Walmart prepares 5,000+ pharmacies to administer the COVID vaccine

The CDC selected Walmart and Sam’s Club to help administer COVID-19 vaccines in communities across the United States.

Why it’s important: With 5,000+ pharmacy locations, the company can administer the vaccine in hard-to-reach parts of the country.

CDC presses for schools to reopen with precautions

https://thehill.com/policy/healthcare/538646-cdc-releases-guidelines-for-reopening-schools?userid=12325

Image result for CDC presses for schools to reopen with precautions

The Centers for Disease Control and Prevention (CDC) on Friday released long-awaited guidance on safely reopening schools, emphasizing the importance of having schools open as long as proper safety precautions are followed.

The guidance states it is “critical for schools to open as safely and as soon as possible,” given the benefits of in-person learning.

The top recommendations for doing so safely are universal wearing of masks by students, staff and teachers as well as distancing so that people are six feet apart.

Vaccination of teachers should be prioritized, the agency said, but “should not be considered a condition” of reopening schools.

Schools can adjust whether they are fully in-person or hybrid depending on the level of spread in the surrounding community and mitigation measures in place.

Schools are encouraged to use “podding” to separate students into smaller groups to help make contract tracing easier.

What happens after a year without the flu?

https://mailchi.mp/85f08f5211a4/the-weekly-gist-february-5-2021?e=d1e747d2d8

Image result for What happens after a year without the flu?

Doctors and scientists have been relieved that the dreaded “twindemic”—the usual winter spike of seasonal influenza superimposed on the COVID pandemic—did not materialize.

In fact, flu cases are at one of the lowest levels ever recorded, with just 155 flu-related hospitalizations this season (compared to over 490K in 2019). A new piece in the Atlantic looks at the long-term ramifications of a year without the flu. 

Public health measures like masking and handwashing have surely lowered flu transmission, but scientists remain uncertain why flu cases have flatlined as COVID-19, which spreads via the same mechanisms, surged.

Children are a much greater vector for influenza, and reduced mingling in schools and childcare likely slowed spread. Perhaps the shutdown in travel slowed the viruses’ ability to hop a ride from continent to continent, and the cancellation of gatherings further dampened transmission.

Nor are scientists sure what to expect next year. Optimists hope that record-low levels of flu could take a strain out of circulation. But others warn that flu could return with a vengeance, as the virus continues to mutate while population immunity declines. 

Researchers developing next year’s vaccines, meanwhile, face a lack of data on what strains and mutations to target—although many hope the mRNA technologies that proved effective for COVID will enable more agile flu vaccine development in the future. 

Regardless, renewed vigilance in flu prevention and vaccination next fall will be essential, as a COVID-fatigued population will be inclined to breathe a sigh of relief as the current pandemic comes under control.

“I got the vaccine…now what can I do?”

https://mailchi.mp/85f08f5211a4/the-weekly-gist-february-5-2021?e=d1e747d2d8

Image result for after the vaccine covid

A family member in her 70s called with the great news that she received her first dose of the COVID vaccine this week. She mentioned that she was hoping to plan a vacation in the spring with a friend who had also been vaccinated, but her doctor told her it would still be safest to hold off booking travel for now: “I was surprised she wasn’t more positive about it. It’s the one thing I’ve been looking forward to for months, if I was lucky enough to get the shot.” 

It’s not easy to find concrete expert guidance for what it is safe (or safer?) to do after receiving the COVID vaccine. Of course, patients need to wait a minimum of two weeks after receiving their second shot of the Pfizer or Moderna vaccines to develop full immunity.

But then what? Yes, we all need to continue to wear masks in public, since vaccines haven’t been proven to reduce or eliminate COVID transmission—and new viral variants up the risk of transmission. But should vaccinated individuals feel comfortable flying on a plane? Visiting family? Dining indoors? Finally going to the dentist?
 
It struck us that the tone of much of the available guidance speaks to public health implications, rather than individual decision-making. Take this tweet from CDC director Dr. Rochelle Walensky. A person over 65 asked her if she could drive to visit her grandchildren, whom she hasn’t seen for a year, two months after receiving her second shot. Walensky replied, “Even if you’ve been vaccinated, we still recommend against traveling until we have more data to suggest vaccination limits the spread of COVID-19.” 

From a public health perspective, this may be correct, but for an individual, it falls flat. This senior has followed all the rules—if the vaccine doesn’t enable her to safely see her grandchild, what will? It’s easy to see how the expert guidance could be interpreted as “nothing will change, even after you’ve been vaccinated.”

Debates about masking showed us that in our individualistic society, public health messaging about slowing transmission and protecting others sadly failed to make many mask up.

