Category: Corona Virus

Asked by a reporter if there was a plan to publicize the milestone in the US, Health and Human Services Secretary Alex Azar said, "You make me feel as if we should."

"We probably do need to make a plan for, you know, who's going to get it first visibly," said Army Gen. Gustave Perna, chief operating officer of Operation Warp Speed.

The exchange offered the latest example of the lack of coordinated communications plan from the federal government just days before the first Americans could begin receiving a coronavirus vaccine.

As videos of first Britons receiving the vaccine were replayed on televisions and cell phones across the United States this week, Dr. Georges Benjamin, executive director of the American Public Health Association, said it was "one of those Sputnik moments."

"We're way behind the curve," Benjamin said, lamenting the lack of communication from the federal government. "We really need to begin very aggressively working to give people a better understanding of the vaccination needs and the trade-offs."

A senior administration official noted the US doesn't have a centralized health care system akin to Britain's and said federal officials didn't want a ceremonial event to delay the distribution of vaccines elsewhere.

Michael Pratt, an Operation Warp Speed spokesman, added the administration's communications plans are already underway and will be well-timed with the Food and Drug Administration's anticipated emergency use authorization (EUA) of the Pfizer vaccine.

"In perfect lockstep -- as the EUA is set to be announced -- the paid messaging campaign has already begun," Pratt said.

Lack of messaging at the federal level

Operation Warp Speed's latest press briefing highlighted how the federal government is lagging in creating trusted, public channels of information about a vaccine that often has been treated as a political prize -- and has been greeted with unusually high skepticism from the American public. Experts say for the vaccine to potentially reach herd immunity, some 70% of Americans will need to take it.

Although the percentage of Americans willing to take the vaccine is climbing, public health experts said a strong and reliable public education campaign is needed to combat distrust that remains, especially for the overwhelming skepticism that people of color have. Building public trust and creating the proper channels of communication also will help dispel misinformation.

On top of skepticism, people are craving more information about when the vaccine will become available to them. Pharmacies have posted signs to not to expect it when the first shipment goes out, an indication of how the private sector has tried to fill the information void.

Dr. Uche Blackstock, an emergency medicine physician who founded a company focused on health care equity, outlined the outreach needed on CNN earlier this week, especially when it comes to communities of color.

"We need really expansive public health campaigns that are engaging community-based organizations and trusted leaders and Black communities. I also think there needs to be significant transparency around the vaccine development process. People have so many questions," Blackstock said.

First national advertising campaign planned against backdrop of shortfalls

For months the Trump administration insisted a public relations campaign was just ahead. But its plans were plagued with controversy from the start.

House committees launched an investigation into the administration's public relations plans and, after an internal investigation at HHS, the government canceled a $15 million deal for an influencer-based ad campaign.

The investigations also stalled work on a separate $250 million contract for a public awareness campaign with Fors Marsh Group, according to a person familiar with the deal. After assurances that the company would root its campaign in scientific principles and research rather than celebrities, work on the project resumed in November.

The person familiar with the contract acknowledged that pressure has been building on the administration and its partners to deliver on its paid advertising campaign.

"There's a need for clear consistent public education around pretty complicated things right now," the person said.

The national advertising campaign is slated to begin next week across print, social media and radio, said Mark Weber, a spokesman for HHS. The campaign is designed to address Americans hesitant to take a coronavirus vaccine.

From there, "We will be phasing in tailored messaging to groups who are disproportionately affected and areas of the country with the highest infection rates," Weber said.

The administration and its contractors are testing messages slated for a second advertising blitz in January.

"For those who are hesitant, the moveable middle, including multicultural communities, the timing must align with availability and the message must be credible," Weber said. "We are rapidly conducting research with key audiences to ensure the message and the ads are effective."

A senior administration official added that the paid messaging campaign was only one part of the government's communication efforts. The official pointed to top health officials participating in media interviews, White House events about the vaccine, and events with private-sector stakeholders and community organizations.

'No funding:' where things stand with state communication and outreach efforts

Even with a federal ad campaign, states said they face a daunting burden to educate their own residents about the vaccine, and inform them about when doses will be available for different populations.

With only $340 million allocated to states from the federal government to handle vaccine distribution and administration, many states said they do not have the money to build the kind of media campaign needed.

Testifying before the Senate Commerce Committee Thursday, Pennsylvania Secretary of Health Dr. Rachel Levine said states do not have the money to achieve the kind of educational messaging necessary to raise awareness of the vaccine's safety and dispel vaccine myths.

"We currently have no funding to accomplish that part of our mission," Levine said.

Although states submitted their preliminary communication plans to the CDC as part of their vaccine distribution playbook in October, some gave more information than others.

Only 23 states specifically mentioned how to target minorities or vulnerable populations when building their communication strategies, said Josh Michaud, associate director for global health policy at the Kaiser Family Foundation. He analyzed all of the state vaccination distribution plans available and only 18 states included a specific mention of how to address misinformation about the vaccine.

"I haven't seen a whole lot of evidence that states are really robustly rolling out these communications messages," Michaud told CNN. "You're going to have those messages ready to go and that groundwork laid, and the partnerships built for that to be effective."

Even for the states that have planned ahead, a lot of work remains.

The Louisiana Department of Health outlined in October that it would launch a campaign with Feigley Communications through a CDC grant, more than most states had outlined at the time. But when asked Thursday how far along they are in the ad campaign, communications director Alyson Neel told CNN, "We're still very much in the early stages."

Neel also described the state's progress on engaging with stakeholders and community leaders about how to communicate about the vaccine as "a work in progress."

Dr. Bernard Ashby, a Miami-based cardiologist associated with hospitals in South Florida, said the communication he has received from his affiliated hospital is inadequate.

"It's disappointing. They only gave us the bare minimum under pressure," Ashby told CNN, referring to the first communication about the vaccine he had received Thursday. "We have yet to see the strategic proactive planning and clear communication that we have been pleading for."

Outside group stepping in

Private groups and non-profits have started to fill the void left by the federal government.

The Ad Council has begun developing content and will begin releasing it as soon as the end of December, a representative told CNN.

This campaign focused on the vaccine is the council's "largest and most critical communications effort in our history," the representative said.

The campaign, funded by philanthropic and private donors, is being created with input from the US Centers for Disease Control and Prevention and HHS. It will include traditional radio, television and digital ads as well as more targeted messaging from key individuals from different communities in the US, according to the representative.

For most Americans, the prospect of receiving a coronavirus vaccine is still months away, leaving a window of opportunity to educate the public.

But from Ashby's perspective, there is already concern about missed opportunities to start sending these messages early and sway health care workers who may have doubts.

"Something that we don't speak enough about is vaccine hesitancy within the health care worker population. Now, it may be lower than general population but it's still there and it's still very significant," Ashby told CNN.

"There's been no efforts whatsoever to get any feedback of how do we feel about getting the vaccine. It's based on way too many assumptions and that's basically a recipe for issues, down the road."

Read more from the original source:

'Way behind the curve': The messaging failures around coronavirus vaccine distribution - CNN

When Amy Jones burst through the doors of the intensive care unit, she found a line of health care workers in the hallway, she said. Jones was sobbing. Shaking. She let out a scream.

A doctor named Juan Fitz was dying.

Fitz, 67, was Jones common law spouse, she said, and the father of her two young kids. To his co-workers, he was a revered colleague in the emergency department at Lubbocks Covenant Medical Center, where he had worked for roughly two decades.

Fitz had driven himself to the hospital in the early hours of the morning four weeks before, after testing positive for COVID-19. Though his oxygen levels had dropped, he seemed optimistic. He told Jones hed be better soon.

Its going to be five days, Fitz said.

But in mid-October, his texts to her suddenly stopped. Jones video-called Fitz one morning; he looked more scared than shed ever seen him, she recalled.

He was placed on a ventilator that day.

Medical professionals have spent nine months battling on the pandemics front lines, suiting up daily in protective gear to treat patients and holding up screens so loved ones can say final goodbyes. But steadily, their ranks have been depleted as colleagues fall ill, leave the workforce after exhausting their emotional reserves or, occasionally, die.

As the public cheers and applause for health care workers have faded, the virus has claimed the lives of more than 1,000 U.S. health care workers, according to two September estimates. Others have developed symptoms of depression or sleep disorders, and an untold number face mental scars once infections ebb, according to surveys and interviews.

