Data is starting to roll in on Covid-19 vaccine inequities this fall.
And it’s not pretty.
Access. Cost. Outreach. Education.
All of these changed once the federal emergency ended in May.
Vaccines are no longer purchased or distributed by the government, and funding ran out to support vaccine campaigns.
This means the U.S., once again, faces the pre-pandemic privatized and fragmented healthcare and public health systems. And one could argue an even worse system, given the loss of trust.
Unfortunately, our communities continue to feel it disproportionately.
Zoom out: U.S. vs. U.K.
U.S. rates of Covid-19 vaccination this fall are, overall, abysmal. This is especially apparent when we compare it to counterparts like the U.K., where 68% of people over 65 years old are vaccinated (compared to 31% in the U.S.).
Zoom in: Inequities within the U.S.
Within the U.S., vaccination rates are not equally distributed. Disparities were evident last fall and continue this fall:
Are disparities widening after the emergency?
Epidemiologists in Marin County have started digging into this question.
First, they examined California data to determine differences in vaccination rates by race and ethnicity between last fall and this fall. The gaps in vaccination rates have grown between Latinx and non-Hispanic White (hereafter, “White”) and Black/African American and White residents.
Epidemiologists then looked at uptake this fall among those who got a vaccine last fall, among Marin County residents. This would show whether there are new barriers to accessing the fall vaccine for marginalized groups (rather than hesitancy to get vaccinated).
They found lower fall 2023 coverage by usual resource level and race. Among those who got the vaccine last year, uptake of this year’s fall vaccine was 45% in White residents compared to only 18% in Latinx and 31% in Black residents, and differences between these groups were similar when limited to those 60 years of age and older.
This points to new barriers.
Why does this matter?
The gap between Latinx and White residents who are fully protected is more than twice what it was last year. Same with African American/Black residents. Same with residents of low income.
This means two things:
When the nation’s health is at stake, we need public health to ensure our resources are fairly distributed and get to those who need it most. The “marketplace” doesn’t do this naturally. In fact, it works against many of our communities. These inequities will continue unless we make big, systemic changes.
One would hope that a pandemic would jumpstart these changes, but it seems we are quickly falling back to our pre-pandemic ways.
Love, YLE and the brilliant team at Marin County Health Department (Drs. Matt Willis, LeeAnn Prebil, and Pooja Mhatre)
“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH Ph.D.—an epidemiologist, wife. During the day, she is a senior scientific consultant to several organizations. At night she writes this newsletter. Her main goal is to “translate” the ever-evolving public health world so that people will be well-equipped to make evidence-based decisions. This newsletter is free, thanks to the generous support of fellow YLE community members. To support this effort, subscribe below:
Navigating the new normal of respiratory virus season
I hope you all had a wonderful Thanksgiving. There’s no Outbreak Outlook this week due to the holiday. Instead, I adapted this piece from remarks I gave recently at an event hosted by the Duke-Margolis Health Policy Center. Next week, I’ll be back in your inbox as usual with an update on what’s going around.
It’s that time of year again. Flu season. It’s comes around every year, yet each turn brings its own unique challenges and lessons. It’s not just a topic for epidemiologists.
Influenza, RSV and Covid-19 affect our families, our work, and our healthcare systems. Everyone has a stake in figuring out how to reduce the burden of respiratory viruses.
Better Than Last Year
Last year’s tripledemic was a tough one. A surge in respiratory viruses began in late summer and lasted through the winter months. It was hard on families with young kids, healthcare workers, and everyone in between.
The tripledemic likely flared because many of the usual pathogens, like influenza and the common cold, were suppressed thanks to mask-wearing and social distancing during the 2020 and 2021 seasons. But when preventative measures eased, those viruses came back with a vengeance, creating a surge that the health system struggled to manage.
The good news? This year is shaping up to be a bit more manageable. We’re not seeing the same level of early virus activity. And although that’s a relief, it doesn’t mean that this year’s season won’t be disruptive. It will—because most are.
When we talk about seasonal respiratory viruses, there are three big threats: influenza, RSV, and Covid-19. As regular readers of Force of Infection will know, all three are in play right now. To recap:
One other thing. When we talk about a ‘normal’ respiratory virus season, we must remember that ‘normal’ doesn’t mean ‘easy.’ In the pre-Covid era, our healthcare system often endured significant strain during the winter season. Hospitals and clinics were often slammed, and healthcare workers strained under the increased load. Now, add Covid-19 to the mix, and the situation becomes even more complex.
A typical season now means dealing with the flu, RSV, and Covid-19 simultaneously, and that is no small thing.
