A somber milestone on the path to brighter days ahead

https://mailchi.mp/05e4ff455445/the-weekly-gist-february-26-2021?e=d1e747d2d8

U.S. tops 500,000 COVID-19 deaths | PBS NewsHour

Although the nation reached a grim and long-dreaded milestone on Monday, surpassing 500,000 lives lost to COVID—more than were killed in two World Wars and the Vietnam conflict combined—the news this week was mostly good, as key indicators of the pandemic’s severity continued to rapidly improve.

Over the past two weeks, hospitalizations for COVID were down 30 percent, deaths were down 22 percent, and new cases declined by 32 percent—the lowest levels since late October. This week’s numbers declined somewhat more slowly than last week’s, leading Dr. Rachel Walensky, director of the Centers for Disease Control and Prevention, to caution people against letting their guard down just yet: “Things are tenuous. Now is not the time to relax restrictions.” Of particular concern are new variants of the coronavirus that have emerged in numerous states, including one in New York and another in California, that may be more contagious than the original virus.
 
The best news of the week was surely a report from the Food and Drug Administration (FDA) evaluating the new, single-shot COVID vaccine from Johnson & Johnson (J&J), showing it to be highly effective at preventing severe disease, hospitalization, and death caused by COVID, including variants. On Friday, a panel of outside experts met to assess whether to approve the J&J vaccine for emergency use, which would make it the third in the nation’s arsenal of COVID vaccines. If approved, the vaccine will be rolled out next week, according to the White House, with up to 4M doses available immediately.

The sooner the better: new data show that since vaccinations began in late December, new cases among nursing home residents have fallen more than 80 percent—a hopeful glimpse at the future that lies ahead for the general population once vaccines become widely available.

Where the pandemic has been deadliest

Image result for Ratio of COVID-19 deaths to population Map: Michelle McGhee and Andrew Witherspoon/Axios

In the seven states hit hardest by the pandemic, more than 1 in every 500 residents have died from the coronavirus.

Why it matters: The staggering death toll speaks to America’s failure to control the virus.

Details: In New Jersey, which has the highest death rate in the nation, 1 out of every 406 residents has died from the virus. In neighboring New York, 1 out of every 437 people has died.

  • In Mississippi, 1 out of every 477 people has died. And in South Dakota, which was slammed in the fall, 1 of every 489 people has died.

States in the middle of the pack have seen a death rate of around 1 in 800 dead.

  • California, which has generally suffered severe regional outbreaks that don’t span the entire state, has a death rate of 1 in 899.
  • Vermont had the lowest death rate, at 1 of every 3,436 residents.

The bottom line: Americans will keep dying as vaccinations ramp up, and more transmissible variants of the coronavirus could cause the outbreak to get worse before it gets better.

  • Experts also say it’s time to start preparing for the next pandemic — which could be deadlier.

“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

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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.”

Two lawmakers test positive for coronavirus, one after receiving both doses of vaccine

Politics - The Washington Post

Two members of Congress from Massachusetts have tested positive for the coronavirus, one after receiving both doses of the vaccine, a reminder that people can still be vulnerable to infection after being vaccinated, particularly in the two weeks after receiving the second dose.

Rep. Stephen F. Lynch (D-Mass.) tested positive for the virus on Friday afternoon after a staff member in his Boston office tested positive earlier in the week, his spokeswoman Molly Rose Tarpey said.

Lynch received a second dose of the Pfizer-BioNTech vaccine before the inauguration of President Biden on Jan. 20, but his office declined to specify the date it was administered. Lynch had tested negative for the virus before attending the inaugural ceremonies, Tarpey said.

“While Mr. Lynch remains asymptomatic and feels fine, he will self-quarantine and will vote by proxy in Congress during the coming week,” she said.

Tarpey added that Lynch “has followed CDC guidelines and continues to do so since he received the vaccine.”

Another Democrat from Massachusetts, Rep. Lori Trahan, announced Thursday that she had tested positive for the virus and was asymptomatic. Trahan, whose staff members have been working remotely, also said she planned to vote by proxy next week.

“I encourage everyone to continue taking this virus seriously and to follow the science and data-driven guidance to wear a mask, maintain a safe social distance from others, avoid large gatherings and stay home whenever possible,” Trahan said.

