Come for the politics, stay for the snark.

Fuck the extremist election deniers. What’s money for if not for keeping them out of office?

The words do not have to be perfect.

White supremacy is terrorism.

Pessimism assures that nothing of any importance will change.

A last alliance of elves and men. also pet photos.

When someone says they “love freedom”, rest assured they don’t mean yours.

Let me eat cake. The rest of you could stand to lose some weight, frankly.

Accountability, motherfuckers.

Bark louder, little dog.

Sitting here in limbo waiting for the dice to roll

Today’s GOP: why go just far enough when too far is right there?

A snarling mass of vitriolic jackals

Republicans seem to think life begins at the candlelight dinner the night before.

Impressively dumb. Congratulations.

JFC, are there no editors left at that goddamn rag?

Let’s not be the monsters we hate.

A lot of Dems talk about what the media tells them to talk about. Not helpful.

You can’t love your country only when you win.

A democracy can’t function when people can’t distinguish facts from lies.

Take hopelessness and turn it into resilience.

My years-long effort to drive family and friends away has really paid off this year.

I really should read my own blog.

Anyone who bans teaching American history has no right to shape America’s future.

It’s always darkest before the other shoe drops.

You are here: Home / Healthcare / COVID-19 Coronavirus / COVID-19 Coronavirus Updates: Friday / Saturday, Sept. 17-18

COVID-19 Coronavirus Updates: Friday / Saturday, Sept. 17-18

by | 54 Comments

This post is in: ,


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… The government of Xiamen, in a series of notices, told residents not to leave home unnecessarily, closed parks, scenic spots and sports venues, and halted mass activities including tours, fairs and performances.

The measures – short of a full lockdown – came on the first of the four-day Mid-Autumn Festival holidays, a peak travel season across China.

Xiamen, a scenic city of 5 million, is one of four cities in the Fujian province – China’s latest coronavirus hotspot – that have reported cases in recent days.

Visitors to Xiamen’s residential compounds are not allowed without approval, non-essential vehicle traffic in and out of residential areas is forbidden, and dining in at restaurants, cafes and other venues is prohibited.

Also a transport hub for southeast China, Xiamen has reported 92 locally transmitted infections in the past week. That is about half the number of nearby Putian, where the first infection in this outbreak was reported on Sept. 10.

The first patient in the Xiamen cluster was a close contact of a case in Putian, Xiamen authorities said on Monday…

The outbreak comes ahead of the week-long National Day holiday starting on Oct. 1, a far busier tourist season than the Mid-Autumn festival.

The last domestic outbreak in late July to August spread to tens of Chinese cities, hammering China’s tourism, hospitality and transportation sectors.

======

House of Moderna, take a victory lap:

======

Kentucky acts to protect its valuable / vunerable horse population:

Reader Interactions

54Comments

  1. 1.

    NeenerNeener

    Monroe County, NY:

    Monroe County web site says 168 new cases and 4.5% test positivity.
    NYSDOH says 197 new cases.

  2. 2.

    r€nato

    Do vaccine requirements work? Let’s check 
    @United
    went from 59% to 90% vaccinated in 6 weeks 
    @DeptofDefense
    went from 76% to 89% in 3 weeks 
    @LSU
    went from 63% to 81% with a month left 
    @FoxNews, @aboutKP, @RutgersU
    are all at 90% or above. So yes, vax requirements work

    yes, your boss can force you to do a lot of things you’d rather not do when at-will employment and living paycheck-to-paycheck are the dominant paradigms.

    Look, I’m very much pro-vaxx, don’t buy the conspiracy theories about the pandemic, I live in Europe and got my Green Pass and don’t bitch about it being some sort of slippery slope to the Holocaust.

    But the other side certainly does have a point about mandates. It’s just too bad that in other contexts they are generally just fine with Boss Man having too much power over your life. Frankly I believe they fulfill a useful role even if otherwise I profoundly disagree with them about this matter. Progressives angrily advocating that anti-vaxxers should go to the back of the triage line and get charged significantly higher insurance rates are also on the wrong side of things.

  3. 3.

    YY_Sima Qian

    On 9/17 China reported 31 new domestic confirmed cases (6 previously asymptomatic) & 0 new domestic asymptomatic cases.

    Fujian Province reporter 31 new domestic confirmed cases (6 previously asymptomatic) & 0 new domestic asymptomatic cases. There currently are 292 active domestic confirmed cases & 3 active domestic asymptomatic cases.

    • Putian reported 21 new domestic confirmed cases (6 previously asymptomatic). There currently are 179 active domestic confirmed cases (89 mild, 88 moderate & 2 serious) & 3 active domestic asymptomatic cases in the city. 4,390 F1 & 4,382 F2 close contacts have been traced and placed under centralized quarantine. Fengting Township at Xianyou County is currently at High Risk. 1 community & 2 villages have been elevated to Medium Risk. 2 zones, 1 residential building, 1 school, 1 community & 5 villages aren currently at Medium Risk, all at Xianyou County.
    • Quanzhou did not reported any domestic positive cases. There currently are 18 active domestic confirmed cases in the city. 3 villages are currently at Medium Risk.
    • Xiamen reported 8 new domestic confirmed cases (3 traced close contacts & 5 from mass screening). There currently are 92 active domestic confirmed cases in the city. 1,905 F1 & 2,377 F2 close contacts have been traced & placed under centralized quarantine. a community has been elevated to High Risk. 1 zone & 1 community are currently at High Risk. 4 villages & 1 residential compound have been elevated to Medium Risk.
    • Zhangzhou reported 2 new domestic confirmed cases, both close contacts of the case reported on 9/16. There currently 3 active domestic confirmed cases in the city.

