The coronavirus outbreak, or COVID-19, has fundamentally transformed our lives and communities, contributing to economic declines, disruptions in schooling, and distressed hospital systems. However, the pandemic has generated some silver linings, including the widespread adoption of telehealth that has helped to mitigate the risk of community spread by reducing unnecessary hospital visits and ensuring real-time access to medical providers for millions of Americans. According to a report by McKinsey, in the aftermath of COVID-19 epidemic, medical providers have rapidly scaled their telehealth offerings and are seeing 50 to 175 times the number of patients via remote access platforms than they did before. Some patients have even come to prefer virtual office visits as medical providers have been less resistant to the change and even more willing to administer remote care from an internet-enabled device.
Last month, the Trump administration lauded their efforts to relax the legislative and regulatory restrictions limiting the use and adoption of remote medical care. And rightfully so. Early reports indicate various benefits from cost reduction in both medical and mental services to quality improvement, as well as increased patient satisfaction. But given the ravaging effects of the pandemic on U.S. citizens and the focus on health care leading up to the national election, will telehealth still be available, or potentially be made permanent, as an option for patients in need of immediate, primary, or secondary care? Will previous regulatory guardrails be reinstated on emerging models of health care delivery, potentially suppressing the number of providers and patients accessing such resources?
To start, certain conditions must be instituted to ensure long-term delivery of telehealth services, starting with access to high-speed broadband among patients and providers, national interoperability, new fraud detection methods, and more lenient and favorable federal and state policies towards its use. Further, as people of color, especially African Americans, become disproportionately impacted by COVID-19 in both infections and deaths, the adoption of telehealth practices to address and potentially reduce the immediate and long-term delivery of care will be important. Across the U.S., African Americans are dying at a rate of 88.4 deaths per 100,000 population, more than twice the rate of white Americans (40.4 deaths per 100,000 population).
The Federal Communications Commission (FCC) has reported that more than 18 million Americans do not have access to high-speed broadband networks. This lack of access to digital connectivity has far-reaching impacts on more vulnerable populations, including those with medical conditions or those who live in areas with limited access to quality health care facilities. Having access to broadband is a prerequisite in telehealths use. Patients require access to reliable internet connections that support high-speed transmissions to use remote health care services and attend virtual office visits.
Unfortunately, COVID-19 has revealed the relationship between poverty, geography, education and a host of other variables on ones access to broadband in the U.S. For rural populations, access to health care is constrained by the lack of local quality services and infrastructure, doctor workforce shortages, fewer dollars, and cybersecurity vulnerabilities. Low-income, urban populations experience similar problems, making the emergency room their first point of contact for service.
Given the historical effects of being socially distanced from medical care, telehealth can mitigate health care access, costs, and even remediate certain chronic diseases of vulnerable groups, including seniors, who were more likely to be both impacted and isolated by COVID-19. During the pandemic, Congress appropriated $200 million in funding as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act to support the ability of health care providers to offer connected care. The COVID-19 Telehealth Program enabled reimbursements to the providers and last month, several lawmakers requested details on its progress and called for its continuation. But expanding the eligibility and payment of telehealth services are just parts of the larger problem of a widespread digital divide that forecloses on its use by vulnerable populations.
One specific area of broadband expansion that will be critically important to telehealth delivery will be the availability of 5G, which can enable mobile phones as the prime point of contact for providers and patients. Smart phones are now much more common and ubiquitous than personal computers and laptops. The type of latency and resiliency embedded in 5G networks can accelerate more reliable virtual connections as well.
Further, a virtual doctor visit is a very private exchange, which is a concern expressed by a large majority of Americans. While a PC is limited in portability and often shared by multiple members in a household, a smart phone typically has a single user, and allows for encrypted communications that enable a higher level of patient privacy over digital connections. In addition to incentivizing and reimbursing providers for telehealth use, it is imperative that next-generation mobile broadband networks be affordable and available in both rural and urban communities to accelerate adoption.
