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The Evolutionary Perspective
Category Archives: Covid-19
Posted: May 16, 2021 at 1:05 pm
A recent headline was straightforward and factual but nevertheless was objectionable to some readers.
The headline in The Oregonian on Wednesday morning said: Unvaccinated 46-year-old Estacada teacher dies from COVID-19.
Ill admit when I saw it on the front-page proof Tuesday night, I paused. Does the headline read as if we are blaming the victim for her own death? And, as a mother myself, I thought of her two teenage children and wondered how they would feel reading the headline.
But I approved it as written. Headlines are difficult to write, especially for print editions where space is limited. Headline writers must succinctly capture the gist of the article in very few words. They also want to use everyday language and make the headline interesting enough that readers will go on to read the article.
They must choose which of many potential angles they will emphasize by calling them out in the headline.
In this case, I think we got it exactly right.
Samantha Fox, 46, was the first teacher known to have died with COVID-19 since the start of the pandemic in Oregon. An obvious reader question is whether she was inoculated with one of three highly effective vaccines that first became available in December, vaccines government officials are promoting as the best chance of ending the pandemic.
Yes, the vaccines are about saving your life, but also the lives of the people around you, President Joe Biden said last month. But theyre also about helping to get us get back to closer to normal.
It would be a reader question regardless, but the controversial decision by Oregons governor in January to prioritize educators over senior citizens for vaccines (when they were much harder to come by) also looms large. Many senior citizens were outraged by the decision when the death toll was highest among the oldest Oregonians.
In addition, the teachers mother spoke emotionally and in detail about the decision not to receive the vaccine, not due to political reasons but because of a dislike of injections and doctors.
Please, Foxs mother, Mary Beck, told reporter Fedor Zarkhin, if you can get the shot, get it.
The news of Foxs death came on the day Gov. Kate Brown announced the overall vaccination rate of Oregonians would be the determining factor for lifting most restrictions for all. Health officials announcing the change noted that vaccinations greatly reduced severe illness, hospitalizations and deaths.
Comments on our Facebook page were mixed on the question of highlighting Foxs unvaccinated status. Many understood immediately why we included it. Others found it to be victim-blaming.
Victim-blaming, the tendency to ascribe the blame for bad things to some choice or action of the victim, is baked into us. Its a psychological defense that allows us to believe -- however inaccurately -- that such bad things will never happen to us, because, after all, we wear our seatbelt religiously, never bike without a helmet, etc.
Other readers saw bias or an attempt to push an agenda in favor of vaccinations.
Brad Schmidt, the editor who has guided our coronavirus coverage over many months, said readers frequently contact the newsroom asking whether people who had died with COVID-19 had been vaccinated. The state health department discloses deaths daily but does not release the vaccination status of each fatality, instead releasing aggregated reports monthly.
So far, state officials have identified just eight people all 70 and older who died despite being fully vaccinated against COVID-19.
In this case, we knew that Fox had not been vaccinated, and we also knew that Foxs mother felt it had cost the family dearly, Schmidt said. The mothers decision to speak about Foxs vaccination status, in an effort to encourage more people to get vaccinated, was central to the story and an important point of clarity to include in the headline.
Some readers also expressed shock that teachers were allowed to skip the COVID-19 vaccines.
One reader wrote: Why was she allowed in the classroom without proof of vaccination? ... If you are drawing a public salary and working closely with the public, you should be required to be vaccinated and happily comply.
Some readers seemed to think Browns decision to place teachers ahead of others somehow meant that all educators would be vaccinated before returning to in-person teaching. Not so. There is currently no requirement that educators receive the vaccine, according to the Oregon Education Association.
Its undeniable that the issue of COVID-19 transmission, or lack thereof, in schools is an important one for teachers, parents and students.
As with all of our pandemic coverage, we seek to be fair, accurate and thorough. Being an honest broker of news and information has never been more important than during this deadly pandemic. We take the responsibility very seriously.
Thanks to our print and digital subscribers who help support such vital local journalism.
Here is the original post:
Posted: at 1:05 pm
The school-age population accounts for a growing share of recent coronavirus cases across northern Michigan. Lisa Peacock, health officer for Otsego County, told NPR that without the school district's help it would be "literally impossible" to keep up with contact tracing. Getty Images hide caption
The school-age population accounts for a growing share of recent coronavirus cases across northern Michigan. Lisa Peacock, health officer for Otsego County, told NPR that without the school district's help it would be "literally impossible" to keep up with contact tracing.
Chris Hodges, the principal of Gaylord High School in Otsego County, Michigan, never thought he'd be a contact tracer.
"I definitely thought, you know, 'Why why am I doing this?'" he says with a laugh. "That's not what I went to school for."
In what has become a regular part of his school day, Hodges fields reports on his charges such as hearing from the Health Department of Northwest Michigan that a student had tested positive for the novel coronavirus, and was in school for three days when she might have been contagious.
One Tuesday in April, after the school day was over, he found himself walking the almost-empty halls with a laptop and a tape measure, making a list of other students who sat close enough to their sick classmate that they would need to quarantine.
Lisa Peacock, health officer for the department, says that without the school district's help it would be "literally impossible" to keep up with contact tracing.
Gaylord High School principal Chris Hodges measures the space between seats in a yearbook class. A student in the class tested positive for covid, and Hodges is working with the local health department to trace people who might have been exposed to her at school. Brett Dahlberg/WCMU hide caption
Gaylord High School principal Chris Hodges measures the space between seats in a yearbook class. A student in the class tested positive for covid, and Hodges is working with the local health department to trace people who might have been exposed to her at school.
The school-age population has accounted for a growing share of recent coronavirus cases across northern Michigan, and Peacock says quickly identifying people exposed to those cases and telling them how to quarantine is crucial to protecting communities and containing spread.
When Hodges first started helping the health department with contact tracing, he found himself calling teachers on weekends, holidays and late in the day after they'd gone home, asking them where a particular student sat and struggling to orient himself in the classroom as they described the student's position over the phone.
It happened so often that he's now requiring each teacher to keep an up-to-date seating chart in a bright-yellow folder on top of their desk, so he can find it easily.
But in this case, the teacher, Hannah Romel, was still at school. The student Hodges was tracing is in her yearbook class, which has different seating arrangements every day. Romel handed Hodges the three charts, and he got to work.
In each place Romel had marked the student, Hodges extended his tape measure to the surrounding desks.
Teachers have spaced their seats out as much as they can, he says, but sometimes they can't quite get to the 6-foot distance required to avoid counting a student as a close contact.
(The federal Centers for Disease Control and Prevention updated its guidance last month to allow for 3-foot distancing between desks, but only in communities where transmission is low. In this district, Superintendent Brian Pearson explains, during Michigan's recent surge in cases, 6-foot separation is the standard.)
Hodges moved quickly, both because if he didn't complete the contact tracing the same day, the school can't open the next, and because he wanted to get in touch with the families of students exposed to the virus right away.
"We want to make those phone calls as soon as we can, so that those students aren't at work, aren't at church, aren't going to other people's houses. We want to prevent the spread of COVID not only inside our walls, but in our community," he says.
Hodges then passes on the information, about who was in close contact with the infected student, to the local health department. Other nearby school districts run similar operations.
Nationally, this kind of relationship between schools and health departments is not typical in normal times, but it is happening with some regularity during the pandemic, according to Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials.
