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The Club PUBlication  11/30/2020

11/30/2020

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​‘A million moving parts’ to deliver vaccine across U.S.

Deep freezers, GPS tracking, back-up plans – and each state is on their own.

Story by LENA H. SUN and FRANCES STEAD SELLERS

• Washington Post • iStock illustration

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Riverside Health System in Virginia has ordered a specialized freezer for each of its five hospitals to keep precious vials of coronavirus vaccine as cold as a deep Antarctic freeze.

Public health officials in Nashville and Baltimore are revamping routine flu clinics to test delivery methods for coronavirus vaccinations.

Maine’s top health official Nirav Shah spends sleepless nights devising drive-through facilities where vaccinators won’t have to wear parkas in addition to their personal protective gear. Shah’s solution? Fire stations and carwashes.

Those venues are heated “so you have shelter from the snow and cold,” he said.
Buoyed by promising results from major clinical trials of two vaccines, public health officials are preparing for the daunting task ahead of delivering those shots to tens of millions of Americans.

The vaccines need to be distributed across 50 states, plus U.S. territories, that have different demographics and shifting needs. The two leading products must be stored at different temperatures and have different minimum orders, with each requiring two doses but at different intervals.

Complicating matters: A final decision on who is eligible to get the early doses must wait for a federal recommendations. That can’t happen until regulators authorize the new vaccines. And once set in motion, the distribution — from loading dock to upper arm — has to be accomplished equitably and with as few handoffs as possible, all done amid a pandemic.

The stakes are enormous. The massive undertaking to immunize most of the population requires extraordinary communication, planning and coordination. Federal, state and local officials are working with hospitals and pharmacies, suppliers of dry ice, gloves and vials, and carriers. A successful operation could transform the health and economic well-being of society.

“There are a million moving parts … to mount an immunization campaign of historic proportions,” said Bruce Gellin, president of global immunization at the Sabin Vaccine Institute. He warned that there are pitfalls at every step.

Officials are wrestling with how to ensure vulnerable populations receive the vaccine. Almost certainly at the front of the line: about 17 million front-line health care workers. Next up are likely to be other essential workers, many of whom come from Black, Latino and Asian communities hard hit because of socioeconomic factors.

“It’s like treating an individual patient while rebuilding the entire health care system,” said Alfred Sommer, former dean of the Johns Hopkins Bloomberg School of Public Health, who was part of the team that vanquished smallpox four decades ago.

Once the vaccines are authorized by the Food and Drug Administration, doses will be allocated to each state according to population, with some held in reserve in case of loss or theft. Within 24 hours of FDA action, doses will be “prepositioned” at key sites designated by each state where vaccines will be administered to the first priority groups.

U.S. government officials anticipate having 40 million doses of vaccines from pharmaceutical giant Pfizer and biotech firm Moderna by year’s end, enough to vaccinate 20 million of U.S.’s 330 million.

The federal government is paying for much of the delivery and vaccine administration costs. But state officials are asking Congress for at least $8 billion for vaccination efforts; to date, $200 million in federal funds has been sent to state, territorial and local jurisdictions.

The vials will be sent first to large hospitals and other sites where mass immunization clinics can take place. But even that first step presents daunting travel, storage and handling requirements.

The Pfizer vaccine will be shipped to sites selected by states in GPS-tracked, suitcase-sized “shippers” with 50 pounds of dry ice pellets, and must be kept at minus-70 Celsius. Upon arrival, the dry ice must be refreshed, or the vials of vaccine must be transferred to ultralow-temperature freezers. The container cannot be opened more than twice a day, the dry ice must be replenished every five days, and the contents must be used within 15 days.

The Moderna vaccine is less demanding, with a storage temperature of minus-20 Celsius, which is the same for many medications.

The shipments need to be coordinated with kits of syringes, needles, face masks and other supplies.

From there, every state, territory and each of six major metropolitan areas is responsible for its own deployments. States are in varying stages of preparation. Many have designated large hospital systems to be the first places to receive vaccine.

