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2021-04-06
These screenshots show COVID-19 data from the Arizona Department of Health Services for each of Arizona's 15 counties and their cumulative state-wide total. The counties' respective case rate and death rate data are expressed as a percentage of their population and further demonstrate the dichotomies between pandemic experience by residential locale:
Arizona statewide: 11.77% population infection rate (0.236% population fatality rate)
Greenlee County: 5.47% (0.096%)
Yavapai County: 7.91% (0.210%)
Cochise County: 8.92% (0.214%)
Mohave County: 10.26% (0.318%)
Pima County: 10.84% (0.226%)
Pinal County: 10.93% (0.188%)
La Paz County: 11.08% (0.353%)
Coconino County: 11.69% (0.221%)
Gila County: 11.92% (0.402%)
Maricopa County: 12.06% (0.222%)
Graham County: 13.95% (0.200%)
Navajo County: 13.96% (0.462%)
Santa Cruz County: 14.77% (0.325%)
Apache County: 15.60% (0.586%)
Yuma County: 16.01% (0.357%)
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2021-04-09
Our Sunday morning coffee/hiking group, professional women 60 or over, took to Zoom to stay connected. We started in April 2020 wearing Easter hats; we upgraded our haberdashery on Easter April 2021. Wishing to escape daily Covid fears, we chose a topic each week. One individual shared and then we moved on to the next. Topics were seasonal, from Mother's Day, Father's Day, Veteran's Day, Christmas, New Year's. We learned more about each other than we ever knew. Women out-of-state who were part of our circle could join us from D.C., Portland, and Wisconsin. As a former teacher and oral historian, I began to take notes on the conversations and realized these stories were too important to lose. I wrote them up weekly, edited them with the ladies, added photos or clip art, and provided a printed notebook to each friend for her birthday or Christmas. Some of us who are fully vaccinated can now meet in person, but we have decided to meet once a month online to continue telling the stories we might not share in person.
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2021-04-08
This article titled "Coming of Age" is a great article that provides various art pieces from children all around the world. Who, through their art display the feelings they feel during the pandemic, certain stepping stones of their life that they were unable to celebrate fully, and even self-development that was limited. More can be said about the article by looking at the images provided and the unique descriptions below them.
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2021-04-08
This article speaks about obesity in children during the pandemic. With lots of parents work being closed as well as schools, parents struggle to provide healthy options to children and are stuck with buying cheaper option that is mostly filled with preservatives and high calories that is causing obesity rates to increase. Effects of diet during youth effects eating habits that a child developss as it grows. As weight plays a role mentally and physically in a person's health, the pandemic affects children in such away.
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2021-04-08
This article speaks about birth rate spikes around the world during the pandemic. The chart provided shows birth increases. Many families are now welcoming children after 5-6 years. This is described as the next baby boom. The correlation this has with my research topic involves the idea that increased birthrates, and their effects on children at home along with the development of these children as they are born in the middle of the pandemic.
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2021-04-08
The occult experience of Covid19, from my perspective as an adept occultist.
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2020
"The most well-known Yanomami shaman and leader, Davi Kopenawa, with French anthropologist Bruce Albert. Inspired by his words and teaching, Ye'kwana Leadership Forum produced the film "The Shaman’s Message", to bring the #MinersOutCovidOut campaign to the world. The campaign calls for the immediate removal of illegal miners who are active in the Yanomami Territory, destroying the forest and rivers, bringing violence and now COVID-19 with them into the communities."
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2020-03-06T14:57
Early March 2020. We were out of toilet paper and stopped at the grocery store to get some. We sort of knew things were about to get crazy but this scene really cemented it for us.
About a week later, LAUSD shut down for “two weeks.”
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2020
Indigenous Rights Radio, part of Cultural Survival, shares interviews with Indigenous Peoples on the world wide web. This interview covers the topics of Indigenous Peoples and vaccines, human rights, Indigenous rights, land rights, and climate change and the environment.
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2021-04-07
Sacramento City Councilmember Mai Vang distributes information about vaccination opportunities in her district. The notice contains information about registering in various languages including English, Spanish, Arabic, Hmong, and Vietnamese. Vaccination clinics have just begun to offer vaccinations to everyone aged 16 and up in Sacramento.
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2020-03-16
Our headline comes from adapting the title of a novel by the Nobel prize-winning Colombian author Gabriel García Márquez, replacing the infectious Corona for the infectious Cholera. In his love-triangle story, he speaks of the lessons learned from a particular woman, but he may as well have been speaking about the now-global crisis we humans are facing:
“(she) stood him on his head, tossed him up and threw him down, made him as good as new, shattered all his virtuous theories, and taught him the only thing he had to learn about love: that nobody teaches life anything.”
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2021-01-14
A Caracas, Venezuela artist is using his graffiti skills to cheer people up during COVID-19. Wolfgang Salazar has gained popularity for his spray-painted murals of Venezuelan heroes and regular people.
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2020
"Due to the need to present information disaggregated by Indigenous Peoples, Cultural Survival is producing this map to collect and disseminate information to show the situations Indigenous communities are facing as a result of COVID-19. As the number of cases increase daily, and the lack of access to testing in rural areas, the data presented here will evolve over time. Empty areas do not imply that there are no cases of COVID-19 or human right violations. This is a continuous and not exhaustive effort and we invite Indigenous Peoples and their communities to contribute. [...] Our COVID-19 response features a holistic, multi-layered approach including curating a global monitoring system for COVID-19 for Indigenous communities using Google maps technology to document COVID-19 cases and related human rights violations."