Public health funding has declined over the past few decades, she says, forcing local departments to cut staff members who could have boosted their contact-tracing capacity.
Still, getting schools and health departments to work together can greatly help communities, Casalotti says.
Peacock, the local health officer, says that once her staffers get word of exposures at local schools, they will also get in touch with the families to talk them through the details.
"People always have questions," she says. "They have questions about 'What does this mean? What does it mean that I'm quarantined for 14 days?' We recognize that."
And, in some cases, the health department needs more information than Hodges can give, Peacock adds. They might want to find out whether a coronavirus variant is at play, or do a more detailed investigation of how students got sick and where they were, when they were contagious.
Back in Romel's yearbook classroom, Hodges found two students had sat within an area just shy of 6 feet from their classmate who tested positive. They'll need to quarantine for two weeks from the date of this last exposure.
Romel says she's still surprised when she gets the news that a student has gotten sick or infected.
"I worry about the kid," she says. "I hope that it's a mild case, and they get to just be OK and get back to school after their quarantine period and come back and be learning with us again."
After a quick chat with Romel about whether the class did any group work on the days in question (they didn't, which Hodges says is a relief, because it complicates his process), he headed off to the next classroom.
In all, 14 students will be quarantined as a result of exposure to this coronavirus case.
That sounds like a lot, but Hodges says that's a far cry from a single day last month, when 15 students tested positive, and each of them had several close contacts. The number of students who had to quarantine from those potential exposures was in the dozens.
Making phone calls to families informing them their child will need to stay home from school for up to two weeks is not an enjoyable part of the day, for him or the families, said Hodges, but in the long run he's gratified to play a role in mitigating the extent of the pandemic.
This story comes from NPR's reporting partnership with WCMU and KHN.
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Posted: at 1:05 pm
How this hurts the Blues
Jeremy Rutherford, Blues beat writer: If Perron has indeed tested positive for COVID-19, and he's not a "false positive," which the Blues have had a couple of cases of, then this is extremely difficult news for the club.
Ryan O'Reilly may be the captain and the heart of the Blues, but Perron is equally important to the team's success,
Perron had three points (1G, 2A) in Thursday's 7-3 victory over Minnesota, becoming the first player since Pavol Demitra in 2002-03 to average a point-per-game for the Blues in the regular season.
Rutherford: Perron could miss as much as two weeks in quarantine, which means this could be the end of his season if the Blues are eliminated by the Avalanche in the first round.
Perron is the third Blues player to be added to the list recently, joining Walman and Walker. The Blues thought that Walman was a false positive because he had been vaccinated, but it turned out to be a true test. He has missed the last three games. Walker was on the taxi squad and was recently assigned to the AHL.
Rutherford: It's doubtful that the NHL would consider postponing playoff games, but it's too soon to speculate at this point.
The Blues will continue to be tested, and if no further positive cases come up, then the league would assuredly go on with the series as scheduled. But the concern for the club is going to be if it's facing some sort of outbreak with three players being adding to the COVID-19 list within the last week.
Sources have told The Athletic that all but eight Blues players were vaccinated. But with Walman testing positive after being vaccinated, there has to be worry within the organization.
(Photo: Scott Rovak / NHLI via Getty Images)
Here is the original post:
Posted: at 1:05 pm
COVID-19 is a respiratory disease caused by a type of coronavirus that emerged in late 2019 called SARS-CoV-2.
Most people with COVID-19 develop mild illness. Older adults and people with existing conditions like diabetes, cancer, or kidney disease are at the highest risk of developing severe symptoms. Its estimated that more than 80 percent of COVID-19 deaths are in people over 65.
The coronavirus can attack your lungs and heart. It can cause chest pain or a burning sensation in your lungs. The Centers for Disease Control and Prevention (CDC) lists persistent pain or pressure in your chest as a sign that you should seek emergency medical care for COVID-19.
Keep reading to learn why COVID-19 sometimes causes chest pain and when you should seek medical attention.
Burning in your chest can have many potential causes that range from mild to life threatening.
Visit a doctor right away if your chest pain is intense or accompanied by other concerning symptoms. Its especially critical to see a doctor if youre at risk of heart or lung problems.
Go to the nearest emergency room or call 911 if you have the following symptoms:
Chest pain or burning can be a sign of COVID-19. Discomfort in your chest may occur along with shortness of breath or trouble breathing. Studies have found that up to 17.7 percent of people with COVID-19 report chest pain.
People with severe COVID-19 are more likely to report trouble breathing or chest pain than people with mild illness. Research has found that chest pain is reported about three times more often in people who die from COVID-19 than those who survive.
Its thought that chest pain may be a result of heart injury or inflammation of the tissues surrounding the lungs.
The coronavirus can enter your cells through a receptor called angiotensin converting enzyme 2 (ACE2). ACE2 is found in many parts of your body, including your lungs, heart, and gastrointestinal tract. Once the virus enters your cells through ACE2, it can lead to cellular damage and inflammation.
The release of molecules called inflammatory cytokines by your immune system may also cause damage to heart cells. This phenomenon is called cytokine storm syndrome.
Its been suggested to contribute to left ventricle dysfunction (or weakness of the heart muscle) in people with COVID-19 who also have heart complications. Lung dysfunction and low oxygen levels can also contribute to heart damage.
People with a history of cardiovascular disease seem to be at an elevated risk of heart damage. A July 2020 study found approximately 30 to 60 percent of people with heart injury have a history of coronary heart disease or high blood pressure.
The pleural space is an area between layers of the sac that surrounds each of your lungs. Inflammatory molecules released into the pleural space can trigger pain receptors and potentially cause chest pain or burning.
COVID-19 can also lead to the development of pneumonia, which can cause chest pain. Pneumonia is an infection of the alveoli of your lungs. Your alveoli are the tiny air sacs where oxygen and carbon dioxide exchange occurs.
Experiencing throat and chest burning together can be a symptom of COVID-19. COVID-19 has been linked to symptoms like throat pain and acid reflux.
In an August 2020 study, researchers found that in a group of 405 people with COVID-19, 61.2 percent had digestive symptoms. About a quarter of them had a previous history of gastrointestinal disease.
The most common digestive symptoms reported were:
Many other conditions besides COVID-19 can cause burning or pain in your throat and chest. Some potential causes include:
Some people with COVID-19 may experience a burning feeling in their stomach and chest together. Vomiting, acid reflux, and diarrhea may all contribute to discomfort in or around your stomach.
Some other potential causes include:
The CDC lists the following as emergency symptoms of COVID-19. If you notice any of these symptoms or anything else concerning, you should seek emergency medical care:
COVID-19 affects People of Color differently. People of certain races and ethnicities have a higher risk of developing severe symptoms or dying from COVID-19.
One reason for this is systemic racism and healthcare inequities, which elevate the risk of developing underlying health conditions, affect socioeconomic status, and limit access to quality healthcare. All these factors play a role in determining the risk of certain groups.
The CDC reports the following risk ratios compared with white, non-Hispanic people:
Researchers are continuing to examine the side effects of COVID-19 vaccines. Vaccines can potentially cause a burning sensation in the chest in rare instances. The most typical side effects of vaccines include:
One June 2021 case study describes a 56-year-old man who went to the emergency room after chest pain onset 3 days after the second dose of the Pfizer-BioNTech vaccine.
