COVID-19 treatment and vaccine update thread

[Blackhawk]

Operating a police state?

[Max Peck]

I'd go with "police state" more than suppressing infection/death statistics, although I'm sure there is some of that going on as well. Having enough control over society to impose a rigorous lock-down for a few weeks and have people comply with it would be enough to quash the virus anywhere.

[Defiant]

I think it's a combo of both. We know that they falsified the data released, and we know that they had a far more restrictive lockdown than the kind seen in the West. Also, possibly, prior experience with diseases might have also helped (eg, getting people to wear masks), as seen in other East Asian countries.

[Smoove_B]

Just as a follow up, NJ is doing drive up vaccinations for healthcare workers in one town. I really hope this type of thing works out because it will dramatically increase throughput. Obviously pre-screened people that have no history or don't get flagged for potential issues.

The workers at Ocean Health Initiatives pulled up their shirt sleeves and received the shot through their driver’s-side window. They then waited in their vehicle for 15 minutes so staff could if there were any side effects.

[Octavious]

Drive by shootings! I really need to stop reading comment sections on news sites. And social media... And from people walking around in my office... And from family... It almost feels like everyone sucks.

[Isgrimnur]

I've been trying to tell you.

[Hrdina]

Union County Freeholders COVID Response Team

This offends me to my core. Not the Union County Health Department. Not the name (if different) of your local health department. But The *freeholders* COVID response team.

Yeah, when the contact tracers called me back in April it was the Westfield Regional Health Department. Now that there's a vaccine, it's the freeholders.

Potential thread derail, but you can read about it here.

Funny, I didn't know about that. Then again, I stopped following nj.com when they stopped supporting RSS readers some time ago.

[GungHo]

So a funny thing happened to me on my way to get the vaccination:
I'm on shift and we have designated a supply of vaccines set aside for walk-ins to get their shot. Set up in our day surgery building staffed/administered by our employees. I walk in and I'm second in line for the 10am hour of vaccinations, and as I begin filling out my paperwork I hear sirens in the background. Not unusual, I'm at a hospital right? Except they're getting louder and we're not really at the hospital, we're across the street (the actual ER is a good 1/4 mile away). So of course the FD pulls up right outside the doors of the surgery center and goes in to respond to a reaction to the vaccine; we shut down vaccinations until, and I quote "we have secured more EpiPens".
Let's just say that I have questions, and obviously this is a less than auspicious start to my facility's vaccination journey. Hopefully they're ok and we get our act together by tomorrow.

[Daehawk]

A medical place had to call the fire department for an epi pen? As many people that are having serious reactions to this you'd think ALL sites that give vaccinations would have epi pens handy. But a medical place? Weird.

[Zarathud]

There are not as many reactions as you think — or as large of a supply, unfortunately.

[LawBeefaroni]

A medical place had to call the fire department for an epi pen? As many people that are having serious reactions to this you'd think ALL sites that give vaccinations would have epi pens handy. But a medical place? Weird.

You have to call 911. It's a policy/liability thing.

I work across the street from our ER and if there is a medical emergency, we're supposed call 911.


As to why there were no or not enough epi pens on site, not sure. I thought the standard was to observe for any reactions for 15 mins or so.

[Daehawk]

I work across the street from our ER and if there is a medical emergency, we're supposed call 911.

I saw a story on a lady that died because of that. She was at a part of a large hospital and had an emergency but instead of simply wheeling her next door their policy was to call 911. Took the ambulance a while to get there then it couldn't take her to the ER there and had to go someplace else. She died. Such damn stupidity in this country due to being sued. Its nuts.

[Defiant]

I thought the standard was to observe for any reactions for 15 mins or so.

My understanding is 15 minutes for everybody, and 30 minutes for anyone with a history of reactions.

[GungHo]

A medical place had to call the fire department for an epi pen? As many people that are having serious reactions to this you'd think ALL sites that give vaccinations would have epi pens handy. But a medical place? Weird.

