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.
Trypanophobia is an extreme fear of medical procedures involving injections or hypodermic needles. And it might be something for journalists to be thinking about as you show video and images of needles going into people’s arms.
The issue came up in Poynter’s “Reporting on the COVID-19 Vaccines” webinar Monday when Patsy Stinchfield, a registered nurse and vaccine safety specialist, told journalists that showing needles being jabbed into people’s arms may be a turnoff for the public.
Fear of needles may be more common than you think. About 25% of adults are afraid of needles, and around 7% of adults avoid immunizations because of their fear. There is a fairly wide body of research on this topic that found:
- The majority of children exhibited needle fear, while prevalence estimates for needle fear ranged from 20-50% in adolescents and 20-30% in young adults.
- In general, needle fear decreased with increasing age.
- Both needle fear and needle phobia were more prevalent in females than males.
- Avoidance of influenza vaccination because of needle fear occurred in 16% of adult patients, 27% of hospital employees, 18% of workers at long-term care facilities and 8% of health care workers at hospitals.
- Needle fear was common when undergoing venipuncture, blood donation, and in those with chronic conditions requiring injection.
There are some theories that we have a survival instinct not to be punctured by stuff, so taking a shot is an unnatural act for humans (and yes I have a link to actual clinical studies about that).
Trypanophobia becomes a big problem when people fear the needle more than the disease they are trying to prevent. And children may pick up cues from their parents, so we must be really thoughtful about how we talk about our fears because others are listening.
Psycom has a list of ways you can prepare yourself for an injection if you fear needles:
Take the cognitive approach. Psychiatrist Michael D. McGee, MD advises contemplating the worst that can happen and remembering that an injection is only a temporary discomfort. “Remind yourself that a needle is painful for a second but when you process and fully understand what the suffering would be like if you did not get the injection, it can help you be more realistic,” Dr. McGee explains.
Practice deep breathing. “Visualize yourself being in a comfortable place,” Dr. McGee says. “Don’t make your fear an enemy but treat the injection as something that in the end will make you more comfortable.”
Try mindfulness and meditation. Start with a few minutes of mindfulness and then 14 minutes of meditation. Think of three things that you are grateful for and then imagine your goals, long-term or simple, being accomplished.”
This all may seem melodramatic for those of us who have no issue with needles. But don’t underestimate other people’s phobias. You have no idea what trauma might be behind people’s feelings and memories. By the way, The Conversation describes “some needle-free COVID-19 vaccines in development” that “include a bandaid-like patch made up of 400 tiny needles, a nasal vaccine, an oral vaccine as a tablet, and a needle-free device that delivers an mRNA vaccine.”
The history of needles for injection
When I got my flu vaccine a month or more ago, I was quite surprised that I did not feel the shot at all. I mean, not at all. It made me wonder how we got to this point when we can stick a metal thing into human arms and have it not hurt one bit.
We should start by thanking Francis Rynd, an Irish physician who in 1844 invented a hollow needle and used it to try the first documented injections. Some people also credit Scottish physician Alexander Wood. Rynd’s invention let the drug trickle into the body while Wood used a plunger. Rynd didn’t publicize his invention, Wood did, and so began the debate on who should get the credit.
To give you an idea of how far we have come, look at the kind of device Rynd used.
Syringes were invented long before hypodermic needles. There are mentions of ancient Greeks and Romans using reeds. One guy used a goose quill for veterinary medicine in the 1600s. But the technology, unfortunately, did not include sterilization, so injectables didn’t catch on for quite a while.
Is the coronavirus mutating?
The Guardian quotes Secretary Matt Hancock: “Initial analysis suggests that this variant is growing faster than the existing variance. We’ve currently identified over 1,000 cases with this variant, predominantly in the south of England, although cases have been identified in nearly 60 different local authority areas and numbers are increasing rapidly.”
In our Poynter webinar Monday, Dr. Paul Offit told journalists that this kind of mutation is not unusual. He believes that the vaccines will be effective against these “single strain” variants.
Another vaccine trial hits a snag
As if to underscore the achievement that Pfizer, Moderna and others have and are achieving, drugmakers GlaxoSmithKline and Sanofi announced Monday that they are going to have to reformulate their coronavirus vaccines to be more effective for seniors. The delay means they will not have a drug to bring before the U.S. Food and Drug Administration for close to a year. Researchers in Australia also just abandoned their vaccine candidate because it produced false positive results in HIV tests.
Those developments underscore how incredibly fortunate we are to have drugs that are proving to be safe and effective, because there was never a guarantee that it would turn out this way 10 months after the pandemic began claiming lives.
