Imagine for a moment a headline from the perhaps not-too-distant future: The United States announced an approved vaccine targeting the SARS-CoV-2 virus, that spike-protein-studded bastard that causes COVID-19.
Great news, right?
The latest from the coronavirus outbreak in Colorado:
>> FULL COVERAGE
Now, imagine the headline the next day: For the foreseeable future, there wont be enough doses of the vaccine for everyone to get it. Some will be vaccinated right away. Some will have to wait months, maybe even longer, as the pandemic slowly churns on.
So, who should be first in line?
As experts across the country focus their attention on the question, Colorado has ramped up its own effort to create an ethical and logistical framework to distribute the vaccine. The goal is for the process to be rational, fair, transparent and equitable. But, with so many unknowns surrounding the virus, research and vaccine politics still in play, thats a lot harder than it sounds.
It is super-complex to think about how to do this, said Dr. Anuj Mehta, a pulmonologist and critical care specialist at National Jewish Health and Denver Health who is helping to lead some of the discussions. Doing all our due diligence now makes us far more likely to implement a plan when a vaccine becomes available with little delay.
Mehta is part of a working group at the Governors Expert Emergency Epidemic Response Committee, a collection of mostly outside medical and health experts who give advice to Gov. Jared Polis on how to respond to the pandemic. The Colorado Department of Public Health and Environment also has teams of employees working in parallel on vaccine roll-out plans.
And all of this exists underneath the discussion currently taking place within the federal Centers for Disease Control and Prevention and the National Academy of Medicine on what a national vaccine distribution and prioritization system should look like.
Its a lot of moving parts, and thats before you get to the unknowns and what-ifs about the vaccine itself. Will it require one dose or two? Will it need to be shipped and stored at super-cold temperatures? Will it be equally safe for all age groups? Will people actually want to receive it?
These questions are why Colorados plans, when finished in the coming weeks, will likely look pretty unfinished. They need to be more outlines than dictates, and they need to be flexible.
You cant even plan for all these things in advance because your allocation protocol might change based on all the circumstances, said Dr. Matthew Wynia, a bioethicist who leads the Center for Bioethics and Humanities at the University of Colorado Anschutz Medical Campus.
One of the few things that does seem certain now is that the federal government will control the early distribution of the vaccine.
A letter sent to states from the U.S. Department of Health and Human Services earlier this month told states to expect that limited COVID-19 vaccine doses will be available in fall 2020 and that COVID-19 vaccine distribution will be managed centrally. This is similar to the way the federal government has handled the distribution of the drug remdesivir, which actually creates even more uncertainty for state planners.
Remdesivirs distribution has been criticized as opaque and haphazard. States and hospitals have struggled to understand how much they would receive and when, making it difficult to plan for how to allocate it.
If the same thing plays out with a vaccine, it would put intense pressure on state prioritization plans. The fewer doses there are available or that can be planned on to be available the more scrutiny there will be on who is at the head of the line.
In general thats going to be the most contentious thing you see, said May Chu, a clinical professor in epidemiology at the Colorado School of Public Health. And thats more politics than a scientific decision, though I think that science should drive.
Mehta said much of the discussion in his working group has involved thinking about priority tiers based on someones job, risk of exposure and risk of getting really sick if they do catch the virus.
Much like with emerging federal guidance, Mehta said health care workers and first responders would likely be near the top though, again, this is all still under discussion. They are most likely to encounter the virus in the wild as a result of their work, he said. And protecting them has a multiplier effect in that it allows them to continue helping others fight the virus.
Other essential workers people who work in grocery stores and schools, for instance would also be near the top. And people most vulnerable to the virus, such as those in nursing homes or people with underlying health conditions, could also be in line for greater priority.
OUR UNDERWRITERS SUPPORT JOURNALISM. BECOME ONE.
But these are all still pretty broad categories. And if Colorado receives only a trickle of doses, they wont be specific enough to create an orderly process. So Mehta said the working group has been talking about subtiers and subtiers of subtiers.
Health care workers at inpatient hospitals and facilities might be prioritized over those working in outpatient facilities. Inpatient doctors and nurses whose work exposes them to the coronavirus, like emergency room staff or respiratory therapists, would be in line ahead of staff whose jobs bring less risk. Older health care workers in those higher-risk jobs might go in front of younger ones. On and on these discussions go, focusing more and more narrowly on who faces the greatest risk and would benefit most from a vaccine.