    Yunnan Province did not reported any new domestic positive cases. There currently are 9 active domestic confirmed & 1 domestic asymptomatic cases there.

    Hunan Province did not reported any new domestic positive cases. 1 domestic confirmed case recovered. There are currently are 32 active domestic confirmed cases in the province, all at Zhangjiajie

    Henan Province did not report any new domestic positive cases. There currently are 10 active domestic confirmed cases in the province.

    • At Zhengzhou there currently are 2 active domestic confirmed cases.
    • At Shangqiu there currently are 8 active domestic confirmed cases.

    Hubei Province did not report any new domestic positive cases. 3 domestic confirmed cases recovered & 1 domestic asymptomatic case was released from isolation. There currently are 8 active domestic confirmed (6 mild & 2 moderate) & 2 active domestic asymptomatic cases in the province.

    • At Jingzhou there currently is 1 active domestic confirmed case.
    • At Jingmen 1 domestic confirmed case recovered. There are currently 5 active domestic confirmed & 1 active domestic asymptomatic cases in the city.
    • At Wuhan 2 domestic confirmed cases recovered & 1 domestic asymptomatic case was released from isolation. There currently are 2 active domestic confirmed & 1 active domestic asymptomatic cases.

    At Shanghai Municipality there currently are 4 active domestic confirmed cases.

    Imported Cases

    On 9/17, China reported 15 new imported confirmed cases (2 previously asymptomatic), 17 imported asymptomatic cases:

    • Yunnan Province (locations not specified) – 9 confirmed cases, all Chinese nationals returning from Myanmar, all via land border crossings
    • Foshan in Guangdong Province – 2 confirmed cases, both coming from the DRC; 1 asymptomatic case, a Chinese national returning from Ghana; off flights that landed at Guangzhou
    • Shenzhen in Guangdong Province – 1 confirmed case, a Chinese national returning from Serbia; 1 asymptomatic case, a Chinese national returning from South Africa
    • Guangzhou in Guangdong Province – 6 asymptomatic cases, 2 Chinese nationals returning from Sri Lanka & 1 each from Iraq, Jordan (via Muscat) & the UAE, & a foreign national coming from Turkey
    • Shanghai Municipality – 2 confirmed cases, 1 Chinese national each returning from Ethiopia & the US
    • Jinzhou in Liaoning Province – 1 confirmed case, no information released
    • Guangxi Province (location not specified) – 6 asymptomatic cases, no information released
    • Chengdu in Sichuan Province – 2 asymptomatic cases, 1 Chinese national each returning from Kazakhstan & Nigeria (both via Frankfurt)
    • Wuhu in Anhui Province – 1 asymptomatic case, a Chinese national returning from Indonesia; the case had arrived at Wuhan in Hubei Province on 8/30, passed through the 14 days of centralized quarantine  & had tested negative multiple times, upon release from quarantine on 9/13 the case returned to Wuhu via high speed rail & re-entered centralized quarantine, testing positive on 9/16

    Overall in China, 49 confirmed cases recovered (45 imported), 18 asymptomatic cases were released from isolation (16 imported) & 8 were reclassified as confirmed cases (2 imported), & 748 individuals were released from quarantine. Currently, there are 913 active confirmed cases in the country (557 imported), 8 in serious condition (5 imported), 369 active asymptomatic cases (358 imported), 1 suspect case (imported). 16,240 traced contacts are currently under centralized quarantine.

    As of 9/17, 2,170.017M vaccine doses have been injected in Mainland China, an increase of 4.34M doses in the past 24 hrs.

    On 9/18, Hong Kong reported 5 new positive cases, all imported (from India, the Philippines, Qatar & the US, all had been fully vaccinated).

  4. 4.

    rikyrah

    @r€nato:

    Outside of your home, most people spend more hours at the job than anyplace else. I support work vaccine mandates.

    T-27 days at my job, before some of my fellow co-workers are gonna FAAFO.

  5. 5.

    Baud

    @r€nato: 

    But the other side certainly does have a point about mandates. 

    You could say the same thing about taxes. In the end, it’s all a slippery slope argument.

    Employers in the US have too much power because US culture is unreasonably afraid of governmental power. So we’re stuck with dealing with the means we have at our disposal.

  6. 6.

    NotMax

    FYI.

    American Samoa reported its first COVID case Friday after a traveler flying in from Hawaii tested positive while in quarantine.

