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ER Doctor Says He Walks Into A War Zone Every Day – NPR

https://www.npr.org/sections/coronavirus-live-updates/2020/12/17/946910354/er-doctor-says-he-walks-into-a-war-zone-every-day

ER Doctor Says He Walks Into A War Zone Every Day - NPR
ER Doctor Says He Walks Into A War Zone Every Day - NPR

Cleavon Gilman, an emergency room physician and former combat medic, says he has had three colleagues die from the coronavirus. “You can actually die at your job now, and that’s never really been an issue before,” he says.

Cleavon Gilman


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Cleavon Gilman

ER Doctor Says He Walks Into A War Zone Every Day - NPR

Cleavon Gilman, an emergency room physician and former combat medic, says he has had three colleagues die from the coronavirus. “You can actually die at your job now, and that’s never really been an issue before,” he says.

Cleavon Gilman

Emergency room physician Cleavon Gilman compares working in a hospital amid the pandemic to war.

“You can actually die at your job now, and that’s never really been an issue before,” he says.

He has the experience to make the comparison: Gilman served as a combat medic in the Iraq War.

“Health care providers are walking into a war zone every day where we can be killed by this virus, and even serve as a Trojan horse to bring it home to our family and to kill our loved ones,” Gilman tells Rachel Martin on Morning Edition. “The amount of emotional strain our health care providers are under right now is just unimaginable.”

The pandemic has created multiple crises for health care workers.

Hospitals are stretched thin — in beds, but more so in staffing. In Yuma, Ariz., where Gilman works, about half of the county’s hospital beds are occupied by COVID-19 patients. That level is a “nightmare” scenario for staff, as one health researcher recently described it.

Then health workers have to worry about getting sick with COVID-19 themselves. More than 1,400 health care workers have already died, according to one count by The Guardian and Kaiser Health News.

And there’s also mental health strain. Researchers expect many of those working now to be at enhanced risk of developing post-traumatic stress disorder. Physicians are already at higher-than-average risk of suicide, with one analysis putting the number at about 300 to 400 dying by suicide per year in the U.S., or about one per day.

Gilman has spent months writing about the virus and the strains it has caused for frontline workers, but he gained widespread attention last month after tweeting that there were no longer enough ICU beds at Yuma Regional Medical Center.

Gilman says he was let go because of the tweet, but the hospital later called it “a misunderstanding.” On Monday, he was back at work, or “back on the battlefield,” as he tells NPR in an interview about the challenges that he and other health care providers have been dealing with throughout the crisis. Here are excerpts.

Interview Highlights


How have you been doing?

This pandemic has been very personal. I’ve had three colleagues who have died from this. Two nurses, as well as my mentor, Lorna Breen, who got COVID in New York, and she took her own life. I think that this has just been extremely hard. I’ve also lost a cousin as well who was 27 years old, Simon Press. One thing I’ve kind of taken for granted is the toll that this has also taken on my family as well. We’ve been isolated, quarantining for 10 months. And this has really been very hard on my fiancée, who I’ve taken from New York and I’ve brought to a small community here.

Can you talk a little bit about the stigma of mental health and what it means for health professionals?

There’s this false image that we are supposed to be perfect and that things can’t really affect us.

I think even prior to this, I believe that one physician that committed suicide per day and that was twice the national average. It’s a very hard job to be an E.R. doctor. You know, at baseline, we work under a lot of stress. Lives are in our hands. And we have to make split second decisions that will affect an outcome of a person.

And enter the pandemic where upwards of 3,000 people are dying per day or 2,500 people are dying per day. That is unprecedented. And physicians and health care workers are not really trained for that amount of grief, amount of trauma.

One of the problems is if we say something about that, when you actually apply for a job, there’s actually a questionnaire that you have to put psychiatric history on. So people are reluctant to have that follow them throughout their medical career.

When I was a resident in New York, three doctors committed suicide — actually four — over my four years there. And so this is a very prevalent problem and it needs to be addressed. One of the things that’s occurring now is this Lorna Breen Act … to create more mental health programs and well-being programs.

What was it like to watch the first health care workers get vaccinated this week?

It’s really amazing because we’ve been waiting for this so long. And it’s really important to get health care workers vaccinated because we are a limited resource. I’m really excited to get vaccinated here, it’s supposed to happen on December 20th. …

I’ve been doing this since March, for 10 months. God bless that I have not been sick. I’ve been very lucky.

The audio for this story was produced and edited by Nina Kravinsky and Kelley Dickens.