Its the thing that keeps me up at night sometimes, Mehta said. Are we being too specific or are we not being specific enough?
In some broad ways, these debates resemble the ethical discussions around creating crisis standards of care guidelines for how hospitals should triage patients if there are just too many to save everyone. But there are also important logistical and strategic wrinkles, too.
Say you decide the firefighters should be among the first to receive a vaccine. How do you get it to them? Do you hold pop-up vaccination clinics at fire stations? Do you make them all drive to a central location? Does this change if the vaccine thats approved requires special storage or multiple doses? Can you reach rural and urban areas equally as effectively or do you even need to if the virus is more active in one region than another?
Mehta said the forthcoming federal guidance likely wont be detailed enough to answer these questions, which is why Colorado needs to come up with its own plan. But he said Colorado will also need better data to execute on its plan if you want to prioritize health care workers who are 65 or older, for instance, it helps to know how many of those there, he said.
Thats led us to start thinking about what data needs to be collected over the next four months, he said.
So far, what Mehta and his group are discussing tracks mostly with the national conversation about vaccine prioritization its an ethics-heavy dialogue about who most needs and deserves to be protected. Its a conversation that thinks of a vaccine like a shield, guarding against malicious assault.
But Wynia said there are other ways to look at the issue. What if we thought of a vaccine as a sword, allowing us to take the fight to the virus and attack it not where we fear it will end up but where it is right now?
There is a strategy that has been successfully used to combat smallpox called ring vaccination. Whenever a case pops up in a community, the strategy floods the community with vaccine. Contacts of the infected person get vaccinated. Contacts of contacts get vaccinated, as do contacts of contacts of contacts. The goal is to paint rings of immunization around the infection, keeping it confined.
Wynia said that would probably only work for coronavirus if we could first suppress viral transmission to very low levels. As it is right now in the United States, theres just too much spread to be able to isolate cases like that.
But the strategy points to another that could be deployed against the virus depending on local circumstances: Forget about who is most deserving of vaccination; focus instead on who is most likely to spread the virus. In other words, vaccinate irresponsible young people first.
The right allocation protocol might actually change from place to place, Wynia said.
Mehta said he has been in conversations where he has heard Wynia talk about pandemic ethics the idea that you may have to shed certain pre-existing beliefs and think about what works best against the virus. The two are friends, but theyve only ever met in Zoom videoconferences.
Mehta said he thinks the sword approach is the wrong one, even though he said hes seen research that suggests it could be effective. First, he said, its a logistical nightmare, which Wynia agrees with. How would you really identify who between the ages of 18 and 40 is most likely to be spreading the virus, many asymptomatically?
But theres another issue. The public might revolt.
I question how people would view that, even if it mathematically made sense, Mehta said.
To Mehta, the work to create an allocation system also serves an important function beyond public health. In this time of historic stress, a fair and equitable system can help maintain social cohesion. And a system that treats best those who are behaving the worst could damage that sense of unity.
Wynia agrees there, too. Vaccinating the population is important. Keeping the population united is more so.
We tend to go with guidelines in the U.S., Wynia said. Were reluctant to force people to do anything. But that does come with a cost that there will be a pretty high risk that there will be haves and have nots.
Support local journalism around the state.Become a member of The Colorado Sun today!
Several months ago, the inhabitants of one half of the planet braced for a potentially devastating addendum to COVID-19 as another flu season approached. And then, nothing.
In much of the Southern Hemisphere, a meaningful flu season mostly failed to materialize as usual in April around the time autumn is poised to become winter. Now, in what is often the peak period for reported cases, they continue to lag well behind the norm.
For many experts, the notion of dealing with a heavy flu season and a pandemic at the same time is daunting. The combination could overwhelm health systems, and complicate the ability to make accurate diagnoses. Yet, the lack of flu season in the Southern Hemisphere was not entirely welcome.
Thats because the rest of the world north of the equator, including places that have struggled to contain COVID-19 during summer, now lacks a detailed blueprint for dealing with a combined flu season and pandemic as the weather begins to turn.
Researchers hoping to study the interaction between seasonal flu and the coronavirus came up empty in the Southern Hemisphere in recent months. In South Africa, government laboratories that would normally record more than 1,000 cases of flu between April and August instead recorded a single case. Meanwhile Australia reported 193 notifications of laboratory-confirmed influenza for July compared with 70,071 in the same month last year.
Australia did not see a spike in cases during what is normally flu season.
