Wednesday, January 13, 2021

CoViD-19 Vaccine Rollout. 65+? Cool Your Jets | Impeached! (Again) | Capitol Chaos Clues Continue | California Hospital Crisis | Fletch Drops Another Sick Burn - This Time About High School Football |

San Diego Zoo Safari Park Gorilla Troop (Taken 9.28.2019)

I really doubt that news is really gonna slow down anytime soon. While the occupant of the white house was getting impeached for the second time, we found out that he's leaving a wake of international destruction with environmental laws, foreign relations, and general regulations that will prove to be challenging to overturn. But another stupid fucking thing his administration did was to announce that vaccines can be opened up to 65+, completely fucking over current vaccine efforts which are still working through Phase 1A which is supposed to be just healthcare workers and nursing homes, which already exceed available stock. This is another convenient way to make it look like state's and counties' faults when people can't get vaccinated. 
Meanwhile, locally and around the world, movements to reopen economies when we're at peak-COVID continue. My latest beef is with this idiot football coach from Torrey Pines HS who is bitching that the County and State won't listen to their data on how they can safely restart sports. Fletch had a sick burn on that during the press conference, which I've linked below. But it isn't just here. The WHO addressed it a lot today, I linked that below, too. 
Today's County briefing was kinda long but there are a lot of vaccination details that are worth noting and skimming through. I've pretty much been online all day so I'm gonna cut now, but if you're looking for something more entertaining to pay attention to, my pal and frontman for The Bronx and Mariachi El Bronx, Matt Caughthran, is hosting a new podcast for Sailor Jerry Spiced Rum. The launch "coincide(s) with the birthday of brand namesake, iconic tattoo artist and a man that truly defined himself by his own terms, the late Norman ‘Sailor Jerry’ Collins (1911 - 1973.)" It'll air bi-weekly, so subscribe through your favorite app. It will "include conversations around topics the brand loves most like music, tattoos, food and travel and feature chats with engaging artists, chefs, athletes and more."
Hope to see a lot of you at Fanboy on Thursday!!

  • COVID-19:

    • How a Well-Meaning Health Policy Created California’s Coronavirus Nightmare. The state’s hyperefficient health-care system runs pretty well—unless a pandemic strikes. - The Atlantic (1.12.2021)
    • To make Covid-19 exposure apps work, integrate them with existing popular apps like Facebook - STAT (1.12.2021) 
    • U.S. plan to expand access to Covid-19 vaccine likely sets up new debacles - STAT News (1.12.2021)
    • The Covid-19 Vaccine Rollout Faces a Two-Shot Problem. Millions of follow-up doses have been languishing in freezers, causing a massive logjam—and not everyone likes the ideas for a fix. - Wired (1.13.2021)
    • "You know, we are seeing some countries that have brought transmission under control, they've opened up their societies, and they're working incredibly hard to keep transmission down. We cannot emphasize enough the importance of maintaining that, so if transmission has been brought low, do everything you can to keep it low. Prevent any of those embers from turning into forest fires...the good news is we have a lot of tools right now that can bring transmission under control...we need resolve, we need determination, we need focus, to be able to adhere to those interventions that are put in place. The factors that drive transmission in the beginning are still driving transmission, we do have the introduction of some virus variants that are being detected in a number of countries, but this is to be expected. Given the global spread of this virus, given the intensity of transmissions in some countries, there are pressures that the virus is under to want to be more fit, to want to infect more people. The goal of a virus is to replicate, it's to produce more virus, and it needs a human host, or it needs a body or an animal to be able to do that. We have some control to prevent that from happening, but it does make the situation that much harder, but it doesn't mean that we've lost the battle here, there's a lot more that we can do. So, mixed picture, with the holidays over the last several weeks, in some countries, the situation will get a lot worse before it gets better...I think those countries know who they are and those countries are putting systems in place to be able to make sure that they can treat patients, because more cases means more individuals who will need hospitalization, who will need clinical care, who will need ICU beds, and unfortunately, despite great efforts and our ability to provide oxygen and dextamethasone and others, people will die." - Maria Van Kekhove, WHO, 1.13.2021


  • Politics/News: 

  • Other Reading:

  • Global COVID-19 Stats (JHU 1/13/2021 6:22pm):

    • 92,291,033 Known Cases
    • 1,976,509 Known Deaths

  • US COVID-19 Stats 

    • (JHU)
      • 23,067,796 Cases
      • 384,604 Deaths
    • (COVID Tracking Project):
      • 219,090 New Cases/22,757,516 Known Cases (8%+ Change over 7 Days)
      • 4,022 New Deaths/375,471 Known Deaths
      • 130,383 Current COVID-19 Hospitalizations
      • 23,877 Currently COVID-19 patients in ICU
      • 7,898 COVID-19 patients currently on ventilator

