Daily Archives: April 23, 2021

People scrambled for life-saving oxygen supplies across India on Friday and patients lay dying outside hospitals as the capital recorded the equivalent of one death from COVID-19 every five minutes.

For the second day running, the country's overnight infection total was higher than ever recorded anywhere in the world since the pandemic began last year, at 332,730.

India's second wave has hit with such ferocity that hospitals are running out of oxygen, beds and anti-viral drugs. Many patients have been turned away because there was no space for them, doctors in Delhi said.

Ambulance sirens sounded throughout the day in the deserted streets of the capital, one of India's worst hit cities, where a lockdown is in place to try and stem the transmission of the virus.

Mass cremations have been taking place as the crematoriums have run out of space and families have had to wait for two days to cremate the dead.

At Guru Teg Bahadur Hospital in the north east of the city, critical patients gasping for air arrived in ambulances and autorickshaws. One man among half a dozen people waiting for hours on trolleys outside on Friday died before being admitted.

"The staff are doing their best but there is not enough oxygen," Tushar Maurya, whose mother is being treated at the hospital, told Reuters. "If you are not in a serious condition please don't come. It isn't safe."

ALL ALONE

The India Today television channel showed angry relatives outside a hospital in Ahmedabad, the largest city in Prime Minister Narendra Modi's home state of Gujarat.

"People are dying in front of hospitals while they wait for a bed to become available," one man said.

Another young man, who was not identified, said "Is this why we voted for this government? When we need it the most, we find ourselves all alone. Where will the poor go?"

Health experts say India became complacent in the winter, when new cases were running at about 10,000 a day and seemed to be under control, and lifted restrictions to allow big gatherings.

Modi himself has faced rare criticism for allowing political rallies and a Hindu religious festival, in which millions take a ritual bath in the Ganges river, to go ahead. He addressed many of the rallies with packed crowds and few people wearing masks.

"Indians let down their collective guard," Zarir Udwadia, a pulmonologist on Maharashtra's task force, wrote in the Times of India newspaper.

"We heard self-congratulatory declarations of victory from our leaders, now cruelly exposed as mere self-assured hubris."

Delhi's government declared in February it had beaten back the coronavirus. On Friday, Chief Minister Arvind Kejriwal went on live television to plead for medical oxygen supplies in a virtual meeting with Modi, warning that many people would die.

"All of the country's oxygen plants should immediately be taken over by the government through the army," he said.

Police in the northern state of Uttar Pradesh, some wielding assault rifles, escorted trucks to waiting hospitals in Delhi, while city governments traded accusations over hoarding. read more

Modi said government was making a "continuous effort" to increase oxygen supplies, including steps to divert industrial oxygen.

A fire broke out in a hospital treating COVID-19 patients in a Mumbai suburb early on Friday, killing 13 people, underlining the stress the hospitals were under. On Wednesday, 22 patients died at a public hospital in Maharashtra where Mumbai is located when oxygen supply ran out due to a leaking tank.

World Health Organization chief Tedros Adhanom Ghebreyesus said he was concerned about the growing case load in India, which on Thursday passed the previous global high of 297,430 recorded in January in the United States, where case numbers have fallen.

"The situation in India is a devastating reminder of what the virus can do," he told a virtual briefing in Geneva.

WHO emergencies director Mike Ryan said reducing transmission would be a "very difficult task" but the government was working on limiting mixing between people, which he said was essential.

Bhramar Mukherjee, a professor of biostatistics and epidemiology at the University of Michigan in the United States, said it seemed as if there was no social safety net for Indians.

"Everyone is fighting for their own survival and trying to protect their loved ones," he said. "This is hard to watch."

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Hospitals overrun as India's COVID-19 infections top global record for second day - Reuters India

DENVER Health officials in Colorado say virus outbreaks have increased this week, reaching a total last seen in February, with the most outbreaks reported in schools and nursing homes.

The Colorado Department of Public Health and Environment said there were 722 active COVID-19 outbreaks as of Wednesday, The Denver Post reported Thursday.

An outbreak is at least two confirmed cases linked to the same location or event. Outbreaks are declared over after four weeks with no new infections.

