America's vaccine failure

[barney]

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Yet when asked by a reporter whether some of the challenge could stem from the words of members of his own party, Mr. McConnell demurred.

“I’ve already answered the question about how I feel about this,” he said. “I can only speak for myself, and I just did a few minutes ago.”

That's rich.He never hesitates to speak for " the American people " on any number of other matters dear to the GOP's and Trump's heart.Fraud.

Exactly so. And lobotomy party shoves its head further into the sand. Sickening, because people will die.

[maestrob]

Dolly Parton Tried. But Tennessee Is Squandering a Miracle.



July 19, 2021, 5:00 a.m. ET
By Margaret Renkl

Ms. Renkl is a contributing Opinion writer who covers flora, fauna, politics and culture in the American South.

July 16, 2021, 7:40 p.m. ET

NASHVILLE — When Dolly Parton received her first dose of the Moderna vaccine at Vanderbilt University, where her own million-dollar donation helped to fund the research, she sang an updated version of her iconic song “Jolene.” The tongue-in-cheek lyrics were meant to inspire people to get vaccinated:

Vaccine, vaccine, vaccine, vaccine
I’m begging of you, please don’t hesitate
Vaccine, vaccine, vaccine, vaccine
’Cause once you’re dead, then that’s a bit too late

She gave it a good try, a heroic try, but somehow the bonehead politicians running this state managed to overcome even the good will generated by its favorite daughter.

Remember how hopeful we were, earlier this year, when the new Covid-19 vaccines arrived so astonishingly quickly, and were so astonishingly effective and safe? As a nation — politically, institutionally, too often personally — we’d botched almost everything about this pandemic, and we did not deserve a miracle. The miracle arrived anyway.

We were giddy about the prospect of those vaccines. We could not stop talking about how happy we would be to sit in a movie theater again, to hear live music again, to go to church and sing out loud again, to sit and talk around a table again, late into the night, with no care for how long we had been breathing the same air. We would reach for new babies and lean down to smell their downy heads. We would weep with the joy of being skin to skin with new life. New life, after such a long, dark year!

The anticipation of happiness seemed truly ecumenical. Liberals, conservatives, politically indifferent people — everyone I knew was watching for their vaccine priority number to come up. We were signing up for leftover doses that might be available at the end of the day. We were heading out of town to get vaccinated in rural counties where health officials were moving more quickly through the vaccine priority rankings. The empty vaccine lines should have told us something was happening in those counties, something besides the fact that fewer people lived there.

Tennessee’s governor, Bill Lee, understood what was going on. Mr. Lee is vaccinated, but he refused to be photographed getting the shot — the Covid shot, that is: He did post a photo of himself getting a flu shot last November. “Getting a flu shot is more important than ever this year,” his Twitter post read. “I got mine to help protect my granddaughters as we prepare to celebrate their first birthday.” Not a word about protecting children from the deadliest pandemic in a hundred years.

None of this was surprising. Mr. Lee is not a leader who actually leads so much as a politician who reads the room. From the beginning, white people in rural Tennessee have been so skeptical of this vaccine that last month state officials returned an allotment of three million doses to the federal stockpile. “We’re sort of grinding to a halt,” the state’s health commissioner, Dr. Lisa Piercey, told News Channel 5 in Nashville. “The people who want it have gotten it.”

The trouble is that not enough people want it, particularly here in the South, which accounts for eight of the 10 states with the lowest vaccination rates, and infections have begun to climb. “The rate of daily coronavirus infections in Tennessee has more than tripled in the past three weeks — one of the largest increases in the entire nation — as the virus shows signs of renewed spread,” wrote The Tennessean’s indefatigable health reporter Brett Kelman last week. “The state’s average test positivity rate and count of active infections also climbed sharply in the same time period.”

Conservative Tennessee legislators responded, it’s true, but not by working to reduce vaccine hesitancy. Instead, they pressured state health officials to cancel vaccination events aimed at teenagers and retract social media posts urging adolescents to get vaccinated. Worse, these anti-vaccination efforts weren’t limited to the Covid-19 vaccine. Conservative lawmakers also urged the Tennessee Department of Health to halt outreach efforts designed to inform teenagers about all vaccines.

Worse still, they arranged the firing of Dr. Michelle Fiscus. As medical director of the vaccine-preventable diseases and immunization program at the Department of Health, Dr. Fiscus was the state’s top vaccine authority. “It was my job to provide evidence-based education and vaccine access so that Tennesseans could protect themselves against Covid-19,” she wrote in a statement. “I have been terminated for doing my job because some of our politicians have bought into the anti-vaccine misinformation campaign rather than taking the time to speak with the medical experts.”

The politicization of public discourse around immunization is not unique to Tennessee. The question isn’t why Tennessee is so out of step with science. The question is why politics has anything to do with health policy at all.

The planet is growing more crowded, bringing people into closer contact with diverse animal and human populations. At the same time, the health risks associated with climate change are ratcheting upward. But just as protection against communicable diseases becomes increasingly urgent, conservative media outlets are sowing doubt and delusion in the Republican base, and feckless elected officials are following suit. Like Mr. Lee, his licked finger held aloft in the wind of rural white discontent, other Republican leaders in the South take their lifesaving vaccines in private and give lip service to perverse notions of “freedom” in their public statements.

Campaign funding from the national oligarchs is what sets legislative agendas across the red states, so I can understand why these penny-ante politicians are working so hard to limit tax-funded safety nets. I can even understand why they’re so hell bent on killing public education. It clearly benefits the wealthy for taxes to be low or nonexistent and for poor people to be incurious and compliant. But how can it possibly benefit the oligarchs to risk the lives of the very people who keep electing their toadies to statehouses in the first place? I just don’t get it.

“I am afraid for my state,” Dr. Fiscus wrote. I am afraid for my state, too. More than that, I’m afraid for my country. Tech companies won’t stop the spread of misinformation about vaccines, and conservative leaders can’t rouse the political will to combat that misinformation with science.

I’m not saying all is lost. Even in Tennessee, 43 percent of the population has received at least one dose of a Covid vaccine, and 38 percent are fully vaccinated. People are hugging one another and kissing babies again, but people are also continuing to die for no good reason. Their stubborn refusal to take a lifesaving vaccine is more than a pity, and it’s more than a waste. It’s a tragedy, a sign that we have squandered our miracle. I have no faith that we will be given another.

Margaret Renkl, a contributing Opinion writer, is the author of the books “Late Migrations: A Natural History of Love and Loss” and the forthcoming “Graceland, at Last: Notes on Hope and Heartache From the American South.”

https://www.nytimes.com/2021/07/19/opin ... ime-weight

[maestrob]

In Undervaccinated Arkansas, Covid Upends Life All Over Again

While much of the nation tiptoes toward normalcy, the coronavirus is again swamping hospitals in places like Mountain Home, in a rural county where fewer than one-third of residents are vaccinated.

By Sharon LaFraniere
Published July 17, 2021
Updated July 18, 2021

MOUNTAIN HOME, Ark. — When the boat factory in this leafy Ozark Mountains city offered free coronavirus vaccinations this spring, Susan Johnson, 62, a receptionist there, declined the offer, figuring she was protected as long as she never left her house without a mask.

Linda Marion, 68, a widow with chronic pulmonary disease, worried that a vaccination might actually trigger Covid-19 and kill her. Barbara Billigmeier, 74, an avid golfer who retired here from California, believed she did not need it because “I never get sick.”

Last week, all three were patients on 2 West, an overflow ward that is now largely devoted to treating Covid-19 at Baxter Regional Medical Center, the largest hospital in north-central Arkansas. Mrs. Billigmeier said the scariest part was that “you can’t breathe.” For 10 days, Ms. Johnson had relied on supplemental oxygen being fed to her lungs through nasal tubes.

Ms. Marion said that at one point, she felt so sick and frightened that she wanted to give up. “It was just terrible,” she said. “I felt like I couldn’t take it.”

Yet despite their ordeals, none of them changed their minds about getting vaccinated. “It’s just too new,” Mrs. Billigmeier said. “It is like an experiment.”


While much of the nation tiptoes toward normalcy, the coronavirus is again swamping hospitals in places like Mountain Home, a city of fewer than 13,000 people not far from the Missouri border. A principal reason, health officials say, is the emergence of the new, far more contagious variant called Delta, which now accounts for more than half of new infections in the United States.

The variant has highlighted a new divide in America, between communities with high vaccination rates, where it causes hardly a ripple, and those like Mountain Home that are undervaccinated, where it threatens to upend life all over again. Part of the country is breathing a sigh of relief; part is holding its breath.

While infections rose in more than half the nation’s counties last week, those with low vaccination rates were far more likely to see bigger jumps. Among the 25 counties with the sharpest increases in cases, all but one had vaccinated under 40 percent of residents, and 16 had vaccinated under 30 percent, a New York Times analysis found.

In Baxter County, where the hospital is, fewer than a third of residents are fully vaccinated — below both the state and the national averages. Even fewer people are protected in surrounding counties that the hospital serves.

“It’s absolutely flooded,” said Dr. Rebecca Martin, a pulmonologist, as she made the rounds of 2 West one morning last week.

In the first half of June, the hospital averaged only one or two Covid-19 patients a day. On Thursday, 22 of the unit’s 32 beds were filled with coronavirus patients. Five more were in intensive care. In a single week, the number of Covid patients had jumped by one-third.

Overall, Arkansas ranks near the bottom of states in the share of population that is vaccinated. Only 44 percent of residents have received at least one shot.

“Boy, we’ve tried just about everything we can think of,” a retired National Guard colonel, Robert Ator, who runs the state’s vaccination effort, said in an interview. For about one in three residents, he said, “I don’t think there’s a thing in the world we could do to get them to get vaccinated.”

For that, the state is paying a price. Hospitalizations have quadrupled since mid-May. More than a third of patients are in intensive care. Deaths, a lagging indicator, are also expected to rise, health officials said.


Dr. José R. Romero, the state health director, said he still believed enough Arkansans were vaccinated, or immune from having contracted Covid-19, that the “darkest days” of December and January were behind them. “What I’m concerned about now is we’ll have a rise or surge,” he said, “then winter is going to add another surge, so we’re going to have a surge on top of a surge.”

Dr. Mark Williams, the dean of the College of Public Health at the University of Arkansas for Medical Sciences, said the Delta variant was upending his projections for the pandemic. It is spreading through the state’s unvaccinated population “at a very fast rate,” he said, and threatens to strain the ability of hospitals to cope. “I would say we have definitely hit the alarming stage,” he said.

At Baxter Regional, many doctors and nurses are girding for another wave while still exhausted from battling the pandemic they thought had abated.

“I started having flashbacks, like PTSD,” said Dr. Martin, the pulmonologist, who obsesses over her patients’ care. “This is going to sound very selfish but unfortunately it’s true: The fact that people won’t get vaccinated means I can’t go home and see my kids for dinner.”


The Biden administration has pledged to help stem outbreaks by supplying Covid-19 tests and treatments, promoting vaccines with advertising campaigns and sending community health workers door to door to try to persuade the hesitant.

But not all those tactics are welcome. Dr. Romero said Arkansas would happily accept more monoclonal antibody therapies, a Covid-19 treatment often used in outpatient settings. But Mr. Ator, the vaccine coordinator, said door-knocking “would probably do more harm than good,” given residents’ suspicions of federal intentions.

Both said the Arkansas public had been saturated with vaccine promotions and incentives, including free lottery tickets, hunting and fishing licenses and stands offering shots at state parks and high school graduation ceremonies.

The last mass vaccination event was May 4, when the Arkansas Travelers, a minor-league baseball team, had its first game since the pandemic hit. Thousands gathered at the stadium in Little Rock to watch. Fourteen accepted shots.

Even health care workers have balked. Statewide, only about 40 percent are vaccinated, Dr. Romero said.

In April, the state legislature added yet another roadblock, making it essentially illegal for any state or local entity, including public hospitals, to require coronavirus vaccination as a condition of education or employment until two years after the Food and Drug Administration fully licenses a shot. That almost certainly means no such requirements can be issued until late in 2023.


Only fear of the Delta variant appears to be pushing some off the fence.

When the pandemic hit, Baxter Regional became a vaccine distribution center and inoculated 5,500 people. But only half of its 1,800 staff members accepted shots, according to Jonny Harvey, its occupational health coordinator. By early June, demand had tapered off so much that the hospital was administering an average of one a day.

Now, Mr. Harvey said, he is ordering enough vaccine to deliver 30 shots a day because people are increasingly anxious of the Delta variant. “I hate that we are having the surge,” he said. “But I do like that we are vaccinating people.”

At the state’s only academic medical center in Little Rock, run by the University of Arkansas for Medical Sciences, vaccines are also suddenly more popular. Over a recent two-week period, the share of the hospital’s staff who are vaccinated jumped to 86 percent from 75 percent.


But those encouraging signs are outweighed by the soaring number of Covid-19 patients. On Saturday, the Little Rock hospital held 51 patients, more than at any point since Feb. 2. In April, there was one coronavirus death. In June, there were six.

Dr. Williams, who has been charting the coronavirus’s trajectory, said the rise in infections and hospitalizations mirrored what he saw in October. And there are other troubling signs.

A larger share of those who are now becoming infected, he said, need hospitalization. And once there, Dr. Steppe Mette, the chief executive of the Little Rock hospital, said, they appeared to need a higher level of care than those who were sickened by the original variant. That is despite the fact that they are younger.


“What I’m concerned about now is we’ll have a rise or surge,” Dr. José R. Romero, the state health director, said, “then winter is going to add another surge, so we’re going to have a surge on top of a surge.”

The average age of a coronavirus patient in Arkansas has dropped by nearly a decade since December — from 63 to 54 — a reflection of the fact that three-fourths of older Arkansans are at least partly vaccinated. But some patients at the Little Rock hospital are in their 20s or 30s.

“It’s really discouraging to see younger, sicker patients,” Dr. Mette said. “We didn’t see this degree of illness earlier in the epidemic.”

Young, pregnant coronavirus patients were once rare at the hospital. But recently, four or five of them ended up in intensive care. Three were treated with a machine called ECMO — short for extracorporeal membrane oxygenation — a step some consider a last resort after ventilators fail. The machine routes blood from the body and into equipment that adds oxygen, then pumps it back into the patient.

Ashton Reed, 25, a coordinator in a county prosecutor’s office, was about 30 weeks pregnant when she arrived at the hospital on May 26, critically ill. To save her life, doctors delivered her baby girl by emergency cesarean section, then hooked her up to the ECMO machine.

In a public service announcement later urging vaccination, her husband said she went from sinus trouble to life support in 10 days.

“I almost died,” she said. “My thoughts have definitely changed on the vaccine.”

Last month, the hospital had to reopen a coronavirus ward it had closed in late spring. On Monday, it reopened a second.

Many of the nurses there wore colorful stickers announcing they were vaccinated. Ashley Ayers, 26, a traveling nurse from Dallas, did not. Noting that vaccine development typically took years, she said she worried that the shot might impair her fertility — even though there is no evidence of that.

“I just think it was rushed,” she said.

David Deutscher, 49, one of her patients for nearly a week, is no longer a holdout. A heating and air conditioning specialist and Air Force veteran, he said he fought Covid for 10 days at home before he went to the hospital with a 105-degree fever.

The experience has shaken him to his core. He dissolved into tears describing it, apologizing for being an emotional wreck.


When he failed to improve with monoclonal antibody treatment, he said, “that was probably the most scared I have ever been.” He called a friend, the daughter of a medical researcher, from his hospital bed. “Please don’t let me die,” he said.

He said he never got vaccinated because he figured a mask would suffice. In the past 21 years, he has had the flu once.

“Once I started feeling better,” Mr. Deutscher said, “I got on the phone and I just started calling everybody to tell them to go get that vaccine.” He did not even wait to be discharged.

The coronavirus “is no joke,” he told his friends. Three of them got a shot.

Mr. Deutscher went home on July 9, bringing a song for one of his five grandchildren that he had written in his hospital bed. His theme was the value of life.

Robert Gebeloff contributed reporting and Kitty Bennett contributed research.

https://www.nytimes.com/2021/07/17/us/a ... l-surfaces

[maestrob]

Twitter Suspends Marjorie Taylor Greene for Posting Coronavirus Misinformation

The Republican lawmaker from Georgia cannot tweet for 12 hours, after the White House criticized social media sites for amplifying vaccine lies.

By Kate Conger
Published July 19, 2021
Updated July 20, 2021, 2:43 a.m. ET

SAN FRANCISCO — Twitter said on Monday that it was suspending Representative Marjorie Taylor Greene from its service for 12 hours after she posted messages that violated its policy against sharing misleading information about the coronavirus.

Ms. Greene, Republican of Georgia, has been an outspoken opponent of vaccines and masks as tools to curb the pandemic. In tweets on Sunday and Monday, she argued that Covid-19 was not dangerous for people unless they were obese or over age 65, and said vaccines should not be required.

But cases of the coronavirus are on the rise, and the highly contagious Delta variant accounts for more than half of new infections in the United States, federal health officials said this month. In Ms. Greene’s home state, Georgia, new cases have increased 193 percent in the past two weeks.

Twitter said Ms. Greene’s tweets were misinformation, and it barred her from the service until Tuesday. “We took enforcement action on the account @mtgreenee for violations of the Twitter Rules, specifically the Covid-19 misleading information policy,” a Twitter spokesman said. The company also added labels to Ms. Greene’s posts about the vaccines, calling them “misleading” and pointing to information about the safety of the inoculations.

