Covid vaccination status for CF members

[endlesspursuit]

Originally Posted by AK_sailor

Yes, it turns out that the doses allocated for the Native community were not counted against those allocated based on total population. Apparently, this was done at the national level. Given the generally poor level of planning by the Trump administration for distribution of the vaccine, I strongly suspect this was a simple oversight. In any case, it certainly helped Alaska. Also, the Alaska doses have been supplied on a monthly basis (rather than weekly in the rest of the country) which made it somewhat easier for the state to more efficiently run the vaccination program. While there were certainly some problems early on, overall the vaccination program seems be going relatively smoothly as compared to the rest of the country (admittedly a rather low bar).

Actually, there has been a very concerted effort to vaccinate in the bush communities. This is under the Alaska Native Tribal Health Consortium, and has been much more than just a token effort. Covid19 is a very serious issue in the bush. While isolation helps, once it gets into a village it can spread extremely quickly. Besides the native communities, there have been very bad outbreaks at other places in the bush. For example, at a remote Trident Sea Foods plant in Akutan, about half of the 700 employees have tested positive, with one death and several evacuated to Anchorage for treatment.

The problem in rural Alaska is twofold. First, people live in very close proximity, spending much time indoors in small often poorly ventilated structures. Or, like at the Trident plant, large numbers live in bunk houses. Once covid19 arrives, it can spread like wildfire. Secondly, there is little or no infrastructure to care for those who become severely ill. Whether Native or not, when someone needs hospitalization, they get flown (weather permitting) to Anchorage. There is a real risk that a severe bush outbreak of covid19 could quickly overwhelm hospitals in Anchorage. For Alaska the next stop up the health care chain is Seattle, 1500 miles away. And of course Seattle has plenty of their own cases to deal with. At one point in December we were very close to having every available ICU bed in the state filled. Things have abated somewhat, but that risk is still very real.

The bottom line is that on the one hand, Alaska is doing very well at reducing our case count, and at getting people vaccinated. However, due to climate, terrain, lack of infrastructure, and geography, the risk of a catastrophic outbreak is very real.

Maybe that was Trumps plan to send more your way because of the logistics. Plus he knew what would happen as you stated earlier. Here in Florida we are approaching 3 million vaccinated so we would have done Alaska 4 times over already.

[AK_sailor]

Originally Posted by Bill Seal

,
To put things into perspective, the population of Alaska is 700,000, New Zealand is 5,000,000, and Los Angeles COUNTY is 10,000,000.
That number for Alaska seem way too low, but that's what Google says.

In 2019 the population of Alaska was estimated to be about 731,545. About 40% live in the Anchorage area, and about 10% in the Fairbanks and Juneau areas. The remaining roughly half of the population is spread over a land area more than twice the size of Texas. Most of that area is not on the road network, and is accessible only by air or water.

A map of Alaska superimposed on the 48 states gives a sense of scale. We do have some unique issues due to geography, compared to the rest of the US.

[valhalla360]

Originally Posted by AK_sailor

Yes, it turns out that the doses allocated for the Native community were not counted against those allocated based on total population. Apparently, this was done at the national level. Given the generally poor level of planning by the Trump administration for distribution of the vaccine, I strongly suspect this was a simple oversight. In any case, it certainly helped Alaska. Also, the Alaska doses have been supplied on a monthly basis (rather than weekly in the rest of the country) which made it somewhat easier for the state to more efficiently run the vaccination program. While there were certainly some problems early on, overall the vaccination program seems be going relatively smoothly as compared to the rest of the country (admittedly a rather low bar).

Actually, there has been a very concerted effort to vaccinate in the bush communities. This is under the Alaska Native Tribal Health Consortium, and has been much more than just a token effort. Covid19 is a very serious issue in the bush. While isolation helps, once it gets into a village it can spread extremely quickly. Besides the native communities, there have been very bad outbreaks at other places in the bush. For example, at a remote Trident Sea Foods plant in Akutan, about half of the 700 employees have tested positive, with one death and several evacuated to Anchorage for treatment.

The problem in rural Alaska is twofold. First, people live in very close proximity, spending much time indoors in small often poorly ventilated structures. Or, like at the Trident plant, large numbers live in bunk houses. Once covid19 arrives, it can spread like wildfire. Secondly, there is little or no infrastructure to care for those who become severely ill. Whether Native or not, when someone needs hospitalization, they get flown (weather permitting) to Anchorage. There is a real risk that a severe bush outbreak of covid19 could quickly overwhelm hospitals in Anchorage. For Alaska the next stop up the health care chain is Seattle, 1500 miles away. And of course Seattle has plenty of their own cases to deal with. At one point in December we were very close to having every available ICU bed in the state filled. Things have abated somewhat, but that risk is still very real.

