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Abbott deploys 2,500 out-of-state medical staff as youthful sufferers crowd hospitals

Dr. Joseph Varon (right) and Jeffrey Ndove (left) perform a hypothermia treatment procedure on a patient in the COVID-19 intensive care unit on Christmas Eve at United Memorial Medical Center December 24, 2020 in Houston, Texas.

Nakamura go | Getty Images

DALLAS – Texas hospitals are suspending voting and reaching out to 2,500 health workers from other states to tackle a surge in Covid cases as younger and healthier patients who haven’t been vaccinated against the days of treatment of the virus crowd.

The state is preparing for its most aggressive fight to date against the coronavirus as the Delta variant spreads across the country, hitting states with low vaccination rates and relaxed public health measures, particularly in the south and the Midwest.

Covid cases in the Lone Star State have exploded in the past few weeks. Texas averaged about 15,419 new cases per day on Wednesday, according to data compiled by Johns Hopkins University, up 34% from a week ago and more than double the seven-day average of 6,762 two weeks ago.

“What is worrying about the development is that the number of cases is growing much faster,” said Dr. Trish Perl, director of the infectious diseases division at UT Southwestern Medical Center in Dallas.

“We are seeing unvaccinated people who are younger than they were earlier in the pandemic, when we saw many hospitalizations over 65,” said Perl. “Now 18- to 49-year-olds are the biggest and highest gains, and many of these people have no underlying medical conditions.”

The spike in cases comes as Republican Governor Greg Abbott wages war on local school and government officials who reintroduced masked mandates, threatening $ 1,000 fines for communities and officials who oppose him. He initially banned local mask mandates in an implementing ordinance of 18

The second order also prohibited all public and private entities, government agencies, from requiring individuals to be vaccinated or to provide evidence of vaccination.

Local officials across Texas are defying state leaders and turning to the courts to challenge Abbott.

A person will receive the Moderna Covid-19 vaccine at the American Bank Center in Corpus Christi, Texas, USA on Thursday, February 11, 2021.

Nakumura go | Bloomberg | Getty Images

A district judge in Bexar County, home of San Antonio, on Tuesday issued an injunction against Abbott’s mask ban, which allowed local officials to restore mandates and other emergency orders to combat the Delta variant.

About 300 miles north, the Dallas Independent School District issued a temporary mask requirement for all counties on Monday.

Clay Jenkins, a Dallas County Democrat, followed suit with a new mask mandate for schools, businesses and county buildings Wednesday after a local judge issued an injunction preventing Abbott from enforcing his ban.

Abbott has vowed to fight the restraining orders. In a joint press release with Republican Attorney General Ken Paxton, the two said they are relying on personal responsibility to protect “the rights and freedoms of all Texans.”

“Attention-grabbing judges and mayors opposed orders from the very beginning of the pandemic, and the courts ruled on our side – the law,” Paxton said in the statement. “I am confident that the outcome of all lawsuits will come with freedom and individual choice, not mandates and government abuse.”

Austin Mayor Steve Adler, a Democrat, said he was weighing a citywide mask mandate when “the science, the data, and the doctors tell us this has to be something to keep the community safe”.

“Local school districts should be able to make this decision themselves in order to offer their children the best possible protection,” Adler said in an interview with CNBC on July 28th.

“I haven’t heard any scientific or data-driven rationale for policies that do not allow the enforcement of masking to protect public health,” Adler said, adding that he “strongly recommends that all children in schools wear” masks, and that teachers and guests at school do the same. “

Meanwhile, hospital stays continue to rise. Lyndon B. Johnson Hospital in Houston and St. Luke’s Hospital in nearby Woodlands have set up overflow tents outside to cope with the influx of patients, most of whom local officials say are unvaccinated. Texas lags behind the US in vaccinations, with 53.6% of the total population receiving at least one vaccination, compared with 58.9% nationwide, according to the Centers for Disease Control and Prevention.

A construction team is working to pitch tents hospital officials plan to pitch with an overflow of COVID-19 patients outside Lyndon B. Johnson Hospital in Houston on Monday, August 9, 2021.

Godofredo A. Vásquez | Houston Chronicle via AP

Abbott asked the Texas Hospital Association earlier this week to postpone voluntary medical procedures to free up beds in the intensive care unit, and said the state is hiring 2,500 medical staff outside of the state to relieve exhausted doctors and nurses.

