Med – COOPER GENERAL NEWS

A U.S. Army soldier with the 2nd Armored Brigade Combat Team, 1st Infantry Division immunizes Jacklina Mendez with the COVID-19 vaccine on March 9, 2021 on the north campus of Miami Dade College in North Miami, Florida.

Joe Raedle | Getty Images

The Biden government will allow a wider range of medical professionals, including dentists, veterinarians, paramedics and medical students, to administer Covid-19 shots to bring the nation closer to normal by midsummer.

The U.S. Department of Health is using its powers under the Public Preparedness and Emergency Preparedness Act to empower more healthcare professionals and qualified students to manage the admissions, the agency said in a statement Friday.

That means dentists, paramedics, midwives, opticians, paramedics, medical assistants, podiatrists, respiratory therapists and veterinarians can start giving Covid-19 vaccines nationwide, according to HHS.

It also empowers “medical students, nursing students and other health care students in the professions listed in the PREP Act with appropriate training and professional supervision to act as vaccines,” the statement said.

The move comes after President Joe Biden announced Thursday night that he would instruct all U.S. states, tribes, and territories to qualify all adults ages 18 and older for the coronavirus vaccines by May 1.

The president, during his first prime-time address to the nation on the one-year anniversary of the pandemic, said the goal was for Americans to gather in small, face-to-face groups to celebrate July Fourth.

“That doesn’t mean everyone gets a shot right away, but May 1st is the date that any adult can sign up to get the shot,” Biden’s Covid Tsar Jeff Zients said at a press conference on Friday. “We expect an adequate vaccine supply for all adults in this country by the end of May.”

The US currently delivers an average of 2.2 million vaccines per day per week. About 65% of Americans age 65 and over are now vaccinated, Zients said. Only more than a quarter of adults 18 and older have received at least one vaccine, according to the latest data from the Centers for Disease Control and Prevention.

“We are making progress, but there is still a lot to be done,” he said.

On Monday, the CDC released its first guidelines for people who are fully vaccinated. These state that they can now converse with other vaccinated individuals inside without masks or social distancing.

In Niyongere’s office, she first spoke to an intern who disappeared after a full medical history and examination, and then returned with the young doctor the patient had spoken to by phone. A distant part of her brain observed that her doctor was younger than her.

The hematologist sat across from the patient and slowly explained what she knew. In someone who is otherwise healthy and whose other blood types are fine, this severe drop in neutrophils – what is medically called neutropenia – is usually caused by a drug. There were of course other options. Nutritional deficiencies could do this. Insufficient vitamin B12 or copper can affect the blood count. Some viral infections – HIV, mono, hepatitis – could also occur. And they would look for it. But her money was for drugs. The doctor knew that the only drug the patient was taking regularly was Adderall; She had a history of ADHD, and Niyongere had not found anything in the medical literature to associate this drug with neutropenia. Still, the haematologist insisted that this was the most likely cause of her isolated neutropenia.

They would be looking for infections. They would check their levels of vitamins and minerals. And if all of this were normal, the next step would be a bone marrow biopsy. The doctor expected it to be normal – with lots of blood cells of all kinds being made and released. Her first hematologist was right that a cancer or disease process that interfered with the production of these vital defenders was possible – but how healthy the patient looked and felt was very unlikely, according to Niyongere. In the meantime, she should stop the Adderall.

The tests are coming back

The following week was busy as the student prepared to resume the portion of her medical school education. In just a few days she would be in the hospital learning to care for sick patients, and she needed her immune system to be up to the task. She watched the test results come back. The vitamin levels were normal. She didn’t have any of the viruses. So that Friday the student went back to Niyongere’s office for a bone marrow biopsy. The doctor suggested doing this with sedation in the hospital operating room. No, the patient insisted. You would do it in the office. It was a difficult procedure, but the patient wanted to get it over with. She needed an answer and a few more neutrophils before she could be safe with the sick patients she would see in the hospital.

The results came back faster than expected. A wave of weakness forced her to sit down as she read the results: normal. There were no signs of leukemia or any other process that might affect your body’s ability to produce neutrophils. And she made a healthy amount of all white blood cells, including neutrophils. This meant that everything that happened to these warrior cells happened after they left the safety of the bone marrow and entered the bloodstream. That’s what you would expect if this were a response to a drug. Many drugs can cause neutropenia. Some drugs destroy these battle cells directly. Some trigger an immune response so that other parts of the body’s defense system mistake these cells for invading pathogens and attack them.

Sometimes, if it was a response to a drug, cell counts would go back up almost immediately. Neutrophils have a very short lifespan and a full set of new cells are released from the bone marrow every day. The student waited eagerly for her next blood count. Could just stopping Adderall bring them back to normal?