Image: World Economic Forum
Reasons for the diminished influenza spread in the Southern Hemisphere include social distancing and other measures implemented to combat COVID-19. Influenza and the coronavirus spread in similar ways, including via droplets emitted through coughing and talking. They also both put the elderly and people with chronic medical conditions at greater risk.
Now, countries in the Northern Hemisphere, including the US where flu season normally begins around October, must rely on flu shots and whatever preventive measures that have been put in place to fight COVID-19 and are being adhered to in order to likewise keep influenza in check.
The WHO has so far estimated that the crude mortality ratio for COVID-19 is between 3% and 4%, while mortality is usually well below 0.1% for seasonal influenza. Still, influenza-pneumonia is among the leading causes of death in the US. During the 2018-2019 flu season, it resulted in nearly 500,000 hospitalizations there and an estimated 34,157 fatalities.
Influenza is regularly a leading cause of death in the US.
Image: World Economic Forum
Experts seem to have mixed views on whether the Northern Hemisphere will now be better off thanks to the lack of influenza spread in the other half of the globe. In any case, they suggest getting a flu shot to better protect against a perfect storm of influenza and coronavirus as we await a COVID-19 vaccination.
On the Strategic Intelligence platform, you can find feeds of expert analysis related to Vaccination, COVID-19 and hundreds of additional topics. Youll need to register to view.
Image: World Economic Forum
As a public service, Shaw Media will provide open access to information related to the COVID-19 (Coronavirus) emergency. Sign up for the newsletter here
The Illinois Department of Public Health reported 1,492 new confirmed cases of COVID-19 and 39 additional deaths Tuesday. That is the highest number of COVID-19 related deaths announced in a single day since June 26.
The state received the results of 22,961 COVID-19 tests in the 24 hours leading up to Tuesday afternoon. That is the fewest amount of tests reported by the state since July 6. The seven-day rolling average of Illinois positivity rate increased to 4.3%.
"We reached the maximum capacity of our system and currently are in the process of expanding this," IDPH spokesperson Melaney Arnold wrote in response to a question about why the day's test number was so low. "That work is underway now."
"Reporting test results is working, but it is currently slow and backlogged due to the large volume of testing data that we have processed since the beginning of the pandemic," Arnold said. "We are working on [eliminating] the testing data backlog."
In a response to a follow-up question on if this would affect when someone gets a test result, Arnold said "This does not delay a person getting their test results."
Illinois now has seen 236,515 total cases of the virus and 8,064 people have died. The state has conducted 4,087,122 tests since the start of the pandemic.
As of late Monday, Illinois had 1,513 COVID-19 patients in the hospital. Of those, 362 were in intensive care units, and 146 were on ventilators.
Regional update: According to aJuly 15 updateto the governor's COVID-19 response plan, the state will be tracking public health metrics in a slightly different way to monitor any potential resurgences of COVID-19. Additional restrictions can be placed on any of the state's 11 health regions if the region sustains an increase in its average positivity rate for seven days out of a ten day period.
A region may also become more restrictive if there is a seven-day increase in hospital admissions for COVID-19-related illness or a reduction in hospital medical/surgical beds or ICU capacity below 20%. If a region reports three consecutive days with greater than an 8% average positivity rate, additional infection mitigation will be considered through atiered system of restriction guidelinesoffered by the IDPH.
The North Suburban region (McHenry and Lake counties) has seen four days of positivity increases and two days of hospital admission increases. The region's positivity rate decreased to 6.1%. Currently, 42% of medical/surgical beds are available and 48% of ICU beds.
The West Suburban region (DuPage and Kane counties) has seen five days of positivity increases and two days of hospital admission increases. The region's positivity rate increased to 5.9%. Currently, 38% of medical/surgical beds are available and 49% of ICU beds.
The South Suburban region (Will and Kankakee counties) has seen five days of positivity increases and four days of hospital admission increases. The region's positivity rate remained flat at 8.8%. Additional mitigation measures from the IDPH have been placed on the region and it has less than two weeks to get down below 8%, or it will face additional mitigations. To return to the standard Phase 4 restrictions, the region will need to maintain an average positivity rate of less than or equal to 6.5% over a 14-day period. Currently, 30% of the region's medical/surgical beds are available and 29% of ICU beds.
