Hospitals are pleading for more remdesivir

Plus, coming vaccines might produce 'reactogenic' effects, hydroxychloroquine is back in the news, gold and silver prices are spiking, and more.

July 29, 2020

Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.

Hospitals say they need more remdesivir, which is still an experimental drug but has shown some promise in reducing recovery time for COVID-19’s sickest patients. In Florida, hospitals and county health officials are asking the governor to help them find supplies of the drug. Similar shortages are reported in Arizona, Texas and elsewhere.

This shortage has been building in hot spot states for weeks. StatNews reported the problem seemed, in part, to center on how the drug was being allocated:

Soon after a clinical trial revealed that remdesivir could shorten coronavirus patients’ recovery, federal officials started sending cases of it directly to medical centers, but with no rhyme nor reason as far as hospitals could tell. Some overwhelmed centers were skipped over, while less burdened places received precious shipments — and physicians decried the unfairness and lack of transparency.

The government tried to course-correct by collecting COVID-19 patient numbers from hospitals, using those data to determine how much of the drug should be sent to each state and territory, and then letting each one’s health department further parcel out its allocation.

That made the calculus clearer — but doctors still worried that using last week’s numbers to determine this week’s delivery, rather than a predictive model, might create a lag in places where the case count was burgeoning.

CBS News reported that in other countries, remdesivir shortages have created a black market. In India, street supplies of the drug command 10 times the market price.

Florida’s governor blamed the shortages on doctors who prescribe the drug too often.

A COVID-19 vaccine might hurt and make you sick for a while

Let’s learn a new word: “reactogenic.” It means a physical reaction to a vaccination. I almost always have a little reaction to the annual flu shot, including a sore arm and a little hit of that “I think I am getting the flu” feeling. It passes in a day or so.

Clinical trials for COVID-19 vaccines in the works have been producing exactly those reactogenic symptoms, including headaches, sore arms, chills and low-grade fevers.

We will need to tell the public about this is because education is the best way to prevent the fear that will come if people are surprised after they get a shot. If they don’t understand the reaction, they might not return for a second dose, which is almost certainly going to be needed for a COVID-19 vaccine.

StatNews reported that health care providers might explain the reactogenic symptoms by saying they are good news because they signal the immune system is reacting, as it should, to the vaccine:

As long as the side effects of eventual COVID-19 vaccines are transient and not severe, these would not be sources of alarm — in fact, they may be signals of an immune system lurching into gear. It’s a simple fact that some vaccines are more unpleasant to take than others. Think about the pain of a tetanus shot, for instance.

“I think one of the things we’re going to have to realize is that all of these vaccines are going to be reactogenic. … They’re all going to be associated with reactions,” said Kathryn Edwards, scientific director of the Vanderbilt Vaccine Research Program in Nashville, Tennessee.

Among the volunteers who took the highest doses of the Moderna vaccine being tested in a phase 3 trial now, one patient spiked a fever of 103 degrees about 12 hours after getting the shot.

The other leading vaccine candidate, being tested by Oxford University and drug giant AstraZeneca, produced a reactogenic response in about 60% of patients.

StatNews said the main factor that determines whether a patient will endure some discomfort and accept a vaccine depends on how miserable they might be if they don’t take the vaccine.

There’s plenty of evidence that people will accept reactogenic vaccines — will virtually rush to get them — if they are concerned enough about the condition the vaccine is designed to prevent.

Edwards said GSK’s shingles vaccine, Shingrix, which reportedly makes people feel pretty miserable for a short period after injection, is a perfect example. Despite the possibility of discomfort, from the moment the vaccine was brought to market, the company could not keep up with the crush of demand for it.

I can testify to that! I took the shingles vaccinations and felt awful, but I know people who had shingles and there is no comparison. Journalists, this is going to take a lot of explaining. You will be vitally important in educating the public.

Back to hydroxychloroquine

I thought we had moved beyond this. But we have not — because a bunch of doctors spouted unproven claims about hydroxychloroquine that the president of the United States retweeted, and another round of unproven claims circulated. My colleagues at PolitiFact investigated, once again, claims about this drug, which is not a cure for COVID-19 and is not approved for the treatment or prevention of it, either.

About those “physicians” who appeared in Washington, D.C., PolitiFact said, “One of the most inaccurate claims comes from Dr. Stella Immanuel, a Houston-based primary care physician and minister with a track record of making bizarre medical claims, such as believing in alien DNA.”

Silver and gold prices spiked. What does that mean? Should I sell my scrap gold?

Gold prices are up more than 26% this year and silver is up 35% year to date. It is worth noting partly because these are the places some investors go when the outlook is grim.

Market watchers predict that gold could go above $2,000 per ounce.

The Wall Street Journal said:

Monday’s record marked a milestone in gold’s bull run, which many traders rank alongside those of 2008-11 and the late 1970s. The gloomy outlook for the world economy, a decline in interest rates, rising tensions between the U.S. and China, and the dollar’s depreciation have fueled the surge as investors have bought assets they perceive to be havens.

“There are still a lot of things to be worried about, which is why gold is attracting all this attention and all this money,” said David Govett, head of precious metals at commodities brokerage Marex Spectron.

As much as anything, gold investors are betting that a couple of multi-trillion dollar U.S. government stimulus packages will eventually lead to inflation.

Other metals — including silver, copper and aluminum — have also recovered from lethargic prices. Those metals have a lot of industrial value since they are used in manufacturing, so there are many factors that weigh on their popularity, not just as investments.