    The U.S. territory’s health department said the person flew in on Monday — the first day Hawaiian Airlines resumed flights between Honolulu and Pago Pago. Flights were previously suspended since March 2020 due to the pandemic.
    [snip]
    All scheduled flights to American Samoa have been suspended until further notice. Source

    Also,

    Hawaii reported 15 additional COVID fatalities on Friday, the highest single-day total for COVID deaths since the pandemic began. Source

  7. 7.

    lowtechcyclist

    @r€nato:

    Progressives angrily advocating that anti-vaxxers should go to the back of the triage line and get charged significantly higher insurance rates are also on the wrong side of things.

    The anti-vaxxers are causing other people to die. Short of forced vaccinations, putting them at the end of the triage line is about the only way we have of reducing the number of other people they cause to die.

    I’m failing to see the problem here.  This is different from, say, charging overweight people higher rates.  If I’m overweight, it doesn’t threaten your health.  If you refuse to get vaxxed and you clog up the hospitals on account of coming down with Covid, it does threaten my health.  Entirely different.

  8. 8.

    Amir Khalid

    Malaysia’s Ministry of Health reports 15,549 new Covid-19 cases today in its media statement, for a cumulative reported total of 2,082,876 cases. It also reports 388 new deaths as of midnight, for a cumulative total of 22,743 deaths – 1.09% of the cumulative reported total, 1.22% of resolved cases.

    Based on cases reported yesterday, Malaysia’s nationwide Rt is at 0.95.

    888 confirmed active and contagious cases are in ICU, 401 of them on ventilators. Meanwhile, 17,205 more patients have recovered, for a cumulative total of 1,840,453 patients recovered – 88.4% of the cumulative reported total.

    16 new clusters were reported today, for a cumulative total of 5,263 clusters. 1,364 clusters are currently active; 3,899 clusters are now inactive.

    15,544 new cases today are local infections. Sarawak reports 2,929 cases: 113 in clusters, 1,964 close-contact screenings, and 852 other screenings.

    Johor reports 2,208 cases: 348 in clusters, 1,022 close-contact screenings, and 838 other screenings.

    Selangor reports 1,993 local cases: 129 in clusters, 866 close-contact screenings, and 998 other screenings. Sabah reports 1,395 cases: 26 in clusters, 833 close-contact screenings, and 536 other screenings. Penang reports 1,375 cases: 23 in clusters, 481 close-contact screenings, and 871 other screenings. Kelantan reports 1,214 cases: 25 in clusters, 848 close-contact screenings, and 341 other screenings. Perak reports 1,120 cases: 133 in clusters, 413 close-contact screenings, and 574 other screenings. Kedah reports 1,073 cases: 26 in clusters, 622 close-contact screenings, and 425 other screenings.

    Terengganu reports 755 cases: 12 in clusters, 556 close-contact screenings, and 187 other screenings.

    Pahang reports 634 cases: 226 in clusters, 335 close-contact screenings, and 73 other screenings.

    Kuala Lumpur reports 379 local cases: nine in clusters, 156 close-contact screenings, and 214 other screenings.
    Melaka reports 263 cases: 34 in clusters, 128 close-contact screenings, and 101 other screenings.

    Negeri Sembilan reports 131 cases: six in clusters, 81 close-contact screenings, and 44 other screenings.

    Perlis reports 33 cases: 13 close-contact screenings and 20 other screenings. Putrajaya reports 31 cases: 22 close-contact screenings and nine other screenings. Labuan reports 11 cases: eight in clusters and three other screenings.

    Five new cases today are imported: three in Kuala Lumpur and two in Selangor.

    The National Covid-19 Immunisation Programme (PICK) administered 238,002 doses of vaccine on 17th September: 75,986 first doses and 162,016 second doses. As of midnight yesterday, the cumulative total is 39,923,416 doses administered: 21,861,904 first doses and 19,135,561 second doses. 66.9% of the population have received their first dose, while 55.5% are now fully vaccinated.

  9. 9.

    New Deal democrat

    91-Divoc is back up and running today, and the story it tells is pretty straightforward: Northeast, Midwest, Appalachian, and Mountain West cases rising, more strongly in the unvaccinated States; but more than offset by declines on the West Coast, Southwest, and steep declines in the Deep South. This nets out to a continued slight decline nationwide.

    Meanwhile deaths still rising and will probably cross 2000/day this week.

    Unless employment vaccine mandates become widespread (I.e., are permitted by Trumpist courts), vaccination rates are going to hit new lows once teen vaccinations catch up in about a month, because almost all the adults left are hard care antivaxxers. What % of the unvaxxed have some immunity via prior infection then becomes the most important metric for obtaining herd immunity or close to it. My best guess is we get there by next spring after one more winter wave.

  10. 10.

    lowtechcyclist

    @Baud:

    Employers in the US have too much power because US culture is unreasonably afraid of governmental power. So we’re stuck with dealing with the means we have at our disposal.

    This. No question, employers have way too much power in America, and we need to do something about that.

    But that’s not going to happen overnight, and we need to deal with this fucking plague now, not when we achieve the glorious workers’ paradise.

  11. 11.

