While Ms. Khemili had become more diligent about her dental care, she had a history of dental issues before contracting the coronavirus. When she went to the dentist the day after her tooth came out, he found that her gums were not infected but she had significant bone loss from smoking. He referred Ms. Khemili to a specialist to handle a reconstruction. The dental procedure is likely to cost her just shy of $50,000.
The same day Ms. Khemilis tooth fell out, her partner went on Survivor Corp, a Facebook page for people who have lived through Covid-19. There, he found that Diana Berrent, the pages founder, was reporting that her 12-year-old son had lost one of his adult teeth, months after he had a mild case of Covid-19. (Unlike Ms. Khemili, Ms. Berrents son had normal and healthy teeth with no underlying disease, according to his orthodontist.)
Others in the Facebook group have posted about teeth falling out without bleeding. One woman lost a tooth while eating ice cream. Eileen Luciano of Edison, N.J., had a top molar pop out in early November when she was flossing.
That was the last thing that I thought would happen, that my teeth would fall out, Ms. Luciano said.
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Teeth falling out without any blood is unusual, Dr. Li said, and provides a clue that there might be something going on with the blood vessels in the gums.
The new coronavirus wreaks havoc by binding to the ACE2 protein, which is ubiquitous in the human body. Not only is it found in the lungs, but also on nerve and endothelial cells. Therefore, Dr. Li says, its possible that the virus has damaged the blood vessels that keep the teeth alive in Covid-19 survivors; that also may explain why those who have lost their teeth feel no pain.
Its also possible that the widespread immune response, known as a cytokine storm, may be manifesting in the mouth.
At least three coronavirus vaccines are on the horizon, but some Americans appear hesitant to be first in line to take them.
As the likely distribution of COVID-19 vaccines draws near, researchers say its time to begin educating Americans about medical research and the vaccine, with a focus on building trust particularly in communities that experience higher levels of distrust.
A September survey conducted by the Pew Research Center found that just 51% of U.S. adults said they would definitely or probably get a COVID-19 vaccine if it were available the day they took the survey.
What makes people hesitant? Theyre not sure it will work. Sometimes its about side effects. They want to know that it is indeed going to protect them, and thats a message that we need to make sure we get out there, said Kenzie Cameron, a research professor in general internal medicine and geriatrics at Northwestern Medicine. Cameron is a health services researcher with a background that includes health communication, and has studied racial and ethnic disparities in the flu vaccine.
Vaccine skepticism is highest among Black Americans a community that sees historic mistrust in the American medical system and its record of experimenting on Black people.
Dating back to the Tuskegee experiment that was supposed to be a six-month experiment and it lasted 40 years and with the Henrietta Lacks research study that happened in 1951. Because of these long-standing issues, African Americans, they do not trust, said Tonya Roberson, a community psychologist and the director of community engagement, program development and academic support at Governors State University in the college of health and human services.
They feel like the government leadership is not doing what they should do to help or to protect Americans, especially minorities, and current evidence of racial disparities in health care also cause mistrust, she said.
Among Black adults, 32% said they would definitely or probably get a COVID-19 vaccine, according to the Pew Research survey in September. That figure was higher for respondents who were White (52%), Hispanic (56%) and Asian (72%).
Because mistrust in the medical system and vaccines has built over time, Cameron says rebuilding it wont happen overnight, and it should start at the individual level between patients and their nurses and physicians.
There can be very significant distrust in institutions and systems, especially when we are seeing more and more this institutional and structural racism that was there all along, she said. The trust needs to happen between individuals.
Some vaccine trials paused research earlier this fall because they hadnt enrolled enough people of color. Roberson said the danger of not having diverse participants in a trial is that the vaccine may not work on everyone.
There are environmental and genetic reasons that the vaccine drug needs to be tested on these different races so they can be accurately represented African Americans are physically different from other nationalities. Our veins are smaller and our cancer masses are more dense, Roberson said. Her background includes public health and biomedical and social science research. She has a particular expertise in culturally tailoring research methods to address health and racial inequities.
The Black community has been among the communities most impacted by COVID-19. As of Monday, Black residents in Chicago made up 18% of total confirmed coronavirus cases and 41% of total deaths, city data show.
A survey released Monday found that among Black and Latino Americans, safety and effectiveness were key in deciding to get vaccinated. The survey, which was conducted at the beginning of September, found that just 14% of Black respondents said they trust that a vaccine will be safe, and 18% said they trusted a vaccine would be effective. For Latino Americans, those figures were 34% and 40%, respectively.
The survey authors said the responses show the building trust on vaccine safety and effectiveness will be vital.
Roberson is working to educate community members in South Chicago and the south suburbs about medical research and vaccines, where concerns range from not wanting to be part of a medical experiment to not trusting government leadership the same issues of mistrust surrounding the flu vaccine, Roberson said.