In a statement, Ms. Greene said Silicon Valley companies were working with the White House to attack free speech. “These Big Tech companies are doing the bidding of the Biden regime to restrict our voices and prevent the spread of any message that isn’t state-approved,” she said.

Twitter took action after President Biden called on social media companies to do more to combat the spread of vaccine misinformation on their platforms. On Friday, Mr. Biden said that sites like Facebook were “killing people” by allowing misinformation to flourish unchallenged, adding, “Look, the only pandemic we have is among the unvaccinated, and that — and they’re killing people.”

His statement capped weeks of frustration at the White House over the spread of online misinformation, which has led to vaccine hesitancy, health officials say.

Facebook, which took the brunt of the criticism, argued that Mr. Biden’s statement was unfounded. “The Biden administration has chosen to blame a handful of American social media companies,” Guy Rosen, Facebook’s vice president for integrity, said in a blog post on Saturday. “The fact is that vaccine acceptance among Facebook users in the U.S. has increased.”

On Monday, the president softened his criticism, saying that particular users were responsible for the spread of misinformation rather than Facebook. The company should do more to combat “the outrageous misinformation” spreading on its platform rather than taking his remarks as a personal insult, Mr. Biden added.

Twitter has long banned users from sharing misinformation about the coronavirus that could lead to harm. In March, the company introduced a policy that explained the penalties for sharing lies about the virus and vaccines.

“We’ve observed the emergence of persistent conspiracy theories, alarmist rhetoric unfounded in research or credible reporting, and a wide range of unsubstantiated rumors, which left uncontextualized can prevent the public from making informed decisions regarding their health, and puts individuals, families and communities at risk,” the company said in its policy against sharing Covid misinformation.

People who violate that policy are subject to escalating punishments known as strikes and could face a permanent ban if they repeatedly share misinformation about the virus. A 12-hour ban, like the one Ms. Greene is experiencing, is Twitter’s response to users who have either two or three strikes. After four strikes, Twitter suspends users for seven days, and after five strikes, Twitter bars the user altogether.

Other Republicans who have been suspended from Twitter have complained that the social media company is censoring them.

In January, Twitter barred President Donald J. Trump after the company determined that his social media posts played a role in inciting violence during the riot at the U.S. Capitol. Mr. Trump has argued that Twitter and Facebook, which also suspended his account, were censoring him and said the companies required government oversight.

Ms. Greene was previously suspended from Twitter in April, but the company said it was a mistake caused by one of its automated systems for detecting spam and abuse.

“Everyone knows that’s a LIE, and it was no mistake,” Ms. Greene tweeted after her suspension was lifted.

https://www.nytimes.com/2021/07/19/tech ... itter.html

[Rach3]

“Yeah, Biden doesn’t want Facebook to prevent young people from getting vaccinated. Everyone under 30 heard and was like, ‘That is so cute, but literally none of us use Facebook.’” — JIMMY FALLON

[maestrob]

“Yeah, Biden doesn’t want Facebook to prevent young people from getting vaccinated. Everyone under 30 heard and was like, ‘That is so cute, but literally none of us use Facebook.’” — JIMMY FALLON

[Rach3]

From NYT today:

It is the most discordant part of the U.S. government’s response to Covid-19.

Even as President Biden, the C.D.C. and virtually the entire scientific community are urging — pleading with, even — Americans to get vaccinated, the government has not formally approved any vaccine. The Food and Drug Administration has instead given only “emergency use authorization” to the shots from Moderna, Pfizer and Johnson & Johnson. That’s a temporary form of approval that allows people to receive shots while the agency continues to study their effectiveness and safety.

The difference between emergency authorization and full approval matters. Right now, the military, schools and other organizations cannot easily require vaccinations. The “lack of F.D.A. licensure leave schools, colleges, businesses in a legal quandary,” Dr. Jerome Adams, a former surgeon general, recently wrote. Adams argued that lives were at stake and that the issue should be receiving more media coverage than it has.

The situation also feeds uncertainty and skepticism among some Americans who have not yet gotten a shot. Those skeptics, as Matthew Yglesias of Substack wrote yesterday, are effectively taking the F.D.A. at its word. The F.D.A. leaders’ official position is that “they don’t have enough safety data yet,” Yglesias noted.

The strangest part of all this is that the F.D.A.’s official position does not reflect its leaders’ actual views: They agree with the C.D.C. and other scientists that Americans should be getting vaccinated as soon as possible.

Dr. Janet Woodcock, the F.D.A.’s acting commissioner, has said that the F.D.A. “conducted a rigorous and thorough review” of the vaccines before allowing them to be given to people and that the Pfizer vaccine “meets F.D.A.’s high standards for safety and effectiveness.” She also said, “Getting more of our population vaccinated is critical to moving forward and past this pandemic.”


Why, then, hasn’t the F.D.A. taken the final step of formal approval?

It is following a version of its traditional, cautious process for vaccine approval. That process has historically had some big advantages, reducing the chances that Americans end up taking a faulty drug. To move much more quickly would risk undermining the public’s confidence in the F.D.A. and, by extension, the medicines it approves, Dr. Peter Marks, who oversees the process, has argued.

But I think the F.D.A.’s leaders have failed to understand how most Americans really think about the vaccines. It is different from the way that scientists and epidemiologists do. It’s less technical and based more on an accumulation of the publicly known facts.

It reminds me of another example of expert miscommunication, early in the pandemic. Back then, public health officials made highly technical statements about masks that many people interpreted as discouragement from wearing them. These statements ignored the many reasons to believe that masks could make a difference (like their longtime popularity in Asia to prevent the spread of viruses) and focused instead on the absence of studies showing that masks specifically prevented the spread of Covid.

Later, officials insisted that they were merely “following the data.” In truth, though, they were basing their advice on a narrow reading of the data — and not understanding how most people would interpret their comments.

The long wait to approve the vaccines is similar. F.D.A. officials are acting as if most Americans are experts in the nuances of their approval process and will be shocked if the agency expedites it. In reality, many Americans know almost nothing about that process. But some are understandably confused by the mixed messages that the F.D.A. is sending.

Hundreds of millions of people around the world have been vaccinated. Tens of thousands of them were followed for months in clinical trials. And F.D.A. officials have repeatedly urged other Americans to get vaccinated. “In the history of medicine, few if any biologics (vaccines, antibodies, molecules) have had their safety and efficacy scrutinized to this degree,” Dr. Eric Topol of Scripps Research wrote in The Times.

Yet the agency still has not given formal approval to those same vaccines.

Think of it this way: In the highly unlikely event that the evidence were to change radically — if, say, the vaccines began causing serious side effects about 18 months after people had received a shot — Americans would not react by feeling confident in the F.D.A. and grateful for its caution. They would be outraged that Woodcock and other top officials had urged people to get vaccinated.

The combination means that the F.D.A.’s lack of formal approval has few benefits and large costs: The agency has neither protected its reputation for extreme caution nor maximized the number of Americans who have been protected from Covid. “In my mind, it’s the No. 1 issue in American public health,” Topol told me. “If we got F.D.A. approval, we could get another 20 million vaccinated,” he estimated.

Rebecca Robbins, who covers the vaccines for The Times, says she is less sure about the size of the impact. But she agrees that full approval, whenever it happens, is “probably going to be the catalyst for many new mandates.”

My colleague Noah Weiland says: “Right now, it appears a full approval for the Pfizer vaccine could come in September, with Moderna not far behind.”

In the meantime, more Americans may get sick from Covid. About 34 percent of Americans who are eligible for the vaccines have not yet gotten a shot. The number of new cases has roughly tripled this month, largely because of the Delta variant. The number of deaths has almost doubled in the past two weeks.

If you want to read the F.D.A.’s explanation, I recommend a letter Marks wrote to The Times: “We want to assure the public that the review of applications for full approval of Covid-19 vaccines is one of the highest priorities at the Food and Drug Administration.”

Related:

The F.D.A. recently abandoned its usual caution when approving a different product — Aduhelm, an Alzheimer’s drug — despite evidence it might not work, a Times investigation found.

[maestrob]

The long wait to approve the vaccines is similar. F.D.A. officials are acting as if most Americans are experts in the nuances of their approval process and will be shocked if the agency expedites it. In reality, many Americans know almost nothing about that process. But some are understandably confused by the mixed messages that the F.D.A. is sending.

No kidding!

Too many healthcare workers are suspicious of the government and won't take the shot until it's fully approved. Many of their relatives and friends are following their example, and this is costing lives every day.

The minute a variant appears that is resistant to the current vaccines, all hell will break loose again.

And now they're fighting about whether we MIGHT need a booster shot? Yikes! I plan on getting one just as soon as it's available, and I'll bet you will too.

Need I say more?

[Rach3]

Vaccine mandates are controversial. They’re also effective. NYT July 23

Before Houston Methodist became one of the first hospital systems in the U.S. to mandate Covid-19 vaccines, about 85 percent of its employees were vaccinated. After the mandate, the share rose to about 98 percent, with the remaining 2 percent receiving exemptions for medical or religious reasons, Bloomberg’s Carey Goldberg reported. Only about 0.6 percent of employees quit or were fired.

Schools — including Indiana University and many private colleges — that require students and workers to get vaccinated have reported extremely high uptake.

A recent Kaiser Family Foundation survey of Americans who had been opposed to getting vaccinated and later changed their minds found that mandates — or restrictions on the unvaccinated — were one common reason. One 51-year-old man told Kaiser that he began to feel as if he had “limited options without it.”

Dr. Aaron Carroll, Indiana University’s chief health officer, has noted that the country’s victories over many diseases — including smallpox, polio, mumps, rubella and diphtheria — have depended on vaccine mandates by states or local governments. “That’s how the country achieves real herd immunity,” Carroll wrote in The Times. (In the U.S., a national mandate may be unconstitutional.)

When states and school districts have opted not to require vaccines, a disease can often spread needlessly, Carroll explained. That has been the case with human papillomavirus, a sexually transmitted disease known as HPV that can cause cancer. It’s also been the case with influenza, which kills about 35,000 Americans in a typical flu season.

Covid now seems certain to join influenza and HPV as diseases that American society chooses to accept. But it is a choice. Companies, schools and communities that decide to enact vaccine mandates will almost certainly save American lives by doing so.

[maestrob]

Only about 0.6 percent of employees quit or were fired.

These are the people who threaten the health of their patients and co-workers. They don't belong in that sort of responsible position.

If your job is to serve the public, then you have no right not to do so. If you have religious objections, for example, go find work that doesn't cause you conflict.

1) Pharmacists who refuse to dispense abortion pills should be fired.
2) Bakers who refuse to bake a cake for a gay couple should be closed down.
3) Restaurants who refuse to serve people of any ethnicity or religious faith should be closed, or at least be made to fire any employee who exhibits such behavior.

When you work in a service industry or open a business to serve the public, that includes all of us.

'Nuff said.

[Rach3]

From NYT today. Way past time to tell certain a..h...s to pack sand:


Two months ago, the C.D.C. said vaccinated people did not need to wear masks in most indoor spaces, a move that seemed to signal a winding down of the pandemic.

But today, as the Delta variant of the virus pushes up infection rates across the country, the agency revised its guidelines: Vaccinated people should again wear masks in public indoor spaces in parts of the country where the virus is surging.

The new guidance is an admission that the mutating coronavirus is outpacing the vaccination effort, and my colleague Apoorva Mandavilli told me that the recommendation was overdue.

The C.D.C., she said, has recently come under pressure from the White House and public health experts, who wanted the agency to revisit its mask guidance as it became increasingly clear that the Delta variant causes more breakthrough infections than scientists had originally expected.
“We’re hearing more reports of breakthrough infections, and, more important, we’re hearing more reports of vaccinated people who got infected and are symptomatic,” Apoorva said.

“There’s some evidence that people infected with Delta have a lot more virus in their body — as much as a thousand fold higher — and that may also be true for breakthrough infections,” she said. “If that’s the case, vaccinated people may be transmitting the virus to others at a significant enough rate that they should be wearing masks.”


Vaccines against Covid-19 remain remarkably effective against hospitalization and death. But the new guidelines explicitly apply to both the unvaccinated and the vaccinated, a sharp departure from the agency’s position since May that vaccinated people do not need to wear masks in most indoor spaces.

Those recommendations were based on earlier data suggesting that vaccinated people rarely become infected and almost never transmit the virus, making masking unnecessary. But that was before the arrival in the U.S. of the Delta variant, which now accounts for a majority of infections in the country.

“As the number of cases rise among unvaccinated people, vaccinated people will be exposed to more and more virus, and the chances that they will get a breakthrough infection goes up,” Apoorva said.

Alongside the indoor masking guidance, the C.D.C. also recommended that teachers, staff members, students and visitors in schools wear masks, regardless of vaccination status and community transmission of the virus. Dr. Rochelle Walensky, the agency’s director, said today that schools should nonetheless return to in-person learning in the fall, with additional precautions.

“This shows us once again that it’s difficult to predict what the virus will do months down the road,” Apoorva said. “And as frustrating as it is, we just have to be OK with guidelines changing as we see increases or decreases in infections.”

Vaccinated and angry
As cases surge, mask mandates are reimposed and companies are rethinking reopenings, many vaccinated Americans are growing more frustrated with the unvaccinated, and blaming them for the return of the pandemic.

“I’ve become angrier as time has gone on,” said Doug Robertson, a teacher who lives outside Portland, Ore., and has three children too young to be vaccinated. “Now there is a vaccine and a light at the end of the tunnel, and some people are choosing not to walk toward it. You are making it darker for my family and others like mine by making that choice.”

That frustration is contributing to support for more coercive measures — like vaccine mandates. With the pace of vaccinations slowing, and infections rising, tensions are increasing between the vaccinated and unvaccinated at hospitals, workplaces, schools and within closely knit families.

Josh Perldeiner, a public defender in Connecticut who has a 2-year-old son, is fully vaccinated, but a close relative, who visits frequently, has refused to get the shots, although he and other family members have urged her to do so.

She recently tested positive for the virus after traveling to Florida, where hospitals are filling with Covid-19 patients. Now Perldeiner worries that his son, too young for a vaccine, may have been exposed.

“It goes beyond just putting us at risk,” he said. “People with privilege are refusing the vaccine, and it’s affecting our economy and perpetuating the cycle.” As infections rise, he added, “I feel like we’re at that same precipice as just a year ago, where people don’t care if more people die.”


Anna Maria Vona, Philadelphia :

We have a trusted family friend and colleague who declines (I think that is a better word than refuses) to get vaccinated, even though his daughter and wife are. Since the C.D.C. lifted the mask mandate in May, he has been walking into our office (unmasked). Today, we told him that he is no longer allowed inside our office and has to remain at the transaction window until he is fully vaccinated. He complied. We felt bad that it had to come to this, but really, how do you navigate these social waters with the fully vaccinated vs. the unvaccinated?

[maestrob]

What if the Unvaccinated Can’t Be Persuaded?

July 29, 2021
By Ezra Klein

Opinion Columnist

I hate that I believe the sentence I’m about to write. It undermines much of what I spend my life trying to do. But there is nothing more overrated in politics — and perhaps in life — than the power of persuasion.

It is nearly impossible to convince people of what they don’t want to believe. Decades of work in psychology attest to this truth, as does most everything in our politics and most of our everyday experience. Think of your own conversations with your family or your colleagues. How often have you really persuaded someone to abandon a strongly held belief or preference? Persuasion is by no means impossible or unimportant, but on electric topics, it is a marginal phenomenon.

Which brings me to the difficult choice we face on coronavirus vaccinations. The conventional wisdom is that there is some argument, yet unmade and perhaps undiscovered, that will change the minds of the roughly 30 percent of American adults who haven’t gotten at least one dose. There probably isn’t. The unvaccinated often hold their views strongly, and many are making considered, cost-benefit calculations given how they weigh the risks of the virus, and the information sources they trust to inform them of those risks. For all the exhortations to respect their concerns, there is a deep condescension in believing that we’re smart enough to discover or invent some appeal they haven’t yet heard.

If policymakers want to change their minds, they have to change their calculations by raising the costs of remaining unvaccinated, the benefits of getting vaccinated, or both. If they can’t do that, or won’t, the vaccination effort will most likely remain stuck — at least until a variant wreaks sufficient carnage to change the calculus.

You can see the weakness of persuasion in the eerie stability of vaccination preferences. The Kaiser Family Foundation has been surveying Americans about their vaccination intentions since December. At that time, 15 percent said they would “definitely” refuse to get vaccinated, 9 percent said they would get a shot only “if required,” and 39 percent wanted to “wait and see.”

Six months later, Kaiser asked the same question. By then, most of the wait-and-see crowd had seen enough to get vaccinated. The only-if-required crew shrank, but only by a bit: 6 percent of Americans were still waiting on a mandate. But the definitely-notters had barely budged: They numbered 15 percent in December and 14 percent in June.

I don’t want to overstate my case. There was movement between groups. Some people who said they would definitely refuse a vaccine in December had gotten one by June. About a quarter of those who intended to watch and wait decided firmly against getting vaccinated. But the surprise in Kaiser’s data is the consistency of people’s views. In December, 73 percent of American adults said they were eager to get vaccinated or were at least open to the possibility. Today, 69 percent of Americans over the age of 18 have gotten at least one shot. “Most vaccine behaviors match what people planned to do six months ago,” Kaiser concluded.