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Pennsylvania State Troopers Association voices frustration that troopers haven’t been prioritized for vaccination – WGAL Susquehanna Valley Pa.

https://www.wgal.com/article/pennsylvania-state-troopers-association-voices-frustration-that-troopers-havent-been-prioritized-for-vaccination/35716401

Pennsylvania State Troopers Association voices frustration that troopers haven’t been prioritized for vaccination - WGAL Susquehanna Valley Pa.

ACROSS THE COMMONWEALTH. IN HARRISBURG, TOM LEHMAN, WGAL NEWS 8 DANIELLE: THE PENNSYLVANIA STATE TROOPERS ASSOCIATION, OR PSTA, VOICED ITS FRUSTRATION AFTER THE WOLF ADMINISTRATION REFUSED TO PRIORITIZE THE COVID VACCINE FOR TROOPERS. THE PSTA SAYS MORE THAN 700 OF ITS TROOPERS HAVE BEEN INFECTED SO FAR. IT EXPLAINED IN A STATEMENT AN OUTBREAK COULD CRIPPLE OUR DEPARTMENT. PUBLIC SAFETY SHOULD B

Pennsylvania State Troopers Association voices frustration that troopers haven’t been prioritized for vaccination

WGAL News 8 coronavirus coverage

The Pennsylvania State Troopers Association expressed frustration that the COVID-19 vaccination of troopers is not being prioritized.PSTA President David Kennedy issued a statement Wednesday after the Wolf administration moved teachers to the front of the line for the new Johnson & Johnson vaccine.“There are only 4,300 state troopers in Pennsylvania, but they are responsible for patrolling over 85% of our commonwealth,” Kennedy said. “Thus far, over 700 troopers have been infected with nearly 1,000 department employees, overall. An outbreak could cripple our department. Public safety should be a priority right now. The PSTA renews our call for the administration to vaccinate first responders so they can focus on doing their jobs.”

The Pennsylvania State Troopers Association expressed frustration that the COVID-19 vaccination of troopers is not being prioritized.

PSTA President David Kennedy issued a statement Wednesday after the Wolf administration moved teachers to the front of the line for the new Johnson & Johnson vaccine.

“There are only 4,300 state troopers in Pennsylvania, but they are responsible for patrolling over 85% of our commonwealth,” Kennedy said. “Thus far, over 700 troopers have been infected with nearly 1,000 department employees, overall. An outbreak could cripple our department. Public safety should be a priority right now. The PSTA renews our call for the administration to vaccinate first responders so they can focus on doing their jobs.”

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Stark link between obesity and Covid deaths revealed – Financial Times

https://www.ft.com/content/7db2b641-c831-4876-ba0c-0f815a42c8f0

Stark link between obesity and Covid deaths revealed - Financial Times

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Good news about the Moderna arm vaccine rash — its no worse with second shot – USA TODAY

https://www.usatoday.com/story/news/health/2021/03/03/covid-study-moderna-arm-vaccine-rash-no-worse-second-shot/6887483002/

Good news about the Moderna arm vaccine rash — its no worse with second shot - USA TODAY

There’s good news about “Moderna arm,” the raised, sometimes itchy red rash some people get a week or so after being vaccinated with Moderna’s COVID-19 vaccine.

There were concerns people who experienced the annoying rash might have a worse reaction with the second dose. A report published Wednesday finds that’s not the case – and most don’t have any reaction at all the second time.

“We’re encouraging people who’ve had this reaction to go in and get their second shot,” said Dr. Kim Blumenthal, an allergist, epidemiologist and professor of medicine at Harvard Medical School who’s tracking the reaction.

“There was concern that if you had the reaction on the first dose, it might reoccur with the second and possibly be worse. But we now have followed enough cases to know that’s not happening.”

Opinion:Getting the COVID-19 vaccine: I put my faith in science, Moderna, and myself

The reaction appears as an angry red rash, almost always on the arm where the vaccine was given, but can spread to other parts of the arm or hand. It can be a very pronounced oval on the skin, hard and hot to the touch, and sometimes is very itchy. 

The reaction occurs only in people who get the Moderna vaccine, not the one from Pfizer-BioNTech. It is more common in women than men, and is more frequently seen in those under 60.

For Natalie Roth of San Mateo, California, the area where she got her first COVID-19 vaccine shot “was swollen and hot to the touch but not a big deal,” she said. The red splotch grew every day but was never itchy and lasted for about six days.  

