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US coronavirus: Covid-19 cases forcing hospitals to ration care is unfair and unacceptable, expert says

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The Montana health system is under this strain, including St. Peter’s Health in Helena, which operates according to emergency care standards.

“We have come to a point where not every patient in need is getting the care we could want. Your local health system is not going as usual, ”Dr. Shelly Harkins, Chief Medical Officer of St. Peter’s Health, named.

Crisis care standards are activated in emergency medicine when mass accidents occur, such as after a mass shooting or a major fire, and healthcare professionals have to ration their care, Associate Professor of Emergency Medicine and Assistant Dean of the School of Public Health at Brown University, explained Dr. Megan Ranney.

For the past week, the US recorded an average of around 1,926 Covid-19 deaths per day, the highest average since early March.

Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said the “overwhelming majority” of Americans need to get vaccinated to get the virus under control, but according to the US Centers for the Control and Prevention of Diseases (CDC) only 54% of the population are fully vaccinated. Meanwhile, 80% of the country’s intensive care beds are occupied, with nearly 30% occupied by Covid-19 patients, according to data from the U.S. Department of Health.

“It puts our health care providers in a state of moral harm where they have to watch people die they could normally care for,” said Ranney. “It’s an unacceptable condition for us in the United States, and it’s not fair to these doctors, nurses, respiratory therapists, and EMS providers.”

As long as the hospital systems are in this critical condition, some people will not be able to get hospital beds, Ranney said. And others will not be able to receive care.

“People who have had cardiac arrest may not be given CPR, and patients who would otherwise be admitted to the hospital may be sent home with their loved ones who are afraid and do not have the full capacity to care for them, just because there aren’t enough beds and nurses, “said Ranney.

In Kentucky, nearly 85% of Covid-19 deaths were in partially or unvaccinated people, Governor Andy Beshear said Thursday. The partially vaccinated or unvaccinated also accounted for more than 87% of Covid-19 cases and around 92% of hospital stays, he added.

“I hope you … hear very clearly that the most important thing we can do to get through this is to get vaccinated. Over 90 percent of people who are hospitalized are unvaccinated . So how can we not overflow? Our hospitals? We are vaccinated, “Beshear said.

Should already infected people be vaccinated?

When asked whether previously infected people should be vaccinated to protect themselves from the virus, Fauci said recovered patients have “significant immunity.”

However, he told CNN’s Jake Tapper on State of the Union Sunday that it was unclear how long this protection would last.

Vaccine boosters for more people are in sight.  But the unvaccinated remain the main obstacle to containing the pandemic

“You have protection. The only thing we don’t know yet, and hopefully we will get this data, is the durability of the protection and the view into the future, regardless of whether this type of protection is triggered by natural infections or not. how that will be against the variety of incoming variants, “said Fauci.

Ranney said she believed that previously infected people should be subject to vaccination regulations because the protection that a previous infection provides is not up to standard and there is currently no way to confirm that someone has recovered from a previous infection .

“We need a way to confirm that people have immunity, and that shows yours for now (Vaccination) Card, “said Ranney.

And while much of the talk has centered on booster doses, that’s not the top priority right now, Fauci told NBC on Sunday.

“We think giving boosters to people is important, but the overwhelmingly first priority is vaccinating the unvaccinated,” said Fauci.

Jack Kingsley RN cares for a Covid-19 patient in the Medical Intensive Care Unit (MICU) at St. Luke's Boise Medical Center in Boise, Idaho.

What to expect from booster doses

On Friday, advisors to the U.S. Food and Drug Administration (FDA) gave the go-ahead to recommend approval of a booster dose of the Pfizer vaccine six months after full vaccination in an emergency – but only for people 65 and over and people at high risk for serious illnesses caused by the virus. FDA advisors initially rejected Pfizer's booster application - but then voted to recommend a third shot to certain Americans

“The reason for this decision is because of the FDA’s ruling that the goal of vaccination is to prevent serious illness, hospitalization, and death, and the only people we’ve seen two doses fail to do are age 60 years or 65 plus, “said Ranney.

“For the rest of us, hold on and hold on.”

The CDC is meeting with their vaccine advisors this week, and the agency must give their approval stamp before any booster doses can officially be given.