Rebuilding trust requires listening to patient concerns and questions, Cameron said.
A lot of times what happens in public health and in messaging is we assume we know what you want to hear, and Im going to tell you that, Cameron said. But thats not enough. I need to find out from you what your specific concern is.
The Covid-19 vaccines, which are up to 95% effective, have the potential to save millions of lives in the UK and many more around the world.
Yet creating the vaccines is just the first step. We now need to produce them as quickly as possible, work out the logistics of distribution and administration and most importantly ensure as many people as possible take them. And as the history of vaccines shows, that is not as easy as some might assume. You only have to look at the fall in uptake of the measles, mumps and rubella (MMR) vaccine after it was falsely linked with autism.
Despite the Covid vaccines being reported as safe, a recent YouGov survey found that 21% of adults are unlikely to take a vaccine, and a further 12% are unsure. That means a third of the country arent confident they will take the vaccine though reasons vary from a minority of anti-vaxxers, to a larger group of people who are hesitant and want to wait and see if its safe, or think they are too low risk to need it.
This resistance could potentially increase as confirmation bias our tendency to search out and engage with content that affirms what we already believe and polarising social media algorithms cause people to become more entrenched in their views. It is therefore vital to plan ahead of the rollout in order to ensure as many people as possible take the vaccine. Behavioural science can provide useful guidance.
Firstly, and perhaps most importantly, we need to handle the anti-vaxxers the right way. Though, instinctively, many of us would want to tell them theyre wrong, this is not the way to proceed. We must avoid avoid directly confronting anti-vaxxers like this, or dismissing them as crazy or stupid.
Its a human instinct that, if our strongest beliefs are directly challenged, we can end up believing them more firmly whats known as the backfire effect. We often have a defence mechanism that leads us to actively search out information that shows we are right. In this case if people are pushed too hard and feel judged, theyll look for reasons to avoid taking the vaccine.
This knowledge of the backfire effect should impact all of us, not just those directly connected to the rollout. We shouldnt post on social media about how idiotic people who dont take the vaccine are. It wont help. Nor should there be public broadcasts from government ministers disparaging anti-vaccine views. And it means ensuring doctors have a non-judgmental approach when they talk to patients who arent sure about taking them.
If we are talking to someone whos uncertain about the vaccine we should try to be empathetic, actively listen, and focus on the benefits of taking it. And rather than contradicting them, we should suggest places where they can find out additional information. If people feel respected and trusted they are more likely to listen; and if they can find out on their own, then they will have time to process and engage with it without feeling defensive.
And there are broader behavioural science tactics that the government can use to improve the uptake of vaccines, including making it seem like the default and showing it to be a social norm. This means using language that inherently assumes everyone will take the vaccines, making people feel they are actively opting out, rather than opting in.
So health secretary Matt Hancock and other politicians should highlight the extent to which people are taking vaccines; making it a positive social norm. Newspapers should have headlines about high take-up rates, and the positive benefits this will have for society. It is this type of positive story we should be actively sharing and discussing, rather than looking for people to judge negatively.
This will work most effectively when people see those they feel a connection with following the rules. This means, where possible, that messaging aimed at young people following guidelines should be targeted towards young people, and the same applies to aiming messages at people in a certain social group or geographical region. We instinctively want to copy those we feel closest to, and are less likely to disregard the behaviour of those we feel are in our in-group.
Finally, the government and GPs should make it easy for people to get the vaccine. In a 1965 study, students at Yale University were given information about the need for tetanus inoculations. Initially, 3% of the group got the vaccine. But when provided with a map and specific instructions on where to get it, 28% of the students got inoculations. We shouldnt underestimate how important it is to allow people to go when they arent working, and to provide clear directions or support for travel, and easy lines of communication to clarify uncertainties; these things have a bigger impact than is often assumed.
Hopefully, utilising a range of smart behavioural science insights will drive vaccine uptake. Thats vital, because a draconian system of enforcement could embed deeper polarisation and resistance at a time when we need cohesion and agreement more than ever.
Will Hanmer-Lloyd is head of behavioural planning at the consultancy Behave
TheWest Virginia Department of Health and Human Resources (DHHR) reportsas of 10:00 a.m., November 26, 2020, there have been 1,079,066 total confirmatory laboratory results receivedfor COVID-19, with 44,180 total cases and 712 deaths.
DHHRhas confirmed the deaths of a 79-yearold male from Berkeley County, a 50-year old male from Mason County, an 89-yearold female from Jefferson County, a 69-year old male from Cabell County, an 86-yearold female from Kanawha County, a 74-year old female from Putnam County, a 75-yearold male from Taylor County, an 85-year old female from Marshall County, a 57-yearold male from Raleigh County, an 81-year old female from Mineral County, a 47-yearold female from Wyoming County, a 70-year old male from Marshall County, a 98-yearold male from Cabell County, a 69-year old male from Preston County, a 57-yearold male from Jackson County, an 85-year old female from Cabell County, and a 68-yearold male from Doddridge County.
