Vaccine Rollout - State starts out with an 'F' but much improved, Big Island gets B+

[kalianna]

You are correct, Carey. We were sent to the parking lot after our injections, got checked on every few minutes and stayed for fifteen minutes before leaving. Thanks for clarifying. It was ten minutes from entrance to needle. I hope more people volunteer once they are vaccinated. And if people are interested in volunteering whom would they contact?

[TomK]

CareyTom: "no way to print out the online form" I do not know what computer system you use, both my husband (PC) & I (Apple) were able to print, & I have actually seen thousands (yup, sometime I look at almost a thousand in one day!) of folks that have printed theirs.... by far the majority of folks coming into our clinics have printed out their forms...
"extra time I had to stand " EVERY walk-in DOH clinic has had National Guard ready & willing to assist folks with wheelchairs. If you needed assistance, did you ask for it?


The form I filled out was not some PDF form - you answered a question and then went onto the next page. At the end of the process, it said thank you very much, but there was no form to print. It was like answering a questionnaire from a hotel you stayed at asking for your thoughts. I went through the same process again the day before my second appointment and made sure I was careful to answer the questions and see how I could print out the form. There was no option to do so and I'm computer-savvy enough to know how to save a form to disk if I can't print it out, but there was no form to save.

And yes, I asked for help but didn't get any - I was told there was a place to sit before I joined the line, that was the extent of the help I was given. For the second vaccine appointment, I asked HMC for help via their dedicated email address for this, no response. And no, I didn't ask the National Guard member who checked my appointment because I had no idea what I was letting myself into after that. You couldn't see the line from that position.

My guess is that my stuff went through the university which also explains why Hilo staff were given appointments on Oahu. Please, I'm not saying you are wrong, but I am telling you what my experience was. That may not be the same as others experienced, but please understand I'm not given to making things up.

[Carey]

The state runs the DOH clinics & the DOH uses volunteers through the Medical Reserve Corp:
https://health.hawaii.gov/prepare/mrc/

All other clinics, including the HMC clinics TomK went to, are not the state nor the county clinics, but are those run by federal trusted partners with separate agreements with vaccine manufacturers & separate requirements (including computer issues)
AND different ways to volunteer
TomK, as to your form issue, the DOH does not require that prescreening questionnaire to be printed if it has been filled out & is accessible in the online VAMS system (again, computer issues can hamper the best of plans, when you run clinics for hundreds to thousands of participants from hotspot connectivity, there can be issues with online forms not appearing in a national computer system that also has issues, esp on high use weekends.....
I cannot comment at all on the requirements of the HMC clinic you went to, as that is not a part of the state, nor county direct response, but is with a federal trusted partner.

[randomq]

Ages 18 and up can get vaccinated now!*

*If you live in Miloli'i. Includes a free bento lunch and a prize raffle.

https://www.hawaiitribune-herald.com/202...n-vaccine/

[kalakoa]

It's really distressing when the local media floats two versions of the lie on the same day.

https://www.khon2.com/coronavirus/gov-ig...continues/

https://www.hawaiinewsnow.com/2021/04/01...nd-summer/

[kalianna]

I understand the conflicting stories. What is the lie?

[kalakoa]

What is the lie?

The "back to normal" narrative in all its forms.

Example: once enough people are vaccinated, we will achieve "herd immunity", and all the restrictions will be waived. Given the lead time required for government (and especially Hawaii government) to implement a "vaccine passport", will it still be relevant by the time it's available?

Given that the Feds will not be creating a national "vaccine passport" system, how many different systems will I need to register for in order to travel? They're all "free" to use, who pays for that?

Like many people, I'm not even eligible for the vaccine -- maybe solve that problem before talking about a "passport" system to waive quarantine?