The North region (Boone, Carroll, DeKalb, Jo Daviess, Lee, Ogle, Stephenson, Whiteside and Winnebago counties) has seen five days of positivity increases and two days of hospital admission increases. The region's positivity rate increased to 5.5%. Currently, 46% of medical/surgical beds are available and 47% of ICU beds.
The North-Central region (Bureau, Fulton, Grundy, Henderson, Henry, Kendall, Knox, La Salle, Livingston, Marshall, McDonough, McLean, Mercer, Peoria, Putnam, Rock Island, Stark, Tazewell, Warren and Woodford counties) has seen four days of positivity increases and four days of hospital admission increases. The region's positivity rate remained flat at 6.8%. Currently, 46% of medical/surgical beds are available and 45% of ICU beds.
Chicago has seen four days of positivity increases and three days of hospital admission increases. The region's positivity rate remained flat at 5.6%. Currently, 29% of medical/surgical beds are available and 41% of ICU beds.
Suburban Cook County has seen four days of positivity increases and five days of hospital admission increases. The region's positivity rate decreased slightly to 6.7%. Currently, 29% of medical/surgical beds are available and 41% of ICU beds.
Region 4, near St. Louis, has the state's worst positivity rate at 9.6%, but the rate did decrease 0.8 percentage points in one day. Region 6, which includes Champaign, has the state's best positivity rate at 2.0%, an increase of 0.3 percentage points in one day.
To see how other regions across the state are doing, see the full IDPH dashboard here.
Newly reported deaths include:
Adams County: 1 male 80s
Bureau County: 1 male 70s, 1 male 80s
Christian County: 1 female 80s
Coles County: 1 male 70s
Cook County: 1 female 30s, 2 females 70s, 4 males 70s, 1 female 80s
DeKalb County: 1 female 90s
DuPage County: 1 female 80s
Jackson County: 1 male 60s
Kane County: 1 male 80s
Lake County: 1 female 80s
La Salle County: 1 female 80s, 1 male 80s, 1 female 90s
Macon County: 1 male 70s
Macoupin County: 1 female 70s
Madison County: 1 male 80s, 1 female 90s
Mercer County: 1 male 90s
Morgan County: 1 female 80s, 1 female 90s
Moultrie County: 1 male 80s
Rock Island County: 1 female 60s, 1 male 70s, 1 male 80s
Sangamon County: 1 female 80s, 1 male 90s
Tazewell County: 1 female 70s
Vermilion County: 1 male 60s
Will County: 1 male 60s
Williamson County: 1 female 70s
Winnebago County: 1 female 80s
In yet another hitfor IL-6 inhibitors inCOVID-19, Sanofi and Regeneron's Kevzara failed a study in hundreds of severe and critical patientsand the partners are now giving up on the rheumatoid arthritis med as a coronavirus treatment.
In a Tuesday update, Sanofi said that its study of Kevzara in 420 patients inArgentina, Brazil, Canada, Chile, France, Germany, Israel, Italy, Japan, Russia and Spain didn't meet its endpoints. Patients who received the medicine did experience slightly shorter hospital stays and speedier improvements in their condition versus placebo, but the results werent statistically significant.
The Kevzara study, like othersfor Roche's IL-6 inhibitor Actemra, came from a theory that inhibiting IL-6 may help stave off the potentially deadly cytokine storm associated with some COVID-19 infections. Even though thetrial failed,Sanofi isproud of its work advancing knowledge of the disease, R&D chief John Reed said in a statement.
Improving Patient Outcomes & Clinical Trials With Visual Analytics
Drug Development has always been about data. Research insight that comes from data often gets muddied by its vastness and inaccessibility. In this session we discuss Takeda Pharmaceuticals Platypus, a comprehensive set of Tableau visualizations of clinical trial data. Register for this webinar to learn more.
In times like these, commitment to properly designed, controlled clinical trials, provides the information and understanding the scientific community needs for fact-based decision making, he added.
RELATED:Sanofi, Regeneron shut downKevzaratrial in COVID-19 after finding no benefit for ventilated patients
The latest results follow last month's failure of a U.S. study of Kevzara in coronavirus patients. Regeneron, which led that trial, reportedsome minor positive trends," but again the meds benefit didnt reach statistical significance.
While Sanofi and Regeneron aren't planning any further studies on Kevzara, Roche said in late July it's committed to researching Actemra in COVID-19, including in combo with Gilead's remdesivir.
