The simple reason West Virginia leads the nation in vaccinating nursing home residents
by ilene - January 16th, 2021 4:25 pm
The simple reason West Virginia leads the nation in vaccinating nursing home residents
By mid-January, only about a quarter of the COVID-19 vaccines distributed for U.S. nursing homes through the federal program had reached people’s arms. Paul Bersebach/MediaNews Group/Orange County Register via Getty Images
Courtesy of Tinglong Dai, Johns Hopkins University School of Nursing
The urgency of vaccinating nursing home residents is evident in the numbers. The COVID-19 pandemic has claimed the lives of more than 136,000 residents and employees of long-term care facilities in the U.S. alone, accounting for nearly 40% of all U.S. deaths linked to the disease.
Echoing that urgency, Secretary of Health and Human Services Alex Azar declared in mid-December, “We can have every nursing home patient vaccinated in the United States by Christmas.” Yet, by Christmas, most states had barely begun.
Other states were still far behind when West Virginia became the first state to finish round one of the two-dose vaccine series in nursing homes on Dec. 30.
What did West Virginia do differently?
The numbers tell a story. As a professor who specializes in health care operations management, I believe they hold some important lessons for other states and the rest of the vaccine rollout.
The pharmacy math problem
The first important point is that West Virginia opted out of a federal partnership program that relies on the giant CVS and Walgreens pharmacy chains to deliver vaccines to nursing homes. Instead, the state is relying on a network consisting mostly of local pharmacies.
West Virginia has also been praised for how it used the time between when authorization for the first vaccines became evident and when the first doses arrived to plan the rollout.
The big difference is in the numbers. Under the federal partnership program, CVS planned to have about 1,000 of its pharmacies as vaccine hubs to serve some 25,000 nursing home facilities across the nation, a CVS official told The Wall Street Journal in early December. Similarly, a Walgreens official said his company would have 800 to…
What you need to know about the new COVID-19 variants
by ilene - January 16th, 2021 1:15 am
What you need to know about the new COVID-19 variants
B117, the SARS CoV-2 variant that was first detected in the U.K., has been found to be 30%-80% more transmissible. Juan Gaertner/Science Photo Library via Getty Images
Courtesy of David Kennedy, Penn State
Editor’s note: Two new strains of the coronavirus that causes COVID-19 called B.1.1.7 and B.1.351 have been found in the U.K. and South Africa and are thought to be more transmissible. In this interview, David Kennedy, a biologist who studies the evolution of infectious diseases at Penn State, explains how these new strains are different, what “more transmissible” means, what that means for the public and whether the vaccines will be effective against them.
David Kennedy explains the two new COVID-19 strains B117 and B1351, which were detected in December.
What are the two new variants of the SARS CoV-2 virus?
There are actually a few different variants that are emerging that you’ve probably been hearing about recently. Two of the most common ones that people are talking about and are most concerned about are the B.1.1.7 and B.1.351 variants. They were first detected in the U.K. and South Africa. It seems that they have been circulating since October at least but were only noticed in December. The concern about these variants is that they might have some differences in how transmissible they are and how the immune system sees them.
What does ‘more transmissible’ mean when it comes to these variants?
The data suggests that both of these variants are more transmissible. Most of the data that’s available is for the U.K. variant in particular. It’s still not clear exactly how much more transmissible it is, but current estimates are that it’s somewhere between 30% and 80% more transmissible than the original strains that were out there.
How did scientists arrive at those numbers? When spikes in cases in the U.K. raised concerns, they sequenced the virus from the cases during the spikes. They saw that there was this novel variant. They looked at the frequency of this variant…
The Countries With The Most COVID-19 Cases
by stjeanluc - January 15th, 2021 2:08 am
The Countries With The Most COVID-19 Cases
By Martin Armstrong, Statista, Jan 12, 2021
This regularly updated infographic keeps track of the countries with the most confirmed Covid-19 cases. The United States is still at the top of the list, with a total now exceeding the 22 million mark, according to Johns Hopkins University figures. The total global figure is now over 85 million, while there have been more than 1.9 million deaths.