The bottom line is that on the one hand, Alaska is doing very well at reducing our case count, and at getting people vaccinated. However, due to climate, terrain, lack of infrastructure, and geography, the risk of a catastrophic outbreak is very real.

Yes, if it gets to an isolated community, it's bad but again 1 anecdotal story about 350 cases and 1 death doesn't tell us much about the statewide situation. If 99% of isolated communities are kept isolated, they are still better off in the big picture.

Again, I would be curious how many doses per captia wound up in the major population centers vs isolated communities. I'd be willing to bet the population centers have a much higher per captia up take.

Ironically, while Alaska has the highest per capita injections, they have used the worst percentage of the doses received that have made it into arms.

A lot of this is likely similar to Israel where they have enough that they don't have to get picky about who gets an injection. It's a lot easier to get a lot of shots in arms when you don't have to vet the population who wants it.

Really, given the limited supply, the USA has done pretty well. Only the UK is even in the same ballpark for a major country in terms of distribution.

[Montanan]

Originally Posted by valhalla360

Fun anecdotes but if you read between the lines, Alaska has received a much higher number of doses relative to population. In addition to the regular population based supply, they received separate amounts for indigenous populations and for veterans...both of which make up a larger percentage of the population compared to most states. This removed a lot of the concern about running out that limited other states early on.

I would also be curious to see the distribution pattern. The bulk of the population is still pretty concentrated in a few relatively small areas. While they have to at least show that they are sending doses out to rural areas, I'm betting a disproportionate share are going to the urban areas and that's not a bad thing. An isolated community of 50 people with no one coming or going, is at little risk. It's the major population centers where spread is likely.

All the above and lest we not forget, what with it being REALLY cold in Alaska the entire logistics challenge of needing to contend with cold storage of the vaccines is mitigated. The challenge for Alaska is they can't have outdoor vaccination locations because the vaccines would be frozen in the syringe and bottles.

Here in Montana we haven't been receiving "extra" allotments from the Federal government allocation of the vaccines even though the State has placed the substantial native tribal population amongst the second highest category of persons; seconded only to elderly persons living in assisted living facilities and all the first line healthcare workers. I live on the Flathead Reservation and the tribal health clinics are doing a good job of getting the word out and especially of innoculating their cherished elders. The County health department working in conjunction with two local hospitals is focussing on the larger non-native population here on the Rez.

[Montanan]

This bit of news regarding the enhanced problems that a virus variant can derived is evidence of why strict border closures are a viable protocol.

There are very few truly essential purposes for travel during a pandemic, wherein "essential" is defined solely on the benefit versus risk analysis of the country to which the traveller is desiring or in need of entry. An example, might be where the person is the only person in the world that could build or repair a machine needed to make the vaccine.

And said entry can be devised with very strict protocols of isolated quarantine for those select instances of allowing for cross border travel. Such as extended monitored stays where one is alone in a dedicated lodging facility with zero contact with anyone else, i.e., placed in a room and the door locked shut from the outside, except for delivery of food and medicines.

UK Covid variant rapidly spreading in US and doubling every 10 days, study says
"A highly transmissible variant that was first detected in the United Kingdom has now rapidly spread through the United States and doubles about every 10 days, . . .

"The report released on Sunday, which has not been peer reviewed or published in a journal, came from preprint server MedRxiv and it predicted that the UK variant, officially known as B.1.1.7, could become the most dominant Covid-19 variant in the US by next month."

This variant likely entered the country as early as November [2020]. . . .

Besides the variant strain doubling every week and a half within the country, researchers also estimated in the report that it was 35 to 40 per cent more transmissible than any other strain that's previously appeared in the US. Last month, the Centres for Disease Control and Prevention (CDC) model predicted the UK strain could overtake all other strains in the US by March and that it was 50 per cent more transmissible. This latest study has reaffirmed that prediction."

https://www.yahoo.com/news/uk-covid-...162847002.html

[Bill Seal]

Here in LA County, the health dept. is opening up more massive injection sites
UNFORTUNATELY, there ain't no vaccine available.
But, it makes great press.

[AK_sailor]

Originally Posted by valhalla360

Yes, if it gets to an isolated community, it's bad but again 1 anecdotal story about 350 cases and 1 death doesn't tell us much about the statewide situation. If 99% of isolated communities are kept isolated, they are still better off in the big picture.