Maine has held meetings with transportation officials and the National Guard to work through worst-case scenarios, Shah said. If there’s a flood or loss of power, a backup generator for the freezer would kick in. If shots are transported during a blizzard, the vaccine convoy could follow 30 minutes behind a salt truck.

Clinicians will need to be trained to administer the vaccines, which have different protocols. The Pfizer version must be diluted before the shot is given — inverting the vial 10 times “gently,” according to the Pfizer instructions. In contrast, the Moderna vaccine does not require on-site mixing and should not be shaken.

To start with, vaccination efforts may favor urban areas. That’s because the vaccines will arrive in big batches: For Pfizer, the minimum order is 975 doses. Moderna’s smallest batch is 100 doses.

“The most disadvantaging issue is the minimum order,” said Ann Lewandowski, program manager for the Southern Wisconsin Immunization Consortium, a group of 42 rural hospitals in Wisconsin. None has the resources to purchase a special freezer, which can cost $12,000 to $15,000.

Health care personnel from rural hospitals may have to drive to get their shots at larger hubs, Lewandowski said. That could pose a barrier for staffers already stretched thin caring for patients with COVID-19.

A Pfizer spokeswoman said the company is working on a smaller pack size that will be ready early next year.

Final recommendations on who gets the first shots will come from an independent committee on immunizations that advises the CDC.

The new vaccines are likely to produce more unpleasant side-effects than a flu shot, potentially leading recipients to need a day or two off work.

“Any group of individuals that work together, we can’t vaccinate them all at the same time,” said Thomas Talbot, chief hospital epidemiologist at Vanderbilt.

That assumes priority groups — health workers and essential workers — are willing to take the first shots. Health officials say they are increasingly worried about staffers who say they won’t take the vaccine, according to internal surveys and conversations with clinicians.

“When it comes to this vaccine, what I’m hearing from colleagues … is that their confidence is lacking,” said Pamela G. Rockwell, a physician representing the American Academy of Family Physicians. “We need to do this right and get our patients convinced that this is safe so we can save our country.”


HURDLES AHEAD
  • Minus-70 Celsius Temperature Pfizer needs
  • 5 days Lasts at refrigerator temps
  • Minus-20 Celsius For Moderna’s vaccine.
  • 40 million Doses expected from Pfizer and Moderna by year’s end
  • 20 million People initially vaccinated
  • 330 million U.S. population
  • $8 billion States’ request to Congress
  • $200 million Federal funds sent so far



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The Club PUBlication  11/23/2020

11/23/2020

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HOMEGAZING YOU CAN HAVE IT FOR ... $287,500

Converted church offers domed ceilings, stained-glass windows

By KIM PALMER kim.palmer@startribune.com

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The former church still has its domed ceilings and stained-glass windows.
If you’re now working remotely and able to live anywhere, why not a sanctuary in a quaint rural town in central Wisconsin?
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There , a Catholic church built in 1885 has been converted into a Mediterranean-style home and is now on the market for $287,500.

​“It looks like a house that no one else would have,” said Brenda Thompson , owner of Special Finds (www.specialfinds.com), a website for unusual properties.
The church still has its original hand-carved entry door, which opens to an interior with 20-foot domed ceilings, original Gothic arched windows and two huge stained-glass windows — in the kitchen. The 2,544-square-foot home is filled with light, thanks to the tall church windows, and has an open floor plan and original maple floors.

There’s just one bedroom — in the former choir loft — but its bathroom includes a walk-in shower and claw-foot copper tub. There’s also another half-bath.

The distinctive home is located in Weyauwega , a town with a population of 1,900 built around a lake about 250 miles from the Twin Cities. Weyauwega is between Stevens Point and Appleton, and offers proximity to the Chain o’ Lakes and Wolf River.

The town’s claim to fame is that author Robert Bloch lived there for six years while writing “Psycho,” the horror novel that inspired the 1960 Alfred Hitchcock film classic.

The current owners converted the old church into a home after moving from Florida and discovering the property while they were in the area. “They had no intention of buying a church,” said Thompson, but they fell for its distinctive architecture.