Physicians should be able to share medical information between themselves and their patients in order to enhance the quality of medical services and avoid redundancies. National efforts to enable interoperability between different healthcare providers have not been successful. Particularly, lack of interoperability between different electronic systems across the healthcare delivery system is one reason for delay in reporting of the COVID-19 test results. To enhance the quality of virtual visits, physicians need to have access to their patients medical data including medications, labs (such as COVID-19 testing), hospitalizations, and imaging data. For example, New York Citys Health Information Exchange (HIE) platform made it possible to merge the patients COVID-19 testing data with their prior medical data. This enables a much better understanding of patients clinical conditions and more importantly, allows providers to identify high-risk populations and prioritize them in their prevention efforts.
Despite their importance, interoperability efforts have not been successful in many parts of the U.S. This is in spite of the more than a decade of nationwide efforts, trying many different approaches to interoperability and billions of dollars of incentives and grants. While there are still some technical barriers to exchange of health information, the most important impediment to interoperability continues to be economic disincentives for providers to share data. COVID-19 has led to fundamental changes in expectations of patients, providers and payers about data exchange. Given the circumstances, patients are much more willing to receive their test results through online patient portals. It is now in the best interest of providers to willingly share clinical data with public health officials and other providers as part of a community effort to fight the epidemic.
The Department of Health and Human Services (HHS) has just provided effective guidelines to overcome the technical barriers to health information exchange and more importantly, has set specific rules to identify information blocking and sever penalties for violators. These significant economic, legal and technical changes have created the most favorable ecosystem for health information exchange platforms to emerge and expand. Healthcare organizations and IT vendors should take advantage of this environment to streamline their data exchange processes. Otherwise, demand and enthusiasm for telehealth services will wither as the epidemic gets under control and we go back to normalcy.
While telemedicine facilitates legitimate medical services, it can also make it easier for fraudsters to abuse the system. In one commonly-used scheme, fraudsters recruit Medicare patients to visit physicians for unnecessary reasons and get prescribed expensive medical devices which Medicare will ultimately pay for. In a recent incident, DOJ charged a network of telehealth companies, physicians, and patient recruiters in a $1.2 billion Medicare fraud scheme. Given that telehealth is a new medium for delivering health care, the areas of more susceptible to fraud may be unique and unknown to the federal agencies, making it more difficult to detect and stop.
DOJ and HHS may consider collaborations on new models or systems that proactively monitor, and audit unusual billing behaviors related to telehealth services. Considering that the pandemic suddenly increased patient demand for remote care, new fraud detection methods may also improve upon data collection, service coding, and move away from reimbursements based on parity laws to maintain the high quality of services.
The Centers for Medicare and Medicaid Services (CMS) has been extremely proactive to implement a wide variety of policies to expand telehealth services during the COVID-19 epidemic. These policies include waiving limitations on the types of clinical practitioners that can furnish Medicare telehealth services, allowing hospitals to bill for telehealth services to Medicare patients registered as hospital outpatients even when the patient is at home, increasing the payments for telephone visits to match those of in-person office visits, and expanding payments for telehealth services to rural health clinics and federally qualified health clinics. While these policies were implemented as emergency measures in response to COVID-19 epidemic, more than 5.8 CMS beneficiaries took advantage of remote office visits, especially in the areas of mental health.
While it has taken decades for Congress and state regulators to operationalize limited remote health care, it took just weeks to implement such changes nationwide. Bipartisan lawmakers are currently pushing for the permanence of telehealth options post-pandemic in a letter that continues to receive more signatures. Despite the last few months of provability in cost savings and care remediation, the fate of telehealth is still undetermined, especially in an election year where health care is often a partisan issue.
