Biden issuing pandemic plan that aims to expand access to testing and vaccines, reopen schools

[BumRushDaShow]

Source: Washington Post

President Biden plans Thursday to issue a new national strategy to respond to the coronavirus pandemic and to take executive actions intended to make tests and vaccines more abundant, schools and travel safer, and states better able to afford their role in the path back to normal life.

On his second day in office, aides said, Biden will sign an additional 10 executive orders, plus presidential memorandums, dealing with many aspects of the public health crisis the new president has defined as his top priority. They include the creation of a Pandemic Testing Board that can spur a “surge” in the capacity for coronavirus tests. Other orders will foster research into new treatments for covid-19, the disease caused by the virus; strengthen the collection and analysis of data to shape the government’s response to the crisis; and direct the federal occupational safety agency to release and enforce guidelines to protect workers from getting infected.

Other aspects of the plan are intended to steer more money to states, which have complained they need more funding to carry out the work placed on them for testing, vaccinating residents and other functions. The plan says the White House will try to persuade Congress to cover the entire cost for states to vaccinate low-income residents on Medicaid, while directing health officials to explore whether the program’s payment rates for vaccinations should be higher.

The 21-page plan is far from a federal takeover of the nation’s efforts to cope with the worst health calamity in a century. Yet it represents a pronounced shift away from the Trump administration’s deference to each state to design its own plan for coronavirus testing and carry out other elements of its response. The replacement plan synthesizes many of the goals and strategies for fighting the coronavirus that Biden has mapped out in the weeks and days leading to his inauguration, including in a $1.9 trillion request to Congress for these efforts and to hasten the nation’s economic recovery. Many represent promises whose success or failure will be born in the their details and execution.

Read more: https://www.washingtonpost.com/health/biden-coronavirus-executive-actions/2021/01/21/9a4ab954-5b56-11eb-8bcf-3877871c819d_story.html

[HUAJIAO]

1. ".....foster research into new treatments for covid-19, ...."

There already IS a treatment for Covid-19

IVERMECTIN

The NIH now "allows' Ivermectin to be used as a prophylaxis and treatment for Covid-19 !!!


Front Line Covid19 Critical Care Alliance

https://covid19criticalcare.com/

Presser in December –

&t=2s

Congressional hearing

[BumRushDaShow]

2. I heard that on the news last week

the caveat being "some patients".

And what would need to also happen is to look at long-term effects (if any) of use of that (even for a brief period), since we are still in the first year of this particular pandemic. An example of a similar anti-parasitic was the "common" drug pushed for prophylaxis - hydroxychloroquine (yes THAT stuff).

I.e., you had drugs like prednisone, that was touted as a miracle drug for those with rheumatism/rheumatoid arthritis, which it is, but it took decades of it being used and studied to really realize the impact of the dosing and weaning off of it, in order to adjust how it would be used as an anti-inflammatory and therapeutic, and at what cost to the patient (the "risk/benefit" ).

[HUAJIAO]

5. Ivermectin has been used for decades safely.

Did you watch the vids?
It is not just some patients. It is something like 95-99%.(Don't quote me on the exact number)

And it is not meant for 'long term' yet.
To be honest, I trust this more than I trust the vaccines. I've had one shot of Moderna last friday and have been on Ivermectin for about 6 weeks. I'll probably stop 2 weeks after the 2nd shot, which is the current protocol.....

or not, depending.......

[BumRushDaShow]

8. Yes I saw some of that back when I was also watching the CDC & FDA Advisory Committee meetings

but wasn't sure how far that would go and dismissed it. And that was because of the push for similar drugs such as hydroxychloroquine, which has also been used "for decades safely" too - but for specific indications (not just as an anti-parasitic but for people who have lupus). And limits for specific indications need to apply to this as well.

I.e., something might be "approved" for something, but needs to await enough peer-reviewed research over time, and an application for an EUA, in order to gain approval for other indications.