Over the years, the owners invested substantially in the property, Thompson said, converting the 0.39-acre corner parcel from a parking lot to a fenced, lawn-covered yard, and adding an oversized two-car garage.

The systems and mechanicals have been updated, with a newer furnace, a tankless water heater and a new roof.

The owners also added handcrafted, one-of-a-kind chandeliers, decorative tile in the kitchen, hand-stenciled floor designs and shutters to fit the Gothic windows, shipped from a Catholic church in New York.

“There’s a whole breed of people who buy churches” to live in, said Thompson, who currently has three on her website.
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“The benefit of owning a church is it’s built to last forever,” she said, with walls 8 inches thick. “It has stood the test of time.”
​

The property is listed at Special Finds ( www.specialfinds .com).
Kim Palmer • 612-673-4784
Stribkimpalmer


​Photos provided: The main bathroom includes a copper soaking tub, as well as a walk-in shower. The vestibule features an ornate chandelier. The church was built in 1885 and sits on a 0.39-acre corner lot in Weyauwega, Wis.

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Main Bathroom
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Building with added garage.
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Vestibule.
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The Club PUBlication  11/16/2020

11/16/2020

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​An EV for one
Canadian firm introduces a single-person electric-powered vehicle.

​By ROB NIKOLEWSKI San Diego Union-Tribune

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ELECTRAMECCANICA • TNS The three-wheel Solo is a little over 10 feet long, has a 100-mile range and can reach speeds of up to 80 miles per hour.
There’s a new kid on the zero-emissions vehicle block — and it has three wheels.
The Solo, from Canadian designer and manufacturer ElectraMeccanica, is a single-passenger all-electric vehicle with a range of 100 miles and a top speed of 80 miles per hour. It retails for $18,500, and people in a select few U.S. cities on the West Coast can see it for themselves.

The car is slightly more than 10 feet long (122 inches) and 57.5 inches wide at the front wheels — considerably smaller than a typical passenger vehicle. For example, a 2020 Honda Accord sedan is 192.2 inches long and 73.3 inches wide.

“When you’re driving it, you feel like you’re sitting in the cockpit of a fighter jet or in a Formula 1 car,” said Paul Rivera, CEO of ElectraMeccanica. “It’s really cool and really different.”

But a big part of the marketing strategy for the Solo is based on efficiency and practicality. The company quotes pre-pandemic statistics showing that each day, 119 million North Americans commute using personal vehicles — and 105 million of them do so all by themselves.

The Solo looks to attract early adopters looking for an option in an urban environment.

“This is a purpose-built vehicle and it fits beautifully between passenger cars on one end of the spectrum and micro-mobility [scooters, electric bikes, etc.] on the other end,” Rivera said.

Powered by a 17.3-kWh battery that turns a single rear wheel, the Solo features a heated seat, Bluetooth stereo, rearview camera, power steering, power brakes and air conditioning. It has front and rear crumple zones, side-impact protection, torque-limiting stability control and a roll bar.

ElectraMeccanica is based in Vancouver, but the Solo is manufactured in China. The first production shipments of the vehicles arrived in the United States last month.

Customers can take one for a test drive, but they can’t buy one off the lot. To get one, you must place an order for one that will be delivered at a later date. Ordering a Solo requires a $250 deposit, which is refundable.

Rivera would not reveal how many deposits have been made, but he said “the waiting list is pretty long” and estimated that an order placed now probably would not be delivered until “well into the middle of next year.”
Technically not a car

One potential drawback: While a conventional four-wheeled electric vehicle is eligible for a federal tax credit of up to $7,500, the Solo receives no such credit. That’s because it’s categorized as a motorcycle by the federal government.

Ivan Drury, who looks at automotive trends as senior manager at Edmunds.com, is skeptical about the single-seater’s prospects. Last year, Mercedes-Benz announced it would stop selling the all-electric Smart car, which had two seats, in North America, largely due to slow sales.