    Matt McIrvin

    @lowtechcyclist: It’s a real ethical minefield for health-care systems to ration care according to whether they think people morally deserve it. It isn’t the job of doctors or other health professionals to be judges over humanity. They’re supposed to be impartial about that. They’re often not, but when they’re not, we usually decry it as a failure.

    So that leaves other incentives. I’m all for work vaccine mandates because this is what we have to work with in an American context–and it’s an issue of workplace safety, entirely within OSHA’s purview. The unions that have opposed this are being foolish, endangering their own members for some abstract notion of freedom. I think it’s interesting that some have actually come around (such as the big teachers’ unions).

  12. 12.

    The Dark Avenger

    Here’s what it’s like here at the Gateway To the Gateway to the Sierras.

    The number of active cases in Tulare County continues to grow and is expected to continue to increase after the Labor Day weekend. On Monday, the health department reported there were 3,980 active cases in Tulare County.

    Since March 11, 2020 the county health department reported on Monday there has been 58,559 cases. The state figure for Tulare County is 58,582 cases. In Tulare County, 11.7 percent of its residents have tested positive for COVID-19.

    The case rate also remains high as the state reported on Monday Tulare County’s case rate was 45.8 per 100,000.

  14. 14.

    Ohio Mom

    Lots of irony in the story of Eva Baisey, the amazingly long lived heart transplant who died from Covid complications.

    Thirty-five years ago, a DC surgeon and hospital wanted to get into the heart transplant business but they had competition from established heart transplant teams in nearby cities. Who would volunteer to be their first patient when experienced teams were a short trip away?

    The answer was to offer a free surgery to a poor Black woman. Now obviously this time it worked out to the Black woman’s advantage (she remained friends with the surgeon for the rest of her life) but taken in the larger context of Black women being used as medical guinea pigs*, as I said, ironic.

    * e,g., the “father” of modern gynecology who experimented with surgery on unanesthetized women slaves and Henrietta Lacks come immediately to mind.

  15. 15.

    Buckeye

    @r€nato:

     

    But the other side certainly does have a point about mandates.

    Mask mandates? Vaccine mandates?

    Either one, no, not from a public health standpoint they don’t, either from a government standpoint or employer standpoint.

    I’m non-clinical in a hospital, I have to be up to date on a variety of vaccines, and get new ones depending on where I might be-I got TDAP when I was on mom-baby, for example.

    I’ve got no sympathy for someone whining about overreach because they need to take a free vaccine and then show proof of that, or because they need to briefly wear a mask.

  16. 16.

    terben

    @r€nato:

    Yes, it’s horrible that employers have a responsibility to ensure that ALL their workers can return home at the end of the day in the same state of health as when they arrived at work.

    How dare they insist that workers are alcohol, drug and disease free? How dare they insist that workers don’t chose to endanger themselves and their fellow workers?

    I don’t think that your boss can FORCE you to do anything. They can offer you a choice, and that is what the mandates are. A hard choice for some, but still a choice.

  17. 17.

    Barbara

    @r€nato: ​In a world where your employer is your link to health care, and paying for care, employers are going to have outsize power in this particular sphere. I’m all for changing that dynamic but most of the anti-vaxxer types are not. If they didn’t realize what that could mean for them, too bad, so sad.​​

  19. 19.

    germy

    WASHINGTON (AP) — FDA advisory panel endorses COVID-19 booster shots only for Americans 65 and over or at high risk for severe disease.— Kyle Griffin (@kylegriffin1) September 17, 2021

    I saw one of the members of the advisory panel… he looked well over 65!

  20. 20.

    Ohio Mom

    I just went over to the Covidactnow.org page for southwest Ohio (every morning I first check the weather, Anne Laurie’s post and Covidactnow, and then wonder why my day has gotten off to such a rough start).

    The chart showing the number of vaccinated went from a very gently up slope — starting in the beginning of the summer, we’ve languished in the low 50s percentage-wise — to *almost vertical in the last week.*

    From 54% with one dose to 57% in a matter of days. It’s startling and hopeful to see.

  21. 21.

    Robert Sneddon

    @germy: The UK’s planned rollout for COVID-19 booster vaccinations is about the same as the US FDA recommendations for about the same reasons.

    Vaccinations are a medical procedure and there has to be a defined benefit to carrying out a given procedure on a given individual. There’s evidence that boosters will be a benefit to older people, immunocompromised individuals, healthcare workers more than six months from their last vaccination etc. For the rest of the population there’s no clear benefit FOR INDIVIDUALS hence the recommendation.

    Saying that the FDA guidelines are only recommendations, there’s no reason other organisations won’t do something different if they choose to, for reducing the spread of this disease or prophylactic purposes generally.

  23. 23.

    Matt McIrvin

    @Ohio Mom: Often abrupt spikes like that are because of some sort of reporting anomaly–maybe somebody in that area found a bunch of vaccinations they hadn’t reported before.

    covidactnow.com’s vaccination numbers come from the CDC, and I’ve found that the CDC’s numbers often don’t agree with state numbers–there are big gaps and lags in them. The figures for western Massachusetts have been way off for a long time. The New York Times map uses state data as well and seems to be much more accurate, though there are also a lot of areas where the NYT just declines to report because they don’t have numbers they consider reliable enough.

