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When a vaccine is approved, who will get it? How will it get to them?Johns Hopkins has a plan to make front line workers and those most vulnerable first in line. Other experts say that may not be the best approach.“It may be better to immunize people who are at high risk of transmitting the virus both because of jobs, living situations and other circumstances,” said Dr. Ezekiel Emanuel while speaking with the head of the Journal of the American Medical Association. “And that I think we have to leave an open mind and look at some detailed modeling about what the best way is to reduce the premature mortality.”Emanuel says transmission between health care workers and patients is basically zero where he is. He says effective PPE use is the reason.The groups Johns Hopkins said should get a vaccine first could be as big as 90 million people.Emanuel says there won't be enough doses out of the gate to get all of any initial groups.“You don’t actually distribute it evenly among countries,” he said. “You concentrate on countries that at the moment when you have the vaccine have severe hot spots and where the vaccine is going to make the biggest difference in terms of reducing premature death.”Johns Hopkins experts say a vaccine's effectiveness is measured on preventing disease. That doesn't mean it prevents infection and transmission. We won’t know how effective it will be until after it’s in use.“A disease transmission strategy makes a lot of sense, but we need a lot more information before we can know who to prioritize,” said Dr. Eric Toner, a senior scholar at the Johns Hopkins Center for Health Security. “It’s quite possible we will go to a strategy like that.”The World Health Organization said younger people in their 20s, 30s and 40s are increasingly driving spread.The first vaccines will likely be two doses. Experts say that means double the syringes, needles, vials and other supplies, along with getting people to come back for a second dose. 1980

WILMINGTON, Del. – During a year-end address, President-elect Joe Biden warned that country is far from emerging from the coronavirus crisis.“Our darkest days in this battle against COVID are ahead of us, not behind us. So, we need to prepare ourselves and steel our spines,” said Biden in Wilmington on Tuesday. “As frustrating as it is to hear, it’s going to take patience and persistence and determination to beat this virus. There will be no time to waste in taking the steps we need to turn this crisis around.”Watch Biden's speech below:During his speech, Biden spoke about the 0 billion COVID-19 relief bill that Congress approved Monday and is awaiting President Donald Trump’s signature. He said the bill is a good next step, but more funding will be needed in the coming year.“I have said all along, this bill is just a first step — a down payment — on addressing the crisis we’re in. We have a lot more work to do,” said Biden.Biden also took the chance to express sympathy for the many American families who are struggling financially and emotionally as they celebrate the holidays in isolation amid the global pandemic.“With over 320,000 lives lost to this virus, Jill and I send our prayers to all of you facing this dark winter with an empty seat at the dinner table where your loved one used to sit, talk, and laugh,” said Biden. “Our hearts go out to all of you who have fallen on hard times through no fault of your own, unable to sleep at night, weighed down with the worry of what tomorrow will bring for you and for your family.”Like for Thanksgiving, the Centers for Disease Control and Prevention (CDC) is encouraging people to celebrate the end of year holidays at home with the people you live with. Gatherings with family and friends who do not live with you can increase the chances of getting or spreading COVID-19 or the flu.“Like we did over Thanksgiving, we all have to care enough for each other that we have to stay apart just a little longer,” said Biden. “I know it’s hard, but we have a long way to go.”Biden also encouraged Americans to continue taking the necessary precautions to prevent the spread of the coronavirus as the nation ramps up its vaccination efforts.“We need everyone to mask up, stay socially distant, and avoid large gatherings,” said Biden. “And we need to work in a bipartisan way. That’s the only way we’ll get through this.”Biden himself received his initial dose of Pfizer’s COVID-19 vaccine on Monday, shortly after his wife did as well. He joined a growing list of officials who have publicly been vaccinated to show confidence in the vaccination process.During his remarks, Biden said he has “absolute confidence in the vaccine,” but the country is short on supply. He explained that vaccinating millions of people will be a logistical challenge.“Taking the vaccine from a vial and into the arms of millions of Americans will be the biggest operational challenge we’ve ever faced. It will take many more months for that to happen,” said Biden. “In the meantime, the pandemic rages on.”Early next year, Biden said he will put his plans for what’s to come before the Congress. He said we will need more help to fully distribute the vaccine, to reopen our schools, to help our front-line workers, and to make sure those struggling to make ends meet are taken care of.On his day in office, Biden says he will enact masking requirements, a new strategy on testing, and work on accelerated production of protective gear.Biden also discussed the recent cyber security breach against U.S. companies and federal agencies. He blamed the Trump administration for failing to prioritize cyber security“From eliminating and/or downgrading cyber coordinators at both the White House and the State Department, to firing his Director of the Cybersecurity and Infrastructure Security Agency, to President Trump’s irrational downplaying of the seriousness of this attack,” said Biden. “In an age when so much of our lives are conducted online, cyber attacks must be treated as a serious threat by our leadership at the highest levels.”Biden said he believes we must treat cyber threats with the same seriousness of purpose that we treated the threat of other unconventional weapons.“We must work with our allies to establish clear international rules and mechanisms to enforce them and consequences for those that violate them,” said Biden.After his remarks, Biden took questions.When asked about the potential for more direct payments, Biden said his plan will include a new round of stimulus checks for the American people, but the amount is a “negotiating issue.”Regarding his choice for attorney general, he said he’s still trying to determine who will serve in that role and that “there’s not an obvious choice in mind.”When asked if he would announce his 2024 bid early to show he's not going to be a lame duck president, Biden said, "I'm not going to be a lame duck. Just watch me. Just watch me." 4960