The chest pain resolved after 4 hours. The man spent 7 days in the hospital, and acute myocarditis was suspected. Acute myocarditis is inflammation of the heart muscle tissue.
Skin-related side effects of COVID-19 are relatively common. An April 2021 study looking at side effects of the Pfizer-BioNTech COVID-19 vaccine in Czech healthcare workers found that 5.2 percent of people experience at least one skin-related side effect.
A rash was the most common side effect, and the chest and trunk were the second most common location affected behind the arms.
A burning sensation in your chest has many possible causes. If your chest pain is persistent and accompanied by other COVID-19 symptoms, its a good idea to seek medical attention.
If your pain is accompanied by any of the following symptoms, its also a good idea to see a doctor:
Chest pain or burning can potentially be a sign of COVID-19. Chest pain is more common in people with severe COVID-19 than mild illness.
A burning sensation in your chest can have many other potential causes that range from mild to potentially life threatening. Its critical to seek emergency medical attention if your chest pain is accompanied by warning signs of a heart attack, such as pain that spreads down your arm, neck, or back.
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Posted: at 1:05 pm
A light micrograph of a mature sporangium of a mucor fungus. India is seeing a rise in cases of mucormycosis, a rare but dangerous fungal infection. Smith Collection/Gado/Getty Images hide caption
A light micrograph of a mature sporangium of a mucor fungus. India is seeing a rise in cases of mucormycosis, a rare but dangerous fungal infection.
It's called the "black fungus," and it can be deadly. It's also adding to India's growing COVID-19 woes at the moment.
On Sunday, the Indian Council of Medical Research and India's Health Ministry issued an advisory calling for better awareness, screening and management of mucormycosis, a rare but dangerous fungal infection.
"While exact numbers are not available, we're seeing a rise in cases in Delhi, Gujarat and Maharashtra," says Dr. Aparna Mukherjee, a scientist at the Indian Council of Medical Research and one of the experts who wrote the advisory.
The symptoms of mucormycosis are mild at first and can often be missed in the initial stages.
Dr. Ronak Shukla, an ear, nose and throat doctor assigned to COVID-19 care at the government-run LG Hospital in Ahmedabad, treated a 35-year-old male patient who recently recovered from COVID-19 after being administered oxygen for a week in the intensive care unit. Several days after recovering from COVID-19, the patient was back, complaining of an intense headache, pain in the sinus area and the right eye, blurred vision and swollen cheeks. An endoscopic examination revealed discoloration a blackened area around the nasal sinuses.
The disease progresses rapidly and "attacks blood vessels and live tissues," Shukla says. "As it kills them, it turns them all black and that's where [the disease] gets the name 'black fungus.' " In just three days, it can spread to the eyes or the jawbone. In such cases, the only way to stop the spread to the brain is to remove the infected eye or jawbone surgically.
"Once it spreads to the brain, the fatality rate is over 50%. It's sad to think that people who've gone through the immense distress of COVID now have to deal with this severe disability as well," he says.
Mucormycosis isn't a new disease, Shukla says. It's caused by a group of molds, called mucormycetes. Individuals are infected after inhaling fungal spores found naturally in India's environment and soil. "For most people with a healthy immune system, exposure to the fungus really won't matter," he says. "They won't get sick."
India's current battle with COVID-19 may be brewing many of the complications that are leading to an unprecedented rise in these cases, doctors suggest. India has reported 23 million COVID-19 infections and a death toll of more than 250,000 people, accounting for 1 in 5 active infections worldwide.
"Mucormycosis is an opportunistic infection," Mukherjee says. "Before COVID, people were far more likely to contract it only if they were in a situation where their immunity was weak, say after an operation, a prolonged hospital stay or [an organ] transplant, but today COVID-19 has weakened immunity considerably, leaving more people vulnerable to the disease."
Shukla says there are now 100 cases in public hospitals in Ahmedabad, when previously, there were only two to three cases a year.
People who have gotten sick with mucormycosis have had three factors in common, says Dr. Devashish Palkar, a psychiatry resident now treating COVID-19 patients in critical care at the government-run New Civil Hospital in Surat. Thirty cases of mucormycosis have been admitted to the hospital over the past week, he says, and new cases are popping up every day. "COVID-19 is the main culprit, followed by uncontrolled or newly diagnosed diabetes. And finally, the added effects of steroids which though are lifesaving drugs can render you immunocompromised if used at higher doses than recommended or for a longer duration."
"We need to find a way to moderate the drugs," Palkar says, "but with such virulent attacks of COVID, the patient might die without the medication."
Treatment for mucormycosis involves identifying the condition in infected patients quickly, removing all infected tissue through surgery and following up with an antifungal injection called Amphotericin B. The injection costs 3,000 rupees ($40) in India. It has to be administered every day for 21 to 42 days. States such as Mumbai are now making the injections available free at public hospitals since their cases are rising, too. Rajesh Tope, health minister of Maharashtra, says the state may have over 2,000 cases of mucormycosis.
Timely intervention helped save his patient, Shukla says, and he did not suffer other complications.
But as the pandemic rages in India, hospital hygiene will eventually need to come into scrutiny. "If the hygiene in hospitals isn't adequate, then the damp [and dirty] surfaces [such as hospital devices and equipment] can breed the fungal spores, exposing patients when their immunity is most compromised," Shukla says.
COVID-19 patients using oxygen concentrators are also at risk, Shukla says. The devices come equipped with a humidifier bottle to prevent the patient's airways from becoming too dry while breathing directly from the concentrator. But it's where fungal spores can thrive. "If the humidifiers are not properly cleaned or if they don't work, then the chances of contracting mucormycosis are higher," Shukla says.
Even though it's an invasive disease, it can be treated, so there's nothing to panic about right now, Mukherjee says. The advisory was issued to create a greater awareness of the condition among medical professionals who may not have seen many cases. "At the moment, we need to suspect it early and detect it early to save lives," she says.
Kamala Thiagarajan is a freelance journalist based in Madurai, India, who has written for The International New York Times, BBC Travel and Forbes India. You can follow her @kamal_t.
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KFF COVID-19 Vaccine Monitor: COVID-19 Vaccine Access, Information, and Experiences Among Hispanic Adults in the US | KFF – Kaiser Family Foundation
Posted: at 1:05 pm
The KFF COVID-19 Vaccine Monitor is an ongoing research project tracking the publics attitudes and experiences with COVID-19 vaccinations. Using a combination of surveys and qualitative research, this project tracks the dynamic nature of public opinion as vaccine development and distribution unfold, including vaccine confidence and acceptance, information needs, trusted messengers and messages, as well as the publics experiences with vaccination.
The COVID-19 pandemic has taken a stark disproportionate toll on people of color, including the Hispanic population. Hispanic people have faced increased risk of exposure to the virus as many are employed in essential jobs that cannot be done from home and live in larger, multigenerational households. Reflecting these increased risks, Hispanic people have suffered higher rates of COVID-19 infection, hospitalization, and death compared to their White counterparts. Despite being harder hit by the pandemic, Hispanic people have been less likely than White people to receive a COVID-19 vaccine so far. These disparate impacts of the COVID-19 pandemic have exposed and exacerbated longstanding underlying disparities in health and health care facing Hispanic people. Prior to the pandemic, these disparities had already been compounded by immigration policies implemented during the Trump administration that increased fears among immigrant families and made some more reluctant to access programs and services, including health coverage and health care. Although the Biden administration has since reversed many of these policies, they may continue to have lingering effects among families.