With Delta supercharging transmission among the unvaccinated, the debate now is how to persuade them to get a shot (or two). I’m sympathetic to most of the ideas people have offered. The F.D.A. should give the vaccines full approval, not just emergency authorization, as the agency’s absurd process has created mass confusion and fed mistrust. We should respect people’s concerns and their intelligence. We should admit that the medical system has failed many of us before, and treated Black Americans with particular callousness. We should be honest that many are making a risk calculation for themselves, rather than indulging a conspiracy theory. We should support leading Republicans who are trying to ease the barriers of partisan identity. If Sarah Huckabee Sanders wants to call it “the Trump vaccine” and sell shots as a way of sticking it to the media and the Democrats and Anthony Fauci, I wish her the best.

We should also, of course, do everything we can to make vaccination frictionless. It’s easy to get a shot in a big city, but many people still live far from medical providers and cut off from the internet. Others lack transportation, or have jobs that make it hard to take a day off to recover from the fluish side effects, or have physical or mental impairments that make treatment difficult.

But I suspect all of this will change a depressingly modest number of minds. There are no speeches more powerful than the fear of disease and the grief of loss. That’s evident in the vaccination data now. Delta does appear to be driving a surge in vaccinations. But is this really our strategy? More death will lead to more shots in arms? One of the most heartbreaking stories I’ve read lately came from a Facebook post by Brytney Cobia, a doctor in Alabama. She wrote:

I’ve made a LOT of progress encouraging people to get vaccinated lately!!! Do you want to know how? I’m admitting young healthy people to the hospital with very serious Covid infections. One of the last things they do before they’re intubated is beg me for the vaccine. I hold their hand and tell them that I’m sorry, but it’s too late. A few days later when I call time of death, I hug their family members and I tell them the best way to honor their loved one is to go get vaccinated and encourage everyone they know to do the same. They cry. And they tell me they didn’t know. They thought it was a hoax. They thought it was political. They thought because they had a certain blood type or a certain skin color they wouldn’t get as sick. They thought it was “just the flu.” But they were wrong. And they wish they could go back. But they can’t. So they thank me and they go get the vaccine.

Phil Valentine, a conservative radio host in Nashville who said he wouldn’t get vaccinated and made parody songs about “the Vaxman,” caught the virus, and his condition quickly turned critical. He’s now in the hospital, on a ventilator. “He regrets not being more vehemently ‘pro-vaccine,’ and looks forward to being able to more vigorously advocate that position as soon as he is back on the air,” his radio station said in a statement.

This is one problem with trusting our rationality: The choice we make now, before we catch the virus, may not be the choice we will wish we had made once we get sick. Then there’s the stubborn fact that individual decisions have collective consequences. It may indeed be the case that a healthy 19-year-old American has little to fear from the coronavirus. But his immunosuppressed grandfather has much to fear from him. Whether it is a more severe imposition on liberty to ask someone to get vaccinated or regularly tested than to ask all immunosuppressed people in the country to effectively shelter in place for the rest of their lives is a collective question that demands a collective answer.

Other countries are offering that answer, and seeing results. Emmanuel Macron, the president of France, proposed a law requiring either proof of vaccination or a negative test result for many indoor activities. The mere prospect of a vaccine mandate set off mass protests. It also led to a surge in vaccinations. On July 1, 50.8 percent of the French population had gotten at least one shot — putting France 3.5 points behind America. By Sunday, 59.1 percent of France had been at least partially vaccinated, putting it 2.7 points ahead of us.

A number of American employers are following suit. On Thursday, the Biden administration is expected to announce a directive requiring all civilian federal workers to get vaccinated or face routine testing and restrictions. California and New York will require proof of vaccination or routine negative test results for all state employees. New York City is imposing the same requirement for its public employees. Around 600 college campuses have announced that they’ll require vaccinations for students returning in the fall. There’s no hard count of how many businesses are requiring vaccinations or test results to come back to work, but the anecdotal answer appears to be “a lot.”

There is nothing new about this. We do not solely rely on argumentation to persuade people to wear seatbelts. A majority of states do not leave it to individual debaters to hash out whether you can smoke in indoor workplaces. Polio and measles were murderous, but their near elimination required vaccine mandates, not just public education. When George Washington wanted to protect his soldiers from smallpox, he made vaccinations mandatory. It worked. “No revolutionary regiments were incapacitated by the disease during the southern campaign, and the mandate arguably helped win the yearslong war,” wrote Aaron Carroll.

The objection I find most convincing to any kind of vaccine mandate is that we have not built the infrastructure to make it work. What if someone who received a vaccine has lost her card, or her information was wrongly recorded when she got her shot? If we try to carry this out through smartphones, what if you don’t have a smartphone, or you lose it? If you want to choose frequent testing, how do you get access to those tests, and who pays for it, and how are the results recorded? If you have a problem, who do you call to solve it? How long are the wait times when you call? What if you need an answer quickly?

I covered both the debacle of the HealthCare.gov launch and the now-multidecade failure to transition to electronic medical records. We just watched state unemployment insurance systems nearly collapse under the demands of the pandemic. Perhaps we don’t have the capacity to do this well. But with so many public and private employers mandating vaccination for their workforces, we’ll know soon enough. Either they’ll build models that can scale or they will fail spectacularly enough to settle the question. And either way, this suggests a step the government could take right now: Funding, building and deploying an excellent vaccination passport infrastructure — backed up by ubiquitous rapid-testing options, for those cases when the passport fails — that private and public employers can use to implement their own policies.

Though I’d like to believe otherwise, I don’t think our politics can support a national vaccination mandate. The places that would most benefit from a mandate would be those most opposed to following one, and deepening partisan divisions here would be catastrophic (this is a problem that also afflicts the C.D.C.’s new masking guidance, as my colleague David Leonhardt notes). A high-stakes showdown between, say, the federal government and the State of Florida over a mandate would be a distraction we don’t need. Quickly building the records and testing options for individual employers to take the first steps seems like the right middle ground, at least for now.

Making it more annoying to be unvaccinated won’t persuade everyone to get a shot. But we don’t need everyone. According to Kaiser’s data, 16 percent of American adults are still in the wait-and-see or only-if-required categories. If they all got vaccinated, we’d hit herd immunity in most places. If more of the unvaccinated were routinely getting tested, that would help, too. And if cases then fell, the restrictions could lift.

The Delta strain is fearsome enough, but if we keep permitting the virus to dance across the defenseless, we could soon have a strain that evades vaccines while retaining lethality, or that attacks children with more force. Over and over again throughout this pandemic, the same pattern has played out: We haven’t done enough to suppress the virus when we still could, so we have had to impose far more draconian lockdowns and grieve far more death, once we have lost control. For this reason among many, I urge those who object to vaccination passports as an unprecedented stricture on liberty to widen their tragic imagination.

https://www.nytimes.com/2021/07/29/opin ... e=Homepage

[maestrob]

What if the Unvaccinated Can’t Be Persuaded?

July 29, 2021
By Ezra Klein

Opinion Columnist

I hate that I believe the sentence I’m about to write. It undermines much of what I spend my life trying to do. But there is nothing more overrated in politics — and perhaps in life — than the power of persuasion.

It is nearly impossible to convince people of what they don’t want to believe. Decades of work in psychology attest to this truth, as does most everything in our politics and most of our everyday experience. Think of your own conversations with your family or your colleagues. How often have you really persuaded someone to abandon a strongly held belief or preference? Persuasion is by no means impossible or unimportant, but on electric topics, it is a marginal phenomenon.

Which brings me to the difficult choice we face on coronavirus vaccinations. The conventional wisdom is that there is some argument, yet unmade and perhaps undiscovered, that will change the minds of the roughly 30 percent of American adults who haven’t gotten at least one dose. There probably isn’t. The unvaccinated often hold their views strongly, and many are making considered, cost-benefit calculations given how they weigh the risks of the virus, and the information sources they trust to inform them of those risks. For all the exhortations to respect their concerns, there is a deep condescension in believing that we’re smart enough to discover or invent some appeal they haven’t yet heard.

If policymakers want to change their minds, they have to change their calculations by raising the costs of remaining unvaccinated, the benefits of getting vaccinated, or both. If they can’t do that, or won’t, the vaccination effort will most likely remain stuck — at least until a variant wreaks sufficient carnage to change the calculus.

You can see the weakness of persuasion in the eerie stability of vaccination preferences. The Kaiser Family Foundation has been surveying Americans about their vaccination intentions since December. At that time, 15 percent said they would “definitely” refuse to get vaccinated, 9 percent said they would get a shot only “if required,” and 39 percent wanted to “wait and see.”

Six months later, Kaiser asked the same question. By then, most of the wait-and-see crowd had seen enough to get vaccinated. The only-if-required crew shrank, but only by a bit: 6 percent of Americans were still waiting on a mandate. But the definitely-notters had barely budged: They numbered 15 percent in December and 14 percent in June.

I don’t want to overstate my case. There was movement between groups. Some people who said they would definitely refuse a vaccine in December had gotten one by June. About a quarter of those who intended to watch and wait decided firmly against getting vaccinated. But the surprise in Kaiser’s data is the consistency of people’s views. In December, 73 percent of American adults said they were eager to get vaccinated or were at least open to the possibility. Today, 69 percent of Americans over the age of 18 have gotten at least one shot. “Most vaccine behaviors match what people planned to do six months ago,” Kaiser concluded.

With Delta supercharging transmission among the unvaccinated, the debate now is how to persuade them to get a shot (or two). I’m sympathetic to most of the ideas people have offered. The F.D.A. should give the vaccines full approval, not just emergency authorization, as the agency’s absurd process has created mass confusion and fed mistrust. We should respect people’s concerns and their intelligence. We should admit that the medical system has failed many of us before, and treated Black Americans with particular callousness. We should be honest that many are making a risk calculation for themselves, rather than indulging a conspiracy theory. We should support leading Republicans who are trying to ease the barriers of partisan identity. If Sarah Huckabee Sanders wants to call it “the Trump vaccine” and sell shots as a way of sticking it to the media and the Democrats and Anthony Fauci, I wish her the best.

We should also, of course, do everything we can to make vaccination frictionless. It’s easy to get a shot in a big city, but many people still live far from medical providers and cut off from the internet. Others lack transportation, or have jobs that make it hard to take a day off to recover from the fluish side effects, or have physical or mental impairments that make treatment difficult.

But I suspect all of this will change a depressingly modest number of minds. There are no speeches more powerful than the fear of disease and the grief of loss. That’s evident in the vaccination data now. Delta does appear to be driving a surge in vaccinations. But is this really our strategy? More death will lead to more shots in arms? One of the most heartbreaking stories I’ve read lately came from a Facebook post by Brytney Cobia, a doctor in Alabama. She wrote:

I’ve made a LOT of progress encouraging people to get vaccinated lately!!! Do you want to know how? I’m admitting young healthy people to the hospital with very serious Covid infections. One of the last things they do before they’re intubated is beg me for the vaccine. I hold their hand and tell them that I’m sorry, but it’s too late. A few days later when I call time of death, I hug their family members and I tell them the best way to honor their loved one is to go get vaccinated and encourage everyone they know to do the same. They cry. And they tell me they didn’t know. They thought it was a hoax. They thought it was political. They thought because they had a certain blood type or a certain skin color they wouldn’t get as sick. They thought it was “just the flu.” But they were wrong. And they wish they could go back. But they can’t. So they thank me and they go get the vaccine.

Phil Valentine, a conservative radio host in Nashville who said he wouldn’t get vaccinated and made parody songs about “the Vaxman,” caught the virus, and his condition quickly turned critical. He’s now in the hospital, on a ventilator. “He regrets not being more vehemently ‘pro-vaccine,’ and looks forward to being able to more vigorously advocate that position as soon as he is back on the air,” his radio station said in a statement.

This is one problem with trusting our rationality: The choice we make now, before we catch the virus, may not be the choice we will wish we had made once we get sick. Then there’s the stubborn fact that individual decisions have collective consequences. It may indeed be the case that a healthy 19-year-old American has little to fear from the coronavirus. But his immunosuppressed grandfather has much to fear from him. Whether it is a more severe imposition on liberty to ask someone to get vaccinated or regularly tested than to ask all immunosuppressed people in the country to effectively shelter in place for the rest of their lives is a collective question that demands a collective answer.

Other countries are offering that answer, and seeing results. Emmanuel Macron, the president of France, proposed a law requiring either proof of vaccination or a negative test result for many indoor activities. The mere prospect of a vaccine mandate set off mass protests. It also led to a surge in vaccinations. On July 1, 50.8 percent of the French population had gotten at least one shot — putting France 3.5 points behind America. By Sunday, 59.1 percent of France had been at least partially vaccinated, putting it 2.7 points ahead of us.

A number of American employers are following suit. On Thursday, the Biden administration is expected to announce a directive requiring all civilian federal workers to get vaccinated or face routine testing and restrictions. California and New York will require proof of vaccination or routine negative test results for all state employees. New York City is imposing the same requirement for its public employees. Around 600 college campuses have announced that they’ll require vaccinations for students returning in the fall. There’s no hard count of how many businesses are requiring vaccinations or test results to come back to work, but the anecdotal answer appears to be “a lot.”

There is nothing new about this. We do not solely rely on argumentation to persuade people to wear seatbelts. A majority of states do not leave it to individual debaters to hash out whether you can smoke in indoor workplaces. Polio and measles were murderous, but their near elimination required vaccine mandates, not just public education. When George Washington wanted to protect his soldiers from smallpox, he made vaccinations mandatory. It worked. “No revolutionary regiments were incapacitated by the disease during the southern campaign, and the mandate arguably helped win the yearslong war,” wrote Aaron Carroll.

The objection I find most convincing to any kind of vaccine mandate is that we have not built the infrastructure to make it work. What if someone who received a vaccine has lost her card, or her information was wrongly recorded when she got her shot? If we try to carry this out through smartphones, what if you don’t have a smartphone, or you lose it? If you want to choose frequent testing, how do you get access to those tests, and who pays for it, and how are the results recorded? If you have a problem, who do you call to solve it? How long are the wait times when you call? What if you need an answer quickly?

I covered both the debacle of the HealthCare.gov launch and the now-multidecade failure to transition to electronic medical records. We just watched state unemployment insurance systems nearly collapse under the demands of the pandemic. Perhaps we don’t have the capacity to do this well. But with so many public and private employers mandating vaccination for their workforces, we’ll know soon enough. Either they’ll build models that can scale or they will fail spectacularly enough to settle the question. And either way, this suggests a step the government could take right now: Funding, building and deploying an excellent vaccination passport infrastructure — backed up by ubiquitous rapid-testing options, for those cases when the passport fails — that private and public employers can use to implement their own policies.

Though I’d like to believe otherwise, I don’t think our politics can support a national vaccination mandate. The places that would most benefit from a mandate would be those most opposed to following one, and deepening partisan divisions here would be catastrophic (this is a problem that also afflicts the C.D.C.’s new masking guidance, as my colleague David Leonhardt notes). A high-stakes showdown between, say, the federal government and the State of Florida over a mandate would be a distraction we don’t need. Quickly building the records and testing options for individual employers to take the first steps seems like the right middle ground, at least for now.

Making it more annoying to be unvaccinated won’t persuade everyone to get a shot. But we don’t need everyone. According to Kaiser’s data, 16 percent of American adults are still in the wait-and-see or only-if-required categories. If they all got vaccinated, we’d hit herd immunity in most places. If more of the unvaccinated were routinely getting tested, that would help, too. And if cases then fell, the restrictions could lift.

The Delta strain is fearsome enough, but if we keep permitting the virus to dance across the defenseless, we could soon have a strain that evades vaccines while retaining lethality, or that attacks children with more force. Over and over again throughout this pandemic, the same pattern has played out: We haven’t done enough to suppress the virus when we still could, so we have had to impose far more draconian lockdowns and grieve far more death, once we have lost control. For this reason among many, I urge those who object to vaccination passports as an unprecedented stricture on liberty to widen their tragic imagination.

https://www.nytimes.com/2021/07/29/opin ... e=Homepage

[lennygoran]

“Yeah, Biden doesn’t want Facebook to prevent young people from getting vaccinated. Everyone under 30 heard and was like, ‘That is so cute, but literally none of us use Facebook.’” — JIMMY FALLON

Steve, the Republicans new slogan-Make America Sick Again. Regards, Len

[maestrob]

“Yeah, Biden doesn’t want Facebook to prevent young people from getting vaccinated. Everyone under 30 heard and was like, ‘That is so cute, but literally none of us use Facebook.’” — JIMMY FALLON

Steve, the Republicans new slogan-Make America Sick Again. Regards, Len

Precisely.

We're all sick of them.

[Rach3]

Steve, the Republicans new slogan-Make America Sick Again. Regards, Len

And they have.Good luck if you need non-COVID medical care:

https://www.cnn.com/2021/08/01/health/u ... index.html

[Rach3]

Another view:

From NYT Op Ed August 2 Jessica Valenti

..........What I do know is this: I’m furious that the physical and mental health of countless American children are at the mercy of the willfully ignorant and the irrationally fearful. It’s enraging to listen to people complain that wearing a mask or getting a simple shot is akin to an assault on their freedom while children who have no choice bear the brunt of their nonsense.

Most of all, I’m tired of hearing about how my anger won’t change hearts and minds, or that I need to respect other people’s choices — even when those choices put others’ health and lives at risk.

This isn’t a matter of simple disagreement or bipartisan bickering: Gross selfishness masked as American individualism is killing our country and traumatizing our children. That’s not “intolerant” or an overreaction; it’s a fact.

Anger is the very least we can do.