You will find more infographics at Statista
UC San Diego Installs COVID Test Kit Vending Machines
by Zero Hedge - January 14th, 2021 10:20 pm
Courtesy of ZeroHedge
With daily COVID-19 infections getting worse over the last couple of months in Southern California, one university has decided to introduce coronavirus testing vending machines, reported Reuters.
Students at the University of California's San Diego campus were greeted with eleven vending machines over the winter semester packed with do-it-yourself COVID-19 tests.

School officials told Reuters the vending machines are the first of their kind to be installed on any college campus in the US.
There's nothing special about these vending machines; in fact, they're conventional vending machines that would typically hold snacks. School officials said these devices drive down the testing costs.
School officials said at least 10,000 students live on campus. They are required by school regulations to be tested once a week.
Test kits are free and easily accessible from the vending machine with a swipe by a student ID card. The test is simple enough that students can swab their own noses' then deposit the sample into a medical bag where it's then sent to medical labs on campus.

UC San Diego Chancellor Pradeep Khosla told Reuters that result turnaround is about 12 to 24 hours.
"They're an amazing innovation – simple, effective, and impactful," Khosla said, referring to the vending machines.
Deployment of the vending machines comes as Southern California has seen an uptick in infections.
San Diego County has exceeded 80% of its hospital beds due to a significant increase in virus patients. Simultaneously, and oddly enough*, flu cases remain extremely low compared to this time in previous years.
[*It's not odd that flu cases are low. While protecting against COVID, we also protect against the flu. The flu virus is less contagious. ~ Ilene]
Americans have unrealistic expectations for a COVID-19 vaccine
by ilene - January 13th, 2021 3:26 pm
Americans have unrealistic expectations for a COVID-19 vaccine
If too many Americans refuse to take the COVID-19 vaccine, achieving population immunity will be difficult. Paul Hennessy/NurPhoto via Getty Images
Courtesy of Matt Motta, Oklahoma State University
Many Americans appear to be experiencing cautious optimism about the role that vaccines could play in ending the pandemic. But recent public opinion research suggests that 29% to 37% of Americans plan to refuse a COVID-19 vaccine.
According to some epidemiological estimates, as many as three-fourths of Americans must become immune to COVID-19 – either by recovering from the disease or by getting vaccinated – to halt the virus’s spread. As a scholar who studies vaccine hesitancy, I ask how Americans’ vaccine-related expectations might influence their willingness to vaccinate. What attributes do Americans expect a COVID-19 vaccine to have, and will they be less likely to get vaccinated if the vaccine they have the opportunity to take defies some of their preferences?
In a new peer-reviewed study, I found that the vaccine Americans most prefer may not reflect the choices we actually have. Americans are most likely to intend to vaccinate when a vaccine is made in the U.S., administered in a single dose, over 90% effective and carrying a less than 1 in 100 chance of experiencing minor side effects, and has spent just over a year in development.
However, even under these ideal conditions, the likelihood that the average respondent in the study would choose to vaccinate is just 68%. This implies that many Americans may refuse vaccination, even when a vaccine satisfies their expectations.
President-elect Biden publicly receives his second round of the vaccine on Jan. 11 in Newark, Delaware. Alex Wong via Getty Images
Why do some Americans plan to refuse a COVID-19 vaccine?
Since Pfizer and Moderna vaccines gained emergency use authorization, front-line health care workers and other vulnerable groups have started to receive the vaccine.
Public opinion research, however, has documented substantial COVID-19 vaccine hesitancy. While…
Delaying second COVID-19 vaccine doses will make supplies last longer but comes with risks
by ilene - January 11th, 2021 3:02 pm
Delaying second COVID-19 vaccine doses will make supplies last longer but comes with risks
Health care workers wait in line for vaccinations at a site in Los Angeles. Xinhua News Agency via Getty Images
Courtesy of Sanjay Mishra, Vanderbilt University
Drugmakers are facing challenges in manufacturing vaccines and building supply chains to meet the demand for COVID-19 vaccines. Pfizer has even lowered production targets. Scarcity of vaccines has prompted calls for a Band-Aid-like strategy to stretch the precarious supply.
To protect as many people as possible from COVID-19, the U.K.‘s medical officers have chosen to prioritize distribution of a first vaccine dose to as many people as possible – by delaying the second doses of the Pfizer/BioNTech COVID vaccine up to 12 weeks from the recommended 3-4. President-elect Biden wants to release all vaccine doses to speed up the vaccination program – but the risk is that vaccine makers won’t be able to replenish the supply to make sure that the second dose is delivered on time.
