Weekly coronavirus-related chat, questions, and minor updates - week of January 4

Usual personal update:

Anyone who has been following my updates here has probably clearly seen my anxiety on display, in full force. I genuinely didn’t realize how bad it was until it went away. Over the holiday break, after I tested negative following my last exposure, I had a full week of safety, with no contact with anyone save for my husband.

Feeling the anxiety leave me is something I cannot describe in words. The closest I’ve come is the following image: I was a gas stove, with every burner blazing on high, at full strength. On my week off, the dials turned down and the burners dimmed before shutting completely off. Only the pilot light remained lit — the faintest of flames, and one that it’s easy to forget even exists.

I hadn’t felt that way in months. I felt physically lighter. My mind felt clearer. The feeling of normalcy was thoroughly noteworthy for its lack of noteworthiness. I felt empty in the best of ways. There was no “there” there, and it was wonderful.

My district returned to school this week, and we did so remotely rather than in-person due to precautions about rising cases in our area (we had a >10% test positivity rate at the time, and we’re still anticipating an upcoming holiday spike). The plan was originally to return to in-person learning this coming Monday but we just extended remote learning by another week.

I’m reminded of last March, when schools unexpectedly shut down but kept saying they’d re-open in a week or two, week after week after week. I don’t think, come next Friday, our numbers will look better than they are now. And I don’t think they’ll look better the week following that. If I had to call the shot now, I suspect I’ll be doing remote for the foreseeable future.

I understand and empathize how difficult this is for families. I really do. I have some families and kids I know who are really hurting, now more than ever, and I hate that this is one more unfairness they are saddled with.

That said, my empathy has limits, and my heart has hardened to many other families out there. I am not on social media, but most of my colleagues are, so they see the posts that people in the community are making. When parents of students we teach are openly disobeying rules, posting COVID-hoax propaganda, and cheering on the idea of deliberately putting teachers in harm’s way, it makes me wonder why I bother serving the community in the first place.

And, to be clear, teachers aren’t saints either. I work on staff with someone who continues to be an outspoken anti-masker. Some teachers I work with are also posting pictures of their massive, unmasked and undistanced holiday meetups on Facebook.

For a long time I was frustrated with the sort of voyeuristic moralizing that social media enabled with this pandemic. Making character judgments about individuals’ behavior seemed like the product of our perpetual need for culture war conflict — a petty distraction from and degradation of bigger picture planning about an issue that demanded an unwavering focus and a unified response.

As this has gone on, however, and the reality of COVID had permeated everyone’s lives so thoroughly, I find myself unable to ignore or excuse individuals who continue to either flout the rules deliberately or remain ignorant of best practices. I have lost a lot of respect for some people I know because I consider their actions, at this point, inexcusable. I also find that my will to support kids is hugely sapped when I find out their parents are acting in ways that are actively and consciously detrimental to my own safety and the safety of other students with whom their child shares a classroom.

These genuinely are only a very few bad apples, and most of the children and families I serve are wonderful people who deserve the best, but just as it only takes one infectious person to cause an outbreak, so too does it only take one toxic person to pollute. I’m having a hard time finding my usual love of service in my heart right now. I don’t do what I do out of a need for reciprocity, but I do need the minimum assurance that people won’t meet my help by metaphorically spitting in my face, and this pandemic has demonstrated that we cannot even clear that lowest of bars. Do not expect me to put my heart into teaching your child if you openly celebrate my suffering.

Despite these frustrations, I will say that this week was blessedly easy. Because we’re doing remote learning, my stovetop burners never reignited. They’re still off. I feel comfortable and safe doing my job. I could teach this way for the rest of the year and be happy to do it. There has been much said about the alleged benefits of having kids learn in person. I can’t speak for everyone, but I will say that my students get the worst version of me in person and the best version of me via remote. I’m more relaxed, calm, and even joyful. I felt more “myself” in my teacher role this week than I have in months, and that’s something they simply won’t get if they are actually in the same room with me. I can’t be the calm, cool, collected educator I need to be when each of my burners is raging.

I tested positive for covid this week. My only symptoms at first were fatigue, headache, and runny nose. Later though I lost my sense of smell and it still hasn't come back yet :(

This morning Dr. John Campbell and Dr. Roger Seheult held a MedCram podcast (99m) covering a wide range of covid health topics, from vitamin d to current infection rates, the impact of the new strain, long-term covid health effects, and the vaccines. Loads of solid science well presented by experts, cuts right through all the BS in the media at the moment. This is a good one to share with people who are skeptical about the vaccines.

