Outside the Beltway

A Season of Flu Deaths in Two weeks

Yet again: this is not “just the flu”

Steven L. Taylor
47

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Quite obviously, to anyone paying honest attention, the current pandemic is not “just the flu” if we look at death.

Way back on April 14, 2020, I provided the following in a post on this subject (which I have updated to include the 2019-2020 season):

SeasonEstimated Deaths95% U I
2010-201137,000(32,000 – 51,000)
2011-201212,000(11,000 – 23,000)
2012-201343,000(37,000 – 57,000)
2013-201438,000(33,000 – 50,000)
2014-201551,000(44,000 – 64,000)
2015-201623,000(17,000 – 35,000)
2016-201738,000(29,000 – 61,000)
2017-2018*61,000(46,000 – 95,000)
2018-2019*34,000(26,000 – 53,000)
2019-2020*22,000(18,000-29,000)
Source: CDC

The total number of deaths due to Covid-19, as this morning, was 398,185 (via Worldometers). We will almost certainly hit 400,000 today.

To provide further context, I added up the number of deaths for the first two weeks of January 2021 and the total is 43,616.

So, in the first two weeks of 2021, more people died from Covid-19 than the estimated deaths from flu in eight of the least ten flu seasons.

At this pace, January will far outstrip any flu season over the last decade.

Another way that Covid-19 is different than the flu, it is clearly more contagious. Via WaPo: Coronavirus shutdowns have quashed nearly all other common viruses. But scientists say a rebound is coming.

Veteran virus trackers say they are chronicling something never before seen — the suppression of virtually every common respiratory and gastrointestinal virus besides the novel coronavirus. They theorize that is largely due to global shutdowns, mask-wearing and a host of other health protocols aimed at stemming the spread of the coronavirus.

The things we are doing (masks, distancing, and generally decreased social contact) is making a host of diseases less prevalent than normal, even as Covid-19 cases increase. People have also been more likely to get their flu shots this year.

As the linked piece notes, there will be plenty to study on this topic going forward.

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47 responses to “A Season of Flu Deaths in Two weeks”

  1. Sleeping Dog Avatar
    Sleeping Dog

    Covid shovid, it’s no worse than the flu, that’s what they say on Fox etc.

    On the good news front, Cow Hampshire has announced that those over 65 and others with co morbidities can begin signing up for vaccine slots on the 22nd with vaccinations beginning on the 26th, assuming available vaccine of course.

    2
  2. Michael Reynolds Avatar
    Michael Reynolds

    The vaccine roll-out is an absolute fiasco. The federalist folks need to take a long look at this, watch people dying, and maybe get it through their ideologically-compromised heads that a) we need the national government to set rules and organize the distribution, and b) we need to resource the USG for these sorts of emergencies because,’Hey, the states are better at stuff because in 1787…’ is absurd.

    9
  3. ptfe Avatar
    ptfe

    @Sleeping Dog: We just calling the vaccine-forward states “cows” now?

  4. Steven L. Taylor Avatar
    Steven L. Taylor

    @Michael Reynolds: Well, at least the cartoon version of federalism, which Trump seemed to subscribe to, which amounts to: here’s the vaccine, you guys sort it out.

    Real federalism both works and is necessary. The interstate highway system fits that bill, as do a lot of welfare programs, to include SNAP. But that is a much longer post to detail.

    6
  5. Sleeping Dog Avatar
    Sleeping Dog

    @ptfe:

    Cow Hampshire is an old joke description of the state from the days when it was truly a rural backwater and not simply suburban tax refugees from Massachusetts with lots of marshes and hills. It was the late 60’s before there were more people living in the state than cows.

    3
  6. Michael Reynolds Avatar
    Michael Reynolds

    @Steven L. Taylor:
    The infuriating thing is that this is not exactly the Congo. We have not just a functioning distribution network, we have numerous, efficient distribution networks. I order a spatula and 24 hours later I’m flipping eggs. FedEx, UPS, Amazon, Wal Mart, CVS, Walgreens, Costco, Target, the USPS. But only the federal government can take advantage of that incredible power.

    Does my state health department know who I am and where I am? No. Who does? FedEx, UPS, Amazon, Wal Mart, CVS, Walgreens, Costco, Target, the USPS. And CVS has my entire medical history to boot.

    On the plus side it has finally begun to occur to some people at least that giving an intramuscular inoculation is something every pharmacy in the country does, and if that’s not enough, every veterinarian, every EMT, every fucking diabetic knows how to stab a needle in a fleshy bit and squeeze.

