“Shared expectations lead to predictability.”
276. Update on achieving the risk thresholds on 4 Mandatory Metrics”
Q: How close are we to reaching the 4 mandatory metrics allowing a decision to be made to reopen?
A: We are monitoring the pandemic to identify when it will be safe to reopen. Some modifications to the building and program may also be required, but we are continually viewing the five data metrics from the website Covid Act Now to identify when there is an acceptable risk for meeting inside. www.covidactnow.org is the website to find this data. Click on the Connecticut map on opening, and scroll down to view the 5 graphs.
The Policy Board has approved four mandatory metrics that must be reached for 21 consecutive days before the Policy Board will decide to reopen. These mandates are:
- Daily new cases per 100,000 population: Threshold = at or below 5 / 100,000.
Status on May 16 = 9.8 /100,000. This is 4.3 / 100,000 above the threshold
- Infection Rate: Threshold = .at or below 0,9%
Status on May 14 = 0.79%. This is under the threshold, and qualifies.
- Positive Test Rate: Threshold = at or below 3%
Status on May 12 = 1.4%. This is under the threshold and qualifies.
- ICU Capacity Used: Threshold = at or below 70%
Status on May 15 = 56%. This is under the threshold and qualifies
Once the daily new cases per 100,000 population reaches the threshold of 5 or fewer per 100,000 population, all 4 metrics must remain below their thresholds for 3 weeks to allow a recommendation to be made to the board for reopening.
277. “Fully vaccinated people can shed masks and social distancing in most places” is becoming a controversial CDC guideline:
Q: Wasn’t this recent CDC guideline about masks announced without much warning?
A: The CDC had been criticized for being too cautious about holding back on guidance allowing vaccinated people to be released from previously imposed restrictions. Last week, they announced without warning that people who were fully vaccinated no longer needed to wear masks outdoors, and except for a few locations, indoors – except when in tightly congested crowds. It was clearly reported that this was part of a strategy to “prod more Americans to get vaccinated.” The public greeted this with exuberation and enthusiasm. People can’t wait to “get back to normal.” But almost immediately, many officials expressed reservations. Many started to take off their masks in locations where state and local authorities still require them. Instead of encouraging people to get vaccinations, many people are openly stating that they don’t need to get one anymore – “Even the CDC says it’s safe to go out without one!” Some officials calculated that as many as one-third of the population still have no immunity against COVID-19 – calculated by subtracting from the population those fully and partially vaccinated, along with those who have recovered from the disease. Vaccinations are the best way to control this disease. This CDC guidance is now being seen as removing the next most effective mitigation steps available from those with the least protection.
An interesting concept here is that those who are vaccinated cannot (now) be placed at risk by those who are not. This CDC decision answers to the needs of those who are vaccinated separating them from those who aren’t. Of concern to many are the fact that the 30% of the population that is unprotected is primarily made up of the people of color and the impoverished among us. If bars, concerts, and sports arenas are soon to be open in Connecticut, many of those who aren’t vaccinated will surely join in those crowds. After all, there are no official documents to identify if one has truly been vaccinated. (Blank vaccination cards just like the one people receive when getting a shot are now on sale on the internet. They do not have a photo verification on them.) The expected result: we can expect a surge in new cases within a few weeks. This illustrates why some see this as an indication that public health may not be served well.
On May 15, the executive director of the National Nurses United union, Bonnie Castello was quoted by the New York Times, “This is a huge blow to our effort at confronting this virus and the pandemic.” This CDC recommendation “is not based on science,” she added. She noted that more than 35,000 new cases are being reported each day, as well as over 600 deaths. Castello represents one group that routinely encounters both groups – vaccinated and those who are not – and sees the unequal consideration each is receiving under this guidance.
From a different perspective, another issue is taking place in England. Many authorities judge India’s recent surge to be caused by a new triple mutant COVID variant, which was just reclassified as the B.1.617 strain. The World Health Organization has identified this as a “variant of concern” — an indication that the variant has the “highest public health implications.” Speaking at a news conference on Friday, prime minister Boris Johnson warned that this variant recently appears to be much more easily transmitted than the B.1.1.7 (the “UK variant”) that now dominates the U.S. In an article published May 14, it was reported that Johnson added there was currently no evidence that the variant would evade the vaccines that are being deployed in the country. “But I have to level with you, this new variant could pose a serious disruption to our progress,” Johnson said. Other scientists suspect this India variant evades many of the protections of the current vaccines. More study is needed. This Indian B.167 variant has already been found in several patients in the U.S.
278. New mandatory reporting requires nursing homes to report vaccinations.
Q: Are nursing homes still vaccinating new admissions?
A: Medicare has promulgated new rules that require all nursing homes to report vaccinations of newly admitted patients and newly hired staff. Despite representing only 1% of the U.S. population, long-term care facilities account for one-third of all COVID-19 deaths. The new rule is to encourage nursing homes to keep residents and staff immune as new patients and staff are brought in. It also enables families planning admissions to know how prepared the facilities are. By tracking the vaccinations being given, support can be provided to those facilities that are falling behind, and new outbreaks can be prevented.
279. A study finds COVID cases and deaths are far greater than reported
Q: Does anybody know how many people have had and died from COIVD?
A: STAT is a published newsletter that is produced by Boston Globe Media with headquarters located in Boston. They reviewed an extensive study done by the Institute of Health Metrics and Evaluation at the University of Washington. The summary from their exhaustive unpacking of this analysis led to the conclusion that the total death toll of COVID-19 globally is twice what has been reported. The analysis suggests that 6.9 million people have already died worldwide. In the U.S., the analysis estimates that 905,000 Americans have died due to COVID, a number that is 38% higher than the CDC estimates. Experts believe that the unreported cases and deaths are largely due to overwhelmed health care systems and insufficient testing. In the coming months, experts expect India to surpass the U.S. for the world’s highest death toll bringing global COVID cases and deaths to similar levels as seen during the 1919 Spanish Flu pandemic.
280. A devastating fungus outbreak in India is increasing in COVID patients
Q: What else is causing medical problems for COVID patients in India?
A: India is sometimes referred to as the “diabetes capital of the world.” The incidence of diabetes in India is normally quite high. The National Geographic recently published an online article demonstrating a rapidly increasing problem with their recent rapid surge of COVID-19 cases. A 48-year-old woman who had recently recovered from COVID-19 and had lost nearly all of her vision in both eyes was at the emergency room at the Max Super Specialty Hospital in Ghaziabad, a satellite city outside of New Delhi. The diagnosis was an advanced case of mucormycosis, a fungal infection of the eyes. Normally, this is a rare condition, but is increasingly seen in India in patients recovering from COVID. It is colloquially referred to as “black fungus” because of its dark pigmentation. This potentially fatal infection starts in the nose and spreads to the eyes, then to the brain. Public health experts are finding that with the standard treatment for COVID, there is often indiscriminate use of steroids to reduce inflammation. That and high blood sugar in a person is an invitation for this fungus to infect the patient. The number of these infections is also increasing. The complicating problem is that treatment of a person with advanced mucormycosis is limited to enucleation or surgical removal of the eye(s). Otherwise, death is the usual result. In increasing numbers in India, the result of COVID recovery often results in blindness and disfigurement. Not at all a pleasant outcome!
