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.
Today, HealthCare.gov’s market for subsidized health plans reopens for three months. Usually, as you know, signup is in the fall.
During the years of Donald Trump’s presidency, the signup windows got smaller and publicity was practically nil. The Trump administration spent around $10 million a year publicizing Affordable Care Act enrollment. But from now until May 15, the Centers for Medicare and Medicaid Services will be running a $50 million advertising budget. This special signup period will especially encourage Black and Latino communities to explore getting health care coverage.
It would be a real public service if you journalists would report about this.
An Associated Press story says:
Former President Barack Obama’s health law has been on the books over a decade, but surveys consistently show that many people lacking job-based insurance do not realize they may qualify. The Congressional Budget Office estimates that about 33 million people are uninsured this year.
At Foundation Communities, an Austin, Texas, nonprofit that serves low-income working people, program director Kori Hattemer says she’s seeing an uptick in interest. Although her agency had not started advertising, appointments for enrollment assistance booked up quickly. Volunteer counselors are being called back.
For clients, “it’s their last chance probably to enroll in health insurance for 2021,” Hattemer said.
By some estimates, 4 million uninsured individuals could qualify for a plan with no premium payment, and 4.9 million more could get subsidies to reduce the cost.
“If you are uninsured, there is a very good chance you could get free or low-cost coverage,” said Cynthia Cox, a vice president at the Kaiser Family Foundation and director of its ACA program.
You can go to this website to just test drive your circumstances and see what coverage you can get at what cost. Let’s look at the real numbers. Again, from CNBC:
Most enrollees in the marketplace receive subsidies (technically tax credits), which reduce what they pay in premiums. Additionally, they may qualify for help with other cost-sharing like deductibles.
The average national unsubsidized premium for a “silver” plan through the ACA exchange is $462 monthly, according to ehealthinsurance.com. However, that amount varies from place to place, and if you qualify for subsidies, you’d pay less.
Premium subsidies are available to families whose income is 100% to 400% of the federal poverty level, based on household size. That translates into income from $12,760 to $51,040. For a family of four, it would be $26,200 to $104,800.
Meanwhile, in states that expanded Medicaid, you can qualify for coverage through the program if your income is no more than 138% of the federal poverty level. For an individual, that would mean up to $17,609; for a family of four, $36,156. It’s also worth noting that if you qualify for Medicaid, you can sign up at any time.
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Navy considering making COVID-19 vaccines mandatory
Sailors man the rails as the USS Theodore Roosevelt aircraft carrier makes its way into San Diego Bay Thursday, July 9, 2020, seen from San Diego. The carrier returned home to San Diego Thursday, led by a new captain who came aboard after the previous commander was fired and the Navy secretary resigned over the handling of a massive COVID-19 outbreak on board. (AP Photo/Gregory Bull)
The Pentagon admits that a large percentage of Americans in uniform are refusing to take the COVID-19 vaccine. The Department of Defense ordered a million doses of the vaccine and has gotten almost all of them. 82% of those doses have been administered, which is far above the general population. The Pentagon is considering vaccines to be voluntary, even though some other vaccines are not optional for members of the military.
But Military.com reports the Navy may soon change the rules:
Thousands of Navy personnel are about to receive the first dose of the coronavirus vaccine ahead of an upcoming deployment — and while sailors aren’t required to take the shot yet, they soon could be.
Members of the Dwight D. Eisenhower Carrier Strike Group will get the option to receive the first dose of the vaccine for COVID-19, the sometimes-fatal illness caused by the coronavirus, on Saturday. So far, about 80% of the crew — roughly 5,000 strike group members — say they intend to get the shots, Vice Adm. Andrew Lewis, U.S. Second Fleet commander, told reporters Friday.
“We cannot make it mandatory yet,” Lewis said. “I can tell you we’re probably going to make it mandatory as soon as we can, just like we do with the flu vaccine.”
US News and World Report explores the story and finds younger members of the military are refusing the vaccine.
Air Force Brig. Gen. Paul Friedrichs, the Joint Staff surgeon and a top military health adviser, expressed concern last month about the levels at which troops were refusing to take the vaccine.
“The declinations are a little bit more challenging and — and this gets into the fact that this is voluntary,” Friedrichs told reporters on Jan. 29. “Are we seeing people who are declining to it? Yes.”
“I’ve had people say that for a variety of reasons, they’re pregnant, which is a very reasonable concern. They want to talk to their doctor first — very reasonable concern. So there are people who have said they don’t want to get it,” he said.
Military.com found that more than half of a group of 810 polled military family members said they weren’t planning to get the vaccine, citing safety concerns and suspicions over development.
The Navy reports that almost a third of sailors who have been offered the vaccine decline the offer. Military.com adds:
The Navy was the military service perhaps hit hardest by the coronavirus pandemic, since social distancing can be difficult in tight quarters aboard ships and submarines. One aircraft carrier, the Theodore Roosevelt, was sidelined for months last year when coronavirus cases multiplied among crew members.
By the way, we owe a shoutout to the Veterans Administration, which has administered more than a million shots — more shots than 42 states. The VA has delivered 620,000 shots to veterans and another 400,000 shots to VA employees. You can see a facility-by-facility count here.
People over 75 are first in line to be vaccinated against COVID-19, but the average Black American doesn’t live that long
The above headline comes from ProPublica, which challenges us to rethink the blanket prioritization of who should be in the front of the vaccine line. ProPublica points us to the facts:
Prioritizing by age might seem like an obvious choice, given the disproportionate impact of the disease on the elderly. Setting the initial threshold at 75, however, ignores the fact that a smaller share of Black people reach that age than white people.
