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Coronavirus Feels Doubly Dangerous In A Town Haunted By Asbestos : Shots

Frank Fahland, 61, is one of hundreds of Libby, Mont., residents who has an asbestos-related disease. That makes them potentially more vulnerable to complications from COVID-19.

Nate Hegyi / Mountain West News Bureau


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Nate Hegyi / Mountain West News Bureau

Frank Fahland, 61, is one of hundreds of Libby, Mont., residents who has an asbestos-related disease. That makes them potentially more vulnerable to complications from COVID-19.

Nate Hegyi / Mountain West News Bureau

LIBBY, Mont. — Frank Fahland has spent most days since the pandemic began at the site of his dream house, working to finish a 15-year labor of love while keeping away from town and the people closest to him.

Like thousands of people from Libby and Lincoln County, in the far northwestern corner of Montana, the 61-year-old Fahland has lungs already scarred by years of breathing in the asbestos fibers that have contaminated the area’s dust and soil. The asbestos is a legacy of a now-defunct plant in the area that made vermiculite, a mineral used in insulation and gardening.

Fahland recently gave a visitor a tour of his partially finished log home, overlooking a meadow that stretches to the foothills of the Cabinet Mountains. He struggled to climb a small hill and stopped to reach for his inhaler.

“It feels like someone is standing on your chest,he explains, “or almost like someone stuffed a pillow down there in your lung.”

Fahland’s condition makes him more vulnerable to complications from COVID-19, so he’s keeping his distance from people, in hopes of avoiding infection. He has kept his distance from his son and granddaughter for months and he recently wrote his will.

“If it hadn’t been for COVID my will would not be written. But it is now,” Fahland says. “It’s filed in the courthouse and the whole goddamn thing is done. That gives you some idea of how seriously I take this.”

He’s not alone in taking such precautions against the virus. Lincoln County has one of the nation’s highest asbestos mortality rates. At least 400 people have died from asbestos-related diseases, which can include asbestosis, mesothelioma and lung cancer. At least 1 in 10 people in Libby have an asbestos-related illness, according to Miles Miller, a physician assistant at the Center for Asbestos Related Disease.

“Our patients having an underlying lung disease would make recovery from COVID-19 more difficult,” Miller says.

Lincoln County, population 20,000, largely was spared from outbreaks of the novel coronavirus at the beginning, which Miller chalked up to the community’s vigilance in testing, tracking and prevention efforts.

But by the fall, cases began to climb in the county along with the rest of Montana. By early October, the number of confirmed cases in Lincoln County was 170, nearly double the count at the end of August. County health officials said in a Facebook post that cases were all over the county and “it would be irresponsible to classify any towns as safe.”

The town of

‘Twindemic’ test: Massachusetts, many colleges mandate winter flu shots

“This is a brave new experiment by the state of Massachusetts,” said Lawrence Gostin, who heads a university-based center on health law that serves as an official collaborating institute with the World Health Organization. “If it turns out to be a wholesale success, that should influence other states to go a similar route, not just with flu but with other vaccines. But if it causes a backlash and only marginal benefit, states might be hesitant to adopt that model in the future.”

In New Jersey, Democratic lawmakers introduced a bill in the state Legislature late last month that would mandate flu shots for kids in preschool through college. Vermont public health officials also have been considering a vaccine order of their own.

Early evidence suggests the pandemic is widening a nationwide vaccination gap. Preliminary data from the Centers for Medicare and Medicaid Services show vaccination rates for typically given shots dropped by 22 percent this spring compared to last year, among young children enrolled in Medicaid and the federal Children’s Health Insurance Program.

Fewer than 50 percent of adults opt to get vaccinated against the flu in a typical season, a rate CDC Director Robert Redfield hopes to elevate to 65 percent this season.

While states have “the absolute right” under the Constitution to require vaccinations, Gostin said, the stakes are still high for officials who want to expand flu immunity without aggravating anti-vaccine tensions.

“There are a lot of my colleagues, and me included, that worry there’s such large numbers of people in the United States that are vaccine-hesitant or even outright anti-vaxxers, that a mandate might create a vicious backlash not only against influenza vaccines but all vaccines. So, you have to tread very carefully,” said Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University.

Before Massachusetts’ move, Gostin found that no state required influenza vaccinations for adults or K-12 students. Only a handful of states require flu shots for kids enrolled in childcare or preschool, according to the Immunization Action Coalition, even though the American Academy of Pediatrics and CDC recommend the vaccine for children older than 6 months.

Supply isn’t the issue. Flu vaccines are inexpensive, easy to find and often effective. But experts say time is running short before the annual flu season accelerates in the Northern Hemisphere.