Vaccination Uptake: Not great
So what do we do about it?
Non-pharmaceutical measures like masking and improving ventilation work to reduce transmission of all three of those viruses. But this year, we have an expanded vaccine toolkit, too. This is the first season that shots are available to protect against influenza, Covid-19 and RSV (for infants and older adults).
While I don’t expect any of these shots to reduce transmission, they do work to prevent severe illness. That could, in theory, keep people out of the hospital and reduce burden on healthcare systems.
The bad news is that the current uptake numbers are, frankly, poor.
By November 11, only about 36% of adults had received the annual flu vaccine. The Covid-19 vaccine coverage was even lower, at around 15%. For the RSV vaccinations for older adults, coverage is similar at 14%.
Perhaps more alarming is the public sentiment towards these vaccines. A staggering 40% report hesitancy or outright refusal to get the Covid-19 vaccine.
These numbers aren’t just meaningless statistics.
It’s a big red flag.
We’ve got to get the word out about the benefits of vaccination and address the misinformation (or missing information) that often fuels vaccine hesitancy. Improving these figures is important not just for overcoming the current season’s challenges but for fortifying our defenses against future outbreaks, too.
Surveillance of Lesser-Known Viruses
Beyond the well-known culprits, there’s a whole other category of respiratory viruses that fly under the radar. We live with adenovirus, parainfluenza, human metapneumoviruses, and the seasonal coronaviruses, to name a few, yet we know relatively little about those bugs.
Our surveillance of them is quite limited, and we have a minimal understanding of their spread, behavior, and impact. We should improve our surveillance and research into these lesser-studied pathogens, too. Filling in the gaps in our knowledge could help us find ways to reduce the burden of these bugs, too.
And besides, better disease surveillance for respiratory viruses could help us to prepare more effectively for the next epidemic threat. Think of it as shining a light on the ‘viral dark matter’ that surrounds us. Enhanced surveillance of everyday infections would be a step forward in how we approach public health in the context of all respiratory illnesses.
So, where do we go from here? First and foremost, we must recommit to a data-driven approach.
Data is a tool that can guide our actions, ensuring we are responsive, and effective, in our work. By leading with timely data, we can understand the scope of public health challenges more clearly and tailor our interventions accordingly.
And this isn’t just a job for epidemiologists and policymakers.
It’s a community effort.
Each one of us has a role to play, whether it’s staying informed about what’s going around, helping friends and family get vaccinated, or upgrading our surveillance systems. Our response to these public health challenges needs to be collaborative and ambitious. We’ve seen progress, but there’s more work to be done. By learning from our experiences and staying adaptable, we can both navigate the current season and also build stronger defenses for the future.
Force of Infection is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.
Con Edison announced that as of December 1, 2023, the temporary natural gas moratorium, which commenced on March 15, 2019 in most of its Westchester County service territory to address a supply-demand imbalance and support reliability of service to customers in the affected area, will end. In a letter to the Public Service Commission, Con Ed explained that said that the combination of increased supply from the Tennessee East 300 Project and lower forecasted demand resolves the Westchester supply-demand gap which prompted the moratorium on new gas hookups.
In the coming weeks, Con Edison will notify local agencies, elected officials, and those customers who had previously signed up on the gas service interest list which was maintained during the period the moratorium was in effect, even if they signed up on that list months ago. If you signed up on that list any time since 2019, you should expect further communication directly from Con Ed.
The BRI anticipates that Con Ed will both remove moratorium-specific web pages from www.coned.com as well as post information on how to request new gas hookups or conversions from oil to gas beginning December 1.
However, please note that this announcement does NOT change anything with regard to the requirements under the All Electrification Act, whereby there will be statewide ban on fossil-fuel use in new construction. The measure will start in 2026 for structures of seven stories or less. The ban for larger buildings starts in 2029.
To that end, one week after the lifting of the moratorium, the company will hold technical meetings with plumbers and general contractors and will also contact customers , and they will receive information about fossil-free alternatives. All customers who request new service are required to sign an attestation confirming their awareness of New York State clean energy policy goals and the availability of non-fossil fuel alternative heating options.
JOHN BAILEY AND THE NEWS YOU NEED TO KNOW
THE THANKSGIVING NOVEMBER 24 REPORT
EVERY WEEK ON WHITE PLAINS WEEK SINCE 2001 A.D.