Compared with last week, K-12 schools reported 18 more COVID-19 outbreaks and nursing homes reported 13 more outbreaks, health officials said. Manufacturing facilities, offices and restaurants and assisted living facilities also saw an increase in outbreaks.

Long-term care facilities reported 69 active virus outbreaks in Colorado, with 52 of them found since April 1. Nursing home residents were among the first to be offered vaccines, but not everyone took the shot. Some unvaccinated residents may have also moved in since vaccination efforts began.

As of Thursday, about 1.6 million Coloradans were fully vaccinated against COVID-19.

The latest from the coronavirus outbreak in Colorado:

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Officials said schools reported 90 active virus outbreaks, with majority of them being small. Only seven outbreaks involve 20 or more confirmed COVID-19 cases. It is not immediately clear how many teachers are fully vaccinated.

Health officials also said 613 people were hospitalized with confirmed or suspected COVID-19 infections as of Wednesday, 100 more than a week earlier. But officials warn it is too early to see a pattern. That number dropped to 551 on Thursday.

The seven-day average for new COVID-19 cases continued trending down Wednesday, while the percentage of positive tests remained high, indicating the state isnt detecting some infections.

More than 43% of Colorados population has received at least one dose of a coronavirus vaccine, according to the U.S. Centers for Disease Control and Prevention. About 25% of the population is fully vaccinated.

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Schools and nursing home drive increase in Colorado coronavirus outbreaks - The Colorado Sun

The global tally for the coronavirus-borne illness rose above 144.8 million on Friday, as the death toll increased to 3.07 million, according to data aggregated by Johns Hopkins University. The U.S. continues to lead the world in cases and deaths by wide margins, with 31.9 million cases, or 22.1% of the global total, and 570,346 deaths, or 18.6% of the worldwide total. The U.S. added at least 61,901 cases on Thursday, while new deaths rose to at least 719, according to a New York Times Tracker. But the U.S. also leads the world in vaccines administered, with 27% of the poplation now fully vaccinated and 41% receiving at least one dose of two-dose vaccines.India is second to the U.S. by cases at 16.3 million after adding a record of more than 330,000 cases in a 24-hour period, setting a global record for a second day, the Times reported. India has suffered 186,920 deaths, according to its official numbers, or fourth-highest in the world. Brazil is third with 14.3 million cases and second by fatalities at 383,502. Mexico has the third-highest death toll at 214,095 and 2.3 million cases, or 15th highest tally. The U.K. has 4.4 million cases and 127,597 deaths, the fifth-highest in the world and highest in Europe.

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Coronavirus tally: Global cases of COVID-19 top 144.8 million and India sees record of more than 330,000 cases in a single day - MarketWatch

The rollout of coronavirus vaccines in Florida was heralded as a light at the end of the tunnel for a pandemic that has upended normalcy and killed 35,000 people in the Sunshine State alone. Now comes the question of just how long the tunnel is.

Across Tampa Bay, officials are seeing slowdowns in the number of people lining up for doses. One site in Plant City averaged 200 to 300 shots a day during the first full week of April, though managers there had planned for a daily average of 1,000.

We have a lot of vaccines out there all over the place, but people arent getting it, said Kevin Watler, a spokesman for the Florida Department of Health in Hillsborough County. How fast we can resume to normal really lies with people who are choosing not to get vaccinated.

Watler is talking about herd immunity, the point where enough people are immunized to block transmission of a virus. Its the final milestone before the pandemic can end.

Getting there will depend on many factors, experts say, including how many people acquire immunity through vaccination or infection, how long each type of immunity lasts and human behavior.

More than 45 percent of eligible Floridians have received at least one dose of a coronavirus vaccine, and surveys show that hesitancy about the vaccines has been decreasing. After a rocky start to Floridas vaccine rollout, residents can now turn to multiple providers, even with the pause in the single-dose Johnson & Johnson vaccine. And doses, which are free of charge, are fairly easy to obtain for most people.

Still, a significant number of people dont plan to get vaccinated, according to surveys. And so far, children under 16, who make up nearly 20 percent of the population, arent eligible. That leaves roughly 10 million eligible Floridians over 16 who have yet to roll up their sleeve.

