NY may tap National Guard to replace unvaccinated healthcare workers

 New York Governor Kathy Hochul is considering employing the National Guard and out-of-state medical workers to fill hospital staffing shortages with tens of thousands of workers possibly losing their jobs for not meeting a Monday deadline for mandated COVID-19 vaccination.

The plan, outlined in a statement from Hochul https://www.governor.ny.gov/news/preparation-monday-vaccination-deadline-governor-hochul-releases-comprehensive-plan-address on Saturday, would allow her to declare a state of emergency to increase the supply of healthcare workers to include licensed professionals from other states and countries as well as retired nurses.

Hochul said the state was also looking at using National Guard officers with medical training to keep hospitals and other medical facilities adequately staffed. Some 16% of the state's 450,000 hospital staff, or roughly 72,000 workers, have not been fully vaccinated, the governor's office said.

The plan comes amid a broader battle between state and federal government leaders pushing for vaccine mandates to help counter the highly infectious Delta variant of the novel coronavirus and workers who are against inoculation requirements, some objecting on religious grounds.

Hochul attended the Sunday service at a large church in New York City to ask Christians to help promote vaccines.

"I need you to be my apostles. I need you to go out and talk about it and say, we owe this to each other," Hochul told congregants at the Christian Cultural Center in Brooklyn, according to an official transcript.

"Jesus taught us to love one another and how do you show that love but to care about each other enough to say, please get the vaccine because I love you and I want you to live."

Healthcare workers who are fired for refusing to get vaccinated will not be eligible for unemployment insurance unless they are able to provide a valid doctor-approved request for medical accommodation, Hochul's office said.

It was not immediately clear how pending legal cases concerning religious exemptions would apply to the state's plan to move ahead and terminate unvaccinated healthcare workers.

A federal judge in Albany temporarily ordered New York state officials to allow religious exemptions for the state-imposed vaccine mandate on healthcare workers, which was put in place by former Governor Andrew Cuomo and takes effect on Monday.

A requirement for New York City school teachers and staff to get vaccinated was temporarily blocked by a U.S. appeals court just days before it was to take effect. A hearing is set for Wednesday.

The highly transmissible Delta variant has driven a surge in COVID-19 cases and hospitalizations in the United States that peaked in early September and has since fallen, according to a Reuters tally https://tmsnrt.rs/2WTOZDR. Deaths, a lagging indicator, continue to rise with the nation reporting about 2,000 lives lost on average a day for the past week, mostly in the unvaccinated.

While nationally cases are down about 25% from their autumn peak, rising new infections in New York have only recently leveled off, according to a Reuters tally.

In an attempt to better protect the most vulnerable, the CDC on Friday backed a booster shot of the Pfizer-BioNTech COVID-19 vaccine for Americans aged 65 and older, adults with underlying medical conditions and adults in high-risk working and institutional settings.

On Sunday, CDC Director Dr. Rochelle Walensky fleshed out who should be eligible for the booster shots based on their work in high-risk settings.

"That includes people in homeless shelters, people in group homes, people in prisons, but also importantly, our people who work...with vulnerable communities," Walensky said during a TV interview. "So our health care workers, our teachers, our grocery workers, our public transportation employees."

Walensky decided to include a broader range of people than was recommended on Thursday by a group of expert outside advisers to the agency. The CDC director is not obliged to follow the advice of the panel.

https://www.marketscreener.com/news/latest/New-York-may-tap-National-Guard-to-replace-unvaccinated-healthcare-workers--36521109/

US has enough COVID-19 vaccines for boosters, kids' shots

 With more than 40 million doses of coronavirus vaccines available, U.S. health authorities said they're confident there will be enough for both qualified older Americans seeking booster shots and the young children for whom initial vaccines are expected to be approved in the not-too-distant future.

The spike in demand — expected following last week's federal recommendation on booster shots — would be the first significant jump in months. More than 70 million Americans remain unvaccinated despite the enticement of lottery prizes, free food or gifts and pleas from exhausted health care workers as the average number of deaths per day climbed to more than 1,900 in recent weeks.

Federal and state health authorities said current supply and steady production of more doses can easily accommodate those seeking boosters or initial vaccination, avoiding a repeat of the frustratingly slow rollout of COVID-19 vaccines across the country early this year.

“I hope that we have the level of interest in the booster ... that we need more vaccines,” Colorado Gov. Jared Polis said Tuesday. “That's simply not where we are today. We have plenty of vaccines.”

