“Shared expectations lead to predictability.”
201. National COVID-19 Strategic Plan – (Part 2 of 8)
Q: What’s in the new United States strategic plan for controlling this pandemic?
A: On January 21, 2021, Joe Biden released the National Strategy for the COVID-19 Response and Pandemic Preparedness. This week’s summary gives details about Goal 1 – restoring trust.
To rebuild the trust of the American people, there must be clear public leadership shown and a “whole-of-government” response that puts science first. The commitment is made:
• To establish responses that are driven by science and equity;
• To conduct regular expert-led science-based public briefings;
• Openly share with everyone accurate data and public health guidance;
• Engage state / local government officials and citizens to guide policy decisions; and
• Lead science-first public health educational campaigns.
The goal will create uniform and scientifically accurate policies and procedures throughout the federal government, and communicate these to the public. In a word, it offers “shared expectations that can result in predictability” as this pandemic is controlled and eliminated.
Next week: Details about Goal 2 – An effective, comprehensive vaccination campaign.
202. Issues with vaccination registration – as of February 1, 2021
Q. Has anything changed since last week on how we can get vaccinated?
A: The primary issue that remains is developing coordination and control processes after the vaccine doses arrive in the state. Three areas of planning remain unfinished:
• Coordinated procedures for people to make appointments;
• Predictable number of doses being received by the state; and
• Timely arrival of doses arriving at vaccination sites to satisfy appointments.
The first of these is presently a significant problem. It is slowly being addressed. There are two state-level portals to make appointments. The Connecticut Vaccine Line on the phone is: (877) 918-2224. Also, the now official “Vaccination Administration Management System” (VAMS) website.
https://dphsubmissions.ct.gov/OnlineVaccine
Other states have their own phone and/or website access which can be easily identified.
Initially, both these access points were not known or were overwhelmed. The longest reported wait to get through was more than six hours! Coordination remains unavailable between these sites and the expanding number of local clinics that are separately scheduling appointments. If you register on the state website and later decide to call a particular vaccination sponsor and make an appointment, the state website will not learn of this. You will be constantly reminded to make an appointment. In Connecticut, it was reported that 80 more phones have now been added to its phone bank. The average wait is now allegedly only 3 minutes. Some systems do not have the ability to search site availability based on distance from your location. When making an appointment and entering your ZIP Code, a months-long wait may appear before an appointment is available. Instead, re-enter another nearby town ZIP Code instead. There may well be vacant spots in other clinics that are not that far away from your home.
The problem of unpredictable number of doses being received in each state should now be resolved. The federal government recently announced that each state would be told three weeks in advance what their weekly allotments will be.
Distributing enough doses to each clinic to match their appointments is still a problem. Many clinics have reported they have doses left over that might have to be destroyed. On the other hand, last week in Waterbury and at the UConn Health Center, appointments were cancelled because they ran out of doses. It was reported they had “overbooked” their schedule. It was not clear if this was because appointments were made at separate locations without coordination, or if appointments were made without matching them against anticipated supplies. More work on this is needed.
It is frustrating for people to wait several weeks only to learn later that neighbors got an appointment in just a few days. Even more frustrating is to have an appointment cancelled. Another example of unpredictable results when expectations are not shared.
203. Concerns about the emerging variants or mutations of coronavirus-19
Q: What’s all the concern about mutations of the virus? The statistics are so confusing.
A: The concerns focus on three variables:
• How the mutations allow the virus to spread more rapidly to more people;
• The degree to which the resulting disease could be more severe or deadly, and
• The effectiveness of vaccines to prevent infections, serious disease or death.
Mutations occur when a virion enters a human cell in which it replicates or multiplies. A few of these next generation virions may not replicate exactly from the original, and are called mutations. Many of these variant cells do not affect the ability of the virion to infect others or change the course of the resulting disease. But if a mutation enables the virion a more rapid entry into cells, that mutation is replicated. The increase in the number of mutated cells then greatly increases the viral load in a single patient. As the number of mutant virions are exhaled and become exposed to other people, they are more easily taken in by that healthy person’s cell. This causes a rapidly increasing number of new patients with that variant. Michael Osterholm, MD, professor at the University of Minnesota and a member of President Joe Biden’s COVID-19 Advisory Board states that the UK variant will become the predominate strain in the U.S. by March of this year.
There are now three variant strains of coronavirus identified in America. Testing and research is expanding. Current data is not yet conclusive, but one consensus has been reached. The two vaccines now approved along with Johnson and Johnson coming up for approval may be less effective in preventing infection from the variant from South Africa. But vaccines are markedly more effective in preventing serious illness and death. The resulting guidance: regardless of which vaccine is available, when eligible, get vaccinated!
Vaccines reduce infections, which in turn reduces replication and expanding mutations.
204. Face masks required when taking public transportation – penalties may apply.
Q: What are the details of the requirement to wear masks on planes, trains, buses, etc?
A: On January 21, president Biden signed the “Executive Order on Promoting COVID-19 Safety in Domestic and International Travel.” The CDC followed up by issuing an order on January 25 that defines in detail where all passengers over 2 years old must wear masks: while getting on, riding in or leaving: airplanes, trains, buses, subways, ships, ferries, taxis, and rideshare (e.g., Uber). The mandate also includes when passengers are in transportation hubs including airports, train and subway stations, bus and ferry terminals, seaports and ports of entry. These mandates were ordered to begin February 2. The Transportation Security Administration (TSA) followed on January 31 by announcing that effective Tuesday, February 2, through May 11, anyone refusing to wear a mask in airports will be denied access to boarding safety checkpoints. If any person is found not wearing a face mask within airports, they will be subject to penalties. This could result in substantial fines for “attempting to circumvent screening requirements,” and “interfering with screening personnel.” Darby LaJoy, an administrative official from TSA said, “This will prevent further spread of COVID-19 and encourage unified government response,”
205. Biden government contracts for millions of at-home tests to be manufactured
Q: What’s the latest on rapid COVID tests that can be taken at home?
A: On Monday, February 1, senior White House advisor Andy Slavitt announced that the Department of Defense and the Department of Health and Human Services have awarded a $230 million contract to the Australian company Ellume, to manufacture great numbers of over-the-counter, at-home rapid COVID tests. The test was authorized by the FDA in December. Other in-home tests have been authorized. These others either require the samples being sent to a lab resulting in a delay, or have proven to be less accurate. The Ellume test is 95% accurate and delivers results in about 15 minutes. The nasal swab can be self-performed, and the sample is put into a small digital analyzer. The results are then sent to a smartphone. The test is appropriate for all people ages 2 and older. It can be obtained at a pharmacy without a prescription. Initially, starting in February, the U. S. government will initially receive only 100,000 tests per month. The contract will allow Ellume to scale up production to a level of 19 million kits per month by the end of the year. (8.5 million per month of these are reserved for the U.S. Government.)