Roger Seheult, MD is the co-founder and lead professor at MedCram. He is an Associate Professor at the University of California, Riverside School of Medicine and Assistant Prof. at Loma Linda University School of Medicine. Dr. Seheult is Quadruple Board Certified: Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine. He currently practices medicine full time.

John Campbell, RN, BSc, MSc, PGC.Pharm, PhD is a health educator and analyst who has spent over three decades teaching students in the United Kingdom, Asia, Africa, and online with an extensive video library. John has also published textbooks on Physiology and Pathophysiology. He publishes frequent COVID-19 updates at his YouTube channel.

Belgium is now realizing that we could vaccinate on weekends to speed this up.

Fucking unbelievable.

https://www.brusselstimes.com/news/belgium-all-news/148278/vaccinating-people-during-the-weekend-is-not-self-evident-dirk-dewolf-care-and-healt-agency-flanders-vandenboroucke-de-croo-wouter-beke/

The Onion: CDC Unveils List Of Twitter Accounts You Can Follow To Piece Together Vaccine Information

On the personal-good-news front, my wife is getting her first dose of the vaccine today. She's a nurse in Detroit, though she works in a clinic office and not in the ER or similar. So while relative to other healthcare workers her exposure risk is rather low, in our circle of WFH friends she's the main risk vector. So this is a load off of her mind (and mine!).

U.K. scientists worry vaccines may not protect against coronavirus variant found in South Africa

Both Britain and South Africa have detected new, more transmissible variants of the COVID-19-causing virus in recent weeks that have driven a surge in cases. British Health Secretary Matt Hancock said on Monday he was now very worried about the variant identified in South Africa.

Simon Clarke, an associate professor in cellular microbiology at the University of Reading, said that while both variants had some new features in common, the one found in South Africa "has a number additional mutations … which are concerning."

He said these included more extensive alterations to a key part of the virus known as the spike protein — which the virus uses to infect human cells — and "may make the virus less susceptible to the immune response triggered by the vaccines."

Scientists appeal for calm over new Covid variant in South Africa

Scientists are appealing for calm following suggestions that Covid vaccines might not protect people against a new variant of the virus that has emerged in South Africa.

Experts say there is no need for panic, even though the health secretary, Matt Hancock, has said he is very concerned about the latest variant of Sars-Cov-2, which has emerged in South Africa and is said to be highly transmissible, as is the variant first seen in Kent.

If you're keeping score at home, the previously-identified variant first found in the UK is B.1.1.7, and this new variant is 501.V2

Yesterday I hacked together a dashboard of vaccination info in the state of Colorado, since I found the official Colorado vaccination dashboard mostly unusable:

https://vaxtrack.co/

If anyone has any feedback, I'd be glad to hear it!

San Jose hospital worker dies from COVID-19 outbreak possibly tied to inflatable costume

An employee working the Christmas shift at Kaiser Permanente San Jose Medical Center has died after falling ill with COVID-19. The worker was one of at least 43 staff members who tested positive for the coronavirus in recent days, an outbreak possibly linked to a staff member who wore an inflatable holiday costume to lift spirits.

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Chavez said the hospital would no longer allow air-powered costumes at its facilities and was taking steps to reinforce safety precautions among staff, including no gatherings in break rooms, no sharing of food and beverages, and the wearing of masks at all times.

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Last week, county officials said hospitals were stretched to the limit, with 50 to 60 patients each day stuck in emergency rooms waiting for a bed.

Often, the only time a patient can be moved into an ICU bed is after a COVID-19 patient has died, said Dr. Marco Randazzo, an emergency room physician at O’Connor Hospital in San Jose and St. Louise Regional Hospital in Gilroy.

Every single one of the ICU beds at St. Louise Regional Hospital was full, and patients were now in so-called surge beds, Gloria de la Merced, the hospital’s chief operating officer, said last week. “This level of hospitalizations has never happened during my career,” she said. “If we go beyond the surge capacity, everyone will be affected — more people in our community will know someone who died.”

