COVID-19, Year 2: 📈 The fourth surge has begun, centered in Michigan; US vaccination rate hits 32% : 04 April 2021

Federal vaccine distribution system doesn't mean shots get in the right arms locally; cases increasing among children and teens; are vaccination passports a good idea?

One year ago, this was the 75th day after the first case of COVID-19 had been announced in the United States and the outbreak had been labeled a global pandemic.

Unlike last March, we have robust testing across the country (although it’s not being utilized as well as it should be), and most hospitals are not feeling pressured. If you’re fully vaccinated, the CDC says it’s OK to travel, both domestically and abroad (sidestepping the issue of vaccine passports).

On the very good news front, the CDC reported Sunday that 32% of the U.S. population has received a shot; 18.5% are fully vaccinated. Unfortunately, those people tend to be overwhelmingly White: “Black and Hispanic populations disproportionately affected by Covid-19 have been left behind” across the country. Perhaps there is no better example of Covid-19 systemic racism than in Palm Beach County, Florida.

In Palm Beach County, while Black people make up 18% of residents and Hispanic people 21.7%, these communities had received just 4.1% and 4.7% of vaccines respectively, as of March 1…

Vaccine events intended for underserved communities became destinations for those accustomed to getting their way, people who know whom to call and how to advocate for themselves. Nearby elders could drive up for their shot, but so could anyone else. They simply had to head west on Route 98…

A registration system would have helped to prioritize Glades area residents, said McKinlay. “It’s frustrating. But it’s the state’s decision not to allow us to do an appointment system at this location. It was their decision to make this first come, first serve,” she said.

The worrisome news is that cases in the US have again plateaued and begun rising. Case numbers are climbing rapidly in the European Union; since last October, the US has followed the EU trajectory (with a lag).

This chart shows reported cases using a seven-day average, which has been increasing since mid-March. After the initial surge last year, the low in reported deaths and cases occurred on 28 May 2020. This latest plateau in cases is a skosh below the summer peak and not even close to the summer low (34,321). Deaths are where they were on 03 November and below the summer peak. Neither have come close to approaching zero.

“The upper mid-west is just now beginning to start this fourth surge,” Michael  Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, reported on Meet the Press Sunday. Michigan is “seeing an increasing number of severe illnesses, ICU and hospitalizations in individuals who are between 30 and 50 years of age who have not been vaccinated.”

If we are entering a fourth surge, what might be the cause? The easy response is variants, and the cynical one, “Covid fatigue” among the unvaccinated.

The scary one: kids. A 25 March 2021 joint report from the American Academy of Pediatrics and Children's Hospital Association paints a troubling picture. Based on state data (some do not report by age), we have had 3,405,638 cases of children and teenagers contracting Covid-19, which as 13.4% of all cases the date of the report.

The week of March 18-25, children and teenagers represented 19.2% of all new cases.

Michigan Department of Health and Human Services data, reported by CBS on 02 April 2021, suggest opening schools may not be the wisest of moves:

[S]ince February 19, average daily new COVID-19 cases among children under 10 jumped 230%, more than any other age group. The second-highest increase in infections is in the 10 to 19 age group, which saw cases rise 227%. The trends in these groups exceed that of the state as a whole…

In Minnesota, people under age 20 made up nearly a quarter of reported cases in March, up from less than 15% at the end of February. Similar trends have been seen in other states as well, including Illinois and Massachusetts. 

Some children develop a rare condition, multisystem inflammatory syndrome in children (MIS-C) after a Covid-19 infection; MIS-C can affect the brain, eyes, gastrointestinal organs, heart, kidneys, lungs and skin.

And then there’s vaccine hesitancy. Pew reports that only half of long-term health caretakers have been vaccinated. To counter hesitancy, the Biden administration is collaborating with 275 community organizations, including the Catholic Health Association of the United States, NASCAR (!) and the North American Meat Institute. The campaign, We Can Do This, is coming to your TV and phone this month. On YouTube: Louis Gate, Jr. narration (EN); Power of the arm (EN); It’s Time (EN); and Vaccines against Covid-19 (ES).

A word about variants: we know that they are here. But we can only guess at how many and what kinds of variants there are. The first week of March, the UK group responsible for tracking variants sequenced 13,171 viruses. The average new cases per day the first week of March in the UK was about 6,100.