  • California COVID-19 Data:

    • Seniors 65+ Now Eligible to Receive COVID-19 Vaccine to Effectively and Efficiently Increase Vaccine Distribution, Reduce Hospitalizations and Save Lives - CDPH (1.13.2020)
      In order to increase the pace of COVID-19 vaccine distribution to those at greatest risk, the state is prioritizing individuals 65 and older to receive the vaccine as demand subsides among health care workers.
      Those in Phase 1A – health care workers and long-term care residents – remain the highest priority to receive vaccines. Demand for the vaccines continues to far exceed supply.
    • Aggregate California ICU Bed Availability: 0%
    • 33,751 New Cases/2,781,039 Total Cases (1.2% increase)
    • 589 New Deaths/31,102 Total Deaths (1.9% increase)
    • 13.3% 14-day test positivity rate
    • 22,550 COVID-19 Hospitalizations (-115 patients, -0.5% from prior day)
    • 4,929 COVID-19 ICU hospitalized in CA (-33 patients, -0.7% from prior day)
    • 1,183 ICU beds available (-46 from prior day)

  • San Diego County Media Briefing

    • San Diego County Board Of Supervisors Item 5: Framework For Our Future: Actions To Achieve Bold Climate Action at the County Of San Diego - 5-0 Passed Unanimously
    • Free Testing Sites and Schedule in San Diego
    • VaccinationSuperstationSD.com
    • County Of San Diego Influenza Watch 
    • Accelerate Vaccine Distribution
      • $100M on Vaccine Distribution/Hope to be reimbursed at some point
      • Tier1A is 620k in San Diego alone
      • Vaccines open to 65+ 1/2 Million San Diegans in this category
      • Need people to be exceedingly patient because vaccines have not arrived in significant quantities. We don't know when, how many, or which ones will be coming. 
      • County hasn't received any money from State or Federal government for vaccine distribution. County is taking a leap of faith and will provide money upfront, hoping for reimbursement. 
      • Staffing is still a massive problem. Healthcare worker shortages may have to pull from some testing sites to move to vaccination sites.
      • County will continue to ONLY provide vaccines for Phase 1A healthcare workers until we have more vaccines. 
      • Vaccination Superstation is working. County will open another in South Bay in early February. Hope to open in East County and North County by end of February. 
      • Currently have four PODs "point of distribution" centers, want to expand to 12 countywide. 
      • New online appointment portal (Clinical Management System) will integrate all available pods, including SuperStations, for people to make appointments, request email & SMS notifications, check-in at clinics, patient management of data, Immunization file 
      • County still working with healthcare partners, cities within county. 
      • VA, pharmacies, DOD will still continue independent of County operations.
      • Goal: 250k vaccinations by the end of January
      • Goal: Starting Feb 1- 24k per day. 
      • Goal: 70% of 16+ population vaccinated by the end of June
      • All goals are dependent on arrival of vaccines, not in County's control
      • 3,370,418 total pop
      • 2,689,348 population 16+
      • 70% would be 1,882,544 residents; requiring 3,765,088 doses of vaccine
      • To meet goal: 23,434 vaccines a day/7 days a week/150 consecutive days (dependent on reaching 250k goal by January)
      • A lot can change!
      • Vaccine Ecosystem with Health Equity/Accessibility/Convenience:
        • County Hosted Vaccine Events/PODs - 4 now, 12 soon
        • Vaccination Super Station - 1 now, 3 more in Feb
        • Mobile Vax Teams
        • Hospital Based Vax Sites can build out PODs
        • Clinic-Based Vax Sites
        • City Partnerships Vax Sites
        • Military & VA
        • Pharmacies
      • Vaccine Dashboard:
        • 241,825 doses to region as of 1/1/21 (does not include DOD, VA, tribes, prisons)
        • 79,607 first dose only
        • 12,698 both doses
        • 92,305 vaccines used. This number is higher but big lag. 
        • 0.4% of population 16+ have been immunized
    • Board Actions:
      • 3,000,462 Tests To Date
      • $47.5M in Relief Funding for Businesses
      • $13.5M in Housing Relief
      • $5M Childcare Assistance
      • 92k Great Plates meals per day
      • Vaccine infrastructure are being developed for all communities
      • See yesterday notes for Board Actions
    • Media Questions: 