Amid COVID-19 surge, L.A. County ambulance crews told not to transport patients who have little chance of survival

The situation in L.A. County hospitals is so critical that ambulance crews have been advised to try to cut back on their use of oxygen and not to bring to hospitals patients who have virtually no chance of survival. Officials now say they need to focus on patients with a greater chance of surviving.

England to enter lockdown (Jan 4)

California governor says vaccination pace ‘not good enough’

[T]he 454,000 doses of vaccine that have been administered in California represent just a third of the more than nearly 1.3 million received in the state so far, according to the California Department of Public Health. Distribution hiccups and logistical challenges — including hospitals having more vaccine doses available than people available to take them — have slowed the initial vaccine rollout in California.

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Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, said the state assigns the number of doses that local health jurisdictions will receive after getting an allocation from the federal government. The vaccine is then shipped directly to entities like hospitals or county or local public health offices. Pfizer distributes its vaccine directly, while Moderna uses the pharmaceutical company McKesson as an intermediary, which initially led to slow communication, Newsom said.

California is working to expand the list of sites where the vaccine can be distributed to include pharmacies, clinics and dental offices. Officials are also completing a survey of health care workers to find out how many of them do not want to take the vaccine, in response to anecdotal evidence that some are refusing it.

While the state wants to make sure no one is jumping ahead in the line, Newsom said he wants to give providers the flexibility to distribute doses to people not on the priority list if doses are at risk of going to waste.

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County health officials fear the incoming Christmas and New Year’s surge. The additional Thanksgiving cases have swamped hospitals, forcing them to treat patients in hallways, ambulances and the gift shop, and forced an oxygen shortage. The California National Guard is contributing freezer trucks to help store bodies as hospitals run out of space.

Meanwhile, some older hospitals in Southern California have oxygen systems that can’t handle the demand for coronavirus patients, and the state is contracting with the Army Corps of Engineers to upgrade the systems. Giant oxygen containers may also be placed in hospital parking lot systems as back ups.

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Elsewhere, organizations representing actors, commercial advertisers, advertising agencies and independent film and television producers recommended a hold on in-person production in Southern California.

The hold would last until mid-January, according to a statement by the Screen Actors Guild-American Federation of Television and Radio Artists and the Joint Policy Committee, which represents commercial advertisers and ad agencies. The Producers Guild of America made a similar plea.

Major studios are already on a production hiatus until the middle of this month.

Pope's personal doctor dies from Covid-19 complications

Pope Francis' personal doctor, Fabrizio Soccorsi, has died as a result of “complications due to Covid,” the Vatican’s newspaper L’Osservatore Romano announced on Saturday.

Pope Francis chose Soccorsi as a personal doctor in 2015, the news outlet said. He was 78 years old when he died.

Soccorsi was hospitalized in Rome on December 26 for a previous oncological disease, according to the Italian Bishop’s Conference newspaper Avvenire. It’s unclear exactly when he was last in direct contact with Pope Francis.

In an interview with Italy's Canale 5 channel set to air on Sunday night, Pope Francis said the Vatican will begin Covid-19 vaccinations next week and he is in line to take it.

Germany mulls delaying second COVID-19 vaccine shot, Denmark approves delay

In Berlin, the health ministry was seeking the view of an independent vaccination commission on whether to delay a second shot beyond a current 42-day maximum limit, according to a one-page document seen by Reuters on Monday.

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According to the latest daily update from the Robert Koch Institute, Germany has vaccinated around 239,000 people since starting its campaign on Dec. 27 - well short of the 1.3 million doses that were delivered by the end of 2020.

By way of comparison, Britain has administered more than a million COVID-19 vaccines so far, more than the rest of Europe put together, Health Minister Matt Hancock said.

[...]

The Danish Health Authority will allow a wait of up to six weeks before administering a second dose, its head Soren Brostrom told local news wire Ritzau on Monday, after scrutinising vaccine data.

But Brostrom said the original guidelines of waiting only three to four weeks should be followed whenever possible.

Also, here is an opinion piece in the Washington Post:

We are not arguing against people receiving two shots. The second shot adds a measure of effectiveness and likely makes vaccination-derived immunity more durable. That’s why we’re advocating that it be delayed, not dropped altogether. And an argument can be made that for groups at highest risk for exposure (such as health-care workers) and for death (such as Americans over age 75), sticking with the early second-shot strategy is reasonable. But for everyone else, the deferral strategy makes sense.