Large numbers of people without immunity makes a return to pre-pandemic life more risky, experts say. Infection could spread through non-immunized communities, which would offer a greater chance for the virus to mutate and become harder to control.

The result: more cases and a lengthening of the pandemic.

Already, a fourth spike of coronavirus cases has been fueled by variants that are more transmissible and have become dominant in the U.S., particularly in Florida.

We are in a race to get people vaccinated as soon as possible, because were just starting the next surge, said Marissa Levine, a professor of public health at the University of South Florida. We dont know what it will look like, but it has the potential to cause preventable suffering and death.

Between 60 and 85 percent of people need to be immune to the coronavirus to reach herd immunity, based on experts varying estimates.

That number becomes even more difficult to hit considering that all children arent eligible for shots yet. Without them, the percentage of immune adults would need to be even higher, said Josh Michaud, associate director of global health policy at Kaiser Family Foundation.

About 25 to 30 percent of American adults have contracted COVID-19 at some point in the pandemic, which gave them an estimated six to nine months of natural immunity, Michaud said. Vaccination, meanwhile, is thought to provide one to three years of immunity.

That means those infected in early 2020 have likely run out of antibodies to fight COVID-19, although some may have since been vaccinated, as directed by health experts. The overlap makes it difficult to know just how close we are to herd immunity, Michaud said.

In Hillsborough County, about 20 percent of adults have natural antibodies against COVID-19, according to a March study by Moffitt Cancer Center led by Dr. Anna Giuliano, founding director of the Center for Immunization and Infection Research in Cancer.

The only realistic way the state can get close to reaching herd immunity is through large numbers of people choosing to get vaccinated, Giuliano said. Some other experts disagree, saying it can be achieved over time as the virus continues to spread. But most agree that reaching it with vaccination will be less painful.

At some point, we will reach herd immunity, its just at what cost, said Dr. Edgar Sanchez, an infectious disease specialist with Orlando Health. Depending primarily on natural immunity, he said, would mean scores of more deaths.

Michaud, from Kaiser, said he isnt confident that herd immunity is just around the corner for the U.S., citing lower demand for shots. He called it difficult if not impossible to get there in the next few months.

As of April 21, more than 26 percent of Americans were fully vaccinated. Combine that with an optimistic 20 percent of people with natural defenses, and its still not enough to meet even the lowest estimate of immunity to eradicate the virus.

Edwin Michael, a professor of epidemiology at USF who is modeling predictions of the coronavirus in Florida, estimates that the state will reach herd immunity by December if the vaccination rate and current social measures stay the same.

At double the speed, the state would reach it in July, he estimates. At three times the speed, it would reach it in June, he said. But much could change those estimates, including human behavior and the current and future introductions of new coronavirus variants.

The state could slip in and out of herd immunity or see the threshold needed for it rise as some people who were inoculated early on run out of immunity and require booster shots, or as more contagious strains emerge.

This is now a race, Michael said, between the rate of vaccination, the social measures in place and the new wave of coronavirus cases.

Vaccine providers in Florida say they have doses for people who want them. But in many cases, available appointments are now taking longer to get filled, even as millions more people have recently become eligible.

Thats frustrating to those working in public health.

We fought to get the vaccine, and we got the vaccine, said Watler, the health department spokesman in Hillsborough County, where demand has slowed.

Last Monday, Pasco Countys health department said only 150 out of 900 vaccine appointments were taken. The health departments in Hernando and Pinellas counties are also seeing unfilled appointments.

Statewide, tens of thousands are getting vaccinated every day, state data shows. Floridas rate of vaccination is about on par with the nationwide average, according to the U.S. Centers for Disease Control and Prevention. But its still not going as quickly as some had hoped.

The number of daily vaccinations for residents 65 and older, who have been eligible for shots since December, has been slowing since late March. Thats likely because about 80 percent of people in that age group already have been at least partially vaccinated.

But vaccinations among people ages 45 to 54, some of whom have been eligible for about three weeks, also have been trending down on a daily basis so far in April. About 40 percent of people in that age group had gotten at least one dose as of Wednesday.