A harmless but annoying rash that appears in some people who have gotten the Moderna vaccine for COVID-19. A report in the New England Journal of Medicine published March 3, 2021 found the reaction is not more severe with the second dose of the vaccine and often didn't occur at all. The new data was reassuring to physicians who encourage people who had had the rash to get their second dose.  This patient was seen at Massachusetts General Hospital in Boston. The reaction lasted four days.

The reaction can come as a surprise because it typically doesn’t appear until seven or eight days after the immunization.

“In all the patients, they had totally resolved any initial symptoms from when they first got the shot and then this popped up out of nowhere,” Blumenthal said.

The rash is now termed “delayed large local reaction” though many patients have begun informally referring to it as “Modera arm.”

Doctors and patients first began to hear reports of the reaction soon after the Moderna vaccine began to be distributed. USA TODAY wrote about it on Jan. 27, but at that point little data was available. 

Blumenthal and Dr. Esther Freeman have been tracking the phenomenon and published the first paper on it in the New England Journal of Medicine on Wednesday.

They have been following cases of the reaction at Massachusetts General Hospital and have seen no instances where the reaction worsened with the second shot.

“This paper should be really reassuring to both patients and health care providers,” Freeman said. “The reaction only seems to reoccur in about half the cases and in no cases did we see it get worse.”

In about 50% of cases, the patient had no reaction at all with the second dose. In 25%, the reaction was milder; in 25%, it was about the same. 

“The big concern people might have had was that they were going to have a full-body, full-blown allergic reaction. But on that point we can be reassuring,” said Freeman, director of global health dermatology at Massachusetts General and a professor at Harvard Medical School.

Race against variants:Moderna to begin trial of new COVID-19 vaccine to address virus variant first found in South Africa

Another positive finding was that in people who got the rash with both shots, it seemed to fade more quickly after the second.

Those who had it after the first shot reported the rash lasted for six to 11 days. Those who had the reaction after the second shot said it faded within two to three days, Freeman said.

Wendie Holman’s first rash lasted for 10 days but the second one only lasted for three.

“Today, if I look closely, I see a faint remnant of pink skin around the inoculation site. There is no itching and no pain,” said Holman, a Santa Rosa, California, resident.

So far, side effects for both the Moderna and Pfizer-BioNTech vaccines seem to be almost identical, apart from this one reaction. Experts caution that a small number of people having a reaction is not a reason to prefer one vaccine over another. People should take whatever vaccine they can get, Freeman said.

Treatment is simple for most patients. Ice on the site of the rash and non-sedating antihistamines are usually all that’s needed to deal with the symptoms, Blumenthal said. Getting the second shot on the opposite arm can help but isn’t necessary.

In a few, more severe cases, steroids were required. The good news is, in those few cases, patients didn’t have a reoccurrence of the rash with their second dose of vaccine, she said.

The doctors reported some patients were treated with antibiotics when the rash was misdiagnosed as an infection. 

Safe early rollout:The first 22M Americans have been vaccinated for COVID-19, and initial safety data shows everything is going well, CDC says

It’s not known how common the reaction is. In the initial Moderna tests, “delayed injection site reactions” occurred in .08% of participants. However, Freeman thinks the number is probably higher because Moderna counted only reactions that began on or after Day 8.

Such delayed skin reactions to vaccinations are rare but have been reported with other routine vaccinations, she added. 

Researchers encourage those who experience the reaction to report it on the Centers for Disease Control and Prevention’s vaccine adverse reaction system, known as V-safe.

The doctors continue to study the reaction and are especially interested in collected images of the rash in people with darker skin tones. There is no indication the reaction is any different in people with darker skin; they simply want to document the phenomenon across all skin shades. 

Contact Elizabeth Weise at [email protected]

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Mass. reports 1,553 new COVID-19 cases, 66 new deaths – Boston.com

https://www.boston.com/news/coronavirus/2021/03/03/ma-covid-data-wednesday-march-3-2021

Mass. reports 1,553 new COVID-19 cases, 66 new deaths - Boston.com

Newly reported cases: 1,553

Total confirmed cases: 553,220

Estimated active cases: 28,550

Newly reported deaths: 66

Total confirmed deaths: 15,925

Newly reported tests: 102,052

Total tests: 16,419,989

Percent positivity (seven-day average): 1.82%

Hospitalized patients: 755

ICU patients: 173

Intubated patients: 109

Average age of hospitalized patients: 69

View an interactive version of the state’s dashboard here.