THE SOLUTION TO COMING CONGESTION TAX IN NEW YORK CITY AT 60TH STREET SAVE TIME AND MONEY AND AGGRAVATION
REMEMBERING THE LEGACY OF PRESIDENT JOHN F. KENNEDY. HE WAS MURDERED
60 YEARS AGO ON NOVEMBER 22, 1963
JETELINA AND RIVERS YOUR LOCAL EPIDEMIOLOGISTS REPORT ON HOW TO HANDLE THE HOLIDAYS GOING IN COVID INFECTIONS PROJECT TO 3,000 NEW CASES IN COUNTY–9,000 LESS THAN LAST DECEMBER
THREAT OF VOTER REPRESENTATION LAWSUIT IN MT. PLEASANT AND A DEFINITE THREAT TO WHITE PLAINS “AT LARGE” VOTING SYSTEM
UNEMPLOYMENT UP IN WESTCHESTER COUNTY 3RD STRAIGHT MONTH
HALF OF PATIENTS BEING ADMITTED TO BEDS AT WHITE PLAINS HOSPITAL CONTINUE TO ALSO HAVE COVID AFTER ADMISSION
SANDRA CELANTI (center) SAINT PIO FOUNDATION DELIVERING 60 COMPUTERS TO FATHER ROBERT MORRISTO THE CHURCH OF SAINT BERNARD ALCANCE LATINO TECHNOLOGY CENTER
WPCNR Thanksgiving Portfolio, all photos by WPCNR:
On this Thanksgiving, let us remember the band of hardy intrepid souls who crossed an ocean in a boat no bigger than a large Chris Craft and settled in an unforgiving landscape and started a country in the cold landscape of New England.
They were immigrants.
They were helped by Indians who welcomed them, without Indians’ compassion they would not have survived. And, remember, those pilgrims were immigrants.
A salute to this brave band. A salute, too, to the indians who accepted them without visas, without jobs, with no background checks no green cards. No border wall. No cages for children. No fear on the part of the Indians and their humanitarian leader, Squanto
The pilgrims sailed into a bay, dropped anchor and just carved out a living after living in incredible conditions in a ship’s hold for weeks, crossing the storm-tossed North Atlantic. Here are some views of America’s hometown by the WPCNR Roving Photographer.
Plymouth Rock Landing. Plymouth, Massachusetts.
The Mayflower II. Plymouth Harbor.
Indian Statue of Squanto welcoming the Pilgrim Settlers. Plymouth.
Governor William Bradford Statue on the Shores of Plymouth Harbor
“Plymouth Rock,” The landing place of the pilgrims.
Settlers Home, left, circa 1690.
Church, Plymouth late 1700s. .
The Jury: Old Burial Ground, Plymouth. Last resting place of the pilgrims overlooking Plymouth Harbor. The sacrifices, bravery and perseverance of these persons stand as examples to Americans today.
How are we doin’?
WPCNR NEWS AND COMMENT By John F. Bailey. (reprinted from WPCNR ARCHIVES) UPDATED. November 22, 2023:
Someone made a big mistake again this year. The papers on November 22nd had no reference to the day John F. Kennedy was shot and killed.
Three gunshots on November 22 at 1 in the afternoon just about an hour and a half ago in Dallas, Texas murdered President John F. Kennedy.
Today is the day in Dallas 60 years ago on a Friday afternoon when President John F. Kennedy was shot riding in his motorcade in front of the Texas Book Depository Building.
November 22, 1963. A most unfortunate coincidence that someone should have noticed.
Sixty years ago today at about midday eastern standard time, President John F. Kennedy was shot in Dallas, Texas.
When I heard the news, I was heading up the steps of Gray Chapel at Ohio Wesleyan University in Delaware, Ohio. It was sobering news. Then within the hour it was reported that the President was dead, and the search was on for potential suspects.
It was the first time in my life a national event had ever affected me.
Persons in their mid-70s can probably remember exactly what they were doing when they heard that electrifying news.
Disbelief. Concern. Sadness. Grief. Nothing you could do about it.
Who would shoot the President? How could they? The President no matter who he was was revered and respected at that time — not ridiculed, mocked, vilified, and criticized for his every move as President Biden is today.
President Kennedy’s popularity was ebbing at that time in 1963.
The public was initially inspired by the vision of Camelot and the likable, energetic young president.
However, by the time he was assassinated, President Kennedy was coming under harsh criticism for his foreign policy and his inability to move an agenda through congress. (Sound familiar?)
He was pushed around by congressional heavyweights — eerily not too much different from our President today, who today pushes congress members to pass voting rights and immigration reform and is blocked blocked blocked by congressmen and senators who know better.
When Kennedy was shot, the American public, even those who disagreed with his politics and considered him in over his head in the presidency, were stunned by grief and horror.
Nothing had happened like that in America since 1901 when President William McKinley was assassinated.
