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Panel: People over 75, essential workers next for vaccines – Cochrane Today

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NEW YORK — A federal advisory panel recommended Sunday that people 75 and older and essential workers like firefighters, teachers and grocery store workers should be next in line for COVID-19 shots, while a second vaccine began rolling out to hospitals as the nation works to get the coronavirus pandemic under control.

The two developments came amid a vaccination program that began only in the last week and has given initial shots to about 556,000 Americans, according to the Centers for Disease Control and Prevention.

The COVID-19 vaccine developed by Pfizer Inc. and Germany’s BioNTech already is being distributed, and regulators last week gave approval to the one from Moderna Inc. that began shipping Sunday.

Earlier this month, the Advisory Committee on Immunization Practices said health care workers and nursing home residents — about 24 million people — should be at the very front of the line for the vaccines.

Sunday’s vote by the panel was who should be next in line, and by a vote of 13-1, it decided that it should be people 75 and older, who number about 20 million, as well as certain front-line workers, who total about 30 million.

The essential workers include firefighters and police; teachers and school staff; those working in food, agricultural and manufacturing sectors; corrections workers; U.S. Postal Service employees; public transit workers; and grocery store workers. They are considered at very high risk of infection because their jobs are critical and require them to be in regular contact with other people.

It’s not clear how long it will take to vaccinate those groups. Vaccine doses have come out slower than earlier projections. But at the same time, some experts noted that not everyone who is recommended to get vaccinated may choose to get a shot.

The committee also voted that behind those groups should be people aged 65 to 74, numbering about 30 million; those aged 16 to 64 with medical conditions like obesity and cancer who are at higher risk if they get COVID-19, numbering as many as 110 million; and a tier of other essential workers. This group of as many as 57 million includes a wide category of food service and utility workers but also those in legal and financial jobs and the media.

The expert panel’s recommendation next goes to the CDC director and to states as guidance to put together vaccination programs. CDC directors have almost always signed off on committee recommendations. No matter what the CDC says, there will be differences from state to state, because various health departments have different ideas about who should be closer to the front of the line.

Federal officials expect that vaccine doses will be limited for several months. CDC officials say up to 20 million are projected to start getting shots this month, another 30 million next month, and 50 million in February. That’s 100 million out of a population of more than 330 million.

Pfizer’s shots were first shipped out a week ago and started being used the next day, kicking off the nation’s biggest vaccination drive.

Public health experts say the shots — and others in the pipeline — are the only way to stop a virus that has been spreading wildly. Nationwide, more than 219,000 people per day on average test positive for the virus, which has killed over 316,000 in the U.S. and nearly 1.7 million worldwide.

Earlier Sunday, trucks left the Olive Branch, Mississippi, factory, near Memphis, Tennessee, with the vaccine developed by Moderna and the National Institutes of Health. The much-needed shots are expected to be given starting Monday, just three days after the Food and Drug Administration authorized their emergency rollout.

In Louisville, Kentucky, UPS driver Todd Elble said his vaccine shipment was the “most important load that I’ve hauled” in a 37-year career. His parents contracted COVID-19 in November, and his 78-year-old father died. He said the family speculates that his father got infected while travelling on a hunting trip with four other relatives to Wyoming, and some are still sick.

“I’m going to take the vaccine myself. I’m going to be first in line for my father — I’ll tell you that much — and any others that should follow,” he said. “I feel in my heart that everybody should, to help get this stopped.”

He added: “To bring this back, I feel Dad was in the truck with me today.”

Dr. Moncef Slaoui, the chief science adviser to the federal government’s vaccine distribution effort, said on CNN’s “State of the Union” that nearly 8 million doses will be distributed Monday, about 5.9 million of the Moderna vaccine and 2 million of the Pfizer vaccine.

Slaoui also predicted the U.S. will experience “a continuing surge,” with larger numbers of coronavirus cases possible from gatherings for Christmas.

“I think, unfortunately, it will get worse,” he said.

There won’t be enough shots for the general population until spring, so doses will be rationed at least for the next several months. President-elect Joe Biden pledged earlier this month to have 100 million doses distributed in his first 100 days in office, and his surgeon general nominee said Sunday that it’s still a realistic goal.

But Vivek Murthy told NBC’s “Meet the Press” it’s more realistic to think it may be midsummer or early fall before vaccines are available to the general public, rather than late spring. Murthy said Biden’s team is working toward having the shots available to lower-risk individuals by late spring but doing so requires “everything to go exactly on schedule.”

Meanwhile, Trump’s surgeon general, Jerome Adams, defended the administration’s handling of the Pfizer vaccine Sunday, a day after the Army general charge of getting COVID-19 vaccines across the U.S. apologized Saturday for “miscommunication” with states over the number of doses to be delivered in the early stages of distribution. At least a dozen states reported they would receive a smaller second shipment of the Pfizer vaccine than they had been told previously.