“Many places have already gotten their supply of vaccines. They just need people to take it,” said Tina Tan, a Chicago pediatrician and infectious disease specialist at Northwestern Medicine. “This month is going to be the critical month to try and implement these types of mandates and get people vaccinated.”

Tan said flu shot requirements for school kids did not catch on before now for two main reasons: Doses are often unavailable when students start classes each school year, plus there are misconceptions that the flu shot is unsafe.

In Massachusetts, the governor has defended the flu shot mandate but acknowledged “some people are troubled” by a sweeping requirement that follows

White House Outbreak May Have Spread Coronavirus To Other Communities : Shots

Numerous people have tested positive after attending an event in the Rose Garden at the White House on Sept. 26 to announce the nomination of Seventh U.S. Circuit Court Judge Amy Coney Barrett to the Supreme Court.

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Numerous people have tested positive after attending an event in the Rose Garden at the White House on Sept. 26 to announce the nomination of Seventh U.S. Circuit Court Judge Amy Coney Barrett to the Supreme Court.

Chip Somodevilla/Getty Images

The White House’s apparent failures to thoroughly contact trace its current coronavirus outbreak has led local health officers to take matters into their own hands.

The District of Columbia and nine neighboring jurisdictions are calling on White House staff and visitors who might be connected to the recent outbreak there to contact their local health departments.

“We recommend that if you have worked in the White House in the past two weeks, attended the Supreme Court announcement in the Rose Garden on Saturday, September 26, 2020, and/or have had close contact with others who work in those spaces or attended those events, you should get a test for COVID,” the health officers wrote in a letter shared by D.C. Mayor Muriel Bowser early Thursday morning.

The authors note that this recommendation is being made based on “our preliminary understanding that there has been limited contact tracing performed to date.”

Thirty-seven White House staff and other contacts have tested positive, according to a website tracking the outbreak, citing public information such as media reports and tweets. Eleven of those positive cases are connected to the Amy Coney Barrett nomination event in the Rose Garden on September 26, according to the tracker, from which many attendees flew home to other states.

Emergency physician Leana Wen notes that, given that that event was nearly two weeks ago, it’s likely the outbreak has already sparked other infections.

“We’re not even talking about first generation spread or second generation to spread, we’re talking about third generation spread,” she says. In other words, those who were exposed at the Rose Garden could have infected others who have since infected still more people.

When it comes to tracking down all the contacts that might be connected to the White House outbreak, there are many daunting challenges, from the country’s fractured public health system to the Trump administration’s approach.

1. The White House is on federal land

There are reports of an increase in coronavirus tests in D.C., and some high case numbers in recent days, which has prompted concerns that the outbreak at the White House could be driving spread in the local area. It’s difficult to know for sure if these things are connected.

But because the White House is federal property, the job of contact tracing an outbreak on the White House grounds doesn’t fall to the District’s public health staff, it falls to the White House Medical Unit.

The open letter comes after D.C. Mayor Bowser

Montgomery County Public Health District urges flu shots during COVID-19 pandemic

The Montgomery County Public Health District is urging residents to get vaccinated for the flu and is currently taking appointments for children with adult bookings coming soon.

“This year, it’s even more important with COVID because the signs and symptoms of COVID are very similar to that of the flu,” said Alicia Williams, MCPHD’s public health director.

Looming over this flu season is the possibility of there being a confluence with COVID-19. And that can happen, Williams said as she pointed to a full hospital capacity due to COVID-19 in July.

“We don’t want to have that situation if we can prevent it. And getting a flu shot is one way we can prevent it,” she said, signaling a strain on supplies, nurse and space capacity brought on by flu hospitalizations.

As of Thursday, there are 61 COVID-19 patients hospitalized in the county, including 18 in ICU, according to the Montgomery County Hospital District.


“Getting a flu vaccine is more important than ever during 2020-2021 to protect yourself and the people around you from flu, and to help reduce the strain on healthcare systems responding to the COVID-19 pandemic,” reads a statement on the the Centers for Disease Control and Prevention website.

MCHPD is booking appointments for free vaccines for children 6 months to 18 who are either uninsured, have Medicaid, or lack coverage. Vaccinations for children without insurance are being billed at $10, with waivers available for those who cannot pay.

Unlike in years past, this year, MCHPD is vaccinating adults who are privately insured and with comorbidities or are part of a high-risk group like the elderly. Those who do not qualify can pay the $10 fee with available waivers.

The vaccine includes the four most common and prevalent flu strains and is applied through injection. Williams explained taking the vaccination during the fall is most effective because that is right ahead of the peak season, usually at the end of the year.

