June 21, 2021

Dr. Stuart Weiss: COVID-19 Update Wednesday 6-Jan-2021

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By Dr. Stuart Weiss, Intelligent Crowd Solutions

Rapid Test Center of New York

Dr. Stuart Weiss, FACEP, FAAP, CBCP

January 6, 2021
CoViD-19 News and Information you can trust.Welcome new readers from the Rapid Test Center.
Topics: My vaccine experience and a BIG concern

My Vaccine Experience today and a big concern

Today, I received the first of my two Moderna vaccine doses. I am eligible for a vaccine dose because I am a healthcare worker who works in a CoViD-19 testing center. I have encouraged all of my staff at the testing centers to be vaccinated.

Let me tell you briefly about my experience and raise a major concern. I had an easy seamless experience today. I walked in to the vaccine location in Manhattan and was greeted by a lovely person who checked my paperwork, verified my appointment off of a clipboard and confirmed that I was a healthcare worker. After scribbling something on my consent form, she directed me to station #2. I walked through a doorway into the next room and a greeter at the door directed me to an empty seat at one of six tables. At station #2, I was greeted by another lovely person who read through my consent form again, asked me a few questions that I had already answered on the consent form and took my temperature. She then scribbled some items on the form and directed me to go out the door to the vaccination room.

I then walked around the corner and down the stairs where I was greeted by another lovely person who looked at the consent form again and then looked for an empty curtained off vaccination room. I was escorted into location 5 and was met by yet another lovely person. She confirmed my name and birthdate, visually scanned my consent form looking at my answers and presumably whatever the others has scribbled on the form and then sat down and proceeded to draw up my vaccine, change needles, rubbed alcohol on my arm and inject the vaccine into my right shoulder muscle. She then gave me a card with some follow up information on it and directed me to the observation room where I needed to wait for 20 minutes, Once I got into that room, I was directed to sit in seat number 12 which was socially distanced from the other people and I sat there for 20 minutes.

Overall a smooth operation BUT…..Its totally impractical. It took me 40 minutes to go through the process. At that rate, with 328,239,523 people in the US plus an estimated 11 million undocumented folks, it would take close to TWO YEARS to get everyone vaccinated! So here goes some back of the napkin math, feel free to comment if I get this wrong.

40 minutes per encounter times 339,239,523 people in the United States equals 226,159,682 hours of time to vaccinate everyone. If each state has 1000 vaccination centers (some may have more, some less) then each site needs 4,523 hours. If each site is open 8 hours a day then they need 565 days to get it done. That’s the math for my experience with no hold ups or delays. I know that in some places, it takes way more than 40 minutes to get through the process. Two years to get everyone vaccinated is not acceptable and the root cause of this failure is rooted in some basic disaster medicine principles.

During normal times, we use a principle in medicine that says we devote maximal resources to a minimum number of people. We devote tremendous resources to one sick person. For example, a patient in an ICU will have a nurse dedicated to them and one other person, there is a head doctor on their case, there are consulting doctors, there are respiratory therapists, pharmacists, nursing assistant, etc. A large group of people work together following sometimes intricate protocols to deliver excellent care. At my vaccine center, they had 6-8 people interacting with me and triple or quadruple verifying my answers to every question. Maximal resources to each individual patient.

In disaster scenarios, we flip that over. Instead of maximal care to a minimum number of people, we deliver minimal care to the maximum number of people. The basic principle is to do the most good for the most people with the resources you have. In our mass vaccination effort, we can’t have 6-8 people seeing each patient, triple checking all the answers and taking 40 minutes minimum per patient. We need disaster docs to design an efficient mass delivery system that keeps things safe but moves people rapidly through the system. There are a number of my fellow emergency docs who belong to the disaster medicine section and the event medicine section of the American College of Emergency Physicians. We understand how to apply disaster principles to this effort. I hope that the new administration and governors reach out to these experts around the country and let us help design rapid delivery systems.

The other issue is the prioritization system that is being used. The CDC guidelines for vaccine groups are just guidelines. Alex Azar, the secretary of the Dept of Health and Human Services said today that they didn’t intend to be overly prescriptive with the guidelines. If people in top priority groups had been offered vaccine and there were doses left over then governors should expand the eligible groups.

It is ridiculous to have vaccine sitting in storerooms and warehouses because of priority guidelines. We need to get vaccines in to people’s arms.