During the holiday season, we feel the lossof loved ones with a deeper pain, said Bill J. Crouch, DHHR Cabinet Secretary.Each person lost to this virus is loved and remembered, not only today, butevery day.
CASESPER COUNTY: Barbour (384), Berkeley (2,945),Boone (619), Braxton (108), Brooke (596), Cabell (2,756), Calhoun (69), Clay(106), Doddridge (117), Fayette (1,094), Gilmer (199), Grant (320), Greenbrier(432), Hampshire (299), Hancock (620), Hardy (240), Harrison (1,259), Jackson(684), Jefferson (1,263), Kanawha (5,480), Lewis (238), Lincoln (407), Logan(1,028), Marion (810), Marshall (1,104), Mason (403), McDowell (602), Mercer(1,286), Mineral (1,131), Mingo (966), Monongalia (3,202), Monroe (360), Morgan(252), Nicholas (322), Ohio (1,438), Pendleton (102), Pleasants (86),Pocahontas (152), Preston (541), Putnam (1,830), Raleigh (1,492), Randolph(677), Ritchie (145), Roane (162), Summers (265), Taylor (311), Tucker (126),Tyler (134), Upshur (471), Wayne (961), Webster (61), Wetzel (390), Wirt (95),Wood (2,361), Wyoming (679).
Please note that delaysmay be experienced with the reporting of information from the local healthdepartment to DHHR. As case surveillance continues at the local healthdepartment level, it may reveal that those tested in a certain county may notbe a resident of that county, or even the state as an individual in questionmay have crossed the state border to be tested. Such is the case of Clay County in this report.
Please visit the dashboard located at www.coronavirus.wv.gov for more information.
Upcoming free COVID-19 testing events:
November 27, 2020
Cabell County
9:00 AM 1:00 PM, Cabell-Huntington Health Department, 703 Seventh Avenue,Huntington, WV
November 28, 2020
Jackson County
9:00 AM 1:00 PM, Jackson County Health Department, 504 Church Street South,Ripley, WV
November 30, 2020
BerkeleyCounty
12:00 PM 4:00 PM, Martinsburg High School, 701 South Queen Street,Martinsburg, WV
4:30 PM 8:00 PM, Dorothy McCormack Building, 2000 Foundation Way,Martinsburg, WV
Boone County
10:00 AM 3:00 PM, Boone County Health Department, 213 Kenmore Drive,Danville, WV
Hampshire County
1:00 PM 6:00 PM, Hampshire High School, 157 Trojan Way, Romney, WV
Jefferson County
9:00 AM 1:00 PM, Jefferson County Health Department, Front Parking Lot,1948 Wiltshire Road, Kearneysville, WV
2:30 PM 6:30 PM, Shepherd University, Parking Lot beside Wellness Center,164 University Drive, Shepherdstown, WV
Marshall County
10:00 AM 3:00 PM, Marshall County Health Department, 513 6thStreet, Moundsville, WV
Ohio County
11:00 AM 4:00 PM, Valley Grove Volunteer Fire Department, 355 Fire HouseLane, Valley Grove, WV
11:00 AM 4:00 PM, Warwood Fire Station 9, 1301 Richland Avenue, Wheeling,WV
11:00 AM 4:00 PM, Wheeling Island Fire Station 5, 11 North Wabash Street,Wheeling, WV
Wirt County
Wood County
WyomingCounty
11:00 AM 3:00 PM, Old Board of Education, 19 Park Street,Pineville, WV
Please visit https://dhhr.wv.gov/COVID-19/pages/testing.aspx for more testing locations including the new locator map. Newsites are added daily.
On Thanksgiving, the US marked its 24th day in a row with more than 100,000 new cases. Hospitalizations Thursday hit a new high -- for the 17th consecutive day -- with now more than 90,400 Covid-19 patients nationwide, according to the COVID Tracking Project. More than 1,200 deaths were reported.
The country's death toll since the pandemic's start is now more than 263,000. And nearly another 60,000 could lose their lives over the next three weeks, according to an ensemble forecast published by the US Centers for Disease Control and Prevention this week.
One expert told CNN Wednesday night the number of daily deaths will likely double in the next ten days.
"So, we'll be seeing close to 4,000 deaths a day, which is how you get another 60,000 deaths in only about 20 days," Dr. Jonathan Reiner, a professor of medicine at George Washington University, said.
