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As Delta spreads, some travelers double up on COVID-19 vaccine in U.S.

WASHINGTON, Aug 16 (Reuters) – Alison Toni felt lucky to get Sinovac’s COVID-19 vaccine in Chile earlier this year. A month later, she was in Minnesota getting vaccinated again.

Toni, an American living in Chile, was visiting her parents in Minneapolis in April when she got her first Pfizer shot at a CVS pharmacy. She traveled back for the second dose in June. She did not disclose being previously vaccinated.

“They didn’t ask, and I didn’t tell,” said Toni, 55. She took that step after reading that China’s Sinovac vaccine had a lower efficacy than the Pfizer Inc shot, developed with German partner BioNTech, and the Moderna Inc shot, both widely available in the United States. She also consulted with her doctor beforehand.

Toni is among the group of people coming from abroad who have been vaccinated a second time, or plan to do so, in the United States.

Their reasons range from concerns that the vaccines immediately available to them were not effective enough, fears that they require extra protection against the fast-spreading Delta variant, or a need to meet specific requirements for work or travel. Some are seeking medical advice, others are relying on their own research.

A few countries are also beginning to offer a third booster dose to their citizens based on evidence that the initial protection from vaccines wanes over time, or that an extra shot may help prevent infection against Delta, particularly for older people or those with weak immune systems.

Public health officials have not determined if booster doses are needed for the general population, and there is not yet much data on the relative risks and benefits of complete revaccination.

“It is probably more than is needed,” said Jason Gallagher, an infectious diseases expert at Temple University’s School of Pharmacy. “A fourth dose is probably a waste; a third dose is probably unnecessary for a lot of people.”

The World Health Organization (WHO) has urged countries to hold off on boosters while many people worldwide wait to receive their first doses.

Thirty-six-year-old Chilean engineer Ricardo Dayne, who first received Sinovac’s vaccine at home in April got his first Pfizer shot in New York in June.

“Everyone was also talking about the need to have a booster, so I decided to have it.”

‘PROCESS NEEDS TO BE FIXED’

The U.S. Food and Drug Administration (FDA) last week authorized a third vaccine dose for immunocompromised people. Government health officials have estimated that would apply to less than 3% of the adult U.S. population, but have said that eventually, boosters may be required more broadly.

In the meantime, a surplus of vaccines in the United States, along with a decentralized healthcare system, has made it easier for people to show up at pharmacies and vaccination centers for extra doses. The U.S. Centers for Disease Control and Prevention estimates that over 1.2 million Americans have already received at least one extra dose following their initial inoculation.

When asked about travelers doubling up on vaccines, Moderna told Reuters its vaccine is not authorized for this purpose and J&J directed Reuters to the FDA and CDC. Pfizer did not immediately respond to a request for comment.

A CVS Health Corp spokesperson said the company’s policy is to turn away patients who have been fully vaccinated at one of its pharmacies, or who disclose that they have been fully vaccinated elsewhere. A Walgreens spokesperson said its pharmacies ask patients if they have been vaccinated during the appointment process and have alerts in place to check.

Graduate student Jing Wu, 22, said he had no choice. Wu received the Sinovac vaccine in December while in China before moving to the United States to attend Princeton University.

He heard Princeton was planning to require proof of an FDA-approved vaccine. The university’s health service urged him to get vaccinated again and said it would be safe.

He was not reassured.

“I was nervous and stressed about it, but in April I got vaccinated (again),” he said, this time with the Johnson & Johnson shot.

Princeton announced the policy on April 20 but later decided to accept any WHO-approved vaccine, including Sinovac. The university’s health website still states that “there is no known harm from taking additional” vaccines.

The university did not respond to requests for comment.

“If I knew back then the Chinese vaccine would be enough, I wouldn’t have done it,” Wu said.

The United States is developing a plan to require nearly all foreign visitors be fully vaccinated, potentially creating similar issues for many people inoculated with vaccines not approved by the FDA.

Britain and the European Union’s lists of approved vaccines do not include shots made in Russia or China, which have been used in many countries.