Aside from the danger of a contagion intensified by COVID-19, Williams wants to remind people the flu can cost them work productivity, wages and school time. A vaccine, she continued, could avoid that.

Furnished by the State of Texas, there is currently no shortage of vaccines, according to Williams.

If people do not get vaccinated through MCPHD, Williams is still encouraging the general public to get a vaccine at pharmacy chains offering it. She also wants people to understand the mild aching and fever they may experience from the vaccine does not mean they have the flu, but rather that their immune system is activating antibiotics.

And to that effect, MCHD paramedics were vaccinated last week. Additionally, MCHD will be carrying out flu shots on Meals on Wheels recipients.

“Ideally (mask usage) would reduce the spread of COVID, but it would also reduce the spread of flu,” she said, while also highlighting the importance of social distancing. “Our goal here is prevention, and that’s across the board for public health. One way we can do

Scientists Study The Long Term Health Effects Of Wildfire Smoke : Shots

Smoke blankets Mill City, Oregon, which was evacuated for days following the nearby Beachie Creek Fire.

Nathan Rott/NPR


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Smoke blankets Mill City, Oregon, which was evacuated for days following the nearby Beachie Creek Fire.

Nathan Rott/NPR

Ariel Kinzinger had a headache. Clark Brinkman coughed and wheezed. LaNesha Collins, feeling physically fine, was frustrated by another day mostly trapped inside looking out at a sepia sun, in Portland, Ore.

“I’ve never been in the thick of smoke like this,” said Collins, an Oregonian like the others. “It’s insane.”

In recent weeks, tens of millions of Americans have lived and breathed through a thick haze of wildfire smoke. In places, it lasted for weeks. The immediate health effects of that are well known to the medical community and anyone who’s been exposed: Eyes sting, throats tighten, snot can turn black.

Respiratory problems like asthma and chronic obstructive pulmonary disease (COPD) can be exacerbated, causing spikes in hospital visits. And recent research on the link between wildfire smoke and the flu, even suggests it could increase a person’s risk of contracting COVID-19.

Much less is known though about what happens after the smoke clears.

“Every person who asks me is like, ‘What does this mean for my health a long time from now?,'” says Colleen Reid, a geographer at the University of Colorado Boulder who studies the health impacts of wildfire smoke. “And unfortunately we don’t really know.”

The lack of data and information on the long-term health impacts of wildfire smoke is a hole scientists and epidemiologists are quickly trying to fill. Research teams are looking at long-term lung function after smoke exposure, and potential impacts on pregnant women and infants. These efforts have been slowed by the pandemic, but have taken on new urgency with recent events.

Record-breaking wildfires, like those the West Coast has experienced this year, have become a near-annual occurrence. Human-caused climate change is increasing the length and intensity of fire season globally. More people are moving to fire-prone areas. And there’s a growing understanding among land managers and the public that more “good fire” is going to be needed across broad swaths of the U.S. to chip away at a century’s worth of accumulated vegetation in some Western forests. All of this means more people are going to be exposed to smoke more frequently in the future.

“The paradigm’s changing where a [smoke event] is not just this one-time disaster for many communities in the West,” says Sheryl Magzamen, an assistant professor of epidemiology at Colorado State University. “They’re actually chronic disasters that occur every two to three years.”

Smoke travels far

Days of thick smoke are not a new occurrence in many Western communities. But the breadth and duration of the smoke generated by this year’s fires is without modern precedent.

An NPR analysis of air quality data on the West Coast found that 1 in 7 Americans have experienced at least a day of unhealthy air conditions during this

Hospitals Failing To Meet New COVID-19 Data Reporting Mandate To Get Warning Letters : Shots

The federal government is starting to enforce new COVID-19 data reporting requirements for hospitals.

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The federal government is starting to enforce new COVID-19 data reporting requirements for hospitals.

Studio 642/Getty Images/Tetra images RF

The federal government is starting to crack down on the nation’s hospitals for not reporting complete COVID-19 data into a federal data collection system.

The enforcement timeline starts Wednesday, said Seema Verma, administrator for the Centers for Medicare and Medicaid Services, in a call with reporters Tuesday. CMS issued a rule in early September requiring hospitals to report full, daily COVID-19 data to the federal government, including such information as the number of patients and ventilators they have. On Wednesday, CMS is sending letters to hospitals across America alerting many that they have not been in compliance.

Later this month, the department of Health and Human Services will also start posting a list of hospitals noting whether they are out of compliance.

The consequences are potentially severe. After multiple notifications, hospitals are subject to “termination from both Medicare and Medicaid, meaning the hospital would not receive reimbursement from these programs,” Verma says. This would be a major loss of funding and could go into effect as early as mid-December.