Trahan received her first shot of one of the vaccines last week, spokeswoman Francis Grubar told The Washington Post.

Occasional cases of people testing positive after receiving one or both doses are not unexpected, medical experts say. Clinical trial data published by Pfizer show that the vaccine is about 52 percent effective at preventing illness after the first shot, compared to 95 percent effectiveness seven days after the second dose.

A small number of patients can still become mildly sick even after they are fully vaccinated. But only one of the roughly 20,000 people who received both doses in the clinical trial developed severe covid-19, suggesting the vaccine is powerful protection against the most dangerous cases of the disease.

Members of Congress began getting vaccinated as early as Dec. 18, but Lynch at the time said he was “waiting for the vaccine to be first offered to health care personnel, first responders and vulnerable seniors” in his district, the Boston Herald reported. It is unclear when Lynch ultimately received his first dose of the vaccine; he would have received the second dose of the Pfizer-BioNTech vaccine about three to four weeks after the first.

Public health experts have emphasized that it usually takes one week after the second dose of the Pfizer-BioNTech vaccine to reach 95 percent efficacy and two weeks after the second dose of the Moderna vaccine to reach 94 percent efficacy.

“There’s no vaccine that I know that protects you the same day you get it,” Onyema Ogbuagu, the principal investigator for Pfizer’s vaccine trial at Yale University, told The Post’s Allyson Chiu. “On a population level, 95% efficacy still translates to 5/100, or 50/1,000, or 500/10,000 vaccinated persons still being vulnerable to symptomatic disease and maybe even more having asymptomatic carriage.”

At least 23.2 million people in the United States have received one or both doses of the vaccine. The Centers for Disease Control and Prevention recommends that vaccinated people continue to wear masks, socially distance, avoid poorly ventilated spaces and wash their hands frequently to prevent the spread of the virus.

“We also don’t yet know whether getting a covid-19 vaccine will prevent you from spreading the virus that causes covid-19 to other people, even if you don’t get sick yourself,” CDC guidelines state. “While experts learn more about the protection that covid-19 vaccines provide under real-life conditions, it will be important for everyone to continue using all the tools available to help stop this pandemic.”

Mask-wearing in particular has become politicized, including in the hallways of Congress. After the Jan. 6 siege at the Capitol, several Democrats said they feared they had been exposed to the virus after sheltering with Republican lawmakers who refused to wear masks. In the following, at least three lawmakers tested positive for the virus.

On Friday, Rep. Cori Bush (D-Mo.) accused Rep. Marjorie Taylor Greene (R-Ga.) of berating her in the hallways after she told Greene to put on a mask. The incident, coupled with other hostile rhetoric and Greene’s refusal to abide by rules and protocols put in place because of the pandemic, prompted Bush to decide to move her office away from Greene’s for safety reasons, the Missouri lawmaker said.

My Parents Will Be Vaccinated Long Before Me. Can They Come Visit?

Can I Visit People Who Are Vaccinated During COVID-19? | Time

Welcome to COVID Questions, TIME’s advice column. We’re trying to make living through the pandemic a little easier, with expert-backed answers to your toughest coronavirus-related dilemmas. While we can’t and don’t offer medical advice—those questions should go to your doctor—we hope this column will help you sort through this stressful and confusing time. Got a question? Write to us at covidquestions@time.com.

Today, E.B. in New York asks:

My parents and in-laws will hopefully be vaccinated soon. My husband and toddler and I don’t expect to be vaccinated for quite some time. How should we think about whether it’s safe to spend time together in a mixed-vaccinated group? Could they get on a plane and fly to visit with us unmasked and indoors? Or is there enough risk that we should wait until we are all vaccinated (which may be a very long time especially with children in the mix)? Or split the difference and take some precautions?

To state the obvious, we are in a strange limbo state right now. The vaccines we’ve eagerly awaited for almost a year are here, and yet…nothing about our daily lives has really changed. Unfortunately, that’s going to be the case for a bit longer.

“The end is in sight,” says Dr. Colleen Kelley, a vaccine researcher and associate professor of infectious diseases at the Emory University School of Medicine in Georgia. “I just don’t know that it’s right now.”

