Plus, COVID growing among children, CDC recommends vaccines; what we learned about myocarditis and vaccines, and more. Email not displaying correctly?
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** More muddy mandate rules: Federal contractors get leniency
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A syringe is prepared with the Pfizer COVID-19 vaccine at a clinic at the Reading Area Community College in Reading, Pa., Tuesday, Sept. 14, 2021. (AP Photo/Matt Rourke)

Every day, it seems, we get another mixed message about how much governments at all levels are enforcing vaccine mandates. Case in point: The Biden administration just announced ([link removed]) that federal contractors should suggest counseling for workers who refuse vaccinations. The contractors may also help reluctant workers find a nearby vaccination center. If an employee keeps refusing, then the employer can consider firing them.

The government will defer to contractors ([link removed]) to determine whether employees’ claimed exemptions, such as medical conditions or religious accommodations, are legitimate.

It puts the employer in the role of enforcer, similarly to how states and cities put restaurants and grocery stores in that role when the government didn’t want to do it. Now every federal contractor will make up their own rules.

Federal contractors are being treated very differently than federal employees, who must get vaccinated or be gone. This week we have seen how different branches of the military ([link removed]) are being both lenient and strict ([link removed]) .

The development comes on a deadline of sorts for workers to be fully vaccinated by Dec. 8, as President Joe Biden directed. If you factor in a three-week wait for people who take Pfizer vaccines, then the first vaccination would have to be administered by today. It is already too late to take the Moderna vaccine — which requires four weeks between shots — and still make the Dec. 8 date. Workers could wait until Nov. 24 to get Johnson & Johnson's single-shot vaccine and meet the deadline.

Reuters reports ([link removed]) that in Wichita, Kansas, contractors Textron Inc and Spirit AeroSystems have workforces where fewer than half of employees are vaccinated. Reuters also reported, “For Boeing Co in the United States, more than 7,000 workers have applied for religious exemptions and around 1,000 are seeking medical exemptions.” That amounts to about 6% of the company’s workers seeing exemptions.

Sometime this week, these federal contractors may get an order to mandate vaccines because they have 100 or more employees. The Office of Management and Budget finished its final review of the order Monday but has not yet made it public.


** COVID growing among children, CDC recommends vaccines
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The committee that the Centers for Disease Control and Prevention turns to for recommendations about vaccinations approved the Pfizer COVID-19 vaccine for children ages 5 to 11.

The vaccine will be given in two doses and administered in children’s arms. A number of members of the committee — which is called ACIP — said they wanted the public to know that they would be taking their own children to be vaccinated right away. The CDC panel’s recommendation also got the endorsement of the American Academy of Pediatrics ([link removed]) .

The committee did not recommend booster doses for children. That could change once researchers have had more months to observe how children’s immune systems react over time. In addition, the Food and Drug Administration and CDC are still studying Moderna’s pediatric vaccine.

The recommendation follows presentations from CDC staff showing the youngest Americans represent a growing percentage of new cases, even while the overall number of cases fall. On this chart, shown in the hearing, the purple part of the graphic represents 5- to 11-year-olds. You can see the rate is growing.
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Data from Oct. 10. (CDC)

The 5 to 11 age group represents 8.7% of the U.S. population but also makes up 10.6% of known infections. The researchers said that figure is likely understated since many infected children do not show symptoms and some who do are not diagnosed.

The committee heard new data that said about 7 to 8% of children who get infected have long-term complications, which is less than for adults.

The data shows that children and adults seem to pass along COVID-19 at about the same rate and it is also true, the researchers said, that vaccinations reduce transmission.

The evidence shown at the ACIP hearing said that if children had been in classrooms last year, the combined effect of a typical flu season and a COVID-19 outbreak could have been disastrous.

COVID-19 was the eighth leading cause of death for children in the last year. But put in another context, of the 730,000 COVID-19 deaths in the U.S., 94 of them were children. (Note that the chart below shows 66 because it picks up data in October 2020, not the start of the pandemic.)
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(CDC)

The data also showed that younger children are just as susceptible to infection as adults. That counters the widely repeated trope that children are more immune.