[Durian Fiend]

It's really distressing when the local media floats two versions of the lie on the same day.

https://www.khon2.com/coronavirus/gov-ig...continues/

https://www.hawaiinewsnow.com/2021/04/01...nd-summer/

"The governor said, he feels confident he will get the guidance from the CDC to allow those who are fully vaccinated to travel more freely by the end of 2021."

That guidance arrived yesterday.  CDC said go ahead and travel.   Interisland travel for vaccinated individuals should be allowed today with zero restrictions AFAIK.  Well, we keep wearing masks for now, right? This will be required indefinitely.  Bring your little vaccination card to the airport-bon voyage.

[terracore]

[quote='kalakoa' pid='329686' dateline='1617311845']
What is the lie?

The "back to normal" narrative in all its forms.

Example: once enough people are vaccinated, we will achieve "herd immunity", and all the restrictions will be waived. Given the lead time required for government (and especially Hawaii government) to implement a "vaccine passport", will it still be relevant by the time it's available?

Given that the Feds will not be creating a national "vaccine passport" system, how many different systems will I need to register for in order to travel? They're all "free" to use, who pays for that?

Like many people, I'm not even eligible for the vaccine -- maybe solve that problem before talking about a "passport" system to waive quarantine?

------------------------------------------------------

The scary part is that they are already "priming" us for COVID-21.  Look at this:

https://www.route-fifty.com/health-human...er/172960/

Disturbing thing 1)  route-fifty is a publication of govexec.com which for lack of a better description is like the newsletter publisher for the federal government.

2)  "The Atlantic's COVID-19 coverage is supported by a grant from the Chan Zuckerberg Initiative."   

So FACEBOOK is "priming" state, local, and federal governments for "COVID-21" ?

This story was originally published by The Atlantic. Subscribe to the magazine’s newsletters.

Trying to remember March 2020 feels like sticking your head into a parallel universe. This time last year, Americans were just going into lockdown—presumably for two weeks—to protect themselves from a mysterious but deadly virus. We disinfected mail but didn’t wear masks. Few of us knew that COVID-19 symptoms could last for months, that you might lose your sense of smell, or that your toes might break out in purple lesions. The possibility that millions would die was real but incomprehensible.

The pandemic today is almost unrecognizably different. In the United States, an acute, terrifying catastrophe has given way to the monotony of lowered expectations. There are no makeshift morgues in the streets. Businesses are opening despite a thousand American deaths a day. This week, Mayor Bill de Blasio ordered New York City employees back to work, regardless of their vaccination status, while case counts in the city are on a high plateau. The pervasive sense is that we can’t wait forever for the pandemic to end.

When, exactly, will we reach a point that could be considered a finish line? It’s the natural question, but I think it’s a counterproductive one. Not only because, as Anthony Fauci told me recently, the most honest answer is “We just don’t know.” The inability to give a definitive answer is contributing to misperception of risk, conflating better with good enough. It’s also true that much of what defined the COVID-19 crisis at its worst is no longer an issue. Many health-care workers are vaccinated, and the need to “flatten the curve” is in the past. Tests are widely available, and there are better treatments for the disease. Death rates are falling quickly.

The SARS-CoV-2 pandemic may drag on for years, but the nightmare of last year—of an entirely new viral illness, emerging in a specific sociopolitical context—is behind us. Instead we’re facing a new set of challenges, and they are not easily comparable to what has come before. It’s worth considering a new way of thinking about the period of the pandemic now ahead of us—one that leads us neither to complacency nor to paralyzing despair. In many ways COVID-19 is already over. What lies ahead is COVID-21.

Diseases are not static things. Pathogens change, hosts change, and environments change. In the case of COVID, all three are now different than they were in 2020. What began as one coronavirus has infected well over 100 million people and evolved into new forms that appear to transmit more readily and infect us in subtly different ways. Our immune systems have changed as well, as a result of fending off infections. And, of course, our lifestyles have changed, as have social standards, medical systems, and public-health programs.