Robust supply in the U.S enabled President Joe Biden this week to promise an additional 500 million of Pfizer's COVID-19 shots to share with the world, doubling the United States' global contribution. Aid groups and health organizations have pushed the U.S. and other countries to improve vaccine access in countries where even the most vulnerable people haven't had a shot.

Among the challenges states face is not ordering too many doses and letting them go to waste. Several states with low vaccination rates, including Idaho and Kansas, have reported throwing away thousands of expired doses or are struggling to use vaccines nearing expiration this fall.

While most vaccines can stay on the shelf unopened for months, once a vial is opened the clock starts ticking. Vaccines are only usable for six to 12 hours, depending on the manufacturer, according to the U.S. Food and Drug Administration.

Moderna vaccines come in vials containing 11 to 15 doses. Pfizer vials contain up to six doses and Johnson & Johnson vials five doses.

"We are going to see more doses that go unused over time,” said Wisconsin's health secretary, Karen Timberlake. “They come in multidose files. They don’t come in nice, tidy individual single-serving packages.”

State health officials said they have tried to request only what health care providers and pharmacies expect to need from the federal supply. Those numbers have dwindled since the vaccines became widely available in early spring.

But U.S. officials — holding out hope that some of the unvaccinated will change their minds — are trying to keep enough vaccines in stock so all Americans can get them.

That balancing act is tricky and can lead to consternation around the globe as the U.S. sits on unused vaccines while many countries in places such as Africa can't get enough vaccines.

“Somebody sitting in a country with few resources to access vaccines, seeing people in the U.S. able to walk into a pharmacy and get that vaccine and choosing not to, I’m sure that’s causing heartache,” said Jen Kates, senior vice president and director of global health and HIV policy for the Kaiser Family Foundation.

Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, which represents the public health agencies of all 50 U.S. states, the District of Columbia and U.S. territories, said officials anticipate that on-hand doses of COVID-19 vaccines and manufacturers’ ability to supply more will meet needs across the country.

“I think states have tried to plan as if everybody’s going to be offered a booster,” he said, suggesting they will be overprepared for the more narrow recommendations issued by the FDA and the Centers for Disease Control and Prevention.

California, for example, estimated earlier this month that it would need to administer an extra 63 million doses by the end of 2022 — if initial shots for children under 12 were approved and boosters were open to everyone.

U.S. health officials late Thursday endorsed booster shots of the Pfizer vaccine for all Americans 65 and older — along with tens of millions of younger people who are at higher risk from the coronavirus because of health conditions or their jobs.

California, with nearly 40 million residents, has the lowest transmission rate of any state and nearly 70% of eligible residents are fully vaccinated. That leaves nearly 12 million people not vaccinated or not fully vaccinated.

Dr. Mark Ghaly, California's health secretary, said the state will rely largely on pharmacies and primary care providers to give boosters to seniors while some large counties and health care groups will use mass vaccination sites.

In Pennsylvania, more than 67% of residents older than 18 are fully vaccinated. Alison Beam, acting secretary of health, said health authorities now have “two missions”: Continuing to persuade people to get vaccinated and serving those eager to receive a booster or initial shots.

“Pennsylvania is going to be prepared,” Beam said. "And we’re going to have the right level of vaccine and vaccinators to be able to meet that demand.”

https://abcnews.go.com/Technology/wireStory/us-covid-19-vaccines-boosters-kids-shots-80242892

LEGO Foundation becomes single largest private sector contributor to UNICEF COVID response

 UNICEF welcomes the LEGO Foundation’s announcement today of a $70 million contribution to UNICEF’s work within the COVAX and ACT-A facility. This is the single largest private sector donation to UNICEF’s COVID-19 response. It is part of the LEGO Foundation’s $150 million pledge to support children and families affected by the pandemic across the world.

The donation will help accelerate in-country vaccination to protect health and social care, including educators and primary caregivers, to minimalize further disruption in children’s lives. As vaccines become more available, helping countries around the world ensure these vaccines turn into vaccinations is of critical importance.

“Over the past 18 months, the lives of millions of children were put on hold as the pandemic shuttered schools, disrupted health services, and kept children away from relatives and friends,” said Henrietta Fore, UNICEF Executive Director. “Children, like us, want their lives back. UNICEF believes that equal access to vaccines for all countries is the surest pathway out of the pandemic. We thank the LEGO Foundation for sharing in this belief and hope that their support inspires other organizations, businesses and individuals to be as generous.”

To date, some 5.8 billion vaccine doses have been administered worldwide, but only 2 per cent have been administered in Africa.