"In a week, more likely two weeks, we will see a surge upon a surge," Dr. William Schaffner, professor of infectious diseases at Vanderbilt University, said Wednesday. "We're in for a tough time."
In other words, projections for the coming weeks are grim. But that doesn't mean it's too late to begin turning things around.
"It we all got together, wore the masks and did the social distancing, we could bend this curve within two or three weeks," Schaffner said. "We would see actually transmission go down even before we get to the vaccines."
What it would take to turn the tide
While a possible vaccine candidate could soon get the green light, widespread effects of a vaccine are still months away. But Americans have valuable tools that can help in the meantime.
They are the public safety measures that have been touted by officials for months -- face masks, social distancing, avoiding crowds and practicing good hygiene like regular hand washing.
Meanwhile, in West Virginia, Gov. Jim Justice has pleaded with residents in the past weeks to wear a face covering, saying masks are "really the only bullet in the gun."
"If you're inconvenienced, if you don't believe in it, please wear it ... what's the downside," Justice said in a news conference this week. "Look, we're not one to take anybody's rights. My good lord, I get it wholeheartedly, we don't want to do that in any way. But you gotta help me."
It's the kind of message that needs to be echoed by local leaders across the country, Dr. Peter Hotez, dean of tropical medicine at the Baylor College of Medicine, told CNN Thursday morning.
"Keep saying it every day and hope that some people actually start to believe it. That's our only hope at this point. We've got to limit those surges and we need those local leaders to really step up, so this is absolutely vital," he said.
It's the only option that could help keep more people alive until a vaccine, he said.
"It's a matter of keeping your mother, your father, your brother, your sister alive between now and then," Hotez added. "If we could just get those messages out."
Florida extends ban on cities imposing mask mandates
But in many parts of the US, masks remain a point of contention.
Florida Gov. Ron DeSantis extended an order this week that bans local municipalities from issuing fines for violations of pandemic-related mandates -- like mask mandates -- or limiting restaurant capacity without justification.
"It's deeply frustrating that @GovRonDeSantis continues to block local actions and make it harder for local leaders to keep our communities safe," Cava wrote.
"I'm asking the governor to work with local mayors so we can bring our local knowledge to the table," Cava added. "We need to work together to create policies that will protect all our families and our economy in this moment of crisis.
In the past week, Florida has reported more than 56,400 new infections and more than 520 deaths, according to Johns Hopkins University data.
CNN has reached out to DeSantis's office for comment.
Only 1 in 8 US Covid-19 cases may have been counted
In total, more than 12.8 million Americans have tested positive for the virus since the pandemic's start. But a new study suggests that could only be a small fraction of the true number of infections in the US.
Only about one in eight -- or 13% --- all of Covid-19 infections in the country were recognized and reported through the end of September, researchers at the CDC estimate. That means as many as 53 million people in the US could have been infected from February through September -- yet during that time, only about 7 million confirmed cases of symptomatic Covid-19 were reported nationally, the researchers noted.
To estimate the number of Covid-19 cases that may have been missed since the beginning of the pandemic, the researchers used a model to adjust the reported numbers of symptomatic cases in the US. They considered what's known about detecting cases, asymptomatic infections, patients seeking care or not and the risk of false negative test results.
The study's limitations included that the availability and use of testing has changed over time and their findings serve only as estimates.
While the numbers may seem large, the researchers wrote that, still "this indicates that approximately 84% of the US population has not yet been infected and thus most of the country remains at risk, despite already high rates of hospitalization."
CNN's Ben Tinker, Evan Simko-Bednarski, Jacqueline Howard, Melissa Alonso, Amanda Watts and Lauren Mascarenhas contributed to this report.
The companies said that out of 170 cases of Covid-19, 162 were in the placebo group, and eight were in the vaccine group. Out of 10 cases of severe Covid-19, nine had received a placebo.
Pfizer and BioNTech said that the vaccines efficacy was consistent across age, race and ethnicity. The most common serious adverse event was fatigue, with 3.7 percent of volunteers reporting tiredness after they took the second dose. Two percent of volunteers reported a headache after the second dose. Older adults reported fewer and milder side effects, the companies said.
Its pretty amazing, said Akiko Iwasaki, an immunologist at Yale University. She said the results in people over 65 were the most promising. We know from the influenza vaccine that its very difficult to achieve protection in this age group with vaccines, she said, so 94 percent efficacy in that group is really remarkable.
Federal health officials have said the first doses of the vaccines will most likely go to groups like health care workers who are at high risk for exposure, as well as to people who are most vulnerable to the disease, such as older people.
Confused by the all technical terms used to describe how vaccines work and are investigated?Let us help:
Dr. Saad B. Omer, the director of the Yale Institute for Global Health, said the results showing the vaccines protected people from severe disease was also good news, because with such limited availability initially, the first goal will be not to stop transmission of the disease, but to prevent people from becoming extremely ill. So that is very reassuring, he said.
