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jimmy m
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30 Dec 2020, 2:57 pm

As million of Coronavirus Vaccines are released, the question of who should get the vaccine first has materialized.

In general the elderly and those with underlying comorbidities develop the most severe symptoms and in mortal danger of dying from the infection and are the most at risk. This should be the primary demographics that should receive the shot first.

Unfortunately this natural order is being shredded by politicians.

For example, many wealthy are cutting their place in line by using their wealth or influence.

In Massachusetts, the governor has deemed that prisoners should have a high priority.

Now in New York, Governor Andrew Cuomo has decided drug addicts should be one of the first in line.
Source: Domenech presses the ‘dangers of woke-left, centralized approach’ to vaccine distribution


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30 Dec 2020, 4:21 pm

It makes good sense to prioritize drug addicts for the vaccine, as they are more likely to both contract and spread coronavirus or other diseases. This is especially true during winter, where homeless people (who are often addicts) will likely congregate at shelters due to the cold weather - and thus be unable to isolate themselves from others.

Prisons are also potential "super-spreaders by design", as large populations are confined in fairly small spaces - especially in the often overcrowded prisons in the US.

I certainly see no reason why *I* should get a vaccine before anyone from these two groups.

Oh, and Captain Obvious told me to mention that Ben Domenech is an as*hole.



kitesandtrainsandcats
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30 Dec 2020, 5:33 pm

jimmy m wrote:
In Massachusetts, the governor has deemed that prisoners should have a high priority.


GGPViper wrote:
Prisons are also potential "super-spreaders by design", as large populations are confined in fairly small spaces - especially in the often overcrowded prisons in the US.


Our little county seat farm burg has a prison.
One member of our local Creative Writers Group is a prison guard.
One member of our local Model Railroad Club is a prison guard.

They come home from work at the prison to families.
They have friends.

I'm all for prisoners and prison staff being high on the vaccination list.

Quote:
More than 2,000 inmates have tested positive for coronavirus, and one has since died. A total of 27,504 inmates have been tested altogether. Out of the positive cases, 753 are active as of Sept. 29, DOC said.

The first offender tested positive for COVID-19 in late March.


And as of end September, over 130 of those were inmates at our town's prison.

Also, at same date 48 staff had tested positive for covid.


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kitesandtrainsandcats
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30 Dec 2020, 5:49 pm

And let's add some related content I just saw via the Tumblr blog of Autistic Self Advocacy Network,

Quote:
The case is part of a national trend of outbreaks hitting a vulnerable and largely overlooked population: People with mental health disorders who are locked up, often in underfunded mental health facilities that are breeding grounds for the disease.
...
California’s Department of State Hospitals filed motions to stay and dismiss the plaintiff’s latest request, stating the agency doesn’t have the authority to discharge patients without action by the court that committed each patient.

A critical element of that court intervention—which can take months—is to give authorities time “to determine if sanity has been restored, which means the applicant is no longer a danger to the health and safety of others, due to mental defect, disease, or disorder,” according to the defendants’ motion to dismiss.

Patients at Patton are involuntarily committed under various categories, including 39% who were found incompetent to stand trial, and 37% found not guilty by reason of insanity, according to the state Department of Hospitals’ motion to dismiss.


Psychiatric Hospital Called ‘Tinderbox’ of Covid-19 Infections (2)
Dec. 16, 2020, 5:01 AM; Updated: Dec. 16, 2020, 11:59 AM

https://news.bloomberglaw.com/pharma-an ... ch&index=0

Quote:
Psychiatric facilities around the country are uniquely vulnerable to the spread of infectious disease, wrote Gregg Gonsalves, an epidemiologist at Yale School of Medicine and School of Public Health, in an affidavit supporting the lawsuit against public psychiatric hospitals in Massachusetts.

“Congregate settings face special, extraordinary challenges in containing outbreaks,” Gonsalves wrote. “Without reducing the facility population, it will be almost impossible to stop an epidemic.”


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jimmy m
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30 Dec 2020, 6:00 pm

In response to GGPViper's comments:

In the U.S. approximately 42% of the COVID-19 deaths occur in nursing homes and assisted living facilities.
Source: Nursing Homes & Assisted Living Facilities Account for 42% of COVID-19 Deaths

Therefore as of today, approximately 341,801 individuals have died in the U.S. from COVID. Of these approximately 143,556 were people in nursing homes or assisted living facilities.

The Federal Bureau of Prisons (BOP) has 123,625 federal inmates in BOP-managed institutions and 13,731 in community-based facilities. As of today, there have been 179 federal inmate deaths and 2 BOP staff member deaths attributed to COVID-19 disease. Of the inmate deaths, 4 occurred while on home confinement.

I sincerely doubt that giving the vaccine to prisoners will have any measurable effect on reducing the overall death rate from the pandemic. For one thing I doubt that many prisoners or drug users interact with people in nursing homes or assisted living facilities.