The same goes for vaccines: most Americans are motivated to get their vaccine so that they personally don’t die, and so they can resume a more normal life, not by the altruistic desire to slow the spread of COVID in the community and achieve “herd immunity”. 

In addition to focusing on continued risk, educating Americans on how the vaccinated can make smart decisions will motivate as many people as possible to get their shots.

Turning the tide in the battle against the virus

https://mailchi.mp/85f08f5211a4/the-weekly-gist-february-5-2021?e=d1e747d2d8

Image result for Turning the tide

The national COVID indicators all continued to move in the right direction this week, with new cases down 16 percent, hospitalizations down 26 percent, and deaths (while still alarmingly high at more than 3,000 per day) down 6 percent from the week prior.

More good news: both nationally and globallythe number of people vaccinated against COVID now exceeds the total number of people infected with the virus, at least according to official statistics—the actual number of coronavirus infections is likely several times higher.

On the vaccine front, Johnson & Johnson filed with the Food and Drug Administration (FDA) for an Emergency Use Authorization for its single-dose COVID vaccine, which could become the third vaccine approved for use in the US following government review later this month. The J&J vaccine is reportedly 85 percent effective at preventing severe COVID disease, although it is less effective at preventing infection than the Pfizer and Moderna shots.

Elsewhere, TheLancet reported interim Phase III results for Russia’s Sputnik V vaccine trials, showing it to be 91 percent effective at preventing infection, and a new study found the Oxford-AstraZeneca vaccine to be 75 percent effective against the more-contagious UK virus variant.

Amid the positive vaccine news, the Biden administration moved to accelerate the vaccination campaigninvoking the Defense Production Act to boost production and initiating shipments directly to retail pharmacies. With the House and Senate starting the budget reconciliation process that could eventually lead to as much as $1.9T in stimulus funding, including billions more for vaccines and testing, it feels as though the tide may be finally turning in the battle against coronavirus.

While the key indicators are still worrisome—we’re only back to Thanksgiving-week levels of new cases—and emerging variants are cause for concern, it’s worth celebrating a week that brought more good news than bad.

Best to follow Dr. Fauci’s advice for this Super Bowl weekend, however: “Just lay low and cool it.”

How soon can we achieve immunity through vaccinations?

Over the weekend I realized that my son Henry, born in June 2019, has lived more than half of his life in the pandemic era. He’s too young to be cognizant of it, of course, but my wife and I are acutely conscious of the experiences his older brother had already enjoyed by the time he was Henry’s age, things that are impractical or impossible in the moment.

He’s not alone in that, of course. Most Americans are experiencing some ongoing deprivations because of the pandemic. (Most of those for whom the pandemic is not imposing unusual restrictions are, ironically, probably contributing to the pandemic’s extent and duration.) Just about everyone in the United States is eagerly scanning the horizon for signs of normalcy — as we have been for months, occasionally spotting oases that too often turn out to be mirages.

So when will we return to some semblance of normal? It’s hard to say with certainty. The best tool we have to reach that point, though, is the broad deployment of the vaccines approved for emergency use by the government. But even the existence of those vaccines can’t completely answer the question.

For example, the rate at which the vaccines are deployed makes a massive difference. A pace of 2 million shots per day as opposed to 1 million seems like a subtle distinction but, obviously, means achieving immunity for recipients twice as fast.

What level of immunity is necessary is a question of its own. Do we need 70 percent of the country to have been immunized? Or, as infectious-disease expert Anthony S. Fauci has recently said, is the figure closer to 80 or 85 percent?

When doing this calculation, do you include the 26 million Americans who have already had coronavirus infections? What about young people? The vaccine trials included only those age 16 and over. Those younger have constituted about a 10th of the total infections. And what vaccine are we talking about? The Pfizer and Moderna iterations require two shots; the vaccine from Johnson & Johnson requires only one.

All of these factors affect how we can figure out when the country might hit the herd-immunity mark. If we assume that young people will be included among those needed to be vaccinated — a complicated question on its own — the calculator below will allow you to figure out when immunity might be achieved at various immunization rates.

At this rate, the country would reach 70 percent herd immunity through vaccinations by Nov. 10

How we calculate this:
There are about 330 million Americans, meaning that we need 231 million to be resistant to the virus to hit 70 percent immunity. We can take out the 5.8 million Americans who’ve already been vaccinated. That leaves 211.3 million people to be vaccinated.

From there the math is straightforward: doing two-shot vaccinations at a rate of 1.5 million shots per day means it will take 282 days to complete the job.