These decisions have opened up a rift between experts because some support giving a single vaccine dose to as many people as possible, while others want to vaccinate according to the protocol used during the clinical trials. In the U.S. only around a 10th of the 300 million doses promised by January under Operation Warp Speed are actually available. Nevertheless, the Food and Drug Administration has reminded the medical community of the importance of receiving both doses of COVID-19 vaccines in line with the way they were tested in clinical trials. The FDA says there is no data that demonstrates vaccine efficacy if the second dose is delayed.
I’m interested in this debate because I coordinate an international registry of patients with cancer who have been diagnosed with COVID-19. Patients with current or prior cancers are twice as likely to die from COVID-19 than those without cancer. The Centers for Disease Control and Prevention has not included current or surviving cancer patients for inclusion in the first group of COVID-19 vaccine recipents. Altering vaccine doses seems an easy fix to stretch limited supplies and provide vaccines for…
Vaccine delays reveal unexpected weak link in supply chains: A shortage of workers
by ilene - January 9th, 2021 9:33 pm
Vaccine delays reveal unexpected weak link in supply chains: A shortage of workers
Seniors in Fort Myers, Fla. wait for their COVID-19 vaccinations. At this site, 800 doses of vaccine were available. Octavio Jones via Getty Images
Courtesy of Anna Nagurney, University of Massachusetts Amherst
After the initial excitement following the authorization of the first COVID-19 vaccines, a harsh reality set in. People who want a vaccine can’t get it, some counties have more than others and older people are camping out for it the way they once might have for tickets to a Bruce Springsteen concert.
All of this would seem to be an indication of supply chain problems or systems breakdowns. In fact, it’s more about a shortage of employees to support the supply chains and distributions. Some states are even considering calling up the National Guard.
I am an expert on supply chains, and I construct models and algorithms to identify how to enhance their operations as well as to identify their vulnerabilities. Labor problems – and a lack of taking them into account – have contributed in a major way to these delays. My recent paper studied the effect of labor constraints on supply chains and possible disruptions. It quantifies the effects on product flows, firm costs and consumer prices of changes in labor availability and productivity.
Supply chains are an essential part of the delivery of goods to consumers.
From maker to market
As countries evolved from agrarian societies, where food and other goods were consumed close to where they were produced, businesses became more complicated and spread out. Supply chains emerged as networks that tie raw material providers with other suppliers, manufacturers and partners, such as warehouse managers and freight service providers.
Supply chains are networks with links corresponding to important activities of production, transportation, storage and distribution. Pathways in supply chains carry the flow of products from origin nodes to the destinations.
Before the 1990s, supply chains focused on cost, efficiency and speed but were not sufficiently agile to adapt…
How many people need to get a COVID-19 vaccine in order to stop the coronavirus?
by ilene - January 7th, 2021 8:26 pm
How many people need to get a COVID-19 vaccine in order to stop the coronavirus?
Before the U.S. can return to some form of normal, a lot of people need to be vaccinated. AP Photo/Paul Sancya, Pool
Courtesy of Pedro Mendes, University of Connecticut
It has been clear for a while that, at least in the U.S., the only way out of the coronavirus pandemic will be through vaccination. The rapid deployment of coronavirus vaccines is underway, but how many people need to be vaccinated in order to control this pandemic?
I am a computational biologist who uses data and computer models to answer biological question at the University of Connecticut. I have been tracking my state’s COVID-19 epidemic with a computer model to help forecast the number of hospitalizations at the University of Connecticut’s John Dempsey Hospital.
This type of computer model and the underlying theory can also be used to calculate the vaccination rates needed to break the chain of transmission of the coronavirus. My estimate is that for the entire U.S., roughly 70% of the population needs to be vaccinated to stop the pandemic. But variation in how people behave in different parts of the country, as well as open questions on whether the vaccine prevents infection entirely or just prevents people from getting sick, add a degree of uncertainty.
