Category: Healthcare

Covid-19 deaths in Russia are soaring

Mary Pat Campbell

Link: https://www.economist.com/europe/2021/07/10/covid-19-deaths-in-russia-are-soaring

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The number of new daily cases is currently around 25,000, somewhat fewer than in Britain, and rising. But whereas in Britain this surge has translated into an average of 18 daily deaths over the past week, in Russia it has resulted in an average of 670 deaths a day.

The contrast is all the more striking because Russia was the first country in the world to approve a working vaccine, one based on the same science as the British-Swedish AstraZeneca one and apparently just as effective. But whereas in Britain 78% of the population has received at least one jab, in Russia the proportion is only 20%. The difference is not the availability or the efficacy of the jab, but people’s trust in the government and its vaccines.

All of this could have been avoided. A year ago the government decided to lift a partial lockdown (Mr Putin called it “a holiday”), hoping to save itself money and to prop up the president’s faltering popularity after a prolonged slump in incomes. Mr Putin’s ratings did go back up—but so did the risk of infection.

Publication Date: 10 July 2021

Publication Site: The Economist

Biden’s Covid vaccine push crashes into reality

Mary Pat Campbell

Link: https://www.politico.com/news/2021/07/07/biden-covid-vaccine-push-498479

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After falling short of its goal of administering at least one dose of the vaccine to 70 percent of adults by July 4th (it reached 67 percent) the White House is now turning its attention to the toughest populations in the country. That includes places like barber shops in Englewood, which are part of the “Shots at the Shops” effort by the White House. It’s also sending “surge teams” to some of the lowest vaccinated spots in the country, enlisting trusted messengers like church leaders to go door-to-door. And they’ll add mobile vaccination units at places like music festivals, sporting events or neighborhoods with low vaccination rates.

…..

It’s all in an effort to target the stubbornly resistant, or hard-to-reach populations as fear grows that the virus could reemerge thanks to the highly contagious Delta variant.

Much of the coverage of those populations has focused on Trump supporters who have resisted vaccination as a matter of political identity. And data show that vaccination rates do tend to overlap with partisan leanings. But there are other hard-to-reach communities, including young people, Black and minority groups that traditionally vote Democratic.

Author(s): Natasha Korecki

Publication Date: 7 July 2021

Publication Site: Politico

Why has America’s vaccination programme slowed so much?

Mary Pat Campbell

Link: https://www.economist.com/graphic-detail/2021/07/08/why-has-americas-vaccination-programme-slowed-so-much?utm_campaign=the-economist-today&utm_medium=newsletter&utm_source=salesforce-marketing-cloud&utm_term=2021-07-08&utm_content=article-link-6&etear=nl_today_6

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ON JULY 4TH President Joe Biden stood on the White House lawn to declare that America was nearing independence from the coronavirus. But with covid-19 not fully “vanquished”, he called upon his fellow citizens to get vaccinated, telling them that “it’s the most patriotic thing you can do.” About 55% of Americans over the age of 12 have now been fully vaccinated, and a further 10% have had the first of two doses. But in recent weeks America’s vaccination rate has slowed markedly. In April 3m doses were administered each day; since June that figure has fallen to an average of 1m per day.

There are three possible explanations for this slow-down. The first is that it is typical for vaccination rates to fall as more people are jabbed, since those in cities and other easy-to-reach areas are likely to have been targeted already. Yet America does not appear to have reached such a threshold. Other rich countries, such as sparsely populated Canada, continued to vaccinate at a decent clip until about 75% of their populations had received their first dose (see left-hand chart). Germany, which has vaccinated a similar proportion of its citizens as America, is currently vaccinating at nearly three times the rate.

Publication Date: 8 July 2021

Publication Site: The Economist

J&J and Delta update

Mary Pat Campbell

Link: https://yourlocalepidemiologist.substack.com/p/j-and-j-and-delta-update

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Neutralizing antibodies in a lab is difficult to map to real world efficacy. Thankfully, some scientists figured out a mathematical model (here). Using their model, this means the efficacy of J&J would be around 55-60% against symptomatic disease. It will still work well against severe disease.

In the same update, J&J said their vaccine continues to work over time, with strong responses for up to 8 months. This is because there’s only 8 months of data; we are optimistic it will last longer.