“Small doesn’t sell in America,” Drury said.

Rivera said he thinks the Smart car EV didn’t cut it because it didn’t leave enough space to carry luggage or groceries, something the Solo has addressed. In fact, ElectraMeccanica will soon come out with a fleet version of the Solo. It’s the same size as the existing vehicle but the hatchback is removed to create more space for cargo.
​

“We think that’s going to be a home run,” Rivera said.
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The Club PUBlication  11/12/2020

11/12/2020

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covid19risk.biosci.gatech.edu,

Tool can gauge danger of contact
By DEBORAH NETBURN Los Angeles Times

How likely is it you’ll encounter at least one person who is infected with the coronavirus if you go to a bar in Denver? What about a 100-person wedding in Baltimore? Or a Thanksgiving dinner with 25 guests in Los Angeles?
​

The answers to these questions — and many more — can be found on the free, intuitive and now peer-reviewed online COVID-19 Risk Assessment Planning Tool. Built by a team of researchers at Georgia Tech, the tool is designed to help policymakers, event planners and individuals easily grasp the risks associated with gatherings of different sizes throughout the United States, and increasingly across the world.

The tool was conceived in March by Joshua Weitz, a quantitative biologist at Georgia Tech who wanted an easy way to quantify the risk of attending events of various sizes in different locations.

The first iteration was a graph that took into account the number of infections per capita in any given county, along with the size of a proposed event.
Later, that same information was overlaid on a map to make it even easier for users to understand.

To find out how likely you are to encounter a corona-virus-infected person at a friend’s white elephant party for instance, visit the website covid19risk.biosci.gatech.edu, move the slider on the left of the map to the number of people you expect to attend (let’s say 15), then hover your cursor over the outline of the county where the event will take place (let’s say Hennepin).

The tool will tell you that if the gathering were held today, there is a 33% chance someone will bring the virus along with a pair of novelty socks.

What it can’t tell you, however, is whether a 33% chance of sharing space with someone capable of infecting you is too high to make your attendance worthwhile.

That decision is up to you.
“In a way it’s like a weather map,” said Clio Andris, a professor of city and regional planning and interactive computing at Georgia Tech who helped Weitz build out the tool. “It can tell you what the risk is that it will rain, but it can’t tell you if you’ll get wet. That depends on if you carry an umbrella, or if you choose not to go outside at all.”

The map is updated daily with the latest information on how many cases have been tallied in every county across America.

The tool also assumes that the actual number of corona-virus cases is up to 10 times higher than what’s in the official reports, because not all cases will be caught by tests.

The COVID-19 Risk Assessment Tool went live in July, and the creators reported that 2 million people had visited the site by September.

In addition to individual users, the research team was contacted by the Georgia Municipal Association, which represents all the mayors in the state, as well as organizations like the Special Olympics that were using it to assess the risk of holding events.

As we move into the holiday season, Andris said she hoped more people would use the COVID-19 Risk Assessment Tool to help them make decisions about how many local friends and family to invite to their celebrations .
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“I can see a lot of people saying, ‘It’s been a hard year, and we really need to be with friends and family,’ ” she said. “I get that, and I hear that, but it’s going to have consequences.”

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The Club PUBlication  11/09/2020

11/9/2020

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Eta is gaining strength as it heads for Cuba, Florida Keys
By SONIA PEREZ D. Associated Press

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DELMER MARTINEZ • Associated Press Eta left damage like this in Honduras. In Guatemala, search teams pulled bodies from landslides and looked for survivors.
PURULHA, GUATEMALA – Searchers in Guatemala dug through mud and debris looking for an estimated 100 people believed buried by a massive, rain-fueled landslide, as Tropical Storm Eta continued to gain strength Saturday and churned toward Cuba.

The U.S. National Hurricane Center said Eta was located about 230 miles west-southwest of Camaguey, Cuba, and was moving northeast at 17 mph with winds of 60 mph. The storm was expected to approach the Cayman Islands, be near Cuba Saturday night and Sunday, and approach the Florida Keys or south Florida late Sunday.