Bear in mind that sliding the little bar to determine how quickly shots are administered is far easier than actually scaling up the infrastructure to do so. President Biden’s original target for daily vaccinations was 1 million; he recently increased it to 1.5 million. At that rate, we’re still months from resolution. But because administering the vaccine is more complicated and requires more tracking than vaccinations such as that for the seasonal flu, it’s necessarily trickier to scale up.

At this point, the more urgent concern is the efficacy of the vaccine against any variants of the virus that might emerge. Manufacturers have already noted that the vaccine works less well against a virus variant first identified in South Africa, though the vaccines are still broadly effective, particularly at protecting the recipient from severe illness or death after infection.

Well, that and the fact that a fifth of Americans said in a recent Kaiser Family Foundation poll that they won’t get the vaccine or would do so only if it was required. Happily, more Americans are now saying they’re eager to get a vaccine.

The faster we get people immunized, the better we protect against the emergence of new mutations that prove less able to be controlled by the vaccines. The faster we get shots in arms, as the phrasing has it, the faster we get back to normal.

Which would be nice for all of us, including my 1-year-old.

Biden ramps up vaccine distribution to 200 million doses by the end of summer

https://www.healthcarefinancenews.com/news/biden-ramps-vaccine-distribution-200-million-doses-end-summer

Biden administration to buy 200 million more doses of Covid vaccine -  POLITICO

The death toll from the pandemic is projected to climb to 500,000 by the end of  February.

President Joe Biden yesterday announced he is ramping up COVID-19 vaccine distribution to have 200 million doses delivered by the end of the summer.

This is an additional 100 million doses Biden set as his goal for his first 100 days in office.

In remarks yesterday, Biden directed COVID-19 Response Coordinator Jeff Zeints to work with the Department of Health and Human Services to increase the nation’s total supply. 

“And we believe that we’ll soon be able to confirm the purchase of an additional 100 million doses for each of the two FDA-authorized vaccines: Pfizer and Moderna,” Biden said. “That’s 100 million more doses of Pfizer and 100 million more doses of Moderna — 200 million more doses than the federal government had previously secured. Not in hand yet, but ordered. We expect these additional 200 million doses to be delivered this summer.”

After review of the current vaccine supply from manufacturing plants, the federal government believes it can increase overall weekly vaccination distribution to states, tribes, and territories from 8.6 million doses to a minimum of 10 million doses, starting next week.  

But the pandemic is expected to get worse before it gets better, Biden said, with experts predicting the death toll as likely to top 500,000 by the end of  February.

But the brutal truth is: It’s going to take months before we can get the majority of Americans vaccinated. Months. In the next few months, masks — not vaccines — are the best defense against COVID-19,” he said.

WHY THIS MATTERS

The increases in the total vaccine order in the United States from 400 million ordered to 600 million doses will be enough vaccine to fully vaccinate 300 Americans by the end of the summer or the beginning of fall, Biden said.  

“It’ll be enough to fully vaccinate 300 [million] Americans to beat this pandemic — 300 million Americans,” he said. “And this is an aggregate plan that doesn’t leave anything on the table or anything to chance, as we’ve seen happen in the past year.”

Biden’s team said they found the vaccine program to be in worse shape than they thought it would be and that they were starting from scratch.

“But it’s also no secret that we have recently discovered, in the final days of the transition — and it wasn’t until the final days we got the kind of cooperation we needed — that once we arrived, the vaccine program is in worse shape than we anticipated or expected,” Biden said. 

Governors have been guessing at what they’ll receive for vaccine shipments, the president said.

The federal  government is working with the private industry to ramp up production of vaccine and protective equipment such as syringes, needles, gloves, swabs and masks. The team has already identified suppliers and is working with them to move the plan forward.

Also, the Federal Emergency Management Agency is being directed to to stand up the first federally-supported community vaccination centers and to make  vaccines available to thousands of local pharmacies beginning in early February.

THE LARGER TREND

Last week, Biden signed a declaration to begin reimbursing states 100% for the use of their National Guard to help the COVID-19 relief effort, both in getting sites set up and in using some of their personnel to administer the vaccines. 

Biden has also said he wants to expand testing, which will help reopen schools and businesses.

He has formalized the Health Equity Task Force to ensure that the most vulnerable populations have access to vaccines. 

He is also pushing for a $1.9 trillion relief package.

100 million doses in 100 days: How Biden’s coronavirus vaccine push compares with those of other countries

https://www.washingtonpost.com/world/2021/01/23/international-comparison-biden-coronavirus-vaccine-plan/

A key part of President Biden’s new coronavirus strategy is a push to administer 100 million doses in 100 days, or a lofty sounding 1 million immunizations a day.