Even before the pandemic, health care workers were at risk of burnout and suicide. And with the state entering perhaps the darkest phase yet of the pandemic, many health care workers say they are constantly afraid of infecting loved ones and suffer loneliness from staying away from family for long periods.

Thats in addition to feelings of helplessness and frustration as an exhausted public eschews safety precautions, like mask wearing, that could reduce the virus spread.

Were in medicine because we want to help people, but now were putting ourselves in harms way to get infected, we have a high rate of exposure, said Dr. James Williams, an emergency physician in Amarillo and a former colleague of Fitzs. I know a lot of people have said its not worth it.

The government has sent hundreds of medical workers to buttress hospital staff in hot spots like Amarillo and El Paso, where the situation grew so dire last month that jail inmates were recruited to move bodies into refrigerated trucks. Hospitals in other urban areas are short on beds for new patients.

The intensity can take an emotional toll.

In the Rio Grande Valley, where hospitals were overwhelmed during a summer COVID-19 surge, nurse Christian Ramirez said hes started to dream hes in the hospital and will wake up wondering where his patients are. At one point during the summer, he saw a nurse weeping next to a dying patient her own mother wondering if shed infected her.

I dont think anybody whos not there in the trenches understands, he said.

In North Texas, Dr. Justin Fairless said the hospitals where he works in Fort Worth and Azle have turned away some people who would normally be admitted. There simply isnt room, said Fairless, an emergency physician and another friend of Fitzs.

As Fairless faces a crush of cases a few weeks after Thanksgiving, he said hes picked up extra shifts because colleagues are out sick or quarantining. He said others have moved to online care, quit their jobs altogether, or retired early in the face of the relentless strain or to tend to family members battered by the virus.

I feel like every time I go to work, I hear a new story about someones family member that is seriously ill or dying, he said, adding that its the time when were needed most and were burned out.

With the promise of a vaccine on the horizon, some health care providers see cause for optimism. Hospital workers will be among the first in line to be immunized, under state guidelines, and Gov. Greg Abbott has said the state may receive as many as 1.4 million initial vaccine doses this month.

But with the nation facing its most severe outbreak of COVID-19 infections to date, experts fear the country is marching toward a grim holiday season before enough of the vaccine can be produced to immunize a large portion of the population.

Health care workers who already weathered a massive surge this summer worry they would be shattered by another.

Dr. Jamil Madi, a critical care physician in Brownsville, said the tsunami of infections and deaths the Texas border region saw around July was traumatic and something health care workers wouldnt be able to respond to in the same way.

To experience it more than once in one year is something that the human mind and the human body should not tolerate, said Madi, who also works in Harlingen.

At the height of the pandemic in the predominantly Latino Rio Grande Valley, one of the hospitals where Madi works had 90 medical emergencies, known as codes, in one month. It was an astronomical increase from the usual three to four.

You see people dying every day, Madi said. No matter how hard you try, theres nothing much you can do. You know theyre going to die and you just try your best to see if you can save lives.

Seeing how much COVID-19 patients are suffering has become one the greatest strains of the job for Ramirez, the nurse who has worked in two Valley hospitals since the start of the summer surge. So is talking to family members who cant grasp how low the odds of survival can be for severe COVID-19 cases.

Im looking at them crying. Im looking at them saying their last goodbyes, he said.

He said the frenetic pace of his job has slowed somewhat, and the proximity to suffering and grief does not register the same way it did before.

It's normalized a bit. I don't want to come off like I'm desensitized to it, he said. But I have definitely gotten used to it.

Experts worry the pandemic has already taken a long-lasting toll on the mental health of hospital workers. A study in Norway found that more than one-third of people working directly with coronavirus patients showed signs of post-traumatic stress disorder.

While data is limited, what you're seeing is already pretty significant rates of trauma, pretty significant rates of anxiety and depression at least the symptoms, said Dr. Jessica Gold, an assistant professor of psychiatry at Washington University in St. Louis, who has written about the pandemics effect on health care workers mental health.

What exacerbates the circumstances is that the medical field tends to be a place where we don't talk about emotion and where mental health is highly stigmatized and viewed very differently than physical health, Gold said.

An October poll from the American College of Emergency Physicians found that about 45% of emergency physicians did not feel comfortable seeking mental health treatment.

Even in a graduate nursing program at the University of Texas at Tyler, Sandra Petersen said classwork is the last thing students want to talk about during office hours.

The sessions turned into more of a support group for COVID, she said, because I was trying to talk to them about the things in the class, but inevitably it came around to, How are you doing?

Some of Petersens students have gotten sick with COVID-19, and one, she said, became so ill that she was put on a ventilator while being hospitalized for the disease. Though the student made a partial recovery, she will have "long-term health implications as a result of the virus, Petersen said.

Shes encouraged her students to prioritize their own mental health, including by seeking professional help.

Petersen also works as a nurse practitioner, performing house calls for geriatric patients at their nursing homes, assisted living facilities or sometimes in their loved ones homes. She considers her job more vital than ever, but do I come home and sit down and cry sometimes? Absolutely, she said.

Some health care workers say the pandemic has spurred them to talk more openly about seeking mental health care. Leslie Mikus, an emergency room nurse who works at a hospital in Victoria, said she has seen a counselor for anxiety, and that its been very, very helpful.

Mikus lost an uncle after he was diagnosed with COVID-19 in New York, but her family wasnt able to have a funeral.

Unfortunately we didnt have good closure, she said. I feel like our family is missing that. We were able to Zoom, which just seemed so wrong on so many levels.

Theres no comprehensive count of health care workers who have died of COVID-19, but Jones said she knows her family isnt alone.

Jones and Fitz met nine years ago, when Jones moved to Lubbock to help run her mothers medical spa. Fitz was the medical director there, an Army veteran who spoke three languages and had a daughter from a previous relationship.

Though they didnt take to each other at first he was conservative and she is liberal they bonded on a long drive to a medical training session. They arrived at what they thought was a formal event only to see people in casual clothes and concocted an excuse to explain why both were outrageously overdressed, Jones said. She remembered he looked so handsome and that they danced all night.

Fitz loved his job he was nationally recognized as a hero of emergency medicine but he grew stressed as the virus spread through West Texas, she said. Once he got sick, her son was the first to tell her something had gone wrong.

Around 5 a.m. one October night, the child walked into Jones room to wake her.

Daddys not there, he said.

Maybe he had to go into work, Jones told her son. But she later checked her phone and saw a text from Fitz.

His oxygen levels had dropped. He was in the emergency room not to see a patient, but to be treated himself.

Breathing got worse, he said. Didnt want to wake anyone. I love you.

Fitz had tested positive for the coronavirus the day before, Jones said; she believes he was infected after treating a dying patient. Soon after, Jones, 40, would learn she had it, too. So did her son. (Jones recovered at home, and their 5-year-old son did not show symptoms, while their 16-month-old daughter developed a full-body rash.)

On Oct. 13, Fitz texted: Getting intubated.

Jones began sending daily updates to his friends and colleagues. At first, they were optimistic. On Oct. 17, Jones wrote that he was stable and comfortable and that all the numbers are showing improvement.

On Oct. 18, Jones was hopeful he could be taken off the ventilator soon.

But by Nov. 2, Fitz had taken a serious downturn. His lungs were damaged. An X-ray of his chest was not promising. After more than 20 days in the coronavirus ward, when he was no longer thought to be infectious, he was moved to the hospitals intensive care unit on the fourth floor.

The next day, while Jones was driving, her phone started ringing. Jones pulled to the side of the road and began to cry, shaking and fearing the worst. She quickly drove to the hospital and ran to the intensive care unit.

Her husband was dying.

A pall fell over the hospital. Chaplains went to the first floor emergency room where Fitz had worked for years and led the two dozen people gathered there in a prayer.

Williams, the Amarillo physician, still chokes up at the mention of his former colleague. He feels hes not yet had the chance to properly mourn. Everythings virtual. You cant be with his family, you cant be with colleagues, Williams said. Its just really tragic.

A spokesperson for Covenant, the hospital where Fitz worked, said its caregivers are provided with sufficient protective equipment and staff are well-trained on safety protocols.

We are heartbroken by the loss of Dr. Juan Fitz and his presence is greatly missed by the Covenant Health family, the spokesperson said.

Dr. Robert Hancock, a fellow emergency physician and friend of Fitzs, said his death prompted introspection among emergency room doctors.

It made all of us worry about, what if something happened to me? and grapple with things you dont want to think about on a daily basis.