    We used to build entire ships in two weeks. The USG has had ten months to figure this out.

    6
  7. Michael Reynolds Avatar
    Michael Reynolds

    One more timeline comparison. In the same amount of time it took to go from the first Covid deaths in the US to our incompetent distribution of vaccine, we went from Pearl Harbor to landing troops in North Africa. And those people did not have computers.

    4
  8. ptfe Avatar
    ptfe

    @Sleeping Dog: I was just entertained by the etymological connection.

    1
  9. Steven L. Taylor Avatar
    Steven L. Taylor

    @Michael Reynolds: To be clear: the distribution issues has been a disaster, and I blame the Trump administration.

    Having said that, distributing a spatula is a lot easier than distributing something that needs very specific storage requirements and needs a person with some level of medical training to administer.

    (There is also no need to make sure the spatula recipient does not have a negative reacting to the enspatulaning).

    I do concur that partnering with places like CVS and Walgreens would have made a world of sense, although I will admit I am not sure what logistical challenges exist with doing so.

    5
  10. DrDaveT Avatar
    DrDaveT

    @Steven L. Taylor:

    Real federalism both works and is necessary. The interstate highway system fits that bill, as do a lot of welfare programs, to include SNAP. But that is a much longer post to detail.

    I for one would relish a series of posts from you on how federalism can and should work.

    I was struck the other day by how the architectures of so many of our public goods were arrived at by pure accident of history, rather than by design. If we were designing a national public education system, or public health system, or public transportation system, or unemployment insurance system from scratch, none of those would look anything like the ones we currently have. And they’re all very different, for no real reason.

    (Well, except that if you’re a religious fruitcake you would want the education “system” to stay pretty close to the way it is now…)

    3
  11. Michael Reynolds Avatar
    Michael Reynolds

    @Steven L. Taylor:
    The Moderna vaccine:

    Shipping & Long-term Storage: For shipping and longer-term storage, Moderna expects that mRNA-1273 will be maintained at -20°C (-4°F), equal to most home or medical freezer temperatures, for up to 6 months. Using standard freezer temperatures of -20°C (range of -25° to -15°C or -13° to 5°F) is an easier and more established method of distribution and storage than deep freezing and most pharmaceutical distribution companies have the capability to store and ship products at -20°C (-4°F) worldwide.

    Refrigeration Storage: After thawing, to facilitate storage at points of administration, Moderna expects that mRNA-1273 will remain stable at standard refrigerated conditions of 2° to 8°C (36° to 46°F) for up to 30 days within the 6-month shelf life. The stability at refrigerated conditions allows for storage at most pharmacies, hospitals, or physicians’ offices.

    Room Temperature for Vaccination: Once the vaccine is removed from the refrigerator for administration, it can be kept at room temperature conditions for up to 12 hours.

    The Pfizer vaccine:

    KGW’s VERIFY team set out to answer: How long does it take for the COVID-19 vaccines expire?

    The Pfizer-BioNTech and Moderna COVID-19 vaccines both have a shelf life of up to six months, but Pfizer’s requires ultra-cold storage to last that long, the company said in November.

    That means Pfizer’s vaccine must be kept at about minus 70 degrees Celsius (minus 158 Fahrenheit), which requires a special kind of commercial freezer. The vaccine can only be stored for five days at regular refrigeration temperatures.

    1
  12. Michael Reynolds Avatar
    Michael Reynolds

    @Michael Reynolds:
    I’d fix that misplaced code, but….

  13. Steven L. Taylor Avatar
    Steven L. Taylor

    @Michael Reynolds: To my point, yes? (and that we would agree that this all needed to be have been planned for, but wasn’t).

    @Michael Reynolds: I fixed it.

  14. Kathy Avatar
    Kathy

    @Steven L. Taylor:

    To be clear: the distribution issues has been a disaster, and I blame the Trump administration.

    Why? they did absolutely nothing about the distribution. Not one thing. It can’t possibly be their fault, just because it was their responsibility to do it.

    4
  15. Michael Reynolds Avatar
    Michael Reynolds

    @Steven L. Taylor:
    Of course now the edit function popped up. Because of course.

    My point is that if I can order a box of chocolates and have it delivered, still nice and firm, in August, in Los Angeles, I’m pretty sure the aforementioned distribution networks could have effortlessly delivered vaccine within the specified time limits. The super refrigeration thing is bogus. 30 days at standard refrigeration for one, 5 days standard refrigeration for the other.