Author(s): Katelyn Jetelina

Publication Date: 2 July 2021

Publication Site: Your Local Epidemiologist on substack

Without Enough Boots on the Ground, California’s Vaccination Efforts Falter

Mary Pat Campbell
Without Enough Boots on the Ground, California’s Vaccination Efforts Falter

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Lackluster vaccination uptake drove the Newsom administration to pursue the more personal approach that public health experts favor, but the still-nascent campaign leaves out large swaths of the state. The administration launched its “Get Out the Vax” campaign in April, enlisting 70 community-based organizations and 2,000 community canvassers, now focused on Los Angeles and Central Valley neighborhoods where vaccinations have plateaued or declined.

But county public health officials say the campaign isn’t big enough to combat the vaccine misinformation that has infiltrated regions such as California’s rural north.

Author(s): Angela Hart

Publication Date: 29 June 2021

Publication Site: Kaiser Health News

Comparing the COVID-19 Vaccines: How Are They Different?

Mary Pat Campbell

Link: https://www.yalemedicine.org/news/covid-19-vaccine-comparison

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In the United States, the number of cases and deaths that had been rising to a peak for almost a year have been flattening out, thanks, in large part, to COVID-19 vaccinations that began in December. As the weeks pass, more reports have been coming out about the effectiveness of the vaccines that are in use and the potential of those still in development. So, how do they differ? 

It’s important to keep up, but it’s also a daunting task, given the flood of information (and misinformation) coming at us from so many directions.

Vaccines from Pfizer-BioNTech, Moderna, and Johnson & Johnson are being administered in the U.S. right now, and others are on track to do the same. 

We mapped out a comparison of the most prominent COVID-19 vaccines.

Author(s): Kathy Katella

Publication Date: 1 July 2021 (originally published February 2021, updated)

Publication Site: Yale Medicine

The New York City Unions Whose Backdoor Deal Sold Out Retirees, Helped Insurance Industry

Mary Pat Campbell

Link: https://www.newsweek.com/new-york-city-unions-whose-backdoor-deal-sold-out-retirees-helped-insurance-industry-1604661

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In recent years, leadership of some of the nation’s largest unions have publicly opposed single-payer health care proposals, angering their rank-and-file and forcing Democratic politicians who back single-payer to take on a key constituency.

In New York City, for example, the umbrella organization for the city’s public sector unions—the Municipal Labor Committee (MLC)—recently helped the health insurance industry block a statewide single-payer bill, on the grounds that their members wanted to keep the health care benefits for which they had sacrificed wage increases.

But it turns out that the MLC, which bargains for health care benefits for city unions, was also engaging in backdoor negotiations with the city, resulting in a proposal to switch nearly a quarter-million people from Medicare to privately administered Medicare Advantage plans.

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Following the 2018 cost-cutting agreement, union leaders and officials came up with eight proposals to meet the cost-cutting requirements, including switching to a statewide single-payer system or setting up a self-insurance system.

A January 2021 study by The New School found that the city could save about $1.6 billion per year if it adopted a self-insurance program, as most major cities and large companies have done. That would involve setting up a health insurance plan just for the city’s employees and paying for claims directly, rather than paying premiums to a health insurance company which tends to be more expensive because insurance company profit margins are so large.

But since the negotiations between the MLC and Office of Labor Relations were held behind closed doors, retirees don’t know whether this option was ever considered.

Author(s): JULIA ROCK, THE DAILY POSTER

Publication Date: 28 June 2021

Publication Site: Newsweek

Opinion: Amid a Pandemic, a Health Care Algorithm Shows Promise and Peril

Mary Pat Campbell
Amid a Pandemic, a Health Care Algorithm Shows Promise and Peril

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In the midst of the uncertainty, Epic, a private electronic health record giant and a key purveyor of American health data, accelerated the deployment of a clinical prediction tool called the Deterioration Index. Built with a type of artificial intelligence called machine learning and in use at some hospitals prior to the pandemic, the index is designed to help physicians decide when to move a patient into or out of intensive care, and is influenced by factors like breathing rate and blood potassium level. Epic had been tinkering with the index for years but expanded its use during the pandemic. At hundreds of hospitals, including those in which we both work, a Deterioration Index score is prominently displayed on the chart of every patient admitted to the hospital.

The Deterioration Index is poised to upend a key cultural practice in medicine: triage. Loosely speaking, triage is an act of determining how sick a patient is at any given moment to prioritize treatment and limited resources. In the past, physicians have performed this task by rapidly interpreting a patient’s vital signs, physical exam findings, test results, and other data points, using heuristics learned through years of on-the-job medical training.