The funds from the LEGO Foundation will go towards supporting UNICEF’s in-country delivery and administration support of two doses of the COVID-19 vaccine to more than 14 million people in ordinary settings, and over 10 million people in humanitarian settings. 

“This donation builds on the LEGO Foundation’s core values of finding creative solutions to the difficult challenges, caring for children and the communities they live in, and the power of collaboration to address the challenges, and opportunities, posed by the COVID-19 pandemic” said Anne-Birgitte Albrectsen, Chief Executive Officer, LEGO Foundation. “Together we need to make a leap in playful learning, creating a future that promotes inclusive education, lifelong learning opportunities for all children, and where holistic skills and innovation are central. We call on the private sector, philanthropic organisations, governments and other donors to donate generously to the global COVID-19 response. No one is safe until everyone is safe.”  

The LEGO Foundation and UNICEF have partnered since 2015, focusing on child wellbeing and empowering children to become creative, lifelong learners through play.

https://www.unicef.org/press-releases/lego-foundation-becomes-single-largest-private-sector-contributor-unicefs-covid-0

As Advisor Panel Warned, CDC Head's Anti-Science Decision Makes Boosters 'Available To Anyone Who Wants One'

 Now that CDC chief Dr. Rochelle Walensky - possibly working on behalf of her political puppet masters - has overridden her agency's advisory panel to expand the eligibility for Pfizer booster jabs to high-risk workers (a group that ACIP, the advisory panel, had decided to exclude given a paucity of efficacy and safety data), many employers are confused about whether the new guidance applies to them - and whether they might be left in a difficult situation with employees who didn't get the first two vaccines.

At the end of the day, the big worry is that hundreds of thousands of shots allocated for workers might simply go unused, left to expire while dozens of poorer countries would be overjoyed to have them.

According to the Hill, chaotic and at times contradictory messaging from federal health officials has culminated in a confusing set of recommendations about who should, and shouldn't receive booster jabs, and why?

Panel members initially said they had excluded approving jabs on an employment basis because there wasn't enough evidence those people were losing protection. That decision was clearly a disappointment to the Biden Administration, which is possibly why Dr. Walensky interceded.

The depth of Dr. Walsensky's contradiction of the science can be found in the exact wording of her decree: Starting immediately, anyone between the ages of 18 and 64 who is at increased risk of COVID-19 "exposure and transmission because of occupational or institutional setting" can get a third dose.

Legal experts told the Hill that those words are so vague, practically anyone could qualify. Already, many local level officials appear to be leaning toward simply giving boosters to anyone who asks.

"There's going to be confusion. If we are going to create guidelines that are essentially making the vaccine available to almost everyone, the simplest solution is, make it available to everyone," said Celine Gounder, an infectious disease specialist and epidemiologist at NYU and Bellevue Hospital. "The best public health programs are the ones that are simple and easy to understand and clear, and the more complexity you build into it, the more difficult it is to roll out."

That statement above about not creating obstacles to the third shot - that's coming from a scientist who doubted whether they were even necessary.

Gounder, who advised the Biden transition team on COVID-19, has been critical of the administration's fervent push for boosters, and said the evidence for a third dose based on occupation was mixed at best.

"You have to step back and ask the question, why is it that we're vaccinating people in high risk settings? Is it because they as individuals are at high risk, or is it because it would be disruptive to the workplace," Gounder said.

As far as the dramatic conclusion to what was supposed to be a 'staid' scientific process - the CDC director overruling her advisory panel on the issue of occupancy-based eligibility in a late night statement - that should be enough to alert Americans that something strange is happening. Despite the panel's claims, Dr. Walensky took to the White House press briefing on Friday to claim that she did not "overrule" the advisory committee and that she had listened to both sides on the issue of whether to approve boosters by occupational risk.

Amusingly, the assiduously pro-Democratic the Washington Post was willing to dismiss this usurpation of "the science" as simply another communications breakdown from the doddering Dems.

“Everyone is kind of confused,” he said. The current discontent has deep roots. In April, Pfizer chief executive Albert Bourla said a third coronavirus dose was “likely” to be needed. In late July, Pfizer-BioNTech announced that their vaccine’s efficacy waned over time. Data from Israel confirmed a drop. Then, last month, as the delta variant of the coronavirus surged and the World Health Organization decried the distribution of third shots in wealthy countries while poor countries were lacking first doses, President Biden announced that most Americans could begin getting boosters of the Pfizer and Moderna vaccines Sept. 20 — subject to the government’s regulatory processes, which unfolded in recent days and focused only on Pfizer. Regulators already allowed third shots for the immunocompromised who have received Pfizer or Moderna shots but have not yet made recommendations for all recipients of the Moderna and Johnson & Johnson vaccines.