Those who have the ability to be vaccinated and masked have no reasonable excuse not to be. Either you’re someone who cares about their neighbors and community or you’re not. Either you’re willing to sacrifice for the good of others or you’re not. And it shouldn’t take the thought of sick children to get people to do the right thing.

Jessica Valenti is the author of six books on feminism and publishes the newsletter “All in Her Head.”

[maestrob]

I sent that one to my nephew. Hope he reads it.

[Rach3]

More GOP lies today.From Cedar Rapids,Iowa Gazette:

With most Iowa schools scheduled to start the next academic year in less than a month, many families are trying to figure out the risk of their children contracting COVID-19. After all, the vaccines are not yet approved for kids under 12 and there is an uptick in Iowa of cases believed to be connected to the more contagious Delta variant.

U.S. Rep. Mariannette Miller-Meeks said July 14 on “The Evening Edit,” a show on Fox Business, that “we have known for over a year that children don’t transmit the virus.” She went on to say kids should be able to attend summer camps, play sports and go back to school without masks.

Miller-Meeks, a Republican representing Iowa’s 2nd Congressional District, made a similar statement July 12 on Twitter: “Elementary age students rarely die or are seriously ill and don’t transmit virus to adults or other children.”


Analysis
When the Fact Checker asked Miller-Meeks’s staff to provide sourcing for these claims, they sent a column printed in August 2020 in the journal of the American Pediatric Association. The authors are William Raszka, a pediatric infectious disease specialist at the University of Vermont, and Benjamin Lee, a pediatrician at the University of Texas Southwestern Medical Center.

The doctors cited five studies early in the pandemic examining whether children were passing the coronavirus.

Children under age 16 diagnosed with COVID-19 at the Geneva University Hospital in Switzerland from March 10, 2020, to April 10, 2020, underwent contact tracing, the column reports. Of 39 households, in only three was a child suspected of transmitting the virus to an adult. Of 10 children hospitalized near Wuhan, China, in only one case was there possible child-to-adult transmission, the column reported. Other studies in Australia and France had similar findings.

“These data all suggest that children are not significant drivers of the COVID-19 pandemic,” Lee and Raszka concluded, acknowledging more research was needed.

But none of these studies say children don’t transmit the virus at all. In fact, in each study there’s at least one child researchers believe may have passed the virus to another child or adult. Raszka, the Vermont pediatric infectious disease specialist, told the Fact Checker this week the statement children don’t transmit the virus is false.

“I never said or wrote that children don’t transmit the virus,” he said in a phone interview. “That is incorrect. That is absolutely false.”

Raszka said it is accurate children usually do not get seriously ill from COVID-19. The American Academy of Pediatrics reported July 22 children make up just 1.3 to 3.6 percent of total reported hospitalizations and 0 to .26 percent of all COVID-19 deaths.

“Nobody knows why children are less likely to develop severe disease,” Raszka said. “We’ve only been wrestling with this virus for a year and a half. We do know it continues to mutate and infects unvaccinated populations.”

This summer, COVID-19 outbreaks have been reported at summer camps in Texas, Missouri, Ohio and New York, Time reported. At least 157 cases of COVID-19 are tied to an outbreak at a five-day camp held by a Galveston church in June for kids in grades 6 through 12. Among those infected were 30 members of campers’ families infected after the kids got home, Time said. The majority of these camp-related cases were linked to the Delta variant.

The Delta variant, first identified in the United States in March, spreads 50 percent faster than the Alpha strain of the virus, which was 50 percent more contagious than the original version, Yale Medicine reported in June. That means, in an environment without vaccinated people or masks, someone infected with the Delta variant could spread the virus to 3.5 to 4 other people, compared with 2.5 others with the original coronavirus strain.

Because what we know about the coronavirus has evolved — and the virus keeps changing — the U.S. Centers for Disease Control and Prevention has updated its information about child transmission.

“Children and adolescents can also transmit SARS-CoV-2 infection to others,” according to a July 9 CDC science brief. “Early during the COVID-19 pandemic, children were not commonly identified as index cases in household or other clusters, largely because schools and extracurricular activities around the world were closed or no longer held in-person. However, outbreaks among adolescents attending camps, sports events, and schools have demonstrated that adolescents can transmit SARS-CoV-2 to others.”

Conclusion
Miller-Meeks, an ophthalmologist, has been a vocal advocate for Iowans to get the COVID-19 vaccine.

But her claims about children not transmitting the virus are inaccurate. Kids can and do pass the virus, although at much lower rates than adults. If Miller-Meeks had qualified her statement even a little, saying children usually don’t transmit the virus, she’d be correct. But she didn’t. And she uses the claim as a reason for saying children don’t need to wear masks in school — a conclusion that contradicts new CDC recommendations.

Her statement that “elementary age students rarely die or are seriously ill” is true, which saves her overall grade from an F. Instead, we give her a D.

Criteria
The Fact Checker team checks statements made by an Iowa political candidate/officeholder or a national candidate/officeholder about Iowa, or in ads that appear in our market.

Claims must be independently verifiable.

We give statements grades from A to F based on accuracy and context.

If you spot a claim you think needs checking, email us at factchecker@thegazette.com.

This Fact Checker was researched and written by Erin Jordan of The Gazette.

[Rach3]

Per NBC News tonight, today's new case count was the highest since last Summer's largely pre-vaccine high.Enough said.

[maestrob]

A New Surge at a Santa Monica I.C.U.

They thought the worst of the pandemic was behind them. Then a new wave of cases arrived at the I.C.U. at Providence Saint John’s Health Center.

By Isadora Kosofsky and Shawn Hubler
Published Aug. 1, 2021
Updated Aug. 2, 2021

SANTA MONICA, Calif. — Two months ago at Providence Saint John’s Health Center, Dr. Morris Grabie stood at a makeshift plastic wall in the intensive care unit and prayed.

“Baruch atah Adonai, Eloheinu Melech ha’olam,” he began in Hebrew, the sterile divider behind him sealing off the patients with Covid-19 from the uninfected. “Blessed are you, Adonai our God, sovereign of all, who has kept us alive, sustained us and brought us to this season.”

Around the physician at the hospital in Santa Monica, Calif., a small army in scrubs — doctors, nurses, technicians — bowed their heads, bearing witness to what seemed to be the beginning of the end of the pandemic. Sixty-nine lives on the ward had been claimed by the virus. Pain and grief, life and death, fear and loss — month after grinding month — all of it had unfolded behind that thin divider.

And yet on this day, not a single patient in the Saint John’s I.C.U. had tested positive for the coronavirus. Dr. Grabie turned, and the I.C.U.’s medical director, helped by a respiratory therapist, zipped the wall open.

“We were all in awe,” recalled the medical director, Dr. Terese Hammond.

It was June 1 at 7:56 a.m., a Tuesday.

Now the ward’s Covid section is back and sealed off again.

Covid-19 is surging once more, at Saint John’s and in the world around it, driven by vaccine resisters and the virus’s hyper-contagious Delta variant. In California, new infections are appearing at a rate not seen since February. Governments, schools and businesses are starting to require masks indoors and vaccinations.


Los Angeles County is recording more than 2,500 new cases daily, and among the unvaccinated, hospitalizations and deaths are mounting. Even in affluent Santa Monica, where about 80 percent of residents are now vaccinated, dozens of people each day are testing positive for the virus, and hospitals like Saint John’s — a 266-bed facility that typically serves the ordinary needs of the beach communities around it — are being inundated again.

Last week, so many Covid patients were in intensive care that the space behind the plastic wall was not enough. The hospital had to reconfigure and expand the unit. Bonifacio Deoso, a nurse on the unit, was down to one weary question:

“When will this ever end?”


For the past three weeks, the 23-bed intensive care unit has been packed, Dr. Hammond said. Eight patients on the ward were being treated for the virus or related infections as of Sunday morning. Four were being treated with ECMO, a particularly labor-intensive, round-the-clock protocol.

Seven other patients were in the step-down I.C.U. on supplemental oxygen as they recovered from infections. “People are coming in sicker,” Dr. Hammond said. At least six people have died from Covid-19 in intensive care at Saint John’s since June 1.

The wave of new cases is particularly challenging because it accompanies another surge — patients who had put off elective surgeries and other health care during the pandemic. In addition to the Covid-19 cases, Dr. Hammond’s staff has been caring this time for people with severe illnesses unrelated to the pandemic, except to the extent that missed doctor’s appointments and postponed routine screenings helped to land them in intensive care.

The patient demographics this time are different as well. Earlier in the pandemic, most were transfers from other Providence health care centers. Now many more are local and younger, Dr. Hammond said, and are being sent to intensive care after emergency room visits.

Given Santa Monica’s high vaccination rate, she said, the influx is “disconcerting.”

“Santa Monica was pretty protected,” she said.

While vaccinated people appear to be getting far less sick from infections, the superior powers of the Delta variant are allowing the virus to proliferate in their systems and to spread, lethally, to the unvaccinated. Some 20 percent of Santa Monica residents — and nearly 40 percent of those in the county around it — have not yet been fully inoculated, despite the entreaties of public health experts.

“You’re here to take care of the human regardless of the decision they make,” said Vickie Gaddy, a nurse in the unit. But the new rush of infected patients, so soon after the optimism of June 1, has been crushing for Dr. Hammond’s exhausted staff members.

“As an I.C.U. nurse, you know you’re going to see a certain amount of death,” said Masha Crawford, who also works with the hospital’s Covid-19 patients. But, she said, “in this pandemic, you see people who should not be dying die.”

Ms. Crawford said that before the pandemic, she loved working out. Now, she has no appetite for exercise or self-care.

“The new wave” of cases, she said, “has taken that energy.”

Dr. Brian Tu, an emergency medicine physician, says he is concerned about the hospital workers outside the unit who now are being exposed to the virus, a result of so many cases being detected through emergency room visits.

Dr. Stefania Pirrotta says the sheer relentlessness of the new surge has made her “angry.”

Just two months ago, she said, she was hopeful. Now there is no end in sight.


Shawn Hubler is a California correspondent based in Sacramento. Before joining The Times in 2020 she spent nearly two decades covering the state for The Los Angeles Times as a roving reporter, columnist and magazine writer, and shared three Pulitzer Prizes won by the paper's Metro staff.


https://www.nytimes.com/2021/08/01/us/c ... =US%20News

[stickles]

What the public doesn't understand is everyone of us, vaccinated or not, is a walking bio weapons test lab. Every time the virus divides using the human cell, there is a random chance for a new variant to emerge. Given enough time and iterations, a new more deadly variant will emerge. The virus will have a much higher chance of mutation in an unvaccinated host simply because it will produce more generations. IMO, The government should be airing ad campaigns to allow a paradigm shift among the unvaccinated.

[Rach3]

What the public doesn't understand is everyone of us, vaccinated or not, is a walking bio weapons test lab.

Correct, well said. The pubic also does not understand new cases are again overwhelming the health care system and burning out health care workers, so good luck on your next heart attack, acute appendicitis, broken bone, elective surgeries, radiation therapy,dialysis,etc.

No one ever went broke under-estimating the intelligence of the American people, 72M of whom voted for Trump even in 2020.

[Rach3]

From NYT Coronavirus Newsletter tonight:

We’re not where we thought we’d be.

Eighteen months into writing this newsletter — and after a brief post-vaccination high this summer — I’m struck by how similarly frustrating things today feel compared to the earlier, darker days of the pandemic.

Mask wearing is back. A return to the office for many is nowhere in sight. Friends are canceling summer vacations. Parents of unvaccinated children are worried about school safety precautions — yet again.

The national outlook is worsening quickly: The country reported a daily average of nearly 86,000 new infections yesterday, up from about 12,000 in early July.

The crisis President Biden once thought he had under control is changing shape faster than the country can adapt. An evolving virus, new scientific discoveries, deep ideological divides and a year and a half of ever-changing pandemic messaging have left Americans with a sense of whiplash, and skeptical of public health advice. The White House’s promised “summer of joy” has instead turned into a summer of confusion.

Across the country, the questions are piling up again: Can I eat inside at a restaurant or bar? Should children be wearing masks when they go to school in September? What, exactly, is it about the Delta variant that people are supposed to be worried about? And what should they do about it?

There is no easy answer. The risk is different for different people, depending on whether they are vaccinated and the level of infections in their community. (What hasn’t changed is that vaccines remain effective and highly protective against hospitalization and death, even among those infected with the extremely contagious Delta variant. Mask wearing prevents transmission of the virus to those most at risk.)

On top of the confusion, the belated realization among Americans that the coronavirus will become endemic, and a problem that we may be dealing with for many years, is sparking denial. Stat News writes that the early focus on herd immunity as a way out of the pandemic has fueled this current sense of disillusionment. Americans expected to be able to clearly see the light at the end of the tunnel by now.

But while herd immunity through vaccine coverage may not be the magical wand we once thought it was, the long term picture for our ability to fight the pandemic is still positive. Nothing in the virus’s recent evolution suggests it can completely take over the immune systems of those who’ve been vaccinated or previously infected.

“It’s a slower progression with a less clear-cut end,” Jennie Lavine, an epidemiological researcher at Emory University, told Stat News. “That doesn’t mean there’s not an end. It’s just harder to see it definitely, and disappointing when it didn’t happen the way we were maybe led to believe.”

Cutting through the Delta confusion.
The rise of the Delta variant is making many people who are vaccinated review their behaviors to stay safe and avoid breakthrough infections. My colleague Tara Parker-Pope, the founding editor of the Well section, asked experts for advice. Here are some of the answers.

What’s the real risk of a breakthrough infection after vaccination?

Although the C.D.C. has stopped tracking breakthrough cases, about half of all states report at least some data on breakthrough events. The Kaiser Family Foundation recently analyzed much of the state-reported data and found that the rate of breakthrough cases reported among those fully vaccinated is “well below 1 percent in all reporting states, ranging from 0.01 percent in Connecticut to 0.29 percent in Alaska.”

When should I wear a mask?

The C.D.C. has a color-coded map of Covid-19 outbreaks in the U.S. The agency advises people to wear masks if they live in an orange or red zone — which now accounts for about 80 percent of the counties in the United States. Infection numbers remain relatively low in much of the Northeast and Upper Midwest, while Delta has caused huge spikes in cases in Missouri, Arkansas, Louisiana and Florida.

Should I upgrade my mask?

You will get the most protection from a high-quality medical mask like an N95 or a KN95, although you want to be sure you have the real thing. A KF94 is a high-quality medical mask made in Korea, where counterfeits are less likely. If you don’t have a medical mask, you still get strong protection from double masking with a simple surgical mask under a cloth mask. A mask with an exhale valve should never be worn, since it allows plumes of viral particles to escape.

Can I still dine at restaurants?

The answer depends on local conditions, your tolerance for risk and the health of those around you. Risk is lowest in communities with high vaccination rates and very low case counts. A restaurant meal in Vermont, where two-thirds of the population is vaccinated, poses less risk than an indoor meal in Alabama or Mississippi, where just one-third of the residents are vaccinated. Parents of unvaccinated children and people with compromised immune systems may want to order takeout or dine outdoors as an added precaution.



New York City’s vaccine mandate.
New York City will become the first U.S. city to require proof of at least one dose of a coronavirus vaccine for a variety of activities for workers and customers — including indoor dining, gyms, entertainment, indoor movies, concerts and performances, including on Broadway, Mayor Bill de Blasio announced today.

The program, similar to mandates issued in France and Italy last month, is meant to put pressure on people to get vaccinated and will start on Aug. 16. After a transition period, enforcement will begin on Sept. 13.

"If you want to participate in our society fully, you’ve got to get vaccinated,” de Blasio said. “It’s time."

To enter indoor venues, patrons must use the city’s new app, the state’s Excelsior app or a paper card to show proof of vaccination. People will be able to dine outdoors without showing proof of vaccination. Children younger than 12 will not be excluded from venues because they are not eligible to be vaccinated, the mayor said. But the details of those plans remain to be worked out.

The mayor said the city consulted with the U.S. Department of Justice and got a “very clear message” that it was legal to move forward with these mandates, even without full F.D.A. approval for the vaccines.

About 66 percent of adults in the city are fully vaccinated, higher than the national figure at 61 percent, although pockets of the city have lower rates.

Vaccine rollout.
Cyberattackers shut down vaccine bookings for Rome and its region.
Over the past three weeks in the U.S., all 50 states have reported an increase in vaccinations, with the national rate up more than 73 percent, ABC reports.
In Texas, the unvaccinated fall into two main groups: white rural conservatives and Black and Latino people in big cities, the Texas Tribune reports.
In France, President Emmanuel Macron is answering vaccine skeptics on TikTok and Instagram.
What else we’re following.
President Biden is expected to announce a new eviction moratorium for places hard hit by the Delta variant.
The F.D.A. authorized a preventive Covid antibody treatment, an option for the millions of Americans who have compromised immune systems, NBC reports.
Bangladesh is struggling to contain its worst wave of infections yet.
Japan tries a new tactic as virus surges: Public shaming.
Israel will add 18 more countries, including the U.S., to its quarantine list.
The Atlantic reports that Congress has axed a $30 billion proposal to the current reconciliation package that would help the country fight the next pandemic.
McDonald’s is requiring U.S. customers and employees to wear masks at restaurants in areas of high transmission, USA Today reports.

What you’re doing.
"We have followed every rule, guideline and mandate from the governor. We were brought to tears when we were able to get our vaccines. My husband is a diabetic and 65. I am 64. We were feeling relief in the early summer as if “normal” was almost back. Then this week we both tested positive for Covid-19. We had to cancel our beach vacation and are isolating. I feel anger and disappointment. Everything we sacrificed this past year and we still got sick."