Gen. Gustave Perna told reporters in a telephone briefing that he made mistakes by citing numbers of doses that he believed would be ready. Slaoui said the mistake was assuming vaccines that had been produced were ready for shipment when there was a two-day delay.

“And unless it’s perfectly right, we will not release vaccine doses for usage,” he said. “And, sometimes, there could be small hiccups. There have been none, actually, in manufacturing now. The hiccup was more into the planning.”

But Adams told CBS’ “Face the Nation” that “the numbers are going to go up and down.”

“It absolutely was not poor planning,” he said. “There’s what we plan. There’s what we actually allocate. There’s what’s delivered, and then there’s what’s actually put in people’s arms.”

Adams, who is Black, said he understands that mistrust of the medical community and the vaccine among Blacks “comes from a real place,” the mistreatment of communities of colour. He cited the decades-long Tuskegee experiment in Alabama, where Black men with syphilis were not treated so the disease could be studied.

He also said immigrants in the U.S. illegally should not be denied the vaccine because of their legal status because “it’s not ethically right to deny those individuals.”

“I want to reassure people that your information when collected to get your second shot, if you get the Pfizer or Moderna vaccine, will not be used in any way, shape or form to harm you legally,” Adams said. “That is something that I have been assured of.”

Both the Moderna vaccine and the Pfizer-BioNTech shot require two doses several weeks apart. The second dose must be from the same company as the first. Both vaccines appeared safe and strongly protective in large, still unfinished studies.

—-

Hanna reported from Topeka, Kansas. Also contributing was AP Radio correspondent Julie Walker in New York.

John Hanna And Mike Stobbe, The Associated Press















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Quebec to wait up to 90 days to give second dose of COVID-19 vaccine – Yahoo News Canada

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The Canadian Press

Pelosi’s nine impeachment managers hope to ‘finish the job’