Vaccinations among people ages 16 to 44 had been rising but have slowed in recent days. So far, about a quarter of people in that age group have gotten at least one dose.

The more-transmissible B.1.1.7 variant has become the dominant strain of the coronavirus in the country and Florida has the most cases of any state, data from the Centers for Disease Control and Prevention shows.

The introduction of vaccines themselves could drive the mutation of variants, thanks to what is known as selection pressure causing the virus to adapt to survive, said Michael, the USF professor.

The mutations found so far, he said, have spread very fast.

Hillsborough County has seen the effects of the B.1.1.7 variant as COVID-19 admissions at Tampa General Hospital have swelled over the last month, said emergency department director Dr. Jason Wilson. Hardly any of the patients who tested positive had been vaccinated, he said.

The rise in cases is going up faster than the people getting vaccinated, and we want the opposite, Wilson said.

He and Dr. Kami Kim, an internal medicine physician at Tampa General, say the virus has been spreading more among young people, largely because fewer of them have gotten the vaccine, and they may be more likely to eschew social distancing and other safety measures.

Wilson said that, based on conversations hes had with patients, younger Floridians are less likely to get the shot than older people because they have repeatedly heard theyre less at risk for severe complications from the disease.

But even if those unvaccinated people dont get severely ill, experts say, they could still spread COVID-19, giving the virus opportunities to mutate into more-aggressive strains.

A growing share of Americans say they are willing to get the vaccine, according to a March poll by the Kaiser foundation. But vaccine hesitancy and outright resistance remains.

A steady 13 percent of people have said since December that they will definitely not be vaccinated, the poll found. Most identified as Republican or white evangelicals, with half of Republican respondents saying they feared being forced to get a vaccine against their will.

The poll also found that 17 percent of Americans are taking a wait-and-see approach, a smaller percentage than in earlier surveys. Those respondents worried about side effects, that they may be worse than the virus itself, as well as wanting to see more safety data over time.

While hesitancy among Black and Hispanic people has shrunk from earlier polling, those groups still expressed the most concern about not being able to get a vaccine from a trusted source or said they would have difficulty getting to a vaccine site.

Thirty-three percent of poll respondents did not know where to get a shot, and 46 percent werent sure about their eligibility.

Some of the same themes Kaiser found are reflected in Tampa Bay, according to the most recent survey by the Tampa Bay Partnership, which has spent more than a year tracking how local residents feel about the pandemic.

Three-quarters of respondents said they were more likely to get a vaccine in March, an increase from 67 percent in January. Many still cited concerns about side effects and said they needed more information.

More than 40 percent of Black residents said they were not likely to be vaccinated, as did 36 percent of residents ages 18 to 34.

Efforts need to focus on reaching people who are hesitant or dont know where to get vaccinated, experts say.

Its no longer enough to say, come and get your doses, said Jason Salemi, a professor of epidemiology at the University of South Florida. We have to tackle this problem.

Wilson, the Tampa General doctor, has been talking to one of his regular patients, a Black person with sickle cell disease, about vaccination for four months.

The patient has yet to agree, he said. But theyve made progress with longer conversations and more nuanced and focused questions about the vaccines.

This is a long-term, consistent and persistent conversation about some pretty complex science, Wilson said.

That same level of care and understanding needs to happen on a larger level, Wilson and other experts say. Many communities are still lacking information, access and trust in the vaccines and the recent pause on those by Johnson & Johnson has only added to their hesitancy.

The Florida Division of Emergency Management has hired 2,900 canvassers to knock on doors in four major cities, including Tampa, where the state and federal governments are running mass vaccination sites. Theyve visited more than 510,000 homes providing information and helping people sign up for shots, a division spokeswoman said.

Teams have talked to about 43,000 people in Hillsborough County neighborhoods, with about 11,000 agreeing to register for vaccines, the state said. Another 12,000 said they had already received shots, but about half 21,000 said they were not interested.

Pairs of canvassers circled a Brandon neighborhood on Wednesday as registered nurse Stacey Gedeon stood by, ready to answer any clinical questions. People most often ask about side effects, she said.