Although Fauci said he believed that a booster dose would likely be recommended to all Americans at some point, he made it clear that he did not believe the FDA made a mistake in the recommendations.

“I have no problem at all with your decision. I say data will continue to come in and I believe that over the next few weeks you will see this process evolve.” Months, “said Fauci on Sunday.

One development could be the evaluation of data for boosters from Moderna and Johnson & Johnson, which, according to Fauci, is expected in the next three weeks.

CNN’s Amanda Sealy and Aya Elamroussi contributed to this report.

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Pandemic

Mayor Bronson in quarantine after head of Anchorage Community Development Authority tests positive for COVID-19

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Mayor Dave Bronson is in quarantine after coming into close contact with Mike Robbins, executive director of Anchorage Community Development Agency, who has now tested positive for COVID-19.

The mayor’s office confirmed on Monday that Robbins was infected with the virus and that Bronson is under quarantine.

Mayor spokesman Corey Allen Young said Bronson was following the city’s COVID-19 containment policy and would be in quarantine for six days and will be tested for the virus on day six.

Nobody else in the mayor’s office came in close contact with Robbins, Young said.

“Nobody else has tested positive or shown any signs of symptoms,” he said via email, adding that the mayor works from home.

Bronson was in close contact with Robbins at a Visit Anchorage event last week. Two other members of the administration were in attendance but had no long close contact with Robbins, Young said.

This is the second time this month that the mayor has been quarantined after close contact with a COVID positive member of his administration. Community leader Amy Demboski and community attorney Patrick Bergt tested positive for the virus earlier this month.

[Anchorage Assembly calls on Mayor Bronson to enforce mask mandate]

On Monday, Bronson gave the Anchorage Chamber of Commerce an “Address of the State” – from Zoom – during the organization’s “Make it Monday” forum.

“Please again accept my apology for not being there in person as I am falling (under) quarantine protocols,” Bronson told the audience.

The mayor has avoided strongly encouraging the wearing of masks or advocating vaccinations, both of which have been shown to reduce virus transmission and the risk of serious illness. Instead, he often leaves Dr. Michael Savitt – his Chief Medical Officer at the Anchorage Department of Health.

Speaking at the chamber’s forum on Monday, Bronson said the city health department’s top priority is coordinating the city’s response to COVID-19, including “advanced testing, targeted vaccinations and monoclonal antibody treatments for improved and targeted treatments, especially in our underserved communities . ”

Now “we are working to return to pre-COVID-19 service levels while returning to all of the traditional services that the Anchorage Department of Health normally provides,” Bronson said.

The health department has also focused on the city’s mass housing, including communal housing in the Sullivan Arena and out-of-community housing, he said.

Combating homelessness remains a top priority for his government, said the mayor.

“We continue to work with the congregation to develop adequate service capacity for those affected by homelessness in our city and will shortly be launching an initiative to reduce the scare-mongering on our streets,” said Bronson.

The pandemic was largely a footnote in Bronson’s Monday statements to the chamber. He highlighted his government’s other priorities: working with the Assembly to approve a budget for the next year; Replacing aging docks, broken piles and other infrastructure challenges in Port of Alaska modernization program; and promoting economic growth in the city, among other priorities.

The news of Robbin’s positive test result – and Bronson’s quarantine – comes as Anchorage struggles with persistently high virus transmission rates across the community, part of a spike that increased dramatically in late summer and was fueled by the highly contagious Delta variant.

Bronson had a mild bout of COVID-19 last fall and suffered long-term symptoms, he said.

[What’s bringing people to Anchorage’s COVID-19 vaccine clinics: Work mandates, high case counts and good timing]

The Mayor firmly opposes COVID-19 restrictions, including the city’s current Masking Ordinance, which the Anchorage Congregation passed earlier this month. Bronson vetoed the ordinance requiring the wearing of masks in indoor public spaces, but the congregation quickly voted to lift the veto.

Bronson and most of his administration have attended congregational meetings unmasked since he took office. The Emergency Mask Ordinance exempts Bronson and its administration from the requirement, and members said the ordinance was not about getting the mayor to wear a mask, but rather about protecting public health and safety.