Jones said she hasnt processed Fitzs death. Sometimes, shell feel the grief creeping in, like its going to suffocate her, but she pushes the emotion down. She has to be strong for her kids, she said.

I still strongly feel like this didnt have to happen, Jones said in a recent interview. My babies didnt have to lose their dad, and I didnt have to lose my best friend.

See the original post:

Texas health care workers say latest coronavirus spike is crushing them - The Texas Tribune

There is one graph that has to do with the coronavirus that blows my mind. It looks like this. This graph shows coronavirus cases in the United States versus the European Union. Do you see what happens here? Everyone has a surge around the same time, but while the European Union dramatically drops, the United States plateaus for a little bit and then skyrockets. This is shocking to me because the United States is perhaps the most prepared country on earth for a pandemic. The U.S. government has an actual playbook that tells us what we need to do in the case of a pandemic. Not to mention, its like the richest country in the world, with the best health institution on earth, the C.D.C., which literally fights pandemics in other countries and teaches even our peers how to do epidemiology. And yet, you look at this graph and you wonder, what happened? I want to piece together a timeline to find out how this happened. How does the country with the most money and experts and the C.D.C. and a literal pandemic playbook end up with so many deaths, and end up with a graph that looks like this? [MUSIC PLAYING] The countries best and worst prepared for an epidemic, were rated No. 1 at being prepared. Europe has largely contained the virus. Nearly 200,000 Americans dead from Covid. Were doing great. Our country is doing so great. [MUSIC PLAYING] As I piece together this timeline, Im going to need some help. And for that, I turned to Nick Kristof. Hes a Pulitzer Prize-winning journalist. He speaks Mandarin. Hes been all around the world, reporting on and explaining public health crises for decades. Ive always felt that I come from the country that helped invent public health. And now, my own country, arguably the most powerful country in the history of the world, has taken a challenge that we kind of knew what to do with, and just blowing it in ways that cost so many lives so needlessly. So if I want to understand how this all played out and how we got a graph that looks like this, where do we start? Lets go way back, before we were paying any attention to this. I figured our timeline would start somewhere in January of 2020, but Nick told me to go back even further, way back to 2005. That summer, President George Bush was on vacation at his ranch in Texas when he got ahold of this book. It was about the Spanish flu that killed tens of millions of people back in 1918. This book freaked George Bush out. He got back to Washington, and immediately got to work putting together a plan, a step-by-step guide of what the U.S. should do if a pandemic came to our country. He called it a playbook for pandemic response. President Obama developed a playbook of his own that had very specific plans in place on what the government should do in the case of a disease outbreak, including specifically citing coronaviruses. This pandemic playbook was then passed on to the Trump administration. We left them the detailed playbook, which specifically cited novel coronaviruses. Short of leaving a flashing neon sign in the Situation Room saying. Watch out for a pandemic, Im not sure what more we could have done. No one knew when the big pandemic would come, what it would look like. But even still, the previous two administrations were obsessed with making sure we were ready. But if we wait for a pandemic to appear, it will be too late to prepare. So now lets fast forward to when the big one did hit. And that part of the story happens on the last day of 2019. On Dec. 31, 2019, a report of 44 people with pneumonia comes in from a fish market in China. So at this point, it seems like this is a fairly small deal. Its 40 people with pneumonia in China. So who in the U.S. would even care or have this on their radar in the first place? `Epidemiologists were on top of this immediately in early January, about the risk this might be something serious. The World Health Organization was communicating with the C.D.C., the C.D.C. was communicating with the administration. And indeed, it appears to have entered the presidents daily brief in early January. Were going to begin here with the outbreak of a mystery virus in China that now has the World Health Organization on edge. I heard that China was concealing information. And didnt that stop American experts from getting a full picture on what was happening? Yes, absolutely. China behaved irresponsibly and was concealing information. But we had channels into China, into the World Health Organization. We were getting feedback about what was really happening. Its the middle of January, and coronavirus is potentially a thing of concern. Didnt President Trump get on a call with President Xi Jinping? Yeah, they did. They had an important phone conversation then. But what they talked about was trade. But it just doesnt get any bigger than this, not only in terms of a deal. Tell President Xi, I said, President, go out, have a round of golf. This was a huge, huge missed opportunity. OK, so we miss these first two opportunities of taking those early reports really seriously and that call with Xi Jinping, which potentially could have been a health collaboration to stop the virus. But it was still early on. The coronavirus hadnt even been detected in the United States yet. Gwen Stefani and Blake Shelton not quite yet engaged, right? Definitely not married. So while the United States was preparing for the Grammys and the Super Bowl, the coronavirus quietly came into our country. The first case is reported around Seattle on Jan. 21. At this point, Trump has been hearing more and more warnings from his intelligence briefings, as well as from the C.D.C. And as the news breaks of the first case in the U.S., Trump is on his way to Switzerland to speak at the World Economic Forum, where he talks a lot about China, but just not about the virus. Our relationship with China right now has probably never been better. Man, just like imagine what could have happened at this moment. End of January, the president reads his briefing. Hes like, oh, whoa, this is real. This is spreading globally. We need to get serious about this. He calls Xi Jinping back, and hes like, hey, Xi Jinping, I know weve been talking a lot about trade, but why dont we talk about this virus thats coming from your country to mine? What do we need to do to solve it? And Xi Jinping is like, yeah, youre right, lets do it. Trump gets up to tell the nation a pandemic is coming and that weve got to be ready for it, but dont worry because were super prepared. We have all the plans. We have a literal pandemic playbook. We have money. We have experts. We can squash this. Have you been briefed by the C.D.C.? I have. Are there words about a pandemic at this point? No, not at all, and we have it totally under control. Its one person coming in from China, and we have it under control. Its going to be just fine. There was some hope that we could have actually eliminated it in early January and avoided this catastrophe for the world. Instead, our leaders, and our citizens, were completely focused on other things. The Grammy Awards are finally here. CNN breaking news. Kobe Bryant Has been killed in a helicopter crash. Special coverage of the impeachment trial. Did nothing wrong. Did nothing wrong. [CHEERING AND APPLAUSE] So by the end of January, the virus has now arrived to the United States. There are reported cases here. We are now aware that it is a problem. I guess Im wondering, like, what is the response? What should the U.S. have done in that moment? The first step in response to a disease like this is to find out where it is, which means you develop a test. We have 12 cases 11 cases. And many of them are in good shape now, so. The United States and South Korea had their first reported case of Covid-19 on the same day. A month later, South Korea, who, by the way, has like a fifth the number of people that the United States has, had tested 13,000 people. Here in the U.S., we had tested 3,000. Im not afraid of the coronavirus, and no one else should be that afraid, either. A reminder that all of these steps, the testing was not a new idea. This was in the old playbooks. Testing and surveillance of where the virus is is like a fundamental step in responding to a pandemic. Its mind-blowing that because you cant get the federal government to improve the testing because they just want to say how great it is. And the testing is not going to be a problem at all. So this struggle to develop a test, wasnt this more of like an issue with the F.D.A. and the C.D.C. and H.H.S. sort of feuding with each other about who was going to do the test? At one level, the way we fumbled the development of testing in the United States was a result of bureaucratic infighting. But if President Trump had shown the same passion for getting a test that he showed for building a wall or for backing hydroxychloroquine to treat the coronavirus, we would have had a test all ready to go and all around the country by the end of January or beginning of February. Hydroxychloroquine, were just hearing really positive stories. I happen to be taking it. I think its good. Ive heard a lot of good stories. Sierra Leone in West Africa had an effective test before the United States did. And so as a result, we didnt know where the virus was. We were blind. Theyre working hard. Looks like, by April, you know, in theory, when it gets a little warmer, it miraculously goes away. Hope thats true. And then, Americans started to die. [MUSIC PLAYING] It started with just one in February. But soon one became 10 became 100, and soon it was 100 per day, and then 200 per day, and 500 per day. And now, were in the thousands. And then the month of April was here. And in one month, 57,000 Americans died from Covid-19. So was there a moment for you when you realized that this was spiraling out of control? I visited a couple of emergency rooms and I.C.U.s early in the crisis. And this was when people are still talking about how the coronavirus is like the flu. And meanwhile, these emergency rooms are just swamped. The doctors and nurses are traumatized. I need a vent. I need a vent. I need a ventilator. And the strength of those doctors contrasted with just the fecklessness of our political leadership. And again, I said last night, we did an interview on Fox last night You have to be calm. Itll go away. [BEEPING] Many of the places are really in great shape. They really have done a fantastic job. We have to open our country. We cannot let the cure be worse than the problem itself. Were not going to let the cure be worse than the problem. We have to be calm. Itll go away. Ive seen a lot of grim diseases, but the combination in Covid of such large numbers dying, all alone because their loved ones cant go with them, saddens me, but it also just enrages me because this was so unnecessary. OK, so lets realize where we are. Its April, and we really didnt get the early response down. We didnt get testing figured out. But now, were in the thick of a crisis. People are dying. There is a crisis in the United States. So the big question here is, what do you do once youre actually in the thick of this crisis? And in my conversations with Nick, and in all of these playbooks, theres this one theme that just keeps coming up, which is health communications. Which sort of just sounds like a boring P.S.A. from the government. Larry, you know this simple exercise can help you stay healthy. I didnt even know what that meant to begin with. But as I looked into it, I started to realize that there was something there. In fact, the Bush playbook says that the need for timely, accurate, credible and consistent information that is tailored to specific audiences cannot be overstated. So it turns out that, when a country is devolving into pandemic chaos, one of the most important things, if not the most important thing, a government can do is communicate to its citizens how important and risky this is. And the 15, within a couple of days, is going to be down to close to zero. Staying at home leads to death also. Are you telling the Americans not to change any of their behaviors? No, I think you have to always look, I do it a lot anyway, as you probably heard, wash your hands, stay clean. You dont have to necessarily grab every handrail, unless you have to. You know, you do certain things that you do when you have the flu. I mean, view this the same as the flu. The C.D.C. is recommending that Americans wear a basic cloth or fabric mask. This is voluntary. Its easy to focus just on the failures of President Trump, but look, there is plenty of failure to go around, and it involves blue states as well as red ones. New York was particularly hard hit, in part because New York leaders initially did not take this seriously enough. Mayor Bill de Blasio tweeted that people should get on with their lives and go out on the town. It would be difficult to think of any signal that a leader could possibly send that was more wrong and more lethal than that one. Tonight, FEMA is bringing in hundreds of ambulances to help with record-breaking 911 calls in New York. This morning, as an emergency field hospital is being built in iconic Central Park All of those beds, all 20,000, will have to be turned into intensive care beds to focus on Covid-19 patients who are really, really sick. We simply blew it. And the result was that Americans did not take the virus as seriously as they did in other countries. OK, so the U.S. blew it when it came to health communications, whereas Europe and many countries around the world got it right. I want to know what the actual proof is that thats the key to fixing it. Is it just because the playbook said it or because Nick said it? Well, I got my hands on some data that really helped me understand this. Google collected data from a bunch of peoples phones to track before the pandemic and during the pandemic how peoples movement changed. If you assemble that data onto a map, you see something really interesting. If you look over here, you can see these dark blue areas, which represent countries that shut down by up to 80 to 100 percent. This means they werent going out, they werent shopping, they werent going to cinemas. They were staying home like the government implored them to. Austria shut down by 64 percent, France by 80 percent, Ireland by 83 percent. All of this movement shut down in the name of beating the virus. Meanwhile, over here in the United States, were at about 39 percent on this same day in late April. We never really shut down. One of the basic things about this pandemic is that, if people really do take it seriously, and for four weeks or six weeks do adhere to stay-at-home orders in the way Europe did, with 90 percent of the travel shut down, then the virus is stopped in its tracks. Other countries did it, one after the other. The U.S. was never able to do that. We fought the virus, and the virus won. Again, I cant help but think of what could have happened if our president got up and said My fellow Americans This is going to be very difficult. We have to shut down our entire country. Not just the urban spots, the entire country. Its going to be painful, but it will help us reopen our economy quicker and it will help save American lives. But that didnt happen. I remember looking at the graphs in April and watching daily deaths climb so rapidly, just skyrocketing. The natural response wouldve been to say, whoa, slow down, we need to really tighten things up and learn from other countries that have done better. But instead, the very next day The president, remarkably, attacks stay-at-home orders in states around the country and encouraged supporters to liberate states like Michigan. This was an obliviousness to science and public health advice, a lack of empathy for those who were dying. I dont know what to call that failure except an example of extraordinary incompetence. I find that truly heartbreaking. This is where the graph starts to blow my mind, and really starts to get to the heart of my big question of why these lines look so different. Watch how the Covid cases sort of plateau in the U.S., but in Europe, cases start to look like this. Our peers buckled down and did the hard work to get ahead of the virus by following basic pandemic measures articulated in all of the plans, including our own playbooks. They saw the results of that. The U.S., on the other hand, plateaus for a bit, and by mid-June, starts to skyrocket again. In the nations three most populous states, things are going from bad to worse. California, Texas and Florida are in crisis. Today, reporting more than 5,000 Covid-related hospitalizations. And even though Europe is having an uptick now, you need to look at this gap. This gap represents a lot of unnecessary suffering, and the death of tens of thousands of Americans. I understand that were going to make mistakes. This is hard stuff. Lots of countries made mistakes. But what has troubled me is that we just didnt learn from them. We werent self-correcting. Instead, we doubled down on mistakes. And then, we just gave up. OK, so I now feel like I have a much better understanding of why our graph looks like this compared to other countries. It has a little bit to do with those early mistakes and whatever, but those are sort of forgivable. Instead, its what happened once the pandemic was here and raging and killing Americans. Instead of having leaders who told us what we needed to do to make it through this risky and uncertain time, we had leaders that denied that this was even a big deal, and then who eventually just gave up on the whole thing. The death certificates of more than 150,000 Americans will say something like Covid-19. In a larger sense, what should be written on those death certificates as the cause of death is incompetence.