The deluge of phone calls about booster shots to Primary Health clinics in Southwestern Idaho began weeks ago. On Friday morning, the group’s Garden City clinic, where Maddie Morris fields inquiries, saw an increase in calls, mostly from senior citizens.

“The calls seem pretty nonstop,” the customer service representative said. “It seems like a lot of people are anxious to get a booster.”

Doctors say confusion clouds patients’ willingness to receive boosters. In Idaho, the problem coincides with the primary health-care system’s struggle to meet the demands of the latest covid-19 crush, which earlier this month plunged the state into crisis standards of care — essentially the rationing of health care as demand overwhelms resources.

Unfortunately for them, it looks like the whole thing is back-firing...

Maybe they'll think twice next time around (though we doubt it, since 'next time' is literally happening in the coming weeks when they do this all again with Moderna).

https://www.zerohedge.com/political/cdc-directors-late-night-intervention-makes-covid-boosters-available-anyone-who-wants-one

Malpractice Claims During COVID-19: More Questions Than Answers

 Editor’s note: This article has been provided by The Doctors Company, the exclusively endorsed medical malpractice carrier for the Society of Hospital Medicine.

The pandemic has raised pressing questions around preventive measures, vaccines, and safe treatment, but it has also obscured one key lingering uncertainty for medical professionals: Where are all the medical malpractice claims?

A variety of factors create a cloud of uncertainty around when, if ever, we will see the claims we expected from care provided just before the pandemic, much less claims deriving from care during the pandemic of both COVID-19 and non–COVID-19 patients.

Malpractice Claims Take Time to Surface

We won’t know until 2022 or later whether there will be an increase in claims related to the pandemic. When a medical error occurs, it’s not like an automobile accident. Everybody nearby knows when there’s been an automobile accident because they hear screeching tires, a loud crash, and then sirens. But when a medical error occurs, generally speaking, neither the doctor nor the patient immediately knows that something is amiss. It can take months or years for people to realize that something untoward has occurred.

Claims from medical errors that occurred before the pandemic bring additional uncertainties. In 2020, we saw fewer than expected overall claims filed from events occurring 18-24 months before the pandemic. In total, 20% fewer claims were filed than in 2019. This may have had to do with courts shutting down, people being reluctant to meet with attorneys to discuss a claim, and/or lawyers working from home. We may see these claims filed later than expected, or maybe we won’t see them at all.

But without a doubt, pandemic-related claims will be filed. The pandemic’s impact on physicians increases the risk of claims. Burnout is a major cause of medical errors, and a recent study found that out of 60 countries, U.S. health care providers showed the highest rates of burnout. We’re concerned about the stress affecting physicians’ performance – not just the physical stress of the demands put on them while treating COVID-19 patients, but all of the worry. For instance, a lot of doctors at the start of this pandemic stayed at hotels because they didn’t want to bring the virus home to their families – if they got exposed. Those sorts of stressors from life disruptions, on top of the stress of treating COVID-19 patients and the stress of treating non–COVID-19 patients within overtaxed health care systems, contribute to the possibilities for error.

Immunity Protections Are Not Fail-safe

And while health care providers have medical liability protections during the pandemic, these protections may not prevent claims. Health care provider pandemic-related liability laws vary from state to state, and they will be tested in the courts as to whether they’re constitutional. For example, there is pending legislation in New York state that would repeal the provider protections created there at the start of the pandemic. Further, some expert witnesses will couch their statements in terms of what it takes to get around one of these statutes. Therefore, physicians do have reason for concern, even in states with strong liability protections.

The following case example, which is one of about 40 COVID-19–related claims made against our members so far, is a poster child for why these protections are necessary: A quadriplegic patient with COVID-19 had reached the point of organ failure before he reached the ED. There was really nothing medical science could do for him at that point, in terms of a chance at recovery. Therefore, the patient’s physician and conservator placed him in assisted living for palliative care. This was a sad but reasonable decision during a pandemic, with hospital beds needed for patients with a shot at surviving. Following that patient’s death, the physician is being sued.

Defending Claims Regarding Treatment vs. Regarding Infection Control

We are very confident in our ability to protect our members against claims where they are being sued over the treatment of the disease. Claims arising out of treatment are not concerning to us because there is no cure for COVID-19 – one can only treat the symptoms as the virus runs its course.