It is our protocol for any non-hospital facilities to call 911 in an emergency situation; it would take too long for a 'code team' to respond. it's actually not all that unusual for 911 to respond to one of our off sites; by definition they're seeing patients, and patients are sometimes sicker than we realize.
My questions are more about why is our OR using EpiPens? Our RNs should be able to draw up epi from a vial and give an appropriate dose and barring that there are kinda /sorta medical versions of EpiPens that are pre-mixed doses of epi(and several other code drugs are packaged that way as well). Why aren't we using Abbojects?

There are actually reasonable answers to that but honestly my biggest concern was why are we needing more epi??? How many ppl have had reactions in the 24 hours we've been administering this thing, or was it a case of we didn't have enough on hand? There's really no remotely acceptable answer it it's the latter.

[disarm]

There are a number of detail so missing and/or misunderstood in this story...

First, as others have stated, it's not unusual to call emergency help to a medical facility not attached to a hospital. Some degree of help is available on site, but if a patient's requires emergent transport for a higher level of care, you want to initiate that immediately. If it turns out they're not needed, you can cancel the assistance, but waiting until you're sure it's needed could cost someone their life.

Second, an epi pen is not always a single-shot miracle cure for anaphylaxis. One pen contains a relatively small dose of epinephrine that can save someone's life in an emergency, but it's very short acting. In some cases of anaphylaxis, adequate treatment means repeat (or continuous via IV) dosing in order to halt the reaction. Just stabbing someone once with an epi pen doesn't mean they're out of the woods.

Epi pens are probably kept on hand rather than vials or Abboject syringes because it's mindlessness to administer...just pop the cap and stab. You don't have to worry about preparation or appropriate dosing. The name-brand EpiPen autoinjector is a single 0.3mg dose that can be administered in a matter of seconds. Most epinephrine vials or Abboject syringes are 1.0mg and require drawing up or assembly with a proper needle for subcutaneous injection prior to adminstration of the appropriate fraction of the volume.

That said, as an anesthesiologist, the surgery centers in which I sometimes work do not keep epi pens on hand. If we need epi in an emergency, I can have it ready to administer in an appropriate dose very quickly because providing that type of life-saving care in an emergency is exactly what I'm trained to do...unlike many of the people providing these vaccinations. My COVID-19 vaccine was given by a pharmacy student. Do you think she was trained or qualified to do anything more than hit me with an epi pen if I had a reaction?

[Daehawk]

Ive seen a story online and repeated and pasted many times by Trumpites on how to treat your COVID at home with certain foods and supplements today. Ugh.

[LawBeefaroni]

Scheduled to get first jab on Wednesday. Second dose 21 days later.

[GungHo]

Got more info today; went to my director to essentially ask 'WTF' and as is not uncommon for us, mistakes were made. Apparently we (the entire hospital) weren't supposed to be doing walk ins yet, despite the fact that we (the entire hospital) had been doing walk ins for 2 days (sigh). That was the reason for a lack of EpiPens...they hadn't stocked them yet.
But i am told this is our protocol with this vaccine is to utilize the EpiPens. I don't know if this has always been our Employee Health Department's standard protocol for vaccine administration or whether it is specific to covid. Despite working here for 14 years my vaccinations have always been given by one of my teammates (an RN) and they just have a vial of epi and needle and syringe in case of any problems; but we're at the airport and don't even carry EpiPens so obviously it's a different set of circumstances.

We need to be better, obviously.

[Anonymous Bosch]

Ive seen a story online and repeated and pasted many times by Trumpites on how to treat your COVID at home with certain foods and supplements today. Ugh.

Seems a bit like the pot calling the kettle black given your own quixotic approach towards how to treat I.T. security, and stubborn reliance upon an obsolete and completely unsupported version of Windows 7.

[Jeff V]

Scheduled to get first jab on Wednesday. Second dose 21 days later.

Still no word if or when my wife's job and residents will ever be vaccinated. Two more deaths last night.