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2021-03-29
Impacts, understandings, and variants to data of the impacts of COVID-19 on Indigenous People discussed by Cultural Survival.
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2021-04-17
Like many other states, North Dakota has started to test their sewage for COVID-19 variants. Although the testing can't track down the virus to specific households, it can determine if the city still has COVID-19 and what variants are present.
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2021-04-03
This is an interview with Presley McBride about how Corona Culture has affected her personal life and United States Society. Presley first describes any pandemic-related purchases or activities she has participated in and also highlights how her favorite Youtube personalities have incorporated COVID crafts into their shows. She also includes reflections on the impact of plexiglass shields and sanitization on human interaction and socialization. Presley also touches upon the political divide caused by a sense of shame that people in society feel when they are pressured to get vaccinated or wear a mask. Presley includes a description of how businesses have been using more packaging to protect their products since the start of the pandemic. Finally, Presley shares her insights on the negative effects of the stay-at-home mentality on U.S. mental health and culture. Contributed by Kayla Phillips, URE, for Arizona State University for the #CoronaCulture, #HST494, #ASU, #Texas #OralHistories collections.
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03/31/2021
This is an interview with an anonymous narrator about how Corona Culture has affected the narrator's personal life and United States Society. The narrator first describes any pandemic-related purchases or activities he/she has participated in and also highlights how his/her favorite Youtube personality has dealt with COVID on her show. The narrator also shares his/her perspective about COVID themed items that have appeared in U.S. consumer culture over the past few months and includes his/her assessment of Dr. Fauci and his work. The narrator includes a reflection on the impact of plexiglass shields and sanitization on human interaction and socialization. The narrator also emphasizes the potentially harmful effects of strong chemicals used to produce the various kinds of sanitizers used to disinfect surfaces in public. The narrator touches upon the sense of shame that people in society feel when they are pressured to get vaccinated or wear a mask and elaborates on how Corona vocabulary has affected U.S. social mores. Finally, the narrator shares his/her opinion about the effects of the stay-at-home mentality on U.S. culture. Contributed by Kayla Phillips, URE, for Arizona State University for the #CoronaCulture, #HST494, #ASU, #Texas #OralHistories collections.
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2020-06-19
My name is Yesenia, and I am a DACA recipient and a nurse. As of a few weeks ago, I have been a nurse primarily in the COVID-19 unit at my local hospital in Indiana, where I live.
Since COVID-19 began, my world, along with everyone else's, has been flipped upside down. It is hard to express how much my job has changed since COVID-19. I knew when I went into critical care nursing that I would have unexpected situations at work. I never thought there would be a whole floor of uncertainties. It is really overwhelming when you know that you are not enough for what is to come. But you always try your best.
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2020-10-28
Indigenous land stewardship is a relatively new term, forged to compel more people to live in closer relationship with the land. As our world passes through multiple crises of our making, racial justice is the ultimate issue, and goal. As such, across many of the pieces commissioned by Nia Tero is the relationship between Black liberation and Indigenous sovereignty. A key message in these posters is the encouragement for people to get out and vote, use their voices to effect change on these critical issues and uplift diversity in leadership.
The poster on the back of this newspaper page that you’re currently reading is part of a new series made in collaboration with Nia Tero, IllumiNative, and Amplifier Art, which debuted on Indigenous Peoples’ Day 2020 to elevate the work of Indigenous land stewardship, and to promote support of Indigenous peoples every day. The purpose of this collaboration is to demonstrate how coming together now, in this moment, is critically important for racial justice, climate action and collective liberation.
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2021-04-07
I just wanted to make a brief comment on the new controversy over “vaccine passports.” This phrase refers broadly to the idea of a sort of digital certificate to verify that a person has received one of the COVID-19 vaccines. The idea is that certain businesses, schools, etc., could use this digital certificate to instantly verify who has and has not received the vaccine. I think this is a fantastic idea and I wholeheartedly support it. As for those claiming that this is the latest sign of big government tyranny, a recent editorial about this issue in the Washington Post articulated a fantastic response: “Vaccination is voluntary, and the principle of voluntariness goes both ways. The government is not going to make anyone get a vaccine; every civilian has a right to abstain. By the same token, every restaurant should have the right to know whether a customer is immune before opening its doors: no shot, no shoes, no service.” Exactly -- voluntariness does indeed go both ways. If you make the decision not to get vaccinated, you should be willing to deal with the consequences of that decision, which may include contracting COVID-19 and/or being excluded from certain public places like restaurants, sporting events, or even schools or universities. If a person understands and accepts the risks and limitations they are putting on themselves and still insists on abstaining from the vaccine, I respect that. However, people insisting that they have the right to abstain from the vaccine while opposing the rights of businesses and other institutions to create a safer and more comfortable environment for their customers strikes me as a classic example of having your cake and eating too.
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2020-09-18
Pilot Projects Artist Talk: "La Morena" is a conversation with Arizona-based muralist and painter Lucinda Yrene Hinojos and director Pita Juarez about the short film “La Morena,” on view Sept. 15–19, 2020 as part of Pilot Projects: Art. Response. Now. Lucinda talks about the process behind her murals, art and activism, and what she is working on next.
