“Shared expectations lead to predictability.”
176.When, where and how to register to be vaccinated – as of December 28.
Q: My wife is aged 62 with a medical condition. I am 68 years old. Where do we register to be vaccinated?
A: Each state is defining for itself how the people who are not “essential healthcare workers” will next be prioritized and the process they will follow. The State of Connecticut as of last Monday has not yet defined these details. There are several groups in the next “1b” group of vaccinations yet to be scheduled. It is stated on their website, “Those who will be eligible for vaccination in upcoming phases between January and May has not been finalized, but we anticipate it will include:
- Critical Workforce
- Other Congregate Settings
- Adults Over 65
- High Risk Individuals Under 65”
The state indicates that these four main groups in the next scheduled track may be differentiated and further defined. The groups may also be prioritized, meaning that qualified people in three of these groupings may be delayed before they are eligible after others are vaccinated within the “January-May” schedule. Another detail that needs to be defined will be defining the proof people will need to show they are in their authorized group. For example, a driver’s license showing the birth date and photo can be used to show one is over age 65. But what other proof of identity and age can be used for someone who no longer has a driver’s license? What proof does a 30-year-old need to show they really are at “high risk?” In last Monday’s Hartford Courant, an article was published showing that Hartford HealthCare, the parent company of seven Connecticut hospitals including Hartford Hospital, is opening a major vaccination clinic at the Connecticut Convention Center located at the intersection of I-91 and I-84 in Hartford. They are currently vaccinating essential healthcare workers finishing up the “1a” priority group. This facility already has an essential requirement – ample space for large numbers of people to each wait 15 or more minutes after being vaccinated for observation of any rare but possible severe allergic reactions. Other sites including medical offices, and participating CVS and Walgreens pharmacies may also be announced as possible vaccination sites. Details on how to make appointments, and other details will soon be announced by the State. Meanwhile, the current advice for everyone not now being vaccinated is to “remain in close contact with their medical providers as more detailed plans are released.” Or you can directly check the Connecticut coronavirus website[1]: https://portal.ct.gov/Coronavirus/COVID-19-Vaccination—Phases
- The professional pros and conspiratorial cons of vaccinations
Q: Will the “anti-vax” movement interfere with the vaccination program achieving its goal?
A: The goal of all vaccinations is two-fold. To protect the medical health of the person being vaccinated and the public health by preventing the disease from being passed along to others. Science has shown that the two approved COVID-19 vaccines in phase 3 clinical trials have shown 90% to 95% effectiveness – preventing the vaccinated person from contracting COVID-19 and minimal risks or side effects.
For many people, however, the fear of vaccines – all vaccines – has led to their reluctance to being vaccinated. In 1998, an article was published in The Lancet authored by Andrew Wakefield and eleven coauthors. It claimed to link the measles, mumps and rubella (MMR) vaccine to colitis and autism spectrum disorders. This study was found to be fraudulent and was later retracted in 2010. The repercussion has been felt to this date with parents refusing to vaccinate their children against MMR. A wide distrust of medicine, especially by African-Americans began when the U. S. Public Health Service, working with the Tuskegee Institute in 1932 began a study to record the natural history of syphilis. The study initially involved 600 black men without the benefit of patients’ informed consent. They also did not receive the proper treatment and the study actually went on for 40 years before it was halted.
The challenge now for public health officials is to have a significant percentage of the population be vaccinated to stop the spread of COVID-19. The success of the polio vaccine did achieve this goal, as well as the earlier success of stamping out the deadly smallpox disease. But if a significant percentage of the population refuses to be vaccinated against COVID-19, the disease may linger and become endemic.
The increasingly broad fear generated from these previous events has led to many people who are against vaccinations to become known as “anti-vaxxers.” Among the many conspiracies these people share openly with each other is that “COVID-19 is just a hoax created to force global vaccinations.” It was recently learned that multiple leaders of several anti-vax groups in the United Kingdom have banded together stating that the COVID-19 vaccine is a “pivotal opportunity to sow distrust in vaccinations.” They are now laying out extensive campaigns for both the UK and the US to accomplish this.
- “Failure to thrive,,,” a different look at loneliness because of isolation
Q: Why does everyone react differently, yet significantly, from being so isolated?
A: Pediatricians have long seen and treated a condition in children identified as a failure to thrive (FTT). In children, this condition is often correlated with a slower growth rate (height, weight, etc.) compared to others of the same age. One of the causes is abuse or prolonged absence of stimulation. During this COVID pandemic, Megan Sandel, co-director of the GROW Clinic in Boston saw that many “children from families who face barriers to their basic needs may struggle to get the necessary developmental nourishment to keep them healthy and thriving.” Food scarcity is recognized as an element of this FTT. Closing of schools, discouraging group activities and isolation is also cited in this pandemic-caused FTT. Jeff Johnson, AARP Florida State Director stated. “The way isolation and loneliness work on the body is that it adds to stress. And if you are already frail, (and) you already have other health conditions, they’re going to make these even more dangerous.” A newly released study by AARP shows two-thirds of adults in the US have reported experiencing social isolation during this epidemic. One Florida resident in a nursing home lost his wife of 70 years. Family members were unable to visit him and provide solace. Two weeks later, he died. The death certificate listed the cause of death as “adult failure to thrive.” Recently, this term has been more widely adopted to define the effects of isolation and loneliness on adults. Perhaps this helps all of us realize why so many feel distress while functioning “normally” in isolation.
179. “Impatience with vigilance” extends to the near-distant future – traveling
Q: When will it be safe to become a tourist? I just can’t wait!
A: The Washington Post recently published an article indicating people everywhere are now booking international travel and cruises that will take place as early as summer of 2021. The release of a vaccine and the optimistic view that hundreds of millions of people worldwide can be vaccinated in just a few months seemingly has joined with an impatience from all the isolation we’ve been through for less than a year causing the need to leap ahead with planning. Experts are urging caution, however. There is agreement that returning to pre-pandemic normalcy will not be sudden nor universal. At home, unless a significant percentage of the population becomes vaccinated, herd immunity may not be achieved and restrictions could remain in place until 2022. And travel restrictions to other locations may remain for some time if vaccinated people can still become infected and while asymptomatic, spread the virus to others. “Patience is a virtue!”
180. Roles school nurses play in pandemic responses.
Q: What can we do to encourage school nurses who play a key role COVID-19!
A: Not all schools have a nurse available, and fewer have one in the building at all times classes are in session. Some school systems have a nurse that rotates by the day of the week or other periods between several schools. The National Association of School Nurses (NASN) has pointed out the many unique functions school nurses perform. One problem identified is that many local healthcare organizations and school districts often plan and create policies for managing COVID-19 outbreaks in schools without including school nurses. Even when involved with planning, school nurses often work with inadequate personal protective equipment or in a crowded space, restricting social distancing. They not only treat common symptoms of “bumps and bruises” and “not feeling well,” but are responsible for educating children and their parents on many related health matters. They guide staff and teachers on appropriate ways to protect the children while in school. Parents of children who are still in classes, or who will soon return to in-person sessions are encouraged to reach out directly to their school nurses to offer encouragement and to help by being their advocate to shore up this often-overlooked part of healthcare.
[1] To go to this website, copy the complete URL as shown in blue, then paste this into your browser.
