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.
President Donald Trump said Tuesday we will have a vaccine in three to four weeks.
Dr. Robert Redfield, the head of the Centers for Disease Control and Prevention, said Wednesday that even when we get a vaccine, it will not likely be available to the general public until next summer. Redfield also rolled out a playbook for how a national vaccine program might look.
The playbook is loaded with details you have not seen or heard before and it is really important for journalists to start to learn how a vaccination program might unfold. You will be vitally important to its success.
“Early in (the) COVID-19 vaccination program there may be a limited supply of vaccine and vaccine efforts may focus on those critical to the response, providing direct care and maintaining societal functions, as well as those at highest risk for developing severe illness,” Redfield told the Senate Appropriations Committee.
The playbook calls for three phases of vaccinations.
Phase one focuses on three groups first, with a tight supply of vaccines:
- Health care personnel likely to be exposed to or treat people with COVID-19
- People at increased risk for severe illness from COVID-19, including those with underlying medical conditions and people 65 years of age and older
- Other essential workers
Phase two will finish vaccinating essential workers and then start reaching general populations. Supplies may still be tight.
Phase three will reach out to populations that for whatever reason have not yet been vaccinated.
The plan says the Biomedical Advanced Research and Development Authority, part of U.S. Department of Health and Human Services and also known by BARDA, was awarded four big contracts to buy hundreds of millions of needles, syringes and other supplies that will be needed in a national vaccination effort.
Interestingly, the plan — which was given to the Senate Wednesday — says the delivery date for those supplies will be in early January, not in a few weeks.
Who would get the vaccines first?
Inside the playbook given to senators is the first detailed look at who might get the first vaccines in phase one. It includes the possibility that teachers (including college educators), nursing home workers, people living in rural communities and people who have little or no health insurance might be toward the front of the line.
Another group at the front of the line is people who are in prisons and jails, including prisoners and staff. People working in food packing and distribution would be in phase one, as well.
Here is the whole list:
The first step in planning is to identify and estimate the critical populations within a jurisdiction. These populations (listed in no particular order) may include but are not limited to:
Critical infrastructure workforce
- Health care personnel (i.e., paid and unpaid personnel working in health care settings, which may include vaccinators, pharmacy staff, ancillary staff, school nurses, and EMS personnel)
- Other essential workers (see additional guidance from the Cybersecurity and Infrastructure Security Agency [CISA])
Note: The critical infrastructure workforce varies by jurisdiction. Each jurisdiction must decide which groups to focus on when vaccine supply is limited by determining key sectors that may be within their populations (e.g., port-related workers in coastal jurisdictions)
People at increased risk for severe COVID-19 illness
- LTCF residents (i.e., nursing home, assisted living, independent living facility residents)
- People with underlying medical conditions that are risk factors for severe COVID-19 illness
- People 65 years of age and older
- People at increased risk of acquiring or transmitting COVID-19
- People from racial and ethnic minority groups
- People from tribal communities
- People who are incarcerated/detained in correctional facilities
- People experiencing homelessness/living in shelters
- People attending colleges/universities
- People who work in educational settings (e.g., early learning centers, schools, and colleges/universities)
- People living and working in other congregate settings
People with limited access to routine vaccination services
- People living in rural communities
- People with disabilities
- People who are under- or uninsured
Where will the first vaccines be distributed?
The playbook says the most probable first locations include:
- Large hospitals and health systems
- Commercial partners (such as pharmacies)
- Mobile vaccination providers
- Occupational health settings for large employers
- Critical access hospitals, rural health clinics, community health centers, and other central locations that can provide vaccination services for a broad area
Other places that will be considered include homeless shelters, food pantries, senior centers, prisons and jails, and colleges and universities. They will be looking for venues where people do not have to crowd together.
Wherever they are held, the vaccinations will likely be given by appointment to control crowds.
The second dose will be critical
The playbook spells out one more complication you have not heard about. When the U.S. Food and Drug Administration does approve a vaccine, it is probable that more than one manufacturer will produce that vaccine.