That goal, part of a comprehensive national plan launched this week, has raised questions about how quickly the United States can, and should aim to, deliver vaccines to its population.

The strategy document calls the 1 million shots per day pace “aggressive,” an effort that will “take every American doing their part.” But critics have pointed out that it does not constitute a major leap from the current rate, which has already neared or even surpassed the target. Many wonder why the country cannot move more swiftly.

It remains possible that the United States could pick up its pace as vaccine supply increases and logistics improve. But in international context 1 million doses a day does not seem slow.

Though differences in population, logistical capacity and data transparency, along with different levels of vaccine vetting and effectiveness between vaccine types, make it hard to compare vaccination campaigns across countries, the United States is near the top of the pack, behind some of the fastest countries to vaccinate, including Israel and Britain, but ahead of most of the rest of the world.

The biggest factor shaping the rate of vaccination is global supply.

Though the development and emergency approval of coronavirus vaccines has unfolded at an unprecedented pace, drug companies are scrambling to make enough doses to meet demand. As some countries receive a high number of doses from among the limited total produced, others must wait their turn.

So far, a small number of relatively rich countries, including the United States, have snapped up the initial supply, relegating low- and middle-income countries to the back of the line — possibly for years. Some projections suggest poor countries will not have enough doses until 2023 or 2024.

Rich countries are set to fare better. The European Commission aims to vaccinate 70 percent of the adult population of the European Union by the summer, though details of that plan are not yet clear.

Anthony S. Fauci, adviser to President Biden and director of the National Institute of Allergy and Infectious Diseases, said this week that the United States could potentially reach “herd immunity” by fall 2021.

Will other large countries move faster than the United States?

Possibly, but it is hard to say.

Questions about manufacturing capacity, the potential approval of additional vaccines and the impact of the new U.K. variant make predictions tough. However, India offers an interesting point of comparison.

On Jan. 16, India launched a plan to vaccinate 300 million people by August.

The roughly 200 day push to deliver 600 million doses is more ambitious than the U.S. plan. However, India’s population is more than three times larger than that of the United States.

China promised to vaccinate some 50 million people against the coronavirus before the Lunar New Year holiday next month — a seemingly rapid pace. But a report in a news outlet controlled by the ruling Communist Party said the country had administered 15 million doses by Jan. 20.

There are also questions about whether Chinese-made vaccines are as effective as the Moderna, Pfizer and AstraZeneca formulations used elsewhere.

Days after Brazilian officials announced that a vaccine made by Chinese company Sinovac was 78 percent effective protecting against moderate and severe covid-19 cases, for instance, they were forced to clarify that the shot’s efficacy rate among all cases was only 50.4 percent.

Ultimately, the biggest difference between the U.S. vaccination push and the Chinese effort is need.

Though there are doubts about China’s figures, the country reports just above 4,600 coronavirus deaths to date — comparable to the 4,409 U.S. deaths on Inauguration Day alone.

Deborah Birx says Trump received a “parallel set of data” on the coronavirus

https://www.washingtonpost.com/politics/2021/01/25/health-202-hospitals-drag-feet-new-regulations-disclose-costs-medical-services/

The former White House coronavirus response coordinator told CBS News’s “Face The Nation” that she saw Trump presenting graphs about the coronavirus that she did not help make. Someone inside or outside of the administration, she said, “was creating a parallel set of data and graphics that were shown to the president.”

Birx also said that there were people in the White House who believed the coronavirus was a hoax and that she was one of only two people in the White House who routinely wore masks.

Birx was often caught between criticism from Trump, who at one point called her “pathetic” on Twitter when she contradicted his more optimistic predictions for the virus, and critics in the scientific community who thought she did not do enough to combat false information about the virus from TrumpThe Post’s Meryl Kornfield reports.

“Colleagues of mine that I’d known for decades — decades — in that one experience, because I was in the White House, decided that I had become this political person, even though they had known me forever,” she told CBS. “I had to ask myself every morning, ‘Is there something that I think I can do that would be helpful in responding to this pandemic?’ And it’s something I asked myself every night.”

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told the New York Times that Trump repeatedly tried to minimize the severity of the virus and would often chide him for not being positive enough in his statements about the virus. 

Fauci also described facing death threats as he was increasingly vilified by the president’s supporters. “One day I got a letter in the mail, I opened it up and a puff of powder came all over my face and my chest,” he said. The powder turned out to be benign.

Cartoon – Coronavirus Death Toll

Coronavirus cartoons: Trump's ratings jump amid big job losses