What I am saying is that this coronavirus is NOVEL. We don't have decades worth of data for what would basically be an "off label" use of a product normally prescribed as an anti-parasitic, and apply it to viruses (particularly since viruses are constantly mutating). COVID-19 has only been identified for just over a year, so it will take time to see what is "effective" considering that other viruses have little or no prophylactic treatments (i.e., "coronaviruses" are part of a class of viruses that appear alongside rhinoviruses for what we often call "the common cold" ), where an example of attempts at a push for prophylactics for such has been the use of Zinc (like in Cold-Eze) to supposedly reduce symptoms.

And as a note "NIH approval" is NOT "FDA approval". NIH doesn't approve drugs or biologics for human use. FDA does.

FDA's FAQ about this notes this -

Q: Should I take ivermectin to prevent or treat COVID-19?

A: No. While there are approved uses for ivermectin in people and animals, it is not approved for the prevention or treatment of COVID-19. You should not take any medicine to treat or prevent COVID-19 unless it has been prescribed to you by your health care provider and acquired from a legitimate source.

A recently released research article described the effect of ivermectin on SARS-CoV-2 in a laboratory setting. These types of laboratory studies are commonly used at an early stage of drug development. Additional testing is needed to determine whether ivermectin might be appropriate to prevent or treat coronavirus or COVID-19. Read more about ivermectin.

https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-frequently-asked-questions#60096c60c8d49

They also reference this - https://www.fda.gov/animal-veterinary/product-safety-information/faq-covid-19-and-ivermectin-intended-animals

Much of the research initially began with the precursor SARS-CoV-1 (almost 20 years ago) and it's good that so many researchers are looking at every aspect and every way to treat this, because whatever they ultimately come up with may truly be able to help with something as simple as "the common cold". But just keep in mind that right now, it all comes down to "risk/benefit".

[HUAJIAO]

9. Thanks for taking all the time to reply.

I've seen all of the info you quote and understand.

I am taking under a doctor's care.

I guess all I can say is I've decided the risk is worth the benefit.

[BumRushDaShow]

11. I think what you just mentioned

"under a doctor's care" is the key thing. Your physician knows your health history and what other meds you may be taking that might be contraindicated with that, and can monitor for any adverse reactions.

[Bayard]

12. Seriously?

I have a case of the paste Ivermectin on hand for the horses. The liquid injectable is generally used for cattle, sheep, and goats.

Its a livestock wormer for parasites. Don't see how it would work on Covid.

[HUAJIAO]

13. watch the videos and look at the FLCCCA website....

Seriously...

[DeminPennswoods]

3. At this point, the biggest problem is simply

manufacturing capacity. Using the Defense Production Act will help resolve that, but the other things could well confuse the situation more than ever. States like Pennsylvania already have a plan and are moving along with it and improving as they go. To tell them to stop and do something else now would likely be counter-productive.

My county's primary healthcare system, neither AHN nor UPMC, is setting up reservations now and has several large mass vaccination sites ready to stand up. All they need is a known, dependable supply of vaccine doses arriving as scheduled.

[BumRushDaShow]

6. Agree with the "supply" issue

Montgomery County Commissioners' Chair Dr. Val Arkoosh just mentioned in an interview, the struggles that they (as the 3rd largest county population-wise in the state) are having with supply - particularly since the state just expanded the criteria for eligibility for the earliest vaccinations. I was shocked to hear that they are only getting 5,000 doses a week as their allocation. She stated that if that number doesn't change, it will take 50 weeks for just the 250,000 who would qualify for the "expanded" 1a phase - https://www.radio.com/kywnewsradio/news/local/arkoosh-not-happy-with-pa-vaccine-eligibility-expansion

Here in Philly, since our doses are not coming out of the state's allotment but are directly allocated by CDC, we are getting about 20,000 does per week (10,000 each for Pfizer's and Moderna's). THAT is a major disconnect between what we are getting and what Montco is getting.