Remember that the COVID-19 vaccine program will require the patient to get two shots spread out by about three or four weeks. The playbook says there has to be a way to send people a reminder to make sure the second shot comes from the same drug manufacturer as the first shot or the vaccine won’t work. The playbook lays it out on page 30:
For most COVID-19 vaccine products, two doses of vaccine, separated by 21 or 28 days, will be needed. Because different COVID-19 vaccine products will not be interchangeable, a vaccine recipient’s second dose must be from the same manufacturer as their first dose. Second-dose reminders for vaccine recipients will be critical to ensure compliance with vaccine dosing intervals and achieve optimal vaccine effectiveness. COVID-19 vaccination providers should make every attempt to schedule a patient’s second-dose appointment when they get their first dose
Communication will be critical
The vaccination playbook pays attention to how vital public information will become to convince and enable people to get the shots. I thought this section was interesting. It is a warning to all who will be involved to pay attention to the language they use, especially when the messages are translated into other languages and delivered to a diversity of audiences.
Public health messages and products should be tailored for each audience and developed with consideration for health equity. It is important to use plain language that is easily understood. Information should be presented in culturally responsive language and available in languages that represent the communities. Jurisdictions should be careful to address all people inclusively, with respect, using non-stigmatizing, bias-free language. Insufficient consideration of culture in developing materials may unintentionally result in misinformation, errors, confusion, or loss of credibility. When developing/utilizing materials, jurisdictions should check for the following:
- Are there words, phrases, or images that could be offensive to or stereotypical of the cultural or religious traditions, practices, or beliefs of the intended audience?
- Are there words, phrases, or images that may be confusing, misleading, or have a different meaning for the intended audience (e.g., if abstract images are used, will the audience interpret them as intended)?
- Are there images that do not reflect the look or lifestyle of the intended audience or the places where they live, work, or worship?
- Are there health recommendations that may be inappropriate or prohibited for the social, economic, cultural, or religious context of the intended audience?
- Are any toll-free numbers or reference web pages in the message in the language of the intended audience?
It will be interesting to see how the government and local health agencies use local celebrities, sports figures, media celebs and trusted health officials as spokespersons to promote the vaccine programs. The promotions will have to reach others, from youth audiences to skeptics, too.
It’s a COVID-freelance world
A new report from Upwork says the freelance world has increased by more than a third in the last year. And three-fourths of those of you who used to work for somebody else say you earn just as much or more now while freelancing. UpWork’s “Freelance Forward 2020” report found:
Amid a global recession, the freelance workforce remains an essential pillar of the U.S. economy: Freelancers contributed $1.2 trillion to the U.S. economy in annual earnings — a 22% increase since 2019.
More professionals are freelancing full time: The share of independent professionals who earn a living freelancing full time has increased 8 percentage points to 36% since 2019.
Freelancing increases earning potential: Of those who quit their full-time job in order to freelance, 75% say they earn the same or more in pay than when they had a traditional employer.
Young adults are turning to freelancing for economic opportunity: Amid a tough job market for recent college graduates, half of the Gen Z workforce (age 18-22) have freelanced in the past year, and of those, more than a third (36%) started since the onset of COVID-19.
Freelancers are increasingly high-skilled: 50% of freelancers provide skilled services such as computer programming, marketing, IT, and business consulting, up from 45% in 2019.
Professionals are likely to consider freelance work in the future: 58% of non-freelancers who are new to remote work due to the pandemic are now considering freelancing in the future.
For those age 55+, freelancing helps to address financial needs as they grow older. 65% of Boomers who freelance say that independent work is a good way to transition into retirement.
Among the 48% of freelancers who are caregivers, more than two-thirds say that freelancing provides them an alternative that can allow one to support a family without a traditional job.
More than half of freelancers say that even since the pandemic began, demand for their work has held steady. Conversely, 12% of the U.S. workforce began freelancing during the pandemic for the first time.