The warning letters are the latest in a string of actions, over several months, designed to get hospitals to provide more daily COVID-19 data to the federal government. Getting more complete COVID-19 data has been a mission of Dr. Deborah Birx, a lead on the White House Coronavirus Task Force.

Daily hospital admission data is being used “to understand where this epidemic is, how it’s moving through different populations and ensuring that we’re meeting the needs of specific hospitals and communities,” Dr. Birx said on the call. “In order to make that data useful, it also has to be timely, complete and valid.”

Hospitals have struggled with the reporting requests, which increased in July and became mandatory in September, and have added to their administrative burdens in the midst of a pandemic. Hospitals have been asked, cajoled and are now being forced to provide that data on a daily basis. The industry is very concerned.

“Tying data reporting to participation in the Medicare program remains an overly heavy-handed approach that could jeopardize access to hospital care for all Americans,” said Rick Pollack, head of the American Hospital Association, in a statement.

The hospital data reporting system drew controversy in mid-July, when the Department of Health and Human Services instructed hospitals to stop reporting data to the CDC, which had been collecting the data — reported voluntarily by hospitals — through a system many had used for decades. Instead, hospitals were told to report to a newer system directly managed by HHS, which oversees the CDC, raising concerns among politicians and public health experts of political interference in public health surveillance.

Hospitals were initially incentivized to report into the newer system by a threat that

Seal Beach Rite Aid Offers Flu Shots, Coronavirus Testing

SEAL BEACH, CA — Need a flu shot? or a coronavirus test? Rite Aid now offers flu shots and has opened additional, no-charge COVID-19 drive-thru testing at pharmacies across the state.

This year isn’t like most in the past and health officials are encouraging people to get a flu shot.

“Getting a flu shot early is more important than ever this year to maintain a healthy immune system as the COVID-19 pandemic and flu season converge,” the company said.

Several new Rite Aid drive-thru testing sites were added in California in September:

  • 12541 Seal Beach Blvd., Seal Beach

  • 405 West Main St., Brawley

  • 11200 Olive Dr., Bakersfield

  • 16120 Bear Valley Rd., Victorville

  • 1309 Fulton Ave., Sacramento

Pharmacists will oversee coronavirus testing and offer simple self-swab nasal tests from 10 a.m. to 8 p.m. on Monday through Friday and 10 a.m. to 5 p.m. on Saturday and Sunday.

All adults 18 years old or older, even if they are not exhibiting virus symptoms, are eligible for testing and need to pre-register at www.riteaid.com.

Through its partnership with the U.S. Department of Health and Human Services, Rite Aid opened 39 new locations across California, Oregon, Michigan, Ohio, Pennsylvania, New Jersey, New York and Virginia, and now operates a total of 303 testing sites across 15 states.

Learn more and schedule a COVID-19 test at a Rite Aid testing site.
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This article originally appeared on the Los Alamitos-Seal Beach Patch

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High demand for flu shots? Experts hope to avoid ‘twindemic’

October is prime time for flu vaccinations, and the U.S. and Europe are gearing up for what experts hope is high demand as countries seek to avoid a “twindemic” with COVID-19.

“Take flu out of the equation this fall,” said Dr. Daniel Jernigan of the U.S. Centers for Disease Control and Prevention.

A record number of flu vaccine doses are on the way, between 194 million and 198 million for the U.S. alone — seemingly plenty considering last year just under half of adults got vaccinated and there usually are leftovers.

Still, there’s no way to know how many will seek shots this year and some people occasionally are finding drugstores or clinics temporarily out of stock.

Be patient: Flu vaccine ships gradually, in batches, and the CDC and manufacturers say more is in transit.

“This year I think everyone is wanting to get their vaccine and maybe wanting it earlier than usual,” Jernigan told The Associated Press. “If you’re not able to get your vaccination now, don’t get frustrated” but keep trying.

Pharmaceutical giant Sanofi Pasteur, which is supplying nearly 250 million doses worldwide including 80 million for the U.S., says it has shipments staggered into November.

Vaccine maker Seqirus is exploring if it could squeeze out “a limited number of additional doses” to meet high demand, said spokeswoman Polina Miklush.

Brewing flu vaccine is time-consuming. Once production ends for the year, countries can’t simply order more — making for a stressful balancing act as they guess how many people will roll up their sleeves.

Germany usually buys 18 million to 19 million doses, and this year ordered more. As German Health Minister Jens Spahn put it: “If we manage, together, to get the flu vaccination rate so high that all 26 million doses are actually used, then I’d be a very happy health minister.”