If one were to do ballpark amounts based on what Philly is getting, I could see Allegheny County getting at least 15,000 and Montco at least 10,000.

But the other issue is going to be proper handling and storage, as I am seeing more reports of doses that have had to be discarded due to their storage somehow getting compromised (in some cases, where the freezer/refrigerator was operating out of spec, including for brief periods enough to spoil a batch) and/or the vaccine had been kept out of a chilled environment beyond a certain time frame.

[DeminPennswoods]

10. That last part is a training issue

The sites that were scheduled to get the first doses of vaccines were hospitals. Many of them bought cold storage equipment specifically to store the vaccines. There is absolutely no excuse for any of them to have thrown away ANY doses. If there weren't "1A" recipients available, then these institutions should've put out word that whatever the number of unused doses was, were available to the general public 1st come, 1st served. If they didn't do that, it shows a complete lack of common sense on their part.

Anyone paying attention knew about the storage requirements and shelf life for each vaccine.

[BumRushDaShow]

14. When it comes to the large hospitals/hospital systems (and applicable associated academic sponsors)

then they are generally trained on how to calibrate and maintain the ultra-low freezers.

However the mRNA vaccines are literally a "brand new" technology and have tighter specs than run-of-the-mill "viral-component" vaccines, and common sense things like highlighting/emphasizing special "training" would have been part of a "plan" upon a national rollout of these vaccines. And THAT is THE problem.

The previous administration really had "no plan".

They basically had the relevant agencies review the clinical trial data to assess safety and efficacy and then worked out contracts to purchase certain quantities of the product, where the manufacturers basically provided storage requirements that were to be disseminated. Then it was shoved out to the states based on who knows what criteria.

In these novel vaccines' case, it's not like sending out the seasonal flu shots, which many of the vaccine clinicians/techs would be aware of how to handle, so "paying attention" (or not) isn't necessarily the only problem if the desire was to get as many "shots in arms", as fast as possible. I.e., past practice with storage and operating procedures that might have been fine for the standard approved vaccines, is apparently not good enough for this.

And in a number of cases, there is "mass vaccination" going on at stadiums, convention centers (like here in Philly) and other large venues and obviously those locations don't have the best temp storage facilities, where by the time you reach the end of a vaccination day, even with attempting to maintain "portable" cold storage, your vaccine might be close to expiration being out of their long-term storage environment too long. Plus part of the vaccination protocol has been to hold a person newly vaccinated, for at least 15 minutes to watch for adverse reactions before allowing them to go home (or back to work). With the expansion of "1a" for the state (over 65 w/underlying conditions), that makes things worse because the hospitals cannot handle that.

What happens in small, low-population rural counties has little or no applicability in terms of numbers of vaccinations that are being performed as compared to what goes on in high-population areas doing mass vaccinations for extended periods of time.

Neither the Pfizer nor the Moderna vaccines are "fully approved". They are only being distributed under an Emergency Use Authorization so there is still "real world" missing operating procedures that would need to be nailed down. Otherwise both would have had the type of standard instructions for vaccinations as developed for the "common" vaccines (developed by CDC) as seen here - https://www.cdc.gov/vaccines/vpd/vaccines-diseases.html

(and as you'll note, neither of the COVID-19 vaccines are listed there)

An addendum was tacked onto the end of the existing "Vaccine Storage and Handling Toolkit" document that CDC has available here (PDF) starting on page 49. But when you have many of those doing the vaccinations also caring for patients, it gets difficult to jam training in there and understand the implications.

[DeminPennswoods]

15. A fews weeks ago there was a report on CNN/MSNBC about

in CA, one of the hospitals or vaccine sites had vaccines that were about to expire. They went out and found people to whom to give the shots so they didn't go to waste. I understand your points, but, to me, there's just no excuse to let any doses go to waste.

[BumRushDaShow]

18. Yes - that is what states have been doing, but in a hodge podge and inconsistent fashion

THAT is one of the problems of not having a "national" plan.