I gave you one anecdote to illustrate the issues. There are quite a few other similar stories, but I don't have the time or inclination to research them for you. The basic problem is that there is no practical way to keep 99% of bush communities isolated long term. Most travel to the bush was shut down early on, and that did help us dodge a big bullet in the initial outbreak. However, you can only maintain that travel ban for a limited time. Supplies and people still need to fly in and out of bush communities. Locals travel between communities by snow machine. Coastal communities see a constant traffic in fishing boats, many of which are based outside the state. Travel bans can slow the spread, but the virus will eventually get there, and once it gets loose in a bush community it spreads fast.

Originally Posted by valhalla360

Again, I would be curious how many doses per captia wound up in the major population centers vs isolated communities. I'd be willing to bet the population centers have a much higher per captia up take.

Take a look at the State of Alaska Vaccine Monitoring Dashboard. On the two bar graphs on the left, you can select by race, and you will note that a very substantial portion of those vaccinated have been Alaska Native or American Indian.

On that same dashboard, look at the vaccine numbers on the right side of the page. Regarding the % of doses used, as I type this Alaska has been allocated 174,400 doses (119,100 direct to the state, and 55,300 through the Indian Health Service). Of those allocated, 152,871 have been administered. That is about 87%. In the upper right corner is a pull down menu where you can select by region. There you can compare doses administered in Anchorage, Juneau, and Fairbanks, with the other mostly rural regions of the state. If you look at those numbers in detail, and compare them with the relative population of those areas, you will see that it definitely has been a statewide vaccination effort. The numbers indicate you've lost your per capital bet.

Also, keep in mind that Alaska receives its doses on a monthly basis. So there is an inevitable time lag between the time doses are allocated and when they arrive in state, and a further lag to get them into peoples arms. We could always be doing better, but we aren't doing too bad under the circumstances.

[AK_sailor]

Originally Posted by valhalla360

Yes, if it gets to an isolated community, it's bad but again 1 anecdotal story about 350 cases and 1 death doesn't tell us much about the statewide situation. If 99% of isolated communities are kept isolated, they are still better off in the big picture.

It won't let me edit last comment, so I'll add one last item. Regarding the question of where covid19 is in Alaska, bush vs urban, take a look at Alaska Coronavirus Map and Case Count . If you click on "By County" you can compare numbers for the different regions of the state. (We don't actually have counties in Alaska, so it is by Borough or Census Area.) You will note that the Bethel Census Area (which is pretty Effing rural) has more that twice the cases per capita than does Anchorage. Several other of the the very remote areas also greatly exceed the rate in Anchorage. The Aleutian West Census area, which is about as isolated as one can get in North America, has a rate nearly as high as Anchorage.

Unfortunately, the "99% of isolated communties" you keep referring to don't seem to have been isolated enough to keep covid19 out.

[Montanan]

Pfizer hopes to cut vaccine manufacturing time by almost half

By ramping up production and being more efficient, the company expects to reduce the time it takes to produce a batch of vaccine from 110 days to around 60. "Just in the last month, we’ve doubled output,” Chaz Calitri, who runs the company’s main manufacturing plant in Kalamazoo, Michigan

[Montanan]

Supply is severely constrained, making is very difficult to obtain an appointment and the appointments are scheduled for less than 24 to 48 hours from online sign up. Those without online capabilities or awareness, which is many of the elderly have grave difficulty in learning how to sign up and actually getting signed up.

By way of example, at Missoula County the second largest in the State of Montana with a population of 120,000, this week's COVID-19 vaccine dose clinics will take place Tuesday and Wednesday, with online appointment scheduling starting Monday at 4 p.m..

The clinics will dispense only 200 doses per day for the two days only. Total of only 400 for the week.

Appointments are only available to Missoula County residents who qualify for Tier 1 of Phase 1B - Those 70 and older, American Indians aged 16 and older, and people of color aged 16 and older.

Phase 1A patients are also eligible, consisting of the remaining unvaccinated residents of assisted living centers, their staff and all front line healthcare workers.

At this rate, it will be a long time before this pandemic is resolved.

[sail sfbay]

Originally Posted by barnakiel

.............In Spain, whether you have been vaccined or not, when you come from high-risk countries, you still go into a quarantine. And you still have to wear the 'stupid mask'. In other words, the vaccine changes nothing to the vaccinated one (from the point of view of travel formalities).

