When Dr. Brittani James, an assistant professor of community medicine at the University of Illinois and executive director of the Institute of Anti-Racism in Medicine, got the COVID-19 vaccine in December, she recorded the moment and released the footage online, where her nearly 14,000 Twitter followers could watch and share the footage. The reason? Many of those thousands are Black, and they mistrust a health care system that has often left them behind and even exploited them. And that has led to mistrust in the vaccines, with just 42% of Blacks saying they intend to be vaccinated, compared to 61% of whites.
"I talk until I'm blue in the face," James told me when we spoke, "but there's something I think for people to see me or see other Black people getting it that can really do a lot to soothe their fear. Like hey, guess what? If I'm wrong, I'm going down with you."
Black Americans are by no means the only group that is vaccine-hesitant; vaccine acceptance rates across demographic groups in the U.S. are below the 85% vaccine coverage needed to achieve herd immunity.
There are multiple reasons for the Americans' widespread reluctance to line up for shots that many have been anxiously awaiting for months. For one thing, there's the speed with which the vaccines were developed--less than a year, compared to the 15 to 20 years some vaccines can take. Then too there's the new technology behind the Moderna and Pfizer-BioNTech vaccines, both of which use messenger RNA (mRNA) to prompt the body to produce a coronavirus spike protein, which in turn elicits an immune response. Vaccines more commonly use a killed or weakened virus, or at least a portion of the virus, to trigger antibody production. Finally, after a year of sickness and death, there's a rational fear of COVID-19 itself that less rationally gets carried over to the vaccine. "People tend to rate vaccine safety with how dangerous the disease is," says Dr. Paul Offit, professor of pediatrics at the Children's Hospital of Philadelphia and director of its Vaccine Education Center.
Offit, James and others are working hard to disabuse people of their fears, pointing out that while the mRNA technology might seem new, it's been in development for more than 10 years. The vaccines admittedly have potential side effects including a tiny handful of Bell's palsy cases that in the general population would work out to roughly four in 10,000 per year. But that's decidedly less scary than COVID-19 itself, which has already killed one in every 1,000 Americans.
Then too, there's the simple concern of being an early adopter of any vaccine. But here as well there are misconceptions at work. Tens of thousands of people in both the Moderna and Pfizer-BioNTech trials received those vaccines before any member of the general public. What's more, millions of health care workers will be receiving the vaccine before anyone else.
"If there's any issues that come up, we're going to know," says Dr. Richard Pan, a pediatrician, California state senator and vaccine advocate, "because we continue to follow vaccines, not only until approval but past approval."
Ultimately, no vaccine is perfect, and the COVID-19 vaccines do have more questions associated with them than others, because there hasn't been as much follow-up time since the study volunteers got their shots. But those questions are less about safety than about just how long the shots will prove protective. The truth is that they work.
"What I've been saying since the beginning," says Dr. Ala Stanford, a Philadelphia-based pediatric surgeon and founder of the Black Doctors COVID Consortium, "is that it's faith and facts over fear."
The U.S. Food and Drug Administration wants nothing to do with any plans to change the dosing protocols for the Moderna and Pfizer-BioNTech vaccines. Moncef Slaoui, top adviser for Operation Warp Speed, has speculated that the FDA might consider giving half-doses to people in the 18 to 55 age group in order to stretch existing vaccine supplies. But, as CNN reports, the FDA itself is turning a thumbs-down on such freelance dosing strategies. "At this time, suggesting changes to the FDA-authorized dosing or schedules of these vaccines is premature and not rooted solidly in the available evidence," said FDA commissioner Dr. Stephen Hahn in a statement yesterday.
In the U.S., enough time has passed since the vaccine rollout began that early recipients are beginning to receive their second doses, the Associated Press reports. The number of shots administered has grown to 4.6 million, according to the U.S. Centers for Disease Control and Prevention--still only a tiny fraction of the population but an uptick from earlier numbers.
New York and Florida are moving to penalize hospitals that don't get vaccines from vials into patients' arms fast enough, according to Reuters. With 15 million doses of two different types of COVID-19 vaccines in circulation but less than a third of that total actually administered, the hospitals are being singled out as the worst choke points. Florida is taking a carrot approach, offering more vaccine to hospitals that administer the shots quickly; while New York is opting for the stick, both fining and reducing vaccine shipments to hospitals that don't administer their doses within a week of receiving them.
TODAY'S CORONAVIRUS OUTLOOK
The Global Situation
More than 85.6 million people around the world had been diagnosed with COVID-19 as of 1 a.m. E.T. today, and more than 1.85 million people have died. On Jan. 4, there were 549,954 new cases and 10,199 new deaths confirmed globally.
Here's how the world as a whole is currently trending:
Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
And here is every country with over 1.5 million confirmed cases:
Russia claims its Sputnik V vaccine has an efficacy rate of 91.4%, despite the fact that those results have not been published in a peer-reviewed journal. As the Financial Times reports, this has left the Russian public skeptical of the shots, with only 1 million being administered nationwide so far in a country of nearly 145 million. The Russian government is nonetheless celebrating the modest milestone, even as it continues to report the world's fourth highest number of COVID-19 infections. One Russian who has yet to take the shot but promises that he plans to: President Vladimir Putin.
