COVID-19 day 351: 📈 1,876,823 cases, 21,226 deaths since Boxing Day : 03 January 2021

Alarming rate of health professionals refusing vaccination; new case every six seconds in Los Angeles County; King County public health officer on the new variant; vaccination plan pivot?

Jan 4, 2021

Despite weekend- and holiday-related hiccups in reporting, we have averaged 208,536 cases and 2,358 deaths each of the past nine days. As of 02 January 2020, the CDC had bumped that figure on vaccinations in the chart to 4,225,756. Doses distributed: 13,071,925.

I have an ask of you: What do you want to know about COVID-19 in 2021?

I’m having a hard time focusing on COVID-19.

The president of the United States, and his chief of staff, called Republican leaders in the state of Georgia and demanded that they reverse the certified election results from 03 November 2020. Because Georgia alone is insufficient to usurp Joe Biden’s electoral college win, you have to ask yourself: who else did he call who has not gone public? From the transcript:

You're not the only one I mean we have other states that I believe will be flipping to us very shortly.

As journalist Carl Bernstein said on CNN:

In any other conceivable moment in our history, this tape would result in the leadership of both parties calling for the resignation of the President of the United States immediately.

However, Trump did not leave COVID-19 or the CDC out of his Twitter rants.

Donald J. Trump @realDonaldTrump

The number of cases and deaths of the China Virus is far exaggerated in the United States because of @CDCgov’s ridiculous method of determination compared to other countries, many of whom report, purposely, very inaccurately and low. “When in doubt, call it Covid.” Fake News!

Dr. Anthony Fauci responded on ABC.

“To have 300,000 cases in a given day, and between two and 3,000 deaths a day is just terrible. There's no running away from the numbers, Martha… The deaths are real deaths. All you need to do is go out into the trenches. Go to the hospitals and see what the health care workers are dealing with. They are under very stressful situations in many areas of the country. The hospital beds are stretched, people are running out of beds, running out of trained personnel who are exhausted.”

03 January 2021

In the United States, the number of us who who are “somewhat or very likely” to get vaccinated for COVID-19 dropped precipitously from 74% in April to 56% in December.

Health care workers in rural Georgia are refusing the vaccine. In Ohio, 60% of nursing home staff have refused vaccination. In Riverside County, California, it’s 50% of frontline health care workers; 20-40% in LA County. Although the law may be on the side of the employer, we have no surplus of health care workers.

“Employers may require vaccines before employees return to the worksite if the failure to be vaccinated constitutes a direct threat to other employees in the workplace because the virus is rampant and easily transmitted in the workplace,” said Robin Samuel, an attorney with Baker McKenzie in Los Angeles.

In addition, the rollout is proceeding much slower than promised by Trump and Pence and than hoped for by state public health officials.

“There’s a lot states still need to do,” Dr. Ashish Jha, a health policy researcher and dean of the Brown University School of Public Health, told the Associated Press, “but you need a much more active role from the federal government than what they have been willing to do. They’ve largely said to states, ‘This is your responsibility. Figure it out’.”

This headline is representative of the country: Only a fraction of COVID-19 vaccine has been used in Washington state. Los Angeles Mayor Eric Garcetti said that at the current pace it would require more than five years to vaccinate everyone in LA.

Florida takes the prize for theatre of the absurd. First, Lee County had seniors line up outside, first-come, first-served, for the vaccine. Now we learn that Sarasota is using Eventbrite to register seniors.

Annie Case @anniecase1

@shamuskhan It's such a mess. My 90yo grandmother lives in Sarasota and we couldn't get one for her either. No chance she would have even been able to register (or find the eventbrite page) on her own. Can't imagine the situation for those without adequate support and/or internet 😭

While the vaccination process is slow and cumbersome, a new COVID-19 variant is just the opposite. In Los Angeles County, California, SARS-CoV-2 is infecting a new person every six seconds.

We might not all have the same density as L.A., but what’s happening in L.A. can and will be coming in many communities in America.

To that point, here is Seattle-King County Washington public health official Jeffrey Duchin on preparing for the variant:

Jeffrey Duchin, MD @DocJeffD

Straight Talk About the New Variant COVID-19 Strain. As much as I regret saying it just when so many need & deserve a break, the new variant COVID-19 strain is a serious problem. It’s likely a matter of time before it arrives here & we need to beware & prepare. Here’s why. 1/

If your state and local health officials are not talking about the variant, ask them why not.