[malchior]

Scheduled to get first jab on Wednesday. Second dose 21 days later.

Still no word if or when my wife's job and residents will ever be vaccinated. Two more deaths last night.

I was just reading a piece describing how the US vaccination effort is beginning to mirror the testing effort. Uncoordinated. Unprepared. Underperforming. But we are at the outset. Eventually it'll get up to speed. Essentially we got 1M out in a week when we need 2-3M per *day*. So we are running at 5% of desired. We need to keep that in mind while those of us way down the list wait.

[Jeff V]

Scheduled to get first jab on Wednesday. Second dose 21 days later.

Still no word if or when my wife's job and residents will ever be vaccinated. Two more deaths last night.

I was just reading a piece describing how the US vaccination effort is beginning to mirror the testing effort. Uncoordinated. Unprepared. Underperforming. But we are at the outset. Eventually it'll get up to speed.

I've been hearing occasionally stories that nursing home vaccinations are being outsourced to Walgreeen's and this morning they are saying they may be prepared to start administering by the end of March.

[Smoove_B]

I've been hearing occasionally stories that nursing home vaccinations are being outsourced to Walgreeen's and this morning they are saying they may be prepared to start administering by the end of March.

I can only say that in my own state various pharmacy chains are offering vaccinations to medical workers in the 1a category. How that's being coordinated, I don't know but its definitely possible.

[malchior]

Apparently Biden is going to make some pretty harsh comments today about the rollout. We'll see. Hopefully he'll lay out a plan to provide *competent* support in a few weeks.

[Jeff V]

I've been hearing occasionally stories that nursing home vaccinations are being outsourced to Walgreeen's and this morning they are saying they may be prepared to start administering by the end of March.

I can only say that in my own state various pharmacy chains are offering vaccinations to medical workers in the 1a category. How that's being coordinated, I don't know but its definitely possible.

How many pharmacies are equipped to handle the extreme cold temps required, considering many hospitals are not? I suspect that's the reason for the forecast being months out yet as they await approval and distribution of more temperate vaccines.

[malchior]

I've been hearing occasionally stories that nursing home vaccinations are being outsourced to Walgreeen's and this morning they are saying they may be prepared to start administering by the end of March.

I can only say that in my own state various pharmacy chains are offering vaccinations to medical workers in the 1a category. How that's being coordinated, I don't know but its definitely possible.

How many pharmacies are equipped to handle the extreme cold temps required, considering many hospitals are not? I suspect that's the reason for the forecast being months out yet as they await approval and distribution of more temperate vaccines.

I'd expect Walgreens would get the Moderna and the research hospitals/mega-vaccine sites would get the Pfizer. However, the distribution is so hitched up who knows if anyone is truly even making these sort of calculations.

[Ralph-Wiggum]

I would hope that vaccine rate will pick up as more vaccine becomes available. We certainly aren't vaccinating at the rate we should be now with the vaccine on hand, but I don't think it makes sense to assume we'll continue vaccinating at this same rate once the vaccine is more widely available.

[Smoove_B]

How many pharmacies are equipped to handle the extreme cold temps required, considering many hospitals are not? I suspect that's the reason for the forecast being months out yet as they await approval and distribution of more temperate vaccines.

I have a list that has multiple pharmacies in each of our counties (national chains) that are offering the vaccine. I'm a little confused by it myself, but I guess they're looking to make sure all facets of the 1a care population have options. It could also be part of their smoke test to try and think through the logistics of trying to deal with walk ins (when that day eventually comes).

So far though, total chaos.

The numbers I saw last night said ~2 million vaccines have been distributed nationwide out of the alleged 20 million that were made available.

Pain.

