to look at the development and delivery of a vaccine, improving health data and securing supply chains, among other issues.
Mr. Trump will keep control of the nation’s health apparatus and the bully pulpit that comes with the Oval Office until Jan. 20 — a crucial period for the country’s outbreak, given that infections already have hit new highs and colder weather is driving more interactions indoors.
The president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language, insisting that the country must fully reopen and repeatedly telling voters that the country is “rounding the corner” in the fight against the virus, which has claimed nearly a quarter of a million lives in the country…
Mr. Biden, who made President Trump’s mishandling of the pandemic a centerpiece of his campaign, is expected to name three co-chairs of the 12-member panel: Vivek Murthy, a former surgeon general; David Kessler, the former commissioner of the F.D.A.; and Dr. Marcella Nunez-Smith, a Yale University professor.
The announcement of the task force is part of a weeklong focus that Mr. Biden intends to place on health care and the pandemic as he begins the process of building his administration, a person close to the transition said.
“We’re not waiting to get the work done,” Mr. Biden said in a speech on Friday night.
During the campaign, Mr. Biden repeatedly assailed Mr. Trump for mishandling the virus, refusing to wear a mask and playing down the threat from the pandemic, which has spread across the country.
In the last several days, the number of new cases of the virus has soared to record levels, with more than 130,000 new cases reported in a single day on Friday. So far, nearly 250,000 people have died since the pandemic arrived in the United States.
Mr. Murthy has been a key adviser to Mr. Biden and his campaign for months and aides to the president-elect say they expect him to serve as the public face of the new, Democratic administration when it comes to public health issues and the virus.
Mr. Biden’s aides have assembled an internal group of roughly two dozen health policy and technology experts to look at the development and delivery of a vaccine, improving health data and securing supply chains, among other issues.
Mr. Trump will keep control of the nation’s health apparatus and the bully pulpit that comes with the Oval Office until Jan. 20 — a crucial period for the country’s outbreak, given that infections already have hit new highs and colder weather is driving more interactions indoors.
The president has largely shuttered the White House Coronavirus Task Force and doubled down on anti-science language, insisting that the country must fully reopen and repeatedly telling voters that the country is “rounding the corner” in the fight against the virus, which has claimed nearly a quarter of a million lives in the country.
Mr. Biden’s policy advisers have been developing plans that would go into effect as soon as he took office, including ramping up testing, ensuring a steady supply of protective equipment, distributing a vaccine and securing money from Congress for schools and hospitals.” (C)
“Here are the key ways he plans to get US coronavirus cases under control.
Make tests widely available…
Biden has pledged to make testing more widely available through a government-backed test-development program. He also intends to increase the production of rapid, at-home diagnostic tests and establish at least 10 drive-through testing sites per state…
Expand mask requirements
Biden has said he would consider a national mask mandate, though legal experts say he may only have the authority to enforce mask-wearing on federal property or in federal facilities.
At the very least, Biden plans to work with governors to implement mask requirements…
Tailor lockdowns to local hotspots
It seems unlikely that Biden would impose a nationwide shutdown, based on his comments leading up to Election Day. But the president-elect has repeatedly said he would follow the recommendations of scientific officials…
Restore the CDC’s authority
The Trump administration’s approach has come into conflict with guidelines from the Centers for Disease Control and Prevention (CDC) several times. CDC scientists have said some of their advice about lockdowns and testing was ignored by the federal administration….
Rejoin the World Health Organization
Trump halted all funding to the WHO, which is helping coordinate the global response to the pandemic, in April. Then in July, the US officially withdrew from the WHO, though the decision wouldn’t be finalized until July 2021.
Biden has said he will rejoin the WHO on his first day in office….
Enlist at least 100,000 contact tracers
As of October, the US had 50,000 contact tracers, according to a joint survey from NPR and the Johns Hopkins Center for Health Security. That means the vast majority of states don’t have enough contact tracers to investigate their coronavirus cases, according to NPR’s analysis.
Distribute more ventilators and PPE to hospitals
Biden has promised to lean more heavily on the Defense Production Act, which allows the president to require businesses to prioritize the federal government’s supply-chain needs. Trump has invoked the act, too, but Biden hopes to using it more aggressively to alleviate supply-chain issues with PPE, ventilators, and other resources needed by hospitals.
Ensure free COVID-19 treatment for all Americans
At the moment, COVID-19 treatments — of which there are still very few — may be free depending on the state you live in, your insurer, or your employer. Biden has promised to eliminate co-pays, deductibles, and surprise bills for insured Americans who receive these therapies. He has also pledged to reimburse healthcare providers for COVID-19 treatments for uninsured patients.