Your loved ones getting vaccinated is unequivocally a step forward, Kelley says. It would certainly be safer to visit with your parents or in-laws after they’ve gotten both vaccine doses, but the safest plan is to wait until you and your husband are also vaccinated, she says.

The two coronavirus vaccines currently authorized for use in the U.S.—those made by Pfizer-BioNTech and Moderna—are both extremely effective at preventing people from getting sick with COVID-19. That’s a huge benefit on its own, especially for people at high risk of severe illness, such as elderly adults and people with underlying medical conditions.

But the outstanding question is whether COVID-19 vaccines also stop people from getting asymptomatically infected with the virusEarly evidence suggests both shots offer at least some protection against asymptomatic infection, and many experts are optimistic about their chances of stopping transmission, but the data are still coming together.

If the shots turn out not to stop asymptomatic infections entirely, even your vaccinated parents could feasibly get your family sick if they picked something up while traveling to see you. Or, if you happened to be exposed to the virus, your parents could potentially carry it and pass it to others. And, while the authorized COVID-19 vaccines are very effective, there is always a tiny chance of them failing, leaving your parents at risk of illness.

These are all worst-case scenarios, of course. But given the uncertainty and the extent to which COVID-19 is still spreading in the U.S., Kelley says you should wait a little while longer to visit with your parents and in-laws. If that’s not possible, you should take the same precautions you’ve been hearing about for a year: quarantining beforehand, and ideally staying outdoors and masked when possible.

Here’s the good news, though. Once you and your husband are fully vaccinated (along with more of the general population), Kelley says you can feel much better about spending time with other vaccinated people indoors and unmasked—even if your toddler isn’t yet vaccinated.

As you suggest, it may be a while before kids younger than 16 are eligible for COVID-19 vaccination, since pharmaceutical companies haven’t yet finished testing their shots on younger children. But “if the toddler is the only one who’s not vaccinated, I would say that’s a pretty darn safe scenario,” Kelley says.

Luckily, young kids rarely get seriously ill with COVID-19, so once all the adults in the room are fully protected, Kelley says you can feel pretty comfortable with your parents or in-laws coming for a visit.

“We’re not going to get to a zero-risk situation,” Kelley says, “but we are going to get to places that are safer and safer.”

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.

Fauci: Lack of facts ‘likely did’ cost lives in coronavirus fight

Fauci: Lack of facts 'likely did' cost lives in coronavirus fight | TheHill

Anthony Fauci on Friday said that a lack of facts “likely did” cost lives over the last year in the nation’s efforts to fight the coronavirus pandemic.

In an appearance on CNN, the nation’s leading infectious diseases expert was directly asked whether a “lack of candor or facts” contributed to the number of lives lost during the coronavirus pandemic over the past year.

“You know it very likely did,” Fauci said. “You know I don’t want that … to be a sound bite, but I think if you just look at that, you can see that when you’re starting to go down paths that are not based on any science at all, that is not helpful at all, and particularly when you’re in a situation of almost being in a crisis with the number of cases and hospitalizations and deaths that we have.”

“When you start talking about things that make no sense medically and no sense scientifically, that clearly is not helpful,” he continued.

President Biden on Thursday unveiled a new national coronavirus strategy that is, in part, aimed at “restoring trust in the American people.”

When asked why that was important, Fauci recognized that the past year of dealing with the pandemic had been filled with divisiveness.

“There’s no secret. We’ve had a lot of divisiveness, we’ve had facts that were very, very clear that were questioned. People were not trusting what health officials were saying, there was great divisiveness, masks became a political issue,” Fauci said.

“So what the president was saying right from the get-go was, ‘Let’s reset this. Let everybody get on the same page, trust each other, let the science speak.’”

Fauci, who was thrust into the national spotlight last year as part of former President Trump‘s coronavirus task force, often found himself at odds with the former president. Trump frequently downplayed the severity of the virus and clashed publicly with Fauci.

Speaking during a White House press briefing on Thursday, Fauci said it was “liberating” to be working in the Biden administration.

There have been more than 24,600,000 coronavirus infections in the U.S. since the pandemic began, according to a count from Johns Hopkins University. More than 410,000 people have died.

Cartoon – Coronavirus Death Toll

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

Cartoon – Less “I” and more “US.”

Trump's coronavirus press conference less than inspiring - The San Diego  Union-Tribune