    Aside from issues involving the homeless, state health departments were entirely superfluous. Set a national standard – health care workers first – and ship straight to CVS, etc… distribution hubs. The states are irrelevant and the insistence on including them just made things worse.

    1
  16. CSK Avatar
    CSK

    @Kathy:

    “I don’t take responsibility at all.”
    — Donald Trump, March 12, 2020

    4
  17. steve Avatar
    steve

    The sheer numbers are nothing like the flu as you have documented. On the clinical side these pts are nothing like flu patients either.

    Steve

    1
  18. Kathy Avatar
    Kathy

    The things we are doing (masks, distancing, and generally decreased social contact) is making a host of diseases less prevalent than normal, even as Covid-19 cases increase.

    This looks like a contradiction.

    One benefit of the symbiotic bacteria in the digestive system, is that they take up the room and resources available, that they make it harder for other bacteria, harmful or not, to settle in and take over*. I wonder if something similar goes on with SARS-CoV-2, which then shuts out room and/or resources other respiratory viruses need.

    In a perverse sort of way, this might mean people with asymptomatic cases of COVID-19 are
    protected from other respiratory viruses.

    The question of how, and why, other respiratory diseases are stopped or slowed way down by masks and distancing, but COVID rages on, still remains.

    My guess is that COVID spreads asymptomatically while the others don’t. Add this to the lax wearing of masks and, in many places, non-existent distancing, and one begins to see the problem.

  19. Kathy Avatar
    Kathy

    I orphaned another asterisk…

    * Symbiotic gut bacteria also are metabolically active, and can fight off invading bacteria to some extent. This protects the host, namely us, but is done entirely for the bacteria’s benefit.

  20. Gustopher Avatar
    Gustopher

    @Michael Reynolds:

    Aside from issues involving the homeless, state health departments were entirely superfluous. Set a national standard – health care workers first – and ship straight to CVS, etc… distribution hubs. The states are irrelevant and the insistence on including them just made things worse.

    When the alternatives are a disfunctional federal response, or a semi-functional state response, federalism looks pretty good. And for most of the pandemic, that’s what we’ve had… except in the states where the disfunctional federal response is matched with a disfunctional state response.

    Getting chocolates delivered in August in rural Idaho is going to be a whole different set of challenges as getting them delivered in LA. They aren’t that different from the challenges of Montana or Spare Dakota, but you will need subject matter experts on “Idaho” who know the resources in the area.

    Stronger federal guidelines and assistance are definitely needed — but it can’t happen entirely from the top either. And, as stupid as states might be (they seem like the wrong size for most things — too big to be responsive to local needs, and too small to avoid duplicate identical structures in North and South Dakota), they are they closest to the right level that we have.

    1
  21. flat earth luddite Avatar
    flat earth luddite

    Wait, Trump lied? Say it ain’t so!!!!!!!!!!!!!!!!!!!!

    Last night, I received disturbing news, confirmed to me directly by General Perna of Operation Warp Speed: States will not be receiving increased shipments of vaccines from the national stockpile next week, because there is no federal reserve of doses.

    Oregon Gov. Kate Brown

    Every time. Every. Single. Time. Every time I think the Liar-In-Chief has reached the lowest possible point…

    6
  22. Jay L Gischer Avatar
    Jay L Gischer

    @Kathy: I think that reconciling this is pretty simple: COVID-19 is a lot more contagious than the flu. Or any of those other viruses. A lot.

    I read a piece recently about its origins in bats. Bats have an interesting life cycle – they operate at multiple body temperatures. But a virus can’t do that. It’s enzymes only work in one temperature range. So it has to be able to spread to other bats while they are at their high body temperature and get it done before they go back in the cave and back to sleep and drop their core temperature. Ergo, it had to be able to spread very quickly to even survive and infect bat populations.

    Anyway, it’s a lot more contagious than most other of the viruses we’ve been around. That’s one factor making this harder for us to come to grips with.

    3
  23. senyordave Avatar
    senyordave

    As soon as testing became a real thing, I thought the WH should have gone to Amazon, Walmart, etc. and said “we want you three best supply chain people. Here’s $X for your troubles. No asking, just telling. As others have said, Amazon can turn around some items n less than 24 hours. These people know how to do things.