Looking forward for Sanofi, the companyis advancing two COVID-19 vaccine candidatesone in partnership with GlaxoSmithKline and other with Translate Biowhile Regeneron has a promising antibody treatment. In a note this week, analysts with Morningstar said a Regeneron cocktailtherapy could score $6 billion in revenue next year if approved.
RELATED:Sanofi chose a proven platform over speed in its COVID-19 vaccine hunt, CEO says
Thecoronavirusvaccine field, meanwhile, will be worth around $18billion next year, Bernstein analyst Ronny Gal wroteon Monday. His team predicts the Sanofi/GSK partnership will earnaround $2 billion in COVID-19 vaccine revenues during 2021 and 2022, with the number graduallydecliningin later years.
Existing infrastructures will help get the COVID-19 vaccine to the public.
HOUSTON We fantasize a lot about how life will be better when a COVID-19 vaccine is available. KHOU 11 has learned health officials are now working to build on existing immunization infrastructure, including expanding it, to make it work for COVID-19 vaccine distribution.
In Houston, the Department of Health said it was in the beginning stages of planning, working with the Centers for Disease Control and Prevention, as well as DSHS on what the coronavirus inoculation process will look like.
There is a lot to consider, KHOU 11 learned, including who will administer the vaccine and how they will order and receive it, where the inoculation will take place, who will pay for it and how many individuals in every age group, at high risk or not will need doses.
Vaccines will also have to be properly stored and accounted for, part of the training that will be needed for some providers.
Once the vaccine is available, we're gonna need all hands on deck, the chief of the immunization program for the Houston Health Department Omar Salgado told KHOU 11. It's going to be available to private providers, pubic providers, it's going to be available to hospitals, pharmacies and federally qualified health centers.
In a Zoom interview, Salgado told KHOU 11, the department has to first do a survey of the health care providers that already work with them to administer the Texas Vaccines for Children program, an effort to provide low-cost vaccines to eligible kids from birth to 18 years of age, and the providers who are a part of the Adult Safety Net Program, created by DSHS to increase vaccine access for uninsured adults.
Salgado said the survey will count the existing clients wholl need the COVID-19 vaccine. Health officials will also have to figure out how many total vaccines are needed to inoculate the entire population of Houston and Harris county, including those who dont see a doctor regularly.
Salgado said the list of the providers already in the system, familiar with the vaccine ordering process that first goes through the state and then the CDC system, will have to be expanded. Providers will have to be trained, Salgado said, to make sure as many Texans as possible have access to the coronavirus vaccine.
There are different manufacturers, some of the manufacturers will have a vaccine that is going to take one dose to get immunity. Others are going to need two doses, which means they'll come in for the first dose and come back probably four weeks later to get that booster to build that immunity, Salgado said.
Salgado told KHOU 11 people can expect drive-through vaccination clinics, similar to COVID testing sites.
What we're doing right now, we are creating maps, maps of our community to determine which areas are high in COVID cases, so we can start to target those areas, he said. When the COVID vaccine comes out, we're gonna have to prioritize. It's going to first target first responders and those are the elderly population.
When the vaccine does come out, the Houston Health Department is up to the task.
Well definitely be ready, Salgado said.
In an emailed statement, the Texas Department of State Health Services said its currently working with the CDC, planning for COVID-19 vaccine distribution.
Final plans will depend on the formulation of the vaccine and the distribution schedule once one or more vaccines are approved, wrote Chris Van Deusen, Director of Media Relations. Health care providers interested in administering the COVID-19 immunization should register with ImmTrac2, the Texas immunization registry."
Texas is one of the few states that has an existing adult vaccine program, according to Claire Hannan, Executive Director of the Association of Immunization Managers. Both the adult vaccine and childrens vaccine programs are established immunization framework health officials could lean on to distribute the COVID-19 vaccine.
The Association is a Maryland-based non-profit that includes vaccine experts and leaders from all 50 states, plus large cities, including Houston, and U.S. territories, working to control vaccine-preventable diseases.
Each state has received supplemental funding from CDC to raise flu vaccination rates and will be receiving flu vaccine doses as well, Hannan said. Texas is using these funds to reach out and enroll additional sites to their Adult Safety Net program, including pharmacies, nursing homes, long-term care facilities, etc. And they will be providing the flu doses form CDC to adults through these newly enrolled and existing sites, and then building relationships with these sites in preparation for COVID-19 vaccination.
Hannan said the Texas Adult Safety Net program has 570 clinics enrolled, including 300 Federally Qualified Health Centers and Rural Health Clinics that inoculate uninsured adults.