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Oregon reports 27 more COVID-19 related deaths; 1 million vaccine doses given – KTVZ

https://ktvz.com/news/coronavirus/2021/03/03/oregon-reports-27-more-covid-19-related-deaths-1-million-vaccine-doses-given/

Oregon reports 27 more COVID-19 related deaths; 1 million vaccine doses given - KTVZ

(Update: Adding weekly report; deaths, cases, hospitalizations increase; Western Workgroup recommends Johnson & Johnson vaccine as safe, effective))

PORTLAND, Ore. (KTVZ) — There are 27 new COVID-19 related deaths in Oregon, raising the state’s death toll to 2,252, the Oregon Health Authority reported Wednesday.

OHA also reported 276 new confirmed and presumptive cases of COVID-19 as of 12:01 a.m. Wednesday, bringing the state total to 156,287.

Note: A large volume of backlogged electronic laboratory reports (ELRs) were received Tuesday. As a result, Wednesday’s test counts are higher than anticipated. Test results were from Jan. 1 to March 1. Approximately 99% of these test results were negative results, and Wednesday’s percent positivity is lower than anticipated.

Oregon hits milestone: 1 million doses of COVID-19 vaccine administered

OHA recorded Wednesday more than 1 million vaccines administered to Oregonians. There were 22,346 doses recorded Tuesday, bringing the total number of doses administered in the state to 1,019,767. The first dose was administered on Dec. 14, less than three months ago.

About one in five Oregonians who likely are eligible have received at least one dose.

The vaccine has been delivered to every Oregon county, long-term care and residential care facilities, adult foster homes, group homes for those with disabilities, hospitals, mass vaccination events, mobile events, clinics, Tribal health centers, group homes, congregate care settings, pharmacies, outpatient clinics, federally qualified health centers and other locations throughout the state.

Oregon has now administered a cumulative total of 1,019,767 first and second doses of COVID-19 vaccines. To date, 1,310,175 doses of vaccine have been delivered to sites across Oregon.

 “This could not happen without the partnerships that have been strengthened and developed to move Oregon closer to community immunity, and the thousands of providers, volunteers, nurses and countless other Oregonians who made this happen,” said OHA Director Patrick Allen. “Every day, we are delivering more than 22,000 doses of vaccine that will bring us to the end of this difficult journey for so many.

“Our ability to meet our timelines for opening up scheduling opportunities to additional groups will still require an adequate and consistent supply of doses from the federal government, a large number of Oregonians who are able and willing to get vaccinated and the ability of our vaccination sites to immunize all eligible persons.”

St. Charles Health System has given 27,447 COVID-19 vaccinations as of early Wednesday.

As Oregon continues the vaccine rollout, OHA encourages all Oregonians to keep taking the protective measures to help keep themselves, families, coworkers, loved ones, friends and communities safe and healthy. They continue to recommend that all Oregonians:

  • Maintain 6 feet of physical distance;
  • Wear a face covering when outside the house;
  • Practice good hand hygiene;
  • Avoid any gatherings with non-household members;
  • If you start to have symptoms — even mild ones — consult with a medical provider quickly to get instructions on how to care for yourself and your household members and to determine whether to get tested;
  • And finally, if you get a call from a local public health authority, answer it, and take their advice on how to protect yourself and those around you.

COVID-19 hospitalizations

The number of hospitalized patients with COVID-19 across Oregon is 140, which is nine fewer than Tuesday. There are 31 COVID-19 patients in intensive care unit (ICU) beds, which is two more than Tuesday.

The total number of patients in hospital beds may fluctuate between report times. The numbers do not reflect admissions per day, nor the length of hospital stay. Staffing limitations are not captured in this data and may further limit bed capacity.

St. Charles Bend had 14 COVID-19 patients as of 4 a.m. Wednesday, one of whom was in the ICU and on a ventilator.

More information about hospital capacity can be found here.

Cases and deaths

Details of Wednesday’s reported deaths will be published later.

The new confirmed and presumptive COVID-19 cases reported Wednesday are in the following counties: Baker (2), Benton (3), Clackamas (20), Clatsop (2), Columbia (3), Coos (24), Deschutes (10), Douglas (22), Grant (2), Harney (2), Jackson (47), Jefferson (5), Josephine (5), Klamath (2), Lane (15), Linn (4), Malheur (2), Marion (28), Multnomah (26), Polk (4), Tillamook (4), Umatilla (7), Union (10), Washington (25) and Yamhill (2).

Weekly COVID-19 cases, hospitalizations, deaths rise

The Oregon Health Authority’s COVID-19 Weekly Report, released today, shows increases in daily cases, hospitalizations and deaths from the previous week.