“This help couldn’t come quickly enough. Many hospitals have already shut down non-essential services and are rerouting patients to add staff, ”Ted Shaw, president of the Texas Hospital Association, said in a statement Tuesday. “The hospital industry is losing frontline staff, especially nurses, to burnout and illness; many left the profession due to the extreme nature of the work during a relentless pandemic.”

More than 90% of all intensive care beds in Texas were occupied on Wednesday, according to the Department of Health and Human Services, with around 40% dedicated to Covid patients as of Wednesday.

While cases and deaths across the country have receded from their record highs in January, they’re on the rise again – but much faster in Texas. The state’s death toll is also rising, with a seven-day average of 57 daily Covid deaths on Monday, 36% more than last week, but below the record average of more than 341 deaths per day in late January 2021 data, according to Hopkins.

“It’s honestly heartbreaking. There is this feeling that they are invincible, but that’s not true, we are seeing seriously ill people,” said Perl of UT Southwestern Medical Center in Dallas. She said vaccinations are “the absolute best defense”.

Editor’s note: Nate Ratner and Robert Towey reported from New York and New Jersey, respectively.

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Health

Is the Delta Variant Making Youthful Adults ‘Sicker, Faster’?

Many patients who are hospitalized have underlying health conditions like diabetes, obesity or high blood pressure, which are risk factors for serious illness, he said. However, some younger patients do not have any of these risk factors.

“That really scares me,” he said. “It hits younger healthy people who you wouldn’t believe would respond so badly to the disease.” They often need to recover longer, added Dr. Coulter, and some will have permanent lung damage.

The Delta variant is relatively new in the United States, and evidence is still mounting as to whether and how it behaves differently. It’s more contagious, experts agree. Some studies have shown that infected people may carry large amounts of the variant in their airways.

The variant can also cause more serious illnesses, some researchers have suggested. A study in Scotland published in The Lancet looked at Covid cases in the spring when Delta became the dominant strain in that country.

Patients infected with the variant were almost twice as likely to be hospitalized compared to those infected with the earlier alpha variant. The patients were also younger, presumably because they were last vaccinated, the authors said.

In a preliminary study published online and not yet peer reviewed, Canadian researchers found that the risk of being admitted to the intensive care unit was almost four times higher in patients with the Delta variant than in those infected with other variants. Patients with the Delta variant had twice the risk of hospitalization or death.

Research in Singapore to be published in The Lancet concluded that patients with the Delta variant were more likely to need oxygen, need intensive care, or die. And a study in India, also put online and not yet peer-reviewed, found that in the second wave of infections, when the Delta variant was dominant, patients had a higher risk of death, especially under 45 years of age.

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C.D.C. advisers are anticipated to debate uncommon coronary heart issues in vaccinated youthful individuals.

Advisors from the Centers for Disease Control and Prevention are due to meet on Wednesday to discuss reports of rare heart problems in young people immunized with Pfizer-BioNTech and Moderna’s coronavirus vaccines.

The reports pertain to conditions called myocarditis, inflammation of the heart muscle; and pericarditis, inflammation of the membrane surrounding the heart. Most of the cases were mild, with symptoms such as fatigue, chest pain, and irregular heartbeat that go away quickly. The agency is tracking nearly 800 reports, although not all of them have definitely been linked to the vaccines.

The CDC advisors meeting comes as the Biden administration publicly recognizes it expects to miss its goal of partially immunizing 70 percent of Americans by July 4th.

Experts have said that the benefits of vaccination far outweigh the risk of potential problems, but they are expected to revisit this debate, especially for adolescents and young adults.

More than half of heart problems were reported in Americans ages 12 to 24, while that age group accounted for only 9 percent of the millions of doses given. The numbers are higher than one would expect for this age.

As of May 31, 216 people had developed myocarditis or pericarditis after a dose of either vaccine and 573 after the second dose. While most of the cases were mild, 15 patients remained in hospitals at this point. The second dose of Pfizer BioNTech vaccine was associated with approximately twice as many cases as the second dose of Moderna’s vaccine.

“We look forward to more clarity about the potential risk of myocarditis after mRNA vaccines in order to increase vaccination confidence and rates,” said Dr. Yvonne Maldonado, Chair of the Committee on Infectious Diseases at the American Academy of Pediatrics.