WASHINGTON — House Speaker Nancy Pelosi has tapped nine of her most trusted allies in the House to argue the case for President Donald Trump’s impeachment. The Democrats, all of whom are lawyers and many of whom have deep experience investigating the president, face the arduous task of convincing skeptical Senate Republicans to convict Trump. A single article of impeachment — for “incitement of insurrection” — was approved by the House on Wednesday, one week after a violent mob of Trump supporters invaded the Capitol. At the time, lawmakers were counting the votes that cemented Trump’s election defeat. As members of the House who were in the Capitol when it was attacked — several hiding under seats as rioters beat on the doors of the chamber — the Democrats are also witnesses to what they charge is a crime. So are the Senate jurors. “This is a case where the jurors were also victims, and so whether it was those who voted in the House last night or those in the Senate who will have to weigh in on this, you don’t have to tell anyone who was in the building twice what it was like to be terrorized,” said California Rep. Eric Swalwell, one of the managers. It is unclear when the trial will start. Pelosi hasn’t yet said when she will send the article of impeachment to the Senate. It could be as soon as next week, on President-elect Joe Biden’s first day in office. The managers plan to argue at trial that Trump incited the riot, delaying the congressional certification of the electoral vote count by inciting an angry mob to harm members of Congress. Some of the rioters were recorded saying they wanted to find Pelosi and Vice-President Mike Pence, who presided over the count. Others had zip ties that could be used as handcuffs hanging on their clothes. “The American people witnessed that,” said Rep. Madeleine Dean, D-Pa., one of the managers. “That amounts to high crimes and misdemeanours.” None of the impeachment managers argued the case in Trump’s first impeachment trial last year, when the Senate acquitted the president on charges of abuse of power and obstruction of justice. The House impeached Trump in 2019 after he pressured Ukraine’s president to investigate Biden’s family while withholding military aid to the country. Colorado Rep. Diana DeGette, another manager, says the nine prosecutors plan to present a serious case and “finish the job” that the House started. A look at Pelosi’s prosecution team in Trump’s historic second impeachment: REP. JAMIE RASKIN, MARYLAND Pelosi appointed Raskin, a former constitutional law professor and prominent member of the House Judiciary Committee, as lead manager. In a week of dramatic events and stories, Raskin’s stands out: The day before the Capitol riots, Raskin buried his 25-year-old son, Tommy, after he killed himself on New Year’s Eve. “You would be hard pressed to find a more beloved figure in the Congress” than Raskin, says House Intelligence Committee Chairman Adam Schiff, who was the lead manager during Trump’s first trial. He worked closely with Raskin on that impeachment investigation. “I know that part of what gives him strength to take on this burden that he now carries is knowing that this is something that would be enormously meaningful to his son.” REP. DIANA DEGETTE, COLORADO DeGette, who is serving her 13th term representing Denver, is a former civil rights attorney and one of Pelosi’s go-to allies. The speaker picked her to preside over the House during the first impeachment vote in 2019. DeGette said Pelosi trusted her to do it because she is “able to to control the passions on the floor.” She says she was surprised when Pelosi called to offer her the prosecutorial position but quickly accepted. “The monstrosity of this offence is not lost on anybody,” she says. REP. DAVID CICILLINE, RHODE ISLAND Cicilline, the former mayor of Providence and public defender, is in his sixth term in Congress and is a senior member of the Judiciary panel. He was heavily involved in Trump’s first impeachment and was one of three original authors of the article that the House approved on Wednesday. He and California Rep. Ted Lieu began writing the article together, in hiding, as the rioters were still ransacking the Capitol. He tweeted out a draft the next morning, writing that “I have prepared to remove the President from office following yesterday’s attack on the U.S. Capitol.” REP. JOAQUIN CASTRO, TEXAS Castro is a member of the House Intelligence and Foreign Affairs panels, where he has been an outspoken critic of Trump’s handling of Russia. He was a litigator in private practice before he was elected to the Texas legislature and came to Congress, where he is in his fifth term. Castro’s twin brother, Julian Castro, is the former mayor of San Antonio and served as former President Barack Obama’s secretary of housing and urban development. Julian Castro ran in the Democratic primary for president last year. REP. ERIC SWALWELL, CALIFORNIA Swalwell also serves on the Intelligence and Judiciary panels and was deeply involved in congressional probes of Trump’s Russian ties. A former prosecutor, he briefly ran for president in 2019. “The case that I think resonates the most with the American people and hopefully the Senate is that our American president incited our fellow citizens to attack our Capitol on a day where we were counting electoral votes, and that this was not a spontaneous call to action by the president at the rally,” Swalwell said. REP. TED LIEU, CALIFORNIA Lieu, who authored the article of impeachment with Cicilline and Raskin, is on the Judiciary and Foreign Affairs panels. The Los Angeles-area lawmaker is a former active-duty officer in the U.S. Air Force and military prosecutor. “We cannot begin to heal the soul of this country without first delivering swift justice to all its enemies — foreign and domestic,” he said. DEL. STACEY PLASKETT, U.S. VIRGIN ISLANDS Because she represents a U.S. territory, not a state, Plaskett does not have voting rights and was not able to cast a vote for impeachment. But she will bring her legal experience as a former district attorney in New York and senior counsel at the Justice Department — and as one of Raskin’s former law students. “As an African American, as a woman, seeing individuals storming our most sacred place of democracy, wearing anti-Semitic, racist, neo-Nazi, white supremacy logos on their bodies and wreaking the most vile and hateful things left not just those people of colour who were in the room traumatized, but so many people of colour around this country,” she said Friday. REP. JOE NEGUSE, COLORADO Neguse, in his second term, is a rising star in the Democratic caucus who was elected to Pelosi’s leadership team his freshman year in Congress. A former litigator, he sits on the House Judiciary Committee and consulted with Raskin, Cicilline and Lieu as they drafted the article the day of the attack. At 36, he will be the youngest impeachment manager in history, according to his office. “This armed mob did not storm the Capitol on any given day, they did so during the most solemn of proceedings that the United States Congress is engaged in,” Neguse said Thursday. “Clearly the attack was done to stop us from finishing our work.” REP. MADELEINE DEAN, PENNSYLVANIA Like Neguse, Dean was first elected when Democrats recaptured the House in 2018. She is also a member of the House Judiciary Committee, and is a former lawyer and member of the Pennsylvania House of Representatives. She says she hopes the prosecutors can convince the Senate and the American people “to mark this moment” with a conviction. “I think I bring to it just the simple fact that I’m a citizen, that I’m a mom and I’m a grandma,” Dean said. “And I want my children, my grandchildren, to remember what we did here.” Mary Clare Jalonick, The Associated Press

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Five key takeaways from Canada's latest COVID-19 projections – Virden Empire Advance

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OTTAWA — The federal government’s latest COVID-19 projections show fast, strong and sustained measures are required to interrupt rapid growth cases and deaths.

Here are five things to know from federal modelling data released Friday:

article continues below

Rising Deaths

The number of deaths related to COVID-19 is steadily rising, reaching more than 17,500 as of Thursday. The latest data show another 2,000 people could die by Jan. 24 as the seven-day average number of deaths nears levels recorded at the peak of the pandemic’s first wave in May.

Rising Cases

Canada could see 10,000 daily infections in a little over a week as outbreaks in Ontario and Quebec drive rapid growth. The data also highlight high numbers in B.C., Alberta, Saskatchewan and Manitoba. The latest seven-day average was 7,900 cases each day across the country.

Rapid Growth

In the longer term, Ottawa says Canada remains on a “rapid growth trajectory.” The data show COVID-19 will continue to surge if Canadians maintain the current number of people they’re in contact with each day. The pandemic would surge faster if people increase their contacts. Outbreaks are forecast to come under control in most locations if people follow public health rules and limit contacts to essential activities.