He called on Pfizer to quickly release a more detailed analysis of the data beyond the initial news release so that scientists could more thoroughly evaluate the results. The companies have said they plan to submit the results for review in a scientific journal, a process that can take weeks or months. These are not normal times, this is a pandemic, and major policy is being made, Dr. Omer said. Its always better to make policy on scientific data, not a press release.
In addition to the results of its clinical trial, Pfizer said it was ready to submit to the F.D.A. two months of safety data that the agency had recommended, as well as detailed manufacturing records showing the company can consistently produce high-quality batches of its product. The F.D.A. will review the data and ask an outside panel of vaccine experts to weigh in on the application, a process that could take weeks.
Indiana could received its first supply of coronavirus vaccine soon, federal health officials say. However, there are still many questions about the vaccine. Wochit
LAFAYETTE With promises of a COVID-19 vaccine on the horizon, Tippecanoe County health officials said this week they were making plans for distribution, lining up freezers for specialized storage and determining who would get the first doses.
We have a lot to line up, Dr. Jeremy Adler, Tippecanoe Countys health officer, said Wednesday. Were looking forward to a vaccine, no question. But its going to be a massive undertaking.
Indiana is girding to receive its first doses of a coronavirus vaccine some time next month, Indiana State Health Commissioner Dr. Kristina Box said Wednesday.
Pfizer, the company which makes the vaccine, has submitted an application to the Food and Drug Administration for approval, and the government agency is expected to review it in early December, Box said.
A shot is prepared as part of a possible COVID-19 vaccine developed by the National Institutes of Health and Moderna Inc. in Binghamton N.Y.(Photo: Hans Pennink)
Hospitals and health care workers should be prepared to receive the first doses of the vaccine soon after, Box said.
On Wednesday, Adler said Tippecanoe County would rely on Indiana State Department of Health guidance to decide who, beyond frontline health care workers, will get the first shots once what he called a small allotment of the vaccine arrives later in December.
For the rest of the population, the hope is that sometime later in the winter or in the spring well be able to receive enough vaccine to vaccinate the rest of our population, Adler said. Its, of course, a big, big task.
More: COVID-19 nurses in Lafayette stretched to new limits: Endurance is definitely what we need
Adler referenced the county health departments effort to vaccinate roughly 900 Purdue students after a 2016 mumps scare on campus. He said that operation included bringing in volunteer staff, including medical retirees and some from Purdues School of Nursing, to manage the makeshift vaccine clinic at the universitys Co-Rec.
With COVID, Adler said, were talking an entirely different scope.
Box warned that the vaccine will not be a "get out of jail free card." People will need to continue wearing masks, socially distancing, washing their hands and staying home if ill for the foreseeable future.
More: COVID-19: Greater Lafayette stores prepare for new restrictions ahead of Thanksgiving, Black Friday shopping days
Studies have found the Pfizer vaccine to be about 90% effective in preventing COVID-19 infections. A competitor developed by Moderna, which is expected to receive approval by early next year, has shown similar results.
Both vaccines will require two doses spaced either 21 or 28 days apart, Box said. One dose will not confer immunity.
Because the Pfizer vaccine must be stored in an ultra-cold freezer, at first it will likely only be available at five pilot hospital sites around the state, state health officials have said. Those are Community Hospital in Munster, Clark Memorial Hospital in Jeffersonville, Deaconess in Evansville, Indiana University Health Methodist Hospital in Indianapolis, and Parkview Health in Fort Wayne.
Jeff Houston, Tippecanoe County emergency management coordinator, said the county has lined up use of ultra-cold freezer space through Purdue. Khala Hochstedler said the county health department has freezers that can handle some of COVID-19 vaccine where vaccines for shingles, measles, mumps, and rubella, and chickenpox. Houston said vaccines also will be able to be stored in boxes theyre shipped in by packing it with dry ice to keep it at the proper temperature.
Wednesday Box warned that some people who receive the vaccine may experience side effects such as fever, headache or muscle aches in the days following the shot. These are considered normal and temporary.
"We can be very thankful that we do have vaccines that are showing this kind of efficacy and this kind of safety," Box said.
However, until the vaccine is widely available, the state must get beyond the high number of coronavirus cases it has been seeing on a daily basis, Box said. And short of a vaccine, the only way to do that is to follow the public health advice and wear your mask, social distance and wash your hands.
Reach Dave Bangert at 765-420-5258 or at dbangert@jconline.com. Follow on Twitter: @davebangert. Contact IndyStar reporter Shari Rudavsky at shari.rudavsky@indystar.com. Follow her on Facebook and on Twitter: @srudavsky.