OHA reported 2,652 new daily cases of COVID-19 during the week of Monday, Feb. 22 through Sunday, Feb. 28 — a 17% increase from the previous week.

New COVID-19 related hospitalizations also rose to 164, up from 159 the previous week.

Reported COVID-19 related deaths also increased to 57, up from 17 last week. That represents the lowest total since mid-November.

There were 120,678 tests for COVID-19 for the week of Feb. 21 through Feb. 27, a sharp increase from the previous week. The previous week’s total was most likely affected by the inclement winter weather event that took place throughout the region.

Roughly 117,000 tests were administered on a weekly basis earlier this year. The percentage of positive tests was 3.7%.

People 70 years of age and older have accounted for 40% of COVID-19 associated hospitalizations and 77% of COVID-19 associated deaths.

Friday’s COVID-19 Weekly Outbreak Report shows 56 active COVID-19 outbreaks in senior living communities and congregate living settings, with three or more confirmed cases and one or more COVID-19 related deaths.

Learn more about COVID-19 vaccinations

To learn more about the COVID-19 vaccine situation in Oregon, visit OHA’s web page, which has a breakdown of distribution and other useful information.


News release from Gov. Kate Brown’s Office:

Western States Scientific Safety Review Workgroup Recommends Johnson & Johnson Vaccine, Confirms it is Safe and Effective

Workgroup “Recommends unanimously that the Johnson & Johnson COVID-19 vaccine be used in our states” 
Endorses the transparency and objectivity of the process, and the rigor, validity and reliability of the federal analyses
J&J becomes the third vaccine supported for use by the Workgroup; vaccine shipments are arriving this week

 (Salem, OR) — The Western States Scientific Safety Review Workgroup last night completed its review of the federal process and has concluded the Johnson & Johnson (Janssen Biotech) COVID-19 vaccine is safe and effective for use in the Western States. The Workgroup provided its confirmation to the Governors of California, Nevada, Oregon and Washington this morning, making the J&J vaccine the third COVID-19 vaccine supported for use in these states. Shipments are expected early this week.  

Washington, Oregon and Nevada joined California’s COVID-19 Scientific Safety Review Workgroup in October. The workgroup, made up of nationally acclaimed scientists with expertise in immunization and public health, has concurrently and independently reviewed the FDA’s actions related to COVID-19 vaccinations. It will continue to evaluate other COVID-19 vaccines as they go through the federal process.

Statement from Governor Kate Brown:
“After thorough scientific review by doctors and health experts, we now have three safe and effective vaccines available for Oregonians. And, because the Johnson & Johnson vaccine can be stored in standard refrigerators and vaccinate individuals in a single dose, it gives us the ability to vaccinate even more people. We will work to distribute vaccines as quickly and equitably as possible as we move forward to vaccinate seniors, people with underlying health conditions, frontline workers, and all Oregonians.”

Statement from Nevada Governor Steve Sisolak:
“With the review of the Johnson & Johnson (Janssen) COVID-19 vaccine, the Western States Scientific Safety Review Workgroup has again come together to ensure we have a safe, effective vaccine available to our residents. Their review of this vaccine should give Nevadans added confidence to say ‘yes’ to any of the three vaccines offered.

“The availability of COVID-19 vaccine is crucial as we continue our response and efforts to protect the health of our communities and our state. I am so proud of the work being done on the ground at vaccination sites statewide – almost 670,000 doses administered – and I offer my gratitude and thanks to all of those working for their fellow Nevadans.

“The Johnson & Johnson vaccine gives us additional flexibility as we strive to reach all Nevadans. This vaccine is easy to use, ship and store, which will help our partners in their mission to reach all our residents. Thank you to my fellow governors for sharing your expertise as we all work to slow the spread of COVID-19.”

Statement from California Governor Gavin Newsom:
“With the authorization of the single-shot Johnson and Johnson COVID-19 vaccine, we now have three remarkable vaccines that offer 100 percent protection from death and hospitalizations. We have administered 9.3 million vaccines in California thus far, and we’re building a system that will allow us to vaccinate people as quickly as supply becomes available. There is truly light at the end of the tunnel.”

Statement from Washington Governor Jay Inslee:
“The Western States Scientific Safety Review Workgroup gives us further confidence around the safety and efficacy of Johnson and Johnson’s COVID-19 vaccine. With the delivery of the J & J vaccine this week, and overall increase in the number of vaccine doses coming to Washington, we have increased our capacity to get vaccine to all parts of the state. We are making good progress on vaccination rates, and this third vaccine will help our efforts to get as many people vaccinated as quickly as possible.”

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