On the other hand, suits harder to defend would be those that revolve around transmitting the disease because providers didn’t follow guidelines from the Centers for Disease Control and Prevention or there wasn’t enough personal protective equipment. That’s why we stress the importance of following CDC guidelines, and why we’ve taken proactive steps to communicate with the entire medical community throughout the pandemic as part of our commitment to serve those who provide care.

Robert E. White, Jr. is chief operating officer at The Doctors Company. The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each health care provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

https://www.medscape.com/viewarticle/959644

New Virus Causing 'Alaskapox' Detected in Two More Cases

 Two new cases of a mysterious virus have been reported by the Alaska Department of Health and Social Services. Both people were diagnosed after receiving urgent care in a Fairbanks-area clinic. One was a child with a sore on the left elbow, along with fever and swollen lymph nodes. And the other was an unrelated middle-aged woman with a pox mark on her leg, swollen lymph nodes, and joint pain. In both cases, symptoms improved within 3 weeks.

This isn't the first time the so-called 'Alaskapox' virus has been detected in the region. In 2015, a woman living near Fairbanks turned up at her doctor's office with a single reddened pox-like mark on her upper arm and a feeling of fatigue.

Sampling of the pox mark showed that it was caused by a previously unidentified virus of the same family as smallpox and cowpox.

Five years later, another woman showed up with similar signs and symptoms, and her pox also proved to be the result of what public health experts started calling the Alaskapox virus.

In both cases, the women recovered completely.

 

Smallpox-Like Illness

Public health sleuths figured out that in three of the four cases, the patients lived in a home with a cat or cats, and one of these cats was known to hunt small animals.

Experts already knew that cats mingling in cow pastures and sickened by cattle virus had helped cowpox make the leap from bovines to humans. And just like in the case of cowpox, they suspected that cats might again be spreading this new virus to people too.

All four of the infected people lived in sparsely populated areas amid forests. Officials laid animal traps where some of the affected people lived and identified the virus in several species of small wild animals.

The animals that turned up most often with Alaskapox were small mouse-like voles. The rodents with rounded muzzles are known for burrowing in the region. And scientists suspect the Alaskapox virus makes its way from these wild animals to humans through their pet cats or possibly by direct exposure outdoors.

None of the four people identified so far with Alaskapox knew each other or interacted, so officials also suspect that there are more cases going unrecognized, possibly because the symptoms are mild or nonexistent.

There are no documented cases of person-to-person transmission of Alaskapox, according to public health officials monitoring the small number of cases. But other pox viruses can spread by direct contact with skin lesions, so clinicians are recommending that people cover wounds with bandages. Three of the people with Alaskapox mistook their lesion at first for a bite from a spider or insect.

Source:

State of Alaska Epidemiology: "Additional Cases of Orthopoxvirus Infection in Fairbanks-area Residents, 2021."

https://www.medscape.com/viewarticle/959358

CDC director: Including some workers for boosters was 'close call'

 Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky said Sunday that determining eligibility for people at higher risk for COVID-19 because of their workplace environment was a "scientific close call."

Walensky said on CBS's "Face the Nation" there had been "remarkable consensus" in discussions surrounding booster eligibility for people over age 65 and older along with others with high risk conditions. 

"Where there was some real scientific discussion and a scientific close call was for those people who are at high risk of living by virtue of where they live or where they work," Walensky said.

"Because of all the evidence we reviewed both at the [Food and Drug Administration] FDA and at the CDC, I felt it was appropriate for those people to also be eligible for boosters," she added.

This broader group includes frontline workers in high-risk settings like homeless shelters, group homes, prisons, schools as well as in people in healthcare and other places such as grocery stores and those who work in public transit.

Walensky acknowledged that the guidance was broad and confusing.

"I recognize that this is confusing," Walensky said before encouraging eligible workers to make a "personal decision" about getting a booster depending on their exposure levels.

Walensky also noted the guidance was intended for "people who are working all of the time with many different people who might be unvaccinated," but it does not include others like parents who are surrounded by their unvaccinated children.  

"If you're in a high risk position, I would absolutely recommend you get the boost," Walensky added. 

Walensky's remarks follow the announcement that third-dose boosters would be recommended for older Americans above age 65 and people at higher-risk for COVID-19. 

https://thehill.com/homenews/sunday-talk-shows/573981-cdc-director-including-people-at-high-risk-of-exposure-to-covid