Take the vaccine just before your days off
As front-line health care workers sign up to get their COVID-19 vaccines, hospitals are advising them to sign up for their shots near dates when they are going to be off, just in case they have a reaction that makes them feel a bit under the weather. Hospitals and nursing homes have some concerns that they could see high absenteeism if the whole staff gets the shot on the same day.
Journalists may think about this same advice for newsrooms once vaccines become generally available.
Hospitals, as you know, are not getting enough vaccines to inoculate everyone right away so they are mostly relying on an “honor code” in which people schedule themselves depending on how much exposure they have to the virus and what underlying health conditions they may have. At UVA Health in Charlottesville, Virginia, one of the first groups to get vaccinated is the workers who clean hospital rooms in the ward where COVID-19 patients with the most severe cases are treated.
Stealing to survive: shoplifting in a pandemic
Shoplifting typically increases in troubled economic times. It is happening now.
Shoplifting is up markedly since the pandemic began in the spring and at higher levels than in past economic downturns, according to interviews with more than a dozen retailers, security experts and police departments across the country. But what’s distinctive about this trend, experts say, is what’s being taken — more staples like bread, pasta and baby formula.
“We’re seeing an increase in low-impact crimes,” said Jeff Zisner, chief executive of workplace security firm Aegis. “It’s not a whole lot of people going in, grabbing TVs and running out the front door. It’s a very different kind of crime — it’s people stealing consumables and items associated with children and babies.”
The story says the shoplifting of food, diapers, baby formula, and other necessities appears to be even greater now than it was just after other national crises, like the 2008 recession, when shoplifting rose 34%. The Post article continues:
Dollar Tree and Family Dollar, which often are concentrated in low-income areas, have seen “increasing instances of theft” during the past year, according to spokeswoman Kayleigh Painter. She declined to share specific data or protocols, but said the company is “continually evaluating and enhancing on-premise security and surveillance systems, as well as our associate training.”
In Philadelphia, reports of retail theft jumped about 60 percent, year over year, just after President Trump declared a national emergency in March because of the pandemic. They remained at elevated levels through at least July, according to local police data.
The New York Daily News talks with a local grocer:
“We’re pretty much on our own,” said Pedro Goico, who owns six grocery stores in the Bronx and Brooklyn. “Right now, it’s very tough to be in the grocery store business. We’re getting no help from the city.”
Goico said his stores have been plagued with shoplifters and estimates that 6% to 7% of his bottom line has disappeared because of it since March. Before COVID-19, he said he’d typically lose about 1% to shoplifters.
Maybe it is not a surprise. The Department of Agriculture says 54 million Americans are struggling with hunger right now — a 45% increase from a year ago. Here is the latest data, which you can use to drill down to the state level (see the state tabs at the bottom of the charts):
- Food Sufficiency for Households, in the Last Seven Days
- Food Sufficiency for Households with Children, in the Last Seven Days
Shoplifting is a hot topic for retailers, some of which are pushing for stronger punishment. NPR explains that retailers are pushing states not to raise the dollar amount that is required before a theft is considered a felony.
Retail trade groups have argued that prosecutors should be able to aggregate shoplifting incidents to crack down on repeat offenders. With that same goal, the groups in many states have lobbied in favor of lower thresholds for the value of stolen property that triggers a felony charge.
Opponents of higher felony thresholds argue they encourage more shoplifting because organized groups can simply adjust to stealing more valuable items without fear of facing stiffer charges. In recent years, the Pew Charitable Trusts studied states that raised their thresholds and reported that property crime rates were falling before the change and continued to fall afterward.
The National Retail Federation’s 2020 security survey found that shoplifting apprehensions and prosecutions have fallen dramatically since 2015. Meanwhile, the average loss per each shoplifting incident declined only slightly to $270. According to the Insurance Information Institute, most insurance policies do not cover shoplifting but can cover burglaries.
The federal government will launch a 10-month COVID-19 ad campaign
The federal government is about to launch a $250 million advertising campaign that will run through September 2021 to educate and encourage people to get the COVID-19 vaccine and keep wearing masks and take other precautions. The original plan included using celebrities endorsing the vaccine. That plan was scrapped and a toned-down version is already running on social media.
Meanwhile, groups like the Covid Collaborative and the Ad Council are gearing up to augment government efforts with a $50 million ad campaign in the beginning of next year, including billboards, TV and digital advertisements. The Ad Council has been in touch with the Trump Centers for Disease Control, and Department of Health and Human Services, according to an Ad Council spokesperson.
Public health experts say coordinated messaging on a vaccine should have begun months ago, leaving the incoming administration little time to allay public fears and tamp down growing anti-vaccine sentiment.