As far as drug users are concerned. Most drug users are dying from drug overdoses than from COVID. In fact, the actions taken during the COVID pandemic have led to “more overdoses in a 12-month period than at any point in US history,” experts say. The Daily Caller reports that the country recorded “over 81,000 drug overdose deaths in a 12-month stretch, the worst year-long total reported in American history.”
Source: Drug Overdoses Higher Than Ever In U.S. History, Outpacing COVID-19 Deaths In Some Cities

As far as the comment: Oh, and Captain Obvious told me to mention that Ben Domenech is an as*hole.
According to The Skeptics' Guide to the Universe by Dr. Steven Novella that form of argument is a logical fallacy called an Ad Hominem. "An ad hominem argument is one that attempts to counter another's claims or conclusions by attacking the person rather than by addressing the argument itself."


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kitesandtrainsandcats
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30 Dec 2020, 6:23 pm

Quote:
By June 6, 2020, there had been 42 107 cases of COVID-19 and 510 deaths among 1 295 285 prisoners with a case rate of 3251 per 100 000 prisoners. The COVID-19 case rate for prisoners was 5.5 times higher than the US population case rate of 587 per 100 000. The crude COVID-19 death rate in prisons was 39 deaths per 100 000 prisoners, which was higher than the US population rate of 29 deaths per 100 000 (Table). However, individuals aged 65 years or older comprised a smaller share of the prison population than of the US population (3% vs 16%, respectively) and accounted for 81% of COVID-19 deaths in the US population. The Table provides a standardized calculation showing that the adjusted death rate in the prison population was 3.0 times higher than would be expected if the age and sex distributions of the US and prison populations were equal.


https://jamanetwork.com/journals/jama/f ... le/2768249


Quote:
Discussion

COVID-19 case rates have been substantially higher and escalating much more rapidly in prisons than in the US population. One limitation of the study is that it relied on officially reported data, which may be subject to inaccuracies and reporting delays, but are the only data available. Comprehensive data on testing rates were not available, and testing rates in both prisons and the overall population were uneven, with many facilities testing no prisoners or only symptomatic persons.2,5 Mass testing in select prisons revealed wide COVID-19 outbreaks, with infection rates exceeding 65% in several facilities.2 Reported case rates for prisoners therefore likely understated the true prevalence of COVID-19 in prisons.

A second limitation is that departments of corrections generally did not report demographic data on decedents, and therefore we could not adjust death rates to account for race/ethnicity and comorbidity. This study focused on prisons but did not include jails or other detention facilities where there have been notable COVID-19 outbreaks. Although some facilities did engage in efforts to control outbreaks, the findings suggest that overall, COVID-19 in US prisons is unlikely to be contained without implementation of more effective infection control.


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GGPViper
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30 Dec 2020, 9:20 pm

jimmy m wrote:
In response to GGPViper's comments:

In the U.S. approximately 42% of the COVID-19 deaths occur in nursing homes and assisted living facilities.
Source: Nursing Homes & Assisted Living Facilities Account for 42% of COVID-19 Deaths

Therefore as of today, approximately 341,801 individuals have died in the U.S. from COVID. Of these approximately 143,556 were people in nursing homes or assisted living facilities.

The Federal Bureau of Prisons (BOP) has 123,625 federal inmates in BOP-managed institutions and 13,731 in community-based facilities. As of today, there have been 179 federal inmate deaths and 2 BOP staff member deaths attributed to COVID-19 disease. Of the inmate deaths, 4 occurred while on home confinement.

Federal inmates make up less than 10 percent of the US incarcerated population, so that number is not representative of the actual death toll.

The state of Texas alone has 231 COVID-19 deaths in prisons as of November 2020.
https://repositories.lib.utexas.edu/bit ... sAllowed=y (see page 6)

The number is likely somewhat higher today due to the significant increase in cases since November.

jimmy m wrote:
As far as drug users are concerned. Most drug users are dying from drug overdoses than from COVID. In fact, the actions taken during the COVID pandemic have led to “more overdoses in a 12-month period than at any point in US history,” experts say. The Daily Caller reports that the country recorded “over 81,000 drug overdose deaths in a 12-month stretch, the worst year-long total reported in American history.”
Source: Drug Overdoses Higher Than Ever In U.S. History, Outpacing COVID-19 Deaths In Some Cities

I'm not following this line of reasoning..

People with addiction are hurting more than ever, so let's *also* deny them access to a vaccine? :scratch:

Quote:
As far as the comment: Oh, and Captain Obvious told me to mention that Ben Domenech is an as*hole.
According to The Skeptics' Guide to the Universe by Dr. Steven Novella that form of argument is a logical fallacy called an Ad Hominem. "An ad hominem argument is one that attempts to counter another's claims or conclusions by attacking the person rather than by addressing the argument itself."