When enough people are vaccinated, the coronavirus will not be able to spread from person to person. Cavernia via Wikimedia Commons, CC BY-SA
Cutting off transmission
Clinical trials have shown that once a person gets vaccinated for the coronavirus, they won’t get sick with COVID-19. A person who doesn’t get sick can still be infected with the coronavirus. But let’s also assume that a vaccinated person can’t spread the virus to others, though researchers still don’t know if this is true.
When enough of the population is vaccinated, the virus has a hard time finding new people to infect, and the epidemic starts dying out. And not everyone needs to be vaccinated, just enough…
COVID-19 crisis in Los Angeles: Why activating ‘crisis standards of care’ is crucial for overwhelmed hospitals
by ilene - January 6th, 2021 1:15 pm
COVID-19 crisis in Los Angeles: Why activating 'crisis standards of care' is crucial for overwhelmed hospitals
Hallways busy with COVID-19 patients have become temporary patient holding areas in overcrowded hospitals. Francine Orr / Los Angeles Times via Getty Images
Courtesy of Maria Howard, Gonzaga University
In Los Angeles County, ambulance crews are being told to conserve oxygen and to not take certain trauma and cardiac arrest patients they can’t resuscitate in the field. When ambulances do transport patients, they often wait hours or move to temporary ambulance receiving spaces, often tents where doctors can assess the patient while waiting for space inside.
Ill patients who would normally stay in a hospital for observation are being discharged to make room for sicker patients. Patients who cannot be discharged are being treated in hallways, chapels or wherever there is room.
Hospitals and emergency services in the Los Angeles region are clearly in crisis as COVID-19 cases surge, yet state and county officials have yet to formally make what is known as a declaration of crisis standards of care.
The declaration is important. It triggers protocols that help doctors and overwhelmed hospitals determine the most efficient use of limited resources for the greatest benefit of patients and it provides some legal protection. Without the declaration, there is less transparency or coordination for how resources are allocated, and rationing of resources happens at bedsides. That has consequences for both doctors and patients.
I am a medical ethicist who works with regional and county disaster and triage advisory committees to think through the moral implications of declaring crisis and the ethics of triage decisions necessitated by crisis. I consider these designations vital as hospitals face difficult choices over how to use limited resources, treatments and staff.
Three stages to reach crisis capacity
The Institute of Medicine, now known as the National Academies of Medicine, published guidance for establishing crisis standards of care for use in disaster situations in 2009 amid the H1N1 swine flu pandemic. The report creates guidelines for the fair,…
Oxford COVID vaccine authorised in the UK – global health expert on why this is a key moment
by ilene - December 30th, 2020 10:17 pm
Oxford COVID vaccine authorised in the UK – global health expert on why this is a key moment
Courtesy of Michael Head, University of Southampton
The UK has become the first country to authorise the Oxford-AstraZeneca COVID-19 vaccine for public use, with roll-out to start in the first week of 2021. This vaccine is the second to be authorised in the UK – following the Pfizer vaccine.
The British government has ordered 100 million doses of the Oxford vaccine, enough to vaccinate 50 million people. Other countries will be watching closely: Australia has ordered over 50 million doses, Canada 20 million, and worldwide over 2.5 billion doses have been preordered. AstraZeneca expects to be able to supply large numbers of doses within the first quarter of 2021.
Notably, British people will receive two full doses of the vaccine, which in trials prevented people from falling ill with COVID-19 62% of the time. This is despite trials initially suggesting that an alternative dosing strategy – using half a dose followed by a full dose – could be much more effective, preventing illness with 90% efficacy.
What is the significance of the Oxford vaccine now being available? The Conversation asked Michael Head, an expert in global health at the University of Southampton, some key questions about why its authorisation is important.
Why is this vaccine needed?
The least merry Christmas in recent memory has at least had the silver lining of a highly effective vaccine – Pfizer’s – being available and licensed for use in the UK. But despite the brilliance of this magic bullet, there are limiting factors – particularly around the scale of production required to meet demand.
The multi-country demand for the Pfizer vaccine is akin to a highly intense hour where the local supermarket has just released some new delivery slots during lockdown, and you’re racing to get the order booked before any of your neighbours notice. Everyone wants to get in first to ensure delivery of that last pack of toilet roll – or in this case, that next batch of vaccines.
The difficult logistics of storing and…