“There should be things out in the media now,” said Hemi Tewarson, a visiting senior policy fellow at the Duke-Margolis Center for Health Policy. “They are definitely going to have to play catch up.”
The process of scheduling, getting and paying for a vaccine
Insurance should cover any administrative fees that hospitals or clinics charge to give people the COVID-19 shots.
We don’t know yet how most people will get their shots, but some states are considering drive-thru events. After a few months of vaccinating the highest priority patients and workers, it won’t be just CVS and Walgreens giving the shots, but smaller pharmacies and doctors’ offices as well, just as they currently provide seasonal flu shots.
NBC News describes a few experiments to deliver the vaccine to the masses:
In Louisiana, Ochsner Health has been running drive-thru flu vaccine clinics as a model for how the health system will administer the Covid-19 vaccine. Patients are scheduled in 10-15-minute intervals and pull up to a curbside dosing station where a health care worker administers the vaccine.
In North Dakota, Molly Howell, the state’s immunization program manager, said local health departments are considering using large auditoriums or covered outdoor spaces like car washes. “Being creative about vaccination clinics is a part of the planning process,” she said. “We have to make sure we’re maintaining social distancing while still vaccinating a large number of people.”
Several states are planning to use software programs to assist with scheduling people to get vaccinated. Maryland is using a platform called PrepMod that allows patients to identify vaccination sites near them, schedule an appointment, and remind them if a second dose is needed.
This is what North Dakota’s PrepMod page looks like. Patients will soon be able to use it to search for a vaccination site near them.
It might be worth a moment for you to see how the Germans are setting up vaccination centers, including one in a big arena. They say it makes sense to have people come to a big central location as long as there is enough space to keep them separated while they get their shots.
Vaccine trial volunteers may get shots earlier
About 20,000 people who volunteered their shoulders to Pfizer to test the vaccine may soon be rewarded. They account for the placebo half of the vaccine’s phase 3 trial who got a saline shot rather than the actual drug. The trial will “unblind” the results this week so participants will learn soon which dose they got.
In the big picture, 20,000 doses might not seem like a huge issue when you consider the hundreds of millions of people who will get the shot, but it has been a hotly debated issue among medical ethicists for months and may set the stage for what other drug companies will be expected to do in the weeks to come.
Inspect your local hospital’s records
This is from Jeff Porter, the education director at the Association of Health Care Journalists:
AHCJ has updated its public HospitalInspections.org website to give people a better glimpse of potential COVID-19 problems at some hospitals around the country. For reporters, the inspection reports may prompt news stories on how local hospitals are handling the pandemic.
The data covers January 2011 through the third quarter of 2020. A search for the term “covid” returns 73 records of hospital inspection reports from March 25 through Sept. 16.
Terms such as “coronavirus,” “corona virus” or “SARS-CoV-2” also can return records, although some may be duplicates if the report uses more than one term. Also, some records may not apply to the pandemic if a reported incident of a coronavirus isn’t the same one that causes COVID-19.
Many of the inspectors cite hospitals for failing to properly screen staff and visitors. Other hospitals have fallen short in managing personal protection equipment. For example, one report says that based on:
“… observation, interview and document review, the facility failed to provide active surveillance for COVID-19 infection when the facility failed to daily take and record temperatures of staff and visitors as part of their screening for COVID-19. This had the potential to impact staff and patients.”
The reports identify specific hospitals and, in some instances, dates. They don’t name individuals, but hospital employees often can be identified by title (director of nursing or chief executive officer).
Employers will be critical to public acceptance of the vaccine
It might matter to some people if celebrities, politicians and Dr. Anthony Fauci get vaccinated in public, but the head of the world’s largest public relations firm says employers may have more influence than anybody. Yahoo Finance reports:
“Employers are believed most readily,” said Richard Edelman, the CEO of Edelman, the world’s biggest PR firm, whose company regularly conducts extensive research about trust and reputation. “We see employers as the spearhead because you’ve seen governments aren’t a particularly trusted source of information at the moment. Too much dissonance. Too many tweets. We need consistency and frequency and calm.” …
“If you’re an employer do you just give info? Do you say, ‘we would like you to do this’? Do you say I insist?” said Edelman. “It depends on the kind of employer. If you’re a hospital you better insist. It’s on a spectrum.”
Though companies could legally implement vaccine mandates, many are unlikely to do so.
Edelman said his company, which has around 7,000 employees, won’t require vaccination, but the company would have to find a way to deal with that.
“Are we going to let you come to work (if you don’t get a vaccine)? I don’t know about that,” he said. “But you can work remote, no problem.”
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