Link:

The Coronavirus Vaccine Won't Solve Everything - The New York Times

With some Americans now paying the price for what they did over Thanksgiving and falling sick with COVID-19, health officials are warning people begging them, even not to make the same mistake during the Christmas and New Years season.

Its a surge above the existing surge, said Ali Mokdad, a professor of health metrics sciences at the University of Washington in Seattle. Quite honestly, its a warning sign for all of us.

Across the country, contact tracers and emergency room doctors are hearing repeatedly from new coronavirus patients that they socialized over Thanksgiving with people outside their households, despite emphatic public-health warnings to stay home and keep their distance from others.

The virus was raging across the nation even before Thanksgiving but was showing some signs of flattening out. It has picked up steam since, with new cases per day regularly climbing well over 200,000.

The dire outlook comes even as the U.S. stands on the brink of a major vaccination campaign against COVID-19, with the Food and Drug Administration expected to give the final go-ahead any day now to use Pfizers formula against the scourge that has killed over 290,000 Americans and infected more than 15.6 million.

Deaths in the U.S. have climbed to almost 2,260 per day on average, about equal to the peak seen in mid-April, when the New York City area was under siege. New cases are running at about 195,000 a day, based on a two-week rolling average, a 16 percent increase from the day before Thanksgiving, according to an Associated Press analysis.

In Washington state, contact tracers counted at least 336 people testing positive who said they attended gatherings or traveled during the Thanksgiving weekend. More are expected.

The virus could still be incubating in someone who was exposed while traveling home the Sunday after Thanksgiving; the end of that two-week incubation period is this Sunday.

Zana Cooper, a 60-year-old cancer survivor in Murrieta, California, tested positive for COVID-19 after attending a Thanksgiving dinner with her sons girlfriends family. At the dinner, the girlfriends father, who had recently traveled to Florida, wasnt feeling well and went to bed early.

Cooper learned the following Sunday that he tested positive.

My first reaction was the f-word. I was so mad, she said. I was upset. I was angry. I was like, How dare you take my life in your hands?

She has had fever and headaches, a runny nose and bloodshot eyes, and in recent days it has become more difficult to breathe and she has been using an inhaler. She said she believes she brought the virus home to her daughter and two grandchildren, who live with her and are now ill with what a doctor diagnosed as COVID-19.

In Philadelphia, a woman in her 20s gathered with 10 relatives on Thanksgiving, though she didnt feel well the day before. She later tested positive for COVID-19. Her family started developing symptoms, and seven members tested positive, said Philadelphia Health Commissioner Dr. Thomas Farley.

The next round of festivities could yield even more cases. Wall-to-wall holidays started this week. Hanukkah began Thursday evening and ends Dec. 18, followed by Christmas, Kwanzaa and New Years Eve.

This is not the time to invite the neighbors over for dinner. This is not the time to start having parties, said Arizona State University researcher Dr. Joshua LaBaer.