Here is the actual distribution guidelines for the COVID-19 vaccine in New York:

New York wrote:
Phase One

The first New Yorkers to receive the vaccine as part of Phase 1 will be:

High-risk hospital workers (emergency room workers, ICU staff and Pulmonary Department staff)
Nursing home residents and staff
Federally Qualified Health Center employees
EMS workers
Coroners, medical examiners and certain funeral workers
Staff and residents at OPWDD and OMH facilities
Staff at New York State OASAS facilities

The priority populations will expand the week of December 28, 2020 to include:

Urgent Care Center employees
Individuals administering COVID-19 vaccines, including local health department staff
Residents of OASAS facilities

Next week, we expect to open criteria to ambulatory care health care workers and public-facing public health workers.

Source: https://covid19vaccine.health.ny.gov/ph ... on-vaccine

So Domenech (and the rest of Fox News, as always) was grossly misrepresenting the actual vaccine priorities in New York. The people in the highest risk groups have already been given the vaccine, and people with addiction are the next (and lower) ones on the list of priorities.

Like I said, Domenech is an as*hole. And there isn't enough storage space on the Internet to fact-check every as*hole on Fox News.



jimmy m
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31 Dec 2020, 12:15 am

OASAS = Office of Addiction Services and Support
OPWDD = Office for People with Developmental Disabilities
OMH = Office of Mental Health

There are many individual in their 80's and 90's living at home or in assisted living facilities. Where do they fit in New York's immunization framework?

Image

Most of those individuals under 65 have a very low probability of dying from COVID. For many young people the effect of contracting COVID is similar to the effect of contracting the flu. But for the aged and those with comorbidities, contracting COVID can be lethal. The scary part of COVID is the death rates. That is what is shutting down society and producing lockdowns. So when individuals that are at minimal risk are pushed up to the front of the line, the result will be to prolong the high death rates and therefore this pandemic.


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31 Dec 2020, 10:53 am

Health care workers, without a doubt. Societies can't run without them. Among them, the ones with priority should be those who work with patients with the virus, those who have most potential to accidentally come in to contact with the virus (like ambulance drivers) and those in risk groups (like those with asthma.) After that, the vulnerable ones, especially those who live in some kind of care homes since the virus can spread easily in those. After that... maybe family members of vulnerable ones and of medical staff?



jimmy m
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01 Jan 2021, 6:49 pm

Dr. Marty Makary said, "There's a lot of cutting in line" to get the coronavirus vaccine in the early weeks of nationwide distribution." "It should go to the highest-risk individuals after it goes to nursing homes and front-line health care workers, not all health care workers," he said. "I’ve taken a pledge not to take the vaccine, along with many health care workers, until every high-risk American has had the opportunity to have it first."

People are inserting themselves – people with access, people with wealth, people with connections to the local facilities, and they’re basically saying their life matters more.

However, according to Makary, the CDC's recommendation that "health care personnel" receive priority access to the vaccine has led to the likes of cosmetic surgeons, hospital board members and spouses of health care workers getting the shot "inappropriately."

He also questioned the decision by some states to "hold back 50% of the vaccine supply so people could be sure to get a second dose." Nearly 5% of the U.K. population has already been vaccinated, while not even 1% of the U.S. population has been dosed.

Source: Dr. Marty Makary decries people 'cutting in line' to get coronavirus vaccine


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01 Jan 2021, 7:41 pm

People who don't refuse to wear their mask...idk.


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kitesandtrainsandcats
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01 Jan 2021, 8:10 pm

jimmy m wrote:
Nearly 5% of the U.K. population has already been vaccinated, while not even 1% of the U.S. population has been dosed.


Let's see, Google finds ...
UK population 2019 = 66.65 million
US population 2019 = 328.2 million

UK > 66.65 x .05 = 3.3325 million people vaccinated
US > 328.2 x.01 = 3.282 million people vaccinated

Nice try at creating artificial controversy there.
But ...
Fail.


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jimmy m
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01 Jan 2021, 10:51 pm

kitesandtrainsandcats wrote:
UK > 66.65 x .05 = 3.3325 million people vaccinated
US > 328.2 x.01 = 3.282 million people vaccinated
Nice try at creating artificial controversy there.
But ... Fail.


Not creating artificial controversy, comparison should be by percentage not total number vaccinated.

Consider a small country like Monaco. If they had 38,682 people vaccinated thus far, would they be doing good or poorly. Comparing to the total number of people in the U.S. vaccinated (~3 million), one might falsely believe they are doing poorly if you consider total numbers. But consider the entire population of Monaco was 38,682 people as of 2018, one would conclude that almost 100% of their people would have been vaccinated.

In reality I suspect that the U.S. is lagging slightly behind because the U.K. began a week earlier and it takes a little time to come up to speed.