    2
  24. DrDaveT Avatar
    DrDaveT

    @Jay L Gischer:

    So it has to be able to spread to other bats while they are at their high body temperature and get it done before they go back in the cave and back to sleep

    I don’t think that works — they do all go back to the cave, so no matter how many of them did or didn’t spread it around, the virus has to be able to survive the dormant period. They all rest at the same time; there’s no population it can get passed to to keep the spread going across the rest period.

  25. Michael Reynolds Avatar
    Michael Reynolds

    @Gustopher:

    they are they closest to the right level that we have

    No, they aren’t. What they are is 51 levels of unnecessary bureaucracy. They are underfunded, (flat-ass broke now), unprepared, and irrelevant, useful only in distributing to a tiny percentage of the population. The other 99% of us – especially the elderly, duh – have accounts at pharmacies, or with our PCP.

    But sure, instead of just toddling down to my CVS like I do for a flu shot, it’ll be so much better waiting in an hours-long car line in Dodger Stadium parking lot. Will the health department even tell me when that is available? No, of course not, because they have no idea I exist. You know who would tell me? CVS. Just like they remind me to get a flu shot.

    Target #1: medical people. Target #2: old people. How many medical professionals and old people know how to find their drug store? All of them. How many can sit in a car line for hours? Fewer than all of them.

    This is a job for the national government and national distribution networks. The infrastructure is already in place, and we’ve had 10 fucking months to get ready.

    4
  26. Kathy Avatar
    Kathy

    @flat earth luddite:

    Yesterday, two coworkers were discussing flying to Florida or California to get a COVID vaccine early.

    Guess not.

    1
  27. Jay L Gischer Avatar
    Jay L Gischer

    @DrDaveT: The virus doesn’t die during the dormant period. It is simply dormant as well.

  28. Kathy Avatar
    Kathy

    @flat earth luddite:

    Related, remember when One Term Loser said he’d expected a healthcare bill to be on his desk when he took office? that was not unreasonable, seeing how long the GOP had been going on about “repeal and replace,” IMO.

    Well, trump aside, back in the Summer when the first phase 3 trials got going, several vaccine manufacturers said they’d already started production and would have plenty of doses to distribute come December.

    This definitely does not now appear to have been the case. Surely if Moderna had been cranking out doses since August, there’d be many millions more now.

  29. DrDaveT Avatar
    DrDaveT

    @Jay L Gischer:

    The virus doesn’t die during the dormant period. It is simply dormant as well.

    Then I am entirely missing why the virus has to be extra-contagious to survive in a bat population. Yes, it can only be transmitted while the bats are active — but it doesn’t have to be transmitted tonight; it can wait until tomorrow night, or the night after, if it can just go dormant with the bat.

    Put a different way, I don’t see why this isn’t an argument that the flu also needs to be super contagious because people go home and sleep at night, and have almost no ability to spread the virus while they’re asleep.

  30. Kathy Avatar
    Kathy

    About the whole bat issue, I’ve read the bat immune system is particularly good at limiting viral activity, though the reasons aren’t known. This means viruses successful at infecting bats (or rather at reproducing within bats), have adapted to replicate quickly and spread effectively.

    This means we should stop encroaching on bat habitats.

    3
  31. Gustopher Avatar
    Gustopher

    @Kathy:

    About the whole bat issue, I’ve read the bat immune system is particularly good at limiting viral activity, though the reasons aren’t known.

    Ok, hear me out… we should begin using gene therapy to create human-bat hybrids. If we are lucky, we will gain the ability to limit viral activity. If we are unlucky, we will have sonar and be able to fly like Man-Bat.

    This means we should stop encroaching on bat habitats.

    That is another option, yes.

    3
  32. Kathy Avatar
    Kathy

    @Gustopher:

    I saw the Batman animated series in the 90s. The experiments didn’t end well.

    As I understand most bats hunt insects or eat fruit. Both are plentiful in places where you find humans, so… Another type of bat, the infamous vampire bat, drinks mammal blood, usually from cattle. They make a superficial wound on an ankle with their teeth, and lap the blood that comes out. This must be the type that often carries rabies. And cattle often comes with humans, too.

    When I think of genetic changes to make on people, I often focus on the immune system. It’s pretty good (exhibit A: Humans are still around rather than extinct from some plague), but it’s also limited. Antibodies take a long time to get produced. In a way, vaccines serve as an augmentation of the human immune system.

    But it also sucks at telling friend from foe, to the point that transplant patients need to suppress it, or it often ignores cancerous cells. And then there are autoimmune disorders.