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Tennessee could receive its first doses ofCOVID-19 vaccines as soon as Dec. 15, and vaccines could be widely available to Tennesseans by early summer,state officials announced Tuesday.
The state is prepared to distribute the vaccine immediately when it arrives, Tennessee Department of Health Commissioner Dr. Lisa Piercey said.
"This is our top priority," she said. "This is the one ray of hope that we've got, so we are putting a ton of effort forth to make sure we get it to you as fast and as safely as possible."
RELATED: COVID-19 vaccines in Tennessee: You've got questions. We have answers.
The vaccine updates come as COVID-19 infections climb to new heights in Tennessee. In the past two months, the number of hospitalized COVID-19 patients increased two-and-a-half fold. One in three intensive care unit patients in the state has COVID-19, said Dr. Wendy Long, president of the Tennessee Hospital Association.
During Tennessee's last infection spike in July, COVID-19 patients made up 19% of ICU patients. Long said hospitals are "running out of levers to pull" to preserve access to critical healthcare services while addressing increasing needs for COVID-19 response.
Businesses in Tennessee's healthcare industry have started discussing allowing COVID-positive healthcare staff to work in COVID-specific units, something that is allowed by the Centers for Disease Control and Prevention, Long said, noting the hospital association has made no official recommendations, and that decision ultimately will be industry driven.
Tennessee anticipates it will receive its first round of vaccines from Pfizer. The state is currently one of four states participating in the company's pilot delivery program for the vaccine, which must be stored at ultracold temperatures.While all dates are subject to change, Tennessee will be ready to distribute vaccines around Dec. 15.
The Moderna vaccine candidate is now expected to arrive about one week later, Piercey said.
RELATED: Tennessee among 4 states in Pfizer COVID-19 vaccine pilot delivery program
MORE: Dolly Parton helped fund 95% effective Moderna COVID-19 vaccine that could end pandemic
It is not yet clear how many vaccines Tennessee will receive, and the number of doses delivered to the state in the next few months "fluctuates widely," Piercey said. Between 80,000 and 100,000 doses are expected in the first delivery, enough to vaccinate between 40,000 and 50,000 people as thevaccine requires two doses per person.
Vaccines will be distributed in phases according to the state's draft distribution plan. Frontline healthcare workers and first responders who are the most likely to have contact with infected individuals and materials will receive the vaccine first, and Tennessee will move through the following phases as supply allows.
In the second phase, when the state expects to have enough vaccine doses to meet demand, it will prioritize vaccination of staff in schools and childcare businesses, older adults and those with illnesses who have a medium risk of complicating the virus. At this point, the vaccine also would be made available to workers in critical infrastructure industries: construction, utilities, food and beverage supply, public transportation and the shipping of goods.
Finally, once the vaccine has sufficient supply and demand has begun to slow, it will be provided to young adults, children, others in congregate care settings, and, eventually, everyone else.
Children and pregnant women are among the last to receive the vaccine because they are generally not included in early clinical trials that test the vaccine's safety.
Piercey expects Tennessee to complete phase one of distribution and potentially a portion or all of phase two in the winter and early spring. The remainder of phase two and phase three should be complete in late spring or early summer. Estimates predict widespread availability in July or August.
"The good news, though, is even when we start vaccinating small numbers of folks, 100,000, 200,000, I know that doesn't seem like a lot in the context of 6.8 million Tennesseans, but that's 200,000 who are not transmitting the disease," Piercey said."Sowe're going to start to see some measurable improvement in our case trends when we get some vaccines in arms."
Tennessee expects to lean on hospitals, public health agencies and pharmacies to distribute vaccines. Ideally,there will be a least two locations in every countywhere the vaccine is available.
According to the states disbursement plan, the state will prioritize disbursement from hospitals with emergency rooms and ICUs. The vaccine probably will be available at every county public health agency in the state.
Finally, in rural areas where there is no hospital, vaccine will be available at local pharmacies.
Pfizer's COVID-19 vaccine is being shipped in specially designed, insulated containers that hold between 195 and 975 five-dose vials and areabout the size of a carry-on suitcase. The vials are stored in flat, pizza box-sized compartments, each of which holds 195 vials. A fully-loaded thermalcontainer, which is reusable, contains five of theseandweighs about 70 pounds. These "shippers" as Pfizer calls them have space at the top for dry ice, which can keep the vaccine at the necessary temperature for ten days if unopened, or five days as long as its opened no more than twice a day for very short periods of time(Photo: Pfizer Inc.)
The vaccine must be stored and transported at negative-94 degrees Fahrenheit, but because Tennessee covers a wide swath of land with pockets of sparse population, officials donot plan to store doses in a centralized freezer. Instead, the vaccine will be delivered using Pfizer- and manufacturer-recommended "thermal shippers."
