Frequently Asked Questions about COVID-19 — November 17, 2021

  “Shared expectations lead to predictability.”

406. Some healthcare workers refuse to protect their patients from being infected

         QHow are hospitals doing in getting their staff vaccinated?

         A:  Two months ago, a conflict emerged when several states mandated Covid-19 vaccination of their hospital staff.  More recently, the White House has issued a requirement that all healthcare workers be vaccinated against Covid-19.  The federal Equal Employment Opportunity Commission allows private employers and state governments to legally require workers to be vaccinated.  But there is fear of the possible outcome – staff refusing to comply leading to their being fired or quitting, resulting in worker shortages.  During September and October, the results have been mixed.  Some agencies have held back from issuing such mandates.  Others have shown success.  Some have acted to fire uncooperative staff members.  A North Carolina hospital system discharged about 175 workers in one of the largest-ever mass terminations due to a vaccine mandate. A health system in Delaware allegedly fired about 150 employees.  In a survey of 50,000 health care workers, 13% of respondents said they have been or will be vaccinated only because their employer required it, according to the Healthcare Worker Exposure Response and Outcome (HERO Registry).

Still, there are points of conflict everywhere, and many healthcare workers are encouraged to seek legal relief after watching the action of the federal courts blocking the national OSHA attempts to require businesses with over 100 workers to keep records of all workers taking weekly Covid-19 tests.  These are the most recent of an expanding number of challenges to the practice of public health.  People who consider vaccinations as a private medical decision only affecting themselves threaten the entire system protecting the community.

407. “Red states” have more Covid-19 deaths than “blue states.”

         Q: Does the attitude toward vaccinations affect the fatality rate of Covid-19?

         A:  In a recent article published by The Atlantic, David Leonhardt compared the early difference between conservative “red states” and the more liberal “blue states” as to the death rates from Covid-19.  Conservatives tend to be older, poorer, and more resistant to wearing masks and following guidelines, Liberals tend to live in urban areas, and closer to airports.  As 2020 came to an end, it was difficult to predict which group had fewer Covid-19 deaths.  An analysis actually showed the per capita death toll in red states and blue states were essentially the same.

And, as David puts it, “then the vaccines arrived.”  “They proved so powerful, and the partisan attitudes toward them so different, that a gap in Covid’s death toll quickly emerged.  The gap in Covid’s death toll between red and blue America has grown faster over the past month than at any previous point.  In October, 25 out of every 100,000 residents of heavily Trump counties died from Covid, more than three times higher than the rate in heavily Biden counties.  October was the fifth consecutive month that the percentage gap between the death rates in Trump counties and Biden counties widened.”

There is hope that the new oral therapeutics (pills) by Merck and Pfizer may bring this gap down.  This could be certain if the public in red and blue states can more equally accept FDA-approved therapeutics over Ivermectin and Hydroxychloroquine.  More study is needed.

408. Children may be seriously anxious about Covid-19 misinformation.

         Q:  How do children react to the misinformation about Covid-10 they hear?

         A:  On November 7, Rachel Buchholz published an article in National Geographic that recognized children can have significant anxiety and resistance to taking the Covid-19 vaccinations.  A recent study showed that 68% of six-to-eight-year-olds and 65% of nine-to-12-year-olds reported a fear of needles.  That number was reduced to 51% among 13-to-17-year-olds.  Because kids who have trouble coping with needles often become adults who are reluctant to go to a physician or cooperate with helpful medical advice or procedures, it is important if parents can help their kids with any shots.

Rachel suggests the following:

  • Talk to your child about what will happen. Make predictable the various steps that will be taken.
  • Give them a sense of control. Affirmations like “you can do this” help, as can deep breathing and other meditation techniques for children.
  • Don’t lie. Telling your kid you are going somewhere they will enjoy only to end up at the clinic can destroy trust.
  • Reward after the shot. A lollipop can help.
  • Start early to talk and prepare for any subsequent shot(s)

409. Misinformation about sex heard by children can be difficult to identify and resolve.  

         Q:  How do we learn of and correct Covid misinformation older children are anxious about?

         A:  There is a flood of Covid misinformation out there.  Reducing fears when some older children are not willing to talk about this may sometimes be difficult–especially over threats of fertility, puberty, and sexual activity.  Two handicaps have to be overcome before factual information can be effective.  First is the tendency for anyone who is concerned or has questions about sexually-oriented information to find it hard to talk about with people who can help – especially parents!  Secondly, young people trust most their own peers.  And those other young people probably have a trove of the same or different misinformation they can share.

If a parent finds a child filled with anxiety, the natural tendency is to ask “what’s wrong?”  When there is denial or obfuscation, another way might be effective.  Pick any misinformation you might know of, research, and print a copy of what the authoritative facts are.  Then ask the child a non-personal question.  “What do you think about what I just heard  – that vaccinations may cause a delay in puberty?”  Their response can then be supported or corrected by offering the printout from a recognized authority.  This can teach the child to challenge things they hear, check references to confirm reality, and not be afraid of talking about it with parents.  It also lets the parent know what’s causing anxiety.

410. Considerations for a safe Thanksgiving in 2021.

         Q:  Last year we were told to stay home for the holidays.  With the vaccines now available, how is this year any different?

         A. Caroline Mimbs Nyce, the senior associate editor of the Atlantic recently consulted with Katherine J. Wu, a science writer, to offer some sage advice (pardon the pun!).  This year, Covid vaccines give us opportunities for a safer Thanksgiving than last,  However, not all celebrants come to the table with equal risk factors. School-age children between the ages of 5 to 11 won’t be able to be fully vaccinated with the two rerecommended shots.  Those under age 5 still remain unvaccinated.  And there are over a quarter of the citizens of Connecticut that haven’t or won’t become vaccinated.  People not living in the household where the celebration will be held are advised to be tested in advance to assure them they are not infected with coronavirus-19,  But not all areas provide access to free testing, and commercial home tests are costly to obtain ($36.99 from Amazon, for example).

To quote from Caroline’s article, you have to consider who is most at risk. How can we best accommodate them?  Taking a test is probably a good idea if possible.  A positive test can stop you from going, making it safer for those who do.  A negative test probably increases the likelihood you’re not a threat to others.

If you’ve been traveling or going to work and not masking in the office, you can probably assume that you might have had a recent exposure.  Especially if your last shot was six months earlier and you have not received a booster shot, there is a chance for you to become infected.  This may be a good reason to test yourself and your family a couple of times the week of Thanksgiving.  This testing would be more important if you’re about to go to a gathering where there might be unvaccinated people or vaccinated people who are at high risk.  Another increase in risk would be a gathering that is totally indoors with a large number of people not wearing masks.  If you cannot or do not take tests before attending, consider a layered approach. Thanksgiving with vaccines, masks, distancing, or outdoor dining can reduce your risks.  Is everyone there vaccinated?

The prevalence of cases (number per 100,000 population) infection rate and if the hospitals are at capacity in the community where the Thanksgiving gathering is held are other important factors to judge risk.  Consider what position that puts you in. If someone, God forbid, were to get really sick in your group, would the local health system have the capacity to take care of them?  Last year the number of Covid-19 cases surged after the holidays.  Experts are worried that this year, another surge will occur, even though vaccines are available.  It will take effort and thought to remain safe.