The short film “La Morena” features Arizona artist, Lucinda Yrene Hinojos, who is claiming her roots and activism through her art. She brings all her love, inspiration and pain into creating murals with the guidance of her ancestors who energize her art. The result is a mural that focuses on the power of community, family and healing. This film was produced in association with Mango Skies and Poder in Action. To learn more about La Morena, check out: https://lamorenaart.com/
***They discuss art during the pandemic, police brutality, social justice, how Covid-19 has affected their art.
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2021-04-07
My dad is a paramedic currently working three jobs within the EMS field. He's basically only home one day out of the week. I take care of the house and my little sister while he's gone but I know the job is hard right now, especially with Covid-19. When I can, I buy him little gifts I think he would appreciate, like this Hawkeye Funko Pop. I honestly just wish they would pay paramedics and other EMS related first responders more than what they get now, especially since this pandemic has shown how necessary and essential their job is.
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2021-03-21
Banksy will donate the hammer price of £14.4m to help support health organisations and charities across the UK that enhance the NHS’s care and treatment. Christie’s Auction House will “donate a significant portion of the Buyer’s Premium to these causes” too.
The Game Changer canvas first appeared in May 2020 at the University Hospital Southampton as a thank you to all the staff and NHS workers across the country during the first wave of the Covid-19 pandemic.
The black and white artwork shows a little boy playing with a superhero nurse whilst Batman and Spiderman’s usual heroes are now in the trash.
A reproduction of Game Changer will remain on view at University Hospital Southampton hospital.
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2021-01-27
This article tells about youth depression and suicide rates in the United States and how they have been affected by the COVID-19 pandemic. Children and teenagers, who are normally bright-eyed, idealistic, and sometimes too socially adept for their own good, are developing mental afflictions like depression and suicidal ideation, using drugs and alcohol as coping mechanisms, and generally suffering from all sorts of silent illnesses because of lockdown policies that have deprived them of the activities that keep them busy. When a kid has a busy life, friends at school, activities they enjoy, and various tasks to perform in order to keep their minds occupied, they turn out to be a well-balanced, healthy adult later in life. However, when every single one of these things is abruptly stripped from and the only type of structured activity they have is getting on the computer every day for “Zoom school” (which, by what I have been told by teenagers currently experiencing it, is a poorly-planned waste of time put on for show), the affect on that child’s mental health can be catastrophic. The overdramatic teenage mind will tend to think that this period is going to last “forever,” leading to a downward spiral of emotional despair and existential nihilism. Furthermore, the financial strain that the pandemic has put on these kids’ parents surely plays into this as well, making the child feel like a burden since they have to sit at home all day and watch their parents worry about the family’s financial situation. While high-income individuals with significant savings got to have lots of fun on their cute little house-camping quarantine adventure, low-income and middle-class households, the ones with the most children, had to suffer and pay a serious price for something the government decided they would do. This general phenomenon of depression, financial worries, nihilism, drug abuse, and suicide is a direct result of government lockdowns, and brings to light a shining concept that rings true for all things legislative and bureaucratic; there will always be an unintended consequence of any blanket action like these lockdowns. Perhaps they should be considered before our so-called “representatives” just do stuff without considering the wants, needs, and condition of the people that they supposedly serve.
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2021-04-06
The Gila County webpage provides clear and concise information for residents on COVID-19 updates, as well as specific data to allow residents who wish to be vaccinated to choose which manufacturer's product they receive. This is unlike any of the major Arizona county sites, or even the state's site, as they do not allow residents to differentiate between the vaccines. Additionally, the information displayed here demonstrates how far ahead rural Gila County is in achieving President Joseph R. Biden's directive to allow all adults in America access to vaccines by April 19.
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2020
Dragon76, originally from Japan is a world renowned street artist who's art touches on coexistence and justice. This public mural of George Floyd asks those who view it to coexist.
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2020-04-06
DAY 1: On 4/6/21, I received a single dose of the Johnson and Johnson/Janssen vaccine courtesy of my university. Although out of my control, I was determined to not experience side effects.
I woke up somewhat late, so I only had time to eat half a Cliff bar on the way there. I did not drink that much water either.
I finished my shot at 11:46am. I don't really mind needles, but I will say that the vaccine shot hurts very slightly more than the flu shot. I think the needle has to stay in for longer. Nevertheless, it was just a short pinch, not bad at all. The process was very quick. After my shot, I sat in the lobby, where I was instructed to wait 15 minutes just in case I had a bad reaction.
After my fifteen minutes were up, I received my vaccination card. Although many people do, I chose not to post it on social media.
I carried about my day as usual. It was only around 9:30pm when I finally started to feel the side effects. It was ironic because right after I told my friend I felt fine, I felt the aches. Throughout the night, my body felt sore and achy, like I worked out the day before. Stretching made it feel better.
At 11:30pm, I was getting fever symptoms. I was extremely tired and had chills, despite being told that my skin felt very hot. I kept shivering despite being wrapped up in a blanket. While I was uncomfortable, the side effects were more of a mild inconvenience. If need be, I could've continued to carry on my day. But it was getting late and I had an early exam the next day, so I decided to snuggle up in a blanket and watch videos until I fell asleep.
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2021-04-06
By Associated Press
Originally Published: April 6, 2021 10:11 a.m.
PHOENIX – Gov. Doug Ducey on Monday signed legislation giving businesses, nursing homes and others a broad shield from lawsuits related to COVID-19, making Arizona the latest state to limit liability after the pandemic.
Republican lawmakers approved the legislation in party-line votes in the House and Senate last week, saying businesses struggled during the pandemic and shouldn’t have to worry about frivolous lawsuits.
The measure was opposed by consumer advocates, who say it will reward bad actors who flouted health guidance and endangered their workers or the public. They say there’s been no deluge of COVID-19 lawsuits.
Business and medical groups have pushed hard for a liability shield since the start of the pandemic. The Arizona bill is one of dozens introduced across the country and in Congress.