Recommendations from CDC advisors after Wednesday’s meeting may also influence decisions about immunizing children under 12 if vaccines are available for that age group. Some experts have questioned whether the benefits to children outweigh the potential risks given the low likelihood of serious illness in young children.

The CDC strongly recommends Covid-19 vaccines for Americans 12 and older. The agency reported this month that Covid-19-related hospitalizations among teenagers in the United States were about three times higher than influenza-related hospitalizations for the past three flu seasons.

By June 10, according to the American Academy of Pediatrics, nearly 17,000 children in 24 states had been hospitalized for Covid-19 and 330 children had died.

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To Vaccinate Youthful Teenagers, States and Cities Look to Colleges, Camps, Even Seashores

Not all teenagers crave the vaccine. Many hate taking pictures. Others say because young people often get milder cases of Covid, why should they risk a new vaccine?

Patsy Stinchfield, a nurse who oversees vaccination for children in Minnesota, has strong evidence that some cases can be serious in young people. Lately, not only have more children with Covid been hospitalized, but also Covid patients aged 13, 15, 16 and 17 years in the intensive care unit.

The new FDA approval means all of these patients would be eligible for admissions, she noted. “If you can keep your child from going to intensive care with a safe vaccine, why wouldn’t you?” She said.

Mr. Quesnel, the superintendent of East Hartford, Connecticut, said the strongest message of reaching older teenagers would likely appeal to younger ones too. Instead of focusing on the fact that the shot will protect them, they are taking up the idea that this will avoid having to quarantine them if exposed.

“They are not so afraid of the health threats from Covid as they are of the social losses it brings,” he said, adding that 60 percent of his district’s seniors or about 300 college students received their first dose at a mass vaccination website published on April 26th operated by the Community Health Center. “Some of our biggest levers right now are this social component – ‘You will not be quarantined. ‘“

Michael Jackson of North Port, Florida can’t wait for his 14-year-old son Devin to receive the vaccine. Last year, he said, his son’s popular Little League games were suspended and the family had to skip regular Sunday meals with their grandparents. Devin, an eighth grader, had to be quarantined three times after being exposed to Covid.

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Entertainment

Why Youthful Is Higher Than Emily in Paris

The final season of Younger has landed on Paramount + and it’s hard not to compare it to creator Darren Star’s other current show. Emily in Paris. On the surface, both seem similar: shiny, stylish, fleeting comedies about professional women in beautiful, glamorous cities. In reality, however, they are very different shows, and in fact they are Younger is very much the show that Emily in Paris tried (and failed) to be.

The fundamental difference between Younger and Emily in Paris is his heart, plain and simple. Even in the early seasons, when Liza was deep in her escalating web of lies, there was, paradoxically, an emotional honesty for everything. Although Liza lied to everyone, the show tried hard to make it clear why she was doing it and to build sympathy for her situation. Their love for their friends and their love interests was real; The only thing that wasn’t real was her lie about her age. The heart of the show has always come before its humor (though there are plenty of both); Emily in Paris often seems too anxious to be really vulnerable, and the result is a show that feels emotionally flat, even – or especially – when it tries to be emotionally deep.

The other big difference? Younger seems to care about its characters primarily while it’s hard not to feel like it Emily in Paris it’s all about aesthetics. Youngerlike with Star Sex and the City before that, a love letter to the glamor of New York City and the women who live there. There’s no shortage of beautiful, Instagram-perfect locations as the impeccably dressed characters stroll through town, but it never overshadows the characters and their journeys. Emily in Paris I always feel like the “Paris” part is more interested in exploring than the “Emily” part, which leaves us with characters that are hard to like when their bad choices take over.

YoungerOn the other hand, it has managed to create a range of characters whose flaws are not annoying but deeply human. In the final season, these themes are explored in more depth, with the “themes” and themes being closely linked to the characters’ journeys and not just put in for reasons of relevance or nervousness. When two characters hit a dead end because of the concept of marriage, it’s understandable where both of them are from, and it’s heartbreaking that they can’t see eye to eye. The flaws in all of these characters – Charles’ stubbornness, Kelsey’s trust in the wrong people, Maggie’s negligence – all come home to sleep, but it never makes them unlikely. Why? Because the show is careful to make them three-dimensional characters and really fight. They don’t giggle and wipe criticism off with a self-deprecating joke, like the heroine of Emily in Paris tends to do. Instead, they screw up and hit and get called and find out their stuff, all with the help of the people they love. That’s why it’s so satisfying when these characters are able towards the end of the season to prepare for the happier future we’ve been choosing all along.