An entire nation reflected in guilt for a week as the three television networks showed 24 hours a day assassination and funeral coverage. Walter Cronkite shed a tear on camera when he reported Kennedy was dead. No commentator would think about reacting in glee on the air as they do now at Biden presidential defeats.
And please, no congressional personality would ever show video of himself cutting the throat of a fellow member of congress. That throat slitter guy needs to be thrown out of congress or at least arrested for threatening Congresswoman Alexandria Castro Cortez.
Does this mean in today’s law, threatening the life of a member of congress is not a crime or at least a menacing charge???? Please.
Until the Trade Center Horror in 2001, this nation had not experienced anything on that national scale of reaction to an event.(With the exceptions of the Detroit riots in 1967 and anti-Vietnam War protests.)
Were we a more sensitive nation then? More sensitive to what killing actually is? I no longer wonder.
In the fast-moving sensationalism of news ambulance and shootings chasers today, would the same sensitivity be there today? No. And it’s not!
Or, have we been hardened to violence, and do we now see violence as more of an acceptable solution to problems than to be avoided at all costs? Yes, we do.
We have an an ex-“president” who came out supporting a vigilante teen with an AK-47 who gunned down unarmed people in Kenosha Wisconsin as protecting himself. That takes my breath away. Whose Ak-47 was it? His? His parents? Very key question.
It seems so. With disgruntled, overly sensitive misfits just taking guns and shooting innocent people and they get acquitted on self-defense?
When persons take out a gun and shoot a “neighbor” over a property line. Hey. It’s the Wild West out there.
Time to check your guns at the door. And don’t bring your guns to town, Billy.
I remember how Americans sat mesmerized in front of their televisions as the Kennedy goodbye played out.
I remember, too how Kennedy’s death swiftly paved the way for the landmark Civil Rights act of 1965, legislated by Kennedy’s successor, Lyndon B. Johnson.
That legislation, without Kennedy’s assassination would probably never have been passed. I believe it passed because of collective guilt over Kennedy’s murder.
For 60 years, politicians, when their charisma is measured, have always been compared to Mr. Kennedy.
However, charisma does not get things done any more and it has lost its lustre as being a good thing.
Charisma and popularity does not make for change by itself.
The last four years we have seen the downside of charisma without compassion and thought.
It is nice but it achieves nothing unless you have some good solid ideas, management skills, and are willing to work hard for it. And compromise for the greater good. There are not people in congress both houses, who do that today.
Even, then, as a recent Kennedyesque President, with a license to use charisma, Barack Obama found out, it may not happen.
However, the political rancor and hysterical hatred of our President Obama that was expressed in the Republican debates, on talk radio and by candidates who should know better back in 2016, created an atmosphere of disrespect for then President Obama and the Democratic nominee, Hillary Clinton exceeded even that aimed at George W. Bush.
The lack of respect for President Biden today and hatred of Democrats has created an atmosphere that is far more dangerous for the President and the country than we can ever tell.
But we’re about to find out.
Mr. Trump, the former “president” polarized the nation into two warring camps with unprecedented name-calling, purely nasty, hurtful policies towards minorities and immigrants, bragging about the right to molest women, and supporting womanizers in his administration, and planned takeaways of health care, and blatant giveaways to robber barons on poshly appointed carpetted crags in concrete canyons reminiscent of the cruel British aristocracies.
The toxicity against the Presidents, both Obama, President Trump (though much is of Mr. Trump’s own immaturity and inability to manage) and now the pathological vilification of President Biden has been inflamed
Mr. Trump’s whining about the election being rigged is reckless and immature. Poor Little Rich Boy’s whining. No presidential candidate has ever acted this way before. But people bought it.
They stormed the capitol with Mr. Trump’s “Stop the Steal” campaign in the last 14 days of the worst American Presidency ever.
Mr. Trump is a winner in only one field: He has a solid grip on the title of “Worst American President” from Richard Nixon, Andrew Johnson, both George Bushes, and Bill Clinton.
Daily, Americans are assailed by website propaganda that tell them the economy is terrible.Social Security is going to be taken away. The Trump economy was better. They are believing that, forgetting the slow-to-act on covid situation. Truth is what you say it is today. And that is not good.
The job of the nation is to make sure they do not bring Mr. Trump to finish wrecking the nation in 2024.
Al Gore when he lost the 2000 election did not, to my memory come out and call for revolution.
Mitt Romney’s petulance in 2012 at his defeat by President Obama started a tradition of losing ungracefully.
Voters saw right through this Mitt “Guy Smiley” of a candidate they in their guts knew the phony he was. Voters were not as astute in 2016.