COVID-21 is the product of all these changes in aggregate. It’s the disease as it will be experienced in the months and years to come: with new variants of the virus, new public policies and health behaviors, various degrees of immune memory, and—most important—a cavalcade of new vaccines.
One-quarter of all Americans have now received at least one shot, and that number is racing up. This month, New Yorkers lined up outside Yankee Stadium throughout the night at a makeshift 24/7 vaccination site, until the supply ran out. “If we open 3,000 appointments, they will immediately fill,” says Ramon Tallaj, a physician who oversees clinical care in underserved communities across New York City. Demand seems to be growing. If there were sufficient supply, Tallaj told me, his team could be giving out 40,000 doses every day. And this should happen soon; the White House says that shortages will end in the coming weeks.
The vaccination effort is sure to change the nature of COVID in unexpected ways. The habitat for the virus is changing: It may still stick in the nasal passages of an immunized person, but it shouldn’t continue on its way into the lungs, much less the toes. The key question is just how long this protection will last, especially against a rapidly mutating virus. Clinical trials have shown the vaccines to be fantastic at preventing serious illness so far, but haven’t yet been able to observe how protection might dissipate over long periods.

Because SARS-CoV-2 hasn’t been infecting humans for much longer than a year, it’s impossible to say exactly how immune responses will play out. The common-cold coronaviruses can reinfect the same person after a year or two. Early research on COVID vaccination shows that people develop high levels of antibodies, but that these begin to decline about a month after the first dose. The CDC’s official position on how long immunity lasts after vaccination is “We don’t know.”
Antibodies are not the whole story, though. Monica Gandhi, an infectious-disease specialist at UC San Francisco, believes that we’ll be well protected by other immune mechanisms, even after antibody levels drop. Her research focuses on how HIV evades and weakens the body’s immune system, particularly the T cells. She reminded me that T cells, and also B cells, store a memory of prior infections, and are generally more important than antibodies for maintaining long-term protection against viruses.

Reassuring evidence has already emerged indicating that these cells can form durable memories of SARS-CoV-2. Recently, a group of researchers biopsied the lymph nodes of vaccinated individuals and found “remarkably” strong B-cell development. In a February Science paper, another team found that the T cells generated in people who have had COVID-19 seem to have similar half-lives to the T cells you get from being vaccinated against yellow fever—and yellow-fever protection usually lasts a lifetime.

Another promising sign comes from those who contracted the original SARS coronavirus in 2003. The T cells of people who were infected at the time reliably recognized the spike protein from the virus in lab experiments 17 years later. Gandhi believes that this memory, while not always as protective as having high levels of neutralizing antibodies in your blood, will likely be sufficient to prevent severe disease. “Do I think that we’ll have lifelong immunity from severe infection?” she said. “I am very heartened that we will.”

If that’s the case, then COVID-21 will eventually be a milder, less deadly version of the illness that we started with last year. “The worst-case scenario is we render it a cold,” Gandhi said. “The best-case is we reach herd immunity and the virus goes almost entirely away.”

But others expect a much worse worst-case scenario, in which immunity to severe disease is only temporary. The biologist and former Harvard professor William Haseltine warns against the rosy view: “It seems to me clear that the T-cell theory isn’t going to hold up,” he told me. Although our memory cells could continue to recognize the virus, that won’t necessarily be enough to give us meaningful protection. The disease might end up being milder the second time around, or after vaccination, but he worries that, as the virus mutates, it also could get worse. As for herd immunity, Haseltine called that a “fantasy.” “The best we’ll get is seasonal herd immunity. We have 60 years of experience with coronaviruses, and they come back every year.”

Even the bad version of COVID-21 would be far different from the depths of COVID-19, though. Millions of cases of severe disease would be prevented with vaccines, but boosters would have to be given out at regular intervals. “The Moderna and Pfizer vaccines are shockingly good mimics of natural infection,” Haseltine told me. “But it’s really important to stress the fact that these vaccines are likely to be temporary protection. A year or maybe two.” That means we’d need a more enduring system of vaccine production and distribution. It will be an enormous challenge to keep the public up-to-date with annual or semiannual injections—and if uptake flags and the virus remains pervasive, even immunized people won’t be 100 percent free from risk.

