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.
In New Jersey and Mississippi, smokers, or even just people who say they are smokers, can sign up for COVID-19 vaccines along with seniors and other at-risk populations. The Kaiser Family Foundation says other states are considering doing the same.
The calculation is one that ethicists have been warning us about for months as policymakers have to distribute vaccine supplies based partly on popular opinion and partly on protecting the most vulnerable populations. The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices said smokers should be included in phase 1c, but it is up to states to decide how they open eligibility for the vaccine.
Phase 1c also includes people 65 to 74 years of age, people 16 to 64 years of age with high-risk medical conditions, and other essential workers. Some states include warehouse and front-line retail workers in this category. Some include teachers, too. Phase 1a includes health care workers and long-term care facility residents, while phase 1b includes people 75 years of age or older and non-health care front-line and essential workers.
The CDC listed smokers as being more at-risk than nonsmokers just as obesity, age, underlying health issues and professions are risk factors. The CDC’s list of at-risk conditions includes:
- Chronic kidney disease
- COPD (chronic obstructive pulmonary disease)
- Down syndrome
- Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
- Immunocompromised state (weakened immune system) from solid organ transplant
- Obesity (body mass index of 30 kg/m2 or higher but < 40 kg/m2)
- Severe obesity (BMI ≥ 40 kg/m2)
- Sickle cell disease
- Type 2 diabetes mellitus
You can see the medical evidence on which these risk-factors are based here.
Many of these kinds of choices are not going to be popular. New Jersey, for example, has not prioritized teachers. At the same time, while jails and prisons are some of the hottest COVID-19 hot spots, moving those populations toward the front of the line is also controversial, even though it also would include prison workers. Three Harvard scholars produced a report on which incarcerated people should be priorities for vaccines. Here is an excerpt:
Additionally, according to data from the U.S. Department of Justice, about 40% of those in U.S. prisons and jails have a chronic medical condition, such as hypertension, asthma, and diabetes, which makes them vulnerable to worse COVID-19 outcomes, including death. Prisons, jails, and detention centers do not have the medical facilities to treat severe COVID-19 cases. These individuals are brought to nearby hospitals, creating dangerous conditions for the staff involved in transporting highly infectious COVID-19 patients, critically delaying the care of severely ill individuals, and stressing local hospitals. Many facilities are located in rural areas where there are fewer hospital resources overall and hospitals are becoming increasingly overwhelmed.
CNN points out that smokers are the single biggest risk category opened so far:
Prioritizing smokers is a matter of public health, not a judgment of personal choices, said Dr. Albert Rizzo, the chief medical officer of the American Lung Association.
“It’s a population that we know is at risk, whether it was a good choice, or a bad choice to become a smoker. They are smokers, they’re at risk of getting sick, and needing medical services, so if we can keep them healthy that helps society in general,” Rizzo told CNN.
Rizzo, a pulmonologist in the Christiana Care Health System in Delaware, says it’s difficult to rule out all smokers in favor of smokers who have additional diagnosed respiratory diseases.
“We can make arguments on either side, but we do know that smoking by itself, whether you have chronic bronchitis, but no COPD, or really just have a cough but no shortness of breath, put you still at risk,” Rizzo said. “And I think most people from a scientific standpoint says if you inhale, tobacco vapors and nicotine and tar, all those things inflame your airway and put you at risk whether or not you’ve reached the point of developing COPD or not.”
The World Health Organization launched a “Commit to Quit” campaign in December, cautioning smokers around the world of the risks related to the pandemic and offering resources to encourage people to quit.
Doctor: Post-COVID lungs ‘look worse than any type of terrible smokers’ lung’
CBS Dallas reporter Nicole Nielsen talked with a trauma surgeon about the aftereffects of COVID-19. Read this passage:
Texas trauma surgeon Dr. Brittany Bankhead-Kendall says it’s a rarity that any of her COVID-19 patients X-rays come back without dense scarring.
In one of her Twitter posts, she says “post-covid lungs look worse than any type of terrible smokers lung we’ve ever seen.”
“Everyone’s just so worried about the mortality thing and that’s terrible and it’s awful. But man, and all the survivors and the people who have tested positive this is, it’s going to be a problem,” Dr. Bankhead-Kendall said.