  24. 24.

    Starfish

    @r€nato: The other side has zero points about mandates. You participate in society beyond your doorstep, you have an obligation to the people around you. You want to home school and live on a remote farm because you are captain self-reliance, go for it; but there is no right to poop in the public swimming pool. The people who are saying that they should get to participate in society with no basic obligation to the people around them are wrong.

    I agree with you about the people wanting to play God and send anti-vaxxers to the back of the triage line. That is ghoulish. No one should have to decide who lives or dies, and we should not be so flippant about such decisions.

  25. 25.

    lowtechcyclist

    @Matt McIrvin:

    @lowtechcyclist: It’s a real ethical minefield for health-care systems to ration care according to whether they think people morally deserve it.

    I disagree. IMHO, you have a bright line here, between unhealthy behaviors that create adverse health outcomes for others as well, and unhealthy behaviors that don’t affect anyone but oneself.

    Now I agree that on the other side of that bright line, there’s an ethical minefield. We’ve managed to all but eliminate places outside the home where one has to inhale secondhand smoke. So smokers are no longer endangering others, yet they have to pay higher rates.  That gets into an ethical minefield. What I propose doesn’t.

  26. 26.

    Starfish

    @Robert Sneddon: At a get together last week, a healthy 64-year old was telling me how she had worked the system to get her third vaccine, and I cannot tell you how unimpressed I was with this behavior.

  27. 27.

    Chetan Murthy

    @r€nato:

    your boss can force you to do a lot of things

    Uh, in this case, the boss is doing so as a proxy for the government, though.  Almost all businesses waited for the government to demand mandates thru OSHA.  That’s a pattern that’s been repeated over and over during the pandemic: it’s been rare for businesses to demand things of their workers, until the government (whether federal, state, or local) demands that they do so.

    I fail to see anything objectionable about this, from the point of view of a worker?

  28. 28.

    Percysowner

    @Ohio Mom: Well, I’m glad about that. Here in Central Ohio we have 3 hospitals for adults and 1 of children. On Thursday it was announced that there is a whopping total of 21 beds total available in the area, 10 ICU beds, 11 general/surgical. The hospitals are begging people to go to their Primary care doctors for symptoms of COVID.

    With 4 major hospitals, I thought we would be okay, but the rural hospitals are sending people here and our numbers aren’t that good in Columbus, either.

    Damn, the State Legislature that hobbled DeWine’s ability to out mask mandates and other remediation efforts.

  29. 29.

    Starfish

    @lowtechcyclist: Your willingness to send people to the back of the triage line says that you do not know the long history of eugenics in the US and are dancing in a domain that you do not understand at all. If people are sent to the back of the triage line do they stick around the hospital, or do they go home and continue to infect as many people as they can until they die?

    Smokers paying more for insurance is not an ethical minefield. It is based on solid actuary work. These people cost insurance companies a lot more.

  30. 30.

    lowtechcyclist

    @Starfish:

    I agree with you about the people wanting to play God and send anti-vaxxers to the back of the triage line. That is ghoulish. No one should have to decide who lives or dies, and we should not be so flippant about such decisions.

    It’s too late: the anti-vaxxers are forcing those decisions on us.

    As long as we don’t have to ration care, everyone should be taken care of to the maximum extent possible.  But in many parts of the country, we are having to ration care (officially doing so in Alaska and Idaho, but unofficially in many other places), and the people who have forced this on us should bear such costs as there are, rather than the risks of delayed or denied treatment being imposed on a random selection of those needing hospital care.

    To me, the latter option is the immoral option: choosing to have random people suffer and perhaps die because of the bad decisions of some other group of people.  To me, that’s the morally abhorrent choice.

  31. 31.

    lowtechcyclist

    @Starfish:

    Smokers paying more for insurance is not an ethical minefield. It is based on solid actuary work. These people cost insurance companies a lot more.

    Similarly solid actuarial work could undoubtedly identify other such groups. That’s why it’s a minefield.

  32. 32.

    lowtechcyclist

    @Starfish: ​

    If people are sent to the back of the triage line do they stick around the hospital, or do they go home and continue to infect as many people as they can until they die?

    No, they’re the ones we ship to other hospitals hundreds of miles away, and bear the risks of any delay or interruption in their care, rather than the guy who just had a heart attack but there isn’t an ICU bed to be had for miles.

    ETA: Like it or not, choosing not to choose, but to distribute randomly the additional risks and health costs of an overloaded health care ‘system,’ is still a choice.  People want to pretend it isn’t, but it is.

  33. 33.

    Matt McIrvin

    @Chetan Murthy: Also, in several states businesses were actually forbidden from instituting vaccine mandates, by ostensibly “business-friendly” state governments, which just illustrates the power of culture-war point-scoring.

    (Technically I think large businesses in these states are now both forbidden AND required to mandate vaccines, which I presume just means big and stupid court battles.)

  34. 34.

    Ken

    @Chetan Murthy: Almost all businesses waited for the government to demand mandates thru OSHA.