— Susan Morrison, North Carolina

[Rach3]

From Kansas City Star today:

Kansas City emergency rooms are overwhelmed. Hospitals ask some patients to stay away.
“People come here and they’re very frustrated that they hate to wait four, six, eight, ​10 hours to be seen.”

[Rach3]

Why there is not much hope going forward.Listen to some of these crazies in Arkansas confronting their Trumpist GOP Governor.Whole news conference is instructive, but might want to watch a segment starting at about 28:00 in:

https://www.youtube.com/watch?v=GpsVaqBFrHU

These people cant be reasoned with as they do not want to be reasoned with or ever acknowledge facts inconsistent with their preconceived beliefs.Neanderthal man had more sense ; we have regressed.

[Rach3]

From NY Coronavirus Newsletter tonight:

Younger, sicker, quicker

Doctors working in Covid-19 hot spots across the nation say that the patients in their hospitals are not like the patients they saw last year: The new arrivals are younger, many in their 20s or 30s.

These patients — almost all of them unvaccinated — also seem sicker than younger patients were last year. And they are deteriorating more rapidly.

Earlier in the pandemic, patients would come into the hospital after spending a week or two at home with symptoms. Often they were treated on a regular floor before needing intubation or intensive care, but doctors report some younger patients are experiencing more severe symptoms now.

Physicians have coined a new phrase to describe them: “younger, sicker, quicker.” Some have no underlying health conditions that would make them more susceptible. The culprit, many suspect, is the Delta variant, which now makes up 80 percent of cases nationwide.

“This to us feels like an entirely different disease,” said Dr. Cam Patterson, chancellor of the University of Arkansas for Medical Sciences.

In January, adults under 50 represented 22 percent of hospitalized patients, according to the C.D.C. Now, people ages 18 to 49 account for 41 percent. Some experts think the shift in patient demographics is due to vaccination rates: Less than 50 percent of Americans ages 18 to 39 are vaccinated, compared to more than 80 percent for those ages 65 to 74.

Some experts say what appears to be greater virulence may be simply the result of the Delta variant’s greater contagiousness. As more people are infected, the sheer number of severely ill patients is bound to increase, even if the variant itself does not cause more severe disease than previous versions.

Still, studies from other countries suggest that Delta may cause more severe disease, but there’s no definitive data that shows the variant is worse for young people. Even so, some doctors think younger people are more susceptible.

“That’s what really frightens me,” said Dr. Terrence Coulter, director of critical care at CoxHealth Medical Center, in Springfield, Mo. “It’s hitting younger healthy people that you wouldn’t think would have such a bad response to the disease.”

[maestrob]

The authorities in Austin warn residents that the city’s Covid situation is ‘dire.’

The authorities in Austin, Texas, warned the public on Saturday that the city’s Covid-19 situation had grown desperate, as a surge in cases driven by the Delta variant swamped hospitals while city officials were prevented from issuing mandates for masks and vaccinations by order of the state’s governor, Greg Abbott.

In an alert sent via text, phone call, email, social media and other channels to people in the area on Saturday, the city authorities said: “The Covid-19 situation in Austin is dire. Healthcare facilities are open but resources are limited due to a surge in cases.”


Bryce Bencivengo, a spokesman for the city’s Office of Homeland Security and Emergency Management, said that Friday had been one of the worst days for Austin’s hospitals since the pandemic started. More than 100 new Covid patients were admitted that day, he said, and intensive care units were near capacity, with Covid patients occupying more than 180 I.C.U. beds and 102 of those patients on ventilators.

“We are in the single digits of I.C.U. beds available,” Mr. Bencivengo said, adding that patients in emergency rooms were being forced to wait for space in the I.C.U.s to open up.

Austin’s mayor, Steve Adler, said in an interview on Saturday that the crisis could have been avoided if Mr. Abbott had not barred local government officials from issuing mandates on masking. He said the city’s authorities wanted to avoid suing Mr. Abbott, but that “ultimately we’re going to need to do what is necessary to fight for the safety of our community.”

“Our hospitals are just beyond strained,” he said.

Alison Alter, a City Council member, was more blunt. “The governor is preventing the city from keeping kids and adults safe,” she said in an interview. “He’s going to have a lot of deaths on his hands here. This is a matter of life and death for our community.”

An executive order Mr. Abbott issued in May prevents counties, cities, public health authorities and local government officials from requiring people to wear masks, and warns that violators could be fined $1,000. Mr. Abbott signed a more far-reaching executive order on July 29 barring both mask and vaccination mandates, and prohibiting public agencies and any private entities that take public funds, including grants and loans, from requiring proof of vaccination.

In a statement on Friday, three Austin-area hospitals said the vast majority of the Covid patients they were admitting were unvaccinated or partly vaccinated.

“We urge the community to get vaccinated to protect themselves and their loved ones — and to lessen the burden on our frontline workers who have been fighting this virus for the last year and a half,” said the statement, issued by Ascension Seton, Baylor Scott & White Health and St. David’s HealthCare.

The hospitalizations in Austin are at the tip of a surge in the area, hitting heights last seen before vaccinations became widely available, according to a New York Times database. Travis County, where Austin is, reported more than 3,400 active coronavirus cases on Friday, including 467 new infections. Its daily average of new cases rose 189 percent over the last two weeks.

Scores of the state’s counties have reported caseloads that have more than doubled over two weeks, and some are seeing even larger surges than Austin. Bexar County, where San Antonio is, has seen its daily average shoot up more than 300 percent, to nearly 1,500 cases.

With 76 percent of the state’s most vulnerable population — those over 65 — fully vaccinated, deaths have risen far more slowly. But some of the counties seeing huge surges lag behind the state’s overall vaccination average of 44 percent. Some counties fall below 30 percent.

Sophie Kasakove contributed reporting.

— Alyssa Lukpat

https://www.nytimes.com/live/2021/08/07 ... nt-vaccine

[Rach3]

Thanks,had not seen the article on Austin, where my wife has relatives.

Probably should have titled this thread originally as the Right’s vaccine failure.

[barney]

Wow. Just as well the virus is a hoax and they're not really sick. The lobotomy party at its best.

[Rach3]

NYT Aug.9
Charles Blow, Op Ed

Nothing better exemplifies the gaping political divide in this country than our embarrassing and asinine vaccine response. Donald Trump’s scorched earth political strategy has fooled millions of Americans into flirting with death. And now thousands are once again dying for it.

Almost from the beginning, efforts to combat the virus were met with disdain from a president who felt the crisis made him look bad. The science was denied. We came to live in a world where masking was mocked and ingesting disinfectant was offered up as a possible cure.

All the while, the patients on ventilators gasped for breath, and refrigerated trailers filled with bodies. Death is one of the ultimate truths of life, and yet not even it could dissuade the headstrong from casting doubt on the science.

And then, a miracle.

In response to this raging, deadly virus, scientists developed multiple, highly effective vaccines with breathtaking speed. It was like a prayer had been answered. An antidote to the plague had arrived.

We should all have been celebrating in the streets and running to a lifesaving serum with our sleeves rolled up and a smile on our face. But not enough of us were.

The public had been poisoned by partisanship. Masking was a political statement. Social distancing was a political statement. Receiving the vaccine, for far too many, was a political statement.

And so, countless Americans responded with a political statement of their own: defiance.

They hated that businesses were forced to close, and being asked to wear masks inside when they reopened. They hated their children having to stay home from school and being made to wear masks when they returned.

But, the simple truth is that all of this could have been avoided if all Americans eligible for the vaccine — and that’s pretty much every adult at this point — had simply chosen to be vaccinated. But they didn’t. They haven’t. They are too dug in, too committed to the lies and conspiracies, too devoted to rebellion.

In the beginning, as the vaccine was rolled out, there were some access hurdles and some understandable apprehensions. But now, billions of people worldwide have received the vaccine, and very few have had adverse effects.

The vaccine is safe, incredibly safe.

There are no microchips or magnets in it. It does not cause Covid and it is not more dangerous than Covid.

Believing all these lies is a luxury of people who have not sat by a hospital bedside, or watched from behind glass, because Covid regulations prevented them from comforting a relative or friend as they drew their last breath, struggling against a virus that choked that breath off.

It is a luxury to be irresponsible in a society where others will be responsible for you, where you simply assume that you are safer because others take the appropriate precautions to be safe: You do not need to get the shot because others have.

But the Delta variant is testing that faith.

You will not be safe as an unvaccinated person riding on the coattails of the vaccinated. Delta is extremely transmissible and unremitting. It is stronger than its progenitor.

As the Delta variant surges there is an uptick in the pace of vaccinations in the country. It’s almost like religion: Many disbelievers will call out to whatever God there may be when the reaper is at the door. Fear of ideological defeat is no match for the fear of imminent death. And yet, it shouldn’t have taken another surge of sickness and death for good sense to set in.

Why were Americans turning away a vaccine that many people in other parts of the world were literally dying for? Many did so because of their fidelity to the lie and their fidelity to the liar. They did it because they were — and still are — slavishly devoted to Trump, and because many politicians and conservative commentators helped Trump propagate his lies.

A recent Monmouth University poll found that “among those who admit they will not get the vaccine if they can avoid it, 70 percent either identify with or lean toward the Republican Party while just 6 percent align with the Democrats.”

The optics of countless socially distanced funerals is less offensive to those conservatives than the optics of being socially distanced in a Fuddruckers.

It was all lunacy. It is all lunacy. This should never have happened. There are people dead today — a lot of them! — who should still be alive and who would be if people in the heights of government and the heights of the media had not fed them lies about the virus.

But apparently, after you get so used to so much blood on your hands, you forget — or make yourself forget — that you weren’t born with red palms.

So, we have a situation in America where people are dying and will continue to die of ignorance and stubbornness. They are determined to prove that they are right even if it puts them on the wrong side of a eulogy.

This is like watching millions of people playing in traffic.

[maestrob]

Local officials in Florida prepare to defy the governor’s no-mask mandate.

The recent rise in U.S. coronavirus cases has led local leaders to defy Republican governors who have banned mask mandates in states like Florida and Texas, where the virus is surging.

Starting on Tuesday, the Dallas public school district will require everyone on school property, including students, employees and visitors, to wear masks. The rule comes as Gov. Greg Abbott of Texas remains one of the most strident opponents of mask mandates: His office said in a statement on Monday that he “has been clear that we must rely on personal responsibility, not government mandates.”

In Florida, Gov. Ron DeSantis is threatening to withhold the salaries of local superintendents and school board members who enact them, even though just half of people in the state are vaccinated, and the Delta variant is driving a surge that has made the state one of the worst-hit in the nation. Forty-three percent of the state’s adult intensive-care beds are filled with coronavirus patients, The Wall Street Journal reported.

Mr. DeSantis signed an executive order last month that blocked local officials from enacting mask mandates. But several local officials and community leaders are preparing to defy him.

Schools in Leon County, Alachua County and Duval County have decided in recent weeks to require masks for students, although some schools are allowing students to opt out or are mandating them only for certain grades.

The Broward County School District, one of the largest in Florida, also voted last month to require its students to wear masks, although in light of the governor’s recent executive order, the district said in a statement that it was “awaiting further guidance before rendering a decision on the mask mandate for the upcoming school year.”

Other opponents of the bans are turning to the courts.

Lawsuits have been filed against Mr. DeSantis’s order in Florida. In Texas, the top elected official in Dallas County sued Mr. Abbott on Monday evening, arguing that his ban on mask mandates violates state law.

— Azi Paybarah and Daniel E. Slotnik

https://www.nytimes.com/live/2021/08/10 ... nt-vaccine

[maestrob]

Virus Misinformation Spikes as Delta Cases Surge

Researchers have recorded a new burst of false and misleading information about the coronavirus after a decline in the spring.

By Davey Alba
Aug. 10, 2021, 5:00 a.m. ET

In late July, Andrew Torba, the chief executive of the alternative social network Gab, claimed without evidence that members of the U.S. military who refused to get vaccinated against the coronavirus would face a court-martial. His post on Gab amassed 10,000 likes and shares.

Two weeks earlier, the unfounded claim that at least 45,000 deaths had resulted from Covid-19 vaccines circulated online. Posts with the claim collected nearly 17,000 views on Bitchute, an alternative video platform, and at least 120,000 views on the encrypted chat app Telegram, where it was shared mostly in Spanish.

Around the same time, Britain’s chief scientific adviser misstated that 60 percent of hospitalized patients had been double-vaccinated. He quickly corrected the statement, saying the 60 percent had been unvaccinated. But antivaccine groups online seized on his mistake, translating the quote into French and Italian and sharing it on Facebook, where it collected 142,000 likes and shares.

Coronavirus misinformation has spiked online in recent weeks, misinformation experts say, as people who peddle in falsehoods have seized on the surge of cases from the Delta variant to spread new and recycled unsubstantiated narratives.

Mentions of some phrases prone to vaccine misinformation in July jumped as much as five times the June rate, according to Zignal Labs, which tracks mentions on social media, on cable television and in print and online outlets. Some of the most prevalent falsehoods are that vaccines don’t work (up 437 percent), that they contain microchips (up 156 percent), that people should rely on their “natural immunity” instead of getting vaccinated (up 111 percent) and that the vaccines cause miscarriages (up 75 percent).

Such claims had tailed off in the spring as the number of Covid cases plummeted. Compared with the beginning of the year and with 2020, there was an observable dip in the volume of misinformation in May and June. (Zignal’s research isn’t an accounting of every single piece of misinformation out there, but the spiking of certain topics can be a rough gauge of which themes are most frequently used as vehicles for misinformation.)

The latest burst threatens to stymie efforts to increase vaccination rates and beat back the surge in cases. The vast majority of people testing positive for the virus in recent weeks, and nearly all of those hospitalized from the coronavirus, were unvaccinated. Public health experts, as well as doctors and nurses treating the patients, say misinformation is leading to some of the vaccine hesitancy.

Disinformation researchers say the spike shows that efforts by social media platforms to crack down on misinformation about the virus have not succeeded.

“These narratives are so embedded that people can keep on pushing these antivaccine stories with every new variant that’s going to come up,” said Rachel E. Moran, a researcher at the University of Washington who studies online conspiracy theories. “We’re seeing it with Delta, and we’re going to see it with whatever comes next.”

In the past few weeks, the vast majority of the most highly engaged social media posts containing coronavirus misinformation were from people who had risen to prominence by questioning the vaccines in the past year.

In July, the right-wing commentator Candace Owens jumped on the misstatement from Britain’s scientific adviser. “This is shocking!” she wrote. “60% of people being admitted to the hospital with #COVID19 in England have had two doses of a coronavirus vaccine, according to the government’s chief scientific adviser.”

After the scientific adviser, Patrick Vallance, corrected himself, Ms. Owens added the correct information at the bottom of her Facebook post. But the post was liked or shared over 62,000 times — two-thirds of its total interactions — in the three hours before her update, a New York Times analysis found. In all, the rumor collected 142,000 likes and shares on Facebook, most of them coming from Ms. Owens’s post, according to a report by the Virality Project, a consortium of misinformation researchers from outfits like the Stanford Internet Observatory and Graphika.

When reached for comment, Ms. Owens said in an email: “Unfortunately, I’m not interested in The New York Times. The people that follow me don’t take your hit pieces seriously.”

Also in July, Thomas Renz, a lawyer, appeared in a video claiming that 45,000 people had died from coronavirus vaccines. The claim, since debunked, relies on unverified information from the Vaccine Adverse Event Reporting System, a government database. The baseless claim had been included in a lawsuit that Mr. Renz filed on behalf of an anonymous “whistle-blower,” in coordination with America’s Frontline Doctors — a right-wing group that spread misinformation about the pandemic in the past.

Mr. Renz’s video got more than 19,000 views on Bitchute. The unfounded claim was repeated by the top Spanish-language Telegram channels, Facebook groups and the conspiracy website Infowars, collecting over 120,000 views across the platforms, according to the Virality Project.

In an email, Mr. Renz said his practice had “performed the due diligence necessary” to believe in the accuracy of the allegations in the lawsuit he had filed. “We actually do not believe that the Biden administration is responsible for this, rather we believe that President Biden, like President Trump before him, was misled by the same group of conflicted bureaucrats,” Mr. Renz said.

On Thursday, Mr. Torba, the Gab chief executive, claimed that he was “getting flooded” with text messages from members of the military who said they would be court-martialed if they refused a coronavirus vaccine. Though military leaders have pushed to vaccinate troops and Defense Secretary Lloyd J. Austin will seek to mandate coronavirus vaccines by September, there is no evidence that the military plans to court-martial troops who do not get vaccinated.

Mr. Torba’s post collected 10,000 likes and shares on Gab, according to data from the Virality Project. Documents that he pushed on Gab’s news site to help service members request vaccine exemptions, including for religious reasons, also contained misinformation.

One of the documents made use of an old antivaccine talking point that aborted fetal cell lines were used in the development of the Covid-19 vaccines — but Catholic and anti-abortion groups have said the vaccines are “morally acceptable.” The documents reached up to 2.2 million followers on Facebook, according to CrowdTangle data.

“I’m telling the truth,” Mr. Torba said in an email. “Your Facebook-funded ‘fact checkers’ like Graphika are wrong and are the people peddling disinformation here.”

Facebook, which has become more aggressive at enforcing its coronavirus misinformation policy in the past year, remains a popular destination for people discussing the misinformation.

Media Matters for America, a liberal watchdog group, found over 200 public and private Facebook groups, with around 400,000 members, that were dedicated to antivaccine discussion. The groups, which The Times reviewed, added 13,000 members in the last seven days, according to Media Matters.