We have about 40,000 providers across the country enrolled in this childrens program, Hannan said. We probably need to triple or quadruple that with providers that serve adults. We need to get them enrolled. We need to get them trained. We need to make sure they understand how to store the vaccine. We need to get them to agree to give it to the right people to manage their inventory, report the doses administered into immunization registries. So, you know, that system we have in place for children, we just need to expand that for adults.
Hannan said the system in place to administer the flu vaccine is a good one to build on, as well as the experience the country had in 2009 with the H1N1 pandemic.
I guess I'd say we're probably almost halfway there, Hannan said. We just need to put those all those pieces together to make it work.
This is an unprecedented time, she added. Getting all of America vaccinated with a brand-new vaccine, we've never done anything like that before. In this case, it's a massively larger campaign. We're looking at getting more Americans vaccinated and potentially with two doses. So, it's a little bit bigger than the flu.
Hannan said she anticipated the COVID-19 vaccine to be free of charge. How this will work is clearer if you have a private provider.
We think that enrolling private providers will allow the providers to have an incentive to give the vaccine because they will be able to charge insurers for an admin fee, Hannan said. So, the vaccine will be free. The insurance will cover the admin fee. You know, this is what we anticipate happening. This is the way that it happened in 2009. And this is the way it also works with the Vaccines for Children program.
The details of how this will work for the uninsured are being worked out, she said.
[What] we're really working through now is working with pharmacies, community health centers and figuring out how we're going to make that work, Hannan said. It's unknown exactly who's going to pay for the admin fee. We want to make sure the vaccine is accessible and is available and is affordable, as widespread as possible in as many communities as we can get.
Hannan said the Federal Governments COVID-19 vaccine effort, dubbed Operation Warp Speed, is taking a deep dive at certain areas in the United States to see what challenges the nation-wide coronavirus vaccine distribution could encounter, and how to solve those before the vaccine is available.
According to the Department of Health and Human Services (HHS) website, Operation Warp Speed is supposed to produce and deliver 300 million doses of safe and effective vaccine, with the initial doses available in January of 2021.
Operation Warp Speed is a partnership between HHS, the CDC, the FDA, the National Institutes of Health, the Department of Defense and the Biomedical Advanced Research and Development Authority.
They're going to North Dakota, California, Philadelphia, Florida and Minnesota, Hannan said. And they're going to be focusing on different challenges in those areas
and working through a number of the issues and then putting out some guidance and a model plan following these visits.
Hannan is hopeful the COVID testing issues that have been widely reported across the country wont be repeated with vaccine distribution.
With the time period we have to prepare, we can really work out some of these kinks and work out a way to get the vaccine seamlessly out to the public, she said.
Governor Ralph Northam walks through the Foodbank of Southeastern Virginia and the Eastern Shore in Norfolk Friday morning July 31, 2020. Sentara Healthcare, Truist and the Federation of Virginia Food Banks started a initiative to provide free meals to families during the pandemic. The "We Care" COVID-19 Virginia Emergency Food Support Plan features a five day food supply and will be distributed through Virginias seven regional food banks and their associated partners. (Jonathon Gruenke/Daily Press)
RALEIGH, N.C. (AP) North Carolina Gov. Roy Cooper is ready to make changes to his orders prohibiting certain retailers from opening during the COVID-19 pandemic.
Cooper plans to hold a Tuesday afternoon news conference, in which his office says he will share information about the next phase of easing restrictions. Changes would begin later this week, according to Dory MacMillan, a spokesperson for Cooper.
The year 2020 hasnt just been one for the history books: Its made quite an impact on K-12 grade books as well.
As the COVID-19 pandemic drags on into another academic year, the school playground has instead become a battleground for adults teachers, parents, school administrators, public health officials, lawmakers rowing over the future of education:
Should schools reopen? Is remote learning just as effective as in-person classes, and is the technology available to ensure equity for all students? For schools that open, is enough funding available to effectively protect teachers and students from COVID-19? For those that dont, what about parents need to return to work despite the need for at-home teaching?
For answers, we turned to Bradley Marianno, a UNLV College of Education professor and expert on teachers unions.
Read on for an explainer of unions' influence and what's drivingtheir battles with school districts over fall instruction; the impact of economic concerns on school reopening plans; how in-person, remote, and hybrid learning impact various populations of K-12 students; and his predictions about the future of education in light of the COVID-19 pandemic.