Finally, the challenges of being stricken by multiple health factors that impact is all too familiar among vulnerable populations. Lack of access to doctors, insurance, nutritious food, and safe workspaces, among other areas can all contribute to the persistent and growing health disparities impacting people of color, especially African Americans and Native Americans. These heightened risk factors for people of color can trigger a host of chronic ailments, including diabetes, pulmonary failures and disruptions, cancer, and other rare conditions. In cities where Black people comprised the majority of the population, COVID-19 related illnesses and deaths have been disproportionately high and correlated with such underlying medical conditions.
For all the reasons previously stated in a May 2020 Brookings report, telehealth can improve upon the health inequities that have debilitated communities of color through real-time delivery and availability of care, provided that broadband access and lenient CMS policies were still made available to these populations. Vulnerable populations would also benefit from the institution of new and improved fraud detection monitors to avoid the deceptive practices of bad actors in the medical community who prey upon people of color, the elderly, and their frail conditions.
In the end, measures to reduce the spread of COVID-19 have accelerated the availability and adoption of remote health care services. However, as the last six months have largely represented a national pilot to creatively redress the challenges of social contact, the federal government and the next administration must determine whether telehealth can continue to play a competitive and complementary role in health care. The regulatory conditions, the incentives for doctors, and the political will of the country to remedy health disparities and care fragmentations will largely determine if telehealth becomes permanent.
The 83-year-old media magnate, who first became the country's leader in 1994, was admitted to hospital on Thursday with mild coronavirus symptoms. He subsequently tested positive for Covid-19.
"Berlusconi, after the appearance of some symptoms, was admitted to the San Raffale hospital in Milan as a precaution. The clinical picture does not cause concern," his press office told CNN.
It comes after his press office told CNN Wednesday that the former Italian Prime Minister had coronavirus but was not displaying symptoms.
"He did a precautionary swab test but was asymptomatic. He is currently in his Arcore home [near Milan, in the Italian region of Lombardy] where he will continue to work and give interviews remotely," his representatives said Wednesday.
Italy reported 996 new Covid-19 cases and six deaths on Monday, with the region of Campania recording 184 infections. This marked the first time a southern region had seen the highest daily rate of cases.
As of Monday, there were 94 coronavirus patients being treated in Italian Intensive Care Units across the country, more than at any date since June 29.
But despite the success story in beating back the virus, Italy has suffered tremendous economic losses, with GDP expected to contract by around 10% this year.
Covid-19 could now be endemic in some parts of the country that combine severe deprivation, poor housing and large BAME communities, according to a highly confidential analysis by Public Health England.
The document, leaked to the Observer, and marked official sensitive, suggests the national lockdown in these parts of the north of England had little effect in reducing the level of infections, and that in such communities it is now firmly established.
The analysis, prepared for local government leaders and health experts, relates specifically to the north-west, where several local lockdowns have recently been put in place following spikes in numbers. But it suggests that the lessons could be applied nationally. Based on detailed analysis of case numbers in different local areas, the study builds links between the highest concentrations of Covid-19 and issues of deprivation, poor and crowded accommodation and ethnicity.
If we accept the premise that in some areas the infection is now endemic how does this change our strategy?
Produced in the last few weeks and containing data up to August, it states: The overall analysis suggests Bolton, Manchester, Oldham and Rochdale never really left the epidemic phase and that nine of the 10 boroughs [of Greater Manchester] are currently experiencing an epidemic phase.
The five worst-hit areas are all currently in the north-west. Bolton had 98.1 cases per 100,000 people last week, with 63.2 in Bradford, 56.8 in Blackburn and Darwen, 53.6 in Oldham and 46.7 in Salford. Milton Keynes, by comparison, had 5.9 per 100,000, and it was 5.2 in Kent and 3.2 in Southampton.
Comparing other English regions, the study says: Each region has experienced its own epidemic journey with the north peaking later and the NW [north-west], Y&H [Yorkshire and Humber] and EM [East Midlands] failing to return to a near zero Covid status even during lockdown, unlike the other regions which have been able to return to a near pre-Covid state.