Tropical storm warnings were issued for central Cuba, southern Florida and the Florida Keys. The hurricane center said flash floods could occur in the Cayman Islands, Jamaica, the Bahamas and southern Florida.

Back in Central America, which Eta reached as a Category 4 hurricane Tuesday, authorities from Panama to Mexico were still surveying the damages from flooding and landslides following days of torrential rains. The confirmed death toll was in the dozens and expected to rise.

On Friday, search teams in Guatemala pulled the first bodies from a landslide in San Cristobal Verapaz, but the work was slow and help was trickling in. Teams first had to overcome multiple landslides and deep mud just to reach the site where officials have estimated some 150 homes were devastated.

In the village of Queja, where a hillside collapsed onto homes, rescue workers used a helicopter to evacuate survivor Emilio Caal. He suffered a dislocated shoulder when the landslide sent rocks, trees and dirt hurtling onto the home where he was about to sit down to lunch with his wife and grandchildren. Caal said he was blown several yards by the force of the slide, and that none of the others were able to get out.

“My wife is dead, my grandchildren are dead,” said Caal from a nearby hospital.

In neighboring Honduras, Maria Elena Mejia Guadron, 68, died when the brown waters of the Chamelecon River poured into San Pedro Sula’s Planeta neighborhood before dawn Thursday.

Mirian Esperanza Najera Mejia had fled her home in the dark with her two children and Mejia, her mother. But while she held tight to her children, the current swept Mejia away.

Najera continued searching desperately for her mother Friday morning. But Mejia’s body was recovered later and taken to the morgue, where her relatives identified her.
​
In southern Mexico, across the border from Guatemala, 20 people died as heavy rains attributed to Eta caused mudslides and swelled streams and rivers. The worst incident in Mexico occurred in the township of Chenalho, where 10 people were swept away by a rain-swollen stream; their bodies were later found downstream.
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The Club PUBlication  11/02/2020

11/2/2020

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​What those latest mouthwash studies really mean

By ALLYSON CHIU Washington Post

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RICH SCHULTZ • New York Times Experts warned against misinterpreting studies that suggest mouthwash can inactivate coronaviruses, noting that the findings might not have practical relevance outside the lab.

​Contrary to some of the buzz about mouthwash, a daily gargle is probably not going to protect you from the novel coronavirus. Instead, experts say new research has “promising” implications to help infected individuals reduce their risk of spreading the virus.

“It’s an exciting avenue,” said Nicholas Rowan, an ear, nose and throat surgeon and assistant professor at Johns Hopkins Medicine. “ I think it’s also important to realize that it’s not an instant solution.”

Here’s what those studies actually mean, and why scientists say we should view them with cautious enthusiasm.

Over the past several months, researchers in the U.S. and abroad have examined mouthwashes, oral antiseptics and nasal rinses in controlled laboratories to see whether they can inactivate coronaviruses.

A team in Germany found that when several products, including Listerine, were applied to strains of the novel coronavirus for 30 seconds, they “significantly reduced viral infectivity to undetectable levels,” said a study in the Journal of Infectious Diseases.

Researchers at Pennsylvania State University College of Medicine released similar findings. A 1% solution of baby shampoo was also shown to inactivate the virus after two minutes , the study said.

Craig Meyers, the study’s lead researcher, noted that the focus of the research was to find a way to lower transmission in situations where masking and distancing might not be an option, such as during dental procedures. The findings do not necessarily mean using mouthwash or rinses will protect you from getting infected, Rowan said.
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The studies have limitations. The experiments were conducted in labs and may not reflect what happens in humans. Researchers also don’t know how long an infected person’s mouth might stay virus-free after using mouthwash.

Although the findings are “intriguing,” they are “not yet at the point where the average person can use them,” said Hana Akselrod, an infectious-disease physician at George Washington University. “If people were to stop wearing masks and observing social distancing because they think having everyone gargle is going to prevent viral spread … that could be a big mistake, and it would cause more disease and death.”
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