In the end, Haseltine said, we might hope for a universal vaccine that protects against all strains of SARS-CoV-2, as well as future coronaviruses that might emerge. Early research has shown some promise using nanoparticle immunization technology, which combines fragments of different viruses. Fauci and others have been pursuing a universal influenza vaccine for years, and they are now, at last, seeing some indications of success. A universal coronavirus vaccine should theoretically present fewer obstacles, because the viral structure is more straightforward, and it changes less readily. As the race to develop the current generation of COVID-19 vaccines finishes, the race for a universal vaccine begins.

Between Gandhi’s vision and Haseltine’s is another, quite disturbing, one. Imagine that the vaccines work well, but not indefinitely. The virus continues to spread and mutate. COVID can still have severe, even life-threatening, effects. Vaccination brings rates of serious disease and death down substantially, but not close to zero. And we come to think of this as pretty much okay.

In other words, imagine a world in which the disease persists, and is accepted, as something that is far less deadly than it was last year—more like a bad flu than a common cold. As with influenza, the world might lose hundreds of thousands of people to this illness each year. And yet we would come to see its toll as being within the bounds of acceptable loss. As with diseases like malaria, HIV, influenza, and so many others, enormous effort and resources would go into preventing infections and treating sick people. But the singular global war against the SARS-CoV-2 virus that began in 2020 would fade in intensity. Instead of working toward a post-COVID future, we’d come to see the disease as yet another unfortunate but inevitable feature of the modern world.

This version of COVID-21 would be most dangerous, not because the virus has developed some new, sinister mutation, and not because our vaccines turn out to be inadequate. The risk instead would come from the way that it’s normalized. As the bioethicist Jackie Scully wrote in 2004, diseases morph “partly as a result of increasing expectations of health [and] partly due to changes in diagnostic ability, but mostly for a mixture of social and economic reasons.” They change with how we perceive them, and react to them.
We are at an inflection point that will change the reality of this disease. The most insidious future is one in which we fail to change our moral benchmarks, and end up measuring the danger of COVID-21 by the standards of 2020. If wealthy countries with early access to vaccines abandon continued, global coronavirus-vaccination efforts as their cases fall or when the disease becomes milder for them, a still-severe disease could haunt the world indefinitely—and lead to rebounds everywhere.

Avoiding this myopia is the central challenge of COVID-21. It extends to the systemic problems highlighted by this pandemic. Much of the damage the virus has wrought has come indirectly, by exacerbating food and housing insecurity, for example, or restricting access to medical care. The Biden administration has elevated science and begun to focus on comprehensive approaches to prevention. No longer is federal leadership hawking hydroxychloroquine, suggesting injections with “disinfectant,” or stoking xenophobic sentiment. But this sudden sense of order is a beginning, not an end.

Last year’s sense of terror and panic belongs behind us. This is the phase of the pandemic when we can move from haphazard emergency plans to concerted measures to eradicate a life-threatening illness. Despite lingering unknowns about exactly how long immunity will last and how many cases we’ll continue to see, we now have the knowledge and resources to become much more certain very quickly. If we beat COVID-21, the numbering could end there.

The Atlantic's COVID-19 coverage is supported by a grant from the Chan Zuckerberg Initiative.

[kalakoa]

The scary part is that they are already "priming" us for COVID-21.

If we refuse to change the conditions that foster these viruses, we will continue to see new mutations, probably every year or two -- just like the annual flu shot. Yet we're all pretending that this is an isolated event, and that everything can just go "back to normal".

Vaccine passports now prohibited in Florida. This will be fun to watch.

https://www.wtxl.com/news/local-news/gov...-passports