This report from the KFF COVID-19 Vaccine Monitor is based on interviews with 778 Hispanic adults in the U.S., including 334 conducted in Spanish and 408 with adults born outside the U.S., including 185 who indicated that they do not have lawful permanent resident status (referred to in this report as potentially undocumented). It provides insights into how Hispanic adults have been affected by the COVID-19 pandemic and their access, information, and experiences with COVID-19 vaccinations. Moreover, it illustrates the varied experiences within the Hispanic population, including describing the experiences of Hispanic immigrants, for whom data remain limited. Throughout this report, Hispanic adults include people of any race, other groups (i.e., White and Black adults) are non-Hispanic.
The survey findings reveal that Hispanic adults have substantial fears about getting sick from coronavirus, and that many have close connections to people who have gotten sick or died from COVID-19. They also highlight the widespread negative financial impacts of the pandemic for Hispanic adults. In addition, they provide insight into how immigration-related fears may be affecting Hispanic adults willingness to participate in assistance programs for food, housing, and health care, at a time when many have growing needs due to the financial impacts of the pandemic.
About two-thirds of Hispanic adults say they are worried that they or someone in their family will get sick from coronavirus, including 41% who say they are very worried. The share saying they are very worried is higher among Hispanic adults than among Black adults (30%) and is four times the rate among White adults (10%). Worries about getting sick from coronavirus are even more prevalent among Hispanic immigrants, particularly those without permanent resident status. Seven in ten (69%) of potentially undocumented Hispanic adults say they are very worried about themselves or a family member getting sick from COVID-19 as are over half (57%) of foreign-born Hispanic adults with permanent resident status. Among U.S.-born Hispanic adults (who are much younger on average than their foreign-born counterparts), one quarter (24%) express this level of worry. There also are stark differences in levels of concern among Hispanic adults by language spoken and household income, with nearly three in four (73%) of Hispanic adults who completed the survey in Spanish and over half (53%) of those in lower income households reporting being very worried about getting sick.
This higher level of worry is not unfounded, as Hispanic adults are more likely than White adults to report close connections to someone who has gotten sick or died from coronavirus. Nearly three in ten (28%) of Hispanic adults say they or someone in their household has tested positive for coronavirus, higher than the shares of Black (21%) and White adults (18%). This share rises among Hispanic adults born outside the United States, including 40% of the potentially undocumented. About four in ten (38%) Hispanic adults say a close friend or family member has died from coronavirus, similar to the 34% among Black adults and higher than the 18% among White adults. There were no major differences in the likelihood of having a close friend or family member die by immigration status.
The pandemic has also taken a disproportionate financial toll on Hispanic families in the United States. About half (48%) of Hispanic adults say the pandemic has had a negative effect on their personal financial situation, higher than the share of White adults who say the same (36%). Among those with lower household incomes (under $40,000 per year), 56% of Hispanic adults say their financial status has been negatively affected by the pandemic, higher than the shares among lower-income Black or White adults (42% each). There were no major differences in the likelihood of reporting negative financial effects by immigration status. However, a 55% majority of Hispanic adults who completed the survey in Spanish say their financial situation has been negatively impacted by the pandemic, higher than the four in ten (43%) of English-speaking Hispanic adults who report being negatively affected.
Some Hispanic adults, particularly those who are potentially undocumented, report that they have avoided seeking assistance for food, housing, and/or health care due to immigration-related fears. The Trump administration implemented a range of immigration policy changes, including changes to public charge policy, that increased fears among immigrant families and made some more reluctant to access programs and services, including health coverage and care. While the Biden administration has since reversed many of these policies, they may continue to have lingering effects among families at a time when many are facing growing needs due to the pandemic.
Overall, one in ten Hispanic adults (11%), say there was a time in the past 3 years when they or a family member decided not to apply for or stopped participating in a government assistance program because they were afraid it might negatively affect their or a family members immigration status. Across Hispanic adults overall, 6 percent say they did not apply for or stopped participating a program to help with food, 4 percent say assistance for housing, and 3 percent say a health care program.
The share saying they or a family member did not apply for or stopped participating in a program in the past 3 years due to immigration-related fears increased rises to 26% among potentially undocumented Hispanic adults. Among potentially undocumented Hispanic adults, 21% say they did not apply for or stopped participating a program to help their family with food, 12 percent say assistance for housing, and 11 percent say a health care program. While undocumented immigrants generally are not eligible for any federally-funded assistance, many live in mixed immigration status families, including other family members such as U.S.-born citizen children, who may qualify for assistance.
Nearly half (47%) of Hispanic adults say they have already received at least one dose of a COVID-19 vaccine and another 17% say they intend to get one as soon as they can. The share of Hispanic adults who say theyve received at least one dose of the vaccine is lower than the share among White adults (60%), while a larger share of Hispanic adults compared to White adults say they will wait and see how the vaccine is working for other people before getting vaccinated themselves (18% vs. 13%). Nearly one in five (17%) Hispanic adults report that they have not yet been vaccinated but want to get one as soon as possible, higher than the shares among White adults (6%) and Black adults (9%).
Among those who have not yet been vaccinated, Hispanic adults are twice as likely as White adults to say they want to get a COVID-19 vaccine as soon as they can, making them a key target for outreach and information. Looking just at those adults who have not yet received a COVID-19 vaccine, one-third of Hispanic adults say they want to get one as soon as they can compared to 16% of White adults and 17% of Black adults. By contrast, larger shares of unvaccinated White and Black adults compared to Hispanic adults say they will definitely not get a COVID-19 vaccine (34%, 26%, and 17%, respectively).
Some groups of Hispanic adults are more likely to say they have not yet gotten the vaccine but want to get one as soon as possible, suggesting they are particularly likely to face access barriers to getting the vaccine. For example, three in ten (31%) of potentially undocumented Hispanic adults report having gotten a COVID-19 vaccine, and nearly four in ten (37%) want one as soon as possible but havent yet gotten one. This finding is similar for uninsured nonelderly Hispanic adults, with about three in ten (29%) of this group reporting receiving the vaccine and another 30% wanting one as soon as possible. Adults who completed the survey in Spanish are also more likely than English speaking adults to say they want a vaccine as soon as possible, but this largely reflects a higher share of English-speaking Hispanic adults saying that they do not plan to get the vaccine.
Among Hispanic adults, divides in COVID-19 vaccination intention by age, education, and partisanship mirror those seen in the general population. Large majorities of Hispanic adults ages 50 and over say theyve already gotten at least one dose of the vaccine or will do so as soon as possible (85% of those ages 50-64 and 88% of those ages 65 and over). By contrast, larger shares of younger Hispanic adults say they want to wait and see how the vaccine is working (20% of those ages 30-49 and 31% of those ages 18-29). Similarly, Hispanic adults who identify as Democrats or lean that way are much more likely than those who identify or lean Republican to say they have either gotten a vaccine or will do so as soon as they can, while Republicans are more likely to say they will definitely not get vaccinated. Hispanic adults with a college degree are more likely than those with lower levels of education to say theyve already gotten a COVID-19 vaccine (61% vs. 45%), while those who are not college graduates are more likely to say they have not been vaccinated but want to do so as soon as possible (18% vs. 10%), suggesting possible access barriers for this less-educated group, similar to the groups mentioned above.