[Smoove_B]

Also, Ed Yong has released his thoughts this morning:

On the Fourth of July, Ashish Jha wants to host a barbecue at his house in Newton, Massachusetts. By then, the state expects to have rolled out COVID-19 vaccines to anyone who wants one. The process will be bumpy, but Jha is hopeful. He thinks that the SARS-CoV-2 coronavirus will still be spreading within the U.S., but at a simmer rather than this winter’s calamitous boil. He expects to keep all his guests outside, where the risk of transmission is substantially lower. If it starts raining, they could come indoors after putting on masks. “It won’t be normal, but it won’t be like Fourth of July 2020,” says Jha, the dean of the Brown University School of Public Health. “I think that’s when it’ll start to feel like we’re no longer in a pandemic.”

Many of the 30 epidemiologists, physicians, immunologists, sociologists, and historians whom I interviewed for this piece are cautiously optimistic that the U.S. is headed for a better summer. But they emphasized that such a world, though plausible, is not inevitable. Its realization hinges on successfully executing the most complicated vaccination program in U.S. history, on persuading a frayed and fractured nation to continue using masks and avoiding indoor crowds, on countering the growing quagmire of misinformation, and on successfully monitoring and countering changes in the virus itself. “Think about next summer as a marker for when we might be able to breathe again,” said Loyce Pace, the executive director of a nonprofit called the Global Health Council and a member of Biden’s COVID-19 task force. “But there’s almost a year’s worth of work that needs to happen in those six months.”

[Jeff V]

We also don't know for sure at what point vaccinated people will need to be re-vaccinated, and to what extent mutations have on efficacy. It could well be we never get ahead the virus in a meaningful way to shut it down.

[Defiant]

This looks useful: Giving it our best shot

A website giving information on the ordering of rollouts of the vaccine (who'd getting it first) in all the states, with links to websites with more information.

[Smoove_B]

https://twitter.com/DrLeanaWen/status/1 ... 6854196225

Here’s the math: If the goal is to reach 80% of Americans vaccinated with a 2-dose #covid19 vaccine, it will take 10 years at our current pace. We are at 1 million vaccinations a week. To get to herd immunity by June 2021, we need to be at 3.5 million vaccinations a day.

[Defiant]

I have a hard time believing the pace will remain the same. The supply of vaccines should increase significantly in Q1/Q2 (and hopefully, the vaccines that don't require difficult to do cold storage will prove effective and be approved), and I would assume many of the logistic problems will be solved.

[Kraken]

Probably shouldn't have called distribution Operation One-Quarter Impulse.

[LawBeefaroni]

Our delivery due today got delayed so my appointment for tomorrow was cancelled. I can go in on my day off Thursday or schedule for next week.

Off to a great start...

[GungHo]

Our delivery due today got delayed so my appointment for tomorrow was cancelled. I can go in on my day off Thursday or schedule for next week.

Off to a great start...

Seems to be a common refrain.

Does the information yet exist on when we'll be expected to apply for a second round of vaccinations (3rd and 4th shots) and does the new, more tranmissable variant change expectations with RE: to that?
Which I see now is basically a question Jeff V already asked...

[Blackhawk]

What we really need to pick up the pace is to have the right people in charge. Luckily, there is a change of leadership scheduled for a few weeks from now.

[Jeff V]

It was reported on the news this morning that vaccination is proceeding at 1/10th of the expected pace, and now those who got the first shots are going to miss the second because vaccine is not available. We are currently trending to a pace of reaching 80% (the presumed "herd immunity" target by 2030 -- 10 years from now.

[$iljanus]

It was reported on the news this morning that vaccination is proceeding at 1/10th of the expected pace, and now those who got the first shots are going to miss the second because vaccine is not available. We are currently trending to a pace of reaching 80% (the presumed "herd immunity" target by 2030 -- 10 years from now.

I've read this. I'm just hoping that when Biden gets into the office he can mobilize Federal resources that aren't completely dependent on our dysfunctional Congress and speed things along in conjunction with ramped up vaccine production.

Of course, due to the damage that Trump has wrought I think the original timeline that was put forth is completely out the window. If only there was something else we can do to mitigate the spread of this virus...?

[Daehawk]

Biden has said he will invoke defense production act.