In other vaccine news, the vaccines seem to be very safe. Dr. Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases at the CDC said that they are seeing 11 severe allergic reactions per million vaccine doses based on the first three weeks of vaccination. The good news is that we can treat allergic reactions and all of the cases in the US have recovered. The vast majority have the reaction within the first 15 minutes and 17 of the 21 patients who had severe allergic reactions has a prior history of allergies to food,medicines or insects.

Stay safe, we will all get through this together.

Dr. Stu Weiss
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The Doctor Stu YouTube channel is up and running but we haven’t added new videos in a little while. I’ll get back to that after the New Year. Go towww.DoctorStu.org to submit questions.
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Coronavirus update for January 6, 2021

World Wide Updates

WHO team blocked from entering China to study origins of coronavirus
South Africa’s Covid-19 variant spurred discovery of the UK’s
UK hits winter record of 1,041 daily deaths as Covid-19 cases surge
Zimbabwe health system overwhelmed as country goes into new strict lockdown, doctors say
EU authorizes Moderna vaccine against Covid-19
Portugal reports record 10,027 Covid-19 infections, as president goes into isolation
Swiss restaurants and cultural sites to remain closed until end of February, government says
Seychelles reports its first Covid-19 related death
Italy received 100,000 fewer doses of Pfizer/BioNTech vaccine than expected
German health minister asks for patience as frustration mounts over speed of vaccine rollout
Bavarian leader says vaccination is the only long term strategy against Covid-19
Over a hundred virus cases detected in China’s Hebei province 
Denmark bans entry for travelers from South Africa over variant fears
Beijing negotiating with WHO as expert team tries to enter China to probe origins of Covid-19
Germany records second highest daily death toll from Covid-19
Ireland Covid-19 hospital admissions surpass first wave peak
UK vaccination target is “Herculean” but can be achieved, minister says
Czech Republic reports more than 17,000 new Covid-19 cases in new daily record
The Netherlands administers its first Covid-19 vaccine dose
South Korea will test every prisoner in the country for Covid-19
North Korea just held a major political meeting with about 5,000 people — and there wasn’t a mask in sight
In Australia and Taiwan’s fight against Covid, flight crews are proving to be their Achilles heel
Portugal extends state of emergency amid record daily Covid-19 cases
Peru and Bolivia see hospitals overflow and cases rise as fears of second wave grow
Thousands to get tested as Australia-India cricket match named possible Covid-19 hotspot
Total Cases Worldwide: 87,457,764
Total Deaths Worldwide: 1,887,064
Total Recovered: 62,946,258

US Updates

California records more than 450 Covid-19 deaths as hospitalizations reach new high
NY Governor asks for proof of Covid-19 testing from international travelers
In less than a week, more than 1,000 people have died of coronavirus in Los Angeles County
US states call in National Guard as country hits daily Covid-19 death toll record
California orders hospitals to delay non-essential surgeries in regions hardest hit by Covid-19 surge
Operation Warp Speed says it distributed 3 million coronavirus vaccines Tuesday
The US recorded at least 3,775 Covid-19 deaths on Tuesday
Georgia nursing home forced to delay vaccination due to COVID-19 outbreak
Loss of smell and taste occurs in 86% of mild Covid-19 cases, study says
USWNT star Alex Morgan tests positive for COVID-19
Carnival won’t resumé’s U.S. cruises through at least March as company announces latest extension
Governors scramble to speed up vaccine effort after slow start
California hospital distribute 850 COVID-19 vaccines in two hours after fridge breaks
FDA warns Congress about COVID-19 test that may give false results
A Trader Joe’s closed early amid mask protest
GOP Rep. Kevin Brady tests positive for COVID-19
Doctors encourage vaccination despite reports of cosmetic filler swelling
Total US cases: 21,776,661
Total US deaths: 368,748
Total Recovered: 12,966,905
Total Tested in US: 256,136,757
Total cases in CA: 2,518,492
Total deaths in CA: 27,609
Total cases in TX: 1,868,949
Total deaths in TX: 29,028
Total cases in FL: 1,409,906
Total deaths in FL: 22,332
Total cases in NY: 1,097,945
Total deaths in NY: 38,866
Total cases in IL: 999,288
Total deaths in IL: 18,735
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