You have an issue right here in PA with pharmacies (Rite Aid is on) that are fulfilling vaccination requests outside of the state's phased priorities, because of their own company "ethics" policies. I.e., if someone basically "asks for one" and it is available, they will not "turn them away" and there is no checking/verification if that individual fits that state priority phases.

What that means is that you may have people in need who might normally have challenges either with scheduling (due to their work shifts) and/or getting to a location where the vaccines are given, and they end up getting continually shoved to the back of the line by those with more resources. At that point, they won't even bother.

An example down in D.C. is here - https://www.nbcwashington.com/news/coronavirus/dc-man-vaccinated-for-covid-19-after-getting-on-pharmacy-waitlist-for-no-shows/2530182/

And in the case of who the virus impacts the most, it's the most vulnerable communities, who are also the ones who have the hardest time accessing the treatments and vaccines due to socioeconomic issues, including few or no supermarkets or pharmacies in their communities, and if they have a city or federal clinic nearby, those facilities are strictly following the eligibility guidelines and may end up getting allocated less to dish out if a pharmacy is able to pull strings and get more doses, but are not accessible to the right people.

This is a manufactured heath care divide.

And I agree that a prudent way to "use up" vaccine each day, could be having something like "first come/first served walk up" access at the end each day. Or it could be handled with "waiting lists", etc. However from what I gather, at least from Philly's pressers, is that most non-retail organizations who are providing vaccines and have an advanced scheduling process - if they have 500 people scheduled for a Saturday, then they request 500 doses for that day, but they might only have 470 actually show up, leaving 30 extra doses left. So for them, it will always be a hassle for how to handle this other than hodge podge -

"Well can I get my healthy 15 year old sister here to get vaccinated?""

while there are teachers and other frontline workers, let alone those who meet the severe underlying health criteria who need it and can't even get an appointment for any place near them (I have 2 sisters going through this right now - one who is immuno-compromised with rheumatoid arthritis and another a cancer survivor - they live in 2 different counties outside of Philly), and it is already causing not only angst but anger. And it's more difficult because this vaccine can't be treated like standard vaccines and just thrown in the fridge for another day.

As an example of a non-hospital/non-clinic-related organization that does rotating "location-based" testing and vaccinations for the underserved, we have the "Black Doctor's COVID Consortium"

Black Doctors Consortium push for greater COVID-19 vaccine distribution
By Jeff Cole
Published 2 days ago
Coronavirus Vaccine
FOX 29 Philadelphia

FAIRMOUNT - There is growing concern over the COVID vaccine and the issue is the vaccine is taking longer than anticipated. Some are trying everything they can to keep it moving and get as many people vaccinated as possible. One group actively participating in moving the vaccine along is the Black Doctors Consortium. They came on foot, in cars and in large numbers to Girard College in the city’s Fairmount neighborhood on the Martin Luther King Jr. holiday for COVID-19 testing. "I lost my mother-in-law last year to COVID. It’s personal and real important for me to know what’s going on. Know what I mean," asked Tony Mapp.

In any other day, on the MLK holiday, Girard would be a place for ceremonies marking the achievements of the slain civil rights leader. Instead the focus turned to the deadly virus ravaging communities of color. 500 were tested, but the head of a group of Black doctors battling the virus for months believes vaccinations are the way out among people where skepticism is high. "It really depends where you’re giving it, who’s giving it and the trust that they have in those individuals," stated Dr. Ala Stanford, Founder of the Black Doctors Consortium.

The Black Doctors Consortium began vaccinating in North Philadelphia over the weekend of January 15 and found concerns over taking the vaccine slip away as 1,000 took the shot over two days and 9,000 people signed up. "It’s access. It’s trust. It’s all the things that widen health disparity gaps that are so pervasive in our nation," Dr. Stanford remarked.