    If we could fix all that, perhaps we’d live healthier lives. Imagine most pathogens beaten within 24 hours, no arthritis, no type-2 diabetes, no lupus, no issues with transplants, etc. We may even live longer.

    or we may spur the development of HIV-like pathogens that attack the immune system. Kathy’s Law: there’s a downside to everything.

  33. Gustopher Avatar
    Gustopher

    @Michael Reynolds: I’m not going to defend the current roll-out, because it is obviously a complete clusterfuck.

    But, if we had only a CVS roll-out, would that reach all communities? Rural and urban? A lot of people in this country don’t have a doctor, so what makes you think they have a pharmacy conveniently located, and affiliated with one of the national chains?

    There are going to be gaps. Finding fresh fruit can be hard in some neighborhoods (google “food deserts”), so I’m not willing to assume that there are outposts of national pharmacy chains everywhere.

    What about targeting specific groups first — nursing homes, native american reservations, asylums for the criminally insane, etc?

    That’s where states would come in. Yes, compared to what is happening right now, CVS would do a better job — pretty much anything other than rampaging mobs with blow darts would be better — but to do a more than half-assed vaccine campaign, states are going to be a key part.

    But yes, a half-assed version is likely to be better than where we are now.

  34. Michael Reynolds Avatar
    Michael Reynolds

    @Gustopher:
    It is all apparently moot now. Biden just rolled out a plan that is basically federalizing the whole thing, with some cash to medical clinics, etc…

    Mr. Biden intends for the federal government not only to develop mass vaccination sites, but also to reimburse states for the use of National Guard troops to administer vaccines. To staff the mass clinics, Mr. Biden promised to “mobilize thousands of clinical and nonclinical professionals.”

    That’s a hell of a lot of sites if they’re to come anywhere close to the saturation of CVS et al. I think this would be a better plan if we actually had sufficient stocks of vaccine to warrant the sledgehammer approach. And those thousands of ‘clinical and non-clinical professions’ may be hand-waving if they don’t have a capability to override state laws that may, for example, forbid vets or LPNs from giving shots, not to mention the insurance.

    But at least someone is trying to something.

    1
  35. Just nutha ignint cracker Avatar
    Just nutha ignint cracker

    @senyordave: Did testing ever really become a thing? I’m asking because in a county with a population of 110,000 people and 200 new cases a week for the past 2 months, we’ve still only tested the equivalent of one out of every 3 or 4 people at 33k total tests (allowing for people needing to be tested more than once and such).

    (Of course, I’m comparing to Tuberculosis during a bygone era where in any given year, I got a patch test or 3 during the year at school, my doctor tested me once or twice (patch tests had both false positives and negatives, IIRC), and the Seattle Chapter of the Lung Association had 4 or 5 busses fitted with x-ray machines that traveled the city offering walk up chest x-ray screening.)

    2
  36. Jax Avatar
    Jax

    @Michael Reynolds: On that note, do you know how much relief I felt to actually hear a President who had a plan….and complete sentences….and actually acted Presidential?! Mercy me, I felt some hope that our long national nightmare might actually be about to end!!! 😉

    7
  37. JohnSF Avatar
    JohnSF

    In the UK, bad news;
    Passed 100,000 dead on Wednesday.
    R still estimated 1.2 to 1.3
    Deaths now averaging over 1000 per day.
    All travel corridors closing from Monday.

    Good news;
    3.2m 1st doses of the vaccine have now been administered in the UK.
    316,694 yesterday.
    Govt. has switched from earlier (stupid) plan to use only the new system of special centres, to using NHS to set up local centres, and use of GP/pharmacy network.
    Target of vaccinating 15m people by mid-February now looks achievable.

  38. Just nutha ignint cracker Avatar
    Just nutha ignint cracker

    @Michael Reynolds: “…if we actually had sufficient stocks of vaccine to warrant the sledgehammer approach…”

    Yeah, that’s the rub. Additionally, at least according to the article that I read in my January issue of The Atlantic, my (relatively blue) state, Washington, was on the record as not being able to use shipments of at least one vaccine because of an inability to warehouse the vaccine effectively as it’s distributed.

    Of course, it could be that our Demonrat governor is merely hoarding the vaccine to give to the loyalists who live in Seattle at the expense of our health out in the heartland of the state (i.e. the part where I live). Either way, while the county does have a plan and is officially in Phase 1A and 1B of the state vaccination program, there are not reports of people having been vaccinated yet here. (And overall, it doesn’t matter for me because even at 68, I only qualify for Phase 2B.)