Bronson has spoken out against vaccination regulations and against vaccination regulations for staff in local hospitals. In his campaign, at Congregation gatherings and other public forums, he downplayed the severity of the pandemic and its impact on hospitals.

Robbins did not immediately respond to a request for comment. Young didn’t immediately respond to a question about whether Robbins had symptoms.

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Gov. Pritzker to Give COVID-19 Update, Discuss Pediatric Vaccinations Monday – NBC Chicago

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NOTE: NBC Chicago will be streaming the governor’s address live starting at 1:30 p.m. CT. See it live in the player above.

Illinois Governor JB Pritzker is expected to give a COVID-19 update on Monday, which is expected to be a day before an FDA panel on pediatric vaccination to discuss whether Pfizer child-size vaccinations for children ages 5 through 11 years should be recommended or not.

The governor is expected to speak from the Thompson Center in Chicago at 1:30 p.m.

The governor’s address comes shortly after the White House announced that children ages 5-11 can get a COVID-19 shot at their pediatrician office, local pharmacy, and possibly even school, which the plans state Elementary school children will be listed for the expected approval of the Pfizer shot in a matter of weeks.

This week will be an important step in getting COVID vaccines approved for such age groups.

The Food and Drug Administration’s panel of experts will discuss Tuesday whether the Pfizer shots are ready for the roughly 28 million children ages 5-11.

Federal health officials said late Friday that child-sized doses of Pfizer’s COVID-19 vaccine appeared to be highly effective in preventing symptomatic infections in elementary school children and did not cause any unexpected safety issues.

In their analysis, FDA scientists concluded that the vaccine’s benefits in preventing hospitalizations and death from COVID-19 would outweigh any serious potential side effects in children in almost any scenario. But the agency’s reviewers stopped asking for Pfizer’s shot to be approved.

If the FDA approves the syringes, the Centers for Disease Control and Prevention will make additional recommendations on who should be given them in the first week of November. Children could start vaccinations early next month – with the first children in line, fully protected until Christmas.

Full-strength Pfizer syringes are recommended for ages 12 and up, but pediatricians and many parents are eagerly awaiting protection for younger children in order to contain infections from the extra-contagious Delta variant and keep the children in school. Both Moderna’s and J & J’s vaccines can only be used in people aged 18 and over, although Moderna is also researching its vaccines in elementary school children.

While children are at lower risk of serious illness or death than the elderly, COVID-19 has killed more than 630 Americans under the age of 18, according to the CDC. Almost 6.2 million children contracted the coronavirus, more than 1.1 million in the last six weeks when the Delta variant increased, says the American Academy of Pediatrics.

Doctors at Advocate Children’s Hospital said last week that while children’s cases tend to be less severe than adults, “more children are hospitalized with severe COVID-19 infection than earlier in the pandemic”.

The group also warned that multiple cases of a life-threatening COVID-19-related illness called Pediatric Multisystem Inflammatory Syndrome have been reported in the Chicago area, and that experts are still unaware of the long-term effects of COVID-19 on children.

The Biden government has bought enough child-sized doses – in special orange-capped vials to distinguish them from the adult vaccine – for the country’s 5-11 year olds. When the vaccine is approved, millions of doses, along with child-sized needles, will be shipped across the country in an instant.

More than 25,000 paediatricians and general practitioners have already signed up to receive the syringes in little arms.

Pfizer and Moderna are also investigating vaccinations in even younger toddlers up to 6 months old. Results are expected later in the year.

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Wasted COVID-19 vaccine doses exceed 50% for some Erie County providers

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UPMC Hamot and Albion Pharmacy wasted almost the same number of COVID-19 vaccine doses. Hamot disposed of 384 unused doses while Albion Pharmacy disposed of 376 doses.

The difference is that Hamot received 66,105 doses of vaccine, which is only 0.6% of its vaccine wasted, while Albion Pharmacy received 550 doses of vaccine, of which 68.4% was wasted.

“When we first ordered the vaccine, the only way to order it was to get 450 doses from Pfizer,” said Megan Dreher, manager of Albion Pharmacy. “We didn’t have any special refrigeration to store it, so the vaccine was only good for six weeks. There just wasn’t much demand. We even tried to get to schools.”