Governments should standardize their definition of fully vaccinated to include shots that may not be approved in their countries, but which are still effective, said Dr Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security.

“This whole process needs to be fixed, otherwise, as we get more vaccines and more people traveling, this will only happen more,” Adalja said.

Reporting by Ahmed Aboulenein; Additional reporting by Aislinn Laing in Santiago, Carl O’Donnell and Michael Erman in New York; Editing by Michele Gershberg and Aurora Ellis

Our Standards: The Thomson Reuters Trust Principles.

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U.S. nurses’ COVID-19 grief pours out online: ‘I just don’t want to watch anyone else die’

Aug 6 (Reuters) – Nichole Atherton couldn’t take it anymore.

The intensive care nurse watched helplessly last year as COVID-19 sufferers died in her Mississippi hospital – slowly, painfully and alone. Then in July she was again confronted with a wave of deathly ill patients, even though almost all likely could have saved themselves by getting the coronavirus vaccine.

“People want to argue about masks and vaccines and freedom. I just don’t want to watch anyone else die,” the 39-year-old mother of two wrote on Facebook a few days ago. “I see their faces in my nightmares. And it feels like it is never ending.”

As the United States grapples with rising infections, hospitalizations and deaths amid a surge of the virus’ Delta variant, exhausted and desperate health care workers are turning to social media to describe the grim reality they face.

For some, the writing is cathartic, a way of processing their grief and anxiety. Others see it as a responsibility, using their devastating encounters with death to try to convince skeptical Americans to take the pandemic seriously.

“I just wanted people to know that it’s real, and it’s scary, and it’s hard for us,” Atherton said in a phone interview. “The first wave was heartbreaking, because there was nothing people could do except stay away from the people they love. This time, there are options.”

New daily coronavirus cases in the United States have hit a six-month high, with the seven-day average reaching nearly 95,000. That rate is five times higher than it was less than a month ago, Reuters data shows. read more

Health officials have said the surge has been driven almost entirely by the unvaccinated. Vaccines are not widely available in many other countries, yet in the United States just 49% of the population of 330 million is fully vaccinated.

Doctors, nurses and hospital leaders interviewed by Reuters in six states described a workforce that is depleted and demoralized by wards overflowing with mostly unvaccinated patients.

The health providers who have waded into public forums in an effort to counter disinformation said they have sometimes been attacked online by anti-vaccine skeptics.

“There’s so much misinformation out there,” said Tiya Curtis-Morris, an emergency and intensive care nurse in southeastern Louisiana. “Maybe if I tell people, and they understand what we deal with everyday … but they don’t want to hear it.”

Louisiana’s governor reinstituted a mask mandate this week as the state set new daily hospitalization records and Curtis-Morris has been urging Facebook friends to wear them.

She is more careful discussing vaccines, saying she understands why some people are hesitant. The 46-year-old single mother of four daughters is vaccinated but held off until recently in having her younger children inoculated, in consultation with their pediatrician. Her mother has thus far refused, citing fears of side effects.

‘IT DIDN’T HAVE TO BE LIKE THIS’

Nichole Atherton, an intensive care nurse who has seen a fresh wave of coronavirus disease (COVID-19) patients at the hospital where she works, gives a thumbs-up in this undated handout photo in Ocean Springs, Mississippi, U.S., Nichole Atherton/Handout via REUTERS

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Earlier this week, ICU nurse Kathryn Ivey, 28, spent her break time at a Tennessee hospital crafting an emotionally raw Twitter thread.

“It is so much worse, this time,” she wrote. “We all have so much less to give. We are still bearing the fresh and heavy grief of the last year and trying to find somewhere to put all this anger. But the patients don’t stop coming. And the anger doesn’t stop coming.

“It didn’t have to be like this,” she concluded.

The thread went viral.

Ivey said in an interview that she put her feelings down in writing for the sake of her mental health. A rash of patients – younger and younger, she said – have flooded her hospital, virtually all unvaccinated.