Ducey called for the measure in his State of the State address in January. The bill raises the bar for winning a pandemic-related lawsuits against businesses, health care providers, nursing homes, nonprofits, governments, churches and schools. Instead of proving negligence by a preponderance of the evidence, plaintiffs would have to prove “gross negligence” or “willful misconduct” by clear and convincing evidence.
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2021-04-01
By Amanda Morris of the Arizona Republic:
Arizona State University researchers have found a home-grown variant of the coronavirus emerging in Arizona that they say should be monitored closely because it carries a mutation known for weakening vaccines.
In a non-peer reviewed study that published Sunday, researchers said they have detected 17 cases of the new variant since February, 15 of which were in Arizona. The other two cases were found in Houston in late February and New Mexico in early March, suggesting that the variant has begun to spread.
"My hope is that we do not see more of these cases. The whole point of surveillance is to keep this from spreading," said Dr. Efrem Lim, an ASU virologist and assistant professor.
The variant is known as the B.1.243.1 variant, and descends from a common lineage of the virus called B.1.243, which nationally makes up about 2.5% of all cases, according to David Engelthaler, director of the Translational Genomics Research Institute's infectious disease division in Flagstaff.
"It's not dominant. But, there's a fair amount of that lineage that has been able to hang around," Engelthaler said. "It seems to have picked up this E484K mutation, what we call the 'eek!'"
This E484K mutation has also been seen in the variants first detected in South Africa and Brazil, as well as one new variant recently discovered in New York.
Numerous studies have shown that this mutation — located in the spike of the virus — lowers antibody responses to the virus and could weaken vaccines. Antibodies are one of the body's tool to recognize and fight the virus.
The E484K mutation has been shown to weaken antibody responses.
One study from Seattle showed that it caused the neutralizing effects of antibodies to decrease by tenfold, and numerous other studies have shown similar results.
American vaccine development company Novavax reported that its COVID-19 vaccine was 96.4% effective against the original coronavirus strain and 86.3% effective against the U.K. variant, but was far less effective in South Africa, where the South Africa variant carrying this mutation is dominant.
In the South Africa trials, the vaccine was shown to be 48.6% effective overall, and 55.4% effective in HIV-negative individuals.
Moderna announced a sixfold reduction in antibody responses from its vaccine against the South Africa variant, and Pfizer observed a drop in vaccine-induced antibody responses against the South Africa variant. The Johnson & Johnson vaccine is reported to be 64% effective against moderate to severe COVID-19 in trials in South Africa vs. 72% effective in U.S. trials.
Though the E484K mutation appears to reduce antibody response and possibly reduce vaccine efficacy, Lim stressed that vaccines still work well and said people should get their vaccines as planned.
Scientists are monitoring mutations in the spike of the novel coronavirus.
Community spread is a concern
Though the new Arizona variant carries this mutation, it's still possible for the variant to fizzle out and stop spreading. Lim said researchers have found two other cases where viruses within the B.1.243 lineage independently picked up the E484K mutation, but did not spread.
"In both cases, they never led to more transmissions," Lim said.
Engelthaler has also tracked other lineages where the E484K mutation showed up, but those strains fizzled out. Overall, researchers have detected over 60 samples containing the E484K mutation statewide, according to TGen's Arizona COVID-19 sequencing dashboard.
In order to continue spread, Engelthaler said variants need to be very "fit."
"This mutation has popped up on multiple instances and then just goes away," he said. "This one mutation by itself doesn't give the virus superpowers."
"It’s definitely a mutation of concern but time will tell if it will be a variant of concern," he added.
If the mutation shows up in a more fit version of the virus, then Engelthaler said it becomes more of a concern.
The new variant in Arizona is different than past cases because it has already spread from one person to another and could spread further, according to Lim. He said "one-off" mutations here and there are normal, but that the bigger question is about the transmission levels of this variant.
A variant's ability to spread to others is also dependent on human behavior, Lim said. If people follow public health guidelines, they are less likely to spread variants to others.
In total, Lim said the new Arizona variant has 11 mutations, which is "quite a bit more" than normal virus variations. These 11 mutations could be helping the virus survive or spread and could also act as a "fingerprint" to help researchers identify the new variant, Lim said.
Another one of the 11 mutations is located in the spike that the virus uses to attach to and infect cells. Engelthaler said that because of the importance of the spike, any mutations in that area could affect things like how fast the virus spreads or how severe the related illness is.
Both Lim and Engelthaler said it's too soon to tell whether the other mutations in this variant have any effect.
Overall, this variant still seems to account for a very low percentage of overall cases in the state, according to Dr. Joshua LaBaer, the executive director of ASU's Biodesign Institute. ASU researchers wrote that it's still possible there are more undetected cases of the variant since there are limited efforts to genetically monitor the virus nationwide.
In Arizona, roughly 1.3% of cases overall have been genetically sequenced, or analyzed, according to TGen's Arizona COVID-19 sequencing dashboard. In February and March, over 3% of cases were sequenced, higher than national rates of sequencing, which were below 1% in January.
ASU is working with the Arizona Department of Health Services to monitor the new variant and hopefully prevent further spread through contact tracing and other public health measures, Lim said.
California and UK variant cases rise
Currently the Arizona variant is only considered a "variant of interest" and not a "variant of concern." These are different categories outlined by the CDC and used to assess the risk level of each variant. The CDC defines "variants of interest" as those that are associated with potential changes, whereas "variants of concern" have evidence showing actual changes such as increased transmission, more severe disease or antibody evasion.