YOUNGER, from left: Peter Hermann, Sutton Foster,

That real feeling of love may matter YoungerThe brand of escapism is so special. Younger is a show about love: love for the true self, love for friends and yes, romance too. It’s the true love between characters that really hurts the series’ betrayal, rather than just feeling like twists and turns that the writers thought would make for a good “OMG!” Moments. We are shown that they love each other instead of just being told. More than ever, the last season is about, because friends support each other through personal and professional exams without worrying. Gone are the days of secrecy and lingering pain; This is a group of people who really love each other.

The show’s Gal-Pal-Comedy-meets-Rom-Com vibe features some of the best moments of last season – it’s tropical, but in a playful, heartfelt way rather than trying too hard to tick off “relevant” topics (and condescending) without detailing any of them – see Emily’s “Surprise Influencer” story in Emily in Paris). This is what great escape means: home cooking, something fun, warm and stylish, but also something that represents the kind of life one can dream of. Sure, I would love to live in Emily’s Paris, but I would much rather live in the world of Youngerand have a loyal, loving support system like her.

Let’s be fair too: Younger has some of the same cracks in his escapist glamor as Emily in Paris. Here’s definitely something to say about how this particular brand of glamorous, glitzy escapist dishes mostly focuses on almost entirely white performers, and that can and should change. But when it comes down to it, escapism shouldn’t just be about aesthetics – it should be about the warmth and joy of the characters and the stories, and right here Younger Shines and other potential escapist shows should be noted.

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Surgeon says pausing J&J vaccine for youthful populations is sensible, however could possibly be lifted for older age teams

Dr. Atul Gawande said he “thinks something special is going on here” when it comes to blood clotting and Johnson & Johnson’s Covid-19 single-dose vaccine.

“We have an unusual type of clotting syndrome, very specific to these vaccines, in women in the younger age group, and it’s not like the other cases where these rare incidents happen. I think there are probably adenovirus vaccines. A some risk for this rare disease, which is increased in a certain age group, “said Gawande.

Experts from a panel of the Centers for Disease Control and Prevention decided to postpone a decision on the use of J & J’s single-dose Covid vaccine on Wednesday. They found they needed more time to assess the data and risks.

The meeting comes a day after federal health officials advised the US to temporarily suspend use of J & J’s single-dose vaccine as a “caution” after six women out of approximately 6.9 million people who received the shot reported getting heavy blood clots. Due to the postponement of the vote, the pause remains in force for the time being.

Gawande, a surgeon and professor at TH Chan School of Public Health at Harvard, said he thought the J&J vaccine hiatus made sense for younger populations, and he also thought it could be lifted for older age groups.

“I think there is enough information to know that this is safe for people over 50 and I think they could possibly have left the break for the older age group,” Gawande said on CNBC’s “The News with Shepard Smith” . “I think this could end up here like you saw for AstraZeneca in Europe.”

More than 7.2 million J&J doses have been administered nationwide, and the vaccine is responsible for 9.5% of the roughly 75 million Americans who are fully vaccinated, according to CDC data.

Gawande noted that the Moderna and Pfizer vaccine supply can be used to contain the increase in cases in states in the United States. He told host Shepard Smith that he was in favor of increasing the second dose of the Moderna and Pfizer vaccines to two, four, six weeks “in order to double the number of people currently vaccinated.

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In Line for Vaccination, and Not Getting Youthful

Ruth Ann Platt, who saw the news on television about effective vaccines against the coronavirus, couldn’t wait for them to get to her nursing home in Gainesville, Ga. “I thought it was great from the start,” she said.

When Ms. Platt, 88, moved to New Horizons Lanier Park last year after surgery for a broken femur, the facility had already put strict restrictions in place to contain Covid-19 outbreaks. “I lived in this room for seven months,” she said.