With coronavirus cases ramping up in a number of US states, more and more US governors have issued mandates to wear masks while in public settings.The continued spike in COVID-19 cases has caused several states to close bars and pause plans to reopen some businesses such as movie theaters.While a number of states had previously mandated masks in many public spaces, several more have been added to the list in recent days. Requiring face coverings are largely being seen as a way to avoid reinstituting stay-at-home orders, which most states implemented during the spring.Researchers from the University of Washington say that a projected 33,000 American lives would be saved between June 23 and October 1 if 95% of the population wore masks in public settings.A study in the Lancet found that the use of masks and respirators by those infected with the virus reduced the risk of spreading the infection by 85%. The authors analyzed data that showed that N95 respirators in healthcare settings were up to 96% effective. Other masks were found to be 77% effective.The following states generally require face coverings to be worn in public:Alabama - July 16Arkansas - July 16California – June 18Colorado - July 17Connecticut – April 20Delaware – May 1District of Columbia – May 16Hawaii - April 17Illinois – April 30Indiana - July 27Kansas - July 3Kentucky - July 10Louisiana - July 13Maine – April 29Maryland – April 18Massachusetts – May 6Michigan - April 24Minnesota - July 25Montana - July 16Nevada – June 24New Jersey - April 10New Mexico – May 15New York – April 15North Carolina – June 26Ohio - July 23Oregon - July 1Pennsylvania – April 18Puerto Rico Rhode Island – May 8Texas - July 2Vermont - August 1Virginia - June 8Washington - June 26West Virginia - July 7Some states, like Ohio and Texas, require mask wearing only in counties where there are high coronavirus case rates. More than a dozen other states have issued recommendations for wearing masks. Some of those states require employees in certain fields to wear a mask while at work. 2059

With health care costs on the rise, a growing number of Americans are throwing out the old way of seeing a doctor and turning to a membership model. A monthly or annual fee gets you direct access to a doctor, no insurance needed.Twenty years into her career, bogged down by red tape, too many patients and long days, Dr. Shaila Pai-Verma was looking for a better way to practice medicine.“I was just miserable,” she said. “The joy of medicine is gone and then you're just doing paperwork.”So, a year ago, she started a new primary care practice with a new business model.“The patient basically has a direct contract with the physician and they take insurance companies out of it,” she explained.Patients pay a flat monthly or yearly fee. In exchange, they receive a broad range of primary care services and quick, unlimited access to their doctor via in-person office visits, phone or by text.“Everyone wants everything immediate. And so, I think this is it. It's good, especially in this time for people to have access,” said Pai-Verma.Membership fees range from about 5 to 0 per month on average – about 0 less than having typical health insurance. Most patients still carry catastrophic coverage for emergency treatments and hospitalizations, but that insurance is usually only -100 a month, so patients still save money.For Bonnie Micheli and her family, it was all about access.“With this, it's just so much easier to just know that I can contact directly here within a few hours for any issues that I'm having,” said Micheli.In late September, a bipartisan proposal was introduced in Congress that would expand access to the model and allow people to use their health savings account for direct primary care (DPC).Because they see fewer patients than traditional practices, some critics say the model could worsen the shortage of primary care physicians, a trend that’s already driven by burnout.But according to a recent study, DPC members had 25% lower hospital admissions and the cost of emergency room claims was reduced by 54%.“There's less ER visits and you know, better health care for the patient,” said Pai-Verma.While there is still debate, for a growing number of Americans, like Micheli, it’s becoming a simplified health insurance alternative.“Honestly, it’s just so nice to know what I'm paying every month or if you do the annual, what you're getting for that money, and you know exactly who to go to when you have a problem.” 2467

With lawsuits, recounts and protests all looming, here is the official timeline for reporting and certification of the 2018 General Election results from the Florida Department of State:November 6 204

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