In addition, 48% of freelancers are caregivers (no surprise there). In fact, one of the fastest-growing segments of new freelancers are people who have to find ways to juggle child care and work-from-home duties during the pandemic.
Of those that started freelancing:
48% already see it as both a full time and long-term career opportunity
60% say that there is no amount of money that would convince them to take a traditional job
The study does not say how many of you would become freelancers if it weren’t for one thing: the cost of health care insurance.
The Canada-U.S. border is likely to stay closed until November
A number of Canadian newsrooms reported Wednesday that the U.S.-Canada border will probably stay closed until the end of November, at least.
The month-long ban, which does not cover trade or travel by air, was first imposed in March and has been rolled over several times. The current range of restrictions runs out on Sept. 21.
“The thinking is that this is probably going to have to extend through at least until American Thanksgiving (Nov. 26),” said one source, who requested anonymity given the sensitivity of the situation.
Canadian officials, especially those in provinces bordering the United States, insist the restrictions must remain.
Canada on Friday reported zero COVID-19 deaths in the previous 24 hours for the first time since March 15. By contrast, the number of deaths reported on Sunday in the United States rose by 807 to hit a total of 193,195.
Big Ten COVID comeback
The Big Ten football season is back on the calendar beginning Oct. 23-24 and will include daily COVID-19 testing of players and staff. In fact, it was the development of reliable rapid-results testing that the schools said allowed them to reopen their seasons. Each school will have a “Chief Infection Officer.”
ESPN said players who opted out of college football and declared themselves available for the NFL draft can still opt back in to college sports — unless they have hired an agent. That might make a college athlete ineligible to return to a college team.
The decision comes even after we learned last week that five of the conference’s athletes who tested positive for COVID-19 were found to have inflammation of the heart muscle. The condition, called myocarditis, can, in rare cases, lead to a stroke or heart attack.
Here is the protocol the Big Ten schools will use:
The Big Ten Conference will use data provided by each Chief Infection Officer (CInO) to make decisions about the continuation of practice and competition, as determined by team positivity rate and population positivity rate, based on a seven-day rolling average:
- Team positivity rate (number of positive tests divided by total number of tests administered):
- Green 0-2%
- Orange 2-5%
- Red >5%
- Population positivity rate (number of positive individuals divided by total population at risk):
- Green 0-3.5%
- Orange 3.5-7.5%
- Red >7.5%
Decisions to alter or halt practice and competition will be based on the following scenarios:
- Green/Green and Green/Orange: Team continues with normal practice and competition.
- Orange/Orange and Orange/Red: Team must proceed with caution and enhance COVID-19 prevention (alter practice and meeting schedule, consider viability of continuing with scheduled competition).
- Red/Red: Team must stop regular practice and competition for a minimum of seven days and reassess metrics until improved.
Make no mistake, this is a health story to be sure, but also a big money story. The 14 Big Ten schools provide $200 million in scholarships to 9,800 students who participate on 350 teams in 42 different sports.
And this is a season when half of the Big Ten teams were in the top 25 teams in the AP preseason poll, including No. 2 Ohio State and No. 7 Penn State.
It is unclear how much influence the Big Ten’s decision will have on other conferences. The Pac-12 could not reopen if it wanted to because local restrictions in California and Oregon prevent it. Those two states make up six of the Pac-12 teams. Even if there had been no COVID-19 shutdown, it is possible that at least some games might not have happened on schedule because fires have caused so much air pollution in the northwestern states.
Even if the schools do not allow crowds into stadiums, there is not much they can do except discourage fans from tailgating and threaten students who will assuredly gather at gameday parties.
The way we work now
This is just priceless and perfect. Bravo, Gretchen Goldman and to all you good people who pull off the TV live shot while sitting in your shorts, surrounded by baby toys.
— Gretchen Goldman, PhD (@GretchenTG) September 15, 2020
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Al Tompkins is senior faculty at Poynter. He can be reached at email@example.com or on Twitter, @atompkins.