There are five variants of concern, which include variants first identified in the United Kingdom, South Africa, Brazil and California. Two variants from California were elevated from variant of interest to variant of concern this month and have rapidly spread in Arizona.
"They're closely related to each other and have definitely been documented with increased transmissibility and some impact on some antibody treatment," Engelthaler said.
In November 2020, both the California variants accounted for only 0.73% of Arizona's genetically sequenced samples. By March, they accounted for 31.64% of samples and are predominant variants statewide.
One non-peer reviewed study from the University of California San Francisco showed weaker antibody responses against the California variants.
Because of concerns that monoclonal antibody treatments may be less effective against these two variants, the U.S. Department of Health and Human Services announced two weeks ago that it would limit the distribution of one treatment to states with high levels of the California variant, including Arizona.
The California Department of Public Health also recommended that the state stop distributing the treatment, which is made by American pharmaceutical company Eli & Lily. In a health alert, the department said this treatment was unlikely to be active against the California variants.
The U.K. variant, which is highly contagious, has also been spreading statewide ever since it was first detected in late January. In March the U.K. variant accounted for 4.72% of genetically analyzed samples.
Currently, Engelthaler said Arizona has over 100 cases of the U.K. variant and over 1,000 cases of the California variants.
Arizona also detected its first cases of the South Africa variant last week.
So far, Lim said that all of the variants of concern are manageable and have not risen to the level of "variant of high consequence," which the CDC defines as variants that are shown to significantly reduce the effectiveness of prevention and medical measures.
"The risk is whether one of these current variants of concern acquire additional mutations that push it up to the next level," Lim said.
To prevent further mutations, LaBaer said it's important to prevent spread of the virus by continuing to follow health guidelines and getting vaccinated. The more the community can prevent the spread of the virus, the less mutations will occur, he said.
"We're kind of in this race right now between the developed dominance of these much more infectious variants that are now spreading throughout the country and getting people vaccinated," LaBaer said. "At the moment, I'm a little worried that the spread of this virus is so fast that that may outpace our ability to get vaccines in arms."
He said it was theoretically possible that new variants could escape the vaccines, meaning that the public would move backward away from reaching herd immunity.
But Lim said the vaccines can easily be updated to protect against new variants. Pharmaceutical companies like Pfizer and Moderna are already working on developing updated booster shots.
In the meantime, researchers will continue to monitor the Arizona variant to see if it spreads further. Engelthaler said he expects the most fit variants of the virus to become more dominant statewide as people continue to get vaccinated and stamp out less successful strains.
"There's a bit of a race here with the virus — a survival of the fittest race," Engelthaler said. "But what we don't want is to raise too much concern that things are going in the wrong direction...what we're doing is closely watching the evolution of a virus like we never have before. It's good that we have this capability, it's more important to put it into context."
Amanda Morris covers all things bioscience, which includes health care, technology, new research and the environment. Send her tips, story ideas, or dog memes at amorris@gannett.com and follow her on Twitter @amandamomorris for the latest bioscience updates.
Independent coverage of bioscience in Arizona is supported by a grant from the Flinn Foundation.
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2021-04-04
By Amanda Morris of the Arizona Republic:
When someone on the Fort Apache Indian Reservation receives a confirmed diagnosis of COVID-19, health care workers from the Whiteriver Indian Hospital jump into action.
They personally visit the individual's home to test other household members, perform health evaluations on everyone there and trace any other potential contacts at risk for COVID-19 exposure.
Health care workers in the community say that could be one reason why, even though the rate of confirmed COVID-19 cases among White Mountain Apache tribal members is nearly triple the state's rate, the death rate is much lower and continues to fall.
Over 90% of COVID-19 cases in the White Mountain community are investigated within 24 hours of testing, according to Ryan Close, the director of the Department of Preventative Medicine at the Whiteriver hospital, which is the only hospital on the 1.67 million-acre reservation.
"I feel like what we did made a huge difference," Close said. "We evaluated and admitted people aggressively and early. The tribe deserves an incredible amount of credit for mobilizing staff ... to make this response possible, because at some point it would have been very difficult to maintain without their considerable help."
The quick response may have also helped the tribe turn the tide against rapid community spread of the virus, which scientists say could have been fueled by a single variant found only in the White Mountain tribal communities. The variant carried a mutation in the spike protein, which scientist theorize could have made it spread more rapidly than other strains of the virus.
The number of confirmed COVID-19 cases among White Mountain Apache tribal members accounts for 24% to 28% of their population, according to Close, but the cumulative death rate among known cases is only 1.2%.
By comparison, the statewide rate of infection was 11.5% with a 2% death rate among known cases.
And over the winter, Close said the rate for the tribe dropped even lower, to about 0.5%.
In a community with a high number of individuals with underlying health conditions, the low death rate and work of the tribe has been "remarkable," said David Engelthaler, director of the Translational Genomics Research Institute's infectious disease division in Flagstaff.
The death rate also stands out as unusually low when compared with death rates in other Indigenous communities.
Indigenous populations have been disproportionally affected by the pandemic. CDC data shows that Indigenous people are 3.5 more likely to be diagnosed with COVID-19 and almost twice as likely to die from COVID-19 than white people.
Close credits a proactive strategy to combat COVID-19 that involved rapid contact tracing, in-person health evaluations and frequent outreach to high-risk COVID-19-positive individuals as well as early treatment with monoclonal antibodies and other antiviral therapies.
Volunteers and health workers from the White Mountain Apache community were on the Whiteriver hospital's contact tracing team and high-risk COVID-19 outreach team, which Close said helped the team connect better with the people and work faster.