For the US to match that rate, we would have needed to sequence about 135,000 viruses each week. Instead, we sequenced about 8,000 the first week of March. The Biden plan announced in February was to boost that to 25,000 per week. That’s still too few to be meaningful.

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🤓 Recommended reading

▪️ ‘Vaccine passports’ are being developed to digitally verify Covid-19 immunization status. They are currently being used in Israel and are under consideration in parts of Europe and in New York state. Around the country, GOP representatives are preparing legislation to ban them. Vaccination cards have been required for travel for almost 100 years; I don’t understand why the vaccination card isn’t sufficient. In addition to the “what if you don’t own a smartphone” issue, I think the name “passport” is problematic.

 ▪️ If you have wondered (as I have) how the death rate in India can be so low, then this is the analysis for you.
Why Does the Pandemic Seem to Be Hitting Some Countries Harder Than Others? New Yorker, 22 February 2021.

▪️ About J&J’s manufacturing mess last week: the Baltimore plant operated by Emergent BioSolutions has had repeated FDA violations, according to an AP analysis of inspection records since 2017.
Company producing J&J vaccine had history of violations, AP, 31 March 2021.

▪️ What are the known variants circulating in the US? How are they different? Are vaccines effective? And what’s going on in British Columbia?

▪️ The World Health Organization has published its initial report on the Global Study of Origins of SARS-CoV-2. Supporters of the lab-leak theory are unlikely to be satisfied. Here’s a lay-person summary.

▪️ Full text: Pope Francis’ Easter Urbi et Orbi blessing 2021

⚡️04 April 2020 flashback

Unfortunately, we have made no progress here, although the need for UBI to be part of the political conversation is no less critical today…

I was chatting with a friend on Facebook about the need to seriously examine universal basic income policies in the light of this crisis. Until now, the driver of that conversation has been technological disruption: jobs that vanish due to automation, never to return.

On Saturday, as though I had conjured it, the Financial Times (think of it as the Wall Street Journal of Europe) wrote an editorial entitled Virus lays bare the frailty of the social contract:

Policies until recently considered eccentric, such as basic income and wealth taxes, will have to be in the mix [in order to] forge a society that will work for all (emphasis added).

Link: COVID-19 day 75 : 📈 312,237 cases; 8,502 deaths : 04 April 2020

📊 Where we are today (04 April 2021)

Summary, Johns Hopkins

  • US: 30,706,121 cases; 555,001 deaths

  • Global: 131,212,766 cases; 2,852,462 deaths

Vaccine report, CDC 💉

  • Doses distributed to states: 207,891,295

  • Doses distributed within states (“administered”): 165,053,746

  • Vaccinations given: 106,214,924 (32% population)

  • People fully vaccinated: 61,416,536 (18.5% population)

  • Record for daily doses given: 2,408,716 (reported 03 April)

Context

16 September 2020: “We’ll be able to distribute 100 million doses by the end of 2020 and a large number much sooner than that.”

08 October 2020: “We may have up to 100 million doses by the end of the year, enough to cover especially vulnerable population.” 

15 December 2020: “We expect to have immunized 20 million of our American people” during the month of December. The Administration also pledged to distribute at least 40 million doses.

25 March 2021: Biden Administration doubles its first-100-days distribution goal from 100 million to 200 million doses of Covid-19 vaccines. There is a significant lag between distribution to states and shots-in-arms.

Vaccine map, Bloomberg

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 Trump White House Task Force set a goal of 10%.

Some states should not be open. Using these data, NYTimes reported on 01 April 2021 that Kansas is only testing about 60 people per capita; that rate is similar for Alabama, Iowa, and Mississippi, for example. New York, on the other hand, is averaging 1,200 tests a day; Rhode Island, 1,677.

The positivity rate in Idaho is 27.3%; the highest in the country. In New York, it’s only 3.6 %. Check out your state.

US hospitalizations, Washington Post

Michigan (29) has the most per capita hospitalizations in the country, followed by the District of Columbia, New Jersey and New York (27) and then Maryland (22). The fewest: Hawaii (3).

Cases, domestic and global (normalized)

You can see that the US is an extreme outlier in terms of cases per capita. Also, the US case trajectory has lagged the EU since October 2020. The US still accounts for one-in-four cases worldwide, and one-in-five deaths.

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