Coronavirus Briefing: What Happened Today
Excruciating choices for Alaska’s doctors
Alaska is currently home to the worst Covid-19 outbreak in the country and there are doctors there given the nightmare scenario of rationing care.
Emergency rooms across the country are overloaded, test supplies have run out, patients are treated in hallways, and doctors are rationing oxygen.
While many countries have adopted guidelines for crisis preparedness, only a few have officially implemented them. Alaska did this. On Saturday, the state announced that it had activated crisis standards for 20 health facilities in large and small cities.
“I never thought I’d see that,” said Dr. Steven Floerchinger, a doctor at Alaska’s largest hospital. “We are so heavily taxed that we decide who will live and who will not.”
In one case, another ICU bed was available at his Anchorage hospital, but several Covid-19 patients in line. And there was someone from one of the remote rural communities in the state who had to be flown in for emergency surgery.
Medical staff have a better chance of saving a patient in the emergency room, said Dr. Flörchinger and his colleagues as the country patient. Then the rural patient died.
“Alaska is going through a really bad situation right now,” said Mike Baker, our colleague who spoke to doctors across Alaska. “It’s insulated in a unique way so that hospitals that are overwhelmed don’t have simple relief valves.”
Overloaded hospitals in the lower 48 states have more flexibility in moving patients, Mike said. But in Anchorage, the closest aid is in Seattle, 2,500 miles away.
“When you have someone in Alaska who needs intensive care, you will almost always end up in Anchorage,” said Mike. “With the Anchorage hospitals running out of space, more patients are staying in their home communities even though they would otherwise receive a higher level of care.”
Gov. Mike Dunleavy, a Republican, has also opposed restrictions such as a nationwide mask mandate to contain the virus. In Anchorage, our colleague Mike Baker went to a city council meeting on a proposed mask mandate and saw angry protesters attacking doctors in between who had come to share their experiences and convey the dire situation.
“It was really staggering to see just this huge gap between what is going on in the hospitals and what is going on outside the hospitals,” said Mike.
This spring, Alaska became the first state to open vaccinations to everyone over the age of 16, and a legion of planes, ferries, and sleds brought cans to distant communities. Still, only about half of the state’s residents are fully vaccinated.
Positive trends in India
After a brutal second wave this spring, India is now reporting its lowest case and death rates in about six months. While the country’s virus statistics have been dramatically underestimated throughout the pandemic, the new numbers suggest a positive trend. To understand more, we spoke to our colleague Mujib Mashal, who is responsible for South Asia.
Why have cases and deaths decreased?
Two things. The first is that the virus ran a remarkably efficient run for the first few waves. The Indian government did some studies that showed that two-thirds of the population had antibodies. The sample sizes were small and some have questioned the survey, but while the evidence is inconclusive, that’s a clue backed up by what experts say that the official numbers under-counted the infections. If you take the results of the government survey at face value, the first and second waves reduced the population at risk of infection. Coupled with a fairly impressive surge in vaccinations from a deeply misguided start – they have given around 900 million doses to date – this has resulted in a downward trend in daily cases.
The state of vaccine mandates in the United States
- Vaccination rules. On August 23, the FDA granted Pfizer-BioNTech’s coronavirus vaccine full approval for people aged 16 and over, paving the way for mandates in both the public and private sectors. Such mandates are legally permissible and have been confirmed in legal challenges.
- College and Universities. More than 400 colleges and universities require a vaccination against Covid-19. Almost all of them are in states that voted for President Biden.
- Schools. California became the first state to enact a vaccine mandate for all educators and announced plans to add the Covid-19 vaccine as a requirement for school attendance, which could begin as early as next fall. Los Angeles already has a public school vaccination mandate for students 12 and older, beginning November 21. New York City’s mandate for teachers and staff, which went into effect October 4th after delays due to legal challenges, appears to have spurred thousands of last-minute recordings.
- Hospitals and medical centers. Many hospitals and major health systems require their employees to be vaccinated. Health worker mandates in California and New York state appear to have forced thousands of objecters to be injected.
- New York City. Evidence of vaccination from workers and customers is required for indoor dining, gyms, performances, and other indoor situations. City education staff and hospital staff also need to be vaccinated.
- At the federal level. On the 9th of September President Biden announced a vaccination mandate for the vast majority of federal employees. This mandate applies to employees of the executive branch, including the White House and all federal agencies and members of the armed forces.
- In the private sector. Mr Biden has ordered that all companies with more than 100 employees mandate vaccinations or weekly tests to drive new company vaccination policies. Some companies, such as United Airlines and Tyson Foods, had mandates prior to Mr. Biden’s announcement.
How do Indians feel?
The mood and mentality are still marked by caution. The second wave was ridiculously bad. It was like the worst India had seen in a long time – they ran out of oxygen, people died in parking lots, people died on the street. When things opened up there was fear of a third wave. But because people have accepted the vaccination decently and the number of cases has not returned, there is less and less talk of a third wave, at least in metropolitan areas like Delhi.
But the government’s message is still caution. There are still warnings about festivals, for example with the words: “Listen, we may feel like we have come around the corner, but do you remember how bad things went in the second wave?”
What are the possible pitfalls in front of you?
When I look ahead, I think there are the two concerns. Look out for new variants and study the changing nature of the virus, which was not seen as closely before the second wave. The second is political complacency. India is a land of festivals and politics. Diwali is in November and there are some big elections coming up, and that election is being pushed with big campaigns and rallies. So looking to the future, the apprehension is how much the festival season and campaign season will add to creating another wave of cases as they were certainly a factor in the second wave.
What else are we pursuing
What you are doing
Life is slowly returning to a certain “normal”. For the first time since the pandemic started, getting back to the office is no longer scary. Seeing colleagues face-to-face and having meaningful conversations reminded me of how remote work has robbed us of those connections and the value of those interactions. The past weekend while hiking and eating in the Magaliesburg with family reminded me of precious freedoms from a long-forgotten past. I’ve been stabbed twice since the beginning of September, after months of deliberation and prayer. Slowly but surely I am starting to dream again and to plan ahead, for myself and my children – without constantly having the feeling that my plans will never come true. I am hopefull.
– Veronica, South Africa
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