It also questions, under a heading marked for discussion, why anyone should expect fresh local lockdowns to work in these areas now: If we accept the premise that in some areas the infection is now endemic how does this change our strategy? If these areas were not able to attain near zero-Covid status during full lockdown, how realistic is it that we can expect current restriction escalations to work?
The comments point to friction between Public Health England and the government over the strategy to tackle local outbreaks as a potential second wave of Covid-19 threatens.
Doing something about housing conditions for someone who has an active infection cannot be handled by a call centre run by a commercial company hundreds of miles away
Last night, Gabriel Scally, visiting professor of public health at the University of Bristol and a member of the independent Sage committee, described the findings of the leaked report as extremely alarming after being shown them by the Observer.
The only way forward is to build a system which provides much better, more locally tailored responses, Scally said. There is no integrated find, test, trace, isolate and support system at the moment. The data on housing is extraordinarily important. Overcrowded households are part of public health history. Housing conditions are so important and always have been, whether it was for cholera or tuberculosis or Covid-19.
Doing something about housing conditions for someone who has an active infection is extremely important and it is not something that can be handled by a call centre run by a commercial company hundreds of miles away.
Scally said that helping people to isolate by giving financial support was also crucial: Taking two weeks off if you are on a zero-hours contract is not an option for people.
Matthew Ashton, director of public health at Liverpool city council, said on seeing the study: This report shows a strong link between our most deprived areas, our BAME communities and poor housing communities, and that can lead to the virus becoming endemic. I absolutely agree with that. But I think it is also more complicated in that there are different types of outbreaks and different types of ways in which the virus could become endemic, such as opening the night-time economy and young people getting the virus asymptomatically and then passing it on.
Last night, amid continuing confusion over rules on quarantining when returning to the UK, Labour called for a rapid review to restore public confidence. In a letter to the home secretary, Labour is urging the government to consider introducing a robust testing regime in airports that could help to safely minimise the need for 14-day quarantine.
There have been more than 340,000 confirmed cases of coronavirus so far in the UK, and more than 40,000 people have died, according to government figures.
Local lockdowns are now being implemented or relaxed across the country in response to surges. The most recent have seen Norfolk, Rossendale and Northampton added as areas of enhanced support, meaning the government will work with local authorities to provide additional resources such as testing or contact tracing to help bring infection numbers down.
Improvements in Newark and Sherwood in Nottinghamshire, Slough in Berkshire and Wakefield. West Yorkshire, mean they have been removed from the watchlist. Restrictions already in place in parts of Greater Manchester, Lancashire and West Yorkshire have been eased.
In Scotland, restrictions on visiting other households were reintroduced this week in Glasgow, West Dunbartonshire and East Renfrewshire.
BOISE (Idaho Statesman) Almost 2,200 cases of COVID-19 have been reported in Idahos nursing homes, assisted living facilities and group homes since the pandemic reached Idaho in March, according to Idaho long term care and federal nursing home records.
Idaho has just over 400 long-term care facilities. Of those, 173 have reported at least one case of suspected or lab-confirmed COVID-19, the records show. Most of the outbreaks 112 of them have settled down or stopped entirely, with no new suspected or confirmed cases among residents or staff. The other 61 outbreaks are growing.
Dozens of facilities have managed to halt the coronavirus before it could infect more than one resident or staff member, records show. Others have reported large outbreaks, with 50 or more people infected. COVID-19 has taken the lives of at least 212 people in Idahos long term care facilities.
Several nursing homes told the Centers for Disease Control and Prevention in mid-August that they lack adequate protective equipment to keep their staff and patients safe. Six nursing homes said they had no adequate supply of N95 masks, and at least one nursing home had no supply of hand sanitizer.
Many long-term care facilities are dealing with shortages of nursing staff, aides and other employees.
More than half the people with COVID-19 in Idahos nursing homes are the staff, according to CDC records.