One way to think about teachers unions is as a type of insurance policy for teachers. Teachers will invest in their unions (i.e. pay membership dues) based on the degree to which the union organization can provide a return value, particularly in difficult and uncertain situations. COVID-19 is an unprecedentedly difficult and uncertain situation. Teachers are turning to their unions to help them voice their concerns and unions, with membership dues as the primary way in which they survive, take up the banner.
Polling of teachers confirms that health and safety sit atop their list of concerns regarding a return to school (see here, here, and here). Anecdotally, we heard of teachers preparing wills over the summer in case they had to return to face-to-face classroom instruction.
Teachers unions, as the voice for the safety concerns, have put forward what safety measures should be in place before teachers should return to schools (see here and here for examples). These typically include the same measures we hear from health experts: adequate protective equipment, social distancing, and sterilization protocols. They also include additional items, some of which are more challenging for school districts to implement due to cost, like retrofitting HVAC systems, regular testing and contact tracing of employees, temperature screenings on campuses, and isolation rooms for sick students. Teachers unions aim to ensure that these measures are taken before schools are reopened. We have seen them threaten strikes, advocate for teachers to delay their decisions to return to teaching for the fall, and file lawsuits (see here, here and here).
The story of school reopening is a local story. While we saw several governors take steps to close schools in the spring, the decision to reopen in the fall has largely been left to local school districts, their school boards, and their employees (see here for an analysis).
And for the most part, reopening decisions have been pushed too late in the game, with the beginning of the school year right on the horizon. This is partly because the June and July surge in COVID-19 cases left many school leaders in a holding pattern. Its also because local school district leadership in many places around the country were looking for more of the same guidance from state leaders about school closures that they received in the spring to also occur in the fall. But that fall guidance never really came in most areas around the country.
So as districts navigate the waters of reopening, they are caught between the demands of teachers unions, as representatives of teachers, and those of parents, which sometimes complement one another and sometimes compete. To navigate union tensions, some places have signed formal agreements (Memorandums of Understanding) to set forth the expectations of teachers. These are legally binding documents. Other places are creating their distance learning plans with union input without signing a legally binding MOU. And still others have created plans without much input from their unions. For example, Los Angeles Unified School District received heavy union input. Other locations, like Arizona, faced pressure from parents to reopen and followed through against objections from teachers and their unions. They now are facing protests from teachers, which will likely disrupt face-to-face learning.
Economic concerns have compounded the challenge of reopening schools. Federal CARES Act funding largely went to shore up budget gaps created by the spring stay-at-home orders. Whether additional federal funding is on the way is unclear. Consequently, when school district leadership looks at the demands put forward by teachers unions like retrofitting HVAC systems or implementing widespread COVID testing of staff and students even if they agree with the measures, the fiscal situation precludes them from being able to act. Even implementing social distancing in classrooms as crowded as those in CCSD is a costly endeavor because it requires the creation of more classrooms, the hiring of more teachers, and the provision of more space. Sufficient funding could have changed the landscape of fall reopening.
Stay-at-home orders forced parents to serve as teacher, guidance counselor, and recess monitor, giving many a newfound appreciation for the complex jobs of teachers. How might the current battle over returning to school impact that perception?
The longer distance learning draws on, the more likely public perception regarding teachers and teachers unions will change (and probably not positively). We know that teachers are essential workers. Parents know that. Research over and over again shows that they are the most important school-based factor in student learning. If distance learning 2.0 is of higher quality than distance learning 1.0, than we might see public perception remain in support of the teachers for some time. But if not, or if distance learning drags on for a while, then be prepared to watch the reopening debate continue to play out in the school board meetings around the country. Parents are reporting worsening mental health for themselves and more behavioral problems for their children since March (see here). No doubt, the closing of schools played a role.
We also have to remember that there is an equity issue at play heresome homes are in a better position to manage distance learning than others. Polling of teachers suggests that they are also acutely aware of this from their springtime experience trying to maintain contact with all households (see here). Perception among teachers could certainly change as well based on the degree of success they believe they are having with distance learning 2.0 and on the perceived risks of COVID-19 exposure, as case counts change.
Polling suggests that schools that serve a majority of Black and Brown students are far less likely to have access to the technology needed for remote learning (see here). Additionally, these populations of students were far less likely to be engaged in remote learning in the spring time (see here). With the suspension of some formative and summative tests, documenting the exact amount of learning lost will be difficult and tailoring instruction to help students catch up will be a challenge.