It also fails to account for research, released by the nonprofit Brookings Institution in June, showing that Black people who die of COVID-19 are, on average, about 10 years younger than white victims of the disease.
“If you (allocate the vaccine) strictly by age, you’re going to vaccinate white people who have lower risks before you vaccinate Black people with higher risks,” said Sarah Reber, co-author of the Brookings research and associate public policy professor at the UCLA Luskin School of Public Affairs.
“If you’re trying to avert deaths, you would want to vaccinate Blacks who are about 10 years younger than whites.”
When local governments have tried to prioritize vaccines by some factor other than age or profession — such as putting health care providers at the front of the vaccine line — the plans were quickly abandoned. ProPublica explored some examples:
In some communities that have tried more race-specific solutions for vaccine distribution, the blowback has been swift. After early data showed residents in affluent and predominantly white neighborhoods were the primary vaccine recipients, the Dallas, Texas, County Commission decided in mid-January to target the most vulnerable ZIP codes. The very next day, Texas health officials announced that the state would shrink Dallas County’s vaccine allocation unless it abandoned the plan, which the county did.
Tennessee’s vaccination plan states that “equity remains a crosscutting consideration,” and sets aside 5% of its weekly vaccine allocation for counties, including Shelby (which includes Memphis) that rank high on the CDC’s social vulnerability index, which includes race as one of 15 factors.
After you get a vaccine, what can you do safely?
The first thing to remember is that It takes a few days to a few weeks for the vaccine to work, according to the Centers for Disease Control and Prevention. You could come in contact with the virus between the time you get the shot and the time the vaccine kicks in.
There is a difference between “infection” and “disease.” CNN explains it this way:
“The information is less clear whether the vaccines will prevent the virus from infecting us and we can remain without symptoms. That’s still under study.” said Dr. William Schaffner, an infectious disease specialist and a professor of preventive medicine in the Department of Health Policy at Vanderbilt University.
“As far as what we’ve seen, these vaccines are really game changing at preventing disease and even severity of disease,” said Namandje Bumpus, director of the department of pharmacology and molecular sciences at Johns Hopkins University.
We do not know yet how long the COVID-19 vaccines will last. Will it be a year? Longer? Less? The typical multi-year studies that we usually fund for vaccines would have told us this before the drug hit the market. But the vaccines we are depending on now have not been around long enough to know all of the answers about how long they offer protection.
While we are at it, we should also admit that we do not have clear answers about how or whether the vaccines prevent the spread of the virus from a vaccinated person to somebody who has not been vaccinated.
The CDC just changed its recommendations for people who have been vaccinated but might have come in contact with an infected person. The CDC writes, “Fully vaccinated persons who meet criteria will no longer be required to quarantine following an exposure to someone with COVID-19. Additional considerations for patients and residents in healthcare settings are provided.”
What if you and your friend both are vaccinated? Would it be safe for you to hang out together? The answer lies in the fact that even vaccinated people may still be carriers. National Geographic asks this question of experts:
“To be on the safe side,” says Cynthia Leifer, associate professor of immunology at Cornell University, “we should still practice distancing measures as much as we can in the shorter term until we get broader distribution of the vaccine.” She recommends people continue to follow the guidelines of avoiding large groups, wearing masks and staying at least six feet apart.
“So, you immunize 100 people, they’re all going to have varying levels of response to that vaccine; some may be not good enough to protect them,” Leifer says. There is really no way to know what kind of response your own body had to the vaccine, so wearing a mask adds an extra layer of protection. There is also still the open question of how much people who have had the vaccine will be able to transmit the virus.
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Booking vaccines is too complicated: Young people to the rescue
The process that we are using to book vaccinations magnifies the barriers that stop some older folks from getting the care they need. How many of you have tried for hours to book appointments for your parents, grandparents, extended family and neighbors? Meet a 13-year-old who is helping seniors around the country.
Of course, we should not need to turn to benevolent teenagers to fix a registration system in a world where you can book everything from an airline seat to a haircut online.
Maybe we need a vaccine mascot
Boston Red Sox mascot, Wally the Green Monster, gestures while dressed in a medical white coat outside Fenway Park, Monday Feb. 1, 2021, in Boston. Fenway Park is one of several large COVID-19 vaccination sites in the Boston area. (AP Photo/Elise Amendola)
Don’t dismiss this idea right off. Think about what Smokey Bear did to raise awareness of forest fire prevention. McGruff the Crime Dog was somewhat less effectual, but not lame. The NRA tried Eddie Eagle for gun safety. Faux Paw the Techno Cat, the internet safety awareness mascot, never caught on. But Donald Duck helped sell war bonds.
I am not a big fan of Brazil’s COVID-19 vaccine mascot, and let’s not go back to the CDC’s lame Wellbee character of the 1960s, which urged people to take their polio vaccine that it claims “tastes good” and “works fast.”
(CDC)
The Washington Post talks with experts who say this kind of thing can help deliver messages that press releases can’t.
Japan has an anti-COVID cat named Koronon who hands out masks.
Thailand has a red virus named Covid-kun.
Covid-kun is a new coronavirus mascot from Thailand who teaches kids to wash their hands and social distance. pic.twitter.com/pxZDOUNjj7
— Mondo Mascots (@mondomascots) March 26, 2020
And maybe it is best if the United Kingdom’s mascot for the Male Cancer Awareness Campaign goes unmentioned, but if you are curious I will link to it.
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