In parts of New York state, contact tracers are regularly hearing from the newly infected that they attended Thanksgiving festivities, said Steuben County Public Health Director Darlene Smith. Still unknown is how many they will infect and how many eventually will need a bed in intensive care, she said.

Its the domino effect, Smith said.

Harry and Ashley Neidig, of Shepherdstown, West Virginia, tested positive for COVID-19 last week. They said they believe they contracted it from someone at their jobs as security officers but didnt know of their possible exposure before they celebrated Thanksgiving with both sides of the family.

On the Tuesday after Thanksgiving, Ashley Neidig, 25, noticed she couldnt smell a menthol-scented body scrub. After the couple got tested, they contacted their families to warn them. Some were awaiting test results, and so far no one else has had any symptoms, said Harry Neidig, 24.

We feel bad because we definitely shouldve put a heavier weight into our decision to go, he said. We should have told our family, Hey, given the nature of our job, we cant quarantine like other people in an office job.

He added: You might want to take another look before you go somewhere for Christmas.

The surge around the country has swamped hospitals and left nurses and other health care workers exhausted and demoralized.

Compassion fatigue is the best word for what were experiencing, said Kiersten Henry, an ICU nurse practitioner at MedStar Montgomery Medical Center in Olney, Maryland. I feel weve already run a marathon, and this is our second one. Even people who are upbeat are feeling run down at this point.

While some hospitals are scrambling to find beds and convert storage rooms and other places for use in treating patients, they are also dealing with dire staff shortages.

We know how to make new beds, said Dr. Lew Kaplan, a critical care surgeon at the University of Pennsylvanias Perelman School of Medicine. We dont know how to make new staff.

By CARLA K. JOHNSON and AMY FORLITI, Associated Press. AP data journalist Nicky Forster in New York and Associated Press writer Marion Renault in Rochester, Minn., contributed to this report.

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Coronavirus spread: Americans paying the price for Thanksgiving - Tampa Bay Times

CLEVELAND, Ohio The coronavirus death toll among suburban Cuyahoga County residents for last week was more than triple the previous week.

The Cuyahoga County Board of Health reported 107 new deaths recorded between Nov. 29 and Dec. 5. There were 32 deaths reported between Nov. 22 and Nov. 28, according to the Board of Health.

While data for this week wasnt yet complete on Friday, Health Commissioner Terry Allan told cleveland.com and The Plain Dealer that case and death counts remain high.

We are seeing more deaths as a result of the surge of cases that we saw during November, Allan said.

More complete figures released Friday by the board of health show that new cases of coronavirus were down last week at 4,187, compared to 5,005 for the week ending Nov. 28. However, week-to-week variations are expected, and are not necessarily indicative of a long-term trend, Allan said.

As of Thursday, 87% of the beds in intensive-care units at Cuyahoga County hospitals were occupied. That matched the previous weeks record-high.

Occupancy rates of regular hospital beds dipped slightly on Thursday to 77%, compared to last Thursdays occupancy rate of 80%.

Ventilator usage as of Thursday increased to 42%, compared to 39% last week, according to the data.

Between Nov. 29 and Dec. 5, the positivity rate for tests administered at MetroHealth, Cleveland Clinic and University Hospitals was 25.5%, up from the previous week when the positivity rate was 24.9%. The rate has climbed steadily since October.

Of the 32,637 total suburban cases recorded through Dec. 5:

2,256 patients required hospitalization

497 required intensive care

At least 8% are health-care workers (occupational data is not known for 53%)

At least 21% had no pre-existing conditions while at least 28% did have a pre-existing condition (health information is not known for 51%)

Most of the data released Friday only involves cases prior to Dec. 5. The board opted last month to start providing six-day-old weekly totals each Friday rather than the one-day-old weekly totals it previously reported. Board officials said they made the switch to allow them to simultaneously monitor flu and coronavirus cases.

Hospitalization data is the only information the board now provides that reflects more recent trends.

Asked on Friday to provide more information about new trends since Dec. 5., Allan said new cases this week averaged 700 per day. The average was 590 last week, and 671 the week prior, Allan said.

Our [emergency room] visits are increasing and ICU bed capacity continues to worsen, Allan said.

The board has also found that people are waiting longer to get tested after their symptoms start, because they mistakenly believe they have a cold or allergies.

We want people to get tested when their symptoms start and/or isolate for the 10-day period. If they wait longer to be tested and dont isolate at the first sign of symptoms, they could be contributing to community spread, Allan said.

The board data does not reflect cases in the city of Cleveland, which has its own health department and reports its own case numbers.

Data obtained Friday from the Ohio Department of Health showed there have been 53,832 cases countywide since the start of the pandemic. As of Thursday, the total number of cases in Cleveland was 14,509, according to the city.

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Coronavirus death toll for suburban Cuyahoga County last week was triple the previous week, Board of Health s - cleveland.com

But this year, so many things she never expected have happened.

First there was the letter she got in March, telling her she was an "essential worker."

There were the weeks she felt so sick she feared she wouldn't make it to the other side.

And -- most jarring of all -- there was the day she learned, after 13 years on the job at a meatpacking plant in Wisconsin, that she was fired.

The 42-year-old single mom says she went from packing hamburger meat in a crowded room -- helping people across the country feed their families -- to wondering how she'd come up with enough money to feed her own.

All of this was months ago. But these moments are still shaping her life, her choices and her fears.

"I get so stressed," says Maria, who asked to be identified only by her first name because she is undocumented and wants to protect her family. "I don't even know what to do."

Many essential workers like her face 'layers of fear'

But Marielena Hincapi, executive director of the National Immigration Law Center, says Maria's story speaks to a troubling national trend that must be acknowledged -- and put to a stop.

"What we are doing to workers in this country in this moment -- we are ... relying on them ... and yet we are subjecting them to layers upon layers of fear," she says.

Maria says she sees her firing as retaliation for concerns she raised about coronavirus safety and other matters. And an advocacy group that represents her says she wasn't the only worker targeted.

Strauss Brands, the company where Maria worked, maintains the firing of workers there in July had nothing to do with retaliation, and that any claim suggesting that is "completely false." The workers were let go solely because they couldn't prove they were legally authorized to work in the United States, Strauss says.

"Strauss has been, and will continue to be, very committed to the health, safety and well-being of all of our very dedicated and hard-working employees," the company said in a statement to CNN.

She says Covid-19 sidelined her for more than a month

Maria says her four children -- ages 21, 16, 13 and 5 -- were terrified when she kept heading into work as news of the pandemic spread. They worried she'd get sick on the job. And Maria says that's exactly what ended up happening. At the time, she says, hand sanitizer and masks weren't provided to workers.

Asked by CNN to respond to that allegation, Strauss Brands did not directly address Maria's case but said in a statement that it had "worked closely with the local Health Department, employees, and the union providing early adoption of CDC recommended COVID-19 policies, protections, and communication."

Maria says she started to feel achy one day at work. At first, she thought it was an old on-the-job injury flaring up. But the medicine she typically took to ease the pain didn't help. Hearing her symptoms, Maria says her doctor told her to come in for a Covid-19 test. Days later, she got her results: positive.

Her kids, she says, were the main thing on her mind. She'd sent her two younger children to live with a nephew as soon as she got sick.

"I was just thinking, 'My God, my children -- I am going to die, and what is going to happen to them?'" she says. "It's something terrible that haunts you, thinking that you are never going to see your family again."

Maria says it took more than a month for her to be well enough to return to work.

By then, she says, there was more protective equipment available. But social distancing, she says, was only enforced in the break area -- not while workers were on the floor.

Maria says concerns she raised repeatedly about the lack of social distancing weren't heeded.

"Nobody did anything," she says.

Weeks later, Maria feels she received the company's response to those complaints and others she'd raised about how much she was paid. She was fired in July along with dozens of other workers who she said had also been complaining about conditions and other matters.

Her employer cites a different reason for why she was fired

Strauss Brands says there was only one reason the workers lost their jobs, and it had nothing to do with the pandemic or pay.

"The employees were let go because they were unable to produce documents establishing that they were legally authorized to work in this country," the company said in a statement, adding that employees were given a chance to prove they were legally authorized to work before they were let go.

In response to questions about the firings and Maria's case, the company released statements describing the overall situation but did not specifically mention Maria or detail why she was let go. On the matter of worker compensation, the company said employee payment is governed by a collective bargaining agreement between Strauss and the union that represents its workers.