Ostensibly, the core assumption of the Deterioration Index is that traditional triage can be augmented, or perhaps replaced entirely, by machine learning and big data. Indeed, a study of 392 Covid-19 patients admitted to Michigan Medicine that the index was moderately successful at discriminating between low-risk patients and those who were at high-risk of being transferred to an ICU, getting placed on a ventilator, or dying while admitted to the hospital. But last year’s hurried rollout of the Deterioration Index also sets a worrisome precedent, and it illustrates the potential for such decision-support tools to propagate biases in medicine and change the ways in which doctors think about their patients.

Author(s): VISHAL KHETPAL, NISHANT SHAH

Publication Date: 27 May 2021

Publication Site: Undark Magazine

Report and Recommendations of the Task Force on Nursing Homes and Long-Term Care

Mary Pat Campbell

Link: https://nysba.org/app/uploads/2021/06/11.-Task-Force-on-Nursing-Home-and-Long-Term-Care-Report-staff-memo-and-comments-6.11.2021.pdf

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Because of the anticipated need for large numbers of hospital beds, the Governor, in his first Executive Order issued under his emergency powers, authorized hospitals to “rapidly discharge” patients47. An especially important event in terms of the State’s health care capacity occurred on March 23rd. On that date, Governor Cuomo issued an Executive Order requiring that all hospitals cancel elective surgeries to free up hospital beds, and urged that hospitals go beyond the order and increase their capacity by 100%. Health officials said that day that New York had 53,000 hospital
beds with an anticipated need due to COVID-19 of 113,000. Officials also stated that New York had 3,000 ICU beds with an anticipated need due to COVID-19 of 18,000.


Two days later, on March 25th, the Department of Health issued the now infamous Advisory to nursing homes. The Advisory was explicitly issued out of concern for hospital capacity. It said so in its second sentence. “There is an urgent need to expand hospital capacity in New York State to be able to meet the demand for patients
with COVID-19 requiring acute care.” The Advisory went on to state the expectations for nursing homes.

Author(s): New York State Bar Association Task Force on COVID-19 in New York Nursing Homes and Long-Term Care

Publication Date: June 2021

Publication Site: New York State Bar Association

The Challenge of Covid-19 Vaccines for the Immunosuppressed

Mary Pat Campbell

Link: https://www.wired.com/story/the-challenge-of-covid-19-vaccines-for-the-immunosuppressed/?

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Millions of Americans are immunosuppressed or immune-compromised. That is, they take drugs to make sure that a transplanted organ is not rejected or to tamp down the overactive immunity that produces rheumatoid arthritis and lupus; or, alternatively, they have illnesses that undermine their ability to defend against pathogens. A handful of research papers published over the past few months all find the same result: When these patients receive Covid vaccines, their bodies don’t create as many defensive antibodies as those of healthy people. Some have contracted the disease despite being fully vaccinated—meaning that, to protect themselves, they must continue to behave as though their vaccinations never occurred.

As a result, some are seeking extra vaccinations, arranging for third doses that they hope will act like booster shots. A study published Monday in the Annals of Internal Medicine by a team at Johns Hopkins University School of Medicine documents the experience of 30 people living with organ transplants who sought out a third shot in hopes of boosting their immune responses. After their second shots, none of the 30 had high antibody levels; in fact, only six showed any antibody response at all. After the third shot, 14 out of 30 saw some improvement, and 12 of 30 had antibody levels that the researchers considered protective.

Author(s): Maryn McKenna

Publication Date: 16 June 2021

Publication Site: Wired

CDC says vaccine link to heart inflammation is stronger than previously thought

Mary Pat Campbell

Link: https://thehill.com/changing-america/well-being/prevention-cures/558321-cdc-says-vaccine-link-to-heart-inflammation-is

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Males under 30 may face heart problems after getting vaccinated.

Myocarditis and pericarditis share the same symptoms.

Treatment for myocarditis can be solved with over-the-counter medication or resolve itself.

Author(s): Christian Spencer

Publication Date: 14 June 2021

Publication Site: The Hill

Covid vaccine: How many people in the UK have been vaccinated so far?

Mary Pat Campbell

Link: https://www.bbc.com/news/health-55274833

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The UK has four vaccines approved for use: Pfizer-BioNTech, Oxford-AstraZeneca, Moderna and Janssen; three of which require two doses for maximum protection.

The campaign to reach as many people as quickly as possible was boosted by a shift in policy in early January – to prioritise the first dose of a vaccine, with a second dose up to 12 weeks later, a bigger gap than originally planned.

Progress made in the UK so far means the country continues to be among those with the highest vaccination rates globally.

Author(s): The Visual and Data Journalism Team

Publication Date: 15 June 2021

Publication Site: BBC