But the main point here is that in some places in the U.S. they are putting in reserve half the vaccines. One would only do this if they believed that the vaccines deliveries would dry up and prevented people for getting their second dose. That in my opinion is a very poor decision. These vaccines have a limited shelf life and the Pfizer vaccine requires an extremely cold storage temperature to maintain. So the reserve shots that were put in storage might have to be discarded. It would be an epic waste of good vaccine.


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02 Jan 2021, 11:02 am

I think that people 65 and older should be getting the vaccine first. Seniors are the most likely to be crowned by that horrible virus.


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jimmy m
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02 Jan 2021, 11:46 am

jimmy m wrote:
Dr. Marty Makary said, Nearly 5% of the U.K. population has already been vaccinated, while not even 1% of the U.S. population has been dosed.

Source: Dr. Marty Makary decries people 'cutting in line' to get coronavirus vaccine


Those figures were wrong.
Approximately 1.47% of the U.K. populations has already been vaccinated, while only 0.84% of the U.S. population has been dosed. This equates to 2.79 million vaccinations in the U.S. vs. 1 million in the U.K.

Source: COVID-19 vaccine tracker: How many people in Canada have received shots?


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jimmy m
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25 Jan 2021, 12:51 pm

I read an interesting article by Josh Bloom on this subject:

Is Vaccine Prioritization By Health Status A Losing Proposition?

Trying to get the COVID vaccine into people based on the highest medical risk sounds like a no-brainer. But it's nothing of the sort. Here's why.

It cannot be entirely coincidental that Disneyland has been designated as a COVID vaccination site because the vaccine rollout has been a Mickey Mouse operation by any measure. It would take hours to describe the chaos we've seen so far. But things could very well get even more chaotic if individuals' health status is figured into an already unsolvable equation.

Although it may intuitively (and perhaps ethically) make medical sense to inoculate people who are most likely to become seriously ill if infected, the nearly-impossible logistics of doing so will almost certainly cause more damage than it will prevent. One need look no further than the CDC's "People With Certain Medical Conditions" publication to see one reason why such a protocol is a bad idea.

1. Medical Problems
Medically, some of the CDC classifications border on ridiculous. For example:

* As I previously wrote, people who smoke, along with 11 other conditions "are at increased risk of severe illness from the virus that causes COVID-19."
* On the other hand, severe asthma, cystic fibrosis, and an immunocompromised state are relegated to "second place"; "conditions [that] might be at an increased risk for severe illness from the virus that causes COVID-19."
* Regardless of the data CDC used to establish this pecking order, it does not pass the "common sense test." There can be no sane explanation for deciding to put smokers ahead of severe asthmatics or people with high blood pressure.

2. Bureaucratic Problems
If the medical side of this prioritization plan is bad, the logistics of implementing it are far worse. Adding this layer on top of an already dysfunctional system will no doubt, further hamper the goal of vaccinating as many people as possible.

* How can health status be factored into a system that is so broken that people spend hours online trying to schedule their vaccination only to find that appointments may become available in three months, provided that there is a supply of vaccine, while in other places leftover doses are thrown away?
* Even with an adequate supply, it will be impossible to apply CDC criteria. Will the workers who are vaccinating thousands of people really be able to check to see whether a 55-year old man who wants the vaccine actually has any of the conditions listed by the CDC? Of course not.
* Many of the criteria are subjective. How high is high blood pressure? Is someone with a BMI of 31 (highest risk) be distinguishable from someone with a BMI of 29 (lower risk)? Will there be someone present with a scale to measure height and weight and calculate the number? Of course not.
* How can someone prove that they actually belong in a group that will be given higher priority? Will a letter from the doctor suffice? Who will read and interpret that letter? The answer, of course, is no one.
* Application of the CDC guidance guarantees that there will be line jumping. People will exaggerate (or simply make up) the severity of their asthma, heart disease, obesity, or COPD and there will be no way to challenge these claims. It is impossible.

3. Exacerbation of Healthcare Inequities
* If some type of documentation is required for people to receive the vaccine before their age group qualifies, this can only serve to amplify the disparity in vaccinations of those who are already being medically underserved.
* People who are poor, live in underserved communities, or disabled, that already have substandard medical care, will be less likely to even know about conditions that will put them at high risk let alone be able to call their long-time PCP for documentation of their condition.
* And people in this group are more likely to have these conditions.

In a perfect world where an ample supply of vaccine is available and some (any) kind of coherent policy is in place, it would be sensible to provide vaccines to those who have specific medical needs that would get them to the front of the line. But we have nothing of the sort.

Right now the best thing we can do is use simple determinants like age, job/career, and being in an assisted living facility or nursing home to push people to the head of the line. Anything more will only make a dysfunctional system even more so. People with the greatest need will be lost in the mad rush – exactly what this flawed policy was supposed to prevent.


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