Many of the most popular posts in the groups did not include explicit falsehoods. One was an image of a Scooby Doo character unmasking a ghost with a caption that read, “Let’s see what makes you scarier than all the other variants.” The unmasking revealed the logos of MSNBC and CNN, implying that the cable channels were overstating the severity of the Delta variant.

But like the comments on many of the other pages, those beneath the Scooby Doo item did contain unfounded claims. They also included calls to violence.

“China is completely to blame,” one comment said. “We’re going to have to fight them eventually, so I advocate a preemptive nuclear strike.”

Facebook said that it removed confirmed violations of its coronavirus misinformation policy from comments, and that it had connected people with authoritative information about the virus.

“We will continue to enforce against any account or group that violates our Covid-19 and vaccine policies,” Aaron Simpson, a Facebook spokesman, said in an email.

Ms. Moran, the researcher, predicted there would be a “natural attention cycle” for this new round of misinformation. “After this spike, like with the original Covid strain, we’ll see it simmer down to normal levels of misinformation for a little while,” she said.

But the coronavirus misinformation will not go away anytime soon, Ms. Moran predicted. “Unfortunately it’s not spikes and troughs, but steady levels of misinformation,” she said.

Jacob Silver contributed research.

https://www.nytimes.com/2021/08/10/tech ... surge.html

[maestrob]

The Vaccine Refusers Are Testing My Love of the South

Aug. 13, 2021, 5:00 a.m. ET
By Anton DiSclafani

Ms. DiSclafani is a novelist and an associate professor of creative writing at Auburn University.

AUBURN, Ala. — When I had just moved here — six years ago and a lifetime ago — I was shopping at Publix, wheeling my cart out to the car. My baby sat in the buggy; I hit a bump and the bottle of sparkling water I’d just bought skittered onto the ground, exploding. A young man in a Publix uniform ran up; I anticipated frustration (I’d made quite a mess) but instead he apologized for my mistake and ran inside to get another bottle to replace it.

I tell that story to illustrate the extreme, sometimes unbelievable courteousness of the South. Here my neighbors think nothing of building a bridge over the creek in my backyard, so that all our children can play on it.

I love this place. Out of all the places in the world, I feel most comfortable in the South. I even like that as a Democrat, I cannot assume that everyone thinks the same way I do. I appreciate the diversity of thought and the spectrum of political views here.

But as I told a friend a few weeks ago, I didn’t know that moving here would mean I would be at a disadvantage in future pandemics. As I write this, just 34 percent of eligible adults here in Lee County, Ala., are vaccinated. When I went into Ace Hardware last week, my 6-year-old son and I were the only people in the entire store wearing masks.

The school board passed a mask mandate for public schools two weeks ago, in a meeting I livestreamed, then turned off because it was too painful to watch. I’ve been plunged into déjà vu, but not the mysterious or pleasant kind. The kind that makes you want to weep. Because even as parts of the country with higher vaccination rates start to return to something resembling normal, we’re basically back to where we were last year. Our hospital, East Alabama Medical Center, where my younger son was born three years ago, is again being flooded with Covid patients. The Delta variant is ripping through our community, and people are furious, but their anger is directed at, variously, the pediatricians who are encouraging vaccines for older children, the City Council who appointed the school board who passed the mask mandate and businesses that are not “Pro-Freedom.”

I don’t like much of what Kay Ivey, our Republican governor, stands for, but she earned my respect when she passed a mask mandate in our deep-red state. And more recently, too, when she bluntly told the unvaccinated that they were putting everyone else at risk. At this point, everyone here who wants a vaccine has had the chance to get one. Others have been begged, cajoled, threatened and reasoned with. But people who compare wearing a mask to being subjected to experimental medical treatment — as they do in a Facebook group for Lee County parents I’ve been invited to join — are not particularly susceptible to reason.

It’s easy to think, who cares what happens to them, the people who don’t believe in medicine, in science? But I care. I live with them, I go to the grocery store with them, I send my children to school with their children. There’s nothing like a pandemic to make you understand how connected we all are. And not always in a good way.

The South is a troubled place, of course, partly because of its devotion to the past. I was raised in northern Florida and now teach creative writing to students who are mainly from the state I now call home, Alabama. I read their stories and essays about what it’s like to be from here, to live here, to love the natural beauty of a place while they grapple with racism in their communities and monuments that honor evil.

Sometimes it seems as if the South is the butt of the nation’s jokes, but in my nonfiction class last spring we read an essay about Catherine Coleman Flowers, who is trying to improve her home state Alabama by repairing its appalling sewage problems. We spoke at length about the Amazon unionizers in Bessemer, Ala., a place all my students knew. We talked about what it must feel like to be a normal person going up against the most powerful corporation in the world. I was proud of those workers, proud to share a state with people who were that brave.

But the pandemic has complicated that pride. It has done so by upending one of my deeply held beliefs — that living among people who are different from you is a good thing. That it is good because it challenges you to think and act compassionately. To love your neighbor. I still believe all that, but to be honest, right now I’d rather live in a place where everyone thought the same way I do, simply because I’d like to live in a place where everyone was vaccinated.

This year has opened my eyes. I have lived in a place where you never meet a stranger, but of course I’ve experienced it as a white woman. I can acknowledge the terrible aspects of the South — of the country, the world — but I have the privilege not to have had to deal with many of them firsthand. I’ve had the advantage, unfairly, of being able to ignore ideological differences while I go about my day, the days that turn into years, the years that turn into a life.

Southerners are famous for their graciousness. All of that seems lost right now; one only has to witness a City Council meeting, as I did last week, and listen to people ranting furiously about their freedoms and all that they have lost, and stand to lose, by masking to understand that we live in a deeply troubled place. A place where a local pediatrician is mocked online for enrolling her children in vaccine trials, where science and medical advice are sources of deep, unending suspicion.

If only the people who are so opposed to masks and vaccines could put that energy to something that is a real threat, like climate change. But they won’t. I sometimes imagine that their houses could be washed away in a flood or burned down by a wildfire, as is happening in some places right now, and they’d still refuse to believe that humans have any effect whatsoever on the weather. You could put them on top of a melting iceberg, you could — well, I could go on. But there’s no point, because the idea of truth has suddenly become slippery. There is no truth, it seems. Only what you choose to believe, and how.

I find myself astonished these days, by my fellow humans’ meanness, their outrageous spitefulness, as if Covid has invaded not only our lungs but also our psyches, the parts of our brains that ask us to care about not only the people we don’t know, but also the people we do. The people we see every day, as we drop our children off at school and shop for groceries and do all the things that make a life.

I went to Publix recently and was standing in front of the vast granola bar section, trying to work out which brand had the lowest sugar, when an unmasked store worker asked me if he could help.

I glared at him and said no, though I’m not sure whether he could discern my glare, since half my face was covered. And even if he could, I’m not sure he would understand why I was glaring, since out of all the people I saw at Publix that day, very few of them were masked.

https://www.nytimes.com/2021/08/13/opin ... itics.html

[Rach3]

The Vaccine Refusers Are Testing My Love of the South

Aug. 13, 2021, 5:00 a.m. ET
By Anton DiSclafani

Ms. DiSclafani is a novelist and an associate professor of creative writing at Auburn University.


I find myself astonished these days, by my fellow humans’ meanness, their outrageous spitefulness, as if Covid has invaded not only our lungs but also our psyches, the parts of our brains that ask us to care about not only the people we don’t know, but also the people we do. The people we see every day, as we drop our children off at school and shop for groceries and do all the things that make a life.

I went to Publix recently and was standing in front of the vast granola bar section, trying to work out which brand had the lowest sugar, when an unmasked store worker asked me if he could help.

I glared at him and said no, though I’m not sure whether he could discern my glare, since half my face was covered. And even if he could, I’m not sure he would understand why I was glaring, since out of all the people I saw at Publix that day, very few of them were masked.

It's ok to glare at criminals, and potential murderers.

https://www.cnn.com/2021/08/13/us/baby- ... index.html

[Rach3]

More reasons (not that more are needed ) to tell your GOP “friends” to pack sand.


From NYT Coronavirus Newsletter Aug.13:

Even communities where vaccination rates are high are not exempt from this summer surge in cases. The Post analyzed areas with full vaccination rates of 54 percent or higher, and found that 2 out of 3 Americans in these places were still living in virus hot spots. It's important to keep in mind, though, that the vaccines remain protective. It is much safer to live in a hot spot while being vaccinated this summer than it was to be in a hot spot last summer, before vaccines were available.

Health officials in Mississippi warned this week that hospitals in the state are teetering on the edge of failure. With almost 2,700 new cases each day, infections there have spiked, and more than 1,500 patients are hospitalized with covid-19. “If we continue that trajectory within the next five to seven to 10 days, I think we’re going to see failure of the hospital system in Mississippi,” a University of Mississippi Medical Center executive said at a news conference.

Across the Mississippi River in Arkansas, hospitalizations have risen among children 17 and younger. Some children such as 13-year-old Caia Alexx Morris have spent more than a month on a ventilator. Even otherwise healthy children in Arkansas are being hospitalized with covid-19, something that hadn't happened in earlier surges, one respiratory therapist there said.

[Rach3]

More reasons (not that more are needed ) to tell your GOP “friends” to pack sand.

Expert says transmission rates in Florida and Louisiana "probably the highest in the World " :

https://www.cnn.com/2021/08/14/health/u ... index.html

We're gonna' need a bigger hospital.
And, a bigger jail.

[maestrob]

More reasons (not that more are needed ) to tell your GOP “friends” to pack sand.

Expert says transmission rates in Florida and Louisiana "probably the highest in the World " :

https://www.cnn.com/2021/08/14/health/u ... index.html

We're gonna' need a bigger hospital.
And, a bigger jail.

Just heard last night that FEMA is sending out medical personnel to help construct "tent" hospital wings in Mississippi and perhaps other states by now.

They're going to need them. Oregon(!) is sending some of its National Guard contingent to help as well.

This will get much worse before it gets better. Just wait until the kids go back to school....

[maestrob]

Are Delta Symptoms Different?

We asked experts to describe the most prevalent symptoms they’re seeing right now among people with Covid-19.

By Christina Caron
Aug. 12, 2021
Two years ago, a sneeze or a cough wouldn’t have been cause for concern, but now even the mildest of symptoms can leave us wondering, “Do I have Covid?”

Early in the pandemic, we learned about the hallmark signs of infection, which can include loss of taste and smell, fever, cough, shortness of breath and fatigue. But what about now, more than a year later? Have symptoms changed given that the Delta variant is currently the most common form of the virus in the United States?

There is little data on this question and much left to untangle.

Unvaccinated patients make up the vast majority of those hospitalized with Covid-19, so they may be more likely to develop severe symptoms, like trouble breathing, or persistent pain or pressure in the chest. In areas with lower vaccination rates, like Louisiana, Texas and Arkansas, unvaccinated children and young adults are being sent to the hospital in larger numbers than they were at other points during the pandemic. Researchers do not yet know for sure whether Delta alone is responsible for these severe symptoms or if it is the surge in childhood infections, which can result in more hospitalizations.

The Delta variant is nearly twice as contagious as prior variants and just as contagious as chickenpox. It replicates rapidly in the body, and people carry large amounts of the virus in their nose and throat.

Dr. Andrew T. Chan, an epidemiologist and physician at Massachusetts General Hospital and one of the lead investigators of the Covid Symptom Study, has been tracking millions of people from Britain, the United States and Sweden via an app that asks participants to monitor their symptoms. A preprint using data from the study that has not yet been published in a peer-reviewed journal, suggests that those who are vaccinated are well protected against Delta. Breakthrough infections, while rare, tend to produce milder symptoms that are of shorter duration.

At this point, nearly 90 percent of the adult population in Britain has received at least one dose of the vaccine. In the United States, 71 percent of adults are partially vaccinated.

Among vaccinated adults, “the symptoms we are seeing now are much more commonly identified with the common cold,” Dr. Chan said. “We are still seeing people presenting with a cough, but we are also seeing a higher prevalence of things like runny nose and sneezing.” Headaches and sore throat are other top complaints, he added. Fever and loss of taste and smell are being reported to a lesser degree.

Dr. Chan said the researchers started to see milder reported symptoms around the time the Delta variant became prevalent in Britain, starting in the late spring, which also coincided with the country’s mass vaccination program.

Pediatricians in New York City, where 67 percent of adults are fully vaccinated, say they are seeing many of the same symptoms in children that they have seen since the start of the pandemic, and that the more severe cases tend to be among unvaccinated adolescents, especially those with underlying conditions like diabetes or obesity. Some toddlers or school-age children can get very ill from Covid too, but doctors don’t always know why one kid gets much sicker than another, said Dr. Sallie Permar, pediatrician-in-chief at NewYork-Presbyterian and Weill Cornell Medicine.

Fever, cough, fatigue, headache and sore throat are the “classic presentation of Covid” among symptomatic children, she added.

If your child has any potential Covid symptoms, including gastrointestinal problems, arrange for both yourself and your child to get a Covid test and then stay home until the results are negative, said Dr. Adam Ratner, director of the division of pediatric infectious diseases at Hassenfeld Children’s Hospital at N.Y.U. Langone.

“That’s part of how we keep schools safe,” he added.

Testing is essential for adults too, the experts said. Even if you have been vaccinated and your symptoms are mild, it’s best to get tested. The Centers for Disease Control and Prevention believes that vaccinated people can still transmit the virus to others.

“It’s a time to be humble about the fact that this is a new variant. We’re still learning,” said Dr. Mark Mulligan, the director of the N.Y.U. Langone Vaccine Center and the chief of infectious diseases at N.Y.U. Langone Health. “Be cautious and err on the side of caution in terms of going ahead and getting a test.”

Christina Caron is a reporter for the Well section, covering mental health and the intersection of culture and health care. Previously, she was a parenting reporter, general assignment reporter and copy editor at The Times.

https://www.nytimes.com/2021/08/12/well ... e§ion=Well

[Rach3]

Nice going American " freedom fighters " :

https://www.webmd.com/lung/news/2021081 ... wj96i5U%3d

[maestrob]

In a Handful of States, Early Data Hint at a Rise in Breakthrough Infections

With the arrival of the contagious Delta variant, Covid hospitalizations and deaths among vaccinated Americans also may have increased, according to preliminary figures.

By Apoorva Mandavilli
Aug. 17, 2021

Since Americans first began rolling up their sleeves for coronavirus vaccines, health officials have said that those who are immunized are very unlikely to become infected, or to suffer serious illness or death. But preliminary data from seven states hint that the arrival of the Delta variant in July may have altered the calculus.

Breakthrough infections in vaccinated people accounted for at least one in five newly diagnosed cases in six of these states and higher percentages of total hospitalizations and deaths than had been previously observed in all of them, according to figures gathered by The New York Times.

The absolute numbers remain very low, however, and there is little doubt that the vaccines remain powerfully protective. This continues to be “a pandemic of the unvaccinated,” as federal health officials have often said.

Still, the rise indicates a change in how vaccinated Americans might regard their risks.

“Remember when the early vaccine studies came out, it was like nobody gets hospitalized, nobody dies,” said Dr. Robert Wachter, chairman of the department of medicine at the University of California, San Francisco. “That clearly is not true.”

The figures lend support to the view, widely held by officials in the Biden administration, that some Americans may benefit from booster shots in the coming months. Federal officials plan to authorize additional shots as early as mid-September, although it is not clear who will receive them.

“If the chances of a breakthrough infection have gone up considerably, and I think the evidence is clear that they have, and the level of protection against severe illness is no longer as robust as it was, I think the case for boosters goes up pretty quickly,” Dr. Wachter said.

The seven states — California, Colorado, Massachusetts, Oregon, Utah, Vermont and Virginia — were examined because they are keeping the most detailed data. It is not certain that the trends in these states hold throughout the country.

In any event, scientists have always expected that as the population of vaccinated people grows, they will be represented more frequently in tallies of the severely ill and dead.

“We don’t want to dilute the message that the vaccine is tremendously successful and protective, more so than we ever hoped initially,” said Dr. Scott Dryden-Peterson, an infectious disease physician and epidemiologist at Brigham & Women’s Hospital in Boston.

“The fact that we’re seeing breakthrough cases and breakthrough hospitalizations and deaths doesn’t diminish that it still saves many people’s lives,” he added.

The C.D.C. declined to comment on the states’ numbers. The agency is expected to discuss breakthrough infections, hospitalizations and vaccine efficacy at a news briefing on Wednesday.

Most analyses of breakthrough infections have included figures collected through the end of June. Based on the cumulative figures, the C.D.C. and public health experts had concluded that breakthrough infections were extremely rare, and that vaccinated people were highly unlikely to become severely ill.

The states’ data do affirm that vaccinated people are far less likely to become severely ill or to die from Covid-19. In California, for example, the 1,615 hospitalizations of people with breakthrough infections as of Aug. 8 represents just 0.007 percent of nearly 22 million fully immunized residents, and breakthrough deaths an even smaller percentage.

But in six of the states, breakthrough infections accounted for 18 percent to 28 percent of recorded cases in recent weeks. (In Virginia, the outlier, 6.4 percent of the cases were in vaccinated people.) These numbers are likely to be underestimates, because most fully immunized people who become infected may not be taking careful precautions, or may not feel ill enough to seek a test.

“There’s just a lot more virus circulating, and there’s something uniquely infectious about the variant,” said Natalie Dean, a biostatistician at Emory University in Atlanta.