Vaccinations are also being limited by a sluggish national rollout of doses, leaving large vaccination sites with just a few hundred doses to inject. Tracie Taylor is a diabetic who tested for COVID Monday and wants the vaccine as soon as she can get it. "I’m a little anxious because you don’t know what the side effects are. Everybody’s different, but I will get it. Better safe than sorry," Taylor explained. The Black Doctors Consortium expect to vaccinate twice this week with at least 1,000 doses.

https://www.fox29.com/news/black-doctors-consortium

They have been able to battle the city to initially get registered as a non-profit, and then finally get a contract with the city for COVID-19 testing and now vaccinations. But again, that is why a thoughtful, researched, and detailed "plan" needs to be developed to take into consideration the unique circumstances and contingencies so that the usual "wealthy" aren't ahead of the "poor".

[DeminPennswoods]

19. Don't disagree with you, but I think we

can both agree that no doses should be wasted even if doing so would sometimes be outside the priority list.

[BumRushDaShow]

20. I agree about wasted doses

but the issue is that the usual people who would be most at need are never "in place" to get them, which is why hundreds of years after the founding of this country, there is still a "divide" - in the past, "dejure" and nowadays "defacto".

[HUAJIAO]

7. I agree biggest problem is supply...... BIGGEST !!

[ancianita]

4. Hoping Congress gets to a faster work pace now.

[Midnightwalk]

16. Just saw a 100+ page plan on whitehouse.gov

[link:https://www.whitehouse.gov/wp-content/uploads/2021/01/National-Strategy-for-the-COVID-19-Response-and-Pandemic-Preparedness.pdf|]

Here's the letter from Biden at the start

My fellow Americans,

As I swore an oath to God and country to serve as your president, I offered a prayer for the 400,000 Americans and counting who have lost their lives this past year from the once-in-a-century pandemic in our midst. They were mothers and fathers, husbands and wives, sons and daughters, friends, neighbors, and colleagues who leave behind grieving loved ones and a nation on edge.

For the past year, we could not turn to the federal government for a national plan to answer prayers with action — until today. In the following pages, you will find my Administration’s national strategy to beat the COVID-19 pandemic. It is a comprehensive plan that starts with restoring public trust and mounting an aggressive, safe, and effective vaccination campaign. It continues with the steps we know that stop the spread liked expanded masking, testing, and social distancing. It’s a plan where the federal government works with states, cities, Tribal communities, and private industry to increase supply and administer testing and the vaccines that will help reopen schools and businesses safely. Equity will also be central to our strategy so that the communities and people being disproportionately infected and killed by the pandemic receive the care they need and deserve.

Our national strategy will be driven by scientists and public health experts who will regularly speak directly to you, free from political interference as they make decisions strictly on science and public health alone.

Above all, Vice President Harris and I, and our entire Administration, will always be honest and transparent with you about both the good news and the bad. The honest truth is we are still in a dark winter of this pandemic. It will get worse before it gets better. Progress will take time to measure as people getting infected today don’t show up in case counts for weeks, and those who perish from the disease die weeks after exposure. Even as we make progress, we will face setbacks. But I know we can do it, and that a true national strategy will take all of us working together. It will take Congress providing the necessary funding. Families and neighbors will need to continue looking out for one another. We will need health care providers, businesses, civic, religious and civil rights organizations, and unions all rallying together in common purpose and with urgency, purpose, and resolve. We will need to reassert America’s leadership in the world in the fight against this and future public health threats.
There are moments in history when more is asked of us as Americans. We are in that moment now and history will measure whether we were up to a task. Beating this pandemic will be one of the most difficult operational challenges we have ever faced as a nation. I believe we are ready, as fellow Americans and as the United States of America.

May God bless the lost souls of this pandemic, and all of you on the frontlines who define the best of who we are as Americans.

Sincerely,

President Joe Biden

[BumRushDaShow]

17. I caught his remarks near the end

but have the video queued up so that I can hopefully watch it from the beginning. I did see the "big blue book" up there.