Several nursing homes notified the CDC in August that they couldnt test their residents and staff for the coronavirus as often as necessary, citing a lack of supplies and lab capacity. Some told the CDC that it took more than a week to get test results.
Families have reported trouble getting information about outbreaks and coronavirus testing in their loved ones facilities. To help provide more transparency, the Idaho Statesman has created a searchable online database and map, using state and federal records.
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There are likely to be some inaccuracies in the data. These may be due to reporting delays, data entry errors, clerical errors or faulty reporting.
The state records are based on information reported to the Idaho Department of Health and Welfare by local health districts. The federal records are based on information reported to the CDC by nursing homes.
The CDC record is more than a week behind the state record, so its data may be significantly delayed. In some cases, the CDC data may overstate the number of cases in a facility. For example, one nursing homes CDC record showed three infected residents for every one person who actually lived there. The Statesman has redacted CDC numbers that are likely to be inaccurate in the database.
On the other hand, some outbreaks that nursing homes reported to the CDC do not show up in state records, or they show up much later. A handful of nursing homes were reporting cases to the CDC for months before the states records showed any cases there.
While the CDC data includes all confirmed and suspected cases of COVID-19, the state only includes an outbreak when a facility has at least one case confirmed by a lab test.
The numbers in the Statesman database include confirmed and probable/suspected cases residents or staff who have symptoms and a known exposure to the coronavirus but didnt test positive or werent tested at all.
The state recently completed 115 inspections at nursing homes, looking specifically at COVID-19 infection control. They found 49 nursing homes had no deficiencies in their practices, 66 with at least one deficiency and nine nursing homes with deficiencies that put their residents in immediate danger.
The most common problems inspectors found included failing to properly isolate or separate patients with COVID-19, improper hand hygiene or use of PPE, screening people who entered the facility and not having dedicated staff for residents with COVID-19, according to the Idaho Department of Health and Welfare.
See an error in the database? Email reporter Audrey Dutton at adutton@idahostatesman.com. Have a story for us to investigate? Follow the instructions at idahostatesman.com/news/investigative-tips to communicate with our investigative team as safely and securely as possible.
Yesterday marked the 29th straight day that New York States COVID-19 positive test rate was under 1% statewide but about a dozen counties, including Suffolk and Nassau have positive rates over that benchmark.
Suffolk Countys positive rate was 1.5% yesterday and 1.6% Thursday, according to State Health Department data posted online today. Nassaus positive rate was 1.2% yesterday and 1.6% yesterday. Positive rates in both counties were 1.1% on a seven-day rolling average, according to the states numbers. Other downstate counties outside of New York City Rockland, Putnam, Orange and Sullivan reported similar positive rates.
Upstate Otsego County, where SUNY Oneonta is located, had a 4% positive rate 5.1% on a seven-day rolling average, the state reported today. A COVID-19 outbreak at SUNY Oneonta forced the university to send its students home for the semester during the second week of classes. The school announced the decision Thursday, when it said confirmed cases had risen to 389 since the start of the semester on Aug. 24. Oneonta had already begun a two-week pause on Aug. 30 in an attempt to limit the spread of the virus. As of today there were 559 confirmed cases among students there.
Oneonta is the most extreme example of community spread of COVID-19 on college campuses in New York, but it is by no means alone. SUNY Buffalo reported 91 confirmed cases as of late yesterday, just a handful of cases shy of the 100-case threshold requiring a two-week shutdown under rules announced by Gov. Andrew Cuomo last week.
Stony Brook University, which reported its first positive case on Aug. 28, on Wednesday announced 17 new cases. The university said it was retesting the 18 students whose tests came back positive and would have new test results within 24 hours. It has not updated the data on its COVID-19 dashboard since then. Stony Brook also reported two positive tests among employees. A university spokesperson could not be reached for comment.
