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.
Over the weekend, a federal judge tossed out a lawsuit filed by Houston hospital workers who were suspended for not having gotten a COVID-19 vaccination.
Houston Methodist Hospital suspended 178 workers who have not been vaccinated. 117 workers filed the lawsuit and said the hospital was trying to force them to take a vaccine that had only gotten the U.S. Food and Drug Administration’s emergency approval, which they said is not enough to make them feel safe.
The hospital says if they are not vaccinated by June 21, they will be fired.
In the ruling, U.S. District Judge Lynn Hughes said, “This is not coercion. Methodist is trying to do their business of saving lives without giving them the COVID-19 virus. It is a choice made to keep staff, patients, and their families safer.”
The judge flatly rejected the lawsuit’s claims that people who did not want to take the vaccines were being forced to be part of a “human trial” and called the workers’ claims that they were like Nazi medical experiment victims “reprehensible.”
The judge wrote: “If a worker refuses an assignment, changed office, earlier start time, or other directive he may be properly fired. Every employment includes limits on the worker’s behavior in exchange for renumeration. That is all part of the bargain.”
The workers say they will appeal.
This is a battle that will spread. In Washington, D.C., the District of Columbia Hospital Association said last week that most D.C. hospitals will soon require workers to be vaccinated. USA Today lists some others that are requiring vaccinations:
At least three large hospital systems are requiring vaccination by September. Indiana University Health announced last week that it would require its 36,000 employees to be vaccinated: “Requiring vaccinations for healthcare employees is not new or unprecedented,” health system officials said in a statement.
The University of Pennsylvania Health System will require all 44,000 employees and clinical staff to be vaccinated. Almost 70% are already vaccinated, the hospital system said. And the University of Maryland Medical System announced the requirement Wednesday for its 29,000 employees.
Hundreds of colleges and universities are requiring vaccinations, as are many nursing homes — hot spots in the early days of the pandemic. And the Equal Employment Opportunity Commission has issued guidance saying employers have the right to require COVID-19 vaccination.
A few vaccine-related lawsuits have been filed against public employers, including a county detention facility in New Mexico and a school district in California. But none includes a large-scale suspension and imminent firing as is happening in Houston.
The federal Equal Employment Opportunity Commission recently clarified that employers can require employees to be vaccinated.
States are slowing case reporting. Epidemiologists say it is a bad move.
More than a dozen states have stopped reporting daily COVID-19 cases. Some dropped to five days a week. Florida dropped to once a week. Look at this map from Johns Hopkins.
The daily reporting is critical, health officials say, to understanding the good news and the concerning news about a pandemic in almost real-time. The data told them when we could start loosening restrictions, but they also surfaced hot spots.
Beth Blauer, executive director of the Johns Hopkins Coronavirus Resource Center, writes:
Maintaining daily reporting will be necessary to ongoing virus tracking efforts and mitigation of the COVID-19 pandemic, which makes state rollback of data reporting extremely concerning. Some states have argued that the dashboards are no longer necessary since the CDC tracks pandemic data.
While the CDC does aggregate COVID-19 data, it is important to note that the CDC is limited to using data filed through official reporting channels, which are not publicly available. This can result in a serious reporting lag as well as data discrepancies when state updates are out of sync with official federal channels.
If states decide to roll back their COVID-19 dashboards, then the nation’s ability to respond and react quickly to the continuing pandemic will be seriously impeded. The rollback of reporting frequency indicates that many states do not see this past year of investment in data infrastructure and public data reporting as a permanent fixture.
It is crucial that we maintain the infrastructure developed during the pandemic, both to monitor the continued spread of COVID-19 and safeguard against future public health crises. States signaling that they want to treat the COVID-19 response like the responses to previous pandemics — a temporary fix that doesn’t prioritize planning for the next crisis — is unacceptable.
State officials are defending the changes, which they say allow public health workers to focus limited resources where they are needed most, such as improving the quality of the data and boosting vaccinations.
“As our cases were trending downwards and our vaccination rates were increasing, it made more sense for us to go to weekly reporting for certain things,” says Jolianne Stone, the Oklahoma Department of Health’s epidemiologist. “We still do have a pulse of what is going with COVID here in Oklahoma. And I feel very confident in that.”
“We do not feel that this is going to change that response at all,” says Dr. Karen Landers, an assistant state health officer at the Alabama Department of Public Health, which cut back reporting to three days a week. “We are going to continue to monitor very closely and respond expediently to the pandemic as we have been from the beginning.”
Journalists, this is worth your inquiry. Are states prepared to quickly catch and act upon the spread of virus variants that will likely grow when fall and winter months set in?
How concerned should we be about a link between COVID-19 vaccines and teen myocarditis?
Just as the government pushes to get teens their COVID-19 vaccinations, there is some concerning news linking the vaccines and rare cases of myocarditis in teens. Myocarditis is a heart inflammation. To understand the threat, you must dig through the data.
In almost all of the cases detected among 16- to 24-year-olds who were vaccinated, the myocarditis symptoms went away quickly.