Among those who report receiving a COVID-19 vaccine, Hispanic adults are more likely than White and Black adults to report getting their vaccine through a community health clinic. The most common place people report receiving a COVID-19 vaccine across race and ethnicity groups is a large vaccination site. At least one-third of those who have received at least one dose of a vaccine reporting receiving it there (35% of vaccinated Hispanic adults, 37% of Black adults, and 35% of White adults). Consistent with other analysis showing community health centers are vaccinating larger shares of people of color, particularly Hispanic people, over one in five (22%) vaccinated Hispanic adults reported getting their vaccine at a community health clinic, twice the share of White (11%) and Black (10%) vaccinated adults who report the same. Among Hispanic adults, 30% of those who completed the interview in Spanish say they got vaccinated at a community health clinic compared to 17% of those who completed the interview in English. There were no significant differences in the share of Hispanic adults getting vaccinated at a community health clinic by immigration status or income.
Hispanic adults are less likely than White adults to report signing up for a vaccine appointment online. Among those who have gotten a vaccine or have tried to get an appointment, about half of Hispanic adults (48%) either signed up or tried to do so online compared to nearly six in ten White adults (58%). A quarter (25%) of Hispanic adults say they signed up or tried to sign up by phone, and another 16% scheduled or sought to schedule an appointment in person.
Many Hispanic adults report being asked for certain types of information or documentation when they signed up for or received a vaccine that may pose barriers to getting the vaccine for some. The COVID-19 vaccines are available for free regardless of insurance status. Some vaccine providers request health insurance information from people receiving the vaccine in order to bill for the cost of administering the vaccine, which may lead some people to be confused about whether uninsured people can get the vaccine or if they have to pay to receive one. The federal government has also clarified that vaccines are available to individuals regardless of immigration status. Despite this, requests for information and/or documentation to provide proof of identity or residency may vary across states, localities, and vaccination providers. For example, in some cases, individuals are being requested to provide government-issued identification or a Social Security number, while others provide a range of options to prove identity or residency, including self-attestation, and specify that a Social Security number is not required.
Among all Hispanic adults who made or attempted to make an appointment to receive a vaccine, about a third (32%) report being asked to provide health insurance information when making an appointment. Four in ten (42%) say they were asked to provide a government-issued identification and 14% say they were asked to provide a Social Security number. Among those who have been vaccinated for COVID-19, over half (56%) say they were asked for their ID at the vaccination site, 23% were asked for insurance information and 15% report being asked to provide a Social Security number.
Hispanic adults who have not yet been vaccinated for COVID-19 are more likely than White adults to express concerns that reflect access-related barriers to vaccination. Although potential side effects and vaccine safety are the top-ranked concerns among Hispanic adults who have not yet been vaccinated for COVID-19, many also report concerns related to potential challenges getting the vaccine. Among unvaccinated Hispanic adults, nearly two-thirds (64%) are concerned about missing work due to side effects, over half (52%) are worried they might have to pay out of pocket for the vaccine, and nearly half are concerned they wont be able to get the vaccine from a place they trust (49%), shares that are significantly larger than their White counterparts.
Notably, among Hispanic adults who say they have not yet been vaccinated but want to do so right away, six in ten are concerned that they wont be able to get the vaccine from a place they trust (61%) or that they might have to pay an out-of-pocket cost to get the vaccine (59%) and half (52%) are concerned about missing work due to vaccine side effects, highlighting that access remains a barrier even for those in the most eager group.
Because the Hispanic population includes higher shares of noncitizens compared to other groups, immigration-related concerns may also particularly affect this population. Four in ten unvaccinated Hispanic adults (39%) are concerned they might be required to provide a Social Security number or government-issued identification in order to get vaccinated, and just over a third (35%) are concerned that by getting the COVID-19 vaccine they might negatively affect their own or a family members immigration status.
Among unvaccinated Hispanic adults, those who are potentially undocumented, those without health insurance, and those with lower household incomes are more likely to express potential access-related barriers or immigration-related concerns to vaccination. The top access-related concern across these groups is that they might have to miss work due to side effects. Not surprisingly, potentially undocumented Hispanic adults are particularly concerned they may need to provide a Social Security number or government issued ID to get the vaccine (58%), and nearly two thirds (63%) are concerned getting the vaccine might negatively affect their or a family members immigration status.
In addition, unvaccinated Hispanic adults who are uninsured are more likely than those who have health insurance to say they are concerned about not being able to get the vaccine from a place they trust, being required to provide a Social Security number or government-issued ID, or negatively impacting their own or a family members immigration status.
Compared to their higher-income counterparts, unvaccinated Hispanic adults with incomes under $40,000 a year are more likely to say they are concerned about missing work due to COVID-19 vaccine side effects, having to pay an out-of-pocket cost to get vaccinated, negatively affecting someones immigration status, and having difficulty traveling to a vaccination site.
Strategies that address access-related concerns may be particularly effective for increasing enthusiasm to get the COVID-19 vaccine among Hispanic adults. For example, nearly half of Hispanic adults who have not gotten the vaccine and are not ready to get it right away (46%, rising to 64% among those born outside the U.S.) say theyd be more likely to get a COVID-19 vaccine if it was offered to them at a place they normally go to health care, compared to 23% of White adults. Four in ten Hispanic adults in this group (39%, rising to 49% of foreign-born) would be more likely to get vaccinated if they only needed to get one dose compared to a quarter (25%) of White adults. Over half (54%) of employed Hispanic adults who are not yet ready to get the vaccine say they would be more likely to get it if their employer gave them paid time off to recover from side effects compared to 19% of employed White adults. In addition, four in ten (38%) employed Hispanic adults in this group say they would be more likely to get vaccinated if their employer arranged for a medical provider to administer the vaccine at their workplace, compared to 14% of their White counterparts.
Certain financial and travel-related incentives may also be particularly effective in increasing vaccine enthusiasm among Hispanic adults, especially those born outside the United States. Over four in ten (41%) of Hispanic adults (including 63% of those born outside the US) who are not yet ready to get the vaccine say theyd be more likely to get vaccinated if it was required for international travel compared to 17% of White adults. There are also differences in responses to employer incentives to get vaccinated. Nearly four in ten (38%) of employed Hispanic adults who are not yet ready to get the vaccine said they would be more likely to get it if their employer offered them a $200 incentive to get vaccinated, versus 22% of their White counterparts.
Increased outreach and education about how, where, and when to the vaccine may also facilitate increased vaccinations among the Hispanic population. Increasing awareness that the vaccine is free regardless of insurance status and available to all individuals regardless of immigration status may also encourage vaccination among those concerned about costs or potential negative immigration-related consequences.
Larger shares of Hispanic adults compared to White adults report lacking information about when and how to the get the vaccine, with particularly large information gaps among those who are foreign-born, who are Spanish-speakers, and who have lower incomes. Despite broadened eligibility for vaccines across states, 42% of unvaccinated Hispanic adults (compared to 26% of unvaccinated White adults) say they are unsure if they are eligible to receive the vaccine in their state, with this share rising to 57% among the potentially undocumented, 49% among Spanish speakers, and 47% with household incomes below $40,000. Similarly, 29% of Hispanic adults overall say they dont have enough information about where to get a vaccine, including higher shares of potentially undocumented (43%) and Spanish-speaking (38%) Hispanic adults. Nearly half of all unvaccinated Hispanic adults (45%) say they lack information about when they can get a vaccine, and this share rises to more than half among those who are potentially undocumented (58%), those who completed the interview in Spanish (56%), and those with household incomes under $40,000 a year (54%).