Breakthrough infections accounted for 12 percent to 24 percent of Covid-related hospitalizations in the states, The Times found. The number of deaths was small, so the proportion among vaccinated people is too variable to be useful, although it does appear to be higher than the C.D.C. estimate of 0.5 percent.

If breakthrough infections are becoming common, “it’s also going to demonstrate how well these vaccines are working, and that they’re preventing hospitalization and death, which is really what we asked our vaccines to do,” said Anne Rimoin, an epidemiologist at the University of California, Los Angeles.

A vast majority of vaccinated people who are hospitalized for Covid-19 are likely to be older adults or those who have weakened immune systems for other reasons. C.D.C. data show that 74 percent of breakthrough cases are among adults 65 or older.

Most states do not compile the numbers by age, sex or the presence of other conditions. But in Oregon, which does, the median age for a breakthrough-associated death is 83 years.

The numbers suggest that people who are at higher risk for complications from Covid-19, and anyone who lives with someone in that group, “really needs to seriously consider the risks that they’re taking now,” said Dr. Dean Sidelinger, a state epidemiologist and state health officer for Oregon.

Especially for high-risk groups, “the most important message is that if you do get Covid, then take it seriously,” Dr. Dryden-Petersen said. “Don’t assume that it’s going to be mild. And seek out therapies like monoclonal antibodies if you’re high-risk, to try to prevent the need for hospitalization.”

The figures also underscore the urgency of vaccinating all nursing home residents and staff members.

The states’ numbers come with many caveats. Immunized adults greatly outnumber unvaccinated adults in most states, and their ranks are growing by the day. So the proportional representation of the vaccinated among cases, hospitalizations and deaths would also be expected to rise.

Breakthrough infections are also likely to be most severe among older adults or those who have conditions like obesity or diabetes. These individuals have the highest rates of vaccination, and yet the highest risk of weak or waning immunity.

Their representation among the hospitalized may skew the percentages, making it seem that vaccinated Americans overall are hospitalized more often than is really the case.

“People who are older are both more likely to be vaccinated and more likely to be hospitalized given a breakthrough,” Dr. Dean noted.


To draw more direct conclusions about breakthrough infections, she and other experts noted, states would need to collect and report timely and consistent data to the C.D.C.

Instead, each state slices its data set differently, in different time frames, and many still don’t record mild breakthrough cases because of a directive from the C.D.C. in May. “This is a microcosm of the larger challenges that we’ve had getting data together,” Dr. Dean said.

Studies are also needed on how often people with breakthrough infections spread the virus to others, including to unvaccinated children, and how many of them have persistent symptoms for months after the active infection has resolved, Dr. Rimoin said.

Some scientists noted that while the vaccines are highly effective, people ought to be more cautious, including wearing masks in public indoor spaces, than they were earlier this summer. As more vaccinated people comply, the incidence of cases and hospitalizations may decrease.

In the meantime, the trend in breakthrough infections, if it holds up nationwide, is likely to intensify the debate around boosters.

Most experts still say that boosters are unlikely to be needed in the near future for the general population. But a rise in hospitalizations among the vaccinated may indicate that the boosters are required for some high-risk groups.

Data from Israel and from a handful of studies have suggested that immunity to the virus may wane after the first few months in some groups and may need to be supplemented with booster shots.

Among vaccinated Americans, 72 percent of those who are 65 or older already say they want a booster shot, according to one recent survey.

“When boosters become available, barring arguments about ethics about global supply of vaccines, you should go and get a vaccine,” said Dr. Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health.

Ideally, Dr. Mina said, doctors would track their patients’ antibody levels over time to assess who needed a booster shot, much as they do for measles and rubella vaccines in health care workers. But the C.D.C. and the Food and Drug Administration have said that available antibody tests are not accurate enough for that purpose.

Dr. Dryden-Peterson said it was hard for him to reconcile the idea of boosters for Americans with his work in Botswana, where vaccines are mostly unavailable.

“Even just one dose helps a lot in terms of preventing death,” he said. “We have done an incomplete job of vaccinating the United States, and that should probably be our focus rather than moving on to boosters.”

https://www.nytimes.com/2021/08/17/heal ... tions.html

[Rach3]

From AxiosAM today:


There's not much foot traffic over at the Iowa State Fair's COVID-19 vaccine booth.

We reviewed the Hy-Vee pharmacy booth's attendance and vaccine numbers, and found that few people are getting their shots.
By the numbers: As of Sunday, 150 people had been vaccinated at Hy-Vee's booth.

That equals less than .07% of the nearly 216,000 fair attendees from Friday through Sunday, the first three days the vaccines were offered.
Why it matters: Just over half (51%) of Iowans have been fully vaccinated, according to The New York Times.

What they're saying: A Hy-Vee nurse stated the obvious to the Iowa Capital Dispatch Tuesday, "We're not really changing a lot of minds."

Yes, but: They are reaching people.

Otley resident Arlan DeHeer, 61, got his first dose at the fair Tuesday.
"My arm was kind of twisted a little bit" by my family, DeHeer told the Dispatch.

Of note: Free COVID-19 vaccinations are part of multiple other state fairs this year, the AP reports.

In Wisconsin, 608 people were vaccinated during the fair's 11-day run.
(Rach3: 608/11= 55 per day )

[maestrob]

School boards in Miami and Tampa mandate masks in defiance of the state.

Teachers speaking with anti-mask protesters outside a Broward County School Board meeting in Fort Lauderdale, Fla., last week. Credit...Amy Beth Bennett/South Florida Sun-Sentinel, via Associated Press

Florida’s state board of education threatened this week to penalize local school board members and superintendents in Broward and Alachua Counties because they were requiring students to wear masks at school.

But those threats did not stop Florida’s largest school district, Miami-Dade, as well as the school district in Hillsborough County, which includes Tampa, from approving similarly strict mask mandates on Wednesday, in further defiance of the state board.

“Yesterday, I spoke with a mother of a child who died,” Alberto Carvalho, the superintendent of the Miami-Dade County Public Schools, told the state board of education on Wednesday. “Over the week, I’ve spoken with employees and their relatives, begging me to do the right thing.”

He said he would “wear proudly as a badge of honor” any consequences that may come from his recommendation to require masks, which the school board adopted with a 7-1 vote later on Wednesday.

Lubby Navarro, a board member, cast the lone dissenting vote. “I am not going to sit here and violate state law,” she said.

Battles over school mask policies have engulfed Florida as hospitals have filled with Covid-19 patients, many of them young people. In Broward County, local officials warned this week that only five beds remained available in pediatric intensive care units there.

This month, Gov. Ron DeSantis, a Republican, ordered school districts to allow parents to opt out of mask requirements for their children. He also allowed parents whose children feel “bullied” by mask mandates to apply for a private-school voucher.

The Hillsborough County Public Schools began the school year on Aug. 10 with parents allowed to opt out of its mask requirement. But the district quickly found so much virus in its schools that the board called a special meeting on Wednesday to consider stricter rules. They voted 5-2 to limit mask opt-outs to students with medical exemptions, in spite of a recommendation from Addison G. Davis, the superintendent, that the district keep its existing rules.

“Right now, I think it’s really important to mask our children,” said Nadia T. Combs, one of the board members. She added that she’s “not here for the adults.”

“I’m not here for politics,” she said. “I’m here to keep kids in school.”

In the last week, the district has had to quarantine or isolate 10,384 out of its more than 214,000 students — nearly 5 percent — because of virus exposure.

The emotional meeting in Tampa on Wednesday featured masked parents — some of them health care workers wearing scrubs — pleading for a stronger mandate, and unmasked parents — some of them wearing “Freedom Fighter” T-shirts — insisting on keeping the existing rules.

“My children need to be unmasked,” said Kelly Boynton, one of the opponents. “It’s tyranny.”

Before the meeting, Jennifer Buschner, who has two children in the district, said that her daughter, who is in second grade and has a rare genetic disorder, had hoped to return to the classroom, but the lack of a mask mandate made it too dangerous.

“I was appalled,” Ms. Buschner said. “They took my daughter’s safety away from her, and made it so that she has to be home.”

The county school boards in Alachua (based in Gainesville) and Broward (in Fort Lauderdale) each voted to require masks, with allowances for medical exemptions signed by a physician or other health care provider. The districts argued that such a mandate complied with both state health regulations and the governor’s order.

But the state board of education disagreed. On Tuesday, the board directed the state commissioner of education to investigate and punish the two districts by withholding funds, suspending or removing school board members, or withholding their salaries.

President Biden has condemned states that are blocking mask rules in local schools, saying they are putting politics above public health. His administration has offered to step in and help the districts financially or cover board members’ salaries if the state imposes those sanctions.

On Wednesday, Education Secretary Miguel Cardona said that the administration would use the Department of Education’s civil rights enforcement authority to deter states from banning universal mask mandates in classrooms.

Hours after the Florida state board of education threatened to penalize the two districts, the Alachua school board unanimously extended its mask mandate for eight more weeks.

“That’s not defying me — that’s defying the state of Florida’s laws,” Mr. DeSantis told reporters in Broward on Wednesday. “That was the Legislature of Florida that said the parents are the ones that have ultimate responsibility for health, education and welfare.”

Vickie Cartwright, the interim superintendent of the Broward County Public Schools, said that district officials agreed with the governor’s view that children need to be in brick-and-mortar schools to do their best learning, and that was why the masks were necessary, amid so much virus spread.

“We want our students back in person,” Dr. Cartwright said in an interview on Wednesday. “We want to keep them there.”

— Patricia Mazzei and Giulia Heyward

https://www.nytimes.com/live/2021/08/19 ... nt-vaccine

[maestrob]

Alabama has no more I.C.U. beds available, the state authorities said.

There wasn’t a single I.C.U. bed available in Alabama on Wednesday, a possible sign of what other states may confront soon amid a deadly surge of new infections in parts of the United States with low vaccination rates.

I.C.U. beds are filling up across Southern states, and Alabama is one of the first to run out. The Alabama Hospital Association said on Wednesday night that there were “negative 29” I.C.U. beds available in the state, meaning there were more than two dozen people being forced to wait in emergency rooms for an open I.C.U. bed.

The situation has grown desperate in Alabama, one of several states reporting a wave of cases driven by the highly contagious Delta variant and low vaccination rates.

Last week, at least two hospitals in Houston were so overwhelmed with virus patients that officials erected overflow tents outside. Elsewhere in Texas, in Austin, hospitals were nearly out of beds in their intensive care units. And in San Antonio, cases reached levels not seen in months, with children as young as 2 months old tethered to supplemental oxygen.

Arkansas hospitals were also close to capacity.

Only 47 percent of people in Alabama are at least partially vaccinated, far lower than the national rate of 60 percent, according to a New York Times database.

On Monday, the seven-day hospitalization average hit 2,603, up from a low of 252 on June 26. Only January’s numbers were higher, when the seven-day average peaked at more than 3,300 on Jan. 10.

Gov. Kay Ivey of Alabama said last month that the surge in new cases was attributable to the large number of people who remain unvaccinated. On Friday, she reinstated Alabama’s state of emergency, which had expired in early July, in an effort to expand hospital capacity.

— Alyssa Lukpat

https://www.nytimes.com/live/2021/08/19 ... nt-vaccine

[maestrob]

The Quiet Rage of the Responsible

Aug. 19, 2021
By Paul Krugman

Opinion Columnist

Let’s talk for a minute about Lollapalooza. After canceling in-person events last year, a few weeks ago Chicago once again hosted the long-running music festival, drawing more than 385,000 people. Many feared that the huge, raucous crowds could produce a coronavirus superspreader event.

But the festival required proof of vaccination or a negative Covid test for entry, and it introduced indoor mask requirements halfway through. And very few people appear to have been infected.

What does this tell us? That the return to more or less normal life and its pleasures many expected Covid vaccines to deliver could have happened in the United States. The reason it hasn’t — the reason we are instead still living in fear, with hospitals in much of the South nearing breaking point — is that not enough people have been vaccinated and not enough people are wearing masks.

It’s possible to have sympathy for some of the unvaccinated, especially workers who find it hard to take time off to get a shot and are worried about losing a day to aftereffects. But there’s much less excuse for those who refuse to get their shots or wear masks for cultural or ideological reasons — and no excuse at all for MAGA governors like Ron DeSantis in Florida, Greg Abbott in Texas and Doug Ducey in Arizona who have been actively impeding efforts to contain the latest outbreak.

So how do you feel about anti-vaxxers and anti-maskers? I’m angry about their antics, even though I’m able to work from home and don’t have school-age children. And I suspect that many Americans share that anger.

The question is whether this entirely justified anger — call it the rage of the responsible — will have a political impact, whether leaders will stand up for the interests of Americans who are trying to do the right thing but whose lives are being disrupted and endangered by those who aren’t.

To say what should be obvious, getting vaccinated and wearing a mask in public spaces aren’t “personal choices.” When you reject your shots or refuse to mask up, you’re increasing my risk of catching a potentially deadly or disabling disease, and also helping to perpetuate the social and economic costs of the pandemic. In a very real sense, the irresponsible minority is depriving the rest of us of life, liberty and the pursuit of happiness.

Furthermore, to say something that should also be obvious, those claiming that their opposition to public health measures is about protecting “freedom” aren’t being honest.

Most notably, ever since masks became a front in the culture war it has been clear that many opponents of mask mandates aren’t merely demanding the right to go unmasked themselves — they want to stop others from acting responsibly. Tucker Carlson has called on his viewers to confront people they encounter who are wearing masks, and there have been scattered reports of violent attacks on mask-wearers.

Also, it’s striking how quickly supposed conservative principles have been abandoned wherever honoring those principles would help rather than hurt attempts to contain the pandemic.

For decades, conservatives have insisted that business owners should have the right to do as they please — to hire and fire at will, to deny service to whomever they choose. Yet here we have Abbott threatening to pull the liquor licenses of restaurants that ask for proof of vaccination, even as Texas runs out of I.C.U. beds.

Conservatives have also championed local control of education — except, it turns out, when school districts want to protect children with mask rules, in which case MAGA governors want to seize control and cut off their funding.

So the friends of Covid-19 aren’t motivated by love of freedom. I could offer some hypotheses about their real motives, but understanding what’s driving these people is less important than understanding how much harm they’re doing. That goes double for politicians who are cynically playing to the anti-vax, anti-mask crowd.

Recent polling suggests that the public strongly supports mask mandates and that an overwhelming majority of Americans opposes attempts to prevent local school districts from protecting children. I haven’t seen polling on attempts to prevent businesses from requiring proof of vaccination, but my guess is that these attempts are also unpopular.

But politicians like Abbott and DeSantis are catering to the anti-public health minority because it’s loud and angry, and they don’t think they’ll pay any political price.

Well, I think the pro-public health majority is also getting increasingly angry, and rightly so. It just hasn’t been vocal enough — and too few politicians have sought to tap into this righteous rage. (Gavin Newsom, California’s governor, is trying. He’s pointing out, correctly, that voting for his recall would probably install an anti-vaccine, anti-mask fanatic as governor, with dire consequences for the state.)

So it’s time to stop being diffident and call out destructive behavior for what it is. Doing so may make some people feel that they’re being looked down on. But you know what? Your feelings don’t give you the right to ruin other people’s lives.

https://www.nytimes.com/2021/08/19/opin ... es-breadth

[maestrob]

As Childhood Covid Cases Spike, School Vaccination Clinics Are Slow Going

Districts are heeding President Biden’s call to host pop-up vaccination clinics. But promoting vaccines is politically difficult, and persuading parents isn’t easy.


By Sheryl Gay Stolberg
Aug. 20, 2021
Updated 10:25 a.m. ET

CHEYENNE, Wyo. — There were no cheery signs urging “Get your Covid-19 vaccine!” at the back-to-school immunization clinic at Carey Junior High School last week. In the sun-drenched cafeteria, Valencia Bautista sat behind a folding table in a corner, delivering a decidedly soft sell.

Hundreds of 12- and 13-year-olds streamed through with their parents to pick up their fall schedules and iPads. Ms. Bautista, a county public health nurse, wore a T-shirt that said “Vaccinated. Thanks, Public Health” and offered vaccines against ailments like tetanus and meningitis, while broaching the subject of Covid shots gently — and last.

By day’s end, she had 11 takers. “If they’re a no, we won’t push it,” she said.

Vaccination rates among middle and high school students need to rise drastically if the United States is going to achieve what are arguably the two most important goals in addressing the pandemic in the country right now: curbing the spread of the highly infectious Delta variant and safely reopening schools. President Biden told school districts to hold vaccination clinics, but that is putting superintendents and principals — many of whom are already at the center of furious local battles over masking — in a delicate position.

The Pfizer-BioNTech vaccine is authorized for people 12 and older, but administering it to anyone younger than 18 usually requires parental consent, and getting shots into the arms of teenagers has proved harder than vaccinating adults. Only 33 percent of 12- to 15-year-olds and 43 percent of 16- and 17-year-olds are fully vaccinated, according to federal data, compared with 62 percent of adults.

Yet some school districts offering the shots, along with pediatrics practices, appear to be making progress: Over the past month, the average daily number of 12- to 15-year-olds being vaccinated rose 75 percent, according to Biden administration officials.


As the school year begins, many superintendents do not know how many of their students are vaccinated against Covid-19; because it is not required, they do not ask.

It is no surprise that nurses like Ms. Bautista are circumspect in their approach. In Tennessee, the state’s top immunization leader, Dr. Michelle Fiscus, said she was fired last month after she distributed a memo that suggested some teenagers might be eligible for vaccinations without their parents’ consent.