She still has to share a meal with another resident, attend a concert, or take an art class. The hair salon stayed closed, she said, so “I’ll be Rapunzel pretty soon.” She is tired of video chatting as a substitute for visits with her children, grandchildren, and eight great-grandchildren.

Fortunately, she received her second dose of the Moderna vaccine last month. New Horizons, part of the nonprofit healthcare system in northeast Georgia, has opted out of a federal partnership that relies on CVS and Walgreens to serve long-term care facilities. With its own pharmacy and nurses, the company quickly began vaccinating residents on December 29th.

Now Ms. Platt said: “I would like to find someone who plays a good game of pinochle.”

The testimony for vaccination in long-term care facilities, whose residents were supposedly on the front lines, shows a mixed performance.

Nationwide, nearly 3.4 million residents and long-term care workers received at least one shot, the Centers for Disease Control and Prevention reported on Thursday. Almost 800,000 got two.

By mid-January, Medicare data showed that cases in long-term care facilities had decreased nearly 46 percent from four weeks earlier, reflecting the decline in cases across the country but likely the impact of vaccination as well.

However, experts and advocates, who note that an estimated five million people live or work in long-term care, expressed great frustration with the slow adoption. “Long-term care has not lost any pace,” said David Grabowski, a health policy researcher at Harvard Medical School.

They are also concerned about the even slower rate in assisted living facilities and about workers suspected of being vaccinated.

Last fall, the Trump administration signed a deal with the two major pharmacy chains that agreed to keep three clinics in each facility: first dose, second dose, and one to catch previously missed stragglers.

The vaccination rate has increased significantly. Walgreens increased the number of doses administered from 165,000 in December to 1.3 million last month. It has completed the first doses in all 5,529 of the nursing homes it has contracted with and expects to deliver the second doses by February 25 and complete the third visits by mid to late March.

Similarly, CVS, which has the larger program, has dispensed first doses to all 7,822 nursing homes it serves, and about 77 percent of the second doses.

Company executives stressed that while the Centers for Disease Control and Prevention prioritized long-term care for vaccination, each state determined when programs began.

“We were actually planning a national rollout on the same day,” said Chris Cox, CVS senior vice president, pharmacy business. “We were ready to go.” While nearly all states activated nursing home clinics on December 21 or 28, most did not open assisted living clinics until January, often weeks later.

The virus didn’t wait. Long-term care infections peaked in December, according to an analysis by the Kaiser Family Foundation; also deaths in many states. Although residents and long-term care workers account for just 5 percent of the country’s Covid-19 cases, they account for 37 percent of deaths.

With a quicker answer: “We could have had more nursing home residents vaccinated more effectively four to six weeks earlier,” said Dr. Michael Wasserman, geriatrician and past president of the California Association of Long Term Care Medicine. “That’s a lot of deaths that could have been prevented.”

Updated

Apr. 5, 2021 at 1:51 am ET

Future business students may question this plan for years. “With over 30,000 facilities and millions of residents and employees, this has never been easy,” said Dr. Grabowski. “The states and the federal government have gladly transferred this to the private sector.”

Facility administrators had to deal with cumbersome consent forms early on, a problem that has since been resolved. CVS and Walgreens executives also report having to contact some facilities multiple times to simply schedule clinics.

The administrators, in turn, questioned the three-visit plan. How would these clinics reach employees who worked night and weekend shifts? Or newly admitted residents returning from hospitals and discharged after just one dose? The CDC is reportedly working on a transition plan.

Although the chains publish numbers updated daily, “we still don’t have the information we wanted,” said Tricia Neuman, executive director of the Medicare Policy Program at the Kaiser Family Foundation. The totals do not give any indication of which facilities the companies visited or how many residents and employees they vaccinated.

The residents reacted enthusiastically. The CDC estimated that in nursing homes with clinics, an average of 77.8 percent of residents received their first doses in the first month of the program.

“People who live in nursing homes would do almost anything to reconnect with the outside world and the people they love,” said Dr. Kathleen Unroe, a geriatrician at Indiana University School of Medicine who also practices at Northwest Manor, a nursing home in Indianapolis.

One of her patients initially had doubts. “I didn’t want to be a guinea pig,” said Norma Ware, 86. “I’m not crazy about shots anyway.” But after talking to her family and “a very kind nurse,” she received both doses and became a believer.