Most Hispanic adults who completed the survey interview in Spanish (68%) say it is either very easy or somewhat easy to find COVID-19 vaccine information in Spanish, but 27% say it is at least somewhat difficult. Similarly, most Spanish speakers say they were able to access information or communicate in their preferred language when making their vaccine appointment (68%) and when getting their vaccine (77%), but some say they were not able to communicate in their preferred language when making an appointment (26%) or getting the vaccine (22%).
There are gaps in knowledge that the vaccine is available for free among unvaccinated Hispanic adults. Roughly half (46%) of unvaccinated Hispanic adults know that the vaccine is available for free even for those without health insurance while 9% believe this is not the case and four in ten (43%) are not sure. More than half (54%) of unvaccinated Hispanic women know that vaccines are available for free while four in ten (39%) of Hispanic men are also aware of this. Knowledge that the vaccine is available for free is higher among unvaccinated Hispanics who completed the survey in Spanish (60%) versus those who completed it in English (37%). Among Hispanic adults ages 18-64 who have not yet gotten vaccinated, similar shares of those with and without health insurance are aware that the vaccine is available regardless of health insurance status (47% and 44%, respectively).
There also are gaps in knowledge about the vaccine being available to all people regardless of immigration status among unvaccinated Hispanic adults. The federal government has clarified that all people are eligible to receive the COVID-19 vaccine regardless of immigration status. Four in ten unvaccinated Hispanic adults (42%) are aware that all adults living in the U.S. are eligible to receive a vaccine regardless of their immigration status, larger than the share of unvaccinated Black adults (15%) and White adults (27%) who know this is true. Yet, 9% of Hispanic adults believe it is not the case that all adults are eligible to get the vaccine regardless of immigration status and nearly half (48%) are not sure. Among unvaccinated Hispanic adults, a larger share of those who completed the survey in Spanish know that the vaccine is available regardless of immigration status compared to those who completed the survey in English (55% vs. 33%). Hispanic adults who are potentially undocumented are somewhat more likely than those born in the U.S. to incorrectly say it is not true that U.S. residents are eligible to get the vaccine regardless of immigration status (14% vs. 5%), while those born in the U.S. are more likely to say theyre not sure (56% vs. 35%).
Together these findings suggest that addressing access barriers and providing information through outreach and education efforts will be key for closing ongoing racial disparities in COVID-19 vaccinations for Hispanic adults. They indicate that increasing access to paid time off to get and recover from any side effects from the vaccine and making vaccines easily accessible through trusted sites of care and workplaces may facilitate uptake of vaccinations among Hispanic adults. Moreover, they highlight continued needs for outreach and education efforts within the Hispanic community to communicate how and where to get the vaccine and to clarify that the vaccines are free regardless of insurance status, that they are available to all people regardless of immigration status, and that receiving a vaccine will not negatively affect an individuals current or future immigration status. The findings also reinforce why prioritizing equity in COVID-19 vaccinations is key, given the disproportionate health and economic impacts of the pandemic for Hispanic families and other people of color.
Posted: May 4, 2021 at 8:12 pm
Austin, Texas Austin Public Health (APH) updatedthe COVID-19 Risk-Based Guidelinestoday, May 4, to clarify personal behavior recommendations for those who are fully vaccinated versus those who are partially or not vaccinated.
Individuals who are vaccinated may:
Individuals who are partially or not vaccinated may:
Regardless of vaccination status or stage, individuals need to continue to follow the additional requirements of local businesses, venues and schools, as theHealth Authority Rulesremain in place through May 18.
We want people to getvaccinated, said Dr. Mark Escott, Interim Austin-Travis County Health Authority. Now andcertainly in the future asthe vaccination rate improves,there will be improved freedom associated withvaccination. In other words, the need to continue masking and the other necessary precautionswill continue to decrease for those who are vaccinated.
Additionally, the threshold to enter Stage 2 has been updated to 5-14 new hospital admissions on the 7-day moving average. The threshold to enter Stage 1 has also been updated to less than 5 new hospital admissions on the 7-day moving average or 70%-90% herd immunity is achieved through vaccination.
While APH monitors the 7-day moving average of COVID-19 new hospital admissions as the primary key indicator for the Risk-Based Guidelines, additional key indicators, including positivity rate, the doubling time of new cases and current ICU and ventilator patients, are monitored to determine the current staging.
As a result of both declining length of hospital stays and declining mortality rates, we feel comfortable reassessing the transition of stages, added Dr. Escott. We expect that there isgoing to be a long tail interms of achieving vaccine herdimmunity or completely getting COVID-19 out of our community. So, we expect that we may seea slow decliningplateau of cases, and as thevaccination rate improves inthe community, and we hit70% to 90% vaccinated we could lookat transitioning to Stage 1 safely.
Austin-Travis County remains in Stage 3 of the Risk-Based Guidelines, with acurrent 7-day moving average of new hospital admissions of 17.
For additional COVID-19 information and updates, visitwww.AustinTexas.gov/COVID19.
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Posted: at 8:12 pm
Rajat Arora, an interventional cardiologist, is the managing director of the Yashoda Hospital and Research Centre, a medical system that operates several hospitals in and around New Delhi. For the past year, Arora and his team have designated two specific hospitals for their systems COVID-19 patients. Situated in the city of Ghaziabad, just east of Delhi, the hospital that Arora looks after is large and modern, with a full range of subspecialties; it has two hundred and forty COVID beds, including sixty-five in the adult I.C.U. and fifteen in a pediatric I.C.U.
India, like the rest of the world, has struggled with the coronavirus. The number of patients at the COVID hospital reached a hundred and thirty in the fall. Still, by December of 2020, life in Delhi had almost returned to normal. Temples had been opened for worship, political rallies had resumed, and Indias famously large wedding celebrations were back on. Aroras COVID hospital was never stretched beyond capacity and was always flush with supplies and medications; in February, it was caring for fewer than ten coronavirus patients at a time, and many had symptoms of long COVID, not acute infection. The rest of the hospital provided cardiac care, elective surgeries, and labor and delivery services. It came as a surprise to Arora, therefore, when he contracted the virus, in late January. Everyone said, COVID is gonewhere the hell did you get COVID? This is such a random time to get COVID, he told me. All around him, he recalled, a sense of triumph had settled in: people asked, Are we immune to this disease? and Did we win the war?
For Arora, as for many Indians, the apocalyptic COVID-19 surge the country now faces was unexpected. In March, cases started to rise in the western state of Maharashtra, home to Mumbai. We thought it would be like the first wave, Arora said. We thought things would pick up but pretty much be manageable. You always reason from your past experience. Today, India is home to the worst coronavirus outbreak in the worlda medical and humanitarian crisis on a scale not yet seen during the pandemic. Though the reported case numbers are in the hundreds of thousands, some experts estimate that millions of Indians are infected each day; thousands are dying, with more deaths going uncounted or unreported. More than one in every five coronavirus tests returns positivea marker of insufficient testing and rampant viral spread. Hospitals are running out of oxygen, staff, and beds; makeshift funeral pyres burn through the night as crematoriums are flooded with dead bodies.