One essential part of the team are the tribe's community health representatives, or CHRs, who are members of the community that serve as a cultural bridge between patients and medical establishments.
JT Nashio, director of the Community Health Representatives for the tribe, said the "visceral connection" that CHRs have to the community helps them bring cultural awareness to the way questions are asked for contact tracing, which makes the process more effective and allows officials to better distribute information.
"On top of that, quite simply, they know how to get around. It’s a big reservation and not all homes are easy to find," Nashio said. "But when you’ve lived here your whole life, you know where to find people. That became invaluable during the tracing and testing push during case surges."
Virus mutation may have made it more transmissible
When COVID-19 hit the White Mountain Apache nation, it spread rapidly. The community's first documented case was on April 1, 2020, from someone who had likely recently visited the Phoenix area, unknowingly caught COVID-19 and returned, according to Engelthaler.
Within the first few weeks, Close said the community experienced a handful of deaths.
"We soon had incidence rates that were skyrocketing. Case counts were going up very, very quickly," Close said.
It's unclear why the disease spread so rapidly in the community, but the initial strain of COVID-19 that hit the community carried a mutation that Engelthaler believes could have made it more transmissible.
"They were seeing the virus just rip through and have an 80 to 90 to 100 percent attack rate," he said.
TGen partnered with the tribe and the U.S. Indian Health Services early on to provide tests to diagnose a case of COVID-19 and provide genetic analysis of the virus from each case. It showed one strain of the virus circulating in the tribal community that wasn't present anywhere else in the state.
"This virus moved much faster than anything else we were seeing in Arizona at the time," Engelthaler said. "So we actually believe that we had one of these variant strains in Arizona that was causing very large numbers of cases, but it was secluded and maintained really only in that tribal population."
The mutation, called the H245Y mutation, occurred in the spike of the virus, which Englethaler said is a "very sensitive" part of the virus where mutations can have a significant impact.
Because of the low death rate, Engelthaler said TGen researchers would like to investigate the mutated strain of coronavirus seen among tribal members to see if it is also associated with a lower fatality rate.
He acknowledged that other strains of the virus have since entered the community and that the actions of health care workers in the community and at the Whiteriver hospital is also responsible for the lower death rates.
'The earlier you treat an illness, the better'
Close's biggest concern was that an outbreak would cause a "tsunami" of sick COVID-19 patients that would run the risk of overwhelming the Whiteriver hospital, which does not have an intensive care unit. Any patients that require intensive care need to be transported to other hospitals in the state.
"We're a small hospital, we cannot take a wave of all very acute patients because there aren't enough ventilators in the hospital," Close said. "There aren't enough helicopters in the state to transport people out from our facility to a higher level of care."
Within the first few weeks, Close said the community experienced a handful of deaths, and patients who had the poorest outcomes were the ones who self-presented at the hospital — often meaning they waited until they felt sick enough to go to the hospital.
"People don't always bring themselves in early enough," Close said. "The earlier you treat an illness, the better."
In response to this phenomenon, the hospital started a high-risk outreach program the third week of April. Health care workers regularly visited the homes of anyone who tested positive for COVID-19 and was at high risk for a poor outcome.
Close recalls multiple days when he evaluated patients and found their oxygen levels dangerously low, even though they felt fine. It's a condition associated with COVID-19 known as "silent hypoxia," or "happy hypoxia."
"They had no sense that they were even ill. They went on to get pretty sick in the hospital, but they survived and you can't help but think to yourself, 'Yeah, that's a life saved,'" Close said. "That person, if they had stayed home another day or another two days would not have done as well. They would have ended up on a ventilator or something."
The Arizona Republic previously reported that the effects of the high-risk outreach program and contact tracing led to a fatality rate among tribal members of 1.6% last June, which was less than the state's rate of 2.5% and country's at 2.7% at the time.
But the effect of the outreach program became even more pronounced over the winter, as the tribe and health workers gained access to monoclonal antibody treatments, according to Close.
He said the high-risk outreach team started referring patients for antibody treatment in December as part of their protocol after the therapy received emergency use approval from the Food and Drug Administration. Hospital staff at the Whiteriver hospital then administered the antibody treatment.
"We give that to people who are asymptomatic or mildly ill to prevent hospitalization," Close said. "The evidence currently suggests that reduces the risk that they're going to get sicker and get hospitalized and reduces the risk that they're going to die."
Though there's no data proving the antibody treatments made a difference, Close said that after health care workers started using them, the community's COVID-19 death rate fell to 0.5%. Hospital workers also gave antiviral therapies, such as remdesivir, to patients early and often.
"We probably overtreated some people," he said. "But the good news is it definitely led to significant reductions in mortality."
Lessons for the future
Close believes the different programs were so successful because health care workers were often able to test, trace, diagnose and treat individuals all in the same day — a feat he said was only possible because of how closely integrated hospital workers and community health workers were.
"There were no barriers in communication between the public health arm of our response and the clinical care arm of our response," Close said. "It's really a case for an integrated health care system."
As the tribe emerges from the pandemic and tribal members get vaccinated against the virus, Close said the hospital may start exploring other health conditions where it can use the high-risk outreach team, which is already trained and experienced in clinical evaluations.
"The goal is to take what we've learned from COVID and now apply it to things that are not COVID-related," Close said.
Another valuable lesson Close hopes to carry forward is how much of a difference visiting residents in their homes can make and how important building trusting relationships with the community is.