Just be happy you got vaccinated......as I can give up travel to know we are protected from Covid symptons. My wife (70) and I (1 month shprt of 70) are still waitning in California for our 1st and 2nd vacinnations, just scheduled for February 11 and March 4, respectively, in San Francisco for 65+ with a backup scheduled for Feb 24 and March 24, respectivly, our 55+ community for 65+.

[sail sfbay]

Originally Posted by barnakiel

.............In Spain, whether you have been vaccined or not, when you come from high-risk countries, you still go into a quarantine. And you still have to wear the 'stupid mask'. In other words, the vaccine changes nothing to the vaccinated one (from the point of view of travel formalities).

Just be happy you got vaccinated......as I can give up travel to know we are protected from Covid symptons. My wife (70) and I (1 month short of 70) are still waitning in California for our 1st and 2nd vacinnations, just scheduled for February 11 and March 4, respectively, in San Francisco for 65+ with a backup scheduled for Feb 24 and March 24, respectivly, our 55+ community for 65+.

[aquadreams]

For folks in the US, here is the current (updated daily) Covid vaccination eligibility criteria in each US state.



https://www.walgreens.com/images/ada...y_Criteria.pdf.



I'm not eligible yet so will have to wait my turn. Not really a problem as I can't travel internationally most places for a boat purchase yet either :-)

[GordMay]

Originally Posted by barnakiel

The vaccine "does has not been proven prevent getting infected, it only lessens the effects." And "after vaccination, you will have to follow all the rules the same as applied to non-vaccinated people"...

There are some indications, that some of the vaccines, may offer some sterilizing immunity.


There are two main types of immunity. you can achieve with vaccines.
One is so-called "effective" immunity, which can prevent a pathogen from causing serious disease, but can't stop it from entering the body or making more copies of itself.
The other is "sterilising immunity", which can thwart infections entirely, and even prevent asymptomatic cases.

Asymptomatically infected people typically produce virus at lower levels. Though there is not a perfect relationship, usually more virus equals more disease.[1] Therefore, vaccinated people are less likely to transmit enough virus to cause severe disease. This in turn means that the people getting infected in this situation are going to transmit less virus to the next susceptible person. This has been neatly shown experimentally using a vaccine targeting a different virus in chickens [2]; when only part of a flock was vaccinated, unvaccinated birds still showed milder disease, and produced less virus.Wwhile sterilising immunity is often the ultimate goal of vaccine design, it is rarely achieved.
Fortunately, this hasn’t stopped many different vaccines from substantially reducing the number of cases of virus infections, in the past. By reducing disease levels in individuals, this also reduces virus spread through populations, and this will hopefully bring the current pandemic under control.
For example, vaccines targeting rotavirus, a common cause of diarrhoea in infants, are only capable of preventing severe disease (effective immunity). But this has still proven invaluable, in controlling the virus. In the US, there has been almost 90% fewer cases of rotavirus-associated hospital visits, since the vaccine was introduced in 2006.
A similar situation occurs with the current poliovirus vaccines, yet there is hope this virus could be eradicated globally. It is also reassuring to note, that seasonal flu vaccines, despite being unable to induce sterilising immunity, are still extremely valuable at controlling the virus.

[1] “SARS-CoV-2 viral load is associated with increased disease severity and mortality” ~ by Jesse Fajnzylber et al
➥ https://www.nature.com/articles/s41467-020-19057-5

[2] “Pathogen transmission from vaccinated hosts can cause dose-dependent reduction in virulence” ~ by Richard I. Bailey et al
➥ https://journals.plos.org/plosbiolog...l.pbio.3000619

[valhalla360]

Originally Posted by AK_sailor

It won't let me edit last comment, so I'll add one last item. Regarding the question of where covid19 is in Alaska, bush vs urban, take a look at Alaska Coronavirus Map and Case Count . If you click on "By County" you can compare numbers for the different regions of the state. (We don't actually have counties in Alaska, so it is by Borough or Census Area.) You will note that the Bethel Census Area (which is pretty Effing rural) has more that twice the cases per capita than does Anchorage. Several other of the the very remote areas also greatly exceed the rate in Anchorage. The Aleutian West Census area, which is about as isolated as one can get in North America, has a rate nearly as high as Anchorage.

Unfortunately, the "99% of isolated communties" you keep referring to don't seem to have been isolated enough to keep covid19 out.

Playing around on the Alaska dashboard, it looks like around 85% of the vaccinations are in the urban area (including areas more accessible by road). Saying urban vs rural in Alaska is a little misleading.

This makes sense. Even for the truly remote communities, if you can break the spread in the urban areas, that should largely stop the introduction in most rural areas.