Hofstra University said yesterday it had a total of 27 confirmed positive cases for students, including confirmed positive cases from on-campus testing and confirmed positive cases from off-campus testing confirmed through the Department of Health. Hofstra has had no positive tests among employees, according to its website.
SUNY Old Westbury has not had any confirmed cases, according to its website. Farmingdale State College is not posting the information on its website. St. Josephs College will begin on-campus classes after Labor Day.
Statewide, 801 additional coronavirus cases were confirmed yesterday a .8% positive rate bringing the states total to 438,772.
Suffolk County had 98 new confirmed cases yesterday, according to state data, bringing the overall county total to 45,200.
Riverhead Town has had 801 confirmed cases to date, or 23.78 positives per 1,000 people.
The hamlet of Riverhead has the highest total in the township, with 514 cases, or 36.6 cases per 1,000 people.
Case totals for other hamlets in Riverhead Town are as follows:Aquebogue 30Baiting Hollow 15Calverton 120Jamesport 17Northville 14Wading River 108
Across the river, the hamlet of Flanders, with 211 cases total to date, has a per-thousand rate of 44.1. Riverside has had 95 cases (30.2 per thousand) and Northampton has had just 20 cases, but a per-thousand rate of 33.2.
A state of emergency due to the coronavirus pandemic remains in effect in New York, Suffolk County and in Riverhead and Southampton towns, with restrictions on business, civic and social activities extended to at least the end of the month.
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Some Ohio State students that have tested positive for COVID-19 being housed in hotel ABC6OnYourSide.com
The world is in the midst of a COVID-19 pandemic. As WHO and partners work together on the response -- tracking the pandemic, advising on critical interventions, distributing vital medical supplies to those in need--- they are racing to find a vaccine.
Vaccines save millions of lives each year. Vaccines work by training and preparing the bodys natural defences --- the immune system--- to recognize and fight off the viruses and bacteria they target. If the body is exposed to those disease-causing germs later, the body is immediately ready to destroy them, preventing illness.
Immunization currently prevents 2-3 million deaths every year from diseases like diphtheria, tetanus, pertussis, influenza and measles. There are now vaccines to prevent more than 20 life-threatening diseases, and work is ongoing at unprecedented speed to also make COVID-19 a vaccine-preventable disease.
There are currently over 169 COVID-19 vaccine candidates under development, with 26 of these in the human trial phase. WHO is working in collaboration with scientists, business, and global health organizations through theACT Acceleratorto speed up the pandemic response. When a safe and effective vaccine is found,COVAX(led byWHO,GAVIandCEPI) will facilitate the equitable access and distribution of these vaccines to protect people in all countries. People most at risk will be prioritized.
Would you get the COVID-19 vaccine?
We could have a coronavirus vaccine sooner than we thought but polling shows many Americans would rather wait.
LAKE MARY, Fla. - Federal health officials say the coronavirus vaccine may be ready in less than two months but recent polls show Americans are hesitant to get it.
Im fairly skeptical. Ive never even had a flu shot. Im probably not going to be quick to run to it, said Andrew Losinger inOrlandoFriday.
On the other hand, Philip Maxwell says hes excited to be among the first to have access.
I work in healthcare. As a healthcare provider, because Im actually on the frontline, we are required to get it if were going to continue fighting the pandemic and being on the front doorstep, Maxwell said.
Recent polls attempt to take the temperature of people ahead of the vaccines approval. A USA Today/Suffolk poll says two-thirds of voters wont try to get the vaccine as soon as its available. A FOX News poll from last month showed around 55% percent of Americans planned to get it.
Before COVID started we were already seeing increases in vaccine hesitancy people that either delay or refuse vaccines that was before the pandemic, said Rupali Limaye, an associate scientist at Johns Hopkins School of Public Health.
She says theres another element at play right now that may be scaring people away from the vaccine.
Then we have an administration that calls vaccine development Operation Warp Speed. That doesnt necessarily convey a comprehensive, thorough process, Limaye explained.