Ensure a vaccine is safe and free
The Trump administration’s Operation Warp Speed program is currently manufacturing vaccine doses in large quantities while clinical trials are ongoing. It’s also funding the research and development of promising candidates. Congress has directed nearly $10 billion in CARES Act funding to Operation Warp Speed.” (D)
“Much of the work has already begun. In interviews with STAT, several Biden health advisers described a forthcoming effort to court skeptical mayors and governors, select and vet leaders for key public health agencies, and set a new tone for the nation’s pandemic response, even in the 10 weeks before he takes office. Many in the president-elect’s brain trust spoke on the condition that the conversations remain private until Biden was declared the winner.
“There are some things he’s going to do right off the bat,” said Nicole Lurie, a Biden campaign adviser who served as the Obama administration’s top pandemic-preparedness official. “He will reach out to Tony Fauci. He will declare his intent to be an active participant in the WHO and in the world. And I believe that in very short order, he’ll be in touch with governors and mayors around the country, listening to what it is that they’ll need to pivot this response.”” (E)
“President-elect Joe Biden’s victory signals a turning point in the U.S. response to the coronavirus pandemic, as he promises a newly aggressive federal effort to contain a virus that is spiking nationwide in contrast to a president who has consistently downplayed the outbreak’s dangers and promised it would disappear….
Biden released a plan to combat the coronavirus that says its aim is to restore trust, create a cohesive national strategy, make treatments affordable, provide economic relief to those impacted by the virus and work with other countries to combat the spread.
Biden said he would restore the White House National Security Council Directorate for Global Health Security and Biodefense, which the Trump administration had folded into another office at the NSC.
He also plans to provide a daily public White House report on how many tests have been conducted, expand surveillance programs by the U.S. Centers for Disease Control, instruct federal agencies to take action to expand America’s hospital capacity and expand tele-health capabilities across the country.
The plan also says federal health agencies will collaborate on vaccine development, establish a public health corps to assist with testing and contract tracing, and fully fund and expand authority for the National Disaster Medical System to reimburse providers for Covid-19 treatment costs that are not directly covered by health insurance.” (F)
“Biden gave a speech on his COVID-19 plan on Oct. 23, and he and running mate Senator Kamala Harris have circulated a seven-point plan for “beat[ing] COVID-19 and get[ting] our country back on track.” It is, experts say, what they’ve asked for since the pandemic began—but “the real devil’s in the details,” says Eric Toner, a senior scholar at the Johns Hopkins Center for Health Security. Everything comes down to execution and specifics. And on that front, it’s too early to say how things would go if Biden is elected.” (G)
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.”
“Meadows was last seen by reporters on election night, when Trump gave a defiant speech to supporters packed into the East Room of the White House. Meadows walked into the room ahead of Trump’s adult children just ahead of his remarks….
Meadows, who infrequently wore face masks, traveled extensively with Trump in the late stages of his campaign as he raced across swing states. He was seen in close quarters with most of Trump’s senior staff as well as with Vice President Mike Pence. He also joined Trump for an Election Day visit to Trump’s campaign headquarters in Arlington, Va..
Trump has long undermined guidance even from his own administration regarding pandemic protocols, including social distancing and mask-wearing. The president continued to hold massive campaign rallies where most supporters packed close together and did not wear masks.” (B)
“During the pandemic, Mr. Meadows has encouraged Mr. Trump’s desire to minimize the threat of the virus and focus instead on the economy. He was dismissive of mask-wearing in the White House, and wore one only very sporadically as he traveled with the president or during events in the Oval Office.
Like Mr. Trump, Mr. Meadows often mocked reporters who wore masks around him, saying the face coverings muffled their voices. A video clip of Mr. Meadows refusing to give a statement to reporters at the Capitol because they asked him to wear his mask was widely shared across social media.
He has also been among the West Wing officials who have favored minimizing the public appearances of Dr. Anthony S. Fauci, the nation’s top infectious disease expert, who has issued far more dire warnings about the threat of the virus than Mr. Trump has wanted to have publicly declared.
In the waning days of the presidential campaign, Mr. Meadows made unwanted headlines when he acknowledged during a television interview that the government would not be able “control” the pandemic. Critics and Mr. Trump’s political rivals seized on the comment as evidence that the administration had given up on fighting the virus.
“We are not going to control the pandemic,” Mr. Meadows told Jake Tapper, the host of “State of the Union” on CNN. “We are going to control the fact that we get vaccines, therapeutics and other mitigation areas.”… (C)
“Meadows reportedly informed several advisers of his COVID-19 diagnosis after Election Day. Meadows was in the White House on Tuesday night with Trump, Ivanka Trump, Jared Kushner, Donald Trump Jr. and others, and attended a party there that had hundreds in attendance…
Meadows, who was a Republican congressman from North Carolina before becoming chief of staff in March, remained physically close with Trump through the president’s own case of COVID-19 last month, often working in the same room with Trump while he was being treated at Walter Reed National Military Medical Center. During that time, Meadows defended speaking with reporters without a mask despite having been in the room with Trump.
In June, Meadows teased reporters for wearing masks on Capitol Hill. He has repeatedly refused to wear one, going against the advice of the nation’s top health officials.” (D)