Arora, like leaders at other Indian hospitals, now regularly hears that critical supplies and medications could run out at his hospital in days or hours, if they havent already. He is constantly working the phones to procure whats needed for basic COVID-19 care: oxygen, ventilators, immunosuppressive medications, antiviral drugs, and the like. Day and night, these calls are interspersed with pleas from increasingly desperate patients or their families, who ask and sometimes beg for admission. Almost always, Arora has to refuse. His hospital can admit around thirty patients per day, based on the number of discharges and deaths; he estimates that he and other hospital administrators receive upward of a thousand requests daily. Aroras cousin, a woman in her thirties, is currently admitted. After arriving, she required escalating doses of oxygen and needed I.C.U.-level care, but Arora was unable to get a bed for her until nearly half a day had gone by. Theres nothing we can do until someone gets better or someone dies, he said. If I put up a thousand-bed hospital today, it would be full in an hour.
Not infrequently, Arora receives messages from families of patients to whom he refused admission and who later died. The other day, a loved one of a previously healthy, thirty-nine-year-old man texted Arora that if he had given her just two minutes of his time the man would have survived. Not long afterward, Arora received a message from another mans son: My father left us, he wrote. I begged you Doctor. Last week, a young girl called him in the middle of the night on behalf of her father, whose breathing was rapidly deteriorating. The I.C.U. was filled past capacity, and Arora couldnt admit him. The next day, the girl told Arora that her father had died and that now her mother was struggling to breathe. Arora treated the mother in the emergency room, and she survived.
In addition to a shortage of beds, Aroras hospital doesnt have enough medications. Supplies of the immunomodulator drug tocilizumab, which is given to patients to treat the immune-system storm that can devastate the lungs and other organs, are in short supply. The scarcity of the antiviral drug remdesivir has given it an almost mythic status. Some studies have found that the medication confers a modest benefitshortening the duration of COVID-19 symptoms by a few daysbut others suggest that its no better than a placebo. (Its routinely given in the U.S., but the W.H.O. recommends against it.) Nonetheless, everyone is desperate for it, Arora said. We dont have much else in our armamentarium. He estimates that his hospital has enough remdesivir for about a fourth of eligible patients. At some Indian hospitals, patients are ableeven encouragedto bring in scarce medications and supplies, if they can procure them. Some of Aroras patients have turned to the black market, paying thousands of dollars for a vial of remdesivir, only to learn that its counterfeit. Families buy these vials, desperate to save their loved ones, Arora said. Then we find out theyre filled with coconut water and milk.
The tale of the Indian pandemic is both mysterious and familiar. For much of the past year, the worlds largest democracywith a population of some 1.4 billion living on a landmass a third the size of the U.S.escaped the worst. Researchers have advanced all sorts of theories to explain this outcome. They point out that India is a young country, with a median age of twenty-eight; that it instituted an early and strict lockdown; that it has undercounted cases and deaths; and that Indians may have had some level of prexisting immunity to the novel coronavirus, owing to exposure to similar viruses in the past. Studies have indicated, perplexingly, that more than half of the residents in some dense urban centers had previously been infected, even though their hospitals hadn't filled up. None of these explanations have been fully proved, and, separately or in combination, they may not account for why India was spared last year. That debate will likely continue for a long time to come.
The reasons for the countrys current surge, on the other hand, appear straightforward. Since the New Year, theres been a substantial relaxing of public-health precautions. Mask-wearing declined; sporting events, political rallies, and religious festivals brought large numbers of people close together. Lacking a sense of urgency, the countrys vaccination campaign proceeded slowly: India is the worlds leading manufacturer of vaccines for a wide range of diseases, but has fully immunized roughly two per cent of its population against COVID-19.
Many assume that the rise of more contagious variants is accelerating the damage. Almost certainly, B.1.1.7originally identified in the U.K. and now dominant in many countries, including the U.S.is contributing to Indias viral spread. But a new variant, known as B.1.617, has also captured headlines and the attention of scientists and the general public. The predominant form of the variant, misleadingly referred to as the double-mutantit has at least thirteen mutationswas first detected in December. B.1.617 has several mutations on its spike protein, including E484Q and L452R, which seem to increase the viruss ability to bind to and enter human cells, and which may improve its capacity for evading the immune system. Some scientists have hypothesized that another mutation, P681R, could improve the variants ability to infect cells.
Still, the role played by B.1.617 in Indias crisis is uncertain. India has sequenced only about one per cent of positive coronavirus tests, rendering claims about the relative contribution of variants hard to disentangle from other factors, such as a rise in unrestricted gatherings in a densely populated country with limited health-system capacity. In any case, CovaxinIndias domestically developed COVID-19 vaccineappears to work against both B.1.1.7 and B.1.617. Arora told me that, although several fully vaccinated clinicians at his hospital have recently contracted the virus, none went on to develop severe diseaseexactly the kind of protection the vaccines are designed to deliver.
Last week, the Biden Administration announced that the U.S. would send a hundred-million-dollar aid package to India, including testing kits, ventilators, oxygen cylinders, and P.P.E. The U.S. has also removed restrictions on exporting raw materials for vaccines so that India can increase its production. Last weekend, syringes, oxygen generators, and ventilators poured in from across Europe, and a hundred and fifty thousand doses of Sputnik V, Russias vaccine, landed in Hyderabad. The Indian diaspora has committed tens of millions of dollars in aid.
Whether these interventions will be enough remains to be seen. In a country as large, diverse, and bureaucratically complex as India, the logistical challenges of converting aid into impact cannot be overestimated. Meanwhile, the Indian experience holds a deeper lesson for the worldespecially for wealthy countries that have hoarded vaccines and supplies. The constellation of forces that led to Indias crisispandemic fatigue, the premature relaxation of precautions, more transmissible variants, limited vaccine supplies, weak health-care infrastructureis not unique; its the default in most of the world. Absent a paradigm shift in our approach, theres no reason to believe that whats happening in India today wont happen somewhere else tomorrow.
When we spoke, Arora told me that most patients arrive at his hospital in taxis or in vehicles driven by their families. Few can afford the luxury of an ambulance, either because none are available or because private companies have raised prices amid endless demand. When they arrive, many patients linger in emergency rooms, where they can receive some oxygenand a modicum of reliefeven if they are ultimately refused admission to the hospital. At other hospitals, people have died in the parking lot.
As hospitals, emergency rooms, and the streets fill with younger and younger COVID-19 patients, Arora said, an all-consuming, unrelenting despair has taken hold among health-care workers. At Aroras hospital, even the pediatric I.C.U. is now full, with children as young as six struggling to breathe. (In India, more children than in the first wave now seem to be falling ill; data is limited, and its not clear whether there is a higher proportion of children getting sick or just a higher over-all number.) Many of the deceased are people middle-aged or younger.
Our staff is struggling, Arora said. Many are on the brink of a complete breakdown. Every day, they come to work and see nothing but death. They go home, and their own family has gotten COVID and cant breathe or have died. This is the situation. Theres no end in sight.