There are lingering questions about the efficacy of China's domestically produced Sinopharm vaccine, NPR reports. The government claims that the shot has proven 79% effective in tests conducted within the country--lower than the 86% efficacy rate it is said to have achieved in tests conducted in the United Arab Emirates. No explanation has been offered for the difference. Despite that, the vaccine has been rolled out in the UAE and Bahrain, with orders placed by Pakistan and Ukraine. In Beijing, vaccinations have just begun, with the government setting up 220 vaccination centers around the city and claiming to have inoculated 73,000 people in the first two days.
Few countries need a robust coronavirus vaccine campaign more than Brazil, which trails only India and the U.S. in total number of cases. But the country is lagging behind some of its South American neighbors, like Chile and Argentina. In an effort to step on the gas, Brasilia is negotiating for a major Indian-made shipment of the U.K.'s AstraZeneca vaccine, Al Jazeera reports. But India, facing an even worse outbreak, is considering restricting exports. Brazil is hoping to make up for any import shortfall by relying on purchases of India's domestically made Bharat Biotech vaccine, even though results from late-stage trials have not yet been made public. That vaccine, even if India makes it available, would still have to be approved for use by Brazil's health regulators.
The Situation in the U.S.
The U.S. had recorded more than 20.8 million coronavirus cases as of 1 a.m. E.T. today. More than 353,000 people have died. On Jan. 4, there were 180,477 new cases and 1,903 new deaths confirmed in the U.S.
Here's how the country as a whole is currently trending:
And here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
Where a need for a scarce commodity exists, scams are sure to follow, and so it has been in Nebraska with the COVID-19 vaccine. As the Associated Press reports, state Attorney General Doug Peterson is warning Nebraskans to be wary of unsolicited calls or emails offering the vaccine, especially if callers ask for credit card or bank information. "Rely on your own health care practitioners for accurate information rather than unknown and unverified sources," Peterson said in a statement.
Back in the spring, as the coronavirus was burning through New York state and residents were losing jobs and livelihoods, Governor Andrew Cuomo ordered hospitals to stop suing patients over unpaid medical bills. Most complied, but as the New York Timesreports, there is an outlier: Northwell Health, which sued more than 2,500 patients in 2020, dunning them for an average of $1,700 each. Other small private hospitals have filed similar claims against patients, but Northwell is conspicuous both for its size--it operates 23 hospitals, generated $12.5 billion in revenue last year and received $1.2 billion in stimulus funding through the CARES Act--and the number of its lawsuits. Northwell defends its actions. "We have no interest in pursuing these cases legally. It's not what we want to do," Richard Miller, the system's chief business strategy officer, said. "Unfortunately, in some cases, they're not leaving us much of an option."
As California braces for a winter surge in cases on top of its current spike, the Los Angeles County Emergency Medical Services Agency has issued some stark orders, NPR reports. For one thing, paramedics are being instructed to conserve scarce supplies and administer oxygen only to people whose blood saturation level falls below 90%. Worse, ambulance crews are being told that patients who have little chance of survival should not be brought into hospitals at all. Separately, the crews are being instructed not to transfer patients who experience cardiac arrest unless their heartbeat can be restored on the scene. Los Angeles is the hardest hit county in the country in terms of both number of COVID-19 cases and number of deaths. The new and more highly contagious U.K. strain of the virus has also been discovered in Southern California.
All numbers unless otherwise specified are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of Jan. 5, 1 a.m. E.T. To see larger, interactive versions of these maps and charts, click here.
WHAT ELSE YOU SHOULD KNOW
Meet the New Year, Same as the Old Year?
As my colleague Alex Fitzpatrick wrote in yesterday's Coronavirus Brief newsletter, the mere turning of the calendar page has not meant a sudden release from the grip of the pandemic. If anything, things have gotten worse, in some senses. The Associated Press takes a chilling look at the dark trifecta--slow vaccine rollouts, surges in cases and overtaxed hospitals--that are likely to keep 2021 looking a lot like 2020 for most of the world, at least for a while. Read more here.
No Work for the Overworked
If there's one thing frontline doctors and other medical workers should not have to worry about, it's finding gainful employment. But many of them--especially emergency medicine residents who have spent the past year treating COVID-19 patients--are struggling to find jobs when their residency is done, the Washington Post reports. The cause is an unkind paradox: With people afraid to come to hospitals for fear of contracting COVID-19, foot traffic in emergency rooms has fallen, leading to less demand and fewer jobs. Read more here.
School Nurses Bracing for the Worst
It's been a bad year to be a school nurse, standing on the front lines of the pandemic in a close-quarters environment that all by itself can be a super-spreader site. Now, as my colleague Katie Reilly reports, things could grow even worse. The four-day Thanksgiving break already led to a bump in COVID-19 cases nationwide. With students returning from what, in many districts, has been a two-week break, even harder times loom. Read more here.
Thanks for reading. We hope you find the Coronavirus Brief newsletter to be a helpful tool to navigate this very complex situation, and welcome feedback at coronavirus.brief@time.com. If you have specific questions you'd like us to answer, please send them to covidquestions@time.com.
If you were forwarded this and want to sign up to receive it daily, click here.
Today's newsletter was written by Jeffrey Kluger and edited by Alex Fitzpatrick.
沒有留言:
張貼留言