Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.
Vaccine ‘Hunger Games’
Americans are crossing state lines to get vaccines, and health officials often don’t stand in the way, the New York Times reports.
Given that states have different eligibility rules, patients are making appointments wherever they can get them — and they’re often notified by “vaccine hunter” groups that crowdsource and broadcast appointment availability on social media.
Francisco Garcia, MD, MPH, director of the Pima County Health Department in Tucson, Arizona, told the Times the federal government’s lack of coordinated eligibility rules has “created this ‘Hunger Games’ scenario where people are out there doing everything they can to get to the front of as many lines as they possibly can.”
For instance, Chanel Maronge, who lives in Baton Rouge, Louisiana, saw on a Facebook group that she could grab a vaccine appointment across the border in Mississippi.
The 37-year-old school librarian has hypertension, which made her eligible for the vaccine in Mississippi — but not in her home state. Similarly, her 69-year-old mother was just a year shy of eligibility in Louisiana, but made the cutoff in Mississippi.
Not all states are tracking vaccine recipients’ residency, the Times reported. Ohio does, and it found 21,501 shots went to non-residents. In Florida, more than 57,000 non-residents were vaccinated. In the past two weeks, both Kentucky and Washington state updated their requirements so that only state residents or workers (in Kentucky’s case, healthcare workers specifically) can receive the vaccine there.
Are Reinfections Truly Rare?
Reinfections with SARS-CoV-2 appear to be rare, but they’re not well-studied, Kaiser Health News reports.
Worldwide, fewer than 50 cases of reinfection have been substantiated, with only five in the U.S. But few U.S. labs retain COVID testing samples or perform genetic sequencing that would allow a truer picture of the phenomenon, according to KHN.
The news outlet reviewed surveillance efforts by sending queries to all 50 states plus the District of Columbia. They found that many states aren’t rigorously tracking or investigating suspected cases of reinfection. Of the 24 responses, fewer than half provided details about suspected or confirmed reinfections.
But those that are monitoring said they found more cases of reinfection than anticipated, KHN reported. Washington state is investigating nearly 700 cases that meet criteria for reinfection. Colorado estimates about 0.1% of positive cases are reinfections, which translates to nearly 400 cases. Minnesota said it had more than 150 suspected reinfections but lacks the genetic material to confirm the diagnoses.
Scott Lindquist, MD, the Washington state epidemiologist, told KHN that reinfection is a growing concern given new variants, as these “may cross paths. We wanted to be in front of it, not behind it” so the state is planning to genotype 5% of all samples collected, and fully assess those 700 potential reinfections.
Overall, the U.S. lacks the capacity for robust genetic sequencing, and only a fraction of positive COVID samples have been sequenced, KHN reported. However, the Biden administration is working to ramp up genetic sequencing efforts in light of new variants.
OWS Ignored Vaccine ‘Last Mile’
The Trump administration was focused on delivering vaccines to states rather than actually getting them into arms, according to a Vanity Fair investigation.
Katherine Eban reports that the U.S. vaccine rollout was plagued by turf wars and infighting, “Trumpian overpromises,” and a culture clash between military and public health officials — which played out as a military focus on delivering vaccines to states rather than delivering them to each American.
Eban interviewed more than 20 people with knowledge of Operation Warp Speed, and reviewed dozens of internal emails and documents. She found that a “laissez-faire ideology” pervaded the entire vaccination effort, and that its mantra was “federally assisted, state managed, locally executed.”
OWS chief operating officer Gen. Gustave Perna’s definition of success wasn’t getting people vaccinated, but shipping vaccines within 24 hours of FDA authorization and delivering them to states on a regular schedule, Eban reported. Indeed, in one meeting with CDC, Perna’s staff had to tell him that the CDC measured success by different metrics: vaccine uptake and bringing an end to the pandemic.
Recognizing that void, former CDC Director Robert Redfield, MD, repeatedly asked for funding so states could build their “last-mile” capacity for getting shots into arms, but his efforts were rebuffed for months. The same held true for direct requests from the states.
Ashish Jha, MD, MPH, dean of Brown University School of Public Health, told Vanity Fair: “When you have a policy where only a few states can succeed, the problem is not that you have 47 failing states. It’s that you have a failing federal government.”
Source: MedicalNewsToday.com