Is there any potential downside to a delay? Yes. The strategy hasn’t been studied, so we don’t know if and when the immunity from the first shot begins to wane. But data from Moderna, for example, is reassuring. It shows robust immune response four weeks after the first shot, and most experts believe it is extremely unlikely immunity would somehow plummet by week eight or even week 12 following a single shot. Another concern is that with a delay, some people may forget to get their second shot. It will require effort to track people and remind them to receive it.

China to give coronavirus vaccine to 50 million in a month

Within China, state media on Monday was awash with reports of the vaccination drive. In the capital city, Beijing, municipal officials reported that 73,537 people received their first vaccine dose in the first two days of the new year.

State broadcaster CCTV showed footage of people standing in line over the weekend at pop-up vaccination sites in Beijing and sitting in socially distanced seats afterward for monitoring for any adverse symptoms. The broadcaster said there were more than 200 vaccination sites in the capital.

Other cities across the country have also announced drives to vaccinate front-line workers over the past two weeks.

Health Times, a state-run newspaper, quoted vaccine expert Tao Lina last month as saying the government planned to vaccinate 50 million people by Lunar New Year, with the first shot by Jan. 15 and second shot by Feb. 5.

Front-line workers eligible for this round of vaccinations include those age 18 to 59 employed in ports, delivery companies, the transportation industry, health and sanitation, public servants, police and firefighters, utilities, elder care, telecommunications, and people whose work or studies takes them overseas.

Hospital Scrambles To Find Patients Before Freezer Failure Ruins 830 Vaccines

Somewhere around 2 a.m. the compressor of the freezer holding vials of the medicine at the Adventist Health Ukiah Valley Medical Center in Mendocino County, Calif., failed, President Judson Howe told NPR.

That started a ticking clock on the shelf life of the vaccines, which can only be used for 12 hours once they're removed from refrigeration of 36 to 46 degrees Fahrenheit.

Normally, this would have triggered an alarm, Howe explained. But for some unknown reason, that also failed.

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Together hospital staff worked the phones, sent out text blasts and relied on word-of-mouth to ensure every available vaccine dose was delivered into every available arm.

Two hundred doses were immediately sent to Mendocino County Public Health, which distributed them to some of the region's most high-risk employees and citizens, including sheriff's deputies, jail staff and some jail inmates.

Another 70 doses went to two nursing homes in the area which house many of the county's most vulnerable patients. Howe added the hospital also provided nurses to administer the vaccinations.

The remaining doses were given out at emergency vaccine clinics set up at various locations manned by hospital employees or other emergency response workers from around the region.

By the end of the day, more people received an injection in just a couple of hours than have been vaccinated since the start of the vaccine program on Dec. 18, Howe said.

On the one hand, nice job! On the other hand, it shows how much faster it could be done if the problem were treated with proper urgency.

One almost wishes for more freezer failures.

Biden will release nearly all available vaccine doses in break from Trump administration policy of holding back stock for second dose

Releasing nearly all vaccine doses on hand could quickly ratchet up the availability of coronavirus vaccines by allowing more people access to a first dose. It could also be a risky strategy as both Pfizer/BioNTech and Moderna's vaccines require two doses, administered at specific intervals, and vaccine manufacturing has not ramped up as rapidly as many experts had hoped.

"The President-elect believes we must accelerate distribution of the vaccine while continuing to ensure the Americans who need it most get it as soon as possible. He supports releasing available doses immediately, and believes the government should stop holding back vaccine supply so we can get more shots in Americans' arms now," said TJ Ducklo, a spokesman for Biden's transition. "He will share additional details next week on how his Administration will begin releasing available doses when he assumes office on January 20th."

"Risky" compared to vaccinating half as many people?

False Reports of a New ‘U.S. Variant’ Came from White House Task Force

Reports of a highly contagious new variant in the United States, published on Friday by multiple news outlets, are based on speculative statements made by Dr. Deborah Birx and are inaccurate, according to several government officials.

The erroneous report originated at a recent meeting where Dr. Birx, a member of the White House coronavirus task force, presented graphs of the escalating cases in the country. She suggested to other members of the task force that a new, more transmissible variant originating in the U.S. might explain the surge, as another variant did in Britain.