The sickest children are Black, Native American and Hispanic.
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(CDC)


** What did we learn about myocarditis, COVID-19 and vaccines?
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Myocarditis is a rare heart inflammation ([link removed]) that affects young people more than adults. There has been some concern that the vaccines could be connected with increased myocarditis rates. But ACIP heard evidence that there are no known cases of children dying from myocarditis after vaccination.

This graphic underscores that statement. You will see that there are three cases in which myocarditis might have been involved in a COVID-19 death, but other factors may have also been in play.
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(CDC)


** How long does natural immunity last after infection? Here’s new data.
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The CDC just released new data ([link removed]) that show that people who have been infected by COVID-19 may develop some level of immunity that lasts up to six months. That is about the same length of time that vaccines seem to hold up before declining in effectiveness, but the difference is some people develop very little immunity from being infected while almost everybody gains immunity from vaccines.

The bottom line, as you might imagine, is, “Substantial immunologic evidence and a growing body of epidemiologic evidence indicate that vaccination after infection significantly enhances protection and further reduces risk of reinfection.” In other words, yes, natural immunity is real, but it is unreliable and usually not as robust as a vaccine.


** In prisons, a dire staff shortage
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Lance Lowry, a recently retired corrections officer with the Texas State Penitentiary, holds his ID badge on the front porch of his home, Oct. 27, 2021, in Huntsville, TX. Lowry, an officer for 20 years, became disheartened watching friends and coworkers die from COVID, along with dwindling support from his superiors. He left the prison system this summer for a job in long-haul trucking. (AP Photo/Michael Wyke)

There’s a dire staff shortage in prisons. Prison workers say the pandemic, which exacerbated short-staffing and contributed to terrible working conditions, is partially to blame. But they also say senior officers are retiring in droves, pay is not enticing enough to recruit new workers and prison populations that fell during the pandemic are rising again.

The Associated Press and The Marshall Project worked together ([link removed]) on an investigation into how the pandemic made the essential work inside prisons more dangerous and difficult. Vaccine mandates are reason enough for some workers to leave.

Unions representing prison officers in states including Massachusetts and California and at the federal level also claim vaccine mandates will drive out unvaccinated employees and exacerbate understaffing, though it’s unclear how big of an impact those rules will have.

“There are dozens of reasons to leave and very few to stay,” said Brian Dawe, national director of One Voice United, a nonprofit supporting corrections officers. “Understaffing, poor pay, poor benefits, horrendous working conditions. … Officers and their families in many jurisdictions have had enough.”

Staffing shortages have caused some prisons to close. Others have gone on lockdown because there is not enough staff on hand to supervise prisoners out of their cells. Some prisons have stopped holding classes or therapy sessions because of staffing shortages.

The Marshall Project ([link removed]) and the AP found some stunningly high job vacancies around the country:

In Georgia, some prisons report up to 70% vacancy rates. In Nebraska, overtime hours have quadrupled since 2010, as fewer officers are forced to work longer hours. Florida has temporarily closed three prisons out of more than 140 because of understaffing, and vacancy rates have nearly doubled there in the last year. And at federal prisons across the country, guards are picketing in front of their facilities over understaffing, while everyone from prison teachers to dentists is pulled in to cover security shifts.

The Marshall Project points out that staffing shortages also make prisons more dangerous. One corrections officer in Georgia said at times there are six or seven officers to supervise 1,200 people.


** Big increase: Children spent 8 hours a day looking at screens during the pandemic
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Lizzie Dale sprawls on the floor to play games on an iPad as her siblings work on school work in the kitchen behind her in their home in Lake Oswego, Ore., Oct. 30, 2020. (AP Photo/Sara Cline)

Kids were already spending a lot of time looking at phones and computer screens before the pandemic but a new study of 5,400 12- to 13-year-olds ([link removed]) found that screen time doubled to almost eight hours per day ([link removed]) during the pandemic. And that does not include school-time screen use.