Romney’s comments to his donors, were echoed by Michael Steele’s statement about Emperor Obama and his “reign of lawlessness” is exactly the sort of talk that paved the way for the Republican campaign of hatred in 2016. It was irresponsible of Romney and Steele.
A losing Presidential candidate has one job, unite behind the new leader. Romney is the only President in my memory ever to have not — until the Little Rich Boy with the forked tongue.
The Republicans’ inability to compromise has stalled the nation on recovery, immigration, health care…you name the issue, the Republican Party has stalled progress in their frantic effort to roll back the clock to the turn of the 20th century. (1899-1900) when white and rich were right no matter what.
Robber barons, oil tycoons, industrialists, bankers, ruled the roost.–until the great Teddy Roosevelt broke up Standard oil, forced the banks to support the economy and supported the union movement. Teddy Roosevelt was the enemy of the rich and powerful and he made them cow-tow. They hate that.
Now we have a misguided America think that the rich will help them thanks to the self-rights movement.
We should always remember The Republicans’ whining. Bullies always whine. Fixers always are sore losers.
Ideas and rhetoric are one thing, but to vilify President Obama on the scale of what we heard in 2016 was irresponsible. Because it was listened to by persons across the country who suddenly got the “OK” from Republican candidates and “leaders” that it was ok to hate, to blame America’s problems on immigrants, and trade policies, and ignore science on climate change.
When educated leaders in congress endorse the policies of hate and punishment people can be OK with that? Leaders are giving people license to hate and hurt, discriminate, exploit, kill and build up themselves at the expense of others.
5 years ago the American people elected a President who did just that. Just that.
He has already told you what he’s going to do.
If you let him. He will do it. Everything.
So when you sit down to turkey Thursday give a thought to be thankful for a nation that once did not rise up in arms whenever a leader is elected that a portion of the populace does not like. (Yet and yet, many did on January 6, 2017 year, at the urging of that “president.”)
Be thankful that the American people once spoke and felt as one, and hopefully will learn to do so again even though we disagree.
I hope so.
WESTCHESTER ON TRACK FOR 2,600 NEW CASES IN NOVEMBER COMPARED TO 6,374 LAST NOV.
PROJECTED DEC CASES IN WESTCHESTER.: 3,000 –9,000 LESS THAN LAST DECEMBER.
WPCNR COVID SURVEILLANCE. Statistics from NY Covid Tracker. Observation & Analysis By John F. Bailey. November 22,2023:
New persons testing positive for Covid in Westchester County numbered 628 from Nov 12 to 18, averaging 93 persons a day.
New Positives rose 17% from 507 the week before.
The first 3 weeks of November total new covid positives were 1,659. .
At the level of infections a week this projects to 3,000 infections in the month of December.
This would reduce the infections of covid experienced in December 2002 (12,000) by 9,000 and vastly lower the chances of a wave in infections in January 2024.
This of course depends on the number of infections during the socializing month from Thanksgiving to January.
Infections are up in Nassau and Suffolk Counties, averaging 300 between the two Long Island Counties.
The infections in the other six counties in the Mid-Hudson Valley region, Dutchess, Orange, Ulster, Rockland Sullivan Putnam averaged 20 new infections per county as of last Saturday.
Total infections for the Mid Hudson Region as of last Saturday, 199 with Westchester having 82 of those (or 40%).
Hospitalizations for Covid were up statewide as of Nov. 21, with 1,239 hospitalizations for covid, compared to 1,274 for all 31 days of October and 1,151 for all 30 days of September.
Locally at White Plains Hospital Medical Center, half of all persons admitted to hospital beds are being found to continue to be positive for covid after admission.
From November 1 through November 20, White Plains Hospital admitted 154 persons to beds, and after admission, 80 or 52% of those admitted were found positive for covid.
Hudson Valley Region:
The October 2023 unemployment rate for the Hudson Valley Region is 3.5 percent. That is up from 3.2 percent in September 2023 and up from 2.6 percent in October 2022. In October 2023, there were 41,400 unemployed in the region, up from 37,800 in September 2023 and up from 30,700 in October 2022. Year-over-year in October 2023, labor force increased by 20,600 or 1.8 percent, to 1,187,000.
The Hudson Valley Region’s October 2023 unemployment rate (3.5 percent) is tied with the Central New York and the Finger Lakes Regions for the third lowest rate among the 10 labor market regions in New York State. The Capital Region (3.2 percent) recorded the lowest rate.
In October 2023, the lowest unemployment rate within the region (3.2 percent) was recorded in Putnam County.
Jobs data for November 2023 will be released on Thursday, December 21 and the labor force data will be released on Wednesday, December 27.