In Detroit, where county health officials have been running school-based clinics all summer, nurses discovered “strong hesitancy” when they made more than 10,000 calls to parents of students 12 and older to ask whether their children would get the shots and answer questions about them, said the deputy superintendent, Alycia Meriweather. More than half said no.

In Georgia, Savannah-Chatham County Public Schools held their back-to-school clinic at the mall — a “neutral location,” said M. Ann Levett, the superintendent. She is also planning school-based clinics, she said, despite some political pushback and “Facebook chatter” accusing her of “pushing the vaccine on kids.”

Ms. Levett said she was deeply concerned about whether she would be able to keep schools open.

“This is only the second day of school, and already we have positive cases among children,” she said in a recent interview. Her district has a mask mandate, but with 37,000 students, “I just introduced 37,000 more opportunities for the numbers to rise.”

In Laramie County, the center of the Delta surge in Wyoming, the Health Department proposed back-to-school clinics to Janet Farmer, the head nurse in the larger of the county’s two school districts. Ms. Farmer knew she would have to tread carefully. The flier she drafted for parents of students at the county’s three middle schools made little mention of Covid-19.

“Vaccines — NOT Mandatory,” it declared.

Nationally, more children are hospitalized with Covid-19 — an average of 276 each day — than at any other point in the pandemic. In Laramie County, Dr. Andrew B. Rose, a pediatrician at the Cheyenne Children’s Clinic and the president of Wyoming’s chapter of the American Academy of Pediatrics, said two newborns — one a few days old, the other younger than two weeks — were recently admitted to the hospital with Covid-19 symptoms after their parents tested positive.


Wyoming, a heavily Republican state where nearly 70 percent of voters cast their ballots for former President Donald J. Trump in 2020, has one of the nation’s lowest vaccination rates, with about a third of its population fully vaccinated. Laramie County has about 100,000 people and Cheyenne, the state capital, which bills itself as “home to all things Western” including “rodeos, ranches, gunslingers” and eight-foot-tall cowboy boots.

At Casey Junior High, few children or adults wore masks at the recent clinic, despite a sign on the door saying they were “strongly recommended.” Parents seemed to have visceral reactions; they were either enthusiastic about the Covid shot or adamantly against it. Those who were wavering were few and far between, and not easy to persuade.

A nurse in blue scrubs and her husband, a nuclear and missile operations officer at the nearby Air Force base, who declined to give their names, wandered past Ms. Bautista’s table with their 12-year-old son. Their daughter, 13, has cystic fibrosis and is vaccinated. But their son was reluctant. They chatted amiably with Ms. Bautista, but decided to wait.

Cheyenne Gower, 28, and her stepson Jaxson Fox, 12, both said they were leaning toward getting the shot after talking with their doctors. Ms. Gower, citing the Delta surge, said she would get vaccinated soon. Jaxson said he was “still thinking about it” after his pediatrician discussed the risk of heart inflammation, a very rare side effect seen in young boys ages 12 to 17.

“Put down that I’m more on the getting it side,” he instructed, eyeing a reporter’s notebook.

Although the vaccines were tested on tens of thousands of people and have been administered to nearly 200 million in the United States alone, many parents cited a lack of research in refusing. Aubrea Valencia, 29, a hair stylist, listened carefully as Ms. Bautista explained the reasons for the human papilloma virus and meningitis vaccines. Ms. Valencia agreed that her daughter should take both.

But when it came to the coronavirus vaccine, she drew the line. “The other two have been around longer,” she said, adding that she might feel “different about it if we had known someone who died” from the coronavirus.

Every once in a while, the nurses encountered a surprise, as when Kristen Simmons, 43, a professional dog handler, marched up with her son, Trent.

“He turned 12 on Monday, and so we want to get his Covid vaccine,” she declared. Ms. Bautista and the other nurses looked stunned.


“We tend to be more liberal,” Ms. Simmons later said — a statement that would have sounded odd in explaining a medical decision before the pandemic.


In the spring, when vaccines were limited to older Americans who were clamoring for them, officials including Dr. Anthony S. Fauci, the top U.S. infectious diseases expert, envisioned fall 2021 as the last mile of a campaign that could produce “herd immunity” by year’s end. Vaccinating children was crucial to that plan.

Now it is clear that will not happen. Children ages 11 and under are not yet eligible, but if and when the vaccine is authorized for them, experts expect it could be harder to persuade their parents than those of older children. A recent survey by the Kaiser Family Foundation found that parents of younger children were “generally more likely to be hesitant to vaccinating,” said Liz Hamel, who directed the research.

For school superintendents and public health officials who are intent on bringing students back to the classroom — and keeping them there — the low vaccination rates, coupled with the Delta surge, are worrisome.

Wyoming won national praise for keeping schools open all last year. Gov. Mark Gordon, who contracted Covid-19 last year and has encouraged people to get vaccinated, imposed a statewide mask mandate in December that he kept in place for schools even after he lifted it in March, which helped limit the spread of disease in classrooms. Despite the Delta surge and a recommendation from the C.D.C. for universal masking in schools, Mr. Gordon, a Republican, said this month that he would not impose another mandate and that he would leave it to each district to decide.

In Laramie County School District 1, which has about 14,000 students, including about 840 at Carey Junior High, the school board recently cut short its public meeting about masking when a man began ranting about another hot-button issue: critical race theory.

“Fifty percent of the calls here have been, ‘Please mask our kids,’ and 50 percent of the calls have been, ‘We’re not wearing masks,’” said Margaret Crespo, who left Boulder, Colo., about six weeks ago to become the new District 1 superintendent. “There’s no gray area.”

Dr. Crespo plans to make an announcement on masking on Friday, just before the school year starts on Monday.

Fights over the masking issue are even more divisive than the vaccination campaign, “and that is playing out in front of our eyes,” said Ray Hart, the executive director of the Council of the Great City Schools, which represents the country’s largest urban school districts.

“Everywhere I go this summer, that’s part of the message: Let’s get vaccinated,” said Allen Pratt, the executive director of the National Rural Education Association. But “because it’s government, you’ve got a line in the sand where people don’t trust you, and you’ve got to be understanding.”

White House officials have also been encouraging pediatricians to incorporate coronavirus vaccination into back-to-school sports physicals. Many districts are offering the shots during sports practice, with a reminder to athletes that if they are vaccinated, they will not have to quarantine and miss games if they are exposed to the coronavirus.


Laramie County District 1 offered coronavirus vaccines at mandatory clinics to educate high school student athletes about concussions; 32 students accepted shots, said Ms. Farmer, the nurse. The numbers were better at the junior high clinics; over two days at three schools with a total of about 2,400 students, more than 100 took their shots.

Ms. Farmer was satisfied.

“If it’s 100 people,” she said, “that’s 100 that didn’t have it yesterday.”

https://www.nytimes.com/2021/08/20/us/p ... pe=Article

[maestrob]

‘Nursing Is in Crisis’: Staff Shortages Put Patients at Risk

“When hospitals are understaffed, people die,” one expert warned as the U.S. health systems reach a breaking point in the face of the Delta variant.

By Andrew Jacobs
Aug. 21, 2021
Updated 9:06 a.m. ET

Cyndy O’Brien, an emergency room nurse at Ocean Springs Hospital on the Gulf Coast of Mississippi, could not believe her eyes as she arrived for work. There were people sprawled out in their cars gasping for air as three ambulances with gravely ill patients idled in the parking lot. Just inside the front doors, a crush of anxious people jostled to get the attention of an overwhelmed triage nurse.

“It’s like a war zone,” said Ms. O’Brien, who is the patient care coordinator at Singing River, a small health system near the Alabama border that includes Ocean Springs. “We are just barraged with patients and have nowhere to put them.”

The bottleneck, however, has little to do with a lack of space. Nearly 30 percent of Singing River’s 500 beds are empty. With 169 unfilled nursing positions, administrators must keep the beds empty.

Nursing shortages have long vexed hospitals. But in the year and half since its ferocious debut in the United States, the coronavirus pandemic has stretched the nation’s nurses as never before, testing their skills and stamina as desperately ill patients with a poorly understood malady flooded emergency rooms. They remained steadfast amid a calamitous shortage of personal protective equipment; spurred by a sense of duty, they flocked from across the country to the newest hot zones, sometimes working as volunteers. More than 1,200 of them have died from the virus.

Now, as the highly contagious Delta variant pummels the United States, bedside nurses, the workhorse of a well-oiled hospital, are depleted and traumatized, their ranks thinned by early retirements or career shifts that traded the emergency room for less stressful nursing jobs at schools, summer camps and private doctor’s offices.

“We’re exhausted, both physically and emotionally,” Ms. O’Brien said, choking back tears.

Like hospital leaders across much of the South, Lee Bond, the chief executive of Singing River, has been struggling to stanch the loss of nurses over the past year. Burnout and poaching by financially flush health systems have hobbled hospitals during the worst public health crisis in living memory.

With just over a third of Mississippi residents fully vaccinated, Mr. Bond is terrified things will worsen in the coming weeks as schools reopen and Gov. Tate Reeves doubles down on his refusal to reinstate mask mandates. “Our nurses are at their wits’ end,” Mr. Bond said. “They are tired, overburdened, and they feel like forgotten soldiers.”

Across the country, the shortages are complicating efforts to treat hospitalized coronavirus patients, leading to longer emergency room waiting times and rushed or inadequate care as health workers struggle to treat to patients who often require exacting, round-the-clock attention, according to interviews with hospital executives, state health officials and medical workers who have spent the past 17 months in the trenches.

The staffing shortages have a hospital-wide domino effect. When hospitals lack nurses to treat those who need less intensive care, emergency rooms and I.C.U.s are unable to move out patients, creating a traffic jam that limits their ability to admit new ones. One in five I.C.U.s are at least 95 percent capacity, according to an analysis by The New York Times, a level experts say makes it difficult to maintain standards of care for the very sick.

“When hospitals are understaffed, people die,” said Patrica Pittman, director of the Health Workforce Research Center at George Washington University.

Oregon’s governor has ordered 1,500 National Guard troops to help tapped-out hospital staff. Officials in a Florida county where hospitals are over capacity are urging residents “to consider other options” before calling 911. And a Houston man with six gunshot wounds had to wait a week before Harris Health, one of the country’s largest hospital systems, could fit him in for surgery to repair a shattered shoulder.

“If it’s a broken ankle that needs a pin, it’s going to have to wait. Our nurses are working so hard, but they can only do so much,” said Maureen Padilla, who oversees nursing at Harris Health. The system has 400 openings for bedside nurses, including 17 that became vacant in the last three weeks.

In Mississippi, where coronavirus cases have doubled over the past two weeks, health officials are warning that the state’s hospital system is on the verge of collapse. The state has 2,000 fewer registered nurses than it did at the beginning of the year, according to the Mississippi Hospital Association. With neighboring states also in crisis and unable to take patient transfers, the University of Mississippi Medical Center in Jackson, the only Level 1 trauma unit in the state, has been setting up beds inside a parking garage.

“You want to be there in someone’s moment of need, but when you are in disaster mode and trying to keep your finger on the leak in the dike, you can’t give every patient the care they deserve,” said Dr. LouAnn Woodward, the medical center’s top executive. With staffing shortfalls plaguing hospitals coast to coast, bidding wars have pushed salaries for travel nurses to stratospheric levels, depleting staff at hospitals that can’t afford to compete. Many are in states flooded with coronavirus patients.

Texas Emergency Hospital, a small health system near Houston that employs 150 nurses and has 50 unfilled shifts each week, has been losing experienced nurses to recruiters who offer $20,000 signing bonuses and $140-an-hour wages. Texas Emergency, by contrast, pays its nurses $43 an hour with a $2 stipend for those on the night shift. “That’s ridiculous money, which gives you a sense of how desperate everyone is,” said Patti Foster, the chief operations officer of the system, which runs two emergency rooms in Cleveland, Texas, that are over capacity.

Ms. Foster sighed when asked whether the hospital offered signing bonuses. The best she can do is pass out goody bags filled with gum, bottled water and a letter of appreciation that includes online resources for those overwhelmed by the stress of the past few weeks.

Business has never been better for travel nurse recruiters. Aya Healthcare, one of the country’s biggest nurse recruitment agencies, has been booking 3,500 registered nurses a week, double its prepandemic levels, but it still has more than 40,000 unfilled jobs listed on its website, said April Hansen, the company’s president of work force solutions. “We’re barely making a dent in what’s needed out there,” she said.

There were more than three million nurses in the United States in 2019, according to the Bureau of Labor Statistics, which estimates 176,000 annual openings for registered nurses across the country in the next few years. But those projections were issued before the pandemic.

Peter Buerhaus, an expert on the economics of the nursing work force at Montana State University, is especially rattled by two data points: A third of the nation’s nurses were born during the baby boom years, with 640,000 nearing retirement; and the demographic bulge of aging boomers needing intensive medical care will only increase the demand for hospital nurses. “I’m raising the yellow flag because a sudden withdrawal of so many experienced nurses would be disastrous for hospitals,” he said.

Many experts fear the exodus will accelerate as the pandemic drags on and burnout intensifies. Multiple surveys suggest that nurses are feeling increasingly embattled: the unrelenting workloads, the moral injury caused by their inability to provide quality care, and dismay as emergency rooms fill with unvaccinated patients, some of whom brim with hostility stoked by misinformation. Nurses, too, are angry — that so many Americans have refused to get vaccinated. “They feel betrayed and disrespected,” Professor Buerhaus said.


Increasing the nation’s nursing workforce is no easy task. The United States is producing about 170,000 nurses a year, but 80,000 qualified applicants were rejected in 2019 because of a lack of teaching staff, according to the American Association of Colleges of Nursing.

“We can’t graduate nurses fast enough, but even when they do graduate, they are often not prepared to provide the level of care that’s most needed right now,” said Dr. Katie Boston-Leary, director of nursing programs at the American Nurses Association. Newly minted nurses, she added, require on-the-job education from more seasoned ones, placing additional strains on hospital resources.

Some of the proposed remedies include federal policies that can stabilize the profession, including financial assistance to help nursing schools hire more instructors and staffing-ratio mandates that limit the number of patients under a nurse’s care.

“This simplistic notion that the labor market will just produce the number of nurses we need just isn’t true for health care,” said Professor Pittman of George Washington University. “Nursing is in crisis, and maybe the pandemic is the straw that will break the camel’s back.”

The crisis is on full display at Texas Emergency Hospital, which has been treating patients in hallways and tapping administrators to run specimens to the lab. In recent days, 90 percent of those admitted to the hospital have tested positive for the coronavirus. Short on ventilators, and with hospitals in Houston no longer able to take their most critically ill patients, officials have been contemplating the unthinkable: how to ration care.

On Friday, Cassie Kavanaugh, the chief nursing officer for the hospital’s network, was dealing with additional challenges: Ten nurses were out sick with Covid. She had no luck renting ventilators or other breathing machines for her Covid patients. Many of the new arrivals are in their 30s and 40s and far sicker than those she saw during previous surges. “This is a whole different ballgame,” she said.

Ms. Kavanaugh, too, was running on fumes, having worked 60 hours as a staff nurse over the previous week on top of her administrative duties. She was also emotionally wrought after seeing co-workers and relatives admitted to her hospital. And her anguish only mounted after she stopped at the grocery store: Almost no one, she said, was wearing masks.

“I don’t know how much more we can take,” she said. “But one thing that hit me hard today is a realization: If things keep going the way they are, we’re going to lose people for sure, and as a nurse, that’s almost too much to bear.”

https://www.nytimes.com/2021/08/21/heal ... delta.html

[Rach3]

From NYT today. DeSantis should be in jail :

"In other virus news, the F.D.A. could give full approval to Pfizer-BioNTech’s vaccine as early as Monday. Orlando residents were asked to cut back on water use for several weeks to preserve the city’s supply of liquid oxygen for treating patients. "

[maestrob]

From NYT today. DeSantis should be in jail :

"In other virus news, the F.D.A. could give full approval to Pfizer-BioNTech’s vaccine as early as Monday. Orlando residents were asked to cut back on water use for several weeks to preserve the city’s supply of liquid oxygen for treating patients. "

Broward County School Board Members have until tomorrow to allow an "opt-out" exception to mask wearing in their schools or face 100% cut in paycheck, according to CNN last night.

[Rach3]

" I regret that you have but one life to give for my freedom from vaccination.You can pick upthe tab , too."


From AxiosAM today:

The spike in hospitalizations of unvaccinated adults — which are almost all preventable — cost the U.S. health system more than $2 billion in June and July, Axios' Caitlin Owens writes per a KFF analysis.

Why it matters: Those costs are ultimately shouldered by all of us, not just those who remain unvaccinated and then get severely ill.

By the numbers: A coronavirus hospitalization costs, on average, about $20,000.

Using CDC data, KFF estimated that there were about 37,000 preventable coronavirus hospitalizations among unvaccinated adults in June and another 76,000 in July.

Between the lines: Someone has to pay for these hospitalizations. Although COVID-19 patients themselves may be on the hook for at least part of the bill, a large chunk of the tab will fall on either private or public insurers.

And health insurance isn't free — we all pay for it either through our premiums or our taxpayer dollars.

"In addition to preventable direct monetary costs for treatment of unvaccinated people, re-opening of schools and economic recovery also suffers as increasing COVID-19 cases continue to put Americans at risk of avoidable severe illness and even death," the analysis writes.

The bottom line: We're all paying for the unvaccinated, and the big question is how large we'll let the bill become.