    One that didn’t being Fox News.

    (At least, I remember reading about their mandate before the announcement a couple of weeks ago.)

  35. 35.

    Matt McIrvin

    @lowtechcyclist:

    I disagree. IMHO, you have a bright line here, between unhealthy behaviors that create adverse health outcomes for others as well, and unhealthy behaviors that don’t affect anyone but oneself.

    When the problem is that medical care is scarce, that line vanishes, and any self-inflicted medical risk becomes potential grounds for refusal.

    Which is why triage is supposed to focus on how successful care is likely to be, and not how deserving the patient is. Now, there is a wrenching issue there too–with COVID there are a lot of “talking dead” who remain alive and even conscious and somewhat functional as long as they’re on oxygen in an ICU environment, but cannot live without it. And almost all of them are people who were unvaccinated. What you do with those people is a really thorny question. But that’s not about whether they deserved it.

  36. 36.

    Ohio Mom

    @Matt McIrvin:
    Oh well — disappointed but I believe you.

    My phone does not like the NYT site so I have come to rely on covidactnow. I also like the way they aggregate the entire metro area instead of just giving stats for single counties.

  37. 37.

    Ohio Mom

    @Percysowner:
    Don’t be jealous, other than that outlier of a small spike in vaccines given this week, the rest of our numbers are awful and our hospitals are stretched thin too.

    We Buckeyes certainly do have a vicious state legislature and a spineless governor.

  38. 38.

    Chief Oshkosh

    @r€nato:

    Progressives angrily advocating that anti-vaxxers should go to the back of the triage line and get charged significantly higher insurance rates are also on the wrong side of things.

    Pretty sure it’s not just progressives that are fed up with the unvaccinated. As to being on the wrong side of things, well, that’s just, like, you know, your opinion, man.

  39. 39.

    New Deal democrat

    @lowtechcyclist: I just want you to know, because you are taking heat from several other commenters, that I agree with you.

    The issue of deciding who does and doesn’t get care is already here; there is no avoiding it.

    There is no way on this planet that little Johnny, gravely injured in a car accident, should get turned away from the ER to die, in favor of loudmouth adult COVIDiot. To choose otherwise is *also* to choose, and is much more an immoral outcome in my opinion than choosing to treat little Johnny.

  40. 40.

    RSA

    @lowtechcyclist:

    I’m failing to see the problem here. This is different from, say, charging overweight people higher rates. If I’m overweight, it doesn’t threaten your health. If you refuse to get vaxxed and you clog up the hospitals on account of coming down with Covid, it does threaten my health. Entirely different

    A few thoughts:

    Not everyone who is unvaccinated is anti-vaxx, and we have no verified reliable procedures for identifying who is or isn’t. A 17-year-old or 80-year-old person with COVID living as a dependent with anti-vaxx relatives, for example?

    Physicians in general don’t have the training in ethics or psychology to make judgment calls about people’s actions and motivations. We do have a high-stakes analogy where this happens, with criminal trials, but those last for days or weeks while triage needs to happen fast.

    As I think others have suggested, the line of people waiting for treatment isn’t just COVID/not-COVID.  Some of the people may have put others at risk. Someone who was in a car crash when traveling at 100mph down the highway after drinking a little too much. A gang member who’s been shot. It’s easy to think of ways in which preference rules give poor outcomes.

  41. 41.

    Cermet

    California doesn’t have the lowest rate per 100 K per the NYT list; rather puzzled by their claim – amoung States, MD has the lowest rate (for now.)

  42. 42.

    New Deal democrat

    @RSA: So, you agree that little Johnny with a 20% chance of survival who was gravely injured in a car crash should be allowed to die, so that an unvaccinated adult (easily checked in a database) with no immunocompromising condition (also should be easy to check), who has a 50% chance of survival, can take up the ER bed.

    Please own your decision: “Yes, little Johnny should die.”

    I am very comfortable owning mine.

  43. 43.

    Miss Bianca

    @New Deal democrat: According to the nurses’ reddit I just read, yeah. If we’re going to ration healthcare, the guy with a better chance of surviving would be the one to get the care, vax status be damned. If you want to gainsay the judgement of a bunch of nurses on the frontline, that’s your lookout. Go ahead and yell at them – apparently, they *love* that.

  44. 44.

    Robert Sneddon

    Scotland — 6,116 new cases reported today, the number is not exact due to a technical issue with some of the reporting of COVID-19 cases. The test positivity rate is 9.0%, also affected by the technical issue. The number of new deaths was 30 overnight. ICU bed occupancy numbers are 99, up twelve from yesterday while hospitalisations are 1,052, up 15.

    There were about 4,800 vaccinations carried out in Scotland yesterday (Friday) with about 35% of these being first vaccinations. 91.0% of 16+ adults are now vaccinated with their first dose and 83.6% are fully vaccinated. 66.4% of 16 and 17-year-olds have now received their first vaccination.