Supply vs Demand: Which States are Reaching their COVID-19 Vaccine Tipping Points? – Kaiser Family Foundation
Posted: at 8:12 pm
We recently estimated that the U.S. was close to its COVID-19 vaccine tipping point that is, the point at which vaccine supply may start to outstrip demand. We also noted that national averages may mask important differences by state. We therefore sought to understand where states fall along this spectrum; such differences are important for understanding how best to target efforts to increase vaccine coverage throughout the country.
To do so, we looked at the share of adults with at least one vaccine dose by state, daily rates of first doses administered (using a 7-day rolling average), and how this rate has changed in the last week (see methods). We were particularly interested in identifying states that may still have relatively low vaccine coverage (i.e., below 50% of adults 18 or older) coupled with evidence of a decline in the uptake of first doses, as these states may present the biggest challenges for achieving sufficient vaccine coverage in the U.S.
As of April 29, among the 50 states and DC, we find that:
The share of adults who had received at least one vaccine dose was 55% overall, and ranged significantly across the country from a low of 41% (Alabama) to a high of 74% (New Hampshire). In addition, there is evidence of a decline in the pace of new uptake in most states. The daily rate of first dose administration at the national level is 451 per 100,000, ranging from 136 per 100,000 (Mississippi) to 889 (Rhode Island). Most states (31 of 51) are vaccinating below the national rate, reflecting the fact that vaccination rates are generally higher in larger states (e.g., California and Pennsylvania). Furthermore, the rate of first dose administration per 100,000 in the last week dropped for the U.S. overall (-27%) and for almost every state (45 of 51) (see Table 1).
At the higher end of the vaccine coverage spectrum, more than 60% of the adult population has received at least one dose in 12 states. These states are primarily in the Northeast (8 of 12). Seven have vaccination coverage of at least 65% and all but 2 (New Hampshire and New Mexico) are administering first doses at well above the U.S. rate. Eight of the 12 states have seen declines in first dose administration rates over the past week, suggesting that these states may be approaching or have reached demand saturation, albeit at relatively high vaccination coverage levels and rates of administration.
At the lower end of the vaccine coverage spectrum, less than 50% of the adult population has received at least one dose in 13 states, including 6 that are below 45%. Nine of these states are in the South and in all, the daily rate of first vaccination per 100,000 is below the national rate. Moreover, most are experiencing declines in the rate of first doses administered. This suggests that these states may not only be approaching or have reached their tipping points, they have done so at relatively low levels of vaccine coverage.
The remainder of the states, which fall in between these two extremes, are primarily in the Midwest and, to a lesser extent, the South and West. In about half of these states, between 55% and 60% of adults have received at least once dose. All but one experienced declines in the rate of first doses administered in the last week.
States that demonstrate a combination of low overall vaccination coverage along with slow and declining vaccine uptake raise the greatest concerns. There are the 13 states with less than 50% coverage with at least one dose, all of which are vaccinating their adult populations below the national rate. Twelve of these states also saw declines in the rate at which they were vaccinating adults over the past week. These include 3 states (Alabama, Louisiana, and Mississippi) with vaccination coverage at or below 42%, the lowest in the nation, each of which is vaccinating at about half the rate of the U.S. overall. These are the states that are potentially the greatest distance from reaching sufficient levels of vaccine coverage and might be at risk for future outbreaks if levels are not increased significantly.
As with the U.S. overall, most states appear to be at or near their COVID-19 vaccine tipping points the point at which their supply is outstripping demand. While this may not be as big a concern for states that have already vaccinated large shares (> 60%) of their adult populations with at least one dose, about one in four states have not yet reached 50%, which is well below coverage levels likely to be needed to drive down the risk of outbreaks going forward. Furthermore, in these states, the pace of vaccination is below the national rate. The fact that most of these states are also seeing declines in the rate of first dose administration suggests that they will be important targets for focused efforts to generate increasing vaccine demand.
Posted: at 8:12 pm
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On Friday, White House health adviser Dr. Anthony Fauci had a vital message for Americans who have gotten their first dose of the Moderna or Pfizer coronavirus vaccine: Don't skip your second shot.
About 8% of people nationwide who have received one dose of the Pfizer or Moderna vaccine have not returned for their second dose, Fauci said Friday. That's normal compared to what health experts have seen with other multidose vaccines. But skipping a second dose will not be as effective in preventing the spread and providing the complete protection needed against the virus that has killed more than 576,000 people in the U.S. and more than 49,000 people in Texas.
"Bottom line of my message: Get vaccinated. And if you're having a two-dose regimen, make sure you get that second dose, too," Fauci said.
A lower percentage of people vaccinated in Texas are skipping their second dose relative to the rest of the country. As of April 25, about 5% or 570,399 of Texans who had received the first dose were 43 days or more past due for their second dose, according to data from the Texas Department of State Health Services.
Health experts say fears of side effects, an inability to take time off of work or incorrectly thinking that a single dose is enough all might be contributing factors to why some are skipping their second dose.
A recent report by the Centers for Disease Control and Prevention found the Pfizer and Moderna vaccines are 64% effective at preventing hospitalizations in the elderly after the first dose. But they are 94% effective after two doses.
"Everything is showing us that you need two doses to get good protection against the virus," said Dr. John Carlo, CEO of Prism Health North Texas and a member of the state medical association's COVID-19 task force.
Carlo said another issue some Texans had earlier this year was finding a second dose, as the number of people eligible for the COVID-19 vaccine surpassed the number of vaccines available. However, he said, that's no longer an issue.
Texas is seeing its first dip in vaccine demand and a surplus in supplies since the states vaccinations began last winter, leading local and state officials to brainstorm ways to get people to their regional vaccination hub. Strategies have included trucks driving through small rural towns with LED signs, a $1.5 million TV and digital ad campaign and even possibly offering bobblehead or gift card incentives.
Since skipping second doses isn't unique to any part of Texas, both state and local officials are trying to spread the word of the second dose's importance, said DSHS spokesperson Douglas Loveday.
"DSHS has launched new TV, radio and digital ads about these important issues, but we're not the only ones carrying the message," Loveday said in an email. "The governor posted a new video ... on his Twitter account about the importance of getting a second vaccine dose, and our region and local partners continue to message about getting fully vaccinated."
Loveday said the second vaccine dose is also essential in preventing the creation and spread of new COVID-19 variants a mutation of the original virus.
While new variants have not yet been identified as deadlier than the original coronavirus strain, according to the CDC, they can be more contagious. This can lead to more cases, more hospitalizations and, potentially, more deaths.
Dr. Catherine Troisi, an infectious disease epidemiologist with UTHealth School of Public Health in Houston, said the first dose primes your immune system. The second dose cements the protection.
"The first dose of the vaccine may protect you from the original virus, but there are variants out there," Troisi said. "Because your immune response isn't as strong without your second dose, variants can replicate and spread. The second dose lowers the odds of that happening."
Health experts say Texans who have missed an appointment for a second dose shouldn't worry about having to start the process over again. While getting the second dose should happen within two to six weeks after the first one and not any sooner than that it's always better to get it late than never. If someone has missed their appointment for their second vaccine dose, they can contact their vaccine distributor to reschedule their appointment.
"There isn't going to be any shaming if you get the vaccine months later," said Dr. Diana Cervantes, assistant professor of epidemiology at the University of North Texas Health Science Center at Fort Worth. "I know people might be hesitant if they missed their second dose. But it's never too late."
Disclosure: The University of North Texas and UTHealth School of Public Health have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.