Nashio said going door to door to trace and monitor COVID-19 cases was a natural step for CHRs, who had already gone door to door in the past for other community health campaigns.
"We know firsthand how difficult it can be to not only connect with patients over the phone but communicate effectively over the phone," Nashio said. "When the community sees their CHRs coming to their door, it helps decrease the stigma of the disease."
In addition to performing checkup evaluations and providing information, Nashio said CHRs can also provide food, medical supplies, cleaning supplies or services like grocery shopping and running basic errands.
Not every tribal member has reliable internet or phone service, nor access to transportation, so Close said going door to door can be a good way to reach, and help, everyone.
"Meeting patients where they are is invaluable," Close said.
Amanda Morris covers all things bioscience, which includes health care, technology, new research and the environment. Send her tips, story ideas, or dog memes at amorris@gannett.com and follow her on Twitter @amandamomorris for the latest bioscience updates.
Independent coverage of bioscience in Arizona is supported by a grant from the Flinn Foundation.
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2021-03-04
In addition to all the other aspects that currently define my life, I can almost see the end of my first year of graduate studies in Arizona State University's Global History program. I returned to academia in the fall of 2019, wrapped up 34 undergrad credit in 9 months with a 4.1 GPA, and started my master's studies in the fall of 2020. I still have to work a dayjob to keep the lights on, and I have a side hustle ghost writing fiction novels and hosting a podcast on creative writing. Time is my most valued and least possessed commodity.
My school schedule is generally comprised of 7.5-week courses, and the university recommends taking no more than one at a time. I couldn't avoid doubling up during the first two months of this spring semester, and, to be candid, I arrogantly denied the validity of the university's guidance. By the end of the first term, I desperately needed to remember what a weekend felt like. Because God blessed me with the Greatest Wife in The History of the World, she scheduled a four-day weekend for us in the White Mountains in eastern Arizona.
For those unfamiliar with the area, eastern Arizona has the largest stand of Ponderosa pine trees in the world. Hunters consistently harvest trophy elk and deer from the White Mountains and Gila National Forest, which spans the Arizona-New Mexico border. Unlike Colorado's coniferous forest, eastern Arizona seems devoid of pine beetle kill. Nothing but healthy, evergreen forest and the scent of sun-warmed pine greets you.
We stayed in a vacation home on the outskirts of Pinetop, brought our groceries from home, and largely intended on hiking, cooking, drinking, and doing a lot of nothing. When we arrived in Pinetop in early March 2021, I had already fully recovered from COVID-19 and had time for both of my Moderna vaccines to have taken full effect. My wife had neither protective barrier, but we had generally become comfortable with purpose-driven shopping (as opposed to "window shopping") and takeout dining. As such, we stopped into a bakery to get breakfast on the way out to the hiking trails as a vacation treat. To our surprise, many of the patrons weren't wearing masks while walking through the restaurant or waiting in line. That made us a little uncomfortable. Then, one of the employees walked out from the kitchen with no mask on and began working on filling orders at the front, cold-food storage counters. Both of us panicked a bit and considered cancelling our orders and leaving.
My wife pulled up the Arizona Department of Health Services site and quickly found that entire county had endured only a little more than 560 cases. A quick bit of division translated that into an average of two infections per day for the entire pandemic year-to-date. The statistical odds of the unmasked clerk or patrons presenting a health risk to either of us fell to just north of zero. NOT zero, but we both felt we could see it from there. The ham, egg, and cheese croissants were delicious, by the way.
In trying to be good guests, we continued to wear our masks whenever we ventured into public spaces and businesses. Less than half of those around did the same, and I didn't see or hear anyone confront each other about mask wearing.
Our last venture out that weekend was to a beer garden with a prominent outdoor patio and seating area. We again wore our masks inside the establishment, but we immediately felt like outcasts for having done so. When we stepped inside, it looked as though the town villain had just stepped through the saloon doors: all activity inside the business stopped, and everyone seated inside turned around to look us up-and-down for few silent moments. If anyone had been playing piano, they would have switched to a minor key. NO ONE else inside wore a mask, and the interior tables didn't appear to have been spaced to comply with prevailing social distancing guidelines. Everyone stayed kind of quiet until we ordered beers and asked to sit outside. In hindsight, I wonder if they expected we were there from some government bureaucracy to issue citations, or just out-of-towners about to have a value-based hissy fit?
I have been generally opposed to broad behavior mandates that typically justify compliance on urban problems, but that weekend compelled me to really consider the divergent pandemic realities Arizonans have endured for the past year. Further analysis of county-specific data seems to suggest at least four divergent pandemic experiences within Arizona: urban centers, border counties, rural counties, and Native American reservations. I hope to better understand the personal experiences of those who lived in these diverse regions and how the pandemic affected their perspective and reality.
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2020-12-31
This article captures images of several murals around the world that were tributes to George Floyd, Breonna Taylor, Trayvon Martin, and Ahmaud Arbery, Kobe Bryant, and Chadwick Boseman, to doctors and nurses, "as well as messages of hope, strength, and resilience in the face of the global health crisis and ensuing economic downturn."
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2020-06-08
Interview with London street artist Ben Eine and his experiences during the pandemic.
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2020-05-19
Houston-based artist Anat Ronen brings hope to her community through her public art during the pandemic.
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2021-03-17
Japanese, New York-based street artist DRAGON76 has just completed a mural in East Village, Manhattan, supporting the “STOP ASIAN HATE” movement. The “STOP ASIAN HATE” mural can be found at East Village, 75 Chrystie St, Lower East Side, Manhattan.