The vaccine comes in flat boxes of 975 vials (Piercey said it "sort of looks like a pizza box). This box is packed with dry ice inside an insulated 2-foot by 2-foot cube. The dry ice is recharged on a specific schedule.
"That is what we intend to use so we can mobilize and distribute vaccines faster than having to keep going back and forth to a stationary freezer," Piercey said.
While some universities might require students to be vaccinated for COVID-19 once vaccines are widely available, Gov. Bill Lee said he does not foresee mandated vaccines for K-12 school systems in Tennessee.
The University of Tennessee requires its students to get flu vaccines and might require COVID-19 vaccines as well if a vaccine is recommended by the CDC and Tennessee Department of Health, according to its website.
"We support local decision-making, and that decision is theirs to make," Lee said of the University of Tennessee's potential requirement.
Lee added that vaccines will be "very important for us in the state to curb the spread of the virus and to ultimately really be able to handle it."
The speed, accuracy and safety of the vaccines approaching availability is a pleasant surprise to Lee's administration and health officials, he said.
"But, vaccines are a choice, and people have the choice and will have the choice in this state as to whether or not they should take that vaccine," Lee said.
Brett Kelman contributed to this report.
Cassandra Stephensoncovers business at The Tennessean, part of the USA Today Network Tennessee. Reach Cassandra at ckstephenson@tennessean.com or at (731) 694-7261. Follow Cassandra on Twitter at @CStephenson731.
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The four recent deaths involved two Anchorage men in their 70s, a woman from the Southeast Fairbanks Census Area in her 70s and a man from the Valdez-Cordova Census Area in his 70s who was out of state when he died, the state health department said Thursday. Additionally, the Department of Health and Social Services said one death that was previously reported was removed through data verification after death certificate review.
A total of 118 Alaskans and one nonresident have died with COVID-19 since March. Alaskas death rate remains lower than other states, but is rising. On Tuesday, the state reported 13 deaths, the most tallied in a single day since the pandemic began in March.
There were 136 people with COVID-19 hospitalized as of Thursday, and an additional nine hospital patients were suspected of having the illness. Twenty-two confirmed or suspected COVID-19 patients were on ventilators, according to state data.
In the Yukon-Kuskokwim Delta region, which currently has one of the highest per capita case rates in the country, the regional health corporation on Wednesday reported the 12th resident death in the region, involving an Alaskan in their 30s. They also reported 66 new cases of the virus in the region Wednesday it can sometimes take a few days for cases and deaths to be reflected on the states data dashboard.
Of the 557 new cases reported by the state Thursday among Alaska residents, 227 were in Anchorage, plus 13 in Eagle River, eight in Chugiak and four in Girdwood; 44 in Homer; 42 in Kenai; 40 in Wasilla; 38 in Soldotna; 16 in Fairbanks; 11 in Delta Junction; 10 in Juneau; 10 in Kodiak; nine in Palmer; nine in Nikiski; six in Ketchikan; five in North Pole; five in Utqiagvik; five in Bethel; three in Sterling; three in Anchor Point; two in Willow; two in Big Lake; two in Chevak; one in Fritz Creek; one in Houston; one in Sutton-Alpine; one in Nome; one in Sitka; and three in an unidentified region of the state.
Among communities smaller than 1,000 people not named to protect privacy, there were 18 resident cases in the Bethel Census Area; five in the northern Kenai Peninsula Borough; three in the Kusilvak Census Area; two in the southern Kenai Peninsula Borough; one in the Valdez-Cordova Census Area; one in the Yukon-Koyukuk Census Area; one in the Matanuska-Susitna Borough; one in the Northwest Arctic Borough; one in the Ketchikan Gateway Borough; one in the Prince of Wales-Hyder Census Area; and one in the Yakutat plus Hoonah-Angoon region.
Six cases were reported Thursday among nonresidents: two in Anchorage, one in Fairbanks and three in unidentified regions of the state.
While people might get tested more than once, each case reported by the state health department represents only one person.
Of the new cases, it is not reported how many patients were showing symptoms when they tested positive. The Centers for Disease Control and Prevention estimates that about a third of people who have the virus are asymptomatic.
In total, 30,102 Alaskans and nonresidents in the state have tested positive for COVID-19 since March.
[Editors note: This story has been updated to reflect that four new deaths were recorded Wednesday and one previously reported death was removed from the states data dashboard.]
(THE CONVERSATION) The pharmaceutical companies Pfizer and BioNtech announced Nov. 20, 2020, that they will seek emergency use authorization from the Food and Drug Administration for a vaccine to prevent COVID-19. On Nov. 16, Moderna announced that a vaccine it has been working on has been shown to be close to 95% effective.