While myocarditis is relatively uncommon, it does happen to young people (and we mean long before the Covid-19 vaccine ever came along). Usually, it’s caused by a viral or bacterial infection. A different vaccine, one against smallpox, has previously been linked to myocarditis.
There’s a wide spectrum of myocarditis. Some people don’t feel anything and they’re fine without treatment. For others, myocarditis can be deadly.
By way of context, one Chicago hospital says it usually sees about one case of myocarditis a week among young people that is not associated with the COVID-19 vaccine.
It is hard to know how many cases are directly related to the vaccine. Again, turning to CNN to tease out a figure:
As of May 31, nearly 170 million Americans had at least one dose of the Covid-19 vaccine, according to the US Centers for Disease Control and Prevention. Through that time, fewer than 800 cases of myocarditis or pericarditis (inflammation of the tissue around the heart), have been reported after receiving the vaccine, according to the CDC, most of them after the second dose.
And these are preliminary numbers — they might be lower as further investigation could show that not all of these people actually had myocarditis or pericarditis.
- The CDC found that among 16-and 17-year-olds, as of May 31, there were 79 reports of the illnesses soon after vaccination, and ordinarily you’d expect to see around two to 19 cases in this group.
- Among 18-to-24 year-olds, there were 196 reported cases, and you’d expect to see between 8 and 83 cases.
- There were also reports of myocarditis and pericarditis in older age groups, but the numbers weren’t higher than what you’d normally expect.
FDA drug advisory panel resignations over Alzheimer’s drug approval
Three members of the Peripheral and Central Nervous System Advisory Committee, which pores over drug trial data to help figure out if a drug is safe and effective, have resigned. The resignations are over the FDA’s approval of a drug to treat (not cure) early-stage Alzheimer’s. There is something in this that is worth exploring, at a minimum because it is so unusual.
Look at what these experts are saying as they resign. CNBC got its hands on the resignation letter submitted by Dr. Aaron Kesselheim, a professor of medicine at Harvard Medical School, which said the decision to approve Biogen’s new drug “was probably the worst drug approval decision in recent U.S. history.”
He added, “At the last minute, the agency switched its review to the Accelerated Approval pathway based on the debatable premise that the drug’s effect on brain amyloid was likely to help patients with Alzheimer’s disease.”
Kesselheim joins Mayo Clinic neurologist Dr. David Knopman and Washington University neurologist Dr. Joel Perlmutter, who both also submitted resignation letters over the Biogen decision.
Knopman told Reuters, “I was very disappointed at how the advisory committee input was treated by the FDA.” He added, “I don’t wish to be put in a position like this again.”
Earlier in the week, Perlmutter, a neurologist at Washington University in St. Louis, resigned from the committee. Perlmutter told Stat that he resigned “due to this ruling by the FDA without further discussion with our advisory committee.”
The FDA is not obligated to follow the recommendations of their advisory committees, which are made up of outside experts. At least one study indicated the FDA approved drugs 21% of the time that the adcoms did not recommend, although those decisions typically involved close adcom votes. With aducanumab, 10 of the 11 committee members voted that there was insufficient evidence to demonstrate the drug slowed cognitive decline. The 11th panelist voted “uncertain.”
The FDA’s approval of aducanumab surprised the medical and financial worlds partly because it has not moved steadily toward approval. In 2019, Biogen pulled the drug from consideration for approval. A short time later, the company came back to the FDA saying it had the data it needed to be approved.
The drug, which is an intravenously administered compound, can only be used after extensive screening. Even then, it will cost patients and their insurance plans about $56,000 a year. Biogen says the disease costs far more and points out that this the first approved Alzheimer’s drug in decades. As the population ages, there may be 13 million Americans who need treatment by 2050.
Airlines probably won’t be weighing you before takeoff
Just before serving you those healthy cookie and cracker snacks, it may come to pass (but probably won’t) that airlines will weigh you or at least ask your weight as you board. Airlines have a legit reason to want to know how much their planeload of people and cargo weighs.
An aviation blog recently reported on some old Federal Aviation Administration documents that said airlines could, if they wanted to, weigh passengers, or at least ask about weight before boarding in order to get an accurate estimate of the plane’s heft. But it is not an order to haul out the scales despite the hundreds of headlines that might lead you to believe you are going to have to share your weight in the ticket line.
The exception may be the smallest planes, which really do have to know exactly how much weight they are carrying.
The 2019 document that got everyone’s attention is nearly the same as an FAA advisory from 2005 and that did not result in weighing passengers. But the airlines are being suspiciously coy about their plans. Fast Company reports nobody seems eager to, you know, weigh in:
Delta Air Lines referred us to the FAA’s statement, while United Airlines referred us to Airlines for America, the industry’s trade association, which declined to comment. A spokesperson for American Airlines indicated that not much would change. “As we do today, American expects to continue using the Centers for Disease Control and Prevention’s (CDC) National Health and Nutrition Examination Survey (NHANES) data to determine accurate standard average passenger weights,” the spokesperson said. “We’ll continue to evaluate average passenger weights for each flight we operate and adjust as needed.”
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