A large group of educational researchers have called for steps to address these inequities (see here). This will not be just a this year problem. It will be an issue for years to come. COVID-19 has shined a light on opportunity gaps, and it will be incumbent upon educators and policymakers to direct the necessary resources to mitigating these disparities in the coming years.
I believe we will see discussions regarding whether we should allow our special education students, homeless students, English-language learners, and other students at high risk of further learning loss to return to face-to-face instruction first. California is beginning these discussions. We may see phased reopening plans begin to include these students as the first to return so long as there are staff willing to serve them.
MADISON - The number of positive cases of COVID-19 in Wisconsin rose by 981 Tuesday, Sept. 1, officials with the Wisconsin Department of Health Services reported, for a total of 76,584.
There have been 1,130 deaths in the state, with eight new deaths reported Tuesday.
Of the positive cases, 5,878 have required hospitalization (7.7%), while 67,234 have recovered (89%), making for 7,229 active cases (9.6%).
More than 1.1 million have tested negative. More than 1.2 million have been tested.
CLICK HEREto view the Milwaukee County COVID-19 dashboard.
CLICK HEREto view the latest COVID-19 totals (updated daily at 2 p.m.) from the Wisconsin Department of Health Services.
CoronavirusNow.com: A Fox Television Stations initiative to provide you with the most up-to-date national and international news on COVID-19.Helpful phone numbers
About COVID-19 (from the CDC)
Symptoms:Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases. These symptoms may appear2-14 days after exposure(based on the incubation period of MERS-CoV viruses).
Aug. 30 (UPI) -- Food and Drug Administration Commissioner Stephen Hahn said the agency would be willing to fast track a COVID-19 vaccube as the United States nears 6 million cases.
In an interview with Financial Times, Hahn said the FDA would consider an emergency authorization of a vaccine for the coronavirus before the completion of phase three clinical trials if it found it appropriate to do so.
"It is up to the [vaccine developer] to apply for authorization or approval and we make an adjudication of their application," he said. "If they do that before the end of phase three, we may find that appropriate. We may find that inappropriate, we will make a determination."
Hahn said the decision would not be politically influenced and would rather be based on science, medicine and data.
"We have a convergence of the COVID-19 pandemic with the political season, and we're just going to have to get through that and stick to our core principles," said Hahn.
He added that an emergency use authorization, like the one the agency issued last week for convalescent plasma treatments following criticism by President Donald Trump, is not the same as full approval.
"The legal, medical and scientific standard for that is that the benefit outweighs the risk in a public health emergency," Hahn said.
Hahn's comments come as the United States nears 6 million total COVID-19 cases, with a world-leading 5,969,916 reported as of Sunday afternoon, according to data collected by Johns' Hopkins University. The United States has also reported more deaths than any other nation since the start of the pandemic with a death toll of 182,909.
California reported 6,070 new cases on Sunday for a total of 699,909, as it leads the nation in total cases. The state also reported 71 new deaths for a death toll of 12,905 in third place behind New York and New Jersey.
Florida on Sunday reported 2,583 new COVID-19 cases, its lowest total since June after reporting a record high of 15,299 on July 12. The state is second in the nation with a total of 621,586 reported cases. Florida also reported 14 new resident deaths for a total of 11,119, also the lowest since 12 in June, and fifth overall.
Texas is third in the nation in total COVID-19 cases, reporting 3,759 new positives for a total of 610,354 and fourth in deaths at 12,510 after reporting 90 new fatalities.
New York Gov. Andrew Cuomo announced the state reported 698 new COVID-19 cases and eight new deaths on Sunday, as the state also set a record-high with 100,022 test results. The state leads the nation in deaths with 32,944 confirmed fatalities and is fourth in cases with a total of 434,100 after having been the U.S. epicenter of the virus.
SUNY Oneonta, a public college in central New York, announced Sunday it would suspend in-person classes for two weeks after they began on Monday.
The university has reported 105 positive cases since the start of the semester as of Sunday, while 36 students have been quarantined on campus and seven are in isolation. State University of New York Chancellor Jim Malatras is set to visit the university on Sunday after reports of "a number of large gatherings and parties" reported on campus.
Georgia reported 1,298 new cases for the fifth highest total in the nation at 268,973 and 28 new deaths for a total of 5,604. It's the first time cases fell under 1,300 since late June.