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2020-03-06
Graffiti of a toilet paper roll and the text, "DON'T PANIC"... People were panic buying items like toilet paper when the pandemic really started to take off in infection and death rates and quarantine/lockdowns were initiated in the spring of 2020.
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2020-05
Artist Amanda Newman created a mural of senior Doctor Ai Fen if the Wuhan Central Hospital. The image is on a pillar of a railway overpass in Urquhart Street, Northcote. Newman chose the doctor as her subject because she was silenced, reprimanded, and accused of spreading rumors during the beginning stages of the COVID-19 outbreak in December 2019.
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2021-03-23
I’ve really learned nothing new: I already knew that people will ignore science when it suits their agendas. Such is the nature of the beast.
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2020-04-27
A group of chalk artists connected remotely to create a piece of chalk art to honor frontline workers. The artists were Naomi Haverland from Seattle, Washington, Jolene Russell from Sacramento, California, Anat Ronen from Houston, Texas, Jessi Queen from Atlanta, Georgia, Shelly and Dave Brenner from Ann Arbor, Michigan. Dave photographed his wife Shelly, who is also a Certified Registered Nurse Anesthetist, for a collaborative chalk art piece with each artist making their part in their hometown.
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2021-03-27
I’ve learned that we should’ve been wearing face masks during flu season this whole time (#neveragain), that stores used to skimp on refilling the hand sanitizer before this (#neveragain), and that despite parents realizing how hard teaching is, teachers and schools are still scapegoated for many a’thing.
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2021-03-23
in the midst of such a trying year, it’s the kindness that always stands out.
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2021-03-23
I've learned that I wasn't spending enough time with my kids and spouse. I have missed so many things this year, but I realized just how much I've missed by prioritizing life outside of my home. My kids are funny, kind, and so smart. It's been a great opportunity to pay attention to the things that they do while they're still little. I've learned that my extended family care deeply for me. The way people have called to check in and set up regular zoom meetings reminds me that in the same way I was missing small regular moments with my kids and spouse, I was also missing mundane conversations with people farther out in my circle.
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2021-03-24
I’ve worked from home for the past year. In the past I’ve always worked in the public, but never expected to have to make this transition. I’ve learned to accept what life throws at you.
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2021-03-23
I've learned that small acts of kindness, go a long way. When I lost my job due to the pandemic, as the only income for my family, I was beyond stressed. When my unemployment application stalled because of the huge number of people applying for assistance, I vented on Twitter. My friends picked up the thread, started an Amazon wishlist, and within days strangers were stepping in and sending my family food, cleaning supplies, essentials, and even toys for my dog. People continued to check in for months to make sure we were doing okay. For most people who helped us, it was a $5-10 purchase; for us it was a lifeline that kept us safe, fed, healthy, and supported. It made a terrifying time a bit easier and kept us afloat until I could find another job.
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2021-03-23
I have learned that some work meetings can definitely be done virtually instead of everyone being together in a room. I have also learned that in person school is much more beneficial than online learning.
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2021-04-01
This Wall Street Journal PRO article on Pfizer's use of artificial intelligence discusses that company's use of predictive technologies to identify geographic areas with the greatest potential for its COVID-19 vaccine clinical trials.
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2021-04-06
This sub-article was the lead item in this week's Wall Street Journal PRO "Artificial Intelligence Weekly" email blast:
"By Angus Loten
Welcome back. Artificial intelligence is set to take a decisive role in shaping the post-pandemic economy, from helping employers reopen workplaces to getting supply chains back on track. Corporate technology leaders and industry analysts offered these and other insights at last week’s virtual edition of the WSJ Pro AI Executive Forum. Some of their views are outlined in the sections below. One broad takeaway: Though still in its infancy, AI is already having a profound impact on our daily lives.
Pfizer’s Speedy Vaccine Rollout
Pfizer Inc. last year developed AI-powered dashboards designed to monitor the effect of Covid-19 on clinical trials in real time, ultimately helping the pharmaceutical giant roll out its coronavirus vaccination in less than a year, The Wall Street Journal’s Sara Castellanos reports.
A shot in the arm. Pfizer fed large amounts of case-rate data into AI-enabled predictive models to quickly generate site selection for clinical trials, said Lidia Fonseca, the company’s chief digital and technology officer.
A smart move. Pfizer two years ago began experimenting with the emerging technologies, focusing on digital tools that promised to offer better outcomes for patients, doctors and employees, with results it was able to draw on during the pandemic, Ms. Fonseca said."
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2021-02-22
#JOTPYLesson I learned that quarantine is a great time to pick up a hobby. I didn’t start drinking coffee everyday until quarantine. Now every morning I have a cup of coffee to look forward to. I try to think of a new recipe every morning. I can’t believe this all started because of the dalgona whipped coffee trend on TikTok! And shoutout to my friends for gifting me a lovely Keurig!!☕️🍵
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2021-02-22
I learned that despite numerous journalists and politicians bemoaning the deep damage quarantine is doing to elementary aged kids, my two kids are thriving. They love having time to roller blade, bike, play legos, build forts, run around the yard, have both parents home to join in the fun, and end the night by watching an after dinner movie or tv show together (currently, the og Muppet Show) - all things our crammed with activities pre-pandemic life didn’t regularly allow for. I guess I learned a slower pace of life isn’t necessarily a bad thing
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2021-02-22
I learned how much of a shift in norms a pandemic can cause. Now, when I watch old TV shows and people cough all over someone or spend a lot of time in public while sick, it freaks me out and seems so gross. I never felt that way about those things before COVID.