Given the risk of out-of-control spread with a more contagious variant, some public health officials are asking if we should focus on vaccinating more people, sooner.

Original plan: depth. Fewer people, greater immunity for each person with the most immunity after the second dose (21-28 days after the first).
Alternative pivot to breadth: more people, some immunity for each person. Circle back with second dose after 8-12 weeks.
Alternative pivot on dose: halve the dose of the Moderna vaccine, but still follow the two-shot plan. Research data show that two 50-microgram doses had an “identical immune response” to two 100-microgram doses.

I do not know enough to have an opinion. The fact that the chair of the UCSF Department of Medicine is talking about the pivot to breadth gives me pause. And Dr. Moncef Slaoui, with Operation WarpSpeed, told the NY Times that they are talking to the FDA and Moderna about implementing the half-dose regimen.

Western countries still fail to take COVID19 seriously, especially the US. Freelance journalists Raphael Rashid details the process a resident undergoes when returning to South Korea from the UK. Worth your time. Try to imagine this process here (such as, private negative air pressure rooms for travelers).

State blurbs:

In LA on Sunday, anti-maskers went wild harassing people wearing masks at Ralph’s and the Century City shopping mall (video).
Florida broke its COVID-19 record on the last day of the year. New Year’s Eve parties crowded Tampa Bay. District 88 Representative Omari Hardy has asked Palm Beach County officials to close Mar-a-Lago for violating county mask polices on New Year’s eve. It was the third state to identify the variant.
Illinois residents (8.4% positivity rate) are reportedly traveling to Indiana (12.6% positivity rate) to dine out at a restaurant.
Massachusetts is opening its second field hospital due to surging cases.
Both men’s and women’s basketball teams at the University of Minnesota Duluth had to cancel games on Sunday due to COVID-19 infections.
Two New Jersey bars have had their licenses revoked for violating state COVID-19 regulations.
Ohio has extended its 10 p.m.-to-5 a.m. curfew until 23 January 2021.
Compare state vaccination plans.

Global blurbs:

Police condemn Australian wedding in Sydney that had massive breach of COVID-19 restrictions. Fine for the venue: $5,000. And a 27-year-old woman was fined $1000 twice in three days for repeatedly failing to self-isolate despite being a close contact of a coronavirus case and health authority direction.
Hong Kong has suspended face-to-face school classes until mid-February.
India has approved the Oxford vaccine and another developed in-country.
Kenya extended night curfew to 12 March 2021 to curb the spread of COVID-19.
Norway had prohibited alcohol after midnight but now has new restrictions due to a “new wave of infections” which include no alcohol at bars and restaurants. No visitors in your home for two weeks, and mandatory tests for anyone entering Norway from abroad.
South Korea has expanded a ban on private gatherings larger than four people to the whole country and also restricted gatherings at churches, restaurants, cafes, and ski resorts. They plan to begin vaccinations in February.
Thailand has asked citizens to “just stay home” as the country set record infections.
Tokyo may be placed under a state of emergency due to growing number of cases. This will be a setback for Japan and for the Olympics.
In the UK, the first patient has received the Oxford-AstraZeneca vaccine.

A few reads (and a listen)

2021 Tokyo Olympics: The longest 200 days: Tokyo Games organisers continue to face mammoth task. The Age (Australia), 04 January 2021.
A Q&A about the new coronavirus variant with the Fred Hutch scientist who’s been tracking its spread. Seattle Times, 30 December 2020.
Early vaccination in prisons, a public health priority, proves politically charged. Washington Post, 02 January 2021.
The coronavirus at 1: A year into the pandemic, what scientists know about how it spreads, infects, and sickens. STAT News, 13 December 2020.
The Holocaust Stole My Youth. Covid-19 Is Stealing My Last Years. NY Times, 03 January 2021.
What Drove The Drop In Kids' Asthma ER Visits At A Boston Hospital During Lockdown? NPR, 04 January 2021.

⚡️Kathy E Gill | Wear a mask, dammit! @kegill

The best Covid19 PSA for wearing masks that I have seen!

Where are we today?

US Positivity rate, Johns Hopkins

On May 12, 2020, the World Health Organization advised governments positivity rates for testing should remain at 5% or lower for at least 14 days before reopening the economy. The White House Task Force set a goal of 10%.