    Generally, the numbers of cases and hospitalisations are remaining worryingly high even with high rates of vaccination. There’s no publicly available breakdown of the age groups testing positive or the hospitalisation rates and deaths. The authorities are not singling out schools or children as being the main cause for the high case numbers in Scotland. England is currently doing a lot better for some reason with lower case numbers and hospitalisation rates. This may change.

  45. 45.

    Sloane Ranger

    Friday in the UK we had 32,651 new cases. I assume this includes the cases that weren’t reported from Scotland on Thursday. Anyway, this is a decrease of 23% in the rolling 7-day average. New cases by nation,

    England – 23,265 (up 316)

    Northern Ireland – 1239 (up 168)

    Scotland – 5529 (did not report cases numbers on Thursday)

    Wales – 2618 (down 273).

    Deaths – There were 178 deaths within 28 days of a positive test yesterday. This is an increase of 5.1% in the rolling 7-day average. 130 deaths were in England, 10 in Northern Ireland, 30 in Scotland (probably some were from Thursday) and 8 in Wales.

    Testing – 1,059,522 tests took place on Thursday, 16 September. This is a decrease of 13% in the rolling 7-day average. The PCR testing capacity reported by labs on that date was 829,828.

    Hospitalisations – As of Thursday, 16 September, 8068 people were in hospital and 1020 were on respirators. As of 13 September, the rolling 7-day average for hospital admissions was down by 1.3%.

    Vaccinations – As of Thursday, 16 September, 48,528,901 people had received 1 shot of a vaccine and 44,298,076 had had both. This means that, as of that date, 89.3% of all people aged 16+ in the UK had had 1 shot and 81.5% were fully vaccinated.

    General – The UK government had relaxed travel restrictions for people entering and re-entering England. The amber list of countries will be abolished, leaving only red and green countries. From 22 October, the pre-departure test will be abolished and fully vaccinated people entering or returning from non red list countries will be able to replace the mandatory PCR test, taken 2 days after entry with a lateral flow test. If this shows positive they will then have to take a confirmatory PCR test and isolate. Rules for unvaccinated people are unchanged. The other devolved administrations are considering their options, but the Scottish First Minister has already said that they won’t go that far.

  46. 46.

    New Deal democrat

    @Miss Bianca:

    1. Own your position. Agree that “yes, little Johnny should die.”

    2. I read the Idaho triage rules. Unlike your comment, in which chance of survival is the priority, iirc Idaho priority #1 was children, and #2 was pregnant women. I forget what #3 was right now, but again iirc unvaccinated adults were only eligible for for the last two tiers, #4 and #5. So apparently Idaho stealthily put unvaxxed adults at or near the end of the line without explicitly saying so.

  47. 47.

    lowtechcyclist

    @RSA:

    As I think others have suggested, the line of people waiting for treatment isn’t just COVID/not-COVID. Some of the people may have put others at risk. Someone who was in a car crash when traveling at 100mph down the highway after drinking a little too much. A gang member who’s been shot. It’s easy to think of ways in which preference rules give poor outcomes.

    The difference being, there would be no ‘line’ without the Covid cases who refused to get vaxxed.

    And drivers with moving violations pay higher auto insurance rates. And the ethics of this are…?

  50. 50.

    Miss Bianca

    @New Deal democrat: “Own my position?” “Agree that ‘yes, little Johnny should die'”? Yeah, sure, dude, whatever. I’ll own my your position. That’s right. You caught me. I think Little Hypothetical Johnny should die, so that Hypothetical Anti-Vaxxer Dude should live. But wait, there’s more! Not only that, I also think your dog should die, too. Hypothetically speaking.

    Again, my favorite line from Sense and Sensibility comes into play: Elinor agreed to it all with a sigh, for she did not consider him worth the compliment of rational opposition. 

  51. 51.

    Another Scott

    Friday night update from Arlington, VA ER doctor. BlueVirginia:

    If you’re a parent of a kid <12, you’ve probably heard the news about the Pfizer vaccine. The Pfizer CEO (and also the CFO) announced this week that they are likely to submit data to the FDA for the 5-12 year ago group by the end of September. This would be a request for an EUA and could be approved within 3 weeks of submission to the FDA. Moderna is likely to be a month or so behind Pfizer. This is great news for those with younger kids.

    Pfizer and Moderna also made some announcements about boosters. I had hoped to be getting my booster next week, but the FDA hasn’t approved it. The FDA’s Advisory Committee met today and voted against recommending boosters for everyone 16+. They then had a subsequent vote recommending booster shots for those 65 and older and those at high risk for severe disease 6 months after their 2nd shot. The CDC advisory committee meets next week and hopefully will also consider those with occupational risk. I do expect a booster recommendation for everyone at some point as well, though it will take more time and data to determine the timing. (The timing on Moderna and J&J boosters isn’t clear at this point though will no doubt be considered by the FDA and CDC in the near future) Boosters are currently recommended for immunosuppressed people and more than 2 million boosters have been given.