    1
  39. OzarkHillbilly Avatar
    OzarkHillbilly

    @Jay L Gischer: So it has to be able to spread to other bats while they are at their high body temperature and get it done before they go back in the cave and back to sleep and drop their core temperature.

    OK, a little bit about bats (or at least bats who spend the day together): When they aren’t roosting in the cave they are feeding, flitting about hither thither and yon, catching whatever night critters are flitting about… and not near any other bats. The only time they are close enough to other bats for long enough to transmit a virus to other bats is when they are huddled tightly together in the cave for the day.

    I can’t speak to ideal body temps and virus transmissability (sp?) but I can assure you it ain’t happening when they are feeding, but rather when they aren’t.

  40. Kathy Avatar
    Kathy

    @Jax:

    Who does not claim every action he takes is the greatest ever, who doesn’t need to praise himself every other sentence, who can talk about other people in modes other than flattery and insult, well, it’s a long list.

    1
  41. OzarkHillbilly Avatar
    OzarkHillbilly

    @DrDaveT: You guys are missing bat habits. When bats are active, they aren’t around other bats. When they are around other bats, they aren’t active. I don’t think temps are that much of a restriction on the virus as you guys are assuming. Tho I can not speak to that very much at all.

  42. OzarkHillbilly Avatar
    OzarkHillbilly

    @Kathy: This means we should stop encroaching on bat habitats.

    Speaking as a caver, I got 3 words: Fuck that shit.

    1
  43. MarkedMan Avatar
    MarkedMan

    @Michael Reynolds:

    The federalist folks need to take a long look at this, watch people dying, and maybe get it through their ideologically-compromised heads

    I think it’s pretty clear that the true believers will literally accept the death of their loved ones without breaking stride. The Market provides the best possible outcome and sometimes Gramma dies. These things are independent.

    1
  44. MarkedMan Avatar
    MarkedMan

    @Just nutha ignint cracker: Here in Maryland the four members of my family have been tested 25-35 times in all. Every time we travel. Every time we come back. Every time we have symptoms. All free. No insurance involved. The longest we’ve waited for results is 36 hours. The shortest is 11.

    Trump states don’t have testing because they are Trump states. Trumpers don’t get tested because they are morons.

    1
  45. Jax Avatar
    Jax

    @MarkedMan: Yeah. Trumper’s literally don’t get tested because they honestly believe testing is what’s causing the case counts to rise. I’m surrounded by them. It’s horrifying, some of them have parents hospitalized, positive themselves but asymptomatic, bragging about going about their lives.

    It’s unfair, really. If God were just and….real….he would strike those down who harm others in that fashion.

    2
  46. Franklin Avatar
    Franklin

    Thanks Dr. Taylor for the graphs. I’ve been curious since the beginning what would happen to the normal flu (and other illnesses) with people isolating so much. And there it is.

    But this leads me to think the number of Covid-related deaths is even further under-reported. When comparing the number of deaths in the United States this year vs. the average of previous years, it’s much more than the 400,000 reported deaths. And with your data above, we know that there should actually be far *fewer* deaths from the flu/etc. Covid has made up for that and more, so it wouldn’t surprise me if we later determine that there have been well more than a half million Covid deaths up to this point.

    (Note: skimming some papers on the subject, there might actually be an increase in deaths from suicide and heart failure during the pandemic, which may be related to isolation, lack of physical activity, etc. – I wouldn’t count those as Covid deaths, although they are Covid-related.)

  47. Gustopher Avatar
    Gustopher

    @Michael Reynolds: Theresa nice Twitter three about why West Virginia is doing better than other states with vaccinations at nursing homes, which I found sone it was liked by our very own Mattbernius.

    https://twitter.com/alexmleo/status/1350095109438787589?s=21

    Short version, they aren’t relying of CVS and Walgreens, because there aren’t a lot of them in the state, and there are reports that the two big pharmacy chains are a bit slow where they do have a presence.

    Meanwhile, Connecticut has roughly one CVS per dozen people (estimating) as is doing pretty good. (Putting the reports of slowness in doubt)

    We aren’t so homogenized that a one-size-fits-all approach is going to be as effective as well supported local governments.

    (I’m more of a “federal government comes up with a few different rough plans, dispatches people to the states to help them choose what plans work best for what parts of the state, set up metrics, pull in more resources if it’s not working” kind of guy than a “leave it to the states” kind of guy.)

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