"The claim that any of these unfortunate events was motivated by retaliation is completely false. Strauss worked collaboratively with the local Health Department, employees, and the union encouraging input and providing early adoption of CDC recommended COVID policies, protections, and communication," Strauss Brands said. "Indeed, even before any such steps were recommended or required, Strauss shut down its plant, at full pay to employees, when it had the first presumed positive COVID-19 case so that it could use the time to clean/disinfect and make certain that it had in place all feasible safety measures."

Strauss says safety measures at the plant include employee education, visitor restrictions, masks and other personal protective equipment, physical distancing when possible, symptom screening and temperature monitoring and paid leave for Covid-19 related absences.

"It was clearly retaliation," says Christine Neumann-Ortiz, executive director of Voces de la Frontera, an immigrant advocacy organization that led protests as part of its Essential Worker Rights Network.

Advocates argue the letters don't have anything to do with work authorization or immigration status, but are frequently used by companies to retaliate against immigrant workers.

"Whatever the worker's rights issue that's being raised, oftentimes that's when employers remember that they've suddenly, conveniently gotten a no-match letter. Sometimes it's months old. Sometimes it's years old. But it is very typical of what we've seen employers do throughout the years," says Hincapi of the National Immigration Law Center.

"You couple that with covid, with the pandemic and the particular conditions that these workers are working under, and it's really a recipe not just for disaster for those particular workers, but for the workplaces as a whole. Employers can use these letters as a tool to depress health and safety."

Strauss says the employees who were let go will be welcomed back to the company, retaining their seniority and severance, if they're able to prove before August 2022 that they're legally authorized to work.

"No employer should immediately terminate employees upon receipt of a social security mismatch letter. We had to work through a thorough investigation and provide the employees with the opportunity to provide legal authorization to work. We then had to work through our negotiation with the union to provide transition packages," Strauss Brands said. "No good time exists for a move like this one; we were devastated, but we had no other choice."

Now she's terrified of getting sick again

Maria says she doesn't have the paperwork the company is now requesting -- but even if she did, she says she wouldn't want to return to work there after what she and other employees endured.

She says Strauss Brands' explanation for firing her and the other workers doesn't add up.

"They found the perfect moment to fire us. ... They used us. We all feel used. They knew the situation. They knew everything about our lives. They said there was no problem," she says. "Why is it that when someone complains about their rights, they get fired?"

The severance money helped, but now her share -- which she says amounted to around $5,000 after taxes -- has run out. She's trying to get by with support friends and family who live nearby occasionally give her.

"Right now I'm surviving with the little help I get. Sometimes (my children's) father gives me $100 or $50. A friend, or my nephew, sometimes gives me $50," she says. "And with this little bit, we buy something."

But she says it's not nearly enough to make ends meet. This month, she says she hasn't been able to pay her rent.

Maria says she feels far healthier than she did back in April. But even now, she says, there are still symptoms she can't shake.

Sometimes, she coughs up phlegm and feels her chest burning. It's harder to breathe at night. She loses focus and struggles to remember details. Thoughts feel harder to grasp onto -- something that Maria says never happened before her diagnosis.

"Sometimes it's like someone has erased my hard drive," she says.

Above all, Maria says there's a feeling that hasn't left her since Covid-19 first took hold: fear.

"I'm afraid of not having work. But another fear is getting sick again. I don't think I can make it through another illness like that. ... I feel powerless," she says. "I'm scared I'm going to get it again."

That's why for now, as tough as things are, Maria says she's not ready to look for a new job. And even once she is, she worries her limitations due to injury will make other companies reluctant to hire her.

Maria says she burned her foot years ago at work and still struggles to stand for long periods of time. Many essential worker jobs were already difficult and dangerous, she says. And the pandemic has made them even more so.

She wonders whether most Americans are aware of the risks she and other food industry workers face.

"Sometimes they don't appreciate what you're doing," she says, "that you're risking your life so that others can survive."

Maria says she's determined to do everything she can to make sure her own family survives. And to her, that means hunkering down at home and staying safe.

These days, Maria says she only leaves to buy food and do laundry.

Fear of getting sick again follows her wherever she goes.

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She got coronavirus, then lost her job. The pandemic makes her scared to look for another one - CNN

The Food and Drug Administration is expected to grant emergency use authorizations to the first two coronavirus vaccines in the next several days. The sheer speed with which doctors and scientists were able to reach this stage is a major achievement, and the early results for both vaccines are undeniably impressive. New vaccines normally take years to develop, and scientists initially worried.

But when all is said and done, making the vaccine might turn out to have been the easy part.

Earlier this year, before President-elect Joe Biden tapped her to head the Centers for Disease Control and Prevention, Dr. Rochelle Walensky ran a computer simulation to game out how a coronavirus vaccine might affect the continuing pandemic. Early reports that at least two vaccines were 95 percent effective at preventing illness were fueling hope that inoculation would bring the crisis to a speedy conclusion, and Dr. Walenskys team wanted to see how realistic that hope might be.

Not very, it turns out. Dr. Walenskys study found that the most important factor in a given vaccines success is not necessarily how well that vaccine works. Its everything else: how quickly and strategically the vaccine is distributed across the country, how well received it is and whether people continue to abide by other edicts, like mask wearing and physical distancing. We find that factors related to implementation will contribute more to the success of vaccination programs than a vaccines efficacy as determined in clinical trials, Dr. Walensky and her co-authors wrote.

Thats especially bad news for the United States, which has invested billions of dollars into vaccine development, but very little into actually getting people vaccinated.

In the coming weeks and months, health institutions across the country hospitals, clinics, nursing homes, pharmacies, health departments will face the unprecedented challenge of administering several entirely novel vaccines, some with stringent and complicated storage requirements, in the middle of a raging pandemic, to a weary populace that tends to be public-health averse in the best of times. Many of these institutions are running on fumes after years of deep budget cuts and months of unrelenting crisis, and most of them have nowhere near the resources that experts say are needed to meet the coming challenges.

The Association of State and Territorial Health Officials has said that its members need at least $8.4 billion to develop and run successful coronavirus vaccination programs. So far, the federal government has allocated less than $400 million.

According the nonpartisan Kaiser Family Foundation, which analyzed the vaccine distribution plans for 47 states, most have not completed plans to expand their vaccine delivery systems a monumental task that will include identifying and vetting hundreds, or potentially thousands, of new vaccine providers per state. Nearly half dont have data management programs comprehensive or reliable enough to keep track of who gets inoculated when (crucial information, especially given that all the vaccines on offer so far involve two doses). Less than half say they are prepared to identify and tally the number of people in their state who will be eligible for the very first shots, and few between half and one-third have plans to combat vaccine misinformation or reach racial minorities and other vulnerable populations.

Each of these shortcomings has been exacerbated by a lack of clarity from federal officials about a range of critical issues. For example, many health systems say they are not even sure which vaccines they will receive, let alone how many doses. Without that information, its difficult to say whether the plans they have drafted on paper will actually work.

So far, health officials have done little to acknowledge the challenges that lie ahead. Moncef Slaoui, the head of Operation Warp Speed, has said that 100 million Americans could be immunized against the coronavirus in the next 100 days: 20 million in December, 30 million in January and 50 million February. That timeline may indeed be possible, but it seems unlikely. Some hospitals are not even planning to administer their first doses until mid-January. The second doses cant be administered until three or four weeks after that, and full immunization will take about a week from there.

Congress could take a crucial step toward correcting these deficits by increasing the funding for state and local vaccination programs across the country. Theres already broad bipartisan support for doing so, but the provisions are being held hostage along with the rest of the federal budget. Lawmakers should extract those provisions and pass them as a separate bill immediately.

In the meantime, health officials at every level should explain clearly and repeatedly why some groups might be vaccinated before others: Some people are much more likely to die from the virus or much more likely to pass it on to others, and vaccinating them first ensures that as many people as possible are protected from the limited vaccine supplies. They can reinforce this important message by setting steep penalties for people who try to cut in line for example, by bribing doctors or by forging their frontline credentials.

Health officials should make clear that it will be crucial to wear face masks and practice physical distancing for a good while still. They should also be clear about the difference between real and imagined risks. While some of the vaccines have been linked to side effects like high fever and nausea, none of them can give a person Covid-19. While they appear to be safe for adults of any race or ethnicity, they have not yet been tested in children, pregnant women or nursing mothers. Its still unclear how long protection will last, and doctors dont yet know if the vaccines will prevent people from contracting the coronavirus, or just keep them from developing the deadly disease that the virus causes, Covid-19. They are working to answer these questions now.