The bigger problem: reluctant staff. The CDC reported that in nursing homes with clinics, only an average of 37.5 percent of employees were vaccinated in the first month.

Other healthcare workers have also hesitated. In nursing homes in particular, many women workers are colored women who are familiar with long-term inequalities in health care and who distrust medical facilities.

“They were badly paid and overworked prior to the pandemic,” said Dr. Grabowski. Noting that workers also faced a shortage of personal protective equipment, he added, “They weren’t on sick leave or paid. So now let’s say,“ You need to get vaccinated. ”I’m not surprised that many say: ‘Wait a minute, why?’ “

Long-term carers, however, are susceptible to Covid-19; They can also spread the virus by entering and leaving facilities and doing secondary jobs to make ends meet.

At the two New Horizons homes in Gainesville, medical director, Dr. Swati Gaur, six staff town halls held in person or online, including one at 2am for the night shift, and offered rewards such as free meals. About half of the workers were vaccinated, said Dr. Gaur.

“If your co-workers, friends, co-workers, and co-workers are vaccinated, those numbers will go up,” said Dr. Wasserman ahead.

The slow pace of vaccination in assisted living facilities, where fatal outbreaks have also occurred, has also sparked fear. In some states, only about half of the population even received an initial dose.

At some point in March, the majority of those needing care and many employees will likely have vaccine protection, either Pfizer or Moderna. Then what?

Being able to see and hug their families is the top priority for residents. Geriatricians fear that the risks of extensive social isolation for residents rival those of the coronavirus.

“It is imperative that we see the restrictions relaxed,” said Robyn Grant, director of public order and advocacy for National Consumer Voice, which promotes quality long-term care. “The residents have suffered. This cannot go on. “Both Medicare and the CDC should prepare guidance on how and when to resume family visits.

Vaccinated residents could also re-establish contact with each other and gradually return to shared meals and activities. “The goal is to get these residents out of their rooms,” said Dr. Gaur.

Mrs. Platt gave some advice that could speed up this day. “This is no time for fear,” she advised roommates. “Get your shot. Just get your shot and get on with your life. “

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Israel’s large vaccine drive is not maintaining with new circumstances — particularly amongst youthful victims

For the first time since the pandemic began, Israel says more than a quarter of the most serious Covid-19 cases requiring hospitalization occur in patients under the age of 60.

The Israeli Ministry of Health blames a new strain first discovered in the UK last month.

Dr. Itamar Grotto, Deputy Director General of the Israeli Ministry of Health, said: “This is because the new British variant is more contagious, especially among young people and children.”

The news that Israel’s hospitals now have a record number of serious Covid cases came within 24 hours of Israel launching a “second dose”. Prime Minister Benjamin Netanyahu was the first to get his second shot yesterday.

Israel has been commended by the global health community for moving to vaccination so quickly. So far, nearly two million Israelis have received their first shot from around 9 million people. Israel has a highly centralized health system in which everyone has to register in a digital system, which makes it easier for the Ministry of Health to organize the vaccination campaign across the country.

Israeli Prime Minister Benjamin Netanyahu will receive the second dose of the vaccine against the coronavirus disease (COVID-19) on January 9, 2021 at the Sheba Medical Center in Ramat Gan near the coastal city of Tel Aviv.

MIRIAM ALSTER | AFP | Getty Images

Despite its success on the vaccine front, Israel is currently in its third nationwide lockdown due to the virus spreading. Without downplaying concerns about the rising percentage of younger people hospitalized with serious infections, epidemiologist Grotto points out that nearly 70% of Israelis over the age of 60 received their first shot, which gives them some immunity.

CNBC employee and former FDA chief Dr. Scott Gottlieb has been keeping an eye on trends in Israel and Europe since the pandemic started a year ago, and used them as a possible model for what could happen in the US, including the relatively newly discovered British variant.

“If we can use the vaccine, we can probably fight it off,” Gottlieb said, referring to the more dangerous, faster-spreading strain.

He believes the recent and alarming surge in cases in the United States is more related to vacation travel and gatherings, “but the bottom line is that we don’t have a good enough surveillance system to know for sure,” said Gottlieb.

The British variant officially only accounts for 0.2% of the US cases. Gottlieb also warned U.S. health officials that they are not yet looking so carefully for the increasingly dangerous burden ravaging an overstretched South African health system.