But no vaccine will be nearly that effective in reality if people refuse to take it. And recent polls suggest that about 40% of Americans wont take a COVID-19 vaccine when it becomes available. Those numbers are even higher among nonwhite Americans.
The factors that lead people to make choices to take vaccines are nuanced. Peoples choices are affected by how they see the world, their perceptions of the choices people like them will make, whom they trust, their perceptions of risk, consistency of message and convenience of actually getting the vaccine.
In a world with unlimited supplies of vaccine and budget to support outreach, public officials could craft highly specific campaigns for each community and identity in the world. The vaccine would be simultaneously available to everyone, and our personal doctors would administer it and assure us of its efficacy.
That world doesnt exist.
Melissa Fleming, the United Nations undersecretary general for global communications, recently launched the Verified initiative to combat misinformation about COVID-19. Verified engaged the Center for Public Interest Communications at the University of Florida. Our team of scholars, strategists and storytellers works with organizations around the world to apply social, behavioral and cognitive science to drive lasting social change. We were asked to identify research-based messages that might overcome vaccine hesitancy. Verified released our guide Thursday.
We quickly identified the leading scholars in this space, and 16 social and behavioral psychologists, medical anthropologists, behavioral economists, neuroscientists and political communications scholars joined us for a series of conversations over five days. We asked questions like: What makes people resilient against misinformation? What drives vaccine hesitancy? Which frames will be most effective? What kinds of message strategies have been effective with specific communities? And finally, what are some of the best ways to make taking the vaccine a social norm?
Eight principles emerged from those conversations that we believe can increase trust, acceptance and demand for vaccination. We have shared these principles with the leaders across the U.N. as part of their global efforts to reduce vaccine hesitancy and overcome misinformation related to COVID-19.
Work within worldviews, identities and moral values. Each of us has a unique set of identities, worldviews and moral values that influence our choices and behaviors, and even what we believe to be true. Its worthwhile to understand what others see as right and wrong and to connect with whats most important to them. Find the common ground between what you hope to achieve and what matters to them. For example, taking a vaccine, then, would become a way to return to activities and behaviors that matter most to them.
Use timing to the best advantage. Its far easier to build trust when youre the first to articulate a message. People are most likely to trust and stick to the version of information they hear first. Its equally important, however, that they hear that same message multiple times from an array of sources.
Use the right messengers for the audience. People act when they trust the messenger, the message and their motivations. Trusted messengers vary greatly from community to community, but there are some broad lessons you can apply. Ideally, the messenger is someone with deep expertise: a doctor, a scientist or a public health practitioner. But trusted messengers are also those in our in-groups, people we see as being like us and who share our values. As behavioral economist David Fetherstonhaugh put it, I couldnt stress enough the importance of a message coming from within an in-group someone thats automatically on the inside. Its almost like such messages even bypass deliberate cognition because they are coming from a trusted source: Theyre my family, or its my pastor, or its my party leader. So the source of a message, in-group vs. out-group, is extraordinarily important for how a message is received.
Make the content concrete, supply a narrative and provide value. If messages arent concrete and dont include stories, our powerful sense-making brains will fill the abstraction with stories and ideas that make sense to us. One particular space to build that narrative is around vaccine trials. Instead of saying were in stage 3, name the number of people who have participated in successful trials and share stories of individuals who participated in those trials.
Recognize that communities have different relationships with vaccination. In some societies, people may be fearful of vaccines, but have a strong trust in authority. In others, mandatory vaccinations have created distrust of government authorities. In others, decades of mistreatment and exploitation have resulted in a profound lack of trust in new medical treatments. Different societies also have different relationships with authority. In societies where people trust authority, theyre more likely to accept direction even if they dont support it.
Reinforce positive behaviors. We are deeply affected by the behavior and choices of people in our networks even people we may not have met. So to change behavior, you have to shift peoples perceptions of what normal behavior looks like. Examining vaccine hesitancy through the lens of social norms offers two opportunities to make a difference. The first is activating trusted influencers within social networks and peoples perceptions of what others are doing. The second is in shifting the communications norms among those communicating on behalf of the vaccine.
Evoke the right emotions. Its tempting to activate emotions like fear or shame to get people to take a vaccine, but its unlikely to work. Fear immobilizes people, and shame is likely to achieve the wrong reaction. Look to more constructive emotions like awe, hope and parental love to get people to act.
Be explicit and transparent about motivations. Our perceptions of the motivations of the messenger matters. Our motivations in seeking information are equally important. Were less likely to trust a vaccine if we question the motives of the people advocating for us to take it.
There is, of course, a weakness in this tool, which is that its based on research conducted on hesitancy around other vaccines. We dont know about COVID-19, because we dont yet have the vaccine. But even with these obvious limitations, science-informed messages are the best tools we have.