Just Sunday, the head of the FDA said the agency would be willing to consider fast-tracking the vaccine.
I think what has happened now is theres a huge concern that there are steps that are being skipped, Limaye said.
She added that vaccine scientists are now concerned that if so many people opt out of the vaccine, we will not be able to achieve herd immunity and it could prolong the pandemic.
When a vaccine is ready to be administered, there wont be enough doses to vaccinate the entire U.S. population, so experts have to figure out who will be first in line.
A task force organized by the National Academies of Sciences, Engineering, and Medicine released recommendations this week on who should get vaccinated first when a COVID-19 vaccine becomes available.
The report, released Tuesday as a draft, prioritizes people at high risk: frontline workers in healthcare facilities along with people who have underlying health conditions greatly increasing their risk of COVID-19 complications and mortality. Older adults living in crowded settings, such as nursing homes, would also be at the front of the line.
Itll serve as a guide for more a specific, detailed vaccination campaign. The Advisory Committee on Immunization Practices (ACIP) is also working on a similar vaccination plan that prioritizes frontline healthcare workers.
The vaccines primary purpose is to prevent severe disease, Dr. William Schaffner, an infectious disease expert at Vanderbilt University School of Medicine, told Healthline. Severe disease is the criterion, and in that regard, everyone knows that older persons, persons with underlying illness, adults who are [marginalized] those are the populations most severely affected by this virus and so it is to those populations that the vaccine will first be directed.
Drawing from past vaccination campaigns during the 2009 H1N1 flu outbreak and 20142016 Ebola outbreak in West Africa, the task force developed four pieces of criteria to inform wholl get access to a vaccine first.
They are as follows:
Using the criteria, the task force outlined four phases in which various groups of people could qualify for the vaccine.
You cant give it to everybody simultaneously, we wont have enough [doses], so were going to have to decide who is first, second, third in line, Schaffner said.
The task force recognizes that people of color specifically Black, Hispanic, and American Indian people have been disproportionally impacted by COVID-19.
The framework laid out was designed to address the underlying factors putting groups at risk occupation, living situation, underlying health issues and ensure vaccine equity.
The recommendations will be updated as researchers learn more about which vaccines work best in whom, according to Schaffner.
In Phase 1, first responders, healthcare workers in high-risk settings like hospitals or nursing homes people with serious comorbidities that significantly increase their risk, and older adults in congregate settings like nursing homes would take priority.
Frontline healthcare workers work in high-risk settings where they provide essential care for people battling COVID-19. A recent United Kingdom study found that frontline workers are 12 times more likely to get COVID-19 than the general population.
A vaccine would allow these workers to continue their work safely and cut the chances theyd contract and spread the virus at work, says the task force.
Dr. Eric Cioe-Pea, Northwell Healths Director of Global Health, says healthcare workers are the most nonrenewable resource available during a health crisis.
I said many times in March and April, you can build more ventilators, you cant build more nurses, Cioe-Pea told Healthline.
Schaffner says most other countries prioritize healthcare providers who provide direct care to COVID-19 patients.
First responders like police, firefighters, and emergency medical services workers are also included in phase 1 as theyre essential to societys functioning and urgently needed for emergency situations, the task force states.
Older adults in nursing homes have been hit hard during the pandemic. The Centers for Disease Control and Prevention (CDC) estimates that 80 percent of COVID-19 deaths have been in people age 65 and up. In addition, nursing home staff have a known role in spreading the disease in these environments and many, at least 800, have died from the disease.
Often because of staffing shortages, you have few people taking care of many residents, and the residents that are in nursing homes tend to be sicker than their peers not living in nursing homes, says Cioe-Pea.
People with two or more serious underlying conditions cancer, kidney disease, obesity, heart disease, to name a few have the greatest risk for developing complications from COVID-19.
The task forces rationale: Nearly 75 percent of patients hospitalized for COVID-19 had two or more underlying conditions. Sixty percent had three or more.