She expressed little hope that her words would make a difference. People who are most adamantly against vaccines will only be convinced if they see their loved ones sick, she said.

“That just breaks my heart: that people need to go through this hurt to understand,” said Ivey, who began her career during the pandemic. “I know beyond a shadow of a doubt that if these people knew what COVID was, they would not risk it. But ignorance is a powerful thing.”

Despair drove Atherton, the Mississippi nurse, to speak out.

On Facebook this week, she described in harrowing detail an unvaccinated woman struggling to breathe and scared of leaving her children behind without a mother.

At one point, the woman was desperate for a sip of water, and Atherton – despite her misgivings – agreed to remove her oxygen for a few seconds to offer her a drink. Soon after, the woman was intubated, having seen her family for the last time via video call.

“I wonder if I hadn’t let her have that sip of water if she would still be alive,” Atherton wrote. “My rational side knows she was too sick. She wouldn’t have made it anyway. My emotional side will never stop wondering.”

Three people have messaged her to say they will get vaccinated, Atherton said.

But the accumulated strain of seeing so much death has become too much for Atherton, who told her hospital last week she is resigning.

She plans to work as a nurse elsewhere, she said. She just can no longer bear witness to COVID-19’s daily toll on members of her own community.

Reporting by Joseph Ax in Princeton, New Jersey; Additional reporting by Sharon Bernstein in Sacramento, California, and Brad Brooks in New Orleans; Editing by Colleen Jenkins and Grant McCool

Our Standards: The Thomson Reuters Trust Principles.

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COVID in Louisiana shows consequences of Delta variant, low vaccination rate

NEW ORLEANS, Aug 4 (Reuters) – Low vaccination rates and the more infectious Delta variant are converging to create a new COVID-19 crisis for Louisiana as the United States and the world face the latest stage of the pandemic.

Thomas Madden said his 13-year-old son, Gabriel, was fighting back. Madden brought Gabriel to the Lakeside Shopping Center in a New Orleans suburb this week for a vaccine at a site run by Ochsner Health System, Louisiana’s largest not-for-profit provider.

“This Delta variant has freaked my wife out,” Madden said as he waited with Gabriel in the indoor mall just after he received his shot. “But it was really up to him – he wanted to get it as he was getting a little nervous about school starting soon.”

Many people were wearing masks at Lakeside Shopping Center. Last week the Centers for Disease Control and Prevention(CDC) recommended that Americans begin wearing masks indoors in areas of substantial transmission, which now includes most of the country. The CDC cited the quick spread of the Delta variant, which the agency said has lead to COVID-19 likely being transmitted by fully vaccinated people.

On Monday, Louisiana Governor John Bel Edwards ordered residents to mask again indoors. Wednesday, state officials said they had set a record for hospitalized patients with COVID, at 2,247 people.

Coronavirus cases worldwide surpassed 200 million on Wednesday, according to a Reuters tally. It took over a year for COVID-19 cases to hit 100 million, while the next 100 million were reported in just over six months, according to the Reuters tally. The United States accounts for one in every seven infections, and surges are occurring in Louisiana and other states with low vaccination rates.

Louisiana’s vaccination rate ranked it 47th among U.S. states for first doses given, according to a Reuters analysis of state and county data. According to the most recent data, 43% of Louisianans had received their first vaccine dose and just 37.1% were fully vaccinated. The respective figures for all the United States were 57.9% and 49.7%. (Graphic on U.S. cases and vaccinations)

(Reuters global vaccination tracker)

Dr. Joseph Kanter, the top medical official in Louisiana, said the state, which was at the epicenter of an outbreak early in the pandemic, was “in the worst place we’ve ever been in the pandemic.”

Staffing and hospital capacity are the most daunting challenges in Louisiana now, Kanter said. Even before the Delta variant surge, more than 6,000 nursing positions were open statewide.

DEMORALIZED AND EXHAUSTED

Earlier in the pandemic, state officials could count on federal help, or on nurses from other states. Now the staffing hole is simply far too large for the small federal teams available that have arrived to make much of an impact. And Delta is causing simultaneous surges around the country, sucking up nursing resources.