The study, which was conducted by researchers at UC San Francisco, included this passage:

UC San Francisco-led researchers found that 12- to 13-year-old children in the United States doubled their non-school-related screen time to 7.7 hours a day in May 2020, compared to 3.8 hours a day before the pandemic. The study also found that children of color and those from lower-income families logged more hours on screens than their white, wealthier peers.


** Medical board getting fed up with doctors prescribing and touting unproven meds
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The Houston Chronicle reports ([link removed]) that the Texas Medical Board took what it calls a “corrective action” against Houston’s Dr. Stella Immanuel after she prescribed hydroxychloroquine to treat a patient’s COVID-19 infection without adequately explaining the health consequences.

California has started ([link removed]) pressing doctors who spread nonsense to give up their licenses, Rhode Island disciplined a doctor ([link removed]) doling out fake COVID-19 info and state officials in Oregon suspended a doctor’s license ([link removed]) for spreading misinformation about masks.

At the same time, medical boards in Arkansas ([link removed]) and Georgia ([link removed]) have turned their heads.


** Totally treatable and preventable syphilis makes a comeback
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NPR reports ([link removed]) :

In the United States, more than 129,800 syphilis cases were recorded in 2019, double the case count of five years prior. In the same time period, cases of congenital syphilis quadrupled: 1,870 babies were born with the disease; 128 died. Case counts from 2020 are still being finalized, but the CDC has said ([link removed]) that reported cases of congenital syphilis have already exceeded the prior year. Black, Hispanic and Native American babies are disproportionately at risk.

NPR takes readers/listeners on the long trail of syphilis’ history in the U.S., including how the federal government has not spent nearly enough money or attention on the problem to finally control it:

From 2015 to 2020, the CDC’s budget for preventing sexually transmitted infections grew by 2.2%. Taking inflation into account, that’s a 7.4% reduction in purchasing power. In the same period, cases of syphilis, gonorrhea and chlamydia — the three STDs that have federally funded control programs — increased by nearly 30%.

“We have a long history of nearly eradicating something, then changing our attention, and seeing a resurgence in numbers,” said David Harvey, executive director of the National Coalition of STD Directors. “We have more congenital syphilis cases today in America than we ever had pediatric AIDS at the height of the AIDS epidemic. It’s heartbreaking.”

Somebody in your community, at your health department, tracks cases, identifies and notifies infected people and knows the shame and stigma associated with this disease. Not talking about it does nothing to end it.


** China locks down a school with kids inside, locks down Shanghai Disneyland after positive test
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You may find these mindboggling, but in Shanghai, when one person who had visited the Shanghai Disneyland ([link removed]) tested positive for COVID-19, the park locked down until all 30,000 people inside the park could be tested.

Then, Bloomberg reports ([link removed]) :

Parents gathered outside a primary school in Beijing late into the night on Monday, anxiously waiting for their children who were caught in a snap lockdown triggered by a teacher diagnosed hours earlier with Covid-19. The principal came out a little past midnight, telling them some of the kids would have to quarantine. Each could have one parent accompany them through the two weeks of isolation. For students whose test results hadn’t yet come back, parents were asked to bring quilts and pillows to spend the night at school.


** How a health reporter pried open info on COVID-19 in private and public nursing homes
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Politico’s executive health care editor, Joanne Kenen, wrote a how-I-did-it piece for the Health Care Journalists Association ([link removed]) about her reporting on COVID-19 infections in nursing homes. She focused on state veterans’ homes — nursing homes for veterans — where vets were dying. She found that these homes are financed by the Department of Veterans Affairs but operated by states, so nobody was “fully in charge.”

We’ll be back tomorrow with a new edition of Covering COVID-19. Are you subscribed? Sign up here ([link removed]) to get it delivered right to your inbox.
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