COVID-19 vaccine waste was a major issue earlier this year when demand was high and the vaccine was in short supply. Hamot and other providers have taken exceptional measures to use each dose, including driving to people’s homes after a vaccine clinic closed for the day to give extra doses.

Now there are enough vaccines and the demand has decreased. Still, vaccine providers don’t want to waste doses.

“I continue to believe that vaccine waste is a big deal,” said Melissa Lyon, director of the Erie County’s Department of Health. “This is a very powerful vaccine and we don’t even want to waste a single dose.”

More:COVID-19 vaccine required for Penn State Behrend faculty, staff until December 8th

The county health department disposed of 4,192 of its doses – 14.4% of the 29,060 received – without administering them. According to the Pennsylvania Department of Health, this is the highest number of wasted doses of any vaccine supplier in Erie County.

A total of 1,414 of these doses were spoiled, while a further 2,771 doses were not administered after opening the vial. Other ways to waste doses are if the vial is broken or if the vaccine is drawn but not given within a period of time, usually two to 12 hours, depending on the type of vaccine.

“One thing that happened was when the state ordered walk-ins to be accepted in vaccination clinics,” Lyon said. “That took control out of you to avoid any waste. If someone wanted a dose, you had to open a vial (with six or ten doses), even if no one else got a syringe. “

More:Erie Hospitals See More Breakthrough COVID-19 Patients, With Nearly 30% Fully Vaccinated

Officials from Adagio Health, a Pittsburgh-based health organization whose clinics primarily serve women and low-income residents, offered a similar explanation for the high percentage of wasted vaccine doses in their Erie County offices.

Its Erie and Edinboro offices disposed of 1,695, or 59.2%, of their combined 2,860 cans.

“When we completed our training with the state health department about the vaccine, they emphasized the importance of putting doses in people’s arms,” ​​said Natalie Crouse, senior director of clinical operations at Adagio Health. “Vaccinating one person and having to dispose of the other five doses in one vial is better than leaving the vial in the refrigerator and letting all six doses expire.”

Larger vaccine providers have wasted little vaccine

Other providers have been able to staff clinics and complete walk-in appointments without wasting a lot of vaccine.

Saint Vincent has set up remote clinics in addition to providing COVID-19 vaccines in the hospital and recently in its doctor’s offices and emergency centers. It wasted 894, or 1.3% of its 70,205 doses.

“Remember, some of those doses weren’t actually wasted,” said Steve Henderson, director of Saint Vincent Pharmacy. “If you look at the ‘other’ category of wasted cans, it includes inexplicable ones. The Food & Drug Administration approved six doses from each Pfizer vial, but none of them contain six doses, so you had to report one as unaccountable. “

Hamot has kept the percentage of doses wasted low, in part because it has the vast majority of its vaccination clinics in one location – the UPMC Health Plan Operations Center, 380 E. Bayfront Parkway.

“But we have held remote clinics and have been very vigilant from the start,” said Jason Chenault, Hamot’s director of emergency, hospital and critical care services. “We continue to focus precisely on the dosages and how many are planned. When we have additional doses, we reach out to the appropriate people to administer them.”

Here’s a look at the number and percentage of wasted vaccine doses from Erie County vendors who disposed of at least 200 doses without administering them:

  • Albion Pharmacy – 376 doses wasted, 68.4% of all doses received
  • Adagio Health, Erie, and Edinboro offices – 1,695, 59.2%
  • Erie County Jail – 269, 22.8%
  • Millcreek Manor Pharmacy – 1,601, 19.4%
  • Erie County Department of Health – 4,192, 14.4%
  • Millcreek Community Hospital – 1,450, 13.7%
  • St. Vincent Hospital – 894, 1.3%
  • UPMC Hamot – 384, 0.6%

Nationwide, vaccine providers wasted 0.28% of their doses, according to the state health ministry.

One way to avoid waste in the future is for vaccine manufacturers to sell syringes filled with a single dose of the vaccine, Lyon said.

“It’s more expensive to make, but it would reduce waste,” said Lyon.

Contact David Bruce at dbruce@timesnews.com. Follow him on Twitter @ETNBruce.

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