Her team interacts with about 300 people a day, with an average of 25 agreeing to register for shots. Earlier in the vaccine rollout, about 50 a day would agree to sign up, but the number has dipped as more people have been vaccinated. She saw a lull after the Johnson & Johnson pause, too, she said.

My team is trained not to pressure people, Gedeon said. We just give them the facts and information. They have to make a decision themselves.

The state has moved on other fronts, too, like locating vaccine clinics at places of worship and in rural communities. The Department of Health is working with Florida A&M University on a public service campaign aimed largely at Black residents in certain parts of the state.

Counties are bringing vaccines to underserved areas and joining with community and faith groups to get the word out. Hillsborough County, for example, recently bused residents of a mobile home park to get shots, and its hosted multiple social media events so residents could ask experts questions.

But Kim said a more coordinated plan and better collaboration among all stakeholders is needed to reach the numbers of people required for herd immunity. She added that the states supply of doses to vaccine providers has not been consistent or predictable enough for optimal and equitable distribution.

As Florida and the U.S. continue to work toward the goal of herd immunity, experts beg people to be patient and not abandon social distancing and other guidelines too quickly.

That could be a struggle, particularly in Florida, which has been open for months.

Dr. Tom Unnasch, a professor of public health and biology at USF, said a move by Gov. Ron DeSantis to preclude businesses from requiring evidence of vaccinations from customers could hurt efforts to contain the virus before enough people have immunity.

Unnasch said incentives to get the vaccine, such as employers requiring them or businesses offering deals, could help prod some who are reluctant.

None of us are really protected until were all protected, Unnasch said.

Staff Writer Langston Taylor contributed to this report.

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To beat coronavirus, herd immunity is the goal. Can Florida get there? - Tampa Bay Times

Oregon reported nearly 1,000 new coronavirus cases for a second day in a row Thursday, with average daily case counts at their highest levels since January.

The Oregon Health Authority also reported one new COVID-19 death.

Thursdays 993 confirmed or presumed infections are four more than Wednesdays numbers, and they are the most since Jan. 16 the last time Oregon recorded more than 1,000 cases in a day.

Oregon is now averaging about 750 daily cases over the past week while the number of people hospitalized with confirmed COVID-19 is approaching 300. Both are at the highest levels since late January. Deaths, meanwhile, are substantially down.

Modeling released Thursday by Oregon Health & Science University projects cases will peak May 4, with a daily average of 1,326 for that week. Active hospitalizations are projected to peak about two weeks later, May 19, at 369. Cases and hospitalizations would precipitously fall afterward, according to the modeling.

Vaccines: Oregon reported 48,387 newly administered doses, which includes 28,535 Wednesday and the remainder from previous days.

Where the new cases are by county: Baker (14), Benton (24), Clackamas (116), Clatsop (4), Columbia (14), Coos (6), Crook (12), Curry (2), Deschutes (57), Douglas (5), Grant (1), Hood River (5), Jackson (46), Jefferson (6), Josephine (17), Klamath (54), Lake (2), Lane (54), Lincoln (7), Linn (34), Malheur (2), Marion (109), Morrow (1), Multnomah (206), Polk (20), Tillamook (1), Umatilla (8), Union (2), Wasco (16), Washington (128) and Yamhill (20).

Who died: Oregons 2,467th death linked to COVID-19 is a 67-year-old Linn County man who tested positive April 21 and died April 21 at Good Samaritan Regional Medical Center. He had underlying health conditions.

State officials also clarified that Oregons 2,461st victim was age 61, not 82.

Hospitalizations: 283 people with confirmed cases of COVID-19 are hospitalized, up 11 from Wednesday. That includes 69 people in intensive care, up four from Wednesday.

Since it began: Oregon has reported 178,110 confirmed or presumed infections and 2,467 deaths, among the lowest per capita numbers in the nation. To date, the state has reported 2,662,784 vaccine doses administered, fully vaccinating 1,091,777 people and partially vaccinating 566,353 people.

To see more data and trends, visit https://projects.oregonlive.com/coronavirus/

-- Brad Schmidt; bschmidt@oregonian.com; 503-294-7628; @_brad_schmidt

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Coronavirus in Oregon: nearly 1,000 cases for second day in row - OregonLive