By Sunita Sohrabji
The United States is weeks away from rolling out Covid vaccines, but pandemic experts say the challenges of vaccinating people will be acute, especially in communities of color.
“Vaccines don’t save lives: vaccinations do,” said Dr. Ashish Jha, dean of the Brown University School of Public Health, speaking at a Nov. 13 briefing organized by Ethnic Media Services and moderated by Dr. Tung Nguyen, professor of medicine at UC San Francisco.
“There’s a huge challenge from a supply chain perspective to getting the vaccines out,” said Jha, noting that the vaccines will have to be stored and delivered frozen. More challenging is “vaccine hesitancy,” especially in communities of color, which have been hit hardest by the pandemic, he said.
Jha predicted 100,000 more deaths from Covid in the United States before the new Biden-Harris administration is inaugurated on Jan. 20, 2021. “We are in the worst moment of the pandemic right now.”
Dr. Nirav Shah, adjunct professor of medicine in the Division of Primary Care and Population Health at Stanford University, stated: “We need to do this in a more structured and standardized way as opposed to the thousand points of light approach where every state, every city is doing something on their own. Simple coordination, using evidence-based approaches, will make a big difference here.”
Dr. William Schaffner, professor of medicine in the Division of Infectious Diseases at Vanderbilt University, agreed that vaccine delivery would pose enormous challenges. “This is not a vaccine that will be available at the local pharmacy or in a physician’s office,” he said.
Schaffner also noted that the vaccine is reactive: people taking it might experience a sore arm, fever or headaches. Nguyen warned that such side effects could increase people’s distrust of the vaccine and deter them from getting the shot.
Skepticism of the vaccine is strong in the African American community and other ethnic communities, said Schaffner. “So we’re going to have to do everything we can to reach out and provide information and also provide reassurance,” he said, noting that much of the work will have to be done through churches or by prominent leaders in ethnic communities.
Pfizer and Germany-based BioNTech announced on Nov. 9 that they had jointly developed a vaccine with an efficacy rate of 90%. The study enrolled 43,538 participants, with 42% coming from diverse backgrounds. The companies have submitted an application for emergency use authorization to the U.S. Food and Drug Administration (FDA). The application is expected to be approved by the end of November.
Concurrently, Moderna announced the results of its trial on Nov. 16 with an efficacy rate of 94%. Approximately 37% of the participants in the Moderna trial were people of color.
Jha noted that a 90% efficacy rate for the Pfizer vaccine was astounding. “I was speaking at a conference and saying that we will be lucky if the vaccine is 60% to 70% effective. A 90% efficacy was not what I was expecting, and am I happy to be wrong on that,” he said.
“We’re not just testing it in 18- to 30-year-old White men and women, but in fact we’re testing it in a broad swath of America,” said Jha, noting that the Moderna trial was delayed as the company tried to diversify its testing recruits.
Shah said the news from Pfizer, which indicated efficacy of the vaccine with just two doses, was an enormous step in the right direction. But once the vaccine is approved by the FDA with emergency use authorization, it is unlikely that most people will be able to get vaccinated right away. A maximum of 10 million–20 million doses will be available by the end of the year, he said.
“There will be a ramp-up after that, but it is going to be some time before we get the kind of widespread availability of multiple vaccines with secure supply chains that get everyone the two doses,” said Shah.
Schaffner said treatment for people infected with Covid is getting better. “We’re doing a better job of getting people out of the Intensive Care Unit and out of the hospital; we are lowering the fatality rate.”
He also spoke about the use of the antiviral medication Remdesivir, which was approved in October by the FDA, and dexamethasone, a steroid that helps control the inflammatory response during the second half of the infection.
Monoclonal antibodies also received emergency use authorization on Nov. 9, but Schaffner said the intravenous treatment poses a challenge as to who should get those and at what stage of the infection.
All four physicians agreed that a coordinated effort by the incoming administration—as opposed to the current patchwork quilt of efforts—would help the United States get the pandemic under control. Jha said he was astounded that some states have closed their schools but opened their casinos.
He noted that the President-elect has no formal powers yet but can use his soft powers to go out to red states and let people know why wearing a mask is effective.
Nguyen said the Biden administration must impose a national mandatory mask mandate. “If we all had worn masks in the last seven months, we would have 100,000 less deaths,” he stated.
“We do not have a silver bullet,” said Shah. “Testing alone won’t work. Contact tracing alone won’t work. Physical distancing alone won’t work. Wearing masks alone won’t work.”
“But all of these together will collectively bring us to where we need to be, so that we actually see cases go down,” he said.
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Sunita Sohrabji is a contributing editor of Ethnic Media Services.
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Update: Covid-19 Cases Surge
Many challenge orders to stay home and safe as video shows
By Community Alliance Staff
To help combat an ongoing increase in coronavirus cases across California, Governor Gavin Newsom announced on Dec. 3 new stay-at-home orders that will affect most California counties, including Fresno.
The measure would be triggered when hospitals dip down to 15% or less of capacity in their intensive-care units. When that happens, some services will face a closure of at least three weeks—including hair salons—and retailers will be limited to 20% capacity for indoor operations while restaurants will go back to provide takeout and delivery services only. Also, nonessential travel statewide will be restricted.
In California, hospitalizations have increased by 86% over the past 15 days, and the number of deaths per day has also climbed, getting close to 20,000 victims as of Dec. 3. Nationwide, almost 15 millions cases were reported, as well as more than 282,000 deaths by Dec. 7.
The surge of Covid-19 infections is already putting a pinch on the capacity of intensive-care units to care for patients.
This new and dramatic surge of the pandemic is in part due to traveling during Thanksgiving and, most of all, due to the refusal to follow protective protocols by parts of the population.
These people even organize protests against stay-at-home orders, the anti-Covid 19 future vaccine and basic measures aiming to reduce the spread of the virus.
What do these people really think? What is their rationale? Why don’t they care about their health and the others’?
To find out, Ismael “smiley” Calderon covered a protest by a group of President Trump supporters—those who claim the pandemic is a “hoax” despite the high number of people affected. The protest took place on Nov. 21 at the corner of Shaw and Blackstone avenues in Fresno. Protestors were unmasked and without observing social distancing.