Phase 2 would green light the vaccine to essential workers in industries impacting the functioning of our society and economy (think: food supply workers and postal workers) along with school teachers.
This group makes sure the rest of the fabric of the essential services in society is preserved, Cioe-Pea said. Many essential workers have acquired COVID-19 on the job, according to the report.
Phase 2 also includes people with underlying conditions that moderately increase their risk.
People with underlying conditions still have the highest risk of a poor outcome with COVID-19, says Cioe-Pea, noting that this group also requires more resources like ventilators and oxygen support.
Finally, in phase 2, are all other older adults, people in shelters or group homes, and individuals who reside or work in prisons, jails, or detention centers.
Not only do many of these individuals have underlying conditions, but congregate living areas are prime settings for disease transmission, according to the report.
Phase 3 includes young adults and kids along with remaining essential workers not included in phase 2.
The report says theres evidence young adults ages 18 to 30 are fueling the pandemic via asymptomatic and pre-symptomatic transmission. A vaccine would lower their risk of passing the virus to friends and family.
Kids, though unlikely to experience severe disease, are thought to play a big role in community transmission, too, especially when they attend camp, day care, or school.
A vaccine will help schools safety reopen while cutting the chances children would give the virus to teachers or bring it home to their families.
They are low risk in that their risk of complications is extremely low they are in phase 3 not 4 because they will likely contribute to the spread of the disease within families, says Cioe-Pea.
Schaffner reminds that the vaccines key purpose is to prevent severe illness, which with COVID-19, greatly affects older adults and people with underlying health issues.
The final phase, phase 4, would allow all remaining U.S. citizens to get vaccinated.
Everyone is at risk of acquiring an infection and the task force hopes to see high vaccination rates in the general population.
The more people who are protected, the less readily this virus will be able to move through our population and be transmitted and find people who are seriously ill, says Schaffner.
The vaccine will also be given in two doses a month apart, which could further complicate the process.
A U.S. task force has released recommendations regarding who should get vaccinated first when a COVID-19 vaccine becomes available.
Since there will be limited doses of the vaccine at first, health officials need to prioritize groups that are most at risk. Frontline healthcare workers and people with serious underlying health issues will likely be first in line to get vaccinated.
The Associated Press checks out some of the most popular but completely untrue stories and visuals of the week. This one is bogus, even though it was shared widely on social media. Here are the facts:
CLAIM: The new vaccine for COVID-19 will be the first of its kind ever. It will be an MRna vaccine which will literally alter your DNA. It will wrap itself into your system. You will essentially become a genetically modified human being.
THE FACTS: Experts say mRNA vaccines do not alter your DNA.
As researchers work to test vaccines to stop the spread of COVID-19, social media posts are sharing misinformation to sow doubt even before they become available to the public. The posts on Facebook, Twitter and Instagram suggest that a new coronavirus mRNA vaccine will genetically modify humans.
The Moderna and Pfizer vaccine candidates that began phase 3 testing in July both use mRNA. Such vaccines are a new and unproven technology that experts say offer an easier and faster way to produce vaccines compared to traditional methods.
They work by introducing a messenger RNA molecule into your body, which causes cells to produce a protein that resembles one of the viral proteins that make up SARS-CoV-2, said Brent R. Stockwell, a Columbia University biology and chemistry professor.
Your immune cells then recognize this viral protein and generate an immune response against it, primarily by generating antibodies that recognize the viral protein, he said in an email.
While there are other concerns with mRNA vaccines, such as the degree and length of protection and possible side effects, Stockwell said, modifying DNA is not one of them.
Dr. Dan Culver, a lung specialist at Cleveland Clinic, agreed its not possible for an mRNA vaccine to alter your DNA. This cannot change your genetic makeup, he said. The time that this RNA survives in the cells is relatively brief in the span of hours. What you are really doing is sticking a recipe card into the cell making protein for a few hours.
Beatrice Dupuy