Outbreaks in Long-term Care

Infections are escalating among high-risk people aged 80 and older. The data show more outbreaks in long-term care homes and retirement residences now than during the first wave. The federal government says the number of active outbreaks is underestimated due to reduced reporting last month, while a modelling chart shows it’s close to 400 countrywide.

Rising Hospitalizations

The number of people in hospital due to COVID-19 has been rising steadily in the five hard-hit provinces. Hospitalizations are highest per capita in Manitoba, followed by Alberta, Saskatchewan, Quebec, Ontario and B.C.

The data came as federal officials revealed deliveries of the Pfizer-BioNTech vaccine have been temporarily reduced due to production delays in Europe.

This report by The Canadian Press was first published Jan. 15, 2021.

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Quebec to wait up to 90 days for 2nd vaccine dose – Winnipeg Free Press

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A man walks past the COVID-19 vaccination site at Maimonides long-term care facility Wednesday, Jan. 13, 2021, in Montreal. THE CANADIAN PRESS/Ryan Remiorz

MONTREAL – Quebec will wait up to 90 days before giving a COVID-19 vaccine booster to people who have received a first shot, Health Minister Christian Dube said Thursday.

That delay goes far beyond the recommendation of vaccine manufacturers Pfizer and Moderna, which propose intervals of 21 and 28 days, respectively, and is more than double the 42-day maximum delay proposed by Canada’s national vaccine advisory committee.

Dube told a news conference that the decision was made in order to vaccinate as many vulnerable people as possible and to reduce the pressure on the health system.

“In our context, this is the best strategy, because we have to contend with (having) very few vaccines, and we’re in a race against the clock,” Dube told a news conference.

He said the province had discussed its decision with vaccine manufacturers and with federal public health officials. The latter, Dube said, acknowledged that the 42-day recommended maximum can be extended depending on the disease’s progression in a particular province.

He said the high rates of community transmission, hospitalizations and deaths in Quebec justified the change. “In Quebec, we don’t have the same situation as in New Brunswick or British Columbia,” he said.

Richard Masse, a senior public health adviser, said the change would allow up to 500,000 seniors who are most at risk of complications — including those in private residences and those aged 80 and up — to receive their vaccine several weeks earlier than originally thought.

Masse said the justification to extend the interval was based on the “experience of working with many vaccines through time,” which shows, he said, that vaccine immunity does not suddenly drop off within a month or two.

He said, however, the province was carefully monitoring the efficacy of the vaccines and would immediately give second doses if authorities saw evidence of decreased immunity in certain groups, such as the elderly.

Health officials, Masse said, were investigating why an unspecified number of elderly nursing home residents who had received their first dose in December had since tested positive for COVID-19.

Two of the facilities where vaccinations took place were experiencing outbreaks before shots were delivered, he said. Masse also noted that the body takes up to 14 days to build immunity against the virus, meaning, he said, that those who had received a shot but who had been exposed before that interval would be less protected.

Some residents, however, had tested positive more than 14 days following their injection. Health officials, Masse said, were trying to find out why. He said possibilities include the vaccine is not perfectly effective, or that it may not work as well in some age groups.

“Ninety three per cent (effective) is not 100 per cent, and it could be lower than that for people who are elderly,” he said.

Both Masse and Dube said the province would work to shorten the interval between first and second doses once the province begins receiving larger quantities of vaccine — likely in March or April, they said.

Meanwhile, Quebec reported Thursday that some regions had few or no doses of COVID-19 vaccine remaining as the vaccination rate outpaced delivery.

As of Thursday morning, the Health Department said the Gaspe region, Iles-de-la-Madeleine, Nord-du-Quebec and the James Bay Cree Nation territories were out or almost out of vaccine, adding that it expected new deliveries Friday or Saturday. Four other regions had almost used up all their doses but received new supplies Tuesday.

Jean Morin, a spokesman for the Gaspe region’s health authority, said the vaccination campaign was going “exceedingly well” despite the fact nearly all the doses had been used. Morin said there are logistical challenges to vaccinating people in the vast and thinly populated region, including having to transport people to clinics to receive their shots.

Dube recognized the federal effort being made to get vaccine to the provinces, but said he wished it would go more quickly because the need is so great. “We recognize the effort but we’re not satisfied, because we have so many people we want to vaccinate,” he said.

The province reported 2,132 new cases of COVID-19 Thursday and 64 more deaths attributed to the novel coronavirus, including 15 that occurred in the previous 24 hours. Quebec has reported a total of 236,827 infections and 8,878 deaths linked to the virus.

The province had administered more than 115,000 doses of vaccine as of Thursday, including nearly 26,000 to long-term care residents.

This report by The Canadian Press was first published Jan. 14, 2021.

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