Like many, she’s treated thousands of patients since March.
Of them, she tells CBS 11 News those who have had COVID-19 symptoms show a severe chest X-ray every time. And those who were asymptomatic show a severe chest X-ray 70 to 80% of the time.
“There are still people who say, ‘I’m fine I don’t have any issues’ and you pull up their chest X-ray and they absolutely have a bad chest X-ray,” she said.
Look at the X-ray that the station showed:
Loss of smell is a safety threat
KWTX in Waco, Texas, told the story of an entire family who had suffered from COVID-19. Three of the four family members lost their sense of smell. When their house caught fire last week, the 17-year-old daughter was the only one who smelled smoke. She got everybody else out safely.
I suppose this is a lesson that underscores the need for smoke and carbon monoxide detectors.
You can’t file for a tax refund until Feb. 12
The IRS says it needs to load information into its computers to take COVID-19 stimulus money into account. The IRS’s delay means refunds this year will be later than normal. CNBC reports:
Early filers who claim certain tax credits will be waiting until the first week of March to get their much-needed refund. The IRS said this would still be the case if the filing season opened in late January.
Low-income taxpayers who receive the earned income tax credit or the additional child tax credit generally can’t receive a refund before mid-February.
That’s because an anti-fraud law requires the IRS to use the additional time to review those returns to prevent refunds from being issued to scammers.
The agency expects filers who claim the earned income and additional child tax credits will collect their refunds the first week of March — assuming they file electronically and there are no issues with their returns
Because there still is a mail backlog, CNBC says that people who file tax returns by paper are just asking for trouble:
Taxpayers who submit their returns in paper format are risking delays. The IRS accumulated a large backlog of mail last year amid the pandemic, and returns have taken a longer time to process.
There were still 7.1 million unprocessed individual returns and 2.3 million processed business returns as of Nov. 24, the Taxpayer Advocate Service found.
Companies rewarding vaccinations
Dollar General says it will give its 6,000 workers who get COVID-19 vaccines four hours’ worth of pay. Dollar General said the extra pay is intended to compensate for the travel time, mileage and child care expenses that employees will incur to get the vaccine.
Trader Joe’s will give workers two hours’ worth of pay if they get the COVID-19 shot and Instacart says it will reward workers who get a vaccine with $25.
An Associated Press story points out that companies can require workers to get the vaccine, with some limitations:
Companies can mandate that workers get COVID-19 vaccines as a requirement for employment, although they must make accommodations for medical or religious reasons, according to guidance from the federal Equal Employment Opportunity Commission.
However, most companies are reluctant to impose such mandates, said Sharon Perley Masling, a partner at the law firm Morgan Lewis who has been advising clients on workplace issues surrounding the COVID-19 pandemic. The emergency nature of the vaccine’s FDA approval makes it impractical for many companies to require it, given that the shots are not available to most of the population, she said.
A couple of health law professors wrote for Fast Company that giving workers money to get vaccinated doesn’t work very well. They point out that money, even up to a thousand bucks, is not enough to lure people to submit to what they consider to be risky clinical research tests. But cash rewards do have some effect on encouraging people to quit smoking.
The professors say offering money to encourage vaccines might send a signal that the vaccines are not trustworthy enough to take without an incentive, and that a cash reward might appeal to people who need the money but would not have an effect on wealthier populations.
Learning new names and faces
I have a TV news friend who, in the course of interviewing journalists for jobs, asks questions about hit movies and music, world leaders, Supreme Court justices and cabinet members. That is on my mind as I try to learn all of the names of the Biden administration’s picks. I have this on my home screen until I can fly through them.
If I remove their name can you fill it in?
What about if I remove their office?
The way we work now
The last time I packed body armor was to go to the Pech and Korengal Valleys of Afghanistan.
Today I’m packing it to go back to my home state of Wisconsin to cover an inauguration.
Explain that one to your kids. pic.twitter.com/vgWyGIV9Fu
— Bill Weir (@BillWeirCNN) January 16, 2021
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A previous version of this article referenced a need for “CO2 detectors.” As a savvy reader pointed out, such a detector would be going off all the time. The issue is carbon monoxide. We regret the extra oxygen atom and the error.