    Here’s our current situation. The Delta variant makes up about 99% of the sequenced cases. Delta is more than two times as contagious as previous variants. Our immune antibody response wanes over time though it’s unclear exactly how clinically significant that is in younger, healthy patients. Pfizer and Moderna submitted more data this week highlighting the decline in effectiveness after 6 months The FDA had asked Pfizer to reanalyze data looking at breakthrough infections in July and August when Delta predominated. Those vaccinated with Pfizer 10+ months earlier had a breakthrough rate of 70 cases per 1,000 person-years, compared to 52 cases per 1,000 person-years for those who had been vaccinated 5 months before. This is where I think it gets interesting and outcome philosophy outweighs the data. Effectiveness is viewed in two ways—reducing the likelihood of infection AND reducing the risk of hospitalization and death. From a macro point of view, and considered the highest priority, Pfizer remains effective at reducing the need for hospitalization and the risk of death. This is likely the logic behind the FDA Advisory Committee’s “no” vote today. It is great that the 2 dose vaccination protocol is so effective and saving lives is really the most important part of the vaccination program. However, in my opinion, it’s also important that we reduce the spread and try to prevent infection, which is the argument for giving boosters more broadly.

    […]

    One issue is whether these booster doses would be better served being used around the world or here in the US. Clearly the first priority still needs to be getting everyone who is eligible fully vaccinated. And perhaps keeping the focus on the unvaccinated may also be part of the argument against a booster for 16+ right now. I’m hoping to get a booster soon, but it doesn’t look like it will be next week.

    Let’s look back at my week. Monday was World Sepsis Day. Sepsis is the body’s response to an infection. There is a spectrum of severity when it comes to sepsis with higher mortality associated with those who have septic shock. About 35-40% of patients with septic shock will die. About 50% of all hospital deaths are related to sepsis, and almost all people who die of COVID are dying of sepsis. We spend a lot of time working on projects that help us identify sepsis early in the patient’s stay and making sure that we follow a complex algorithm to treat sepsis, because those things lead to better outcomes. I spent Tuesday and Wednesday with a multidisciplinary team working on ER flow and efficiency. Like other ER’s around the country, our volumes are up, we’re seeing sicker patients, and we often have psychiatric patients staying in the ER for a long time. In other words, ER’s everywhere are running out of space. We’re looking to reinvent some of how we do business over the next few months.

    Regarding COVID, our percent positive rates, number of admitted patients, and number of ER positives remains consistent over the last 6 weeks or so. There were several very sick COVID patients during my shift yesterday. All unvaccinated, though we still see the occasionally vaccinated patient come to the ER. One patient didn’t want the vaccine in her body but then was fine getting monoclonal antibodies infused. The vaccine teachers your body to generate your own antibodies. Monoclonal antibodies come out of a lab. What’s so frustrating is that we clearly have a protective measure (vaccines) in place and readily available. Just walk into your CVS. The treatments that have been developed over the last 18 months have reduced the mortality rate from 5% to about 1% but things like Ivermectin and Hydroxychloroquine do not work. Prevention is absolutely the best strategy.

    […]

    Cheers,
    Scott.

  52. 52.

    Ruckus

    @Starfish:

    I’m torn on the issue of back of the line.

    Normally I’d agree 100% with you. But this is not a normal time, this is pandemic time. Just over 100 yrs ago we had another pandemic in the US and had no way to deal with it other than cloth masks, and BTW a lot of people complained and refused to wear them and a lot of people died. Humanity for the most part was spread out – a lot less densely populated than now but the contact points were pretty much the same and there was no vaccine and the medical system was still medieval so a lot died. But we have better medical services, we have 3 vaccines, we have masks widely available. Not everyone will survive, even with all the precautions. But with them an extremely larger number would survive and we wouldn’t have a second wave and likely a third wave. Other countries have done this but we can’t because of politics, and at least a third of our country is bugfuck nuts. They attacked our government, they called for the overthrow of the government, before the replacement government had been installed. They fight every concept of actual government and public health. And their ignorance, stupidity and hate is killing themselves and others, when most of it could be rather easily and relatively, cheaply prevented. So a 12 yr old boy, with a normal health issue, a bad appendix, almost died because it burst waiting hours for non vaccinated people with Covid to be treated. This is not a normal situation of most injured get treated first, this is a medical situation manufactured by stupid, willfully ignorant, assholes acting like 3 yr olds having a temper tantrum. As many have pointed out the vaccines are and have been shown to be safe, effective and absolutely necessary to controlling this pandemic and controlling the health care system from collapsing from overload and burnout. And because we don’t have a healthcare system that can handle the pandemic/vaccine deniers and normal health care needs, (which BTW no country in the world does either) the people that are causing the problem get first priority in a rather high percentage lost cause situation that they exacerbated.

  54. 54.

    Ruckus

    @r€nato:

    As I said above in a normal environment I would agree with you 100% about who gets helped healthcare wise.

    But in the US we did not have anything like a normal governmental response to the pandemic. We had political hell. And it’s cost us a lot, and it’s going to continue to cost us a lot. A lot in most every aspect of life in the US for some time to come. And people who have done what was needed, mask up, limit public contact as much as possible, get the damn vaccine, are now paying once again because the stupid, ignorant assholes who refuse to mask, vaccinate and limit public contact as much as possible are dying, and infecting others who are also dying.

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