      • "Safe Return For Play 2021" Focus is on vax distribution and responding to the pandemic. Will meet with people to hear concerns. Context. We all want kids back in school. Have people slow the spread, lower the case count, get the vaccine out. "In terms of getting data or specific public health guidance, you know, if you're facing 3rd and long, that's a situation where you outta really listen to football coaches. If you're facing a global pandemic, that is a situation where you outta make sure you're listening to public health experts and doctors." Nate busts another sick burn to KUSI.
      • SuperStation: This morning had 6 cases of allergic reactions. Higher cluster than expected for time period which slowed down vaccinations. Swapped out 'lot' of vaccines, which may have turned away some appointments, but site is back up and running. Reactions are still under investigation. Site will stay open later today to be sure all appointments are honored.
      • All vaccinations are given under medical supervision. Individuals get information, there's EMT on standby, patients told symptoms to look for. These are standard for all vaccinations. 
      • There is no concern of vaccinations being 'frozen too long'. Challenges in general with funding, staffing, siting. Systems also not up-to-the-minute; there is a significant data lag. 
      • There is regular communication with CDPH, Dr. Ghaly, Governor, etc. "There's a delicate dance here" Local approach is to 'glide scope' allowing providers who have vaccines can do the 75+, but county is still focused on Phase 1A. 
      • High School Athletics: Let Them Play Foundation maintains "tens of thousands" of athletes are going out of state or playing illegal tournament. Decisions are made at the state level. Robust debate and conversations about getting kids back in school. Whether it's restaurants back open, or gyms to indoor, or barber shops, there's a lot of things we all want to get back in our normal daily lives. Daily cases and impact on hospitalization is the information in front of us. Best path forward is getting the vaccine out, following the rules, slowing the spread. "No avoiding that reality."
      • Reporting lag is on vaccines administered. 92,305 administered. 
      • 241,825 total vaccines have been shipped to the region. We don't have enough vax to do Tier 1 Phase 1A, let alone Phase 1B. 
      • All other counties are actively working on Phase 1A. Expansion of eligibility can be interpreted as flexibility when there is excess within systems, i.e. when first-responders were given vax before they spoiled overnight. 
      • CDPH controls distribution allocations, but vax are shipped directly from Pfizer and McKesson (which distributes Moderna.) 
      • "Be Safe" app is run by CDC, data thus far hasn't been available to County.
      • People are driving themselves to vaccines. If you're prone to fainting or allergy, you might consider someone driving you.
      • Enforcement is a problem. San Diego is one of the biggest counties in the country, so it would follow that we're one of the highest death/case rates. 
      • San Diego County will be working to help latino population through community partners, by public service announcements on TV, radio etc in Spanish, and asking people to be patient and to talk to their healthcare providers so that they know when they're in line. Immigration status absolutely does not have any bearing on vaccine eligibility. Vaccines are confidential and only recorded so that people can get information on when to get their 2nd vaccine dosages. 
      • Next media briefing will be next Thursday instead of Wednesday (inauguration)
    • State Data:
      • Southern California ICU Bed Availability: 0%
      • 3,524 New Cases/198,317 Total Cases
      • 41 Deaths/1,898 Total Deaths
      • 89.8 cases/100k population (Assessed on 1/12. Unadjusted Case Rate)
      • 16.4% Test Positivity (Assessed on 1/12)
      • 22.8% Health Equity Positivity (Assessed on 1/12)
      • 1,790 COVID-19 hospitalized patients (+4 patients, 0.2% from prior day)
      • 442 COVID-19 ICU hospitalized patients (+1 patients, 0.2% from prior day)
      • 135 ICU beds available (-15 from prior day)
    • County Data:
      • County Plans to Offer COVID-19 Vaccine to People 65 Years and Older - County News Center 
      • 3,261 New Cases/201,580 Total Cases 
      • 54 New Daily Deaths/1,952 Total Deaths
      • 22% Daily Test Positivity/16% (7-day avg after 7-day lag)/14.4% Test Positivity (14-day average)
      • 69.7 cases/100k population (Assessed on 1/12. Adjusted case rate per 100,000 excluding prisons.) 
      • 39% Case Investigation (under 70% goal)
      • 51.9% Increasing Day Over Day Hospitalizations (1,804 COVID patients. 69% increase over 30 days)
      • 11% ICU Capacity (425 COVID patients. 48% increase over 30 days)
      • 33 Staffed ICU Beds Available (includes adult and PICU)
      • 7 New/46 Community Outbreaks (7-day)

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