Europe’s reluctance to distribute millions of doses of AstraZeneca PLC’s Covid-19 vaccine is coming under pressure after the French government authorized use of the shot for some older people.
The French government announced it would allow people with comorbidities between the ages of 65 and 74 to receive the vaccine developed by Oxford University and AstraZeneca. New data from the U.K. on Monday showed just one dose of the vaccine was effective in preventing disease and deaths among adults aged 70 and older who had received it.
France’s move was a sharp departure from a month ago when President Emmanuel Macron told reporters that the vaccine was quasi ineffective for people older than 65, without providing evidence to back up his claim. The comments helped sow doubts across the European Union that still persist.
In its January 28 report, the attorney general’s office argued that low staffing levels in nursing homes was associated with higher death rates from the novel coronavirus. As evidence of that connection, the report presented a table (reproduced in Table 1 below) comparing death rates in nursing homes based on their star ratings for staffing from the U.S. Centers for Medicare & Medicaid Services (CMS). It showed that homes with the lowest staffing grade of one star had an aggregate COVID-19 mortality rate of 7.13 percent, compared to 4.94 percent for homes with a five-star rating.
However, that table was based on the limited data available in mid-November, which encompassed 6,645 deaths, only half the number that are documented now.
When that table is brought up to date, it shows no clear association between lower staffing grades and higher coronavirus mortality (see Table 2). Homes with a three-star staff rating showed the largest percentage of deaths, at 13.62, compared to 12.98 for two-star homes and 12.14 for one-star homes.
Aides to New York Governor Andrew Cuomo rewrote a July report by state health officials to conceal the number of nursing home residents who died from coronavirus in the state, according to reports.
Cuomo’s top aides worked to hide the fact that more than 9,000 nursing home residents had died from the virus in the state at the time, according to reports from the New York Times and the Wall Street Journal.
Cuomo’s aides clashed with the state’s health officials over the July report, which the Health Department worked on with the consulting firm McKinsey. The report included a chart comparing nursing home deaths in New York with other states, according to the New York Times, which showed that New York’s total of 9,250 deaths was far greater than that of the next highest state, New Jersey, which had 6,150 at that time.
The chart put the death toll at about 50 percent higher than the number the Cuomo administration had touted at the time.
The rest of the world is pursuing a mitigation and suppression strategy, according to which we will have to live with Covid-19 and therefore we must learn to manage it – aiming for herd immunity by the most painless route possible. The poster child for this approach is Sweden’s chief epidemiologist, Anders Tegnell, who told me last week that elimination was a pipe dream for most of the world because even if a country were able to achieve it once, it would be impossible to prevent reintroductions without maintaining a costly and potentially restrictive surveillance apparatus. If the strategy failed, the country would have to revert to suppression anyway, but the population would have paid a much higher price. He too is in it for the long haul, he says; “sustainability” is his watchword. This is how he justifies the gradual tightening of restrictions in his country, from a very relaxed start.
And so the world is cleaved in two, with each bloc operating according to a different set of assumptions, in a kind of public health rerun of the cold war. One bloc assumes that Covid-19 can be eliminated, the other that it can’t. The latter thinks the former is chasing an impossible utopia. The former thinks the utopia could be achieved if only everyone pulled together.
Canada’s National Advisory Committee on Immunization (NACI), a scientific advisory group to the government, has made a forceful and dramatic statement strongly favoring First Doses First (delay the second dose.) This is a very big deal for the entire world. Basically NACI have endorsed everything that Tyler and I have said on First Doses First since my first post tentatively raised the issue on December 8. I am going to quote this statement extensively since it’s an excellent summary. No indentation.
New coronavirus cases among nursing home residents have plummeted by nearly 80 percent from late December to early February, according to The New York Times.
In an analysis of federal data, the news outlet found that outbreaks at long-term care facilities have dropped at a rate almost double that of the general population.
“I’m almost at a loss for words at how amazing it is and how exciting,” David Gifford, the chief medical officer for the American Health Care Association, told the Times. “If we are seeing a robust response with this vaccine with the elderly with a highly contagious disease, I think that’s a great sign for the rest of the population.”
Patients with dementia are at higher risk for Covid-19 and are more likely to have worse outcomes, according to a new study published today.
The study, led by Case Western Reserve University researchers, reviewed electronic health records of 61.9 million adults in the United States and found that the risk for contracting Covid-19 was twice as high for people with dementia compared to the general population.
The risk was even greater still for African Americans with dementia, who were found to be close to three times as likely to be infected with Covid-19.
The study, which was published in the journal Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, also found that certain types of dementia had a greater risk than others.
India, which has had the second-highest number of covid-19 cases in the world, has launched one of Asia’s most ambitious vaccination drives, aiming to inoculate 300 million people by August. To make it happen, the government is using a vaccine management system called Co-WIN. For now, the focus is on getting 30 million health-care and frontline workers vaccinated.
These workers will receive one of two vaccines approved for emergency use: the AstraZeneca-Oxford vaccine—known locally as Covishield and being manufactured by the Serum Institute of India—and Bharat Biotech’s indigenous vaccine, called Covaxin.
Co-WIN is the backbone of the vaccination drive, so to speak. It handles registrations, creates vaccination schedules, informs the recipients through text messages, sends people to the right vaccination center, and also creates a vaccination certificate after they’ve received two doses. Although it’s starting with health-care workers, it’s expected to be used for the general public, too, and people will be asked to self-register through the app.
Despite the fact long-term care workers were the first in Ontario invited to get the COVID-19 vaccine last December, a little more than half of them have volunteered to get the shot.
As of this week, only 55,000 of 100,000 long-term care workers in Ontario have been inoculated, according to the province’s Ministry of Health.
Dr. Hugh Boyd, chair of the Ontario Medical Association’s section on long-term care and care of the elderly, said a lack of confidence in the vaccine and pervasive myths about the quick development and safety of the shot is at the root of the low numbers.
Some of the disparities are a result of who has approval to get shots so far. The elderly are more likely to be White, while the Hispanic population skews young and is less likely to work in hospitals and nursing care, groups targeted in the earliest phases of vaccine distribution.
Other disparities are a result of lower uptake rates among certain groups. Some health-care settings have reported that it’s taking longer to build up trust with communities of color, particularly Black people, who are wary of a medical establishment that for centuries has ignored and mistreated them. Anti-vaxx misinformation campaigns are targeting the already hesitant, including women and Black people. In addition, those with fewer resources may not be able to navigate the notoriously buggy and overloaded online sign-up systems. Meanwhile, others with connections, time, and money can snap up open slots.