“None of us imagined it could get this bad,” said Ecoee Rooney, president of the Louisiana State Nurses Association.

Rooney said nursing staff are beyond exhaustion, and like those across the country are deeply demoralized to be facing what they know was a preventable surge.

“We have COVID patients who don’t believe they even have COVID, because they refuse to believe it exists,” Rooney said. “We’re feeling the brunt of the frustration and the anxiety about what our future looks like if people don’t get vaccinated and wear masks.”

VACCINATION RATES VARY

Kevin Alexander, a sergeant with the Louisiana National Guard, helps run a vaccination and testing site in Louis Armstrong Park in New Orleans.

“It’s been up and down. Within the past two weeks, we’ve been hitting 500 tests a day, compared to 250 a day a few weeks before,” Alexander said.

Late on Tuesday afternoon, he stood guard over a deserted parking lot where the vaccinations and testing take place. On Wednesday morning he also saw little traffic.

Vaccination rates vary county by county and state by state across the United States. Kaytlyn Byers, 32, was visiting New Orleans this week from Pennsylvania, where 65.9% of the population had received at least one vaccine dose and 52.6% were fully vaccinated.

Byers, who had been vaccinated months ago, said she had not realized Louisiana was a Delta hot spot.

“We were shocked that they reinstated a mask mandate and that it went into effect today,” Byers said while standing on Bourbon Street with a drink in her hand. “We were sure the rules here in the South would be more lax than back home in Pennsylvania.”

Festivities were at full tilt around her on Tuesday night on the Big Easy’s famed street, which eternally smells like yesterday’s party baked in today’s hot sun.

Byers said she knows people who have been vaccinated and still contracted a breakthrough COVID infection. She said she planned to be careful and mostly stay outdoors for the remainder of her visit.

Reporting by Brad Brooks in New Orleans
Additional reporting by Anurag Maan in Bengaluru
Editing by Donna Bryson and Matthew Lewis

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Overseas tourists finally roam free on Thai island of Phuket

PHUKET, Thailand, July 3 (Reuters) – Newly arrived overseas tourists on Thailand’s island of Phuket were able to roam free without quarantine on Friday for the first time in more than a year, as Thailand launched a special programme for vaccinated visitors to the island.

Tourists swam in hotel pools and walked along Phuket’s postcard-perfect beaches after receiving a COVID-19 test result within 24 hours of arrival.

“This is the perfect place to just relax and clean our minds, our heads, after a long time,” said Sigal Baram, lying by the pool, who was visiting from Israel with her husband and friends. The group was among the first to arrive in the country.

The ‘Phuket Sandbox’ initiative allows free movement on the island for fully vaccinated tourists, with no quarantine required, although masks are required in most public places.

While five-star hotels and restaurants welcomed back tourists, local street vendors said they were not benefiting from the plan, because tourists frequent mostly large hotels.

The Kalmar family, tourists from Israel, enjoy in a pool as Phuket reopens to overseas tourists, allowing foreigners fully vaccinated against the coronavirus disease (COVID-19) to visit the resort island without quarantine, in Phuket, Thailand July 2, 2021. REUTERS/Jorge Silva

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“There is no way street vendors will get the money from overseas tourists… it will go to hotels and restaurants instead,” said Yupin Papor, a massage therapist who lost her job during the pandemic and became a street vendor selling food on the beach.

Thailand lost about $50 billion in tourism revenue last year, when foreign arrivals plunged 83%.

Phuket was hit particularly hard by job losses and business closures.

“I see the shops closed. It’s a big difference to me from before,” said Omar Alraeesi from United Arab Emirates, who comes to Phuket every year.

Millions of people visited Phuket every year before the pandemic and the government and tourism industry hope the reopening will help save its battered economy.

Additional reporting by Jorge Silva and Artorn Pookasook, Editing by Rosalba O’Brien

Our Standards: The Thomson Reuters Trust Principles.

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