If health officials want to maintain public trust and maximize vaccine uptake in the meantime, theyll have to be transparent about whats known and what isnt, and clear about how that changes as new data emerges. It will be difficult for state and local health departments to develop targeted messaging campaigns without sufficient resources, but health officials at every level can still strive for transparency in their public remarks.

The federal government has invested billions of taxpayer dollars in vaccines to fight the coronavirus pandemic. Some of that investment has already been squandered. By failing to check the spread of the virus these many months, Americas leaders have ensured that no vaccine not even a 95 percent effective one will quickly contain it. But if lawmakers, officials and the waiting public do whats needed now, they might still turn things around and make the most of the significant opportunities that remain.

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The Coronavirus Vaccines Were Developed in Record Speed. Now, the Hard Part. - The New York Times

By Sarah Fortinsky, Christopher Hickey, Janie Boschma, Daniella Diaz and Heather Fulbright, CNN

Since the start of the pandemic, that brings the known count to 11 senators and 34 members of the House who have tested positive for coronavirus or for its antibodies. Included in that total are two members who were diagnosed in March as "presumed positive" before tests were widely available.

The total 45 members come from 25 states and Puerto Rico and include 32 Republicans nine in the Senate and 23 in the House and 13 Democrats two in the Senate and 11 in the House.

While some members of Congress likely were exposed to Covid-19 on Capitol Hill, many lawmakers have traveled between Washington, DC, and their home districts since the beginning of the pandemic. Many of these members of Congress were at home when they learned of their exposure after testing and could have contracted the virus in their home states.

CNN has been tracking the total cases, as well as new cases since November 1, and will continue to update our reporting if more members test positive.

See the article here:

Here's who has tested positive for coronavirus or its antibodies in Congress - CNN

Lennox School District Supt. Scott Price has dealt with academic programs, union negotiations and budget deficits. But nothing has prepared him or other education leaders to make decisions about a pressing medical issue: How to or even whether to provide school-based coronavirus testing to students, teachers and other staff.

Many experts view regular, universal testing at schools as a crucial component to helping campuses reopen and remain open, while also contributing toward curbing the raging pandemic. Yet California does not require school-based testing and no one has offered to pay for it. So, Price is going to take a pass with some misgivings and try to keep his staff and 5,000 students safe through other means when they are able to return to campus.

In a small school district, we dont have the resources or expertise with which we could implement a comprehensive testing program, Price said.

Prices dilemma and his decision appear to be the default for many school systems across Los Angeles County and beyond. Frustrations over closed schools continue to increase and were expressed in early November in a letter to Gov. Gavin Newsom from leaders of seven of the states largest school systems. They called for the testing of all students and staff, uniform testing guidelines, and the resources to pay for it but have not yet received a response, said Los Angeles schools Supt. Austin Beutner.

Assemblyman Patrick ODonnell (D-Long Beach) said the state needs to provide more leadership and clarity, including on testing a conclusion several other legislators have echoed.

The governors office and the state health department did not respond Thursday to a request for comment, but officials have moved incrementally toward clarifying the situation as the pandemic stretches into its 10th month, with millions of students unable to learn on campus since March.

One such step is a task force charged with developing guidelines for school testing and how to increase it, said Daniel Thigpen, a spokesman for the state Department of Education, which is a member of the task force. And several school districts will be participating in a state-funded pilot involving the states new testing lab in Valencia.

In the meantime depending on a countys coronavirus rates and local decisions schools districts have remained closed, have reopened or have partially reopened without the data and assurances that proactive testing, typically called surveillance testing, has the potential to provide.

When it comes to coronavirus testing there is no consensus on whats best. At one end are experts who call for testing virtually the entire nation twice a week so that people with the virus can enter quarantine and avoid spreading COVID-19. Others shudder at the cost and logistics of that approach.

Members of President-elect Joe Bidens incoming administration have advocated for expanded nationwide testing. Biden has also called for rapidly reopening schools, but it isnt clear what role testing would play.

In the fall, colleges in the Northeast partnered with the Broad Institute in Massachusetts to test students once or twice a week and avoided large, sustained outbreaks in direct contrast to colleges elsewhere that lacked such a program.

Some experts say K-12 schools can rely on safety protocols that dont include costly surveillance testing. They point to schools that appear to be successful with fidelity to masking, social distancing, hygiene and keeping students in small, separate groups. Theres also disagreement over how much surveillance testing is adequate, a debate that has played out in New York City.

Backers of extensive proactive testing include Beutner, who says it has the potential to prevent or minimize outbreaks at a school, keeping more people safe and preventing frequent academic disruptions resulting from classroom quarantines and even campus shutdowns.

Price has been tracking the high number of cases and deaths in the Lennox area, a low-income community near Los Angeles International Airport that is heavily populated with essential workers. Cases have especially exploded in the last few weeks.

His districts health resources are thin a few health clerks and one school nurse shared by eight schools.

It would be very difficult to have our community and staff feel confident enough for any type of campus-based learning at this time, Price said. Its an emotional issue, and people are scared.

Both L.A. Unified and San Diego Unified, the states largest and second-largest school systems, have crafted their own surveillance testing. San Diego is scheduled to launch a pilot Monday.

L.A.'s more ambitious effort envisioned one to three tests per person per week along with contact tracing and school-by-school release of testing data. But because of the pandemic, L.A. County schools have only partially reopened. L.A. Unified has been especially cautious; less than 1% had returned for in-person services before Beutner ordered a new, temporary shutdown this week.

Through Dec. 5, L.A. Unified said it had used 201,545 tests. According to the contract schedule, the district was supposed to have used about 1.4 million tests by this point. Regardless, L.A. Unified is obligated to pay in full for a $48.9 million testing contract that runs through June.

The district hasnt necessarily spent unwisely the tests are reportedly good for three years and could be resold and widespread availability of a vaccine could be many months away. Beutner said the district is in discussions over extending the contract to account for the slower rollout. But its possible that the district wont be reimbursed for its costs by other government agencies because it has moved forward on its own. Beutner has estimated the full cost of the testing program, which includes personnel and software costs, at $150 million.

As far as I know, were the only school district doing what were doing because its hard, Beutner said. I believe it will stand the test of time.

Other school systems are simply relying on city and county testing that is free to them, but typically intended only for people who are feeling sick or who have been possibly exposed to someone who tested positive. Whether thats enough to protect schools is difficult to know because of inconsistent and incomplete data collection and disclosure about schools that have reopened.

On a cost-per-test basis, L.A. Unified inked what still looks like an exceptionally good deal with SummerBio, a start-up in Menlo Park. Prices start at $20 a test and drop to $10 after 2 million tests. According to the company and L.A. Unified, the low price is a result of volume purchasing and automated processing.

Across the nation, other innovations are being refined, including home tests that provide immediate results. But it may prove difficult to make fast and deep cost reductions because expenses also include field staff, software engineers and customer service, said Agatha Bacelar, general manager for California of Curative, another start-up. It had 12 employees when she joined in March and now employs about 2,600 and continues to hire.

Curative is providing tests that are free to those who stop by at sites across L.A. The city pays Curative for those not covered by insurance or federal CARES Act funding, said Haley Albert, the companys director of growth in California.

Camino Nuevo Charter Academy, which operates seven charter schools and an early education center, has partnered with Curative to provide free tests to all who want them in a campus parking lot. Because of privacy restrictions under this setup, the school network has no access to testing information that could assist in its planning.

Curative also provided tests free of charge for about 60 Camino Nuevo staff members on two occasions Curative can send the bill elsewhere because teachers are considered essential workers. But the price for students would be about $115 a test, which is comparable to what others are charging. The charter network has about 3,500 students and 550 employees.

Camino Nuevo turned down an opportunity to buy into L.A. Unifieds testing program for an estimated $250 for each student and staff member. School leaders concluded that price tag to be unaffordable. They are still trying to chart the best path forward.

We know that testing is going to be the thing that helps slow the spread, said Adriana Abich, Camino Nuevos chief executive.

Original post:

Schools left to fend for themselves on COVID-19 testing - Los Angeles Times

Oregon set record highs for coronavirus cases for the seventh straight week, posting 10,355 confirmed or presumed infections for the week ending Sunday.

Thats 14% higher than the previous weeks record.

If theres any solace, its that cases appear to be slowing this week and there might not be a new high for the eighth consecutive time.