While gold is near record prices, silver is still half the price it was in 2011. It hit similar highs in the 1980s for very different reasons. In 2011, the price was driven by economic uncertainty, plus silver was in big demand in the solar panel industry. In the 1980s, a couple of investors sparked a rush when they tried to corner the silver market.

Especially at a time when people are scraping around for money to pay bills, the question will arise, “Should I sell my gold and silver stuff?” There is not a yes or no answer that will fit every situation, but generally, advisers say you should only sell your gold and silver when you have a real plan for what you will do with the cash. Keep in mind that the factors in determining the value of your jewelry or coins include purity, weight and, in the case of coins, condition and mintage.

Whatever jewelry you have is not pure gold, so you won’t get a pure gold price. Most jewelry is either 10k, the most durable; 14k, which is common because it has more gold and value but is still fairly durable; and 18k, which is the purest gold used in jewelry but is softer. 24k is pure gold, but it is too soft to be practical for jewelry.

To understand the gold content, turn the number into a fraction. 10k is 10/24 or 41% purity, 14k is 58% purity and so on. You may not know it but the Federal Trade Commission allows stuff to be sold as “gold” even if it has only 1k of gold in it.

Will Muslims ever have a holy pilgrimage again?

Muslim children grow up knowing that at least once in their life, if they are able, they are to make a holy pilgrimage, a hajj, to Mecca. It takes place during Dhu al-Hijjah, which is the final month of the Islamic calendar.

The hajj began yesterday and runs through Aug. 2. Some people plan this trip for years, some for a lifetime. And now, because of the pandemic, it is once again only a trip for the few.

This National Geographic video explained the hajj journey and its significance.

Each year, somewhere around 3 million of the faithful travel to Mecca. It is one of the largest human gatherings on earth. They are typically shoulder to shoulder and health experts have worried about a pandemic outbreak in such a crowd for years.

Slate published an essay from staff writer Aymann Ismail that said:

This year, because of the coronavirus pandemic, the government of Saudi Arabia has limited the hajj, which begins this week, to about 1,000 residents of the kingdom, a far cry from the more than millions who usually attend from around the world. The decision was met with grief around the world. Many hopeful pilgrims have saved for years to be able to book their trips months and even years in advance and could never have predicted that a pandemic would have prevented them from going. While this is a disappointment for Muslims everywhere, it’s worth keeping in mind that it’s only in recent years that the hajj has been accessible to so many.

Smithsonian Magazine added some historic context about times in the past when the hajj has been curtailed or even canceled. Going back to the plague, famine and cholera, and military action in 930 A.D. (that ended in the black stone of the Kaaba — which Muslims believe was sent down from heaven — being stolen and taken to what we now know as Bahrain), hajj organizers have cut back plans. But this is the biggest disruption in more than a century.

I can’t imagine the disappointment and grief of a pilgrim who thought this would be the year they would make the journey and now, they cannot. Tell their story. It is an opportunity to explain the importance of this event in a Muslim’s life.

How local TV will cover political conventions

TVNewsCheck spoke with leaders of some of the biggest local TV groups about how or if they would send news crews to whatever is left of the national political conventions. Sinclair, Gray, Hearst and Fox, just for example, all said they will send a lot fewer people and will focus more on local issues than podium speeches. The story said:

With stations sending fewer personnel to the national conventions, they’re still going to need to fill time. Scripps’ McLaughlin expects that coverage will be “less about who’s speaking at the podium and more about the people who are at home dealing with the things that are going on right now.” These are issues, he says, “that are ultimately going to decide the election.

“In a lot of ways, you can argue that the journalism piece of this is going to be a lot more compelling and a lot more relevant because it’s less produced,” McLaughlin continues. “That’s always been the thing with political conventions over the last few years — they’re produced. We’re sort of along for the ride to a large degree.”

With the delegates being remote and, ironically, more accessible through technology, the situation “provides unique local coverage opportunities,” he says.

Even if the conventions are a shadow of their former selves, host cities are still expecting robust protest groups to show up.

Should cities move police PIOs out of the police department?

The city of Minneapolis is moving the public information officer out of the police department in an attempt to build credibility.

If there is one complaint I hear often, especially from TV and radio reporters, it is the police PIO that they deal with most often is stiff, unresponsive, vindictive and plays favorites. (And you should hear what PIOs say about some journalists they work with.) Interesting that, as The Associated Press reported, the “Minnesota Chapter of the Society of Professional Journalists sent City Council members a letter discouraging the move, saying it was also concerned about access, and that placing the media position under city direction ‘would further erode public trust.’”

In other words, journalists are saying the one thing worse than dealing with the police PIO is not having a police PIO.

Police 1, a law enforcement news site, interviewed six police PIOs about why it is valuable to have a trusted public spokesperson inside the police department.

I generally agree with those views — that the best police PIOs I have known can thread the needle of having the trust of the officers who supply them information and also have the trust of journalists prying for details.

The best PIOs I have known did as much to waive me off stories that seemed like one thing but were something else as they did supply information for whatever I was reporting on.

It is hard to imagine an information officer who is not part of a police department developing the internal knowledge needed to navigate the delicate nature of the information that is shared during a difficult investigation, a tense situation, a civil emergency or a political tussle. It is a healthy exercise to keep pressing for openness and accuracy from police, but this is a change that may produce disappointing results.

We’ll be back tomorrow with a new edition of Covering COVID-19. Sign up here to get it delivered right to your inbox.

Al Tompkins is senior faculty at Poynter. He can be reached at atompkins@poynter.org or on Twitter, @atompkins.

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