Spain purchased extra doses in hopes of vaccinating far more older adults and pregnant women than usual, along with key workers in health facilities and nursing homes.

In contrast, Poland, which last year had 100,000 doses go unused, didn’t anticipate this fall’s high demand and is seeking more.

The good news: The same precautions that help stop spread of the coronavirus — wearing masks, avoiding crowds, washing your hands and keeping your distance — can help block influenza, too.

Winter just ended in the Southern Hemisphere and countries like South Africa, Australia, Argentina and Chile diagnosed hardly any flu thanks to COVID-19 restrictions combined with a big push for influenza vaccinations.

With the coronavirus still circulating and cold weather coming just as more schools and businesses reopen, there’s no guarantee that countries in the Northern Hemisphere will be as lucky with flu.

“How much flu, we don’t know — but there will be flu,” predicted Dr. William Schaffner of Vanderbilt University and the National Foundation for Infectious Diseases.

A flu vaccine only protects against influenza, not the coronavirus. And while its effectiveness varies from year to year, people vaccinated against flu don’t

Vienna unveils ‘vaccine tram’ to help triple flu shots

Usually, Vienna’s trams can be seen gliding past Baroque palaces, but this winter, one of them will take on a new role: helping Viennese get the seasonal flu vaccine.

The “vaccine tram” was unveiled on Thursday as part of a campaign being launched by the city to provide residents with free vaccinations and thereby reduce any potential pressure on hospitals from coronavirus patients.

The Viennese are being urged to either register for a spot on the tram or to head to one of several health centres and around 600 doctors’ offices where the vaccine is being administered.

“We think we can have a threefold increase of the vaccination rate this year and we hope to motivate many Viennese to get vaccinated,” Michael Ludwig, Vienna’s mayor, said at an event to unveil the tram.

He added that the city has acquired 400,000 vaccines, enough to cover about 25 percent of the population.

“The aim is to get a large number of Viennese residents inoculated… so that the capacities in the hospitals remain free because we don’t know what this winter will hold,” in terms of coronavirus infections, Ludwig said.

Currently, Vienna accounts for more than half of Austria’s coronavirus infections, with close to 4,500 active cases.

Medical experts have warned that the medical system could come under strain if it is forced to deal with an influx of seasonal flu and coronavirus patients at the same time.

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How The New Rapid Tests Could Drive A Coronavirus Testing Paradigm Shift : Shots

A new wave of rapid coronavirus tests have entered the market and have the potential to greatly expand screening for the virus.

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A new wave of rapid coronavirus tests have entered the market and have the potential to greatly expand screening for the virus.

Spencer Platt/Getty Images

A new generation of faster, cheaper coronavirus tests is starting to hit the market. And some experts say these technologies could finally give the U.S. the ability to adopt a new, more effective testing strategy.

“On the horizon — the not too distant horizon — there are a whole series of testing modalities coming on line,” says Dr. Ashish Jha, dean of the Brown School of Public Health. “And that gives us hope we can really expand our testing capacity in the nation.”

Until now, testing has been primarily used to diagnose people who may have COVID-19 and any of their close contacts who may also be infected. But a stubborn shortage of the molecular tests most commonly used — and slow turnaround time for results — has hobbled the nation’s ability to stop outbreaks and contain the pandemic.

That could change, argue Jha and other public health researchers, as new rapid tests — primarily antigen tests — become more widely available, enabling communities to start widespread screening of the highest-risk people.

“It is a paradigm shift,” Jha says. “What I think new testing capacity allows us to do is actually play offense — go and hunt for the disease before it spreads to identify asymptomatic people before they spread it to others. It really becomes about preventing outbreaks — not just capturing them after they’ve occurred.”

Jha and a team at the Harvard Global Health Institute have periodically evaluated how much testing the country and individual states need to effectively fight the spread of the virus.

In a new analysis the group completed for NPR, researchers developed daily testing targets, showing what would be needed to routinely screen large numbers of asymptomatic people. The researchers factored in the growing availability of the rapid coronavirus tests.

The U.S. would need 4.4 million tests every day, the analysis concludes, to reach what Jha calls “a basic level of proactive testing.” The idea is to do regular testing of some of the highest risk groups — stopping outbreaks before they can spill over to the rest of the community.

This scenario calls for screening all nursing home residents and staff twice a week and weekly testing of every prison inmate and guard, firefighter, police officer and emergency medical technician, as well as teachers and staff in K-12 schools, and all university students.

Using the older molecular test technology, the U.S. has never managed to perform more than about 1 million tests per day. But the companies that make the new antigen tests are ramping up production and additional tests are in the pipeline. As a result, Jha and others estimate that there could be enough