Twenty-seven ZIP codes in Oregon recorded at least 100 new cases last week, and 15 of those are in the Portland metro area. A Salem ZIP code posted the most new cases statewide, with ZIP codes for Klamath Falls, Medford, Redmond, Albany, Hermiston, Bend and The Dalles also posting large case counts.

The Oregonian/OregonLive is monitoring state coronavirus data, reporting by ZIP code the areas with the greatest weekly changes.

Our analysis also highlights the areas with the most new cases in relation to population. Fully 136 ZIP codes recorded at least 20 new cases per 10,000 residents last week.

(Clickhere for an interactive map).

Heres a brief summary of the communities that added the most new cases for the week ending Sunday, Dec. 6:

97301 Salem

This Marion County ZIP code added 222 cases, raising its tally to 1,917. Thats the fifth most in Oregon and 25th most per capita since the start of the pandemic.

97236 east Portland (Pleasant Valley/Powellhurst-Gilbert/Centennial)

This Multnomah County ZIP code added 213 cases, increasing its total to 1,922. Thats the fourth most in Oregon and 15th most per capita since the start of the pandemic.

97233 east Portland/Gresham (Hazelwood/Glenfair/Centennial/Rockwood)

This Multnomah County ZIP code added 208 cases, raising its tally to 2,126. Thats the second most in Oregon and 11th most per capita since the start of the pandemic.

97123 Hillsboro

This Washington County ZIP code added 200 cases, increasing its total to 1,583. Thats the eighth most in Oregon and 32nd most per capita since the start of the pandemic.

97071 Woodburn

This Marion County ZIP code added 197 cases, raising its tally to 1,964. Thats the third most in Oregon and seventh most per capita since the start of the pandemic.

97305 Salem

This Marion County ZIP code added 183 cases, increasing its total to 1,784. Thats the seventh most in Oregon and 18th most per capita since the start of the pandemic.

97266 east Portland (Lents/Powellhurst-Gilbert)

This Multnomah County ZIP code added 163 cases, raising its tally to 1,273. Thats the 13th most in Oregon and 24th most per capita since the start of the pandemic.

97230 east Portland/Gresham (Argay Terrace/Russell/Hazelwood/Wilkes)

This Multnomah County ZIP code added 151 cases, increasing its total to 1,544. Thats the ninth most in Oregon and 22nd most per capita since the start of the pandemic.

97124 Hillsboro

This Washington County ZIP code added 143 cases, raising its tally to 1,031. Thats the 17th most in Oregon and 93rd most per capita since the start of the pandemic.

97603 Klamath Falls

This Klamath County ZIP code added 141 cases, increasing its total to 600. Thats the 51st most in Oregon and 78th most per capita since the start of the pandemic.

97030 Gresham

This Multnomah County ZIP code added 138 cases, raising its total to 1,479. Thats the 10th most in Oregon and 20th most per capita since the start of the pandemic.

97501 Medford

This Jackson County ZIP code also added 138 cases, increasing its total to 1,449. Thats the 11th most in Oregon and 34th most per capita since the start of the pandemic.

97116 Forest Grove

This Washington County ZIP code added 134 cases, raising its total to 833. Thats the 27th most in Oregon and 37th most per capita since the start of the pandemic.

97045 Oregon City

This Clackamas County ZIP code also added 134 cases, increasing its total to 1,057. Thats the 16th most in Oregon and 95th most per capita since the start of the pandemic.

97007 Beaverton

This Washington County ZIP code added 132 cases, raising its total to 1,077. Thats the 19th most in Oregon and 64th most per capita since the start of the pandemic.

97080 Gresham

This Multnomah County ZIP code added 126 cases, increasing its total to 1,365. Thats the 12th most in Oregon and 38th most per capita since the start of the pandemic.

97006 Beaverton

This Washington County ZIP code added 124 cases, raising its total to 998. Thats the 20th most in Oregon and 61st most per capita since the start of the pandemic.

97303 Keizer

This Marion County ZIP code added 120 cases, increasing its total to 1,082. Thats the 15th most in Oregon and 48th most per capita since the start of the pandemic.

Heres a brief summary of the communities with at least 30 new cases that added the most new cases per capita for the week ending Sunday, Dec. 6:

97761 Warm Springs

This ZIP code recorded new confirmed or presumed infections totaling 128 per 10,000 people during the week ending Sunday, up from the previous week.

The Jefferson County ZIP code, which includes the Confederated Tribes of the Warm Springs Reservation, added 55 new cases, increasing its total to 522.

97071 Woodburn

This ZIP code recorded new confirmed or presumed infections of 67 per 10,000 people during the week ending Sunday, essentially unchanged from the previous week.

The Marion County ZIP code added 197 new cases, raising its tally to 1,964.

97741 Madras

This ZIP code recorded new confirmed or presumed infections of 61 per 10,000 people during the week ending Sunday, double from the previous week.

The Jefferson County ZIP code added 75 new cases, increasing its total to 386.

97032 Hubbard

This ZIP code recorded new confirmed or presumed infections of 58 per 10,000 people during the week ending Sunday, up from the previous week.

The Marion County ZIP code added 30 new cases, raising its tally to 218.

97236 east Portland (Pleasant Valley/Powellhurst-Gilbert/Centennial)

This ZIP code recorded new confirmed or presumed infections of 52 per 10,000 people during the week ending Sunday, down from the previous week.

The Multnomah County ZIP code added 213 new cases, increasing its total to 1,922.

97113 Cornelius

This ZIP code recorded new confirmed or presumed infections totaling 51 per 10,000 people during the week ending Sunday, down from the previous week.

The Washington County ZIP code added 76 new cases, raising its tally to 714.

97233 east Portland (Hazelwood/Glenfair/Centennial/Rockwood)

This ZIP code recorded new confirmed or presumed infections of 51 per 10,000 people during the week ending Sunday, down from the previous week.

The Multnomah County ZIP code added 208 new cases, increasing its total to 2,126.

97116 Forest Grove

This ZIP code recorded new confirmed or presumed infections totaling 50 per 10,000 people during the week ending Sunday, up from the previous week.

The Washington County ZIP code added 134 new cases, raising its tally to 833.

97603 Klamath Falls

This ZIP code recorded new confirmed or presumed infections of 49 per 10,000 people during the week ending Sunday, up slightly from the previous week.

The Klamath County ZIP code added 141 new cases, increasing its total to 600.

97601 Klamath Falls

This ZIP code recorded new confirmed or presumed infections totaling 48 per 10,000 people during the week ending Sunday, up from the previous week.

The Klamath County ZIP code added 108 new cases, raising its tally to 412.

97266 east Portland (Lents/Powellhurst-Gilbert)

This ZIP code recorded new confirmed or presumed infections of 47 per 10,000 people during the week ending Sunday, down from the previous week.

The Multnomah County ZIP code added 163 new cases, increasing its total to 1,273.

97024 Fairview

This ZIP code recorded new confirmed or presumed infections of 45 per 10,000 people during the week ending Sunday, down from the previous week.

The Multnomah County ZIP code added 47 new cases, raising its tally to 517.

97058 The Dalles

This ZIP code recorded new confirmed or presumed infections of 44 per 10,000 people during the week ending Sunday, up sharply from the previous week.

The Wasco County ZIP code added 91 new cases, increasing its total to 580.

97838 Hermiston

This ZIP code recorded new confirmed or presumed infections of 43 per 10,000 people during the week ending Sunday, up from the previous week.

The Umatilla County ZIP code added 112 new cases, raising its tally to 2,182.

97305 Salem

This ZIP code recorded new confirmed or presumed infections of 42 per 10,000 people during the week ending Sunday, up slightly from the previous week.

The Marion County ZIP code added 183 new cases, increasing its total to 1,784.

97301 Salem

This ZIP code recorded new confirmed or presumed infections of 42 per 10,000 people during the week ending Sunday, unchanged from the previous week.

The Marion County ZIP code added 222 new cases, raising its tally to 1,917.

97123 Hillsboro

This ZIP code recorded new confirmed or presumed infections of 41 per 10,000 people during the week ending Sunday, down from the previous week.

The Washington County ZIP code added 200 new cases, raising its tally to 1,583.

97914 Ontario

This ZIP code recorded new confirmed or presumed infections of 40 per 10,000 people during the week ending Sunday, down from the previous week.

The Malheur County ZIP code added 77 new cases, raising its tally to 1,811.

-- Brad Schmidt; bschmidt@oregonian.com; 503-294-7628; @_brad_schmidt

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18 ZIP codes with the most new coronavirus cases in Oregon - OregonLive