Her hypothesis made it into a weekly report sent to state governors. “This fall/winter surge has been at nearly twice the rate of rise of cases as the spring and summer surges. This acceleration suggests there may be a USA variant that has evolved here, in addition to the UK variant that is already spreading in our communities and may be 50% more transmissible,” the report read. “Aggressive mitigation must be used to match a more aggressive virus.”

Dismayed, officials at the C.D.C. tried to have the speculative statements removed, but were unsuccessful, according to three people familiar with the events.

C.D.C. officials did not agree with her assessment and asked to remove it but were told no, according to one frustrated C.D.C. official, speaking on condition of anonymity for fear of retaliation.

NY to expand COVID vaccine eligibility Monday, but short supply will delay shots, Cuomo says

New York will allow police, firefighters, teachers and elderly over age 75 to start making COVID-19 vaccine appointments on Monday, but many will likely wait weeks to get the shots due to supply shortages, Gov. Andrew Cuomo said Friday.

The development came as Cuomo relented to pressure from local officials calling for the expanded eligibility in order to streamline distribution and speed up the slow immunization effort so far.

Meanwhile, from Scott M. Stringer on Twitter

The @nycHealthy site has a multi-step verification process just to set up an account, and then a six-step process to set up an appointment.

Along the way, there are as many as 51 questions or fields, in addition to uploading images of your insurance card.

All of this will be particularly challenging for populations that struggle with digital literacy and digital access—who have been hit hardest by this pandemic and who need the vaccine most.

COVID-19 test that may have inaccurate results used all over Bay Area, FDA warns

The U.S. Food and Drug Administration issued a warning Monday that the COVID-19 test developed by Curative, the Bay Area start-up that brands its tests as "simple-to-use and painless," runs the "risk of false results, particularly false negative results."

The reason for this, the agency explained, is that the test should be used only on "symptomatic individuals within 14 days of COVID-19 symptom onset."

"A negative result does not exclude the possibility of COVID-19" if used on individuals without any symptoms, it warned.

Also:

Congress using Covid test that FDA warns may be faulty

The House and Senate are screening members and staff with a Covid-19 test that the Food and Drug Administration says is prone to false results — complicating the already difficult task of stemming coronavirus outbreaks on Capitol Hill.

The Office of the Attending Physician has been offering the test, made by Curative, to members, staff and reporters on Capitol Hill since at least November. The service, which typically offers results within 12 hours, is used by dozens, if not hundreds, of people a day when Congress is in session.

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Brian Monahan, the Capitol physician, acknowledged the FDA’s warning in a Monday memo obtained by POLITICO, which described the test as “the most accurate available” and noting that the risk of a false negative “is a problem for all coronavirus tests.”

“We expect to have additional information in the coming days from the FDA and our expert consultants with regard to any concerns about the ongoing use of this test for the Capitol community,” Monahan wrote in the memo Monday.

"I'm not an anti-vaxxer, but..." - US health workers' vaccine hesitancy raises alarm

The two authorized vaccines, made by Moderna and Pfizer-BioNTech, are safe according to leading experts and clinical trials – for one thing they contain no live virus and so cannot give a person Covid – and with tens of thousands of patients, they have had about 95% efficacy. But across the country, health workers with the first access to the vaccine are turning it down.

The rates of refusal – up to 40% of frontline workers in Los Angeles county, 60% of care home workers in Ohio – have prompted concern and in some cases, shaming. But the ultimate failure could be dismissing these numbers at a critical moment in the US vaccination campaign.

New, potentially more contagious variant of the coronavirus spreads in California

Officials in San Diego County on Tuesday reported a cumulative total of 32 cases of the new, potentially more contagious variant of the coronavirus that has also spread rapidly in England.

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The new cases have been identified among residents of San Diego and several suburbs, including Chula Vista, La Mesa and Lakeside. The residents range in age from 10 to over 70.

San Diego County officials say no patients infected with the variant have died, but one woman was hospitalized. She is now recovering at home.

California orders hospitals to take transfer patients amid devastating Covid surge

The public health order issued on Tuesday night could result in patients being shipped to northern California from southern California and the agricultural San Joaquin Valley, where 14 counties were immediately ordered to delay non-essential “and non-life threatening” surgeries in order to provide beds. The order, which will last at